Quality of life of women from a quilombola community in northeastern Brazil / Qualidade de vida de mulheres de uma comunidade quilombola do nordeste brasileiro

Abstract Quilombola communities are present in many Brazilian states living in precarious health conditions. This is due to geographic isolation, limitations to the access of the area in which they live in, and the lack of quality in the service when it is needed to be provided. Therefore, the aim of this study was to analyze the quality of life of women from a quilombola community in northeastern Brazil. It is an observational, cross-sectional and descriptive study. 160 adult women were first interviewed through a form to collect a profile and then it was applied the WHOQOL Quality of Life questionnaire - bref. It was observed that the women were on average 40.7 years old (±17.25), married, self-declared black, who did not finish elementary school, housewife, had no income, with their own masonry house, with up to 6 rooms, supplied by a box of community treated water. Quality of Life had median scores in the domains: physical (3.18), psychological (3.4), social relationships (3.45) and environment (2.59). With this research, it was possible to characterize the quilombola community of Santa Luzia do Norte-AL regarding the difficulties of access to health and income generation, issues that affect their health condition. The problems described in this study can contribute to health actions being planned and carried out in order to improve socioeconomic and health conditions in this community, considering the social, political and environmental context, valuing their traditional knowledge and practices.

Resumo As comunidades quilombolas, estão presentes em diversos estados brasileiros, vivendo em condições de saúde mais precárias. Isto ocorre por conta do isolamento geográfico, das limitações de acesso e da falta de qualidade no serviço quando este é prestado. Nesse sentido, o objetivo do estudo foi analisar a qualidade de vida de mulheres de uma comunidade quilombola do nordeste brasileiro. Estudo observacional, transversal e descritivo. Foram entrevistadas 160 mulheres adultas, através de um formulário para a coleta de perfil e do questionário de Qualidade de Vida WHOQOL - bref. Foi observado que as mulheres tinham em média 40,7 anos (±17,25), casadas, autodeclaradas negras, com fundamental incompleto, do lar, sem renda, com moradia de alvenaria, própria, com até 6 cômodos, abastecidas por caixa de água comunitária, tratada. A Qualidade de Vida, apresentou escores medianos nos domínios: físico (3,18), psicológico (3,4), relações sociais (3,45) e meio ambiente (2,59). Com a realização desta pesquisa foi possível caracterizar a comunidade quilombola de Santa Luzia do Norte-AL quanto as dificuldades de acesso a saúde e geração de renda, fatos que repercutem na sua condição de saúde. Os problemas descritos neste estudo podem contribuir para que ações de saúde sejam planejadas e efetivadas com o intuito de melhorar as condições socioeconômicas e de saúde nessa comunidade, considerando-se o contexto social, político e ambiental, valorizando seus saberes e práticas tradicionais.

Using antenatal care as a platform for malaria surveillance data collection: study protocol.

BACKGROUND: While many malaria-endemic countries have health management information systems that can measure and report malaria trends in a timely manner, these routine systems have limitations. Periodic community cross-sectional household surveys are used to estimate malaria prevalence and intervention coverage but lack geographic granularity and are resource intensive. Incorporating malaria testing for all women at their first antenatal care (ANC) visit (i.e., ANC1) could provide a more timely and granular source of data for monitoring trends in malaria burden and intervention coverage. This article describes a protocol designed to assess if ANC-based surveillance could be a pragmatic tool to monitor malaria. METHODS: This is an observational, cross-sectional study conducted in Benin, Burkina Faso, Mozambique, Nigeria, Tanzania, and Zambia. Pregnant women attending ANC1 in selected health facilities will be tested for malaria infection by rapid diagnostic test and administered a brief questionnaire to capture key indicators of malaria control intervention coverage and care-seeking behaviour. In each location, contemporaneous cross-sectional household surveys will be leveraged to assess correlations between estimates obtained using each method, and the use of ANC data as a tool to track trends in malaria burden and intervention coverage will be validated. RESULTS: This study will assess malaria prevalence at ANC1 aggregated at health facility and district levels, and by gravidity relative to current pregnancy (i.e., gravida 1, gravida 2, and gravida 3 +). ANC1 malaria prevalence will be presented as monthly trends. Additionally, correlation between ANC1 and household survey-derived estimates of malaria prevalence, bed net ownership and use, and care-seeking will be assessed. CONCLUSION: ANC1-based surveillance has the potential to provide a cost-effective, localized measure of malaria prevalence that is representative of the general population and useful for tracking monthly changes in parasite prevalence, as well as providing population-representative estimates of intervention coverage and care-seeking behavior. This study will evaluate the representativeness of these measures and collect information on operational feasibility, usefulness for programmatic decision-making, and potential for scale-up of malaria ANC1 surveillance.

Sexual reproductive health service utilization and associated factors among undergraduate students of Addis Ababa University in Ethiopia.

BACKGROUND: Making clinical services attractive to the younger generation has remained a challenge. Students in higher education continue to underutilize sexual and reproductive health services. This group is exposed to a very hostile environment and has a highly mobile and unprotected lifestyle, often resulting in an early sexual debut, physical and drug abuse, and sexually transmitted infections. OBJECTIVE: The aim of this study was to assess sexual reproductive health services and associated factors among undergraduate students of Addis Ababa University 2022. METHOD: An Institution-based cross-sectional study was been conducted among 419 randomly selected students and data were collected by using semi-structured and pre-tested questionnaire. Data were entered to Epi info data 7.0 and exported to SPSS version 21.0 for further analysis. Both binary and multiple logistic regression analysis was used to identify factors at P < 0.05 with 95% CI and AOR. RESULTS: When queried, all 419 youths agreed to participate in the study, for a response rate of 100%. The mean age of the respondents was 22 years. The majority of respondents (371, 88.5%) were between the ages of 19 and 24, and 221 (52.7%) were female. More than half of those polled (273, or 65.2%) were third-year students, while 59, or 14.1%, were first-year students. About 206 (49.2%) of participants lived with their father and mother, but 138 (32.9%) had never discussed sexual and reproductive health. Finally, 205 respondents (or 48.9%) had ever used the Sexual and Reproductive Health Services. College of business (AOR (95% CI) 3.546 (1.62-7.79), respondents who live with only their mother (AOR (95% CI) 9.37 (2.78-31.51) and who live alone (AOR (95% CI) 5.75 (2.40-13.79), positive attitude toward SRHS (AOR (95% CI) 3.15 (1.71-5.80), good knowledge (AOR (95% CI) 4.16 (2.27-7.64), frequency of discussing SRHS(AOR (95% CI) 1.93 (1.12-3.346), Convenient location of youth RHs (AOR (95% CI) 8.31 (1.61-42.93), Fee of RH services (AOR (95% CI) 12.34 (6.48-23.49) and Satisfied to received RH services (AOR (95% CI) 4.59 (2.54-8.33) were independent predictors of utilized SRHS among undergraduate students. CONCLUSION AND RECOMMENDATION: The prevalence of utilization of sexual and reproductive health services was determined to be low in this study, with identified factors increasing the likelihood of utilization being attitude, knowledge, satisfaction, discussion, fee for RH services, and location, in that order. On the other hand, poor knowledge and a negative attitude toward SRHS posed risks that contributed to reproductive health issues, so we worked on advocating for services that were available in a nearby location and raising awareness. Therefore, policymakers and health planners would be better off strengthening the urgent need to ensure adequate SRHS, knowledge, and attitude building among undergraduate students in higher education in Ethiopia.

Reproductive health service utilization and associated factors among secondary school students in Harari regional state, eastern Ethiopia, 2022: a multicenter study.

INTRODUCTION: Reproductive health encompasses all conditions relating to the reproductive system and goes beyond simply being free from disease or infirmity. Several socioeconomic and socio-cultural factors affect reproductive health service utilization. OBJECTIVES: To assess reproductive health service utilization and its associated factors among government secondary school students in Harari regional state, Eastern Ethiopia 2022. METHODS: A school-based cross-sectional study design was conducted among 1275 secondary school students in six randomly selected secondary schools in Harari Regional state, in eastern Ethiopia. The study participants were chosen using a simple random sampling method. Data was gathered using self-administered questionnaires, entered into Epi Data version 3.1, and exported to SPSS version 25 for cleaning and analysis. Descriptive statistics, bivariable, and multivariable logistic regression analyses were carried out to compute the frequency of each independent variable and the magnitude of the outcome variables, then to identify factors associated with the outcome variable, respectively. To declare a significant association, an adjusted odd ratio (AOR) with a 95% confidence interval and a p-value of 0.05 were used. RESULTS: Our finding indicated that 25.3% (95% CI:22.9, 27.7) of the secondary school students utilized reproductive health services. Being in grade 11-12 (AOR = 1.67, 95% CI: 1.18, 2.38), having a history of sexually transmitted infection (AOR = 6.11, 95% CI: 2.20, 16.99), presence of a health facility nearby (AOR = 1.49, 95% CI: 1.12, 1.99), discuss voluntary counseling and testing with family (AOR = 2.73, 95% CI: 1.90, 3.94), and discussing about contraceptive with friends (AOR = 1.22, 95% CI: 0.91, 1.65) were the elements that had a strong correlation with reproductive health service utilization. CONCLUSION: In this study, only one-fourth of secondary school students utilized RH service during the past year. The student's educational level, having a history of STI, the presence of a health facility nearby, and discussing RH service with family/friends were the factors significantly associated with reproductive service utilization among secondary school students.

Prevalence and severity of restless leg syndrome in patients with spinal cord injuries.

OBJECTIVE: To determine the prevalence of restless leg syndrome in patients with spinal cord injury using a consensus criterion. METHODS: The cross-sectional study was conducted from November 29, 2018, to February 28, 2021 at the departments of Neurology and Orthopaedic Surgery, King Edward Medical University, Mayo Hospital, Lahore, Pakistan, and comprised patients of either gender aged 18-80 years having spinal cord injuries. All the patients were interviewed using a 10-item questionnaire, and were assessed using the five-point consensus criteria of the International Restless Leg Syndrome Study Group. Data was analysed using SPSS 20. RESULTS: Of the 253 patients, 128(50.6%) were males and 125(49.4%) were females. The overall mean age was 38.6±14.2 years. Restless leg syndrome was present in 116(45.8%) patients, and 64(55.2%) of them were males (p>0.05). The mean duration of the symptoms was 18.9±16.9 months. Causes of spinal cord injury included metastasis 28(11.1%) multiple sclerosis 32(12.6%), neuromyelitis optica spectrum disorders 68(26.9%), tuberculous spondylitis 85(33.6%), trauma 24(9.5%) and viral myelitis 16(6.3%). CONCLUSIONS: Restless leg syndrome was prevalent in less than half the patients having spinal cord injury. It was more prevalent in males compared to females, but the difference was not significant.

Breaking bad news: a descriptive study of physicians' perspective of Sindh, Pakistan.

OBJECTIVE: To assess the perception and attitude of physicians related to breaking bad news. METHODS: The cross-sectional study was conducted at three teaching hospitals in Karachi and Mirpurkhas, Pakistan, from April 2019 to February 2020, after approval from Hamdard University, Karachi, and comprised physicians of either gender having direct patient contact. Data was collected using a questionnaire based on literature. The questionnaire was pilot-tested before distribution among the subjects. The responses were categorised with respect to age, gender and professional experience. Data was analysed using SPSS 25. RESULTS: Of the 230 subjects, 119(51.7%) were females. The overall mean age was 34.5±8.8 years and mean professional experience was 9.1±8.2 years. Overall, 19(8.3%) subjects believed they had a very good ability to deliver bad news, while 26(11.3%) avoided telling the patient the truth about diagnosis, prognosis and treatment. Age had a significant association with correctly defining breaking bad news (p<0.05). CONCLUSIONS: The skill level related to breaking bad news was found to be deficient.

Correlation of serum anti-müllerian hormone levels with serum follicular stimulating hormone, luteinizing hormone and testosterone levels in male patients of depression.

Objectives: To determine the correlation of serum anti-müllerian hormone with follicular stimulating hormone, luteinizing hormone and testosterone levels in male patients of depression. METHODS: The cross-sectional analytical study was conducted at the Islamic International Medical College and the Armed Forces Institute of Mental Health, Military Hospital, Rawalpindi, Pakistan, from March 4, 2017, to March 29, 2018, and comprised male patients aged 18-60 years suffering from depression diagnosed on the basis of Siddiqui Shah Depression Scale. Serum anti-müllerian hormone, follicular stimulating hormone, luteinizing hormone and testosterone levels of all patients were measured using enzyme-linked immunosorbent assay kits. Correlation of anti-müllerian hormone with the rest was explored. Data was analysed using SPSS 21. RESULTS: There were 72 male subjects with mean age 35.19±9.97 years. A significant negative correlation was observed between serum anti-müllerian hormone levels and serum follicular stimulating hormone levels (p=0.001), but the correlation was not significant with serum luteinizing hormone and serum testosterone levels (p>0.05). CONCLUSIONS: Anti-Müllerian Hormone was found to be significantly correlated with follicular stimulating hormone, but not with luteinizing hormone and testosterone.

Correlation between stages of breast cancer and BMI in females: a multi-centre study.

OBJECTIVE: To determine the link between breast cancer and obesity in women by using body mass index at the time of diagnosis. Methods: The cross-sectional study was conducted from October 2019 to April 2020 at Pakistan Ordinance Factories Hospital, Wah Cantt, and Islamabad Medical Complex National Engineering and Scientific Commission Hospital, Islamabad, Pakistan. The sample comprised women aged 40-70 years with a recent diagnosis of breast cancer. Patients' body mass index values were calculated after they were diagnosed and additional staging examinations were carried out. Data was analysed using SPSS 21. RESULTS: There were 100 cases with a mean age of 52.24±7.47 years. There was a significant link between obesity and breast cancer (p=0.002), with higher body mass index carrying a higher risk of advanced breast cancer. CONCLUSIONS: Obesity may contribute to postmenopausal breast cancer in women.

Inappropriate supplementation of Vitamin D can result in toxicity: a crosssectional study of paediatrics population.

OBJECTIVE: To evaluate children with suspected or definite hypervitaminosis D with respect to prevalence, clinical manifestations and pharmacological aspects. METHODS: The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, and comprised medical records from January 1 to December 31, 2018, of children aged <18 years with 25-hydroxyvitamin D levels >50ng/ml. Clinical and pharmacological data was retrieved. Data was analysed using SPSS 23. RESULTS: Of the 118,149 subjects visiting the clinical laboratory during the study period, children tested for serum 25-hydroxyvitamin D levels were 16,316(13.8%) who had a median age of 9.78 years (interquartile range: 10.2 years). Children who registered for consultation were 2720(16.6%), and, out of them, 602(22%) had serum 25-hydroxyvitamin D >50ng/ml. The median 25-hydroxyvitamin D levels and age were 70.1ng/ml (interquartile range: 100ng/ml) and 3.1 years (interquartile range: 17.93 years), respectively, and 345(57.3%) of them were boys. Children supplemented with vitamin D were 197(33.1%) and 193(97.9%) of them were prescribed by physicians. Mega-doses were taken by 68(34.17%), while the remaining had used various combinations in syrup or tablet forms. Commonly prescribed mega-doses were 600,000IU 30((44.1%) and 200,000IU 31(45.5%) injections of vitamin D. The primary indications were pains/aches in 51(25.8%) cases, developmental delay 50(25.3%), and vitamin D deficiency 49(24.8%). The main symptoms of hypervitaminosis D or toxicity were abdominal pain 27(13.7%) and constipation 31(15.7%). CONCLUSIONS: Children should be given vitamin D supplements with caution as prolonged supplementation and repeated mega-doses can result in toxicity which may cause serious consequences.

An assessment of knowledge, attitude, and practice regarding organ donation among students and physicians.

OBJECTIVE: To assess the knowledge, attitude and practice of students and physicians regarding tissue and organ donation at a teaching hospital. Methods: The cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, in 2019, and comprised physicians and students of ether gender. Data was collected using a 43-item self-administered questionnaire. Dichotomous questions were scored as 1 or 0, while multiple-option questions were scored as 2, 1 or 0. Data was analysed using SPSS 25. RESULTS: Of the 859 subjects, 761(88.6%) were students with a mean age of 20.3±1.5 years and 98(11.4%) were physicians with a mean age of 30.6±9.4. Among the students, 630(82.8%) were medical students, while 131(17.2%) were dental. The largest group among the students was of those in the second year of their studies 271(35.6%). Besides, 531(69.8%) and 64(65.3%) physicians were females. Compared to males, female students reported better mean scores in terms of attitude, while higher practice scores were obtained by both male students and physicians (p=0.021). Muslim subjects scored comparatively lower in knowledge, attitude and practice terms than non-Muslims (p<0.05). CONCLUSIONS: There were high knowledge and attitude scores, while scores reflecting practice were low. Effective measures should be taken to encourage medical professionals to donate organs and promote organ donation.

Ensuring competence of essential skills: clinical examination for final year medical students.

OBJECTIVE: To ensure competence of essential skills of final year medical students in clinical examination by identifying essential skills and by revisiting and practising them before the examination. Methods: The cross-sectional study was conducted at the Aga Khan University, Karachi, from February to November, 2019, and comprised final year medical students and internal examiners from various academic disciplines. An overview of the organisational context, exam structure and process was noted. RESULTS: There were 96 medical students. The four key areas highlighted were development of the list of essential skills across five years of undergraduate medical curriculum with consensus from all disciplines, student motivation for attendance in practice sessions, unfamiliarity of examiners with the assessment tool, and the need for capacity-building. The key areas were based on the feedback received from all the stakeholders, and post-hoc analysis. Conclusion: This form of assessment would enable a thorough analysis of the preparedness of the students to function as independent physicians as undifferentiated doctor at the start of their careers as interns, and improve the quality of subsequent exams based on feedback and suggestions of faculty and students.

Association and outcomes of bacterial infections with acute coronary syndrome; a cross-sectional study from a tertiary care hospital in Pakistan.

OBJECTIVE: To identify the association between acute infection and acute coronary syndrome, and to evaluate the outcomes in such cases. METHODS: The cross-sectional, retrospective, analytical study was conducted at the Aga Khan University Hospital, Karachi, from July to December 2020, and comprised data from January to December 2019 of acute coronary syndrome patients aged >18 years. Data related to demographics, comorbidities, smoking status and history of dyslipidaemia. Binary logistic regression was used to explore the association of infections with acute coronary syndrome. Data was analysed using SPSS 26. RESULTS: Of the 1202 patients with acute coronary syndrome, 189(15.7%) had infection before the coronary event. The mean age of the patients was 68.5±12.4 years, and 97(51.3%) of them were females. Community-acquired pneumonia was found in 105(55.6%) patients, followed by urinary tract infection 64(33.9%) and cellulitis 8(4.2%). For pneumonia, the odds of having non-ST elevated myocardial infarction was 1.1 (95% confidence interval: 0.4-3.0). With urinary tract infections, unstable angina was associated with an odd ratio of 4.2 (95% confidence interval: 1-17.4), and ST elevated myocardial infarction was associated with odd ratio of 3.7 (95% confidence interval: 0.4-31). CONCLUSIONS: Bacterial infections were found to be associated with acute coronary syndrome. Bacterial infections with pneumonia and urinary tract infections showed a higher risk of myocardial ischaemia..

Acceptability and feasibility of intra-peer and social media approach for HIV self-testing among men who have sex with men in Karachi: lessons from a pilot study.

OBJECTIVE: To use a peer-to-peer and social media approach to reach out to men who have sex with men (MSM) and to distribute human immunodeficiency virus self-testing kits among them in an urban setting. METHODS: The cross-sectional, pilot study was conducted by a community-based organisation in Karachi from November 2020 to February 2021, and comprised men aged 18 years or above who have sex with men. The subjects were provided one human immunodeficiency virus self-testing kit (HIVST) per person by trained outreach workers. It was an oral fluid-based kit. Data related to demographics, behavioural patterns and human immunodeficiency virus testing detail was collected on a structured questionnaire with some open-ended questions. The analysis of qualitative data was done manually, using content analysis technique in which all common responses were grouped that led to the generation of themes. RESULTS: There were 150 male subjects with mean age 31.5+/-8.7 years. Overall, 62(41.3%) subjects had received up to 15 years of formal education, 94(62.6%) were first-time testers; 139(92.7%) performed the test at home; 11(7.3%) used the kit at the community-based organisation's office. In terms of results, 1(0.7%) participant had a reactive result which was later confirmed as positive for human immunodeficiency virus. Of the total, 145(96.6%) participants found the instructions and the kit easy to use on their own, 83(55.3%) preferred a social media-based approach, and 68(45.3%) preferred the peer-to-peer approach. CONCLUSIONS: The HIVST was found to be acceptable among men who have sex with men, while peer-led and social media approaches seemed to be an effective method of information dissemination.

The relationship between nurses' perceived organisational, supervisor and coworker support, psychological well-being and job performance.

OBJECTIVE: To examine the relationship involving nurses' perception of organisational, supervisor and co-worker support, psychological well-being and job performance. METHODS: The cross-sectional, correlational study was conducted from June 2016 to January 2017 after approval from the ethics review committee of Istanbul Medipol University, Istanbul, Turkiye, and comprised nurses working in public or private sector and being in their current employment for at least one year. Data was obtained using Organisational Support, Co-Worker Support, Supervisor Support, Psychological Well-Being and Job Performance scales. Data was analyzed using SPSS 26. RESULTS: Of the 1056 nurses, 896(84.8%) were women and 160(15.2%) were men. The overall mean age was 30.69±7.53 years (range: 17-59 years) and mean professional experience was 9.31±7.66 years (range: 1-36 years). CONCLUSIONS: Organisational, supervisor and co-worker support increased psychological wellbeing. Supervisor and co-worker support had a positive effect on job performance, but organisational support did not. Psychological wellbeing also increased job performance. Psychological well-being had a mediating role in the effect of organisational, supervisor and co-worker support on job performance. There was a positive relationship between perceived support, psychological wellbeing and job performance of nurses.

Bone marrow infiltration by Non-Hodgkin lymphoma: An experience in a tertiary care centre.

Objective: To determine the frequency and patterns of bone marrow infiltration in non-Hodgkin lymphoma patients. METHODS: The cross-sectional study was conducted at the Armed Forces Institute of Pathology, Rawalpindi, Pakistan, from April to October 2021, and comprised patients of either gender aged 20-80 years who had been diagnosed with non-Hodgkin lymphoma. Following assessment and as per standard protocol, bone marrow aspirate and trephine biopsy were done on all patients from the posterior superior iliac spine, and slides were prepared and assessed. Data was analysed using SPSS 25. RESULTS: Of the 100 patients, 67(67%) were males and 33(33%) were females. The overall mean age was 54.99±12 years, and mean duration of symptoms was 11.7±1.5 months. Diffuse large B-cell lymphoma was the commonest type 43(43%). Infiltration of marrow occurred in 38(38%) patients, with 12(12%) of them being cases of mantle cell lymphoma. The commonest infiltration pattern was diffuse in 17(17%) cases, followed by focal/nodular in 10(10%). CONCLUSIONS: Diffuse large B-cell lymphoma was found to be the commonest type of non-Hodgkin lymphoma, and marrow infiltration occurred most frequently in cases of mantle cell lymphoma.

Perceived social support and psychological well-being among patients with epilepsy.

This cross-sectional study aimed to explore the relationship between perceived social support and psychological well-being in patients with epilepsy. The study was conducted, from January to December 2019, after ethical approval from the research ethical committee of FMU (Faisalabad Medical University, Faisalabad). A sample of 90 patients, attending free epilepsy camp in Mujahid Hospital Madina Town Faisalabad and psychiatry OPD of government General hospital G.M. Abad Faisalabad, was collected by using the Multidimensional Scale of Perceived Social Support (Urdu version). Moreover, Psychological well-being was assessed by Ryff Scale. Statistical analysis was done through data Correlation and T-test SPSS version 21. A positive correlation between psychological well-being and perceived social support in epileptic patients was established (p<0.001). This study concludes that on the one hand, strong social support enhances psychological well-being, while, on the other hand, both these factors collaboratively improve the mental health of PWE, thus promoting a better outcome.

Factors Affecting Anemia in Pregnancy Women in Ibeju-Lekki, Lagos State, Nigeria.

Anemia progresses due to low red blood cells counts or hemoglobin. The World Health Organization (WHO) has suggested the condition to be a serious global public health problem that affects pregnant women worldwide. Anemic pregnant women may suffer post-partum hemorrhage, pre-term delivery, seizures, and severe cases of anemia that potentially lead to cardiac failure or death. However, it is pertinent for pregnant women and health service providers to have the adequate knowledge about the factors associated with anemia in pregnancy. Thus, this study assessed the factors associated with anemia in pregnancy women attending primary healthcare (PHC) centers in Ibeju-Lekki Local government area, Lagos state. This study employed descriptive cross-sectional design using multi-stage sampling method to recruit 295 pregnant women into the study. Data were collected using a semi-structured, self-administered questionnaire. The recruited participants (56.6%) were majorly in their third trimester, of which their mean age was 28.7 ± 5.9 years. About 80.7% of the participants were married, having a mean knowledge score of 6.6 ± 3.2. More than half of respondents (56.3%) were anemic and had a poor knowledge (50.5%) of anemia in pregnancy. The mean hemoglobin concentration within the population was 11.06 ± 0.73 g/dl with a range of 8.3 to 12.0. There was no significant association between the respondents' knowledge of anemia in pregnancy and anemic status (X2 = 0.549; P = .45). However, this study observed a significant association between dietary diversity score and anemic status (X2 = 8.66; P = .01) and the trimester status of respondents' first antenatal visit (X2 = 9.603; P = .008). The study concluded that anemia in pregnancy was associated with maternal factors such as their first antenatal visit and the dietary diversity score. Due to this, proper education of pregnant women on anemia by health workers during antenatal clinics or visits should be prioritize to improve their anemia status.

Evaluation of Health Literacy and Associated Factors Among Adults Living in Saudi Arabia: A Cross-Sectional Study.

In this westernized culture, maintaining a healthy lifestyle has become a major health concern internationally. Health literacy is an emerging concept and requires effective measures and reform to improve the health status and health of individuals at both national and international levels, and has become one of the important determinants of individual health and healthcare service. This study aimed to assess health literacy among adults in Saudi Arabia. A cross-sectional study was conducted among a randomly selected population using a structured validated questionnaire over 4 months in 2021. The questionnaires designed for the study included 26 items divided into 5 domains assessed on a five-point Likert scale. Data were analyzed using IBM SPSS Statistics 26 (IBM Inc., Chicago, IL, USA) and IBM SPSS 26 (IBM Inc.). The mean score for reading, access to information, understanding, appraisal, and decision-making was 12.01 ± 4.37, 20.16 ± 7.17, 24.84 ± 8.37, 11.85 ± 4.90, and 36.94 ± 10.41 respectively. The mean scores of reading and understanding domains were found to have significant differences concerning gender (P < .05). Additionally, participants' age was significantly associated with the mean score of reading and decision-making (P < .006 and P < .049). The findings reported a prevalence of inadequate HL in the population of Saudi Arabia was 54.4%, and the determinants associated with the scores of HL were age, gender, and education.

Sleep disturbances, glycaemic control, stress, and coping among diabetic patients: A structural equation modelling approach.

BACKGROUND: Sleep disturbances are more prevalent in diabetic patients than in the general population and may consequently be comorbid with hyperglycaemia. OBJECTIVE: The two study aims were to (1) verify the factors associated with sleep disturbances and glycaemic control and (2) further understand the mediation effects of coping and social support in the relationship among stress, sleep disturbances, and glycaemic control. METHODS: A cross-sectional study design was used. Data were collected at two metabolic clinics in southern Taiwan. The study recruited 210 patients with type II diabetes mellitus who were aged 20 years or above. Demographic information and data on stress, coping, social support, sleep disturbances, and glycaemic control were collected. The Pittsburgh Sleep Quality Index (PSQI) was used to assess sleep quality, and PSQI scores >5 were considered to indicate sleep disturbances. Structural equation modelling (SEM) approaches were employed to analyse the path association for sleep disturbances in diabetic patients. RESULTS: The mean age of the 210 participants was 61.43 (standard deviation, SD 11.41) years old, and 71.9 % reported sleep disturbances. The final path model had acceptable model fit indices. Stress perception was divided into stress perceived positively and negatively. Stress perceived positively was associated with coping (ß = 0.46, p < .01) and social support (ß = 0.31, p < .01), whereas stress perceived negatively was significantly associated with sleep disturbances (ß = 0.40, p < .001). CONCLUSIONS: The study shows that sleep quality is essential to glycaemic control, and stress perceived negatively might play a critical role to sleep quality.

The use of benzodiazepines and the mental health of women in prison: a cross-sectional study.

In this article we assessed the prevalence of benzodiazepine (BZD) use in women before and during imprisonment, as well as its related factors and association with symptoms of anxiety, depression, and posttraumatic stress disorder in a quantitative, cross-sectional, analytical study of regional scope. Two female prisons in the Brazilian Prison System were included. Seventy-four women participated by completing questionnaires about their sociodemographic data, BZD use and use of other substances. These questionnaires included the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Posttraumatic Stress Disorder Checklist-Civilian Version (PCL-C). Of the 46 women who reported no BZDs use before arrest, 29 (63%) began using BZDs during imprisonment (p < 0.001). Positive scores for PTSD, anxiety, and depression, as well as associations between BZD use during imprisonment and anxiety (p = 0.028), depression (p = 0.001) and comorbid anxiety and depression (p = 0.003) were found when a bivariate Poisson regression was performed. When a multivariate Poisson regression was performed for tobacco use, the PHQ-9 and GAD-7 scales, BZD use was associated with depression (p = p = 0.008), with tobacco use (p = 0.012), but not with anxiety (p = 0.325). Imprisonment increases the psychological suffering of women, consequently increasing BZD use. Nonpharmacological measures need to be considered in the health care of incarcerated women.