Vulnerable diseases affecting child mortality in Sierra Leone: emerging health issue

Child mortality in Sierra Leone is the highest ranked in the world. The main causes for child mortality are maternal factors, environmental factors and health factors. Minimal research has been carried out on health factors in Sierra Leone. The objective of this study is to see how maternal and environmental factors have an effect on health factors, which in turn cause child mortality. The data used were from the 2008 Sierra Leone Demographic and Household Survey (SLDHS). The study showed that child mortality had statistically significant factors associated with it: place of residence, birth number, religion and type of toilet facility. Furthermore, the SLDHS had not given much information regarding the cause of diseases affecting children, so we looked only at the effects they had on children. Acute respiratory infections, diarrhoea and measles each had one variable that was statistically significant. As for pneumonia, there were no variables associated with children contracting the disease

African emergency nursing curriculum: : Development of a curriculum model

© 2016 The Authors. Published by Elsevier Ltd. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/The African Emergency Nursing Curriculum (AENC) provides a consensus document to guide the development of harmonised standards of emergency nursing theory and practice across Africa for the benefit of the emergency patient population. The need to strengthen emergency care systems to address the global burden of disease is increasingly recognised (Wolf et al., 2012). Most low-income countries lack organised emergency care systems and therefore suffer the highest rates of injury, from primary health burdens such as maternal death due to complications of pregnancy, and acute medical complications of communicable diseases involving tuberculosis, malaria and human immunodeficiency virus (HIV) (Reynolds et al., 2014). Conditions requiring surgical intervention inevitably add to this growing challenge to emergency care systems. Annually, worldwide injuries contribute to a leading public health concern. One hundred million people sustain injuries; 5 million people die from violence and injury; and 90% of the global burden of violence and injury mortality occurs in low-middle income countries (World Health Organization, 2007). It is predicted that by 2030 road accidents will be the fifth leading cause of death in the developing world, with violent crime and conflict contributing significantly to this public health emergency (Institute for Health Metrics and Evaluation, 2010). This critically important prediction requires pre-hospital, emergency/trauma and rehabilitation services to be implemented and/or strengthened as soon as possible. This paper outlines the development of the AENC as part of a strategic action plan of the African Federation of Emergency Medicine (AFEM) Consensus Meeting held in Cape Town in November 2013 (Reynolds et al., 2014) to address the increasing African emergency care burden and other disease burdens addressed in the World Health Organization Millennium Development Goals (World Health Organization, 2015).Peer reviewedFinal Published versio

An overview of the Global Burden of Disease Study 2016 Results

This report explores the progress Portugal has experienced over the last 26 years, in terms of health, well-being, and development, and the new challenges it faces as its population grows and ages. This report provides information about the diseases and injuries that prevent Portuguese from living long and healthy lives. It also sheds light on risk factors that contribute to poor health. Finally, the report presents a country view with regard to the Sustainable Development Goals in 1990 and prospectively in 2030, and compares Portugal’s health performance to that of peer countries.info:eu-repo/semantics/publishedVersio

Household food insecurity in Mexico is associated with the coâ occurrence of overweight and anemia among women of reproductive age, but not female adolescents

We aimed to determine the association between household food insecurity (HFI) and the coâ occurrence of overweight and anemia among women of reproductive age in the Mexican population. We analyzed data on 4,039 nonpregnant female adolescents (15â 19 years) and 10,760 nonpregnant adult women of reproductive age (20â 49 years) from the 2012 National Health and Nutrition Survey of Mexico. The survey uses a twoâ stage sampling design, stratified by rural and urban regions. The Latin American and Caribbean Food Security Scale was used to assess HFI. We assessed overweight and obesity in women based on World Health Organization classifications for body mass index, and BMIâ forâ age Zâ scores for female adolescents, and defined anemia as an altitudeâ adjusted hemoglobin (Hb) concentration < 120 g/L based on measurement of capillary Hb concentrations. In multiple logistic regression models adjusting for potential confounding covariates, HFI was not associated with the coâ occurrence of anemia and overweight among female adolescents. The adjusted odds of women of reproductive age from mildly and moderately foodâ insecure households, respectively, experiencing concurrent anemia and overweight were 48% (OR: 1.48; 95% CI: 1.15, 1.91) and 49% (OR: 1.49; 95% CI: 1.08, 2.06) higher than among women from foodâ secure households. Severe HFI was not associated with concurrent overweight and anemia among female adolescents or women. HFI may be a shared mechanism for dual forms of malnutrition within the same individual, simultaneously contributing to overconsumption and dietary inadequacy.Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138908/1/mcn12396_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138908/2/mcn12396.pd

What proportion of patients with chronic noncancer pain are prescribed an opioid medicine? Systematic review and meta-regression of observational studies

Guidelines now discourage opioid analgesics for chronic noncancer pain because the benefits frequently do not outweigh the harms. We aimed to determine the proportion of patients with chronic noncancer pain who are prescribed an opioid, the types prescribed and factors associated with prescribing. Database searches were conducted from inception to 29 October 2018 without language restrictions. We included observational studies of adults with chronic noncancer pain measuring opioid prescribing. Opioids were categorized as weak (e.g. codeine) or strong (e.g. oxycodone). Study quality was assessed using a risk of bias tool designed for observational studies measuring prevalence. Individual study results were pooled using a random‐effects model. Meta‐regression investigated study‐level factors associated with prescribing (e.g. sampling year, geographic region as per World Health Organization). The overall evidence quality was assessed using Grading of Recommendations Assessment, Development and Evaluation criteria. Of the 42 studies (5,059,098 participants) identified, the majority (n = 28) were from the United States of America. Eleven studies were at low risk of bias. The pooled estimate of the proportion of patients with chronic noncancer pain prescribed opioids was 30.7% (95% CI 28.7% to 32.7%, n = 42 studies, moderate‐quality evidence). Strong opioids were more frequently prescribed than weak (18.4% (95% CI 16.0–21.0%, n = 15 studies, low‐quality evidence), versus 8.5% (95% CI 7.2–9.9%, n = 15 studies, low‐quality evidence)). Meta‐regression determined that opioid prescribing was associated with year of sampling (more prescribing in recent years) (P = 0.014) and not geographic region (P = 0.056). Opioid prescribing for patients with chronic noncancer pain is common and has increased over time

Burden of disease attributable to suboptimal diet, metabolic risks, and low physical activity in Ethiopia and comparison with Eastern sub-Saharan African countries, 1990-2015: findings from the Global Burden of Disease Study 2015

Background: Twelve of the 17 Sustainable Development Goals (SDGs) are related to malnutrition (both under- and overnutrition), other behavioral, and metabolic risk factors. However, comparative evidence on the impact of behavioral and metabolic risk factors on disease burden is limited in sub-Saharan Africa (SSA), including Ethiopia. Using data from the Global Burden of Disease (GBD) Study, we assessed mortality and disability-adjusted life years (DALYs) attributable to child and maternal undernutrition (CMU), dietary risks, metabolic risks and low physical activity for Ethiopia. The results were compared with 14 other Eastern SSA countries. Methods: Databases from GBD 2015, that consist of data from 1990 to 2015, were used. A comparative risk assessment approach was utilized to estimate the burden of disease attributable to CMU, dietary risks, metabolic risks and low physical activity. Exposure levels of the risk factors were estimated using spatiotemporal Gaussian process regression (ST-GPR) and Bayesian meta-regression models. Results: In 2015, there were 58,783 [95% uncertainty interval (UI): 43,653-76,020] or 8.9% [95% UI: 6.1-12.5] estimated all-cause deaths attributable to CMU, 66,269 [95% UI: 39,367-106,512] or 9.7% [95% UI: 7.4-12.3] to dietary risks, 105,057 [95% UI: 66,167-157,071] or 15.4% [95% UI: 12.8-17.6] to metabolic risks and 5808 [95% UI: 3449-9359] or 0.9% [95% UI: 0.6-1.1]to low physical activity in Ethiopia. While the age-adjusted proportion of all-cause mortality attributable to CMU decreased significantly between 1990 and 2015, it increased from 10.8% [95% UI: 8.8-13.3] to 14.5% [95% UI: 11.7-18.0] for dietary risks and from 17.0% [95% UI: 15.4-18.7] to 24.2% [95% UI: 22.2-26.1] for metabolic risks. In 2015, Ethiopia ranked among the top four countries (of 15 Eastern SSA countries) in terms of mortality and DALYs based on the age-standardized proportion of disease attributable to dietary risks and metabolic risks. Conclusions: In Ethiopia, while there was a decline in mortality and DALYs attributable to CMU over the last two and half decades, the burden attributable to dietary and metabolic risks have increased during the same period. Lifestyle and metabolic risks of NCDs require more attention by the primary health care system of in the country

Production Trends, Collaboration, and Main Topics of the Integrative and Complementary Oncology Research Area: A Bibliometric Analysis

Background: The prevalence of cancer has increased over time worldwide. Nevertheless, the number of deaths has been reduced during the past 2 decades. Thus, one-third of the cancer patients are users of complementary and alternative therapies, looking for other types of interventions. The main aim of the present study is to understand the current status of the research in integrative and complementary oncology. Three different aspects were analyzed: production trends, country collaboration, and leading research topics. Methods: The dataset was obtained from the documents indexed under the Integrative and Complementary Medicine category of the Web of Science database from 1976 to 2017. VOSviewer and SciMAT software were employed to perform the bibliometric analysis. Results: The Journal of Ethnopharmacology, China Medical University and the People’s Republic of China are the leading producers in the field. Regarding the collaboration, the United States and China present a close connection. The scientific community is focused on the following topics: apoptosis, breast cancer, oxidative stress, chemotherapy, and nuclear factor-Kappa-B (NF-Kappa-B). Conclusions: The present article shows potentially important information that allows understanding of the past, present, and future of research in integrative and complementary oncology. It is a useful evidence-based framework on which to base future research actions and academic directions