Early life factors associated with the experiences of pain in later life: evidence from a population based study in India.

BACKGROUND: The influence of early life factors is becoming increasingly apparent as studies investigate how experiences, resources, and constraints in childhood affect health and well-being later in life. The present study contributes to this literature by examining the association between several early life factors and self-reported pain among older adults in India. METHODS: Data come from the 2017-18 wave 1 of the Longitudinal Ageing Study of India (LASI). The sample size includes 28,050 older adults aged 60 and above (13,509 men and 14,541 women). Pain is a self-reported, dichotomous measure where participants responded to whether they were often troubled with pain and whether this experience interfered with their ability to carry out daily household chores. Early life factors, which are retrospective accounts of experiences, included the respondent's position in birth order, their health status, school absenteeism, being bedridden, family socioeconomic status (SES), and their parent's experience with chronic disease. Logistic regression analysis is employed to examine the unadjusted and adjusted average marginal effects (AME) of selected domains of early life factors associated with the probability of experiencing pain. RESULTS: 22.8% of men and 32.3% of women reported pain that interfered with daily activities. Pain was higher among men (AME: 0.01, confidence interval (CI): 0.01-0.03) and women (AME: 0.02, CI: 0.01-0.04) with third or fourth birth order compared to counterparts with first birth order. Both men (AME: -0.02, CI: -0.04-0.01) and women (AME: -0.07, CI: -0.09 - -0.04) having a fair childhood health status reported a lower probability of pain. The probability of pain was higher among both men (AME: 0.03, CI: 0.01-0.07) and women (AME: 0.07, CI: 0.03-0.13) who were bedridden due to sickness in their childhood. Similarly, the pain likelihood was higher among men who missed school for more than a month due to health problems (AME: 0.04, CI: -0.01-0.09). Men and women with poor financial condition in their childhood reported (AME: 0.04, CI: 0.01-0.07) a higher probability of experiencing pain relative to their peers who reported a more financially advantaged early life. CONCLUSIONS: Findings of the present study add to the empirical literature on the association between early life factors and later life health and well-being. They also are pertinent to health care providers and practitioners working in pain management, as this knowledge better positions them to identify older adults most susceptible to pain. Moreover, findings of our study underscore that the interventions to ensure health and well-being in later life must start far earlier in the life course.

Ambulatory Care Pharmacist Perception of Formulary Medication Shortage: Tertiary Center Experience.

Background: Medication shortage is a serious issue affecting public health and patient care. It causes a major burden on the medical team of a healthcare organization in the delivery of quality care. Objectives: This study aims to assess the perception of ambulatory care pharmacist about formulary medication shortage as well as to assess the rate of medication shortage and explore the highest classes of the not-available (NA) medication. Methods: A cross-sectional survey was performed to assess pharmacist perception regarding medication shortage. The data for NA medication was collected from the hospital health information system "HIS" (Best care) to investigate the type and classes of medication shortage. Results: The overall survey response rate was 92.7%. The majority (61%) of participants encountered 5 to 15 labels of NA medication per day, 43% of participants encountered unpleasant behavior from patients usually due to NA medication and the main reason of patient dissatisfaction was the negative effect of NA medication on their course of therapy. Ninety-seven percent of participants agreed that medication shortage adds extra pressure/workload and 66% agreed that medication shortage increases the chance of medication error. A total of 113 medication shortage was recorded between January and March 2020. The 2 drug classes, which showed maximum shortage, were gastrointestinal and cardiovascular medications. The most prevalent type of medication shortage was for drugs administered by oral route (91.2%). Conclusions: The study provides insights into the frequency, management, and problems confronted due to medication shortage from the pharmacist perception. The study findings highlight the classes and type of medication shortage in the hospital which needs intervention to enhance patient care. The findings of the study would help the higher administration to implement an effective strategy to mitigate the shortage of medication, improve patient satisfaction, and to reduce pharmacist workload.

Assessment and Association of the World Health Organization's Five Keys to Food Safety Among Selected Food Truck Operators Demographic in Jeddah City.

The World Health Organization (WHO) reports that food handlers play a significant role in the maintenance of food safety from food production to storage. This study aims to assess the implementation of WHO five keys to safer food in the food trucks in Jeddah city. This study was an observational study. A total of 103 registered and licensed food trucks in Jeddah were selected using the opportunity sampling method. The WHO's five keys to safer food questionnaire was used by the researchers to inspect and evaluate the hygiene status of food trucks. A chi-square test was used to assess the association between the demographic characteristics of food truck handlers and the implementation of the variables used to evaluate WHO's five keys to safer food in their food trucks. P value < 0.05 was considered significant. The participation rate was 64.4% (103/160). Most food truck handlers were older than 30 years (55.3%), were men (81.6%), had secondary-level education (40.8%), and were Saudi nationals (69.9%). More than 50% of food truck handlers had less than three years of experience in business, and 67% of food truck handlers had undergone training in food handling. The researchers found good implementation of Key 5c. - "Water from cans/bottles used for cooking" (93.2%), followed by Key 1a. "Cleaning and disinfecting done periodically" (78.6%), and poor implementation for Key 3a. - "Calibrated thermometers are used to check temperatures" (30.1%) in the food trucks. The overall implementation score of WHO's five keys to safer food was found to be good (score ≥ 8) in 57.3% of food trucks. Food handlers' age, gender, and training in food handling indicated a significant association with the implementation of WHO's five keys to safer food. The exposure of food handlers to food handling training indicated a significant association with good implementation of all five keys to safer food.

Impact of short-term exposure to ambient air pollutants and meteorological factors on COVID-19 incidence and mortality: A retrospective study from Dammam, Saudi Arabia.

The symptoms of COVID-19 included fever with or without respiratory syndrome, but patients subsequently developed pulmonary abnormalities. Exposure to air pollution, meanwhile, is associated with complications such as acute respiratory inflammations, asthma attack, and deaths from cardiorespiratory disease. To analyze the association of the air quality index (AQI), ambient air pollutants (PM10, SO2 and O3) and meteorological parameters (temperature and relative humidity [RH]) with COVID-19 incidence and mortality, a retrospective study was conducted to examine COVID-19 infection, meteorological parameters, ambient air quality and ambient air pollutants in Dammam from 1 January to 30 April 2021. Data of COVID-19 incidence and mortality for Dammam were retrieved from Saudi Arabia Ministry of Health's publicly accessible database. Meteorological data, AQI and average PM10, SO2 and O3 values were extracted from the publicly available website of Ministry of Environment, Water and Agriculture. The correlation of COVID-19 incidence and mortality with the independent variables was analysed by Pearson's correlation test or Spearman's rho test as applicable, and a p-value less than 0.05 was considered significant. COVID-19 incidence exhibited a positive correlation with temperature (r = 0.537, p = .0001) and a negative correlation with RH (r=-0.487, p=.0001). No correlation was observed between the meteorological variables and COVID-19 mortality. COVID-19 incidence showed a positive correlation with AQI (r=0.269, p=.015) and with the ambient air pollutants SO2 and O3 (r=0.258, p=.018), and COVID-19 mortality showed a positive correlation with PM10 (r s  = 0.344, p=.002). Short-term exposure to O3, SO2 and higher temperature had direct relationship with COVID-19 incidence, while RH had inverse relationship. PM10 is positively associated with COVID-19 mortality.

Assessing COVID-19 knowledge, attitudes, and practices among hospital employees: identifying sociodemographic determinants for improved public health strategies.

Background: The working environment of healthcare institution during pandemic puts all hospital employees at high-risk of being exposed to contagious infections. An individual's behavior and response are largely determined by their level of knowledge, attitudes and practices (KAP) toward a disease. Therefore, the present study aimed to evaluate and assess the KAP toward COVID-19 among hospital employees working in various positions and to identify the sociodemographic determinants associated with the level of KAP. Methods: A cross-sectional survey was conducted from July 1 to July 15, 2020 in Almoosa Specialist Hospital, Alhasa, Eastern Province, Saudi Arabia in which 221 hospital employees with varied job titles participated. The data for demographics and history of COVID-19 exposure, KAP related to COVID-19 spread and prevention were collected online using a web-based platform (Survey Monkey). Student's t-test/One-way ANOVA were used to compare total mean and standard deviation of KAP scores with demographic profiles and history of exposure. Results: 89.1% employees knew that COVID-19 virus is mostly transmitted from human-to-human, and 76.0% employees acknowledged droplet transmission. 64.7% employees preferred to take a sick person with unconfirmed COVID-19 to a health facility. Physicians had higher knowledge scores for COVID-19 infection and non-medical employees had the lowest scores (7.47 ± 1.23 and 6.47 ± 1.44, respectively). Nurses had the highest practice scores and non-medical employees lowest practice score (6.16 ± 0.74 and 5.37 ± 1.14, respectively). Attitude scores were similar among all the employees. All employees reported an increase in hand-washing frequency and physical contact avoidance. Conclusion: The study results revealed socio-demographic factors; level of education, nationality, and field of service are associated with COVID-19 KAP. The study highlights that there is a gap in the level of knowledge about COVID-19, especially among nonmedical employees. Targeted interventional programs need to be planned and implemented to improve COVID-19 awareness among non-medical employees.

Prevalence of food thermometers usage and temperature control in restaurants in Dammam, Saudi Arabia.

The Saudi Ministry of Municipal and Rural Affairs is planning to initiate a hazard analysis critical control point (HACCP) system in restaurants and cafeterias to manage issues of food safety in Saudi Arabia. One of the most important elements in the HACCP system is the monitoring temperature of cooked and stored food. The present study aimed to investigate the prevalence and use of refrigerators/freezers and food thermometers among food handlers in local and international restaurants in Dammam, Saudi Arabia. A cross-sectional study was conducted in municipality-licensed restaurants. The temperatures of refrigerator and freezer were checked, and the survey form was completed by the researcher according to logbook entries. We then checked for the presence of a food thermometer, and if a functional thermometer was present, the chef was asked to complete an online questionnaire using Survey Monkey website on a tablet. The response rate of the survey was 68% (238/350 restaurants). We found that 88.1% of restaurants used a thermometer to check the temperature of their refrigerators and freezers. Thirty-one restaurants (13.0%) had a regular temperature-monitoring record available for both the refrigerator and freezer. International restaurants had significantly greater temperature-monitoring data than local restaurants (88.1% vs 63.3%; p = .0001). The prevalence of food thermometers in restaurants was 53.4% (127/238 restaurants), with significantly higher prevalence in international restaurants than in local restaurants (96.6% vs 10.8%; p = .0001). The practice of using food thermometer "always" when meat turned brown was significantly associated with the chef's age and education level. The study results showed poor monitoring and documentation of refrigerator and freezer temperatures along with a low prevalence of food thermometer use. The study result provides an insight into one of the barriers to the implementation of the HACCP system in Dammam.

Folic acid awareness and usage among females at Saudi Electronic University in Jeddah, Saudi Arabia.

OBJECTIVES: This study evaluates awareness of folic acid and neural tube defects, use of folic acid and knowledge of folic acid usage among female university students in Saudi Arabia. METHODS: An analytical cross-sectional survey was conducted in the Jeddah branch of Saudi Electronic University. A total of 400 female students in the 19-45 years age group were contacted to participate in the study using a convenience sampling method. Eighty-eight students refused to participate, so 312 students were included in the study. Demographic characteristics of participants and their awareness, usage and knowledge of folic acid are presented as frequencies and percentages. Logistic regression analysis was used to compute crude odds ratios to show the association between demographic factors and knowledge of folic acid supplementation. A further adjusted odds ratio was calculated to control for other cofactors. A p-value < 0.05 was considered significant. RESULTS: Overall, 81.1% (253/312) of respondents had heard of folic acid, 30.4% knew about neural tube defects, and 47.1% of respondents reported using folic acid supplements. Marriage was found to be associated with awareness of folic acid (adjusted odds ratio (95% confidence interval) = 2.64 (1.01-6.91)). Health sciences specialization and experience of pregnancy were associated with the usage of folic acid (adjusted odds ratio (95% confidence interval) = 3.46 (1.73-6.91) and adjusted odds ratio (95% confidence interval) = 6.70 (3.09-14.53), respectively). A bachelor's and above education level was found to be associated with knowledge of folic acid deficiency leading to neural tube defects (adjusted odds ratio (95% confidence interval) = 2.03 (1.17-3.52)), and health sciences specialization was found to be associated with knowledge of natural sources of folic acid (adjusted odds ratio (95% confidence interval) = 2.33 (1.25-4.36)). Similarly, marriage was found to be associated with knowledge of the correct dosage of folic acid and timing of folic acid to prevent neural tube defects (adjusted odds ratio (95% confidence interval) = 6.34 (3.50-11.48) and adjusted odds ratio (95% confidence interval) = 3.45 (1.93-6.16), respectively). Experience of pregnancy was found to be an associated with good total knowledge of folic acid (adjusted odds ratio (95% confidence interval) = 3.05 (1.65-5.63); p = 0.0001). CONCLUSION: The study findings highlight the lack of awareness among female university students about the importance of folic acid usage in the prevention of neural tube defects. There is a need for interventional programs in universities to create awareness.

Evaluation of Public Health Education and Workforce Needs in the Kingdom of Saudi Arabia.

BACKGROUND: An efficient public health workforce is necessary for improving and maintaining the health of population and such a workforce can be prepared through proper educational programs and trainings. OBJECTIVES: The present study aims to investigate the needs in the public health education programs, as well as need and availability of competent public health workforce in labour market of Saudi Arabia. METHODS: A descriptive, cross-sectional survey was administered in two phases in the college of Health Sciences at the Saudi Electronic University (SEU). The first phase was carried out between September 2015 and December 2015, which involved interview with administrative heads of four health-related organizations. The second phase was performed in September 2017 and June 2018 after starting an undergraduate course in public health at the university. A total of 41 faculty and 408 students from different branches of SEU participated in the online survey. RESULTS: According to administrative head of public health-related organization, there is a shortage of qualified workforce in public health. All the four organizations need workforce with the master degree in sub-speciality epidemiology. About 97.5% students agreed there is a shortage of public health speciality in these organizations. About 92.7% faculty had an opinion that there is a requirement to set-up educational programs in public health. To overcome the shortage of competent workforce, two organizations showed interest in updating their employees' skill through bridging courses. The students perceiving bachelor course in public health showed interest to accomplish master's degree in epidemiology (38.5%), public health education and promotion (36.5%) and infection control (35.5%). CONCLUSION: There is a shortage of expertise in the public health organizations and there is a need for development of more public health schools in the Kingdom of Saudi Arabia. The establishment of public health courses especially in the field of epidemiology at undergraduate and graduate level will help in the development of efficient and competent public health workforce.