Child labor and childhood behavioral and mental health problems in Ethiopia

Background: According to ILO estimates, at least 180 million children aged 5 to 14 years are currently engaged in fulltime work in the developing countries. However, very little information exists about childhood behavioral and mental disorders in Ethiopia. Objective: The objectives of this study are to estimate the prevalence and describe the nature of behavioral and mental health problems, as well as child abuse, nutritional problems, gross physical illness and injury among child laborers aged 8 to 15 years in Ethiopia. However, only the behavioral and mental health problems of the study population are examined here. Methods: A cross-sectional survey of children aged 8 to 15 years, and who were engaged in fulltime work in different formal and informal sectors non-laborers, was conducted in four major towns of Ethiopia. The screening instrument known as Reported Questionnaire on Children (RQC) and a diagnostic instrument known as the Diagnostic Interview for Children and Adolescents ( DICA) were used to detect symptoms and signs of behavioral and mental problems in the children. br> Results: A total of 2000 child laborers and 400 non-laborers were interviewed using RQC to screen for probable cases of behavioral and mental problems. Of these, 50% of the laborers and 42% of the non-laborers were males. The mean age of the laborers was 13.8 ±1.8 years while that of the non-laborers was 12.2 ±2.1 years. More females (76.8%) were found to have been engaged in domestic labor than males. The RQC interview screened 9.4% (n=226) of the children as probable cases of mental/ behavioral disorders, (14.0% non-laborers and 8.5% laborers). The second stage DICA interview gave an overall prevalence of 5.5% (4.9% in laborers and 8.8% in non-laborers). Conclusion: The prevalence of childhood behavioral and mental disorders in this study is within the range reported in previews studies conducted on children of the same age group. However, the lower prevalence of childhood disorders in the child laborers compared to that of the non-laborers found in the current study is probably due to selection bias or healthy workers effect. Thus, further study is recommended to explain this unexpected finding. The Ethiopian Journal of Health Development Vol. 20 (2) 2006: 119-12

Beyond handover: supporting awareness for continuous coverage

Abstract Hospitals are required to operate as a continuous system because patient care cannot be temporarily suspended and handover is seen as a key method for enabling this. This paper reports a study of handover in a medical admissions unit. We draw on the notion of awareness as conceptualised within the Computer Supported Cooperative Work literature to explore the role played by a variety of cognitive artifacts in supporting continuous coverage. While such awareness is typically characterised as being ‘effortless’, our study reveals that maintaining awareness in a context such as the medical admissions unit is effortful due to invisible work. We suggest that the notion of awareness is beneficial for exploring the practices of continuous coverage because it moves attention away from the moment of handover, instead encouraging consideration of the variety of practices through which clinicians display their work to, and monitor the work of, colleagues on different shifts. We argue that efforts to support continuous coverage should focus on improving awareness by increasing the visibility of information

Effect of methylene blue on the genomic response to reperfusion injury induced by cardiac arrest and cardiopulmonary resuscitation in porcine brain

<p>Abstract</p> <p>Background</p> <p>Cerebral ischemia/reperfusion injury is a common secondary effect of cardiac arrest which is largely responsible for postresuscitative mortality. Therefore development of therapies which restore and protect the brain function after cardiac arrest is essential. Methylene blue (MB) has been experimentally proven neuroprotective in a porcine model of global ischemia-reperfusion in experimental cardiac arrest. However, no comprehensive analyses have been conducted at gene expression level.</p> <p>Methods</p> <p>Pigs underwent either untreated cardiac arrest (CA) or CA with subsequent cardiopulmonary resuscitation (CPR) accompanied with an infusion of saline or an infusion of saline with MB. Genome-wide transcriptional profiling using the Affymetrix porcine microarray was performed to 1) gain understanding of delayed neuronal death initiation in porcine brain during ischemia and after 30, 60 and 180 min following reperfusion, and 2) identify the mechanisms behind the neuroprotective effect of MB after ischemic injury (at 30, 60 and 180 min).</p> <p>Results</p> <p>Our results show that restoration of spontaneous circulation (ROSC) induces major transcriptional changes related to stress response, inflammation, apoptosis and even cytoprotection. In contrast, the untreated ischemic and anoxic insult affected only few genes mainly involved in intra-/extracellular ionic balance. Furthermore, our data show that the neuroprotective role of MB is diverse and fulfilled by regulation of the expression of soluble guanylate cyclase and biological processes accountable for inhibition of apoptosis, modulation of stress response, neurogenesis and neuroprotection.</p> <p>Conclusions</p> <p>Our results support that MB could be a valuable intervention and should be investigated as a therapeutic agent against neural damage associated with I/R injury induced by cardiac arrest.</p

Population-level risks of alcohol consumption by amount, geography, age, sex, and year: a systematic analysis for the Global Burden of Disease Study 2020

Background The health risks associated with moderate alcohol consumption continue to be debated. Small amounts of alcohol might lower the risk of some health outcomes but increase the risk of others, suggesting that the overall risk depends, in part, on background disease rates, which vary by region, age, sex, and year. Methods For this analysis, we constructed burden-weighted dose–response relative risk curves across 22 health outcomes to estimate the theoretical minimum risk exposure level (TMREL) and non-drinker equivalence (NDE), the consumption level at which the health risk is equivalent to that of a non-drinker, using disease rates from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2020 for 21 regions, including 204 countries and territories, by 5-year age group, sex, and year for individuals aged 15–95 years and older from 1990 to 2020. Based on the NDE, we quantified the population consuming harmful amounts of alcohol. Findings The burden-weighted relative risk curves for alcohol use varied by region and age. Among individuals aged 15–39 years in 2020, the TMREL varied between 0 (95% uncertainty interval 0–0) and 0·603 (0·400–1·00) standard drinks per day, and the NDE varied between 0·002 (0–0) and 1·75 (0·698–4·30) standard drinks per day. Among individuals aged 40 years and older, the burden-weighted relative risk curve was J-shaped for all regions, with a 2020 TMREL that ranged from 0·114 (0–0·403) to 1·87 (0·500–3·30) standard drinks per day and an NDE that ranged between 0·193 (0–0·900) and 6·94 (3·40–8·30) standard drinks per day. Among individuals consuming harmful amounts of alcohol in 2020, 59·1% (54·3–65·4) were aged 15–39 years and 76·9% (73·0–81·3) were male. Interpretation There is strong evidence to support recommendations on alcohol consumption varying by age and location. Stronger interventions, particularly those tailored towards younger individuals, are needed to reduce the substantial global health loss attributable to alcohol. Funding Bill & Melinda Gates Foundation

Trends of Over-the-Counter and Prescribed Medication Use During Pregnancy: A Cross-Sectional Study

Amal A Alyami,1 Manal M Alem,2 Shereen R Dorgham,3 Sahar A Alshamandy4 1Obstetrics & Gynecology Hospital, King Saud Medical City, Riyadh, Saudi Arabia; 2Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 3Department of Nursing Education, College of Nursing, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia; 4Obstetrics and Women’s Health Nursing Department, College of Nursing, Minia University, Minya, EgyptCorrespondence: Manal M Alem, Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, PO Box 1982, Dammam, 31441, Saudi Arabia, Email [email protected]: Globally, unjustified medication use during pregnancy, a critical phase in human life, is a threat that compromises the safety of both, the mother and the child. We aim to investigate the prevalence of over-the-counter (OTC) or non-prescription and prescription medication use during pregnancy in women from the city of Riyadh, Saudi Arabia, the level of prior knowledge, and the sources of their information about medication hazard/safety.Methods: A cross-sectional study was performed using a self-administered questionnaire for 287 pregnant women visiting King Saud Medical City (KSMC) – outpatient departments for routine antenatal care during 3 months (1st Mar– 31st May 2021). The questionnaire was developed by Navaro et al with 4 sections: socio-demographic data, medication use during pregnancy, level of knowledge, and relevant sources of information.Results: The participants had a mean age of 32.21 years ± 6.41 (SD), and gestational age of 23.67 weeks ± 8.47. About 76.66% of them reported using medication during their current pregnancy: predominantly prescribed (86.36%). Women who used medication during pregnancy were slightly older; the mean difference was 1.97 years (95% CI 0.23– 3.71) (P=0.027). Women living in an urban environment as compared with rural had a higher prevalence of medication use (79.01% vs 52%) (P=0.002). Overall, 58.19% reported using non-prescribed medications during pregnancy, with analgesics as the most frequently used class (70.30%). The mild nature of the illnesses and availability of an old prescription and information from pharmacists were the main reasons for self-medication. About 40.77% denied receiving any information about medication use during pregnancy.Conclusion: The prevalence of the medication use during pregnancy in our population is alarmingly high. Analgesics were the most frequently used. Lack of adequate information from treating physicians appears to be contributory to self-medication during this critical time.Keywords: nursing, antenatal care, pregnancy care, prescription medication, non-prescription medications, over-the-counter, fetal health and development, self-medicatio

Access and Disparities in the Use of Telemedicine Among Patients with Chronic Conditions in Saudi Arabia: A Cross-Sectional Study

Ziyad S Almalki,1 Mohammad T Imam,1 Nada F Abou Chahin,2 Naheda S ALSammak,2 Shahad M Entabli,2 Shatha K Alhammad,2 Ghuyudh F Alanazi,2 Rama A Kharsa,2 Layla A Alonazi,2 Rasha A Mandil,2 Ahmed A Albassam,1 Ahmed M Alshehri,1 Abdullah K Alahmari,1 Ghada M Alem,1 Abdullah A Alalwan,1 Ahmad Alamer1 1Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia; 2Collage of Pharmacy, Almaarefa University, Riyadh, Saudi ArabiaCorrespondence: Ziyad S Almalki, Department of Clinical Pharmacy, College of Pharmacy, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia, Tel +966 11 588 7315, Email [email protected]: This study investigated the access to and disparities in telemedicine use among patients with chronic conditions in Riyadh, Saudi Arabia.Patients and Methods: A cross-sectional study of randomly selected primary healthcare centers was conducted to ensure that each of the 17 municipalities in Riyadh were represented. Three hundred and forty-two participants who completed the questionnaire were interviewed using a standardized questionnaire. The relationship between demographic and socioeconomic factors and telemedicine utilization was evaluated using the chi-square test and multivariable mixed-effects logistic regression model.Results: Among the 342 participants, the study revealed that 25.73% of the patients utilized telemedicine. Older participants had lower odds of telemedicine use than did those aged ≤ 30 years [adjusted odds ratio (AOR) = 0.112, 95% confidence interval (CI) = 0.045– 0.279 for 50– 59 years; AOR = 0.19, 95% CI = 0.076– 0.474 for 60– 69 years; AOR = 0.223, 95% CI = 0.092– 0.542 for ≥ 70 years]. Female sex (AOR = 2.519, 95% CI = 1.44– 4.408), having a higher education level (AOR = 3.434, 95% CI = 1.037– 7.041 for secondary education and AOR = 5.87, 95% CI = 2.761– 8.235 for higher education), and living in urban areas (AOR = 2.721, 95% CI = 1.184– 6.256) were associated with higher odds of telemedicine use. Among socioeconomic factors, employed participants had higher odds of telemedicine use (AOR = 4.336, 95% CI = 2.3– 8.174). Furthermore, compared to those with the highest socioeconomic status (SES) index, those with the lowest SES were less likely to use telemedicine than those with the highest SES index (AOR = 0.193, 95% CI = 0.055– 0.683 for the lower bottom (poorest).Conclusion: This study highlights a significant disparity in the utilization of telemedicine services across different populations, primarily due to demographic and socioeconomic factors.Keywords: healthcare system, socioeconomic, digital health, inequitie