Serological Profiles of SARS-Cov-2 among Adult Outpatients and Caregivers of a Family Medicine Clinic in Northern Nigeria.

BACKGROUND: Serological evaluation is essential for investigating the extent of COVID-19 in the studied population and evaluating the potential effectiveness of serum antibodies as a protective factor against future disease. OBJECTIVE: The study aimed to provide data on the seroprevalence and pattern of immune response to SARS-CoV-2 infection and the associated factors among outpatients and their caregivers. METHODS: A cross-sectional study involving 208 patients and caregivers who presented at the Family Medicine Clinic. A structured self-administered questionnaire was used to collect data on sociodemographic and COVID-19-related factors. The SARS-CoV-2 antibodies were assayed with the Realy Tech Rapid Test Device. Inferential statistical analyses were used to determine the associations between SARS-CoV-2 antibody outcomes and other variables. RESULTS: The ages of the participants ranged from 18 to 80 years, with a mean age of 38.87± 11.82 years and with female preponderance. The crude prevalence of anti-SARS-CoV-2 seropositivity was 20.7% (95% CI=1.14-1.28); of which 17.1% was for IgG, 2.9% for IgM, and 0.7% for both IgG and IgM. The overall corrected prevalence was 20.3%. The only identified predictor of anti-SARS-CoV-2 seropositivity in this study was the previous family history of COVID-19 infection (OR=36.548, CI=1.371-74.364, p=0.032). CONCLUSION: The identified predictor and other important outcomes will be useful in forming strategies for the prevention and management of COVID-19 infection.

CONTEXTE: L'évaluation sérologique est essentielle pour déterminer l'étendue du COVID-19 dans la population étudiée et évaluer l'efficacité potentielle des anticorps sériques en tant que facteur de protection contre une maladie future. OBJECTIF: L'étude visait à fournir des données sur la séroprévalence et le profil de la réponse immunitaire à l'infection par le SRAS-CoV-2 et les facteurs associés chez les patients ambulatoires et leurs soignants. MÉTHODES: Il s'agit d'une étude transversale portant sur 208 patients et soignants qui se sont présentés à la clinique de médecine familiale. Un questionnaire structuré auto-administré a été utilisé pour recueillir des données sur les facteurs sociodémographiques et liés au COVID-19. Les anticorps antiSRAS-CoV-2 ont été dosés à l'aide du dispositif de test rapide Realy Tech. Des analyses statistiques inférentielles ont été utilisées pour déterminer les associations entre les résultats des anticorps anti-SRAS-CoV-2 et d'autres variables. RÉSULTATS: Les participants étaient âgés de 18 à 80 ans, avec un âge moyen de 38,87± 11,82 ans et une prépondérance féminine. La prévalence brute de la séropositivité anti-SARSCoV-2 était de 20,7 % (IC à 95 % = 1,14-1,28), dont 17,1 % pour les IgG, 2,9 % pour les IgM et 0,7 % pour les IgG et les IgM. La prévalence globale corrigée était de 20,3 %. Le seul facteur prédictif identifié de la séropositivité anti-SARS-CoV-2 dans cette étude était les antécédents familiaux d'infection par COVID-19 (OR=36,548, CI=1,371-74,364, p=0,032). CONCLUSION: Le facteur prédictif identifié et d'autres résultats importants seront utiles pour élaborer des stratégies de prévention et de prise en charge de l'infection par COVID-19. Mots-clés: Profil sérologique, SRAS-CoV-2, patients externes, soignants et nord du Nigeria.

Socio-economic and Lifestyle Determinants of Functional Capacity of the Senior Attendees of an Outpatient Clinic in Northern Nigeria: A Cross-Sectional Study.

BACKGROUND: Typical ageing changes and the associated health concerns frequently manifest themselves as reduction in their efficiency and functional capacity. OBJECTIVE: To identify the socioeconomic and lifestyle determinants of the functional capacity of elderly patients. METHODS: A cross-sectional study involving 329 patients aged ≥ 60 years who presented to the General Outpatient Clinic. Data on socioeconomic, lifestyle, and functional capacity were collected. The functional capacity was assessed by the self-reported questionnaires: the Lawton and Katz indexes for the activity of daily living (ADL) and instrumental activity of daily living (IADL) respectively. The chi-square test and logistic regression analysis were used to determine associations between the variables. The level of significance was set at a p-value ≤ 0.05. RESULTS: A total of 312 respondents completed the study, with 59.6% females and a mean age of 67.67 ± 7.69 years. The majority of the respondents (76.3%) belong to the low socioeconomic status (classes V and VI). The prevalence of functional dependence was 21.5% and 44.2% for ADL and IADL respectively. The disability in continence and food preparation had the highest prevalence among the components of ADL and IADL respectively. Advancing age, Hausa/Fulani tribe, polygamy, poor social support, and chronic pain were the determinants of functional dependence in ADL while age, female gender, marital status, and Fulani tribe were the determinants of functional dependence in IADL among the respondents.CONCLUSION: The identified determinants of functional capacity among the older persons should be considered when assessing their functional capacity in the primary care or similar settings.

CONTEXTE: Les changements typiques liés au vieillissement et les problèmes de santé qui y sont associés se manifestent souvent par une réduction de l'efficacité et de la capacité fonctionnelle. OBJECTIFS: Identifier les déterminants socio-économiques et le mode de vie de la capacité fonctionnelle des patients âgés. MÉTHODES: Étude transversale portant sur 329 patients âgés de ≥ 60 ans qui se sont présentés à la consultation externe générale. Des données sur la situation socio-économique, le mode de vie et la capacité fonctionnelle ont été recueillies. La capacité fonctionnelle a été évaluée à l'aide de questionnaires autodéclarés : les indices de Lawton et de Katz pour l'activité de la vie quotidienne (ADL) et l'activité instrumentale de la vie quotidienne (IADL) respectivement. Le test du chi carré et l'analyse de régression logistique ont été utilisés pour déterminer les associations entre les variables. Le niveau de signification a été fixé à une valeur p ≤ 0,05. RÉSULTATS: Au total, 312 personnes ont répondu à l'étude, dont 59,6 % de femmes et un âge moyen de 67,67 ±7,69 ans. La majorité des personnes interrogées (76,3 %) appartiennent à un statut socioéconomique faible (classes V et VI). La prévalence de la dépendance fonctionnelle était de 21,5 % et 44,2 % pour les AVQ et les AIVQ respectivement. Les incapacités liées à la continence et à la préparation des repas ont la prévalence la plus élevée parmi les composantes des AVQ et des AIVQ respectivement. L'âge avancé, la tribu Hausa/Fulani, la polygamie, le manque de soutien social et la douleur chronique étaient les déterminants de la dépendance fonctionnelle dans les AVQ, tandis que l'âge, le sexe féminin, l'état matrimonial et la tribu Fulani étaient les déterminants de la dépendance fonctionnelle dans les AIVQ parmi les personnes interrogées. CONCLUSION: Les déterminants identifiés de la capacité fonctionnelle chez les personnes âgées devraient être pris en compte lors de l'évaluation de leur capacité fonctionnelle dans le cadre des soins primaires ou dans des contextes similaires. Mots clés: Capacité fonctionnelle, Socio-économie, Mode de vie, Personnes âgées et nord du Nigeria.

DIETARY LIFESTYLE, HYPOALBUMINAEMIA AND ANAEMIA AMONG OLDER ADULTS ATTENDING A PRIMARY CARE CLINIC IN NIGERIA: A CROSS-SECTIONAL STUDY.

Introduction: Anaemia has been extensively studied in children and women of reproductive age. However, there are few data on anaemia and related conditions in the elderly from developing countries. Objectives: To determine the prevalence and severity pattern of anaemia, and assess the relationship between dietary lifestyle, hypoalbuminaemia, and anaemia in older persons. Methodology: A cross-sectional study involving 378 patients aged≥60 years who presented at the General Outpatient Clinic. Dietary lifestyle was assessed using a structured questionnaire. Samples were collected for packed cell volume and serum albumin. Inferential statistical analyses were used to determine the associations between variables. Results: A total of 348 respondents completed the study. The mean age of respondents was 67.83 ±7.53 years with female (60.9%) predominance. The prevalence of anaemia and hypoalbuminaemia were 42.2% and 17.8% respectively. Hypoalbuminaemia (ß=0.335, 95%CI=0.131-0.229, P<0.001), long duration of co-morbidities (ß= - 0.179, 95%CI= -0.165-0.047, P<0.001), one full meal/day (ß=0.130, 95%CI=0.224-1.879, P=0.013), and low monthly income (ß=0.122, 95%CI=0.179-1.543, P=0.026) were the predictors of anaemia among the elderly in this study. Conclusion: Data on the predictors of anaemia from this study will be useful in developing guidelines and strategies for managing the condition in primary care settings and other similar sites.

Predictors of Satisfaction with Wound Care Services in an Outpatient Setting in Kano, Nigeria.

BACKGROUND: With the global increase in chronic wounds and the paucity of studies on patient experiences at wound care facilities, we assessed the factors associated with satisfaction with wound care services among patients or their caregivers in a Northwest Nigerian outpatient setting. METHODS: Participants were systematically selected from patients or their caregivers attending the General Outpatient Clinic of Aminu Kano Teaching Hospital, Kano, for wound dressing. A structured self-administered questionnaire was used to obtain information regarding their sociodemographic and clinical characteristics and satisfaction with service domains. Data were analyzed using descriptive and inferential statistical methods. RESULTS: There were 170 participants. Their mean age was 31.9±11.4 years, and they were mainly female (55.3%). The overall satisfaction rate was 85.9% (146/170); however, 51.8% and 55.3% of participants were dissatisfied with the advice on home wound care and waiting time, respectively. Employment status, wound location, having sickle cell disease, needing a wheelchair to reach the wound dressing room and perceived availability of a wheelchair were associated with overall satisfaction (P<0.05). The predictors of overall satisfaction were chronic wounds, wound in areas other than the lower limbs/buttocks, and perceived availability of wheelchairs. CONCLUSION: The overall satisfaction rate was high despite service gaps. However, future improvement in patient satisfaction will require addressing challenges such as the waiting time before wound dressing, equipment (e.g., wheelchairs), and staffing.

CONTEXTE: Avec l'augmentation mondiale du nombre de plaies chroniques et le manque d'études sur les expériences des patients aux centres de soin des plaies, nous avons évalué les facteurs associés à la satisfaction des services de soins des plaies chez les patients ou leurs soignants dans une établissement de soins ambulatoires du nord-ouest du Nigeria. MÉTHODES: Les participants ont été systématiquement sélectionnés parmi les patients ou leurs soignants fréquentant la clinique externe générale de l'hôpital universitaire d'Aminu Kano à kano, pour le traitement des plaies. Un questionnaire structuré auto-administré a été utilisé pour obtenir des informations sur les caractéristiques sociodémographiques et cliniciques et leur satisfaction à l'égard des services. Les données ont été analysées à l'aide de méthodes statistiques descriptives et inférentielles. RÉSULTATS: Il y avait 170 participants. Leur âge moyen était de 31,9±11,4 ans, et ils étaient principalement des femmes (55,3 %). Le taux de satisfaction global était de 85,9 % (146/170) ; cependant, 51,8 % et 55,3 % des participants étaient insatisfaits des conseils sur le traitement des plaies à domicile et du temps d'attente, respectivement. Le statut professionnel, l'emplacement de la plaie, le fait d'avoir une drépanocytose, besoin d'un fauteuil roulant pour atteindre la salle de pansements et la disponibilité perçue d'un fauteuil roulant étaient associés à la satisfaction globale (P<0,05). Les facteurs prédictifs de la satisfaction globale étaient les plaies chroniques, les plaies situées dans des zones autres que les membres inférieurs/fesses et la disponibilité perçue des fauteuils roulants. CONCLUSION: Le taux de satisfaction globale était élevé malgré les lacunes des services. Cependant, l'amélioration future de la satisfaction des patients nécessitera relever des défis tels que le temps d'attente avant le pansement des plaies, l'équipement (p. ex., les fauteuils roulants) et la dotation en personnel. MOTS-CLÉS: Patients externes, Caractéristiques des patients, Satisfaction des patients, Soins des plaies, Pansements.

Parental Smoking and Adult Offspring's Smoking Behaviors in Ethnic Minority Groups: An Intergenerational Analysis in the HELIUS Study.

Introduction: To understand smoking behaviors among ethnic minority groups, studies have largely focused on societal factors, with little attention to family influences. Yet studies among majority groups have identified parental smoking as an important risk factor. It is unknown whether this applies to ethnic minority groups. We investigated the association between parental smoking and adult offspring's smoking behaviors among ethnic minority groups with an immigrant background. Methods: We used data from the Healthy Life in an Urban Setting study from Amsterdam (the Netherlands) from January 2011 to December 2015. The sample consisted of 2184 parent-offspring pairs from South-Asian Surinamese, African Surinamese, Turkish, Moroccan, and Ghanaian origin. We collected self-reported smoking data: current status, duration of exposure to parental smoking, number of daily cigarettes, heavy smoking ( > 10 cigarettes/day), and nicotine dependency (using the Fagerström Test). Analyses were stratified by offspring's age, cohabitation with parent, education (parent/offspring), offspring's cultural orientation, and gender concordance within pairs. Logistic regression was used. Results: Overall, parental smoking was associated with offspring's smoking behaviors (eg, current smoking: odds ratio 2.33; 95% confidence interval 1.79-3.03), with little ethnic variation. We found dose-response associations between exposure to parental smoking and offspring's smoking. The associations were similar across different strata but stronger in gender-concordant pairs (3.16; 2.12-4.51 vs. 1.73; 1.15-2.59 in gender-discordant pairs; p-value for interaction .017). Conclusions: Parental smoking is associated with offspring's smoking behaviors in ethnic minority groups across different strata but particularly in gender-concordant pairs. Similar to majority groups, family influences matter to smoking behaviors in ethnic minority groups. Implications: Our findings have deepened our understanding of smoking behaviors among ethnic minority groups. Future studies should simultaneously consider societal factors and parental influences, to comprehensively understand their impact on smoking among ethnic minority groups. Also, smoking patterns among family members should be addressed in individual counselling, irrespective of ethnicity.

Correlation of biochemical constituents of seminal plasma with semen quality in Teddy goat (Capra hircus) bucks.

This study was planned to determine the relationship between semen quality parameters and the levels of biochemical constituents of seminal plasma of Teddy (Capra hircus) buck semen. For this purpose, semen ejaculates were collected from five mature healthy Teddy bucks. All the experimental bucks were kept under natural environmental conditions. Semen was collected twice in a week for the duration of 6 weeks by Artificial Vagina (AV) in the breeding season (February-April). Two successive ejaculates of single buck were pooled at time of collection, and a total of 60 semen samples were processed for semen analysis. Sperm per cent motility, sperm concentration, dead sperm percentage, morphological abnormal spermatozoa, plasma membrane integrity were correlated with biochemical constituents of seminal plasma. The mean per cent motility (89.18% ± 0.37%), sperm concentration (1.86 ± 0.04 × 109 /ml), dead sperm percentage (8.08% ± 0.29%), morphological abnormal spermatozoa (6.05% ± 0.29%) and plasma membrane integrity (88.22% ± 0.34%) were recorded. The seminal plasma contained Na+ (144.12 ± 1.59 mEq/L), K+ (27.38 ± 0.49 mEq/L), Cl- (65.73 ± 0.45 mEq/L), Ca++ (9.34 ± 0.22 mg/dl), P (19.32 ± 0.97 mg/dl), aspartate aminotransferase (AST; 26.48 ± 1.30 IU/L), alanine aminotransferase (ALT; 168.47 ± 5.18 IU/L), lactate dehydrogenase (LDH; 215.98 ± 6.06 IU/L), albumin (1.90 ± 0.10 g/dl), globulins (2.08 ± 0.11 g/dl) and total protein (3.98 ± 0.20 g/dl). The collected data were analysed by applying Pearson's correlation coefficients. Dead sperm percentage had negative correlation with sodium (r = -.278, p < .05), albumin (r = -.294, p < .05), globulin (r = -.266, p < .05) and total protein (r = -.295, p < .05). Phosphorus was negatively associated with sperm concentration (r = -.262, p < .05). AST was negatively correlated with plasma membrane integrity (r = -.292, p < .05). It was concluded that most of the semen quality parameters of Teddy bucks were positively correlated with biochemical constituents, but opposite trends were found in case of dead sperm percentage. The seminal biochemical constituents dynamically interact with each other.

Perceived Ethnic Discrimination and the Metabolic Syndrome in Ethnic Minority Groups: The Healthy Life in an Urban Setting Study.

OBJECTIVE: Ethnic differences in the metabolic syndrome could be explained by perceived ethnic discrimination (PED). It is unclear whether PED is associated with the metabolic syndrome. We assessed this association and quantified the contribution of PED to the metabolic syndrome. METHODS: Baseline data were used from the Healthy Life in an Urban Setting study collected in the Netherlands from 2011 to 2014. The population-based sample included South-Asian Surinamese, African Surinamese, Ghanaian, Turkish, and Moroccan participants (aged 18 to 70 years). PED was measured using the Everyday Discrimination Scale. The metabolic syndrome was determined according to the harmonized definition of the International Diabetes Federation, American Heart Association, and others. Logistic regression was used for analysis. population-attributable fraction was used to calculate the contribution of PED. RESULTS: PED was positively associated with the metabolic syndrome in South-Asian Surinamese, African Surinamese, and Moroccan participants (odds ratio [95% confidence interval] = 1.13 [0.99-1.30], 1.15 [1.00-1.32], and 1.19 [1.03-1.38], respectively) after adjusting for potential confounders and mediators. No significant association was observed among Ghanaian and Turkish participants. For the individual components, the associations were statistically significant for blood pressure, fasting glucose, and waist circumference among Surinamese participants. PED was associated with dyslipidemia in Moroccan participants. The population-attributable fractions were 5% for South-Asian Surinamese and Moroccan participants, and 7% for African Surinamese participants. CONCLUSIONS: We found a positive association of PED with the metabolic syndrome in some ethnic groups, with PED contributing around 5% to 7% to the metabolic syndrome among Surinamese and Moroccans. This suggests that PED might contribute to ethnic differences in the metabolic syndrome.

The relationship between ethnic composition of the residential environment and self-reported health among Turks and Moroccans in Amsterdam.

BACKGROUND: Previous studies from the US and UK suggest that neighbourhood ethnic composition is associated with health, positive or negative, depending on the health outcome and ethnic group. We examined the association between neighbourhood ethnic composition and self-reported health in these groups in Amsterdam, and we aimed to explore whether there is spatial variation in this association. METHODS: We used micro-scale data to describe the ethnic composition in buffers around the home location of 2701 Turks and 2661 Moroccans. Multilevel regression analysis was used to assess the association between three measures of ethnic composition (% co-ethnics, % other ethnic group, Herfindahl index) and three measures of self-reported health: self-rated health, Physical and Mental Component Score (PCS, MCS). We adjusted for socioeconomic position at individual and area level. We used geographically weighted regression and spatially stratified regression analyses to explore whether associations differed within Amsterdam. RESULTS: Ethnic heterogeneity and own ethnic density were not related to self-rated health for both ethnic groups. Higher density of Turks was associated with better self-rated health among Moroccans at all buffer sizes, with the most significant relations for small buffers. Higher heterogeneity was associated with lower scores on PCS and MCS among Turks (suggesting worse health). We found spatial variation in the association of the density of the other ethnic group with self-rated health of Moroccans and Turks. We found a positive association for both groups, spatially concentrated in the sub-district Geuzenveld. CONCLUSIONS: Our study showed that the association of ethnic composition with self-reported health among Turks and Moroccans in Amsterdam differed between the groups and reveals mainly at small spatial scales. Among both groups, an association of higher density of the other group with better self-rated health was found in a particular part of Amsterdam, which might be explained by the presence of a relatively strong sense of community between the two groups in that area. The study suggests that it is important to pay attention to other-group density, to use area measurements at small spatial scales and to examine the spatial variation in these associations. This may help to identify neighbourhood characteristics contributing to these type of area effects on urban minority health.

Inequalities by immigrant status in depressive symptoms in Europe: the role of integration policy regimes.

PURPOSE: We aimed to study whether country integration policy models were related to inequalities by immigrant status in depressive symptoms in Europe. METHODS: This is a cross-sectional study using data from 17 countries in the sixth wave of the European Social Survey (2012), comparing subjects born either in the country of residence (non-immigrants, N = 28,333) or in a country not classified as "advanced economy" by the IMF (immigrants, N = 2041). Depressive symptoms were assessed with the eight-item version of the Center for Epidemiologic Studies Depression scale. Countries were grouped into three integration policy regimes (inclusive, assimilationist, and exclusionist). Linear regressions were fitted adjusting first by age, sex, and education level, then sequentially by citizenship, perceived discrimination, and socio-economic variables. RESULTS: In all integration regimes, immigrants report significantly more depressive symptoms than non-immigrants. The gap is the largest in exclusionist countries (immigrants score 1.16, 95% CI 0.65-1.68, points higher than non-immigrants in the depression scale), followed by assimilationist countries (0.85 and 0.57-1.13) and inclusive countries (0.60 and 0.36-0.84). Financial strain explains all the associations in inclusive countries, most of it in assimilationist countries, but only a small part in exclusionist countries. CONCLUSIONS: Across most European countries, immigrants seem to experience more depressive symptoms than the population born in the country, mostly reflecting their poorer socio-economic situation. Inequalities are larger in countries with more restrictive policies. Despite some limitations, this study adds new evidence to suggest that immigrants' health is shaped by integration policies in their host country.

The role of mastery in the relationship between perceived ethnic discrimination and depression: The HELIUS study.

OBJECTIVE: This study examined the mediating and moderating role of one's sense of mastery in the relationship between perceived ethnic discrimination and depression. METHOD: Questionnaire data from participants of the Healthy Life in an Urban Setting (HELIUS) study were used, containing responses from 9,141 Surinamese, Turkish, Moroccan, and Ghanaian immigrant adults, aged 18 to 70, living in Amsterdam, the Netherlands. RESULTS: Results of path modeling indicated that perceptions of ethnic discrimination were positively related to depression symptomatology, and this relationship was moderated and partially mediated by mastery. Results remained fairly robust across sex, educational level, immigrant generation, and ethnicity. CONCLUSION: This study indicated that mastery may both serve a moderating and mediating role in the relationship between perceived ethnic discrimination and depression, suggestive of a process in which the impact of perceiving discrimination becomes increasingly more deteriorating over time. Thus, interventions focused on mastery may potentially be beneficial to improve ethnic minority mental health. (PsycINFO Database Record

All-cause and cause-specific mortality of different migrant populations in Europe.

This study aimed to examine differences in all-cause mortality and main causes of death across different migrant and local-born populations living in six European countries. We used data from population and mortality registers from Denmark, England & Wales, France, Netherlands, Scotland, and Spain. We calculated age-standardized mortality rates for men and women aged 0-69 years. Country-specific data were pooled to assess weighted mortality rate ratios (MRRs) using Poisson regression. Analyses were stratified by age group, country of destination, and main cause of death. In six countries combined, all-cause mortality was lower for men and women from East Asia (MRRs 0.66; 95 % confidence interval 0.62-0.71 and 0.76; 0.69-0.82, respectively), and Other Latin America (0.44; 0.42-0.46 and 0.56; 0.54-0.59, respectively) than local-born populations. Mortality rates were similar for those from Turkey. All-cause mortality was higher in men and women from North Africa (1.09; 1.08-1.11 and 1.19; 1.17-1.22, respectively) and Eastern Europe (1.30; 1.27-1.33 and 1.05; 1.01-1.08, respectively), and women from Sub-Saharan Africa (1.34; 1.30-1.38). The pattern differed by age group and country of destination. Most migrants had higher mortality due to infectious diseases and homicide while cancer mortality and suicide were lower. CVD mortality differed by migrant population. To conclude, mortality patterns varied across migrant populations in European countries. Future research should focus both on migrant populations with favourable and less favourable mortality pattern, in order to understand this heterogeneity and to drive policy at the European level.

Perceived ethnic discrimination and depressive symptoms: the buffering effects of ethnic identity, religion and ethnic social network.

PURPOSE: Perceived ethnic discrimination (PED) is positively associated with depressive symptoms in ethnic minority groups in Western countries. Psychosocial factors may buffer against the health impact of PED, but evidence is lacking from Europe. We assessed whether ethnic identity, religion, and ethnic social network act as buffers in different ethnic minority groups in Amsterdam, the Netherlands. METHODS: Baseline data were used from the HEalthy Living In a Urban Setting study collected from January 2011 to June 2014. The random sample included 2501 South-Asian Surinamese, 2292 African Surinamese, 1877 Ghanaians, 2626 Turks, and 2484 Moroccans aged 18-70 years. Depressive symptoms were assessed using the Patient Health Questionnaire-9. PED was measured with the Everyday Discrimination Scale. Ethnic identity was assessed using the Psychological Acculturation Scale. Practicing religion was determined. Ethnic social network was assessed with the number of same-ethnic friends and amount of leisure time spent with same-ethnic people. RESULTS: PED was positively associated with depressive symptoms in all groups. The association was weaker among (a) those with strong ethnic identity in African Surinamese and Ghanaians, (b) those practicing religion among African Surinamese and Moroccans, (c) those with many same-ethnic friends in South-Asian Surinamese, Ghanaians, and Turks, and (d) those who spend leisure time with same-ethnic people among African Surinamese and Turks. CONCLUSIONS: Ethnic identity, religion, and ethnic social network weakened the association between PED and depressive symptoms, but the effects differed by ethnic minority group. These findings suggest that ethnic minority groups employ different resources to cope with PED.

The contribution of perceived ethnic discrimination to the prevalence of depression.

BACKGROUND: European research on the association between perceived ethnic discrimination (PED) and health is importantly lacking. It is also unknown how much PED contributes to disease prevalence. In this study, we quantified the contribution of PED to depression in five ethnic groups in a middle-size European city. METHODS: We used cross-sectional data from the HELIUS study (Healthy Life in an Urban Setting), collected from January 2011 to June 2013 in Amsterdam, The Netherlands. We included a random sample of 1753 ethnic Dutch, 1143 South-Asian Surinamese, 1794 African Surinamese, 1098 Ghanaians and 850 Turks, aged 18-70 years. PED was assessed using the Everyday Discrimination Scale. Patient Health Questionnaire-9 was used for assessing depressive symptoms and major depressive disorder (MDD). We used logistic regression and calculated the contribution of PED to depressive symptoms and MDD using the population attributable fractions. RESULTS: Depressive symptoms and MDD were most common in Turks and South-Asian Surinamese, and lowest in ethnic Dutch. PED had a positive association with depressive symptoms and MDD in only the ethnic minority groups. The contributions of PED to depressive symptoms and MDD were around 25% in both the Surinamese groups, and Turks, and ∼15% in Ghanaians. CONCLUSION: We conclude that PED contributes considerably to depression in ethnic minority groups in a European context. As such, ethnic inequalities in depression could be reduced substantially if ethnic minority groups would not perceive any ethnic discrimination. We encourage more European research on the health impact of PED.

How we developed an effective e-learning module for medical students on using professional interpreters.

BACKGROUND: Language barriers may lead to poorer healthcare services for patients who do not speak the same language as their care provider. Despite the benefits of professional interpreters, care providers tend to underuse professional interpretation. Evidence suggests that students who received training on language barriers and interpreter use are more likely to utilize interpretation services. AIMS: We developed an e-learning module for medical students on using professional interpreters during the medical interview, and evaluated its effects on students' knowledge and self-efficacy. METHODS: In the e-learning module, three patient-physician-interpreter video vignettes were presented, with three different types of interpreters: a family member, an untrained bilingual staff member, and a professional interpreter. The students answered two questions about each vignette, followed by feedback which compared their responses with expert information. In total, 281 fourth-year medical students took the e-learning module during the academic year 2012-2013. We assessed their knowledge and self-efficacy in interpreter use pre- and post-test on 1 (lowest)-10 (highest) scale, and analysed the differences in mean scores using paired t-tests. RESULTS: Upon completing the e-learning module, students reported higher self-efficacy in using professional interpretation. The mean knowledge score on the pre-test was 5.5 (95% confidence interval 5.3-5.8), but on the post-test this increased to 8.4 (95% CI 8.2-8.6). The difference was highly significant (p < 0.001). For self-efficacy, the mean score on the pre-test was 4.9 (95% CI 4.7-5.1), and on the post-test 7.0 (95% CI 6.8-7.1); p < 0.001. CONCLUSION: This e-learning module improved students' knowledge and self-efficacy in using professional interpreters during the medical interview. Using such tools in medical curricula might encourage future doctors to use professional interpretation services to overcome language barriers, thereby potentially contributing to equitable healthcare services for a linguistically diverse patient population.

The disease burden across different ethnic groups in Amsterdam, the Netherlands, 2011-2030.

BACKGROUND: Current disease burden estimates do not provide evidence across different ethnic groups. This study aims to assess the disease burden as measured by the disability-adjusted life years (DALYs) for six ethnic groups in Amsterdam, the Netherlands, for 2011 and 2030. METHODS: The DALYs were calculated by combining three components: disease-/sex-/age-specific DALYs per person; disease-specific relative risks (RRs) by ethnicity; and sex-/age-specific population sizes by ethnicity in Amsterdam in 2011 and 2030. Disease-specific DALYs were derived from the National Institute of Public Health. The RRs were obtained through a systematic review of studies published in 1997-2008. The population figures were gathered from the Statistics Netherlands and municipality of Amsterdam. RESULTS: The findings suggest that cardiovascular diseases and anxiety and depressive disorders dominate disease burden in all ethnic groups in 2011 and 2030. In most of the non-Western ethnic minorities, diabetes mellitus is the strongest contributor to the disease burden. The total disease burden will increase more strongly in non-Western ethnic minorities than ethnic Dutch. The 2030 disease burden is estimated to be highest among Surinamese and Antilleans. CONCLUSIONS: In ethnic minorities, diabetes plays an important role in the disease burden, and the total disease burden will grow stronger than ethnic Dutch, resulting in a higher total disease burden for some ethnic groups in 2030. We encourage researchers to estimate the disease burden by ethnicity so that health priorities can be set in the fields of policy, health care and research.

CF-LIBS based elemental analysis of Saussurea simpsoniana medicinal plant: a study on roots, seeds, and leaves.

The plant Saussurea Simpsoniana, which has been used in traditional medicine for its biocompatibility and abundant nutrients, offers a wide range of remedies. Local communities effectively utilize medicines derived from the plant's roots to treat various ailments such as bronchitis, rheumatic pain, and abdominal and nervous disorders. In this study, we present an elemental analysis of the chemical composition (wt%) of this medicinal plant using the laser-induced breakdown spectroscopy (LIBS) technique. In the air atmosphere, an Nd:YAG (Q-switched) laser operating at a wavelength of 532 nm is utilized to create plasma on the sample's surface. This laser has a maximum pulse energy of approximately 400 mJ and a pulse duration of 5 ns. A set of six miniature spectrometers, covering the wavelength range of 220-970 nm, was utilized to capture and record the optical emissions emitted by the plasma. The qualitative analysis of LIBS revealed the presence of 13 major and minor elements, including Al, Ba, C, Ca, Fe, H, K, Li, Mg, Na, Si, Sr, and Ti. Quantitative analysis was performed using calibration-free laser-induced breakdown spectroscopy (CF-LIBS), ensuring local thermodynamical equilibrium (LTE) and optically thin plasma condition by considering plasma excitation temperature and electron number density. In addition, a comparison was made between the results obtained from CF-LIBS and those acquired through energy-dispersive X-ray spectroscopy (EDX) analysis.

Perceived ethnic discrimination in relation to smoking and alcohol consumption in ethnic minority groups in The Netherlands: the HELIUS study.

OBJECTIVES: We examined the associations of perceived ethnic discrimination (PED) with smoking and alcohol consumption in ethnic minority groups residing in a middle-sized European city. METHODS: Data were derived from the HELIUS study in Amsterdam, The Netherlands. We included 23,126 participants aged 18-70 years of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish, and Moroccan origin. We collected self-reported data on PED, current smoking, heavy smoking, nicotine dependence, current drinking, excessive drinking, and alcohol dependence. Logistic regression was used. RESULTS: In general, we observed positive associations in participants of African Surinamese and Ghanaian origin, but no associations in those of South-Asian Surinamese, Turkish, or Moroccan origin. In African Surinamese, the associations were positive for current smoking, nicotine, and alcohol dependence (odds ratios of 1.16; 95% confidence interval: 1.06-1.27, 1.34; 1.15-1.57 and 1.40; 1.20-1.64, respectively). In Ghanaians, positive association was observed for current drinking (1.21; 1.08-1.36). CONCLUSIONS: The associations of PED with smoking and alcohol consumption considerably varied by ethnicity and outcome measure. This suggests that ethnic minority groups in Europe might use different behavioural strategies to cope with PED.

Association of perceived ethnic discrimination with general and abdominal obesity in ethnic minority groups: the HELIUS study.

BACKGROUND: Discrimination is associated with obesity, but this may differ according to the type of obesity and ethnic group. This study examines the association of perceived ethnic discrimination (PED) with general and abdominal obesity in 5 ethnic minority groups. METHODS: We used cross-sectional data from the HELIUS study, collected from 2011 to 2015. The study sample included 2297 Ghanaians, 4110 African Surinamese, 3021 South-Asian Surinamese, 3562 Turks and 3868 Moroccans aged 18-70 years residing in Amsterdam, the Netherlands. Body mass index (BMI) was used as a measure for general obesity, and waist circumference (WC) for abdominal obesity. PED was measured using the Everyday Discrimination Scale. We used linear regression models adjusted for sociodemographics, psychosocial stressors and health behaviours. In additional analysis, we used standardised variables to compare the strength of the associations. RESULTS: In adjusted models, PED was significantly, positively associated with BMI in the South-Asian Surinamese (ß coefficient 0.338; 95% CI 0.106 to 0.570), African Surinamese (0.394; 0.171 to 0.618) and Turks (0.269; 0.027 to 0.510). For WC, a similar pattern was seen: positive associations in the South-Asian Surinamese (0.759; 0.166 to 1.353), African Surinamese (0.833; 0.278 to 1.388) and Turks (0.870; 0.299 to 1.440). When stratified by sex, we found positive associations in Surinamese women, Turkish men and Moroccan men. The strength of the associations with BMI and WC was comparable in the groups. Among the Ghanaians, no significant associations were observed. CONCLUSIONS: Ethnic and sex variations are observed in the association of PED with both general and abdominal obesity. Further research on psychosocial buffers and underlying biological mechanisms might help in understanding these variations.

Association between Integration Policies and Immigrants' Mortality: An Explorative Study across Three European Countries.

BACKGROUND: To integrate immigrants into their societies, European countries have adopted different types of policies, which may influence health through both material and psychosocial determinants. Recent studies have suggested poorer health outcomes for immigrants living in countries with poorly rated integration policies. OBJECTIVE: To analyse mortality differences of immigrants from the same country of origin living in countries with distinct integration policy contexts. METHODS: From the mortality dataset collected in the Migrant Ethnic Health Observatory (MEHO) project, we chose the Netherlands (linked data from 1996-2006), France (unlinked; 2005-2007) and Denmark (linked; 1992-2001) as representatives of the inclusive, assimilationist and exclusionist policy models, respectively, based on the Migrant Integration Policy Index. We calculated for each country sex- and age-standardized mortality rates for Turkish-, Moroccan- and local-born populations aged 20-69 years. Poisson regression was used to estimate the mortality rate ratios (MRRs) for cross-country and within-country comparisons. The analyses were further stratified by age group and cause of death. RESULTS: Compared with their peers in the Netherlands, Turkish-born immigrants had higher all-cause mortality in Denmark (MRR men 1.92; 95% CI 1.74-2.13 and women 2.11; 1.80-2.47) but lower in France (men 0.64; 0.59-0.69 and women 0.58; 0.51-0.67). A similar pattern emerged for Moroccan-born immigrants. The relative differences between immigrants and the local-born population were also largest in Denmark and lowest in France (e.g., Turkish-born men MRR 1.52; 95% CI 1.38-1.67 and 0.62; 0.58-0.66, respectively). These patterns were consistent across all age groups, and more marked for cardiovascular diseases. CONCLUSIONS: Although confounders and data comparability issues (e.g., French cross-sectional data) may affect the findings, this study suggests that different macro-level policy contexts may influence immigrants' mortality. Comparable mortality registration systems across Europe along with detailed socio-demographic information on immigrants may help to better assess this association.

Effect of Mobile Phone Radiofrequency Electromagnetic Fields on.

Since cell phones emit radiofrequency electromagnetic fields (EMFs), this study tested the hypothesis that cell phones placed near the heart may interfere with the electrical rhythm of the heart or affect the blood pressure. Following informed consent, eighteen randomly selected apparently healthy male volunteers aged 21.44 ± 0.53 years had their blood pressure, pulse rates and ECG measured before and after acute exposure to a cell phone. The ECG parameters obtained were: heart rate (HR), QRS complex duration (QRS), PR interval (PR) and Corrected QT interval (QTc). Results are presented as mean ± SEM. Statistical analyses were done using two-tailed paired t test for blood pressure and pulse rate data and one way ANOVA with a post hoc Tukey test for the ECG data. P<0.05 was considered statistically significant. The blood pressure and pulse rates before and after exposure to the cell phone showed no significant difference. The ECG parameters (HR: beats/min, QRS:ms, PR:ms and QTc respectively) did not differ before (66.33 ± 2.50, 91.78 ± 1.36, 151.67 ± 5.39 and 395.44 ± 4.96), during (66.33 ± 2.40, 91.11 ± 1.61, 153.67 ± 5.06 and 394.33 ± 4.05) and after calls (67.22 ± 2.77, 91.11 ± 1.67, 157.44 ± 4.46 and 396.56 ± 4.93) compared to baseline (67.17 ± 2.19, 94.33 ± 1.57, 150.56 ± 4.93 and 399.56 ± 3.88). These results suggest that acute exposure to EMFs from cell phones placed near the heart may not interfere with the electrical activity of the heart or blood pressure in healthy individuals.