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Background: Habits are obtained as a consequence of cue-contingent behavioural repetition. Context cues stimulate strong habits without an individual contemplating that action has been initiated. Because of its health-enhancing effects, making physical activity a part of one's life is essential. This study examined the associations of physical activity (PA) behaviours with PA habits and the role of autonomous motivation in developing PA habits. Methods: This study used a cross-sectional design. A structured questionnaire was implemented through emails to 226 university students, where PA levels, habits and autonomous motivation were self-reported. Results: Binary logistic regression identified age groups, gender and participants who were trying to lose weight as the significant predictors in meeting physical activity guidelines. Path analysis showed that moderate-intensity physical activity (β = 0.045, CI = 0.069–0.248) and strength training exercises (β = 0.133, CI = 0.148–0.674) were significantly associated with PA habits (p < 0.01). Autonomous motivation was directly associated with PA habits (β = 0.062, CI = [0.295–0.541], p < 0.01) and was also significantly related to moderate-intensity physical activity (β = 0.243, CI = [0.078–0.266], p < 0.01) and strength training exercises (β = 0.202, CI = [0.033–0.594], p < 0.05). Conclusions: The emphasis on experiment-based logic and interest in habit formation in the research community is extensive. As the college years offer an excellent opportunity to establish healthy behavioural interventions, encouraging students in regular PA and exhibiting an autonomous motivation towards PA may be necessary. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) is one of the critical diseases due to its adverse clinical, social, and economic consequences for affected people. This study aims to assess the quality of life (QoL) of patients with MS in East Azerbaijan, Iran. Methods: This cross-sectional study was conducted using the multiple sclerosis quality of life-54 (MSQoL-54) questionnaires to interview 300 randomly selected MS patients in East Azarbaijan Province, Iran. The independent t-test, analysis of variance (ANOVA), and Tukey post hoc test were used to examine the relationship between demographic variables, and QoL, and all analyses were performed using SPSS software, version 19. Results: The QoL score in MS patients is 48.22±22.48. The “life satisfaction” is the best and “physical role limitation” is the worst QoL aspect. Significant relationships were observed between marital status, education level, employment status, age of symptoms onset, and years of illness with QoL (P<0.05). Conclusion: The QoL of the MS patients in East Azarbaijan Province is lower than in other parts of Iran and much lower than in Organization for Economic Co-operation and Development (OECD) countries. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is a common condition contributing to impaired quality of life among professional vehicle drivers. Our study aimed to assess LBP prevalence and associated factors among professional bus drivers in Bangladesh. Methods: A cross-sectional study was conducted among 368 professional bus drivers using a semi-structured questionnaire. A Nordic Musculoskeletal Questionnaire (NMQ) subscale was used to measure LBP. Multivariable logistic regression analysis was used to identify the factors associated with LBP. Results: In the last month, 127 (34.51%) participants reported experiencing pain or discomfort in the lower backside. Multivariable logistic regression analysis showed that age of more than 40 years (adjusted odds ratio (aOR): 2.07, 95% confidence interval (CI): 1.14 to 3.75), the income of more than 15,000 BDT per month (aOR: 1.91, 95% CI: 1.11 to 3.26), work duration more than ten years (aOR: 2.53, 95% CI: 1.12 to 5.70), working more than 15 days per month (aOR: 1.93, 95% CI: 1.02 to 3.65), working more than 10 h per day (aOR: 2.46, 95% CI: 1.05 to 5.75), poor condition of the driving seat (aOR: 1.80, 95% CI: 1.08 to 3.02), current smoking habit (aOR: 9.71, 95% CI: 1.25 to 75.15), illicit substances use (aOR: 1.97, 95% CI: 1.11 to 3.48), and four hours or less sleeping time per day (aOR: 1.83, 95% CI: 1.09 to 3.06) were positively associated with LBP. Conclusion: The high burden of LBP among the participants calls for a focus on this vulnerable group's occupational health and safety, with particular emphasis on implementing standard measures. [ABSTRACT FROM AUTHOR]

Background: The importance of improving quality and performance in higher education has led various universities to turn to effective methods of educational evaluation, such as auditing. Objectives: The present study evaluated the academic performance of the Tabriz Faculty of Management and Medical Informatics postgraduate students, an Iranian Center of Excellence in Health Management based on the Tennessee Academic Audit Model. Methods: This descriptive-cross sectional study was conducted in 2019 with the participation of educational managers and faculty members of the same faculties in two phases consisting of self-assessment and external evaluation. After contextualization, the Tennessee comprehensive higher education audit checklist was used. Data were studied descriptively, and the results were reported as frequency (percentage) and mean ± standard deviation. Analysis of variance (ANOVA) and Tukey's post hoc tests were used to evaluate the significance of the difference in academic performance between the educational groups. t-test was also used to evaluate the difference in performance scores in self-assessment and external evaluation phases. A P-value < 0.05 was considered significant. Results: The participants' performance in the self-assessment phase was moderate (total score: 5.32), and their performance in the external evaluation phase was weak (total score: 2.75). The best and the worst self-assessment scores were in the dimensions of "overall assessment" and "follow-up of previous academic audits," respectively. In the external evaluation, the dimensions of "contributions to the program and university goals" and "follow-up of previous academic audits" had the best and worst performance scores, respectively. Conclusions: The results demonstrated that the Tabriz Faculty of Management and Medical Informatics of the Medical School needs to improve in terms of international standards. Therefore, managers and policymakers are required to implement interventions to address this gap. [ABSTRACT FROM AUTHOR]

Background: The population's mental and physical health worldwide are currently at risk due to the coronavirus pandemic. We evaluated the mental health status of the adolescents trapped indoors because of the precautionary restrictions and prolonged closure of the educational institutions. Method: A cross-sectional study was conducted on adolescents from multiple urban and semi-urban areas of Bangladesh from 22 January to 3 February 2021. A self-reported online questionnaire containing questions regarding sociodemographic factors, home quarantine-related factors and mental health symptoms was distributed to collect data. Descriptive analysis, bivariate and multivariable logistic regressions were performed to measure the association of the variables. Cronbach's alpha was estimated to present the internal consistency of the scales. Results: A total of 322 adolescents (aged 12–19) with a mean age of 16.00 years (SD = 1.84) responded to the invitation. 54.97% (n = 177) of them were male, and the participants were predominantly urban residents (87.27%, n = 281). We observed varying degrees of depression in 67.08%, anxiety in 49.38% and stress in 40.68% of the participants according to DASS-21. Age, sex, education, mother's occupation, total monthly income, playing sports, doing household chores, going out of home, watching television, using the internet, attending online classes, changing food habits, and communicating with friends had a positive significant association with mental health burdens. Conclusion: Home quarantine has a noticeable adverse impact on the mental health of teenagers. Psychological evaluations and counselling via online and offline programs are essential to improve adolescents' declining mental health conditions. [ABSTRACT FROM AUTHOR]

Aims: Healthcare utilization is a major challenge for low- and middle-income countries, especially for the publicly funded facilities. The study has tried to explore the women's opinion behind the non-utilization of public healthcare facilities in India. Subjects and methods: This was a cross-sectional study using nationally representative samples of 351,625 women of reproductive age (15–49 years) from the 29 States and seven Union Territories. Indian National Family Health Surveys NFHS-4 (2015–2016) was the data source. The respondents were asked why the members of their households do not utilize public healthcare facilities when members of their households are sick. They have options to respond either 'yes' or 'no'. Five reasons for non-utilization of public healthcare were asked: (i) 'there is no nearby facility'; (ii) 'facility timing is not convenient'; (iii) 'health personnel are often absent'; (iv) 'waiting time is too long'; and (v) 'poor quality of care'. Results: The majority of the women in India (88%) said that their family members did not use public healthcare facilities. The reasons behind this were 'no nearby facilities' (42.4%), 'inconvenient facility timing' (29.6%), 'poor quality of care' (52.3%), 'health personnel often absent' (16.8%) and 'long waiting time' (39.9%). Conclusions: importantly, during the last 10 years, the utilization of public health care facilities has dropped significantly, which should be taken seriously as the Indian Parliament has been placing emphasis on equity. [ABSTRACT FROM AUTHOR]

Background: Multiple sclerosis (MS) causes significant economic burden to the patients, families, health systems and society. This study aimed to estimate the annual economic costs incurred by patients with multiple sclerosis (pwms) at different levels of the disease.Method: This was a cross-sectional study, using the Expanded Disability Status Scale (EDSS) tool for assessing the disease level of 300 (=N) pwms in East Azerbaijan province, Iran. To estimate the cost of MS, a questionnaire with its validity and reliability (CVR 92% and CVI 87%) and pilot test (Cronbach's alpha score 0.89) was used. The data were collected by interviewing pwms and reviewing their clinical records. Multivariate linear regression was used to assess the relationship between disease levels and incurred costs.Results: The results revealed that the mean annual cost for pwms in Iran is 97,521,740 IRR (equivalent to 2321.94 USD; 1978.93 EURO) and the mean score of EDSS in pwms was 3.14. The annual cost incurred by pwms with mild, moderate and severe levels of disease were 83,918,150 IRR (1998.05 USD; 1702.88EURO), 137,772,660 IRR (3280.30 USD; 2795.71 EURO) and 119,962,670 IRR (2856.25 USD;2434.30 EURO), respectively. Also, on average, each increase in EDSS score in pwms in Iran led to increase 8,139,260 IRR (equivalent to 193.79 USD; and 165.16 EURO) in total annual cost which must paid from pwms and their households exclusively. Also, there was a significant relationship between total annual cost and disease severity in such a way that any increase in EDSS degree is led to 8,139,260 IRR (193.79 USD; 165.16 EURO) added cost for pwms.Conclusion: The study results could be helpful for Iranian health managers to solve problems which are facing by the patients with multiple sclerosis and their families. [ABSTRACT FROM AUTHOR]

Catastrophic spending on health care through out-of-pocket payment is a huge problem in most low- and middle-income countries all over the world. The collapse of health systems and poverty have resulted in the proliferation of the private health sector in Cambodia, but very few studies have examined the fairness in ease of utilization of these services based on mode of payment. This study examined the utilization of health services for sickness or injury and identified its relationship with people's ability to pay for treatment seeking at various instances. Based on cross-sectional data from the Cambodian 2007 Demographic and Health Survey, the economic index estimated through principal component analysis and Lorenz curve was used to quantify the degree of fairness and equality in utilization and payment burden among the respondents. A distinct level of fairness was found in health care utilization and out-of-pocket payments. Specifically, use of private health care facilities and over-the-counter remedies dominate, and out-of-pocket payments cut across all socioeconomic strata. As many countries in low- and middle-income regions, and most importantly those in transition such as Cambodia, are repositioning their health systems, efforts should be made towards maintaining equitable access through adoption of finance mechanisms that make utilization of health care services fair and equitable. [ABSTRACT FROM AUTHOR]

Background: The term "intimate partner violence" (IPV) encompasses physical, sexual and psychological violence, or any combination of these acts, and globally is the most common type of violence against women. This study aims to examine the lifetime prevalence of different types of intimate partner violence (IPV) among Malawi women ages 15 to 49, and its association with age, education, and living in rural versus urban areas. Methods: Data was obtained from a cross-sectional study of data as part of the 2004 Malawi Demographic and Health Survey. Women were eligible for the study if they met the following criteria: 1) lived in one of the 15,041 households randomly selected from 522 rural and urban clusters located in 10 large districts of Malawi; 2) were married or cohabitating; and 3) were between the ages of 15 and 49 years. Consenting, eligible women responded to a comprehensive questionnaire covering demographic factors, health issues, as well as items related to physical, emotional and sexual IPV. To assess bivariate associations, chi-squared tests and multivariate logistic regressions were conducted. Results: Among the 8291 respondents, 13% reported emotional violence; 20% reported being pushed, shaken, slapped or punched; 3% reported experiencing severe violence, such as being strangled or burned, threatened with a knife, gun or with another weapon; and 13% reported sexual violence. Data showed women ages 15 to 19 were significantly less likely to report emotional IPV, women ages 25 to 29 were significantly more likely to report being pushed or shaken, slapped or punched (OR 1.35; CI: 1.05-1.73), and women ages 30 to 34 were significantly more likely to report sexual IPV, compared to women ages 45 to 49 (OR 1.40; CI: 1.03-1.90). Finally, women who had no ability to read were less likely to report sexual IPV than their counterparts who could read a full sentence (OR 0.76; CI: 0.66-0.87). Conclusion: The prevalence of different types of IPV in Malawi appears slightly lower than that reported for other countries in sub-Saharan Africa. Further studies are needed to assess the attitudes and behaviors of Malawi women towards acceptability and justification of IPV as well as their willingness to disclose it. [ABSTRACT FROM AUTHOR]

Aims: To investigate the awareness and knowledge of hazardous drinking limits among the general population in Sweden and the extent to which people estimate their alcohol consumption in standard drinks to assess their level of drinking. Methods: A population-based study involving 6000 individuals selected from the total Swedish population was performed. Data were collected by means of a postal questionnaire. The mail survey response rate was 54.3% (n = 3200) of the net sample of 5891 persons. Results: With regard to drinking patterns, 10% of the respondents were abstainers, 59% were sensible drinkers and 31% were classified as hazardous drinkers. Most of the abstainers (80%), sensible drinkers (64%) and hazardous drinkers (56%) stated that they had never heard about the standard drink method. Familiarity with the hazardous drinking concept also differed between the three categories although ∼61% of sensible and hazardous drinkers expressed awareness of the concept (46% of the abstainers). Knowledge about the limits for sensible drinking was very poor. Between 94 and 97% in the three categories did not know the limit. There was a statistically significant association between having visited health care within the last 12 months and being aware of the standard drink method and the hazardous drinking concept, but not with knowing the hazardous drinking limits. Similarly, there was a significant association between having had at least one alcohol conversation in health care within the last 12 months and being aware of the standard drink method and the hazardous drinking concept, but not with knowing the hazardous drinking limits. Conclusion: The results can be seen as a major challenge for the health-care system and public health authorities because they imply that a large proportion of the Swedish population does not know when alcohol consumption becomes a threat to their health. The current strategy to disseminate knowledge about sensible drinking limits to the population through the health-care system seems to have failed and new means of informing the population are warranted. [ABSTRACT FROM AUTHOR]

Objective: To investigate place of delivery, umbilical cord-cutting instruments used, and substances applied to the cord stump in Bangladesh.Methods: A cross-sectional data analysis was performed on a nationally representative sample of 4925 women of reproductive age (15-49 years) with at least 1 child.Results: More than 80% of women delivered at home. In 6% of cases, blades from a clean-delivery kit (CDK) were used to cut the cord; in 90% of cases, the blades used were from another source; in 4% of cases, other instruments such as bamboo strips and scissors were used to cut the cord. In 51% of cases, a substance (e.g. antibiotic powder/ointment, alcohol/spirit, mustard oil with garlic, boric powder, turmeric, and chewed rice) was applied to the stump after the cord was cut.Conclusion: The present findings underscore the need for further advocacy, availability, and use of cord-cutting instruments from CDKs, especially for deliveries that occur outside healthcare facilities. [ABSTRACT FROM AUTHOR]

Background: The current study compared working and non-working groups of women in relation to intimate partner violence. The paper aims to explore the relationship between women's economic empowerment, their exposures to IPV and their help seeking behavior using a nationally representative sample in India. Methods: This was a cross sectional study of 124,385 ever married women of reproductive age from all 29 member states in India. Chi-square tests were used to examine differences in proportions of dependent variables (exposure to IPV) and independent variables. Multivariate logistic regressions were used to assess the independent contribution of the variables of economic empowerment in predicting exposure to IPV. Results: Out of 124,385 women, 69432 (56%) were eligible for this study. Among those that were eligible 35% were working. In general, prevalence of IPV (ever) among women in India were: emotional violence 14%, less severe physical violence 31%, severe physical violence 10% and sexual violence 8%. For working women, the IPV prevalence was: emotional violence 18%, less severe physical violence 37%, severe physical violence 14% and sexual violence 10%; whilst for non-working women the rate was 12, 27, 8 & 8 percents, respectively. Working women seek more help from different sources. Conclusions: Economic empowerment is not the sole protective factor. Economic empowerment, together with higher education and modified cultural norms against women, may protect women from IPV. [ABSTRACT FROM AUTHOR]