Public attitudes towards sexual behavior-Results of the German Health and Sexuality Survey (GeSiD).

Population-level data on predictors for attitudes towards sexual behavior are missing for Germany. The current study investigated sexual attitudes in the German population with regard to sociodemographic and sociocultural factors. Data originated from the German Health and Sexuality Survey (GeSiD; N = 4,955) carried out from October 2018 to September 2019. Computer-assisted face to face interviews were conducted with a large self-administered component due to the sensitive topics of the survey. Public acceptance towards several aspects of sexual behavior (extramarital sex, abortion, same sex sexual activities, sex work, promiscuity, sex without love) was investigated. Age, gender, education, religious aspects and migration background were introduced as predictors into logistic regression analyses. Overall, respondents rather rejected promiscuity (61%) and extramarital sex (81%) and rather supported same sex sexual activities (63-70%). Male respondents more likely rejected same sex sexual activities and abortion. Higher education was associated with more acceptance towards the sexual behaviors whereas first generation migrants, Muslim faith and religious devoutness were associated with less acceptance. Results indicate that gender is relevant in terms of sexual attitudes with male respondents tending to have more traditional and heteronormative gender role values. Furthermore, education, culture and religion play an important role concerning the liberality towards sexual behaviors. Acculturation processes of second generation migrants may lead to an adaptation of values. Comprehensive and culturally sensitive sex education may focus on differences concerning sexuality-related norms and values.

Pre-Ramadan diabetes risk stratification and patient education.

The fast (Sawm) is one of the religious obligations "Pillars" of Islam. The target audience of pre-Ramadan diabetes risk stratification and pre-education are the healthcare providers (particularly the Primary care physicians), diabetic patients and community members including general public. As per IDF-DAR (International Diabetes Federation & Diabetes and Ramadan International Alliance) guideline, it is advisable that healthcare providers should arrange pre-Ramadan session (appointment) at least 6-8 weeks prior to Ramadan quantify/stratify the patient risk category and educate all the diabetic patients on Ramadan aspects of Diabetes Mellitus. Diabetic patients are classified in to three risk groups (very high risk, moderate risk and low risk) based on specific patient characteristics. The physician should estimate the effect of fast on the patient, whether he will be able to fast or not, and the patient will estimate his ability and endurance to fast. The mode of Pre-Ramadan diabetes patient education could be group sessions or one to one consultation. Patient education should include information on risks, glucose monitoring, nutrition, exercise and medication adjustment. Studies have shown that pre-Ramadan counseling reduces the incidence of hypoglycaemia. Altering the drug dosage, dietary counseling and patient education, together with regular blood glucose monitoring enables the patients to fast without major complications. Patients classified as very high/high risk including T1DM and pregnant women with diabetes need close medical supervision and focused Ramadan-specific education if they insist on fasting. With the correct advice and support from healthcare providers most people with T2DM can fast safely during Ramadan.

The Role of Religious Culture in Medical Professionalism in a Muslim Arab Society.

Purpose: Calls have been made to integrate concepts and practices derived from Muslim culture into medical professionalism in Muslim societies. Little is known about how these religious cultural concepts (RCCs) influence medical practice and education. This study explored the influence of RCCs on medical professionalism in Saudi Arabia. Methods: This was a qualitative study that implemented a constructivist, grounded theory approach. Semi-structured interviews about RCCs and medical professionalism were conducted with 15 Saudi physicians at a single academic medical center. Purposive sampling was used to recruit participants of different genders, generations, and specialties. Data collection and analysis were iterative. A theoretical framework was formulated. Results: Key findings: (i) the role of RCCs in medical professionalism is perceived to be constantly evolving due to the evolution of societal interpretations of RCCs; (ii) participants described applying two standards to judge what is professional: a medical standard and a religious cultural standard. Participants shifted between these two standards variably and non-linearly. This variable shifting altered the values shaping medical professionalism, at times unpredictably. Discussion: Academic Saudi physicians argued against assuming a stable traditional interpretation of RCCs, emphasized the evolving contribution of RCCs to medical professionalism, and indicated that the process of merging religious cultural and medical standards in medical practice is variable and may alter medical practice values. Therefore, these physicians perceived RCCs to be useful as supplements to but not as a backbone for medical professionalism. Careful consideration of the potential impact of RCCs on the values of medical professionalism is warranted.

Vaccine hesitancy within the Muslim community: Islamic faith and public health perspectives.

Vaccine hesitancy is a growing public health concern that has fueled the resurgence of vaccine-preventable diseases in several Muslim-majority countries. Although multiple factors are associated with vaccine hesitancy, certain religious deliberations are significant in determining individuals' vaccine-related decisions and attitudes. In this review article, we summarize the literature on religious factors linked to vaccine hesitancy among Muslims, thoroughly discuss the Islamic law (sharia) viewpoint on vaccination and offer recommendations to address vaccine hesitancy in Muslim communities. Halal content/labeling and the influence of religious leaders were identified as major determinants of vaccination choices among Muslims. The core concepts of sharia, such as "preservation of life," "necessities permit prohibitions," and "empowering social responsibility for the greater public benefit" promote vaccination. Engaging religious leaders in immunization programs is crucial to enhance the uptake of vaccines among Muslims.

Adolescent girls in aquaculture ecozones at risk of nutrient deficiency in Bangladesh development and validation of an integrated metric.

BACKGROUND: This study developed and validated an integrated metric that enhances understanding of linkages between agro-ecological and socio-economic factors that are important for explaining nutritional wellbeing in relation to fish consumption; especially among adolescent girls who are at risk of nutritional deficiency in Bangladesh. Currently, there is no metric that takes account of environmental, cultural and economic contexts when considering fish consumption and dietary health from a policy perspective. METHODS: The study was designed as a bi-seasonal survey, repeated in the same population of adolescent girls recruited during the dry and wet seasons. Sampling was stratified by five settings (four aqua-agroecological zones and one processing plant community), with 60 girls recruited in each. Associations between candidate predictors (salinity, diet diversity, religion, socio-economic status and women's autonomy score) and dependent variables representing nutritional outcomes (anthropometry, omega-3 index and micronutrient levels) were explored in multivariable regressions. The fitted model with its predictors was validated, and a risk score derived from responses to a few short questions on religion, salinity zone, female autonomy, diet diversity and tilapia consumption. RESULTS: The omega-3 index showed the clearest distinction between seasons, by salinity and religion. Higher female autonomy, religion (being Hindu rather than Muslim), geographical location (living in a high or mid-saline area), and a higher dietary diversity were the strongest predictors of whole blood omega-3 index. The c-index for the prognostic model was 0.83 and 0.76 in the wet and dry season respectively, indicating good predictive accuracy. There appeared to be a clear trend in risk scores differentiating between those 'chronically at risk' and those 'never at risk'. CONCLUSIONS: Observational data on different aquaculture-ecozones defined by salinity enabled us to establish linkages between seasonal fish intake, religion, diet diversity, female autonomy and nutritional wellbeing. The purpose of the metric is to reveal these specific linkages in practice. This tool should improve targeting of timely, preventative and cost-effective nutritional interventions to adolescent girls most at-risk from low omega-3 levels in communities where seafood is produced.

Palestinian law to protect family and prevent violence: challenges with public opinion.

The Palestinian Family Protection Law was submitted for ratification in November 2020 after much collaboration between advocates, attorneys and governmental officials, as well as community and international organizations. The draft bill addresses a myriad of social issues affecting vulnerable populations in the West Bank of Palestine, including: the legal age for marriage; gender inequality in inheritance; divorce; gender-based violence; and domestic violence. However, immediate feedback from local religious scholars, with increasing pressure from the general Palestinian population, was deeply divided, with negative perceptions relating to the perceived 'foreign' nature of the regulations and criticism that the law was not in accordance with Palestinian culture and Islamic Law. This criticism led to two years of inactivity regarding the bill. The current study sought to evaluate the attitudes, behavior and beliefs regarding the underlying human rights issues and assumptions concerning gender, marriage, and domestic violence that could be found in the codices of the proposed legislation as well as among the general population of Palestine. The data demonstrates that the population sampled viewed the underlying premise of the Family Protection Bill negatively. Individuals with a graduate degree or above tended to view the bill with less negativity, whilst females viewed the bill more positively than males. The results of this study illustrate that, with regard to legislation that relates to family life in Palestine, there is a wide gap between the points of view held by human rights advocates and NGO's and those held by the general population. To further the agenda of family protection community education relating to social issues, the fundamentals of Sharia law and national sovereignty may be needed so as to clarify the core Islamic beliefs in relation to human rights and oppression, as well as to increase Palestinian ownership of the family protection agenda.

Diabetes, Ramadan, and driving - Ensuring patient safety while respecting religious autonomy: A qualitative study.

BACKGROUND AND AIMS: Hypoglycaemia due to fasting during Ramadan may affect the ability to perform complex activities among people with type 2 diabetes mellitus (T2D), but it is unclear how this affects one's ability to drive. This study aims to explore driving experiences and coping strategies to ensure safe driving among people with T2D who fast during Ramadan. METHODS: We conducted an exploratory qualitative study and purposefully selected people with T2D who drove and fasted during the past Ramadan period in 2019. In-depth face-to-face interviews were conducted and transcribed verbatim. Data were analysed thematically using a constant comparative method until saturation was achieved (n = 16). RESULTS: Two major themes were identified, namely: (1) knowing oneself and (2) voluntary self-restriction. Participants described the importance of understanding how Ramadan fasting affected them and their level of alertness. As such, participants often adjusted their daily activities and tested their blood glucose levels to prevent experiencing hypoglycaemia. Other coping strategies reported include adjusting their medications and driving restrictions or driving in the mornings when they were more alert. Findings from this study shed light on participants' experiences and coping mechanisms while driving during Ramadan. CONCLUSION: Given the risks and effects of hypoglycaemia among those who fast, there is a need to provide appropriate and focused patient education during Ramadan to people with T2D to ensure they can perform complex activities such as driving safely, especially in Muslim majority countries.

The fate of health professions education as a profession: a road less travelled.

OBJECTIVE: To explore the views of academics about the identity of Health Professions Education as a discipline, its fate and sustainability as a profession. METHODS: The qualitative exploratory study was conducted from February to July 2021 after approval from the ethics review committee of Islamic International Medical College, Riphah International University, Rawalpindi, Pakistan, and comprised both fulltime and part-time health professions educationists of either gender teaching in different institutions of seven cities of Pakistan; Taxila, Kamrah, Rawalpindi, Peshawar, Lahore, Multan and Karachi. Using Professional Identity theory, data was collected through semi-structured one-on-one interviews which were conducted online. The interviews were transcribed verbatim, coded and thematically analysed. RESULTS: Of the 14 participants, 7(50%) had qualifications and experience of other specialities as well, while 7(50%) were pure health professions educationists. Overall, 5(35%) subjects were from Rawalpindi, 3(21%) were serving in multiple cities including Peshawer, 2(14%) were from Taxilla and 1(7.5%) each was from Lahore, Karachi, Kamrah and Multan. Accumulated data led to 31 codes with 3 themes and 15 sub-themes. The main themes were identity of health professions education as a discipline, its fate and sustainability. CONCLUSIONS: Health professions education has established its identity as a discipline in Pakistan, with independent, fully functioning departments in medical and dental colleges across the country.

Barriers and facilitators to accessing inpatient and community substance use treatment and harm reduction services for people who use drugs in the Muslim communities: A systematic narrative review of studies on the experiences of people who receive services and service providers.

BACKGROUND: The prevalence of drug use in Muslim communities is difficult to estimate due to religious, social, and cultural prohibition toward drug use. With Islam affecting all aspects of life in the Muslim world, people who use drugs do it clandestinely to avoid stigma and exclusion from the community, leading to a low number of them seeking treatment for their drug use. This review explored the barriers and facilitators to accessing inpatient and community substance use treatment and harm reduction services for people who use drugs in Muslim communities. METHODS: This review was in accordance with PRISMA. Seven databases were systematically searched for qualitative, quantitative, and mixed methods studies conducted in countries where at least 70% of the population were Muslim or where data were presented separately for Muslim communities in other countries. Eligible articles were reviewed, and key qualitative themes were abstracted and compared across studies and settings. RESULTS: Twenty-four studies were included from Iran, Bangladesh, Afghanistan, Tajikistan, Kazakhstan, Kyrgyzstan, Egypt, Lebanon, and UAE. Two themes were identified: a psychosocial theme included denial of the problem severity, lack of trust in the treatment system, fear of breach in confidentiality and privacy, the need for community support, religion and women who use drugs. Additionally, an organizational theme included affordability, treatment Service characteristics, lack of Awareness, service providers' Attitudes, drug use registration and fear of legal consequences of drug use. Stigma was also identified as an over-arching theme. The Mixed Methods Appraisal Tool (MMAT) was used to assess the quality of the included studies with where 12 of the studies met all 5 the quality criteria. No studies were excluded for having lower quality scores. CONCLUSION: This review reflected how diverse the Muslim world is in drug use. It is important to use mosques to raise awareness on people who use drugs and reduce stigma. Providing holistic services for people who use drugs specially women will improve their access to treatment and harm reduction services in the Muslim world.

Ramadan during pregnancy and neonatal health-Fasting, dietary composition and sleep patterns.

BACKGROUND AND OBJECTIVES: Large shares of pregnant Muslims worldwide observe the Ramadan fast. Previous research showed that Ramadan during pregnancy is associated with adverse offspring health outcomes lasting throughout the life-course. Evidence on effects on birth outcomes is inconclusive, however, and previous research did not consider the role of dietary composition and sleep patterns during Ramadan. This study systematically documents maternal lifestyle during Ramadan and assesses if diet and sleep adaptations to Ramadan, independent of and in addition to maternal fasting, are associated with neonatal health outcomes. METHODS: This study reports a survey of 326 Muslims who delivered their baby in Mainz, Germany, linked to maternal & infant hospital records. Participants reported on fasting, dietary composition and sleep schedules while pregnant during Ramadan. RESULTS: Fasting during pregnancy was associated with reduced birthweight, in particular for fasting during the first trimester (-352ˑ92g, 95% CI: -537ˑ38; -168ˑ46). Neither dietary composition nor altered sleep were directly associated with birthweight. However, dietary composition during Ramadan outside of fasting hours seems to moderate the fasting-birthweight association, which disappeared for women switching to high-fat diets. CONCLUSIONS: The finding that dietary intake during Ramadan potentially moderates the fasting-birthweight association is of high relevance to pregnant Muslims who wish to fast and their healthcare professionals, since dietary choices outside of fasting hours are often relatively easily modifiable. This is the first study to include information on maternal diet and sleep during Ramadan, and additional research is needed to assess the roles of specific (macro)nutrients and food groups.

Self-flagellation: An Unaddressed Risk Factor of Hepatitis B and C Transmission among Shiite Muslims.

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Influence of Religious Affiliations on Attitudes Toward Homosexuality Among Physicians: A Cross-Sectional Study From India.

Objective: To examine the attitudes among practicing physicians of various specialties toward homosexuality and its association with participants' religious affiliations in India.Methods: A cross-sectional descriptive study was conducted among physicians about their attitudes toward homosexuality between December 2018 and January 2019. Participants completed a survey anonymously in hardcopy form or online. The survey was developed based on the Attitude Toward Homosexuality Scale for Indians (AHSI). A higher AHSI score indicates less homonegativity. It was modified by adding demographic details, career status, and personal experience with homosexual individuals.Results: The study results showed that among 106 respondents, 81 were men with a mean (SD) age of 32.2 (7.3) years. Of the participants, 40 (37.7%) were MBBS graduates with no specialization, while 34 (32.1%) and 32 (30.2%) respondents were from medical and surgical specialties, respectively. The majority of the respondents were Muslim (43.4%), followed by Hindu (35.8%), Christian (10.4%), those not conforming to any religion (5.7%), and other religions (4.7%). The mean ± SD total score on the AHSI was 69.6 ± 17.7, which was higher than the mean neutral score of 60. The AHSI total score was significantly higher among women (P < .001). The total AHSI score was highest among the no religion category followed by Hindus, with the lowest for biblical religions; the difference was statistically significant (P < .001). No significant difference was seen between Muslims and Christians.Conclusions: This study showed an overall positive attitude among the respondents toward homosexuality; however, those belonging to Abrahamic religions, especially Muslims, had more negative attitudes. The results highlight the need for antistigma campaigns and educational interventions targeting the physician population of India to reduce negative attitudes toward homosexuality and improve their knowledge of this topic.

Religious disparities in health in Bangladesh-the case of hypertension and diabetes: evidence from two nationally representative cross-sectional surveys.

OBJECTIVES: Religious affiliation, beliefs, and practices shape lifestyles and disease risks. This study examined Hindu-Muslim differences in the prevalence and management of hypertension and diabetes in Bangladesh, a religiously plural country with 91% Muslims and 8% Hindus. DESIGN, SETTINGS AND PARTICIPANTS: We used the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS) and 2017-2018 BDHS data. The 2011 BDHS collected blood pressure (BP) data with an 89% response rate (RR) and fasting blood glucose (FBG) data (RR 85%) from household members aged 35 years and above. The 2017-2018 BDHS collected BP and FBG data from household members aged 18 years and above with 89% and 84% RRs, respectively. We analysed 6628 participants for hypertension and 6370 participants for diabetes from the 2011 BDHS, 11 449 for hypertension and 10 744 for diabetes from the 2017-2018 BDHS. METHODS: We followed the WHO guidelines to define hypertension and diabetes. We used descriptive statistics and multiple logistic regression to examine the Hindu-Muslim differences in hypertension and diabetes, and estimated predicted probabilities to examine the changes in hypertension and diabetes risk over time. RESULTS: Nine in 10 of the sample were Muslims. About 31% of Hindus and 24% of Muslims were hypertensive; 10% of both Hindus and Muslims were diabetic in 2017-2018. The odds of being hypertensive were 45% higher among Hindus than Muslims (adjusted OR: 1.45; 95% CI: 1.23 to 1.71; p<0.001). The levels of awareness, medication and control of hypertension were similar between the religious groups. Between the 2011 and 2017-2018 BDHS, the Hindu-Muslim difference in the prevalence of hypertension increased non-significantly, by 3 percentage points. CONCLUSIONS: Further studies on religious-based lifestyles, Hindu-Muslim differences in diet, physical activity, stress, and other risk factors of hypertension and diabetes are needed to understand Hindus' higher likelihood of being hypertensive, in contrast, not diabetic compared with Muslims.

Perspectives of Muslim Religious Leaders to Shape an Educational Intervention About Family Planning in Rural Tanzania: A Qualitative Study.

INTRODUCTION: Uptake of effective contraceptive methods can be hindered by poor understanding and uncertainty about its compatibility with religious beliefs. We sought to understand the perspectives of Muslim religious leaders in rural Tanzania on family planning (FP) and acceptable strategies for providing FP education to leaders and their communities. METHODS: We conducted in-depth interviews with Muslim leaders from 4 communities in northwest Tanzania. Open-ended questions explored leaders' views on FP in relation to their communities, Muslim texts and teaching, and their experience as leaders. We also investigated how FP education could be provided in their communities and asked practical questions regarding seminar implementation. Interviews were conducted in Kiswahili and transcribed and translated into English. Data were coded independently by 2 investigators using NVivo 1.5.1 and analyzed thematically. RESULTS: We interviewed 17 male and 15 female Muslim leaders. All leaders supported FP as a concept in which births are spaced, interpreting this as espoused by the Qur'an and a basic right of children raised in Islam. Leaders uniformly endorsed the use of breastfeeding and the calendar method to space births but had divergent and sometimes opposing views on other methods, including condom use, oral contraceptives, and intrauterine devices. All leaders acknowledged the need for FP education among their congregants and were in favor of helping to teach an FP seminar in their communities. CONCLUSION: Our data reveal insights into how education for Muslim leaders may equip them to promote birth spacing and enhance understanding of FP in their communities in ways that are concordant with Islamic teaching. Our findings will guide the design and pilot-testing of an educational intervention for Muslim religious leaders to promote knowledge and uptake of FP in rural Tanzania.

Knowledge, attitudes and practices with regard to prophetic medicine during the COVID-19 pandemic in Saudi Arabia.

OBJECTIVE: The current study explores the impact of Prophetic medicine's knowledge, attitudes, and practices on the Saudi population during the COVID-19 pandemic. SUBJECTS AND METHODS: This study used a web-based cross-sectional design. A self-selected nonprobability sampling technique was utilized to recruit social media users in Saudi Arabia aged ≥18. RESULTS: Four statements were used to evaluate participants' knowledge of the role of prophetic medicine in preventing and treating COVID-19. The participants had significant levels of knowledge, with an average of 90.3% correct answers. They strongly agreed with prophetic advice, including quarantine, travel bans and hand washing to prevent COVID-19 infection, with a mean of 4.3. In addition, the participants followed prophetic advice, including walking for half an hour, keeping social distance, wearing masks, and taking vaccines to prevent COVID-19 infection, with a mean of 4.2. CONCLUSIONS: The current study was conducted to evaluate the knowledge, attitudes, and practices of Muslim residents of Saudi Arabia concerning prophetic medicine during the COVID-19 pandemic. The study revealed that participants had good knowledge of prophetic medicine, including the use of natural products such as honey, ginger, garlic, and olive oil, as well as herbal products such as black seeds, and practices such as cupping. The study also showed that participants strongly believed that COVID-19 preventative measures - including quarantine, travel bans, and handwashing - were introduced by prophetic medicine. Practices including self-isolation, hand washing, and travel bans help prevent, treat and control diseases. They assist in maintaining good health and developing resistance to diseases.

Real-world safety and effectiveness of iGlarLixi in people with type 2 diabetes who fast during Ramadan: The SoliRam observational study.

BACKGROUND AND AIMS: To evaluate the safety and effectiveness of iGlarLixi in adults with type 2 diabetes (T2D) fasting during Ramadan. METHODS: SoliRam was a multinational, prospective, single-arm, real-world observational study conducted during Ramadan 2020 and 2021 in adults with T2D treated with iGlarLixi ≥3 months at study entry. The primary endpoint was the percentage of participants experiencing ≥1 episode of severe and/or symptomatic documented hypoglycemia (<70 mg/dL [<3.9 mmol/L]). RESULTS: Among the 409 eligible participants followed during Ramadan, 96.8% fasted for ≥25 days and 92.4% did not break fasting during Ramadan. Four participants broke their fast due to hypoglycemia. Minimal adjustments were seen in antihyperglycemic therapies from pre to during Ramadan. Documented symptomatic hypoglycemia was experienced by 1.0%, 2.3%, and 0.3% of participants, respectively, during the last month of pre-Ramadan, Ramadan, and first month post-Ramadan. Mean change in HbA1c from pre-to post-Ramadan periods was -0.75% (-8.2 mmol/mol), and participants with HbA1c <7% (<53 mmol/mol) increased from 7.9% pre-Ramadan to 28.6% post-Ramadan. CONCLUSIONS: iGlarLixi is an effective and well-tolerated therapy for people with T2D, including those who intend to fast during Ramadan, and is associated with a low risk of hypoglycemia; benefits were observed both during and after Ramadan.

Clinical Applications of the History of Medicine in Muslim-Majority Nations.

Since the early twentieth century, a number of physicians and professional historians have argued for the integration of the history of medicine into both medical education and clinical practice. After the supplanting of the humoral model of medicine in favor of the germ theory of disease in the late nineteenth century, medical school administrators have repeatedly asked medical historians for their rationale for studying "outdated science" in medical training programs beyond antiquarianism and knowledge for knowledge's sake. However, a number of arguments can be adduced for the use and relevance of the history of medicine, including the observations that history: 1) provides examples of inspiring or highly ethical individuals who can serve as role models in practitioner identity formation; 2) helps to develop critical analytical skills and other modes of humanistic thought and behavior directly relevant to patient care (e.g., empathy); 3) promotes culturally-competent care, since history informs culture; 4) encourages inquiry into the sociocultural factors that affect the development of modern medical ecosystems; 5) provides a philosophical tradition for critiquing ethics in the medical profession. This contribution specifically traces the potential uses of Islamic medical history in the clinic and medical schools in Muslim-majority countries, primarily in the Middle East.

Nutritional status and its associated factors among under five years Muslim children of Kapilvastu district, Nepal.

BACKGROUND: Malnutrition is a major public health problem throughout the world especially in Southeast Asia. This study aims to find out nutritional status and its associated factors among under five Muslim children of Kapilvastu district Nepal. METHODS: Community based cross-sectional study was conducted among 336 under five Muslim children in Kapilvastu district Nepal from December 2021 to May 2022. Multistage probability random sampling was used. Among ten local units, three were selected randomly. Then from selected three units, two wards from each unit which covers large proportion of Muslim were selected purposively. After selecting wards, listing of household having children 6 to 59 months was done with the help of Female Community Health Volunteers and 56 children were selected by simple random sampling from each wards. RESULTS: About half of Muslim children were underweight, 0.9% were overweight, 17.3% were wasted and 63.1% were stunted. Children with >4 members in family (AOR = 2.82, CI: 1.25-6.38), joint/extended family (AOR = 0.33, CI: 0.16-0.68), living with other than parents (AOR = 2.68, CI: 1.38-5.21), mother having primary (AOR = 2.59, CI: 1.09-6.10) and fathers having SLC and above education (AOR = 0.41, CI: 0.19-0.89), school going children (AOR = 0.27, CI: 0.15-0.48), no having agricultural land (AOR = 2.68, CI: 1.55-4.65), history of chronic diseases (AOR = 3.01, CI = 1.06-8.54) were significantly associated with underweight. Mothers having secondary (AOR = 0.30, CI: 0.10-0.88) and fathers having primary education (AOR = 3.50, CI: 1.26-9.74), school going children (AOR = 0.16, CI: 0.06-0.41), no having own land (AOR = 4.73, CI: 2.13-10.48), history of child chronic disease (AOR = 3.55, CI = 1.38-9.12) were significantly associated with wasting. Similarly, male children (AOR = 1.70, CI: 1.01-2.85), living in rural area (AOR = 0.17, CI: 0.09-0.31), joint/extended family (AOR = 0.28, CI: 0.13-0.64), living with other than parents (AOR = 3.71, CI: 1.84-7.49), fathers having secondary education (AOR = 0.50, CI: 0.27-0.94) and no having own land (AOR = 1.95, CI: 1.13-3.37) were significantly associated with stunting. CONCLUSIONS: Underweight, wasting and stunting in under-five Muslim children were above the cutoff point from the significant level of public health and higher than national data. Hence, this study suggests collaborative and immediate attention from responsible governmental and non-governmental organizations working in nutrition for providing informal learning opportunity, intervention regarding parental support to child, school enrolment at appropriate age, prevention and treatment of children's chronic diseases, intervention for income generating activities and addressing problems of household food insecurity among Muslim communities.

Perspectives of Indonesian Muslim patients with advanced lung cancer on good death: A qualitative study.

PURPOSE: Lung cancer is the leading cause of cancer-related death. Patients with advanced lung cancer may experience burdensome distress at the end of life. The concept of good death has been shown to be complex, and continues to be expanded by gaining a better understanding of the cultural views of different populations. This study aimed to explore the perspective of Indonesian Muslims patients with advanced cancer on the concept of good death. METHOD: A qualitative design comprising in-depth interviews was employed. Seven male and 3 female Muslim patients between ages 36 and 68 and diagnosed with advanced lung cancer were recruited from a teaching hospital in Central Java, Indonesia. RESULTS: Content analysis of the interviews revealed five themes: dying without physical discomfort, dying in religious ways and in a desirable place, dying without emotional discomfort, receiving help and support, and having a good relationship with medical staff. CONCLUSIONS: Indonesian Muslim patient with advanced lung cancer have unique perspectives on good death, especially based on the themes of religious ways of dying and support from family. Health care providers should be aware that good death is not an individual concern and should thus adopt highly sensitive observation skills to assess the physical and emotional state of patients. These providers must also understand their patients' preferences and respect their needs, regardless of their own beliefs.