Epidemiology of Hypertension Stages in Two Countries in Sub-Sahara Africa: Factors Associated with Hypertension Stages

Studies using the revised hypertension classification are needed to better understand epidemiology of hypertension across full distribution. The sociodemographic, biological, and health behavior characteristics associated with different stages of hypertension in Ghana and South Africa (SA) were studied using global ageing and adult health (SAGE), WAVE 1 dataset. Blood pressure was assessed for a total of 7545 respondents, 2980 from SA and 4565 from Ghana. Hypertension was defined using JNC7 blood pressure classification considering previous diagnosis and treatment. Multivariate multinomial logistic regression analysis using Stata version 12 statistical software was done to identify independent predictors. The weighted prevalence of prehypertension and hypertension in Ghana was 30.7% and 42.4%, respectively, and that of SA was 29.4% and 46%, respectively, showing high burden. After adjusting for the independent variables, only age (OR = 1.32, 95% CI: 1.14-1.53), income (OR = 1.9, 95% CI: 1.04-3.47), and BMI (OR = 1.16, 95% CI: 1.1-1.22) remained independent predictors for stage 1 hypertension in Ghana, while, for SA, age (OR = 2.27, 95% CI: 1.53-3.36), sex (OR = 0.28, 95% CI: 0.08-1), and BMI (OR = 1.15, 95% CI: 1.07-1.25) were found to be independent predictors of stage 1 hypertension. Healthy lifestyle changes and policy measures are needed to promptly address these predictors

Реконструкция системы электроснабжения ОАО «Гомсельмаш» в связи с изменением технологического процесса и внедрение энергосберегающих мероприятий

Background: The Health System Responsiveness Questionnaire is an instrument designed by the World Health Organization (WHO) in 2000 to assess the experience of patients when interacting with the health care system. This investigation aimed to adapt a Mental Health System Responsiveness Questionnaire (MHSRQ) based on the WHO concept and evaluate its validity and reliability to the mental health care system in Iran. Design: In accordance with the WHO health system responsiveness questionnaire and the findings of a qualitative study, a Farsi version of the MHSRQ was tailored to suit the mental health system in Iran. This version was tested in a cross-sectional study at nine public mental health clinics in Tehran. A sample of 500 mental health services patients was recruited and subsequently completed the questionnaire. Item missing rate was used to check the feasibility while the reliability of the scale was determined by assessing the Cronbach's alpha and item total correlations. The factor structure of the questionnaire was investigated by performing confirmatory factor analysis (CFA). Results: The results showed a satisfactory feasibility since the item missing value was lower than 5.2%. With the exception of access domain, reliability of different domains of the questionnaire was within a desirable range. The factor loading showed an acceptable unidimentionality of the scale despite the fact that three items related to access did not perform well. The CFA also indicated good fit indices for the model (CFI=0.99, GFI=0.97, IFI=0.99, AGFI=0.97). Conclusions: In general, the findings suggest that the Farsi version of the MHSRQ is a feasible, reliable, and valid measure of the mental health system responsiveness in Iran. Changes to the questions related to the access domain should be considered in order to improve the psychometric properties of the measure

There Is Still So Much to Learn From Legislation

Denna rapport tar sin utgångspunkt i den svenska regeringens ställningstagande att barn som inte anses ha skyddsbehov eller andra skäl att stanna i Sverige ska kunna återvända hem på värdiga sätt. Samma regering har dock också tydligt uttalat att antalet av- och utvisningar väsentligen ska öka i förhållande till tidigare år. Det är den potentiella spänningen mellan skarpa krav på effektivitet i av- och utvisningsärenden å ena sidan och kraven på värdighet, respekt för mänskliga rättigheter och barnets bästa å den andra, som undersöks i den här rapporten. Fokus ligger på hur centrala aktörer förhåller sig till och tolkar dessa krav och på vad deras respektive förhållningssätt och tolkningar betyder för samverkan dem emellan. Tre fallstudier i kommuner av varierande storlek belägna i de geografiskt åtskilda länen Västerbotten, Skåne och Värmland har genomförts. Fallstudierna bygger på totalt 49 intervjuer med handläggare på Migrationsverket, socialsekreterare, gode män, HVBpersonal och poliser – alla verksamma som centrala aktörer vid av- och utvisningar. I analysen av det insamlade materialet betraktas de professionella aktörerna (de gode männen undantagna) som gräsrotsbyråkrater med vida handlingsutrymmen. Det som undersöks är i vilken utsträckning de anser sig kunna omsätta de politiska målsättningarna om ökad effektivitet och bibehållen värdighet i praktiken. För att kunna analysera vad det är som utmärker samarbete och samverkan mellan aktörerna används teorier om interorganisatorisk samverkan. De huvudsakliga slutsatser som framkommit i rapporten är att uppfattningar om och förhållningssätt till det effektiva och värdiga återvändandet skiljer sig åt bland de olika aktörerna i Västerbotten, Skåne och Värmland. Aktörerna gör egna tolkningar av begreppen effektivitet och värdighet, i vilka mening skapas utifrån professionella erfarenheter, roller och uppdrag. De största skillnaderna i uppfattning och tolkning har återfunnits mellan aktörskategorierna, inte mellan de tre fallstudierna. Polis och Migrationsverk anser generellt att effektivitet och värdighet går att förena. Poliserna och tjänstemännen på Migrationsverket har jämfört med de andra aktörerna oftare ett uttalat legalt perspektiv och ser både värdighet och respekt för barnens mänskliga rättigheter som inbäddade i det juridiska ramverket. Socialsekreterare, HVB-personal och gode män anser däremot generellt att ett återvändande mot ett barns vilja inte någonsin kan bli värdigt. De är också mer benägna att se det som att Barnkonventionen i relation till utlänningslagen hamnar i underordnad ställning. Vissa likheter mellan aktörerna har också kunnat identifieras. Samtliga betonar gott bemötande, god kommunikation och tydlig information i relation till de barn som fått av- eller utvisningsbeslut. Aktörernas olika förhållningssätt får konsekvenser för deras samverkan. Överlag kan samverkan i samtliga undersökta kommuner beskrivas som begränsad, oklar, personberoende och utan gemensamma mål. Aktörerna uttrycker brist på tillit och många upplever en känsla av ensamhet i sina roller. Goda erfarenheter av samverkan finns visserligen men det är tydligt att skilda professionella normer, organisationskulturer, erfarenheter och perspektiv försvårar samverkan.Vad är ett värdigt återvändand

Client violence toward Iranian social workers : A national study

Introduction   Client violence toward social workers has become recognized as a common problem, and major concern has been raised with regard to its impacts on the workers’ practice, and physical and psychological health. More than half a century has passed since the social work profession was established in Iran, and yet client violence and the associated health-related consequences remain unexplored. This thesis aims to address this gap in knowledge. Methods   A national survey was conducted involving 390 social workers from the Centres for Socially Injured People (CSIP), affiliated to the Social Affairs Department of the State Welfare Organization, Iran. The survey included self-administered questionnaires, namely, the Workplace Violence in the Health Sector questionnaire, the General Health Questionnaire-28 (GHQ-28), the Ways of Coping questionnaire, the Burnout Measure, and the Rosenberg Self-esteem Scale. Results   A high proportion of CSIP social workers (67%) have experienced violence. Psychological violence was about three times more common than physical violence. A high tendency of not reporting psychological violence to managers/supervisors was found. Psychological violence was associated with poorer mental health. Social workers with experience of psychological violence were found to be more worried about occurrences of violent events. Worrying about violence was significantly correlated with poorer mental health. Active coping had a direct effect on health, suggesting a poorer health status with more frequent use of active coping. Burnout was experienced by 10.9% of social workers, and 17.4% were found to be at risk of developing burnout symptoms. Low self-esteem and experience of violence were associated with burnout. Conclusion   The results suggest the importance of not neglecting cases of client violence and of putting the health and safety of social workers on top of the agenda. A victimized social worker with limited resources at work needs to note that coping skills may reduce the impact of stressors, not only by changing the stressors themselves, but also by changing how the social worker responds to them

Client violence toward Iranian social workers : A national study

Introduction   Client violence toward social workers has become recognized as a common problem, and major concern has been raised with regard to its impacts on the workers’ practice, and physical and psychological health. More than half a century has passed since the social work profession was established in Iran, and yet client violence and the associated health-related consequences remain unexplored. This thesis aims to address this gap in knowledge. Methods   A national survey was conducted involving 390 social workers from the Centres for Socially Injured People (CSIP), affiliated to the Social Affairs Department of the State Welfare Organization, Iran. The survey included self-administered questionnaires, namely, the Workplace Violence in the Health Sector questionnaire, the General Health Questionnaire-28 (GHQ-28), the Ways of Coping questionnaire, the Burnout Measure, and the Rosenberg Self-esteem Scale. Results   A high proportion of CSIP social workers (67%) have experienced violence. Psychological violence was about three times more common than physical violence. A high tendency of not reporting psychological violence to managers/supervisors was found. Psychological violence was associated with poorer mental health. Social workers with experience of psychological violence were found to be more worried about occurrences of violent events. Worrying about violence was significantly correlated with poorer mental health. Active coping had a direct effect on health, suggesting a poorer health status with more frequent use of active coping. Burnout was experienced by 10.9% of social workers, and 17.4% were found to be at risk of developing burnout symptoms. Low self-esteem and experience of violence were associated with burnout. Conclusion   The results suggest the importance of not neglecting cases of client violence and of putting the health and safety of social workers on top of the agenda. A victimized social worker with limited resources at work needs to note that coping skills may reduce the impact of stressors, not only by changing the stressors themselves, but also by changing how the social worker responds to them

The predictability of the Addiction Severity Index criminal justice assessment instrument and future imprisonment : a Swedish registry study with a national sample of adults with risky substance use

Objective: In Sweden, social workers uses the Addiction Severity Index (ASI) as their main assessment tool when assessing individuals with risky substance use (RSU) or substance use disorder. The aim of this study is to identify among individuals with RSU, the associations of ASI Composite Scores (CSs) with future imprisonment controlling for age, education level and gender. Method: Baseline ASI-data was merged with national registry data on prison sentences (2003–2016). Cox regression was used to estimate the associations between CSs for alcohol, drugs other than alcohol, legal, family and social relationships, employment, mental- and physical health and future imprisonment for adults (n = 14,914) assessed for RSU. Results: The regression showed that all ASI CSs, age, education level and gender were significantly associated with imprisonment post ASI base-line assessment. The variables with the strongest association with imprisonment were ASI legal CS, followed by ASI drugs other than alcohol CS, ASI employment CS and being a male. ASI legal score showed the strongest association with imprisonment, with a 6 time increase in likelihood of imprisonment. Discussion: Given the findings in this study, the strong significant association between ASI legal CS and future imprisonment, it seems as that the ASI-assessment instrument is a reliable and trustworthy assessment tool to use in clinical work. This should motivate social workers and other clinical health professionals to use and rely on the ASI assessment in their intervention planning for clients with RSU, to hopefully reduce future imprisonment and improve their social situation

Socioeconomic inequalities and body mass index in Västerbotten County, Sweden : a longitudinal study of life course influences over two decades

INTRODUCTION: Life course socioeconomic inequalities in heart disease, stroke and all-cause mortality are well studied in Sweden. However, few studies have sought to explain the mechanism for such associations mainly due to lack of longitudinal data with multiple measures of socioeconomic status (SES) across the life course. Given the population health concern about how socioeconomic inequality is related to poorer health, we aim to tackle obesity as one of the prime suspects that could explain the association between SES inequality and cardiovascular disease and consequently premature death. The aim of this study is to test which life course model best describes the association between socioeconomic disadvantage and obesity among 60 year old inhabitants of Västerbotten County in Northern Sweden. METHODS: A birth cohort consisting of 3340 individuals born between 1930 and 1932 was studied. Body mass index (BMI) at the age of 60 and information on socioeconomic status at three stages of life (ages 40, 50, and 60 years) was collected. Independent samples t-test was used to compare BMI between advantaged and disadvantaged groups and one-way ANOVA was used to compare BMI among eight SES trajectories. We applied a structured modeling approach to examine three different hypothesized life course SES models (accumulation, critical period, and social mobility) in relation to BMI. RESULTS: We found sex differences in the way that late adulthood socioeconomic disadvantage is associated with BMI among inhabitants of Northern Sweden. Our study suggests that social adversity in all stages of late adulthood is a particularly important indicator for addressing the social gradients in BMI among women in Northern Sweden and that unhealthy behaviors in terms of smoking and physical inactivity are insufficient to explain the relationships between social and lifestyle inequalities and BMI. CONCLUSION: In order for local authorities to develop informed preventive efforts, we suggest further research to identify modifiable risk factors across the life course which could explain this health inequality

How the availability and adequacy of social support affect the general mental health of Swedish police officers

Police work is stressful. A protective function against work stress and harm to mental health is social support, either within or outside work. This cross-sectional study analyzes the associations of quantitative (availability) and qualitative (adequacy) aspects of social support with general mental health among Swedish police officers. A total of 728 officers responded to a national survey. Bivariate analyses (t-test and chi square) identified continuous and categorical variables (respectively) statistically significantly associated with sex and social support. Pearson correlation coefficient was provided to indicate the associations between general mental health and different types of social support. Sex-stratified logistic regression modeling calculated crude and adjusted odds ratios (OR) with 95% confidence intervals (CI) and assessed the relationships between different types of social support, sociodemographic variables and general mental health. The findings show that low adequacy of attachment is associated with poorer mental health among female officers, although female officers also reported higher availability of both social interaction and attachment compared to male officers. We found an association between low work-related social support and poorer mental health among single male police officers. Moreover, police officers who worked shifts, were younger, had less work experience, and/or had no children reported higher availability of attachment, whereas older police officers reported higher adequacy of social interaction compared to younger police officers. Variation in the quantity and quality of close social relationships seems to be important to mental health. Police organizations need to be aware of this in their efforts to make the work environment more supportive. Social support might create an environment where officers feel more comfortable discussing their mental health concerns and seeking assistance.

Smoking practices and risk awareness in parents regarding passive smoke exposure of their preschool children: A cross-sectional study in Tehran

Background: Young children living with parents who smoke are exposed to unacceptable health hazards. Aim: To determine patterns of parental smoking, the level of parental awareness about hazards of secondhand smoke, and the effect of risk awareness on smoking behavior. Setting: Health centers affiliated with two teaching hospitals in Tehran. Design: Cross-sectional. Materials and Methods: Data was collected from parents of preschool children visiting the health centers, through face-to-face interview, during a period of 18 months. Statistical Analysis: Data was analyzed by multiple logistic regression, and analysis of variance was done for comparison of means. Results: In a total of 647 families, prevalence of parental smoking was 35.7%, (231 families). In 97.8% of smoking families, only the fathers smoked; and in 5 (2.2%) families, both parents were regular smokers. Prevalence of smoking was higher in poor families as compared with families who were well-off (39% vs. 25%; P = 0.025), and also in families with lower educational level. There was no significant difference in risk awareness between smokers and nonsmokers (P > .05). Conclusion: Low socioeconomic status and low education were identified as risk factors for children′s exposure to secondhand smoke; parental risk awareness had no apparent effect on the smoking behavior. Unlike western societies, fathers were the sole habitual smokers in most families. Since factors that influence smoking behavior vary in different cultures, interventional strategies that aim to protect children from the hazards of tobacco smoke need to target diverse issues in different ethnic backgrounds