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الملخص: أهداف البحث: يعد السرطان سببا رئيسيا للوفاة على مستوى العالم ويضع عبئا ثقيلا على المرضى ومقدمي الرعاية لهم. غالبا ما يشعر مقدمو الرعاية بالتوتر، مما يؤثر على صحتهم العقلية. تهدف هذه الدراسة إلى تقييم مستويات القلق والاكتئاب بين مقدمي الرعاية غير الرسميين لمرضى السرطان في مستشفيات التعليم العالي المختارة في نيبال. بالإضافة إلى ذلك، سعت الدراسة إلى تحديد العوامل الاجتماعية والديموغرافية المرتبطة بنتائج الصحة العقلية. طريقة البحث: تم إجراء دراسة مقطعية على 383 من مقدمي الرعاية غير الرسميين باستخدام مقياس القلق والاكتئاب في المستشفى. وشملت التحليلات الإحصائية التحليل الوصفي والانحدار اللوجستي الثنائي لاستكشاف الارتباطات مع المتغيرات الاجتماعية والديموغرافية. النتائج: كان متوسط عمر المشاركين 36.1 ± 13.1، وتراوحت أعمار 56.1% منهم بين 12 و36 عاما. وكان معظمهم متزوجين (81.5%)، وعاطلين عن العمل (66.6%)، وحصلوا على التعليم الابتدائي حتى الثانوي (66.6%). كشفت النتائج عن انتشار ملحوظ للقلق المعتدل إلى الشديد (52٪) والاكتئاب (45٪) بين مقدمي الرعاية. مقدمو الرعاية للمرضى الذين يتلقون العلاج من مستشفى غير حكومي لديهم أكثر احتمالا ست مرات للإصابة بالقلق وأكثر احتمالا بخمس مرات للإصابة بالاكتئاب. الاستنتاجات: غالبا ما يشعر الأشخاص الذين يعتنون بمرضى السرطان في نيبال بالكثير من التوتر. إن معرفة أسباب هذه المشاعر يمكن أن يساعد في إنشاء برامج لدعم صحتهم العقلية. من المهم حقا الاهتمام بالصحة العقلية لمقدمي الرعاية من أجل رعاية أفضل لمرضى السرطان وحياة أكثر سعادة بشكل عام. Abstract: Objective: Cancer is a major cause of death globally, and places a substantial burden on both patients and their caregivers. Frequent stress among caregivers often affects their mental well-being. This study was aimed at assessing anxiety and depression levels among informal caregivers of patients with cancer treated at selected tertiary hospitals in Nepal. An additional aim was to identify socio-demographic factors associated with these mental health outcomes. Methods: In this cross-sectional study, 383 informal caregivers were surveyed with the Hospital Anxiety and Depression Scale (HADS). Statistical analyses, including descriptive analysis and binary logistic regression, were conducted to explore associations with socio-demographic variables. Results: The mean age of participants was 36.1 ± 13.1 years, and 56.1% were 12–36 years old. Most participants were married (81.5%), were unemployed (66.6%), and had primary to secondary education (66.6%). The prevalence of moderate to severe anxiety (52%) and depression (45%) among caregivers was notable. Caregivers of patients treated at non-governmental hospitals were six times more likely (OR 6.3, 95% CI: [3.62–10.95], P = 0.001) to have anxiety and five times more likely (OR 5.3, 95% CI: [8.28–19.32], P = 0.001) to have depression. Conclusion: People who take care of patients with cancer in Nepal often feel substantial stress. Determining the causes of these feelings can aid in the creation of programs to support caregivers’ mental health. Caring for mental well-being among caregivers is critical to achieving better cancer care and quality of life.

Background: Nurses are essential members of the healthcare workforce and were among the first-line carers for patients in community and hospital settings during the COVID-19 pandemic. As a result, they were at a heightened risk of infection, resulting in several reported deaths among nursing staff. Several preventive measures were adopted to contain the spread of the COVID-19 virus. This study aims to explore the knowledge, attitudes, and practices (KAP) of nurses regarding hand hygiene, mask wearing, and social distancing measures in healthcare settings in Barbados during the COVID-19 pandemic. Method: An online survey of nurses working in public hospitals and polyclinics (public primary care clinics) in Barbados from March 2021 to December 2021 was conducted. A nonsystematic convenience sampling method was employed to recruit nurses who were readily available and willing to participate. A questionnaire captured the sociodemographic information and knowledge and practices related to hand hygiene, the use of face masks, and social distancing. Each correct response received one mark. Overall knowledge scores were categorized as poor (80–100%). Results: Of the 192 participants, the majority were female (82.8%) and had >5 years of experience (82%). The findings revealed that 45.8% had poor knowledge of hand hygiene, and that the knowledge of 43.8% of respondents was average. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 2.1 times increased odds (95% confidence interval 1.0, 4.2) of having good knowledge compared to other nursing categories. Regarding mask wearing, 53.6% of nurses had average knowledge, and 27.1% had good knowledge. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 3.3 times increased odds (95% confidence interval 1.5, 7.4) of having good knowledge compared to nursing assistants. A total of 68.6% of respondents followed the correct steps of handwashing every time, and 98.3% wore a mask in public places. More than half of the nurses (51.2%) kept a safe distance from others to avoid spreading SARS-CoV-2; one-third were in a crowded place(s) in the past three months, and 55.8% usually followed guidelines for social isolation as recommended by the WHO. Conclusions: The study identified knowledge deficiencies related to hand hygiene and wearing masks among nurses. It is imperative to provide additional training on infection control measures.

BackgroundFetal macrosomia, marked by excessive birth weight, is a significant public health issue in developing countries, yet it has received less attention compared to low birth weight. This study aims to determine the prevalence of fetal macrosomia in Bangladesh and its associated factors.MethodsThe study utilized data from 4,754 women with complete birth weight information of their children from the Bangladesh Multiple Indicator Cluster Survey (MICS) −2019, defining fetal macrosomia as newborns with a birth weight ≥4,000 g regardless of gestational age. Bivariate logistic regression assessed associations between independent variables and fetal macrosomia, presenting adjusted odds ratios (AOR) and a 95% confidence interval (CI), while controlling for potential confounders such as women's age, wealth index, education, healthcare utilization, comorbidities, newborn sex, and place of residence.ResultsThe prevalence of fetal macrosomia was 11.6%. Significant associations with fetal macrosomia included higher maternal age group (30–34 years) (AOR = 1.36, 95% CI = 1.07–1.74), secondary level of mother's education (AOR = 1.95, 95% CI = 1.43–2.66), experienced physical attacks (AOR = 1.41, 95% CI = 1.06–1.88), hypertension during pregnancy (AOR = 1.54, 95% CI = 1.15–2.07), and rural residence (AOR = 1.25, 95% CI = 1.15–1.49). Female infants had 18% lower odds of being macrosomic compared to male infants (AOR = 0.82, 95% CI = 0.72–0.93).ConclusionOne in ten infants in Bangladesh are born with macrosomia, necessitating a multi-faceted approach involving improving maternal nutrition, promoting healthy lifestyles, enhancing access to quality prenatal care, and addressing socioeconomic, residential, and healthcare system challenges, underlining the importance of further community-based research to expand the study's scope.

Menstruation-related school absenteeism significantly affects girls’ academic progress and general wellbeing. This study aimed to assess menstruation-related school absenteeism in an urban population in the Northern Region of Ghana. A school-based cross-sectional study was conducted to determine the prevalence of school absenteeism among girls using a structured questionnaire, which was pretested. The data were analyzed using Stata 16. Descriptive and inferential statistics, including cross-tabulation, the chi-square test, and binary logistic regression, were performed. The majority (59%) was between the ages of 15 and 19 years. Approximately one fifth of all respondents missed school during menstruation. Reasons assigned to missing school were menstrual pains (57%), stained clothes (43%), heavy bleeding (40%), and self-stigmatization (2%). The majority (95%) of respondents used some form of materials to absorb menstrual blood. About 88% of respondents used sanitary pads, 11% used cloth, and 1% used tissues to absorb their menstrual blood. The multivariable analysis showed that school girls < 15 years old (AOR: 3.69, 95% CI: 2.02–6.73), first year of Junior High School (AOR: 4.68, 95% CI: 2.14–10.22), and public school (AOR: 3.57, 95% CI: 1.83–6.94) were associated with increased odds of menstruation-related school absenteeism. Menstruation-related school absenteeism is considered high and could affect girls’ educational attainment. School absenteeism due to menstruation, particularly in public schools, warrants attention by the Ghana Education Service.

Studies focusing on the safety and common side effects of vaccines play a crucial role in enhancing public acceptance of vaccination. Research is scarce regarding the usage of COVID-19 vaccines and the side effects experienced by health professions students in India and other countries. This study aimed to document self-reported side effects associated with COVID-19 vaccination among medical and dental students of six medical and dental colleges and teaching hospitals in four states (Tamil Nadu, Madhya Pradesh, Gujarat, and West Bengal) of India. A cross-sectional survey using purposive sampling of medical and dental students was conducted from 26 April to 26 May 2021. Data was collected using a Google Forms questionnaire capturing information regarding receiving COVID-19 vaccines, side effects and symptoms, onset and duration of symptoms, use of treatment to alleviate symptoms, awareness of haematologic risks associated with vaccination, and side effects from previous (non-COVID-19) vaccinations. The majority (94.5%) of participants received both doses of the Covishield/AstraZeneca COVID-19 vaccine. Among participants (n = 492), 45.3% (n = 223) reported one or more side effects. The most frequently reported side effects were soreness of the injected arm (80.3%), tiredness (78.5%), fever (71.3%), headache (64.1%), and hypersomnia (58.7%). The two most common severe symptoms were fever (14.8%) and headache (13%). Most side effects appeared on the day of vaccination: soreness of the injection site (57%), fever (43.1%), and tiredness (42.6%). Most reported symptoms persisted for one to three days–soreness of the injection site (53%), fever (47.1%), and headache (42.6%). Logistic regression showed that women were almost 85% less likely to report side effects. The study’s findings corroborate the safety of the Covishield/AstraZeneca vaccine’s first dose, evidenced by the relatively minor and transient nature of the side effects. However, the study underscores the necessity for ongoing research to assess the long-term impacts of COVID-19 vaccines, especially in the context of booster doses, thereby contributing to the global understanding of vaccine safety and efficacy.

Abstract Introduction This systematic review sought predictors of unfavourable bleeding profiles in women using the etonogestrel contraceptive implant. Unfavourable bleeding is common and a leading cause of requests for removal. Methods We included randomised controlled trials (RCTs), and prospective and retrospective cohort studies from 1998 to October 2022. Inclusion criteria were healthy women using etonogestrel for contraception. Papers not in English were excluded as were ongoing or incomplete studies. We searched Pubmed, Pubmed Central, MEDLINE (Web of Science & Ovid), Cochrane library, CINAHL Plus, WHO (HINARI), Open Grey and Greynet.org. Risk of Bias was assessed using ROB2 IRPGv9 for RCTs and ROBINS‐I for non‐RCTs. We conducted a narrative analysis. Results We included 13 studies. Lower body mass index (BMI), younger age, parity and smoking status were statistically, significantly associated with unfavourable bleeding patterns in one or more studies. No studies reported post‐partum status having a significant association with unfavourable bleeding. The available data was too limited and too heterogeneous to perform a robust meta‐analysis. Discussion Heterogeneity in reported outcomes and timescales limited the accuracy of synthesis. Risk of bias was moderate to serious in non‐RCTs due to baseline differences and missing or imputed data. The protective effect of higher BMI for unfavourable bleeding is in keeping with previous reviews and studies and is a clinically important finding.

Women who are undocumented migrants in Europe encounter a variety of challenges while trying to access health services, including restricted access to antenatal care (ANC) despite the importance of ANC to the well-being of mothers and their infants. This study's aim was to examine the effect that limited access to antenatal care has on the pregnancy experiences and outcomes of undocumented migrant (UM) women in Europe. Systematic searches were done on PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL Plus, and BioMed Central. From the search results, only primary research articles that reported on the pregnancy outcomes and experiences of undocumented migrants were selected. A meta-analysis was not possible because this review included information from both qualitative and quantitative studies. The data that was taken from the included publications was organised, analysed, using the Microsoft Excel programme, and then meta-synthesised. Twelve papers from seven different European nations—Belgium, France, Sweden, Denmark, Norway, Finland, and England—were included in this systematic review. Eight of the studies aimed to explore the access to and utilization of ANC by undocumented migrant women and the related pregnancy outcomes. Two of the included studies examined the pregnancy experiences of UMs and two examined the perinatal risks associated with living as a migrant with no legal status. Although heterogeneous in their specific findings most of the studies showed undocumented immigrants are more likely to experience unfavourable pregnancy outcomes and experience greater anxiety and worries due to a variety of factors than documented migrants and registered citizens. This review's conclusions demonstrate the pressing need for policy modifications and healthcare reforms in Europe to address the problems associated with undocumented migrants’ restricted access to antenatal care. It also highlights the urgent need for structural changes that will give this vulnerable population's health and well-being a higher priority. It is not just an issue of health equality but also a humanitarian obligation to address the many obstacles and difficulties undocumented migrant women endure during pregnancy.

BackgroundCoronavirus disease 2019 (COVID-19) is a global public health concern. Evidence shows that depression and anxiety are common among patients with COVID-19 after recovery. About one-third of the total COVID-19 cases in Bangladesh have been reported in Dhaka city. Therefore, the study aimed to evaluate the prevalence of depression and anxiety among COVID-19 survivors in Dhaka city as well as to identify the factors associated with these mental health conditions.MethodsA cross-sectional study was carried out among a total of 384 COVID-19 survivors aged 18 years or older. Data collection was done through face-to-face and telephone interviews using a semi-structured questionnaire. Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7) scales were used to assess depression and anxiety, respectively. Binary logistic regression analysis was performed to identify the predictors of depression and anxiety among patients recovered from COVID-19.ResultsThe overall prevalence of depression and anxiety was 26.0% and 23.2%, respectively among COVID-19 survivors. The respondents who were ≥60 years were 2.62 and 3.02 times more likely to report depressive and anxiety symptoms, respectively than those aged 18 to 39 years. Hospitalised patients recovered from COVID-19 had a 2.18 times higher chance of developing anxiety than their non-hospitalised counterparts. COVID-19 recovered patients with comorbidities were at 3.35 and 2.97 times higher risk of depression and anxiety, respectively compared to those without comorbidities. Similarly, the respondents who had already passed a period of 15 days to 3 months after recovery showed 3.06 and 1.85 times higher odds of depression and anxiety, respectively than those who had already passed a period of above 3 to 6 months after recovery.ConclusionThe study reported a high prevalence of depression and anxiety among COVID-19 survivors living in Dhaka city. The findings suggest the need for appropriate interventions to reduce mental health complications in COVID-19 survivors.

Introduction: Identifying risk factors would help consider suicide prevention in any specific population. We aimed to assess suicidal behaviour among university students in the UK. Methods: An extensive keyword search was conducted through PubMed, Cochrane, CINHAL Plus, PubMed Central, Web of Science, Trip database, and Science Direct, following the PRISMA guidelines to identify different publications. The search strategy for the literature review was based on the Population Exposure Outcome framework. Critical appraisal utilised the CASP tool for cohort studies and the AXIS tool for cross-sectional studies, resulting in 14 included studies. A narrative synthesis was performed. Results: Postgraduate and undergraduate students used different suicidal methods such as poisoning, jumping, hanging, drowning, and suffocating, with jumping most preferred by male students. The predisposing factors of suicide among university students included: mental health problems (depression, psychological stress, psychosis, mania, neuroticism, financial anxiety, imperfect parents’ connection with students), sexual orientation with risk of suicide among non-heterosexual students due to lowered self-esteem from feeling disregarded, disrespected and insufficient attention from the surrounding. Suicidal behaviour was high among unmarried students, male and unemployed female students, and students with childhood experiences such as physical abuse, family violence, emotional abuse, neglect, and physical punishment—gender, with females seeking more services from general hospitals with more suicide attempts in older females. High risk was also noted in males, with increased risk in white students compared to black students. Conclusion: The review highlighted that students with previous mental health problems, a history of experiencing sexual abuse in childhood, bad relationships with their mother, disrespect and disregard in the community due to sexual identity are the major contributing factors for suicide among university students in the UK.

Background: In the last decade, smartphones have become an indispensable part of our daily life. However, little is known of when smartphone usage becomes problematic and how it can affect mental and physical health. Therefore, this paper aims to analyse to which extent university students suffer from problematic smartphone usage (PSU) and if there are recognisable patterns or predictive factors. Methods: This systematic review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. To identify eligible primary research studies, a pre-defined search strategy was carried out in four databases, including Cochrane databases, CHINAL Plus, MEDLINE, and PubMed. The obtained literature was screened using inclusion and exclusion criteria and critically appraised with the AXIS tool resulting in 11 peer-reviewed studies in English. Results: The prevalence of PSU in university students varied between 36.5% and 67%, with a mean of 52%. Across the literature, PSU was significantly associated with mental health problems like depression, and anxiety. Furthermore, smartphone overuse can lead to physical problems (e.g., neck pain or eye strain) and negatively influence university students' academic performance and sleep quality. Our results suggest that the duration spends on the phone is a potential predictive factor for PSU. Limitations: Most studies in this systematic review are cross-sectional; therefore, no causal explanations can be given. Moreover, the measurement scales used are based on self-reported answers, which carry the risk of recall bias. Conclusion: This study demonstrates that PSU is very common and needs to be considered in the population group of university students. More longitudinal studies are required in order to identify causal relationships between PSU and possible predictive factors.

BackgroundNosocomial infections are infections incubating or not present at the time of admission to a hospital and manifest 48 hours after hospital admission. The specific factors contributing to the risk of infection during hospitalization remain unclear, particularly for the hospitalized population of the United Kingdom. ObjectiveThe aim of this systematic literature review was to explore the risk factors of nosocomial infections in hospitalized adult patients in the United Kingdom. MethodsA comprehensive keyword search was conducted through the PubMed, Medline, and EBSCO CINAHL Plus databases. The keywords included “risk factors” or “contributing factors” or “predisposing factors” or “cause” or “vulnerability factors” and “nosocomial infections” or “hospital-acquired infections” and “hospitalized patients” or “inpatients” or “patients” or “hospitalized.” Additional articles were obtained through reference harvesting of selected articles. The search was limited to the United Kingdom with papers written in English, without limiting for age and gender to minimize bias. The above process retrieved 377 articles, which were further screened using inclusion and exclusion criteria following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. The retained 9 studies were subjected to critical appraisal using the Critical Appraisal Skills Programme (cohort and case-control studies) and Appraisal Tool for Cross-Sectional Studies (cross-sectional studies) checklists. Finally, 6 eligible publications were identified and used to collect the study findings. A thematic analysis technique was used to analyze data extracted on risk factors of nosocomial infections in hospitalized patients in the United Kingdom. ResultsThe risk factors for nosocomial infections that emerged from the reviewed studies included older age, intrahospital transfers, cross-infection, longer hospital stay, readmissions, prior colonization with opportunistic organisms, comorbidities, and prior intake of antibiotics and urinary catheters. Nosocomial infections were associated with more extended hospital stays, presenting with increased morbidity and mortality. Measures for controlling nosocomial infections included the use of single-patient rooms, well-equipped wards, prior screening of staff and patients, adequate sick leave for staff, improved swallowing techniques and nutritional intake for patients, improved oral hygiene, avoiding unnecessary indwelling plastics, use of suprapubic catheters, aseptic techniques during patient care, and prophylactic use. ConclusionsThere is a need for further studies to aid in implementing nosocomial infection prevention and control.

Abstract Background Inadequate cognitive and socio-emotional development in children leads to physical and mental illness. We aimed to investigate the status of early childhood development (ECD) and its associated factors. Additionally, aimed to compare the changes of significantly associated factors using two multiple indicator cluster surveys (MICS) in Bangladesh. Methods We used data from the Multiple Indicator Cluster Surveys (MICS) 2012 and 2019 nationally representative surveys. A total of 17,494 children aged 36–59 months were included in the analysis. The outcome variable was ECD status: either developmentally on-track or not. We used bivariable analysis and crude and adjusted multivariable logistic models to assess the ECD status and its associated factors. Results Comparing both MICS surveys, the overall and individual domains of ECD status improved from 2012 (65.46%) to 2019 (74.86%), and the indicators of child literacy-numeracy domain improved from 21.2 to 28.8%, physical domain improved from 92.2 to 98.4%, and social-emotional domain improved from 68.4 to 72.7%. The learning approach domain was 87.5% in 2012 and increased to 91.4% in 2019. According to the adjusted logistic model in both surveys (2012 and 2019), the age of 4 years had an adjusted odds ratio (AOR) of 1.61 and 1.78 times higher developmentally on track than the age of 3. Female children were 1.42 (in 2012) and 1.44 (in 2019) times more developmentally on track than males. Compared to mothers with only primary education, children raised by mothers with secondary or higher education were 1.77 and 1.50 times more on track in their development. Moreover, Children from affluent families had 1.32- and 1.26 times higher odds- on track than those from the poorest families. Families with books had 1.50 and 1.53 times higher developmentally on track than their counterparts. Conclusion and recommendation In summary, our study shows that the overall ECD status improved between MICS 2012 and MICS 2019. Important factors influence ECD status, including early childhood education programs, families’ possession of children’s books, mothers’ educational level, and wealth index. The findings of our study will help making necessary public health-related initiatives in Bangladesh to improve ECD program.

Introduction Postnatal care (PNC) is critical for the newborn and the mother, as it offers the opportunity to examine the mother and child to ensure early and timely intervention of any obstetric anomalies that might have gone unnoticed during delivery. However, there is a lack of data on PNC utilization and associated determinants in Ghana. Meanwhile, it is suspected that the PNC service should be more patronized by mothers, particularly within the first 2 days after delivery; therefore, investigating PNC utilization and associated factors could inform policies to enhance PNC uptake. Objective The objective is to determine the level of utilization of PNC service and associated factors in the Savannah region of Ghana. Methods The study used a facility-based analytical cross-sectional study design. The study was carried out in 311 postnatal mothers using consecutive sampling. Data collection was carried out using a questionnaire. Univariate and multiple logistic regression was performed to establish the determinants of PNC. Variables/variable categories with P

Background: COVID-19 (Corona Virus disease 2019) is a newly discovered disease that originated in China and quickly spread throughout the world, killing millions of people and infecting many more. People have a new hope due to newly discovered vaccines for this fatal disease. However, the vaccines showed a number of side effects on the people receiving them. Nonetheless, it has proven to be helpful in providing protection against the fatal infection. Purpose: To analyze the probable side effects of the vaccines experienced by vaccine recipient and their belief regarding vaccine. Method: An online survey was conducted through different social media platforms and Email from 11 July’2021 to 16 July’2021. Ethical permission and consent was taken prior to the survey and data collections. Occurance and the extent of vaccine side effects were analyzed using descriptive and logistic regression analysis. Result: Among 175 vaccine recipients, 92 (52.58%) received one dose and 83 (47.42%) received two doses, with 93 (53.1) receiving SinoPharm vaccine, 78 (44.6) receiving AstraZeneca vaccine, and 4 (2.3%) receiving Pfizer vaccine. More than half of the respondents experienced side effects among which headaches (50.3%) and drowsiness (45.71%) were common followed by fever (36%) and muscle ache (32%). Female (P=0.000) and vaccine concerned group (P=0.033) experienced more side effects. Headache (68.8%), fever (40.9%) and drowsiness (50.5%) were more common among Sinopharm recipients. Fever (50%) and muscle ache (50%) were more common among Pfizer recipients while muscle ache (43.5%) and drowsiness (42.3%) were common among AstraZaneca recipients group. Conclusion: Headache, fever, muscular discomfort, soreness at the injection site, drowsiness, nausea, and other adverse effects are common with the COVID vaccination. Females are more susceptible to side effects than males, and the probability of experiencing them increases with the second dose. AstraZeneca vaccine recipient experiencing more side effects than other types of vaccine recipients. Update Dent. Coll. j: 2023; 13(2):3-8

Abstract not available Bangabandhu Sheikh Mujib Medical University Journal 2023;16(3): 186-187

IntroductionAsset-based approaches to improve citizen wellbeing and address inequalities are now being adopted by public health practitioners. There is some evidence that participatory approaches and the promotion of community assets have the capacity to mitigate against the social determinants that generate health disparities. However, questions remain about how they work in practice. This paper reports on research carried out to provide insight into how a diverse range of community assets support (or not) the wellbeing of vulnerable citizens and to provide an improved understanding of people's lived experiences including the challenges of citizens who belong to community assets face. Two subsequent studies were undertaken in a region of England comprising of two neighboring municipalities where health inequalities are stark. Both municipalities contain within them areas of social deprivation. The initial study was completed in March 2020, 1 week before England's first COVID-19 lockdown restrictions were introduced and the subsequent study was conducted to explore the impact of social restrictions on the community assets forum members.MethodsA combined phenomenological and ethnographic methodological approach was adopted for both studies. For the initial study ethnographic methods were used including 42 qualitative face-to-face interviews focusing on the lived experience of participants. Observations, informal conversations, photographs, and field notes were also carried out to allow researchers to become familiar with the setting, to build rapport and trust provide a contextual understanding of the relationship between the activity or place and participants' experiences of wellbeing. For the subsequent study thirty-six interviews (including interviews with community assets leaders) were conducted online or by phone due to COVID-19 social restrictions.Results and discussionThe studies' findings support the supposition that these groups are community assets which help ameliorate against the social detriments of health and wellbeing that have led to widening health inequalities in the region. The findings from both studies clearly illustrate the importance of sociality for wellbeing, and that participation in these groups are an important determinant of wellbeing. The data demonstrates how social capital is generated within a range of community groups and spaces. It also conveys the needs and deficits existing within groups highlighting the need to provide more assistance to vulnerable citizens. While most themes were common to all community forums, there were some noticeable place-based differences.

Abstract Background Childhood stunting, wasting and underweight are significant public health challenges. There is a gap in knowledge of the coexistence of stunting, wasting, and underweight among children under five years (under-5) in Bangladesh. This study aims to (i) describe the prevalence of the coexistence of stunting, wasting, and underweight and ii) examine the risk factors for the coexistence of stunting, wasting, and underweight among children under-5 in Bangladesh. Methods This study included 6,610 and 7,357 under-5 children from Bangladesh Demographic Health Surveys (BDHS) 2014 and 2017/18, respectively. The associations between the coexistence of stunting, wasting, and underweight and independent variables were assessed using the Chi-square test of independence. The effects of associated independent variables were examined using negative binomial regression. Results The prevalence of coexistence of stunting, wasting, and underweight gradually declined from 5.2% in 2014 to 2.7% in 2017/18. Children born with low birth weight ((adjusted incidence rate ratios, aIRR) 2.31, 95% CI 1.64, 3.24)); children of age group 36–47 months (aIRR 2.26, 95% CI 1.67, 3.08); children from socio-economically poorest families (aIRR 2.02, 95% CI 1.36, 2.98); children of mothers with no formal education (aIRR 1.98, 95% CI 1.25, 3.15); and children of underweight mothers (aIRR 1.73, 95% CI 1.44, 2.08) were the most important risk factors. Further, lower incidence among children with the coexistence of stunting, wasting, and underweight was observed in the 2017–18 survey (aIRR 0.59, 95% CI 0.49, 0.70) compared to children in the 2014 survey. Conclusions One out of thirty-five under-5 children was identified to have coexistence of stunting, wasting, and underweight in Bangladesh. The burden of coexistence of stunting, wasting, and underweight was disproportionate among children born with low birth weight, socio-economically poorest, a mother with no formal education, and underweight mothers, indicating the need for individual, household, and societal-level interventions to reduce the consequences of coexistence of stunting, wasting, and underweight.

Background: Oral cancer is one of the major public health issues in Pakistan and is the second most common malignancy in the country. This is mainly attributed to the widespread use of smokeless tobacco products, cigarettes, and paan without tobacco. This review aims to go beyond commonly discussed factors and, consequently, to provide a comprehensive picture of all the multi-faceted contributors to the high prevalence of the carcinoma of the oral cavity, including the role of human papillomavirus and genetic predisposition. The aim is to synthesise all available evidence on the predisposing factors of oral carcinoma in Pakistan. Methods: This is a comprehensive systematic review of all observational studies investigating the contributing factors of malignancy of the oral cavity in Pakistan, and it strictly follows the PRISMA guidelines. Multiple databases, such as PubMed, EBSCO CINAHL Plus, SCOPUS, and Ovid Medline, were used to find studies, and the Cochrane Database of Systematic Reviews was searched for existing/ongoing reviews carried out on the same topic. A meta-synthesis of selected studies was carried out to create robust and statistically valid conclusions. Results: ST and cigarette smoking were found to be the major contributors to the burden of carcinoma of the lip and oral cavity. The included studies indicated that genetic predisposition and human papillomavirus could be major risk factors for the disease in the Pakistani population, but not enough research has been carried out to find their true impact. Conclusions: Smokeless tobacco, cigarette smoking, genetic predisposition, and human papillomavirus can be considered significant risk factors for oral cancer in Pakistan.

Intimate partner violence is the most common kind of violence and a significant public health issue. The relationship between intimate partner violence and pregnancy termination among Tajikistan women was investigated in this study. The data for this research was collected from the Tajikistan Demographic and Health Survey 2017. This research has used the data of married women aged between 15 to 49 years. The findings from the study indicate that around 23.2% of married women in Tajikistan have experienced physical violence. The respondent’s age, region, and employment status was significantly associated with pregnancy termination (p < 0.05). Similarly, women who can refuse sex with their partner and ask their partner to use a condom are more likely to terminate pregnancy (p < 0.05). The characteristics of the husband or partner that had a significant positive association with pregnancy termination of married women in Tajikistan are age, educational level, and alcohol drinking status of their husbands (p < 0.05). This study also establishes the significant relationship between pregnancy termination and physical or emotional violence experienced by women (p < 0.05). The dynamics of domestic abuse need to be understood by healthcare providers to aid women in making decisions on whether or not to terminate their pregnancy.

Mpox (earlier known as monkeypox) virus infection is a recognized public health emergency. There has been little research on the treatment options. This article reviews the specific drugs used to treat mpox virus infection and the vaccines used here. Instead of focusing on the mechanistic basis, this review narrates the practical, real-life experiences of individual patients of mpox virus disease being administered these medicines. We conducted a bibliometric analysis on the treatment of the mpox virus using data from several databases like PubMed, Scopus, and Embase. The research on this topic has grown tremendously recently but it is highly concentrated in a few countries. Cidofovir is the most studied drug. This is because it is indicated and also used off-label for several conditions. The drugs used for mpox virus infection include tecovirimat, cidofovir, brincidofovir, vaccinia immune globulin, and trifluridine. Tecovirimat is used most frequently. It is a promising option in progressive mpox disease in terms of both efficacy and safety. Brincidofovir has been associated with treatment discontinuation due to elevated hepatic enzymes. Cidofovir is also not the preferred drug, often used because of the unavailability of tecovirimat. Trifluridine is used topically as an add-on agent along with tecovirimat for ocular manifestations of mpox virus disease. No study reports individual patient data for vaccinia immune globulin. Though no vaccine is currently approved for mpox virus infection, ACAM 2000 and JYNNEOS are the vaccines being mainly considered. ACAM 2000 is capable of replicating and may cause severe adverse reactions. It is used when JYNNEOS is contraindicated. Several drugs and vaccines are under development and have been discussed alongside pragmatic aspects of mpox virus treatment and prevention. Further studies can provide more insight into the safety and efficacy of Tecovirimat in actively progressing mpox virus disease.

Objective: This study examined the prevalence and existing predictors of depression in international postgraduate public health students at a university in England. Material and Methods: It was carried out as a descriptive cross-sectional survey. A total of 153 students enrolled in MSc in public health and community well-being and MPH in global public health courses were recruited using a convenience sampling technique. The Centre for Epidemiological Studies Depression 10-Item Scale (CES-D-10) and Chi-squared tests were utilized to assess the prevalence of depression and the association of encountered challenges with depressive symptoms, respectively. Outcomes: The prevalence of depression was 34.6% in this study. A link was found between depressive symptoms and several socio-demographic factors such as ethnicity, source of funding, and accommodation status in the United Kingdom. There was also a significant association between depression and all general problems faced by international students except housing. Finally, of all the challenges faced at the university, communicating with lecturers was the only one associated with this disorder. Conclusion: This study highlighted the important predictors of depression among international public health students, which reflect the need for a more collaborative strategy pursued by all teams within the university to compact this crisis.

Reverse smoking is a unique style of tobacco use in which the smoker places the lit end of a chutta into his or her mouth while smoking and then inhales the smoke from the lit end. The purpose of this scoping review is to explore reverse smoking and identify its effects among Indian reverse smokers. Literature search was conducted using PubMed, PubMed Central, Embase, and CINAHL Plus. Boolean operators AND/OR was used with the search terms. Search was limited to the original research articles, English language articles, and full-text articles. Finally seven original articles were selected for the scoping review. The studies were conducted between 1971 and 2016, where more studies were identified in the 21st century (2002–2016). Four themes emerged from the data analysis. The first themes explore the palatal mucosal changes in reverse smokers; the second theme presents carcinoma and reverse smoking; third theme focuses on effects of keratinization on detection of epithelial atypia, and lastly, the fourth theme focuses on reverse smoking and psychosocial factors. Reverse smokers are more likely to develop precancerous palatal alterations and squamous cell carcinoma of the palate. To make healthy choices, a strong focus on health promotion is required, which includes initiatives that emphasize the need of educating individuals about disease risks.

Background and Objectives: Menstruation is a natural occurrence marked by the periodic release of endometrial cells within the uterine lining from the female genital area. Menstruation knowledge remains highly essential for young adolescents. Inadequate awareness and understanding of menstruation have far-reaching consequences on the overall wellbeing and health outcomes of young adults worldwide. Adolescent girls make up a large percentage of high school students in Nigeria. Girls in countries with low to middle incomes are frequently misled or uneducated regarding menstruation. Menstrual health literacy (MHL) is the level of knowledge concerning matters related to menstrual health. It is observed that a lack of menstrual health literacy is seen among young adults. This systematic review aimed to examine menstruation literacy, attitudes, and adolescent girls’ practices in Nigeria. Materials and Methods: This systematic review included quantitative, cross-sectional, quasi-experimental, and qualitative primary research studies relating to menstruation literacy, attitudes, and practices of adolescents in Nigeria. Articles for this study were searched for on databases such as PubMed and BioMed Central using keywords. These studies were subjected to stringent inclusion and exclusion criteria where the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used, and 13 articles were included after critical appraisal. Data extracted were analysed using narrative synthesis. Results: Findings indicated that knowledge regarding menstruation among adolescents (82.6%) was poor. Menstruation information was obtained from mothers, which was positive as some adolescents reported their closeness to their mothers. Regarding attitudes towards menstruation among adolescents, it was reported that more respondents (70.3%) had negative attitudes towards menstruation. Conclusions: Most of the respondents in Nigeria were not adequately prepared for the onset of their first menstrual period. Knowledge and attitude levels were low regarding periods for adolescents. The only exception was their positive attitude towards using water and soap to wash their hands during menstruation. The review shows a significant gap between adolescents’ menstruation knowledge and actual hygienic methods during menstruation. It is therefore required for educational awareness programmes and campaigns to be put in place to educate adolescents about menstruation.

BackgroundThe use of personal protective equipment (PPE) reduces the risk of transmission of infectious agents significantly among healthcare workers (HCWs). The study aimed to investigate the prevalence and characteristics of PPE-related adverse skin reactions among HCWs working at the main COVID-19 isolation center in Barbados.MethodsA cross-sectional web-based online survey was conducted during April to June 2021 which recorded demographic information, details of PPE use and adverse skin reactions including severity and duration of onset of symptoms.ResultsMost of the respondents used PPE for consecutive days (77.9%), 1–6 h/day (59.2%), and more than a year (62.5%). Fewer than half of the participants (45.6%) experienced adverse skin reactions from the use of PPE. The reactions were mostly observed in the cheeks (40.4%) and nose bridges (35.6%). Females had more reactions than their male counterparts (p = 0.003). The use of N95 masks and a combination of surgical and N95 masks produced adverse effects predominantly in the ears (60%) and cheeks (56.4%). Binary logistic regression showed that female HCWs (OR = 5.720 95% CI: 1.631, 20.063), doctors (OR = 5.215 95% CI: 0.877, 31.002), and longer duration of PPE use (>1 year) (OR = 2.902 95% CI: 0.958, 8.787) caused a significantly higher prevalence of adverse skin reactions.ConclusionThe PPE-related skin reactions were common among HCWs which mainly occurred due to prolonged use. Preventive measures inclusive of appropriate training of HCWs on the use of PPE are recommended to minimize these adverse events.

Background Coronavirus disease 2019 (COVID-19) has become a significant disease pandemic. Dhaka City alone has contributed about one-third to the total COVID-19 cases in Bangladesh. Globally, patients with infectious diseases, including COVID-19, experience stigma. There was no quantitative estimate of stigma experienced by patients with COVID-19 in the country. Therefore, this study aimed to assess the prevalence of stigma and its associated factors among patients with COVID-19 in Dhaka. Methods A cross-sectional study was conducted among 384 respondents aged 18 years or older who had been hospitalized or had stayed at home and were tested negative 15 days to 6 months before the day of data collection. Data collection was done through in-person and telephone interviews using a semi-structured survey questionnaire. A 15-item COVID-19-related stigma scale questionnaire was used to assess stigma. Binary logistic regression analysis was performed to identify the predictors of stigma. Results More than half (53.1%) of the respondents experienced stigma when they were COVID-19 positive. Females were at a 3.24 times higher risk of experiencing stigma than their male counterparts. Respondents from the 60+ age group and 40–59 age group were 63.0% and 48.0% less likely to experience stigma than those from the 18–39 age group. Non-hospitalised patients had 1.67 times higher odds of facing stigma than those hospitalised. Conclusions This study reported a high prevalence of stigma among the patients with COVID-19 in Dhaka City. The current evidence base of stigma experience among patients with COVID-19 offers a solid foundation for creating effective strategies and policies and designing appropriate interventions to counter stigma, which will improve the psychological well-being of patients with COVID-19 in Bangladesh.

Healthcare workers (HCWs) are at an increased risk of COVID-19 infection because of their direct exposure to suspected and confirmed coronavirus patients in healthcare facilities. This condition is even more acute in low-and lower-middle-income countries (LMICs). Given the poor healthcare settings of Bangladesh, it is challenging to halt the spread of infection without proper knowledge, attitudes, and good behavioral practices (KAPs). Therefore, this study conducted a cross-sectional study from May 5 to 31, 2020, with 203 healthcare professionals to determine the knowledge, attitudes, and practices (KAP) toward COVID-19. Participants were doctors, nurses, dentists, and allied health professionals. A self-administered questionnaire including several KAP-related items aligned with the World Health Organization (WHO) guidelines was distributed over various online platforms to collect data. Bivariate and multivariable logistic regression analyses were conducted to determine the factors influencing KAP levels. The majority of participants were male (52.22%). The prevalence of high knowledge levels, positive attitudes, and good practices were 51.23, 45.81, and 49.75%, respectively. Social media was the most common source for seeking coronavirus information. Workers at private institutions were less likely (OR = 0.56, 95% CI = 0.30–0.95, p < 0.05) to be knowledgeable than workers at public institutions. Doctors had more positive attitudes than other healthcare professionals. Older participants showed high rates of good behavioral practices (OR = 1.05, 95% CI = 1.06–1.32, p < 0.05) than younger ones. Workers at private institutions had a better practice level toward COVID-19 (OR = 2.11, 95% CI = 1.17–3.83) than those at public institutions. These results point to the necessity for proper training programs for medical professionals that help them gain confidence to deliver the correct treatment to their patients and the need to implement preventative steps during pandemics.

Background: COVID-19 pandemic has caused an unpre-cedented strike on humanity around the world . The scenario in Bangladesh is getting worse day by day, and every aspect of the society is observing its impact. Health care professionals are at a greater risk of contracting the disease while caring for patients. Objective: The research objective is to explore knowledge, awareness, and practices of registered dentists regarding COVID-19 epidemiology and transmission during the rapid outbreak of this highly contagious virus in Bangladesh. Material and Methods: A cross-sectional web-based survey was conducted among the dentists who were enrolled with their valid unique Bangladesh Medical and Dental Council (BMDC) registration number. A structured questionnaire was distributed among the dentists through different social media platforms. A total of 184 dentists participated in the survey between March and April 2020. Both descriptive analysis and multivariable logistic regression analysis was performed. Results: The dentists' mean age was 31.75 years, with a standard deviation of 6.5 years. About 29.3% of dentists completed their postgraduate qualification, and 76% of them were engaged in private practice at the time of data collection. Compared to the dentists with undergraduate education, the dentists with a postgraduate education are three times (OR=3.1, 95%CI 1.2-7.9 and over 5 times (OR=5.3, 95% CI: 1.2-23.3) more likely to have) better knowledge and practices toward COVID-19 respectively. Dentists aged 26-30 years are less likely to have good practices than the younger dentists (OR: .1; 95% CI: .01-.5). However, dentists with less than five years experience are 10.3 (1.6-68.9) times more likely to have good practices compared to the dentists with more experience. Conclusion: Majority of the dentists from Bangladesh have shown good knowledge, awareness, and practice regarding COVID-19. We recommend that the healthcare authorities, professional organizations, and hospitals coordinate, and conduct mandatory advanced infectious disease training for all the practicing dentists in the country.

Introduction: Intimate partner violence (IPV) against women is a global public health issue, and at least 30% of women have exposed to some form of IPV in their lifetime. It was aimed to examine the association between IPV and women's decision-making power in India from the data provided by the National Family Health Survey-4 (NFHS-4) 2015–2016. Materials and Methods: This was a descriptive cross-sectional study where data were collected from the NFHS-4 2015–2016 of India. A total of 670,615 women aged between 15 to 49 years completed the interviews (196,987 women participated from urban areas and 470,578 women from rural areas and 3050 women were from slums). Data were analysed using IBM SPSS version 24. Results: The mean age of the respondents was 29.83 (±9.76) years, 35.4% of women belong to 15–24 years of age category, 70.7% of respondents are from the rural area, 28% of women have no education, only 23.4% of women were employed and about 45.9% of women are using mobile phones. The findings show that place of residence, educational status, employment status, possession of mobile phones, age, knowledge of loans programme and husband/partner age, husband/partner educational level and consumption of alcohol are significantly associated with decision making power of women (P < 0.001). Conclusion: The abused women might attempt to respond to the abuse by trying to control other aspects of her life and making decisions alone without their spouse. This research indicated important factors responsible for decision-making amongst the reproductive women in India.

Aim: The topic of pornography use is controversial. It is important to understand how young people use pornography and determine whether pornography use has adverse effects on health and well-being. Methods: A comprehensive systematic literature search was conducted in 4 electronic databases (PubMed, Google Scholar, CINAHL plus, and Cochrane library) with appropriate MeSH terms “sexual health” and “pornography” and Boolean operators “AND” and “OR,” using SPIDER search strategy tools (sample, phenomenon of interest, design, evaluation, and research type). 11 articles were proceeded with systematic review after critical appraisal following PRISMA guidelines. Results: The major findings of the study imply that traditional and unimaginative activities depicted in some pornography and sexualized media are harmful because they impose restricted and circumscribed concepts of sex and sexuality. As a result, sexism, sexual objectification, neoliberal sexual consumerism, and sexual variety are reproduced and reinforced rather than promoted. FPU is linked to better levels of sexual comfort and self-acceptance and reduced levels of anxiety, shame, and guilt over sexual behavior. Pornography consumption has also been linked to increased arousal and orgasm responses, a greater interest in sex, acceptance of various sexual acts, and more sexual experimentation. Conclusion: Watching pornography may be a healthy phenomenon if it is occasional, not impairing the personal and social life; however, it can become pathological if watched excessively and impairs the individual’s functioning.

Sexual relations suffered from a drastic change because of the pandemic of the COVID-19 and its controlling measures. We performed a bibliometric review of articles conducted on sexual behavior through this COVID-19 pandemic. We performed a search in the Scopus database on August 14, 2021. The search was carried out by the mentioned search terms: “sex* act*” OR “Sex* Behav*” AND “COVID-19.” A total of 230 published articles was identified in the Scopus database, out of which 130 research works were funded and 23.91% (n = 55) articles had international collaborations. R Stephenson published the highest number of papers (n = 4) whilst SK Kar had the maximum number of citations (n = 39) and the highest number of citations per article (13). Universidade de São Paulo and the University of California were the most productive organizations whilst the USA outnumbered the other countries. Sexually Transmitted Infections (n = 13) and Elsevier (61) published the highest number of papers as a journal and publisher, respectively. It is the first bibliometric review on studies that assessed impact of the COVID-19 pandemic on human sexual activities during which identified that more than half of the articles were funded which is a promising sign for the researchers from this field and for those who are keen to work in this field.

Objectives. Parenting is the general child-rearing practice that has both long- and short-term impacts on the physical, emotional, mental, and social development of the children. We aims at seeing the relationship between parenting style and suicidal behaviors. Methods. A search was conducted in Medline, Embase, and PsychINFO to identify the articles assessing the relationship between different types of parenting styles and suicidal behavior. We included 32 articles in the review published from inception to search date. Results. Among the 32 studies, 27 studies used a cross-sectional study design, 17 were published between 2011 and 2020, and most of the studies included respondents with ages between 9 and 21 years. A wide variety of the used instruments to assess suicidal behavior, and parenting style was noted. Eight studies revealed that authoritarian parenting style is one of the predictors of suicidal behavior, while one study reported the authoritarian parenting style as a resilient factor. Both dominating and flexible parenting styles were associated with higher suicidal behavior, and two studies reported that the permissive style is a contributing factor to suicidal ideation among participants. Conclusion. This review identified the supportive notion that authoritarian parenting style has an association with suicidal behavior in adolescence, and later life. However, a prudential judgment is warranted due to the heterogeneity of study methods, population, contexts, and measurement tools.

Objectives The study aims to differentiate the risk factors of single and multiple concurrent forms of undernutrition among children under 5 in Bangladesh.Design A nationally representative cross-sectional study.Setting Bangladesh.Respondents Children age under 5 years of age.Outcome measure This study considered two dichotomous outcomes: single form (children without single form and with single form) and multiple concurrent forms (children without multiple forms and with multiple forms) of undernutrition.Statistical analysis Adjusted OR (AOR) and CI of potential risk factors were calculated using logistic regression analysis.Results Around 38.2% of children under 5 in Bangladesh are suffering from undernutrition. The prevalence of multiple concurrent forms and single form of child undernutrition was 19.3% and 18.9%, respectively. The key risk factors of multiple concurrent forms of undernutrition were children born with low birth weight (AOR 3.76, 95% CI 2.78 to 5.10); children in the age group 24–35 months (AOR 2.70, 95% CI 2.20 to 3.30) and in the lowest socioeconomic quintile (AOR 2.57, 95% CI 2.05 to 3.23). In contrast, those children in the age group 24–35 months (AOR 1.94, 95% CI 1.61 to 2.34), in the lowest socioeconomic quintile (AOR 1.79, 95% CI 1.45 to 2.21) and born with low birth weight (AOR 1.52, 95% CI 1.11 to 2.08) were significantly associated with a single form of undernutrition. Parental education, father’s occupation, children’s age and birth order were the differentiating risk factors for multiple concurrent forms and single form of undernutrition.Conclusion One-fifth of children under 5 years of age are suffering multiple concurrent forms of undernutrition, which is similar to the numbers suffering the single form. Parental education, father’s occupation, children’s age and birth order disproportionately affect the multiple concurrent forms and single form of undernutrition, which should be considered to formulate an evidence-based strategy for reducing undernutrition among these children.

COV-2 SARs has disproportionately affected low- and middle-income countries such as Ghana, where the healthcare system was not prepared enough to provide care, drugs, and equipment. This study was carried out to assess predictors of COVID-19 vaccine acceptance among health professionals in the Bono region of Ghana. A facility-based cross-sectional study was conducted among 424 health professionals recruited through simple random sampling. Univariate and multivariate logistic regression models were utilized to identify the predictors of COVID-19 vaccine acceptance presented as an odds ratio (OR) with a 95% confidence interval (CI). All respondents had heard about the COVID-19 vaccine. The most common source of information was the media (45.8%). The proportion of health professionals who accepted the COVID-19 vaccine was 73.6%. Among those who did not take the vaccine, 64.3% were willing to take it in the future. The key predictors of taking the COVID-19 vaccine included: age 25 to 45 years (AOR = 1.96, 95% CI: 1.14–3.35), age older than 45 years (AOR = 5.30, 95% CI: 2.59–10.87), males (AOR = 4.09, 95% CI: 2.34–7.15), Christians (AOR = 3.10, 95% CI: 1.44–7.72), and at least three years of experience (AOR = 1.74, 95% CI: 1.033–2.93). Reasons for not taking vaccines included: vaccines were rapidly developed and approved (41.0%), immediate side effects (39.2%), and unforeseen future effects (37.5%). This study showed that most participants had received their first dose of COVID-19 vaccination, and most of those hesitant about the vaccine were willing to receive it in the future. This is a positive finding for policy makers since it reflects that fewer resources will be needed for behavioural change initiatives. In addition, it would present a chance to focus on minority individuals who are unwilling to take the vaccine and offer targeted community mobilisation.

BACKGROUND: Women in Myanmar are not considered decision makers in the community and the physical and psychological effect of violence makes them more vulnerable. There is a strong negative reaction, usually violent, to any economic activity generated by women among poorer and middle-class families in Myanmar because a woman's income is not considered necessary for basic survival. OBJECTIVE: Explore the relationship between domestic violence on the decision-making power of married women in Myanmar. DESIGN: Cross-sectional. SETTING: National, both urban and rural areas of Myanmar. PATIENTS AND METHODS: Data from the Myanmar Demographic and Health Survey 2015-16 were used in this analysis. In that survey, married women aged between 15 to 49 years were selected for interview using a multistage cluster sampling technique. The dependent variables were domestic violence and the decision-making power of women. Independent variables were age of the respondents, educational level, place of residence, employment status, number of children younger than 5 years of age and wealth index. MAIN OUTCOME MEASURES: Domestic violence and decision-making power of women. SAMPLE SIZE: 7870 currently married women. RESULTS: About 50% respondents were 35 to 49 years of age and the mean (SD) age was 35 (8.4) years. Women's place of residence and employment status had a significant impact on decision-making power whereas age group and decision-making power of women had a relationship with domestic violence. CONCLUSION: Giving women decision making power will be indispensable for the achievement of sustainable development goals. Government and other stakeholders should emphasize this to eliminate violence against women. LIMITATIONS: Use of secondary data analysis of cross-sectional study design and cross-sectional studies are not suitable design to assess this causality. Secondly the self-reported data on violence may be subject to recall bias. CONFLICT OF INTEREST: None.

Background: Obesity is a life-threatening condition linked to various diseases in all ages. Most common interventions focus on physical activity though there are some drawbacks limiting peoples’ participation in exercise. Swimming targets these limitations offering promising results to people who wish to improve their lifestyle. Objectives: The aim of this review is it to investigate the effects cold water can have on the obese population. This will be done by examining the physiological effects of swimming, understanding if different water temperatures can result in different outcomes and finding any other benefits that come along with swimming exercise. Search Strategy: PubMed, EbscoHost and Google Scholar are used as search engines to find the appropriate papers using the words obese, overweight, swim, aquatics, water immersion. A systematic review summarises the findings of primary research papers. This review is based according to the PICO guidelines and all the selected papers are evaluated using the CASP tool. A meta-synthesis summarises the results of the papers. Results: Results indicated that swimming helps people lose weight while providing additional benefits such as decreasing joint pain in people suffering from osteoarthritis. Furthermore, positive results are seen in anthropometric measures, physiological responses, and body composition. Conclusions: It is concluded that water-based exercise can prove an effective intervention for obese people wishing to lose weight. Results were seen from different protocols and water temperature was difficult to monitor. Future research should use the same exercise design in various water temperatures to fully understand the differences in the results.

Background: The current study aimed to identify the perceptions and issues regarding the affordability, availability, and accessibility of COVID-19 vaccination and determine the extent of vaccine hesitancy among non-vaccinated individuals. Methods: A Prospective cross-sectional study was conducted among 575 individuals for a period of six months. All the relevant information was collected using the peer-validated survey questionnaire. An independent t-test was applied to check the association between variables. Results: Among 575 participants, 80.8% were vaccinated, and 19.2% were non-vaccinated. Among the vaccinated, 35.1% were vaccinated in private centres and 64.9% in public health centres (PHC). In total, 32% had accessibility issues and 24.5% had availability issues. However, responders vaccinated at PHC were having more issues in comparison to other groups which was statistically significant (p < 0.05). Among the 163 privately vaccinated participants, 69.9% found it completely affordable. Another 26.9% and 3.1% found vaccines partly affordable and a little unaffordable. Among the 110 non-vaccinated, 38.1% were found to be vaccine-hesitant. Conclusions: Individuals vaccinated at PHC experienced issues such as long waiting times, unavailability of doses, and registration. Further, a significant level of hesitancy towards COVID-19 vaccines was observed. The safety and efficacy of COVID-19 vaccines contributed to negative attitudes.

Background: The COVID-19 pandemic and lockdown measures have affected the sexuality and emotional bonding among the couple across the world. Objectives: We aimed to assess the effects of the COVID-19 pandemic and lockdown on the married people’s emotional bonding and sexual relationships in 3 south Asian counties (Bangladesh, India, and Nepal). Methods: A cross-sectional online survey was conducted among Bangladesh, India, and Nepal residents from April 3 to April 15, 2020. The survey was designed in English. The participants were selected through convenience sampling technique, the link of the online questionnaire was shared with the participants. Only participants older than 18 years and above, married, and living with their spouses were included in the study. Results: A total number of 120 respondents were included finally for analysis from the participating countries (India, Nepal, and Bangladesh). The mean age of the participants was 35.42 (±5.73) years; the majority were males under the age of 40 years and had completed postgraduation as their qualification. Among the study participants, more than half (53.8%) of the women reported being sexually active during the lockdown, whereas 41% of the men reported being sexually active. Among the sexually active participants, most women (57.7%) reported that they perceived positive emotional bonding with their partners. Nevertheless, there was no significant difference observed when compared with men. There are variations in responses. However, no significant association was identified. Conclusion: There are a few insights from the study, that is, there was no significant difference found in almost 3 countries in emotional intimacy. There had been a trend that there is improved emotional bonding with their partners, although no significant difference was observed.

In recent decades, surge in the usage of pornography is promoting a severe negative impact on health and well-being throughout the world. In recent times, there is a surge in rape cases in India. There may be a relation between pornography addiction and an increase in sexual crime against women. This review aims to document the association between sexual violence and addiction to pornography in India. Six original articles were retrieved from databases for the initial review of the literature, such as PubMed, EMBASE, EBSCOhost, CINAHL plus, and PubMed Central. Out of the six included cross-sectional research, 50% reported primary (sample sizes range from 100 to 600), 33.3% secondary data, and 16.7% study assessed data from Google trend. Only 16.7% of included articles unveiled a significant association between the number of Internet users and increased sexual violence (rapes and or crimes) toward females that revealed an insignificant association when variables were controlled. About 33.3% of studies reported that the male gender was more vulnerable to pornography addiction among medical students than females. Pornography search had no significant association with literacy level. Female population ratio in Scheduled Castes and Scheduled Tribes positively and urbanization and female workforce participation negatively impacted crime against women.

Background: Suicide is a serious global burden of disease. Recent COVID-19 pandemic has been associated with increased psychological distress among general population in UK and suicide is one of them. This research aimed to look into the suicide metrics in UK by analyzing the online news portals, retrospectively. Methods: Six UK online news portals were selected purposively to include in the study and news of suicides were searched retrospectively. Search was conducted by the term “suicide news”. News portals were initially searched with the search term retrospectively. After removal of the repetitions data is inputted into software. Results: Since 2020 January to November 2020, eighty-nine reports were scrutinized. Mean age was 37.91 (± 19.940) years ranging from 10 to 95 years. About 57.3% of the reported cases were less than 40 years of age, 58.4% were male, 41.6% were female, 40.4% of the respondents had mental health issues, covid-19 lockdown and restrictions accounts for 26.96% of suicides, 14.6% had health issues and 3.4% ongoing family issues. Previous suicide attempts were reported in 12.4% reports. Multiple number of persons involved in the suicidal acts in about 13.4% of the respondents. Highest suicide rate was reported in November 2020 with 21.34% of suicides. Conclusions: Early adult and male gender are more vulnerable. Mental health issues, covid-19 lockdown and restrictions, and health issues drew attention as risk factors. Suicide rate was higher in November 2020.

Objective: This study assessed the intention and predictors of accepting the corona virus disease 2019 (COVID-19) vaccine in Jordan. Method: A national-level online survey was conducted among adults (≥18 years) in Jordan between June and September 2021. Descriptive analyses were performed to report vaccination intent. In addition, bivariate and multivariate logistic regression analyses were done to evaluate the association between vaccination intent and its predictors. Results: A total of 2307 adults participated. Most of them (83.7%) expressed an intention to receive a COVID-19 vaccine. Their vaccination intention was significantly (p < 0.001) associated with male gender (aOR: 2.6), residence in the Amman region (aOR: 51.8), and no history of COVID-19 infection (aOR: 6.0). In contrast, individuals aged 50-64 years (aOR: 0.2, p < 0.001), Jordanians (aOR: 0.7, p = 0.038), and those with an occupation designated as “other” (unemployed, general workers, housewives) (aOR: 0.2, p < 0.001) were less likely to have a positive vaccination intent. Among the health belief model constructs, perceived future (aOR: 2.8) and present (aOR: 5.0) susceptibility to COVID-19 infection; severity of complications (aOR: 9.9); and benefits (aOR: 100.8) were significantly (p < 0.001) associated with a higher likelihood of having a vaccination intent. On the other hand, individuals who are concerned about the efficacy (aOR: 0.2) and side effects (aOR: 0.2) of the vaccine were less likely to have a positive vaccination intent (p < 0.001). Conclusion: Despite having high rates of intention to receive a COVID-19 vaccine, Jordanians, older adults and housewives, general workers and unemployed individuals were less likely to be vaccinated. These findings highlight that need-based public health campaigns are necessary to ensure maximum COVID-19 vaccination uptake in Jordan.

Background: Sexual intercourse is one of the important components of well-being, especially in married couples. There is a dearth of baseline research and data regarding the sexual habits of residents in South-East Asia. Objective: We aimed to see the baseline frequency of sexual intercourses among the residents of 3 South Asian countries (Bangladesh, India, and Nepal). Methods: This web-based cross-national, cross-sectional study was done among the residents of Bangladesh, India, and Nepal through Google forms. Married individuals who were living with their spouses were invited to respond to the survey. Results: A total of 120 respondents participated in this survey of which 46.7%, 38.3%, and 15% of respondents were from India, Nepal, and Bangladesh, respectively. The mean of the weekly sexual intercourse was 2.23 (range: 0-8) among the total respondents; 2.70 (range: 0-7) among the Nepalese, 2.32 (range: 0-5) among the Bangladeshis, and 1.82 (range: 0-8) among the Indians. The differences were not statistically significant. Conclusion: This study revealed very baseline and preliminary excerpts of sexual intercourse habit among the residents of 3 South Asian countries. There is a geographical variation in regard to the sexual contacts. Further, large-scale well-designed studies are warranted to explore the behavior.

ObjectivesIn this study we compared two predictions of COVID-19 cases in the Kingdom Saudi Arabia (KSA) using pre-and post-relaxation of lockdown period data to provide an insight regarding rational exit strategies. We also applied these projections to understand economic costs versus health benefit of lockdown measures.MethodsWe analyzed open access data on COVID-19 cases from March 6 to January 16, 2021 in the KSA. To understand the epidemic projection during the pre- and post-lockdown period, we used two types of modeling: the SIR model, and the time series model. We also estimated the costs and benefits of lockdown- QALY gained compared to the costs of lockdown considering the payment threshold of the Government.ResultsPrediction using lockdown period data suggested that the epidemic might slow down significantly after 109 thousand cases and end on October 6, 2020. However, analysis with latest data after easing lockdown measures suggested that epidemic might be close to an end on October 28, 2021 with 358 thousand cases. The peak has also been shifted from May 18, 2020 to Jun 24, 2020. While earlier model predicted a steady growth in mid-June, the revised model with latest data predicted it in mid-August. In addition, we estimated that 4986 lives would have been saved if lockdown continued but the cost per life saved would be more than $378 thousand, which is way above not only the KSA threshold, but also the threshold of any other highly advanced economies such as the UK and the USA.ConclusionsOur results suggest that relaxation of lockdown measures negatively impacts the epidemic. However, considering the negative impact of prolong lockdown measures on health and economy, countries must decide on the best timing and strategy to exit from such measures to safely return to normal life with minimum loss of lives and economy considering its economic and health systems' capacity. Instead of focusing only on health, a balanced approach taking economy under consideration is recommended.

BackgroundPrevalence of different respiratory allergies is increasing in the Kingdom of Saudi Arabia (KSA). Environmental risk factors of respiratory allergy vary regionally, hence the prevalence. This necessitates the needs for regional studies. This article reports prevalence and symptoms of respiratory allergies in the Qassim region, and the factors associated with the prevalence.MethodsEight hundred and fifty individuals aged ≥18 years and were living in the Qassim region filled up our structured online questionnaire between September and December 2020. We estimated the prevalence of different respiratory allergies with 95% confidence intervals. Multi-variable logistic regression analyses were performed to investigate the risk factors of respiratory allergies.FindingsThe prevalence of any respiratory allergy in the Qassim region was 28.8%. Most families (58.1%) had at least one member with respiratory allergy. The prevalence of allergic rhinitis and bronchial asthma were 13.5% and 11.2% 4.1% respectively. The reported symptoms included runny nose (13.6%), red, watery, and itchy eyes (10.4%), difficulty sleeping at night (10.2%), difficulty breathing in cold weather (9.2%), noisy breathing (8.5%), sneezing (8%), repeated coughing (7.5%) and shortness of breath (6.4%). Individuals with a family history were more likely to report any respiratory allergy (OR: 7.8), bronchial asthma (OR: 4.2) and allergic rhinitis (OR: 8.1) compared to the individuals without such family history. Odds of respiratory allergies was higher among males (OR: 1.5). Saudi nationals were less likely to report allergic rhinitis than the non-Saudis (OR: 0.4). Among those who reported a respiratory allergy, most (73.5%) received treatment and majority (61.7%) demonstrated compliance to the treatment, 8.8% needed hospitalization, and 23.1% needed emergency nebulization.ConclusionsPrevalence reported in our study is different than that reported in other regions. Variability in the environmental exposures might explain this. We recommend a meta-analysis to estimate the national prevalence of respiratory allergies.

BackgroundOver the last decade, mobile health applications (mHealth App) have evolved exponentially to assess and support our health and well-being.ObjectiveThis paper presents an Artificial Intelligence (AI)-enabled mHealth app rating tool, called ACCU3RATE, which takes multidimensional measures such as user star rating, user review and features declared by the developer to generate the rating of an app. However, currently, there is very little conceptual understanding on how user reviews affect app rating from a multi-dimensional perspective. This study applies AI-based text mining technique to develop more comprehensive understanding of user feedback based on several important factors, determining the mHealth app ratings.MethodBased on the literature, six variables were identified that influence the mHealth app rating scale. These factors are user star rating, user text review, user interface (UI) design, functionality, security and privacy, and clinical approval. Natural Language Toolkit package is used for interpreting text and to identify the App users' sentiment. Additional considerations were accessibility, protection and privacy, UI design for people living with physical disability. Moreover, the details of clinical approval, if exists, were taken from the developer's statement. Finally, we fused all the inputs using fuzzy logic to calculate the new app rating score.Results and conclusionsACCU3RATE concentrates on heart related Apps found in the play store and App gallery. The findings indicate the efficacy of the proposed method as opposed to the current device scale. This study has implications for both App developers and consumers who are using mHealth Apps to monitor and track their health. The performance evaluation shows that the proposed mHealth scale has shown excellent reliability as well as internal consistency of the scale, and high inter-rater reliability index. It has also been noticed that the fuzzy based rating scale, as in ACCU3RATE, matches more closely to the rating performed by experts.