Expert perspectives on the active role of patients in their safety: Toward a framework using Delphi methodology

Aims: To develop a framework for Patient Engagement in Patient Safety (PEPS) in hospital. Methods: The Delphi technique was embraced to involve a group of knowledgeable healthcare experts in the discussion and rating of the components of the PEPS framework. On a 5‐point Likert scale, every item was separately rated based on the three aspects, which include applicability, clarity and validity. The PEPS framework included items with 75% or more of participants scoring 4–5 on all three aspects. Items not attaining 75% agreement on the aspects were either changed or discarded, after the group discussion and underwent another round of rerating. Results: A total of 17 members participated in the consensus‐building process. Following two rounds of rating, the consensus was reached on the final framework which consisted of 28 items in four dimensions, relating to healthcare professionals, patients, community, and helth system, and three components substituted with patient empowerment, effective communication and patient‐centeredness. Conclusion: The development of PEPS framework is a stimulus to strengthen human resources for health capabilities, sustain a high level of quality patient outcomes, and improve the health system. Further studies to identify strategies are needed for the successful implementation of this framework

Physical education class participation is associated with physical activity among adolescents in 65 countries

In this study we examined the associations of physical education class participation with physical activity among adolescents. We analysed the Global School-based Student Health Survey data from 65 countries (N = 206,417; 11–17 years; 49% girls) collected between 2007 and 2016. We defined sufficient physical activity as achieving physical activities ≥ 60 min/day, and grouped physical education classes as ‘0 day/week’, ‘1–2 days/week’, and ‘ ≥ 3 days/week’ participation. We used multivariable logistic regression to obtain country-level estimates, and meta-analysis to obtain pooled estimates. Compared to those who did not take any physical education classes, those who took classes ≥ 3 days/week had double the odds of being sufficiently active (OR 2.05, 95% CI 1.84–2.28) with no apparent gender/age group differences. The association estimates decreased with higher levels of country’s income with OR 2.37 (1.51–3.73) for low-income and OR 1.85 (1.52–2.37) for high-income countries. Adolescents who participated in physical education classes 1–2 days/week had 26% higher odds of being sufficiently active with relatively higher odds for boys (30%) than girls (15%). Attending physical education classes was positively associated with physical activity among adolescents regardless of sex or age group. Quality physical education should be encouraged to promote physical activity of children and adolescents

Nutritional status of adolescent girls in a selected secondary school of north-eastern part of Nigeria

Background: Adolescence is the most critical period of human life when transitioning occurs from childhood to adulthood. Malnutrition is one of the major global health problems faced by many developing countries across the globe. Objectives: This study aimed to investigate the nutritional status of adolescent girls in a selected secondary school in Nigeria. Methods: A cross-sectional study was conducted on 250 adolescent girls who were available during the study period. A nutrition expert, together with an epidemiologist, gathered anthropometric information and measured the height, weight, and body mass index (BMI) of the participants. The BMI was calculated, and the dietary habits of the participants were reported based on their usual food habits. It is part of our limitations and has been addressed under the limitations. Data were collected using a self-administered and semi-structured questionnaire. Results: The mean age of the adolescent girls was 15.9 ± 0.9 years, and more than half (53.2%) were students of senior secondary class 1 (SS-1). More than half (54.4%) of the adolescent girls had average body weight, 36.0% were underweight, and only 9.6% were overweight. The following socio-demographic factors were significantly associated with the BMI of adolescent girls: Age, class of the students, monthly family income, mothers’ educational status, and area of residence. Close to four-fifths (78.4%) of the participants consumed rice more than twice in a week; more than eight-tenths (88.8%) of the participants consumed milk/milk products at least ≤ 2 in a week. About 84.4% of the participants took red meat at least ≤ 2 in a week; more than half (55.2%) of the participants consumed vegetables and fruits more than twice a week. Most (84.8%) of the participants took lunch regularly, and 91.6% of the adolescent girls took breakfast regularly. Conclusions: The study revealed that nearly one-third of the adolescent girls were underweight, indicating a severe public health concern. Early nutritional screening and interventions are recommended to improve the nutritional status of the adolescent girl school in Nigeria

Cardiovascular disease risk factors among school children of Bangladesh: A cross-sectional study

Objective: Primarily, we assessed the distribution of cardiovascular disease (CVD) risk factors among school children living in urban and rural areas of Bangladesh. In addition to this, we sought the association between place of residence and modifiable CVD risk factors among them. Design, setting and participants: This cross-sectional study was conducted among 854 school children (aged 12&ndash;18 years) of Bangladesh. Ten public high schools (five from Dhaka and five from Sirajgonj district) were selected randomly and subjects from those were recruited conveniently. To link the family milieu of CVD risk factors, a parent of each children was also interviewed. Primary and secondary outcome measures: Distribution of CVD risk factors was measured using descriptive statistics as appropriate. Again, a saturated model of binary logistic regression was used to seek the association between place of residence and modifiable CVD risk factors. Results: Mean age of the school children was 14.6&plusmn;1.1 years and more than half (57.6%) were boys. Overall, 4.4% were currently smoker (urban&mdash;3.5%, rural&mdash;5.2%) with a strong family history of smoking (42.2%). Similar proportion of school children were identified as overweight (total 9.8%, urban 14.7%, rural 5%) and obese (total 9.8%, urban 16.8%, rural 2.8%) with notable urban-rural difference. More than three-fourth (80%) of them were physically inactive with no urban-rural variation. Only 2.4% consumed recommended fruits and/ or vegetables (urban&mdash;3.1%, rural&mdash;1.7%). In the adjusted model, place of residence had higher odds for having several modifiable CVD risk factors: current smoking (OR: 1.807, CI 0.872 to 3.744), inadequate fruits and vegetables intake (OR: 1.094, CI 0.631 to 1.895), physical inactivity (OR: 1.082, CI 0.751 to 1.558), overweight (OR: 3.812, CI 2.245 to 6.470) and obesity (OR: 7.449, CI 3.947 to 14.057). Conclusions: Both urban and rural school children of Bangladesh had poor CVD risk factors profile that demands further nation-wide large scale study to clarify the current findings more precisely.</jats:sec

Longitudinal patterns of lifestyle risk behaviours among UK adults with established cardiovascular disease: a latent transition analysis

BackgroundPeople with cardiovascular disease (CVD) need to engage in healthy lifestyle behaviours. However, there is a gap in identifying longitudinal patterns of change in lifestyle behaviours among people with CVD. This study aimed to identify clustering of lifestyle risk behaviours and their 4 ± year changes among UK adults with CVD, and to determine the associated factors.MethodsWe used the UK Biobank data collected at two time points (2006–2010/baseline data = T0 and 2014+/third visit data = T4). Six key lifestyle risk behaviours were assessed: smoking, high alcohol intake, poor fruit and vegetable consumption, physical inactivity, poor sleep balance (&lt;7 or &gt;8 h/night) and prolonged sitting. A random intercept latent transition analysis was performed to identify patterns of lifestyle risk behaviours at T0 and their changes from T0 to T4.ResultsWe included 5,304 participants with CVD whose data on lifestyle risk behaviours were collected at two-time points. Alcohol intake and current smoking were 75.7% and 5.4% at baseline, respectively, and 67.4% and 3.0% at follow-up. Three latent classes emerged: Latent class (LC) 1—“high alcohol intake, poor sleep balance and poor fruit and vegetable intake”, LC2—“high alcohol intake and poor fruit and vegetable intake”, and LC3—“high alcohol intake”. Most adults remained in the same LC over the 4 + years (range: 83.9%–100.0%). After 4 + years, 3.5% from LC3 and 10.4% from LC2 at baseline moved into LC1. The odds of transitioning to LC2 relative to staying in LC1 and LC3 were 2.22 and 4.13 times higher for males than for females, respectively. A single-year increase in participants' age was associated with a 1.16 times increase in the odds of moving to LC1 relative to staying in LC2.ConclusionPeople with CVD did not show improvement in lifestyle risk behaviours, and interventions targeting multiple lifestyle risk behaviours are needed to improve CVD

Patients\u27 perspective of disease and medication adherence for type 2 diabetes in an urban area in Bangladesh: a qualitative study

BACKGROUND: Patients\u27 perspective of diabetes and adherence to its prescribed medications is a significant predictor of glycemic control and overall management of the disease. However, there is a paucity of such information in Bangladesh. This study aimed to explore patients\u27 perspective of diabetes, their experience of taking oral hypoglycemic medications and explore factors that contribute to medication adherence in patients with type 2 diabetes in Bangladesh. METHODS: We conducted in-depth face-to-face interviews with 12 type 2 diabetes patients attending a tertiary hospital in Dhaka city between February and March, 2014. Participants were purposively sampled representing different age groups, education levels, years since diagnosis with diabetes, and glycemic status, to achieve maximum variation sampling. All interviews were conducted using a topic guide and were audio-recorded, transcribed verbatim, checked for errors, coded and analyzed by means of a qualitative content analysis framework. RESULTS: The data analysis generated rich information on the participants\u27 knowledge and perception on diabetes, its causes, self-management, medication use, adverse effects of medication use, medication adherence, and impact of diabetes, Although most of the participants demonstrated substantive knowledge on diabetes and its consequences, they also reported numerous misconceptions about the disease. Knowledge on diabetes medication, their appropriate use and side effects was rather poor. Respondents also reported non-compliance to dietary and physical activity advice by their physicians and concerns on diabetes diabetes-induced psychological stress. High cost of medications, concerns over medication side effects and forgetfulness was noted as factors for non-adherence to medication. CONCLUSION: Participants\u27 knowledge and perception on diabetes are key factors determining their adherence to medications and, thereby, diabetes management. Healthcare providers should explore to better understand patients\u27 perspective on diabetes, medication beliefs, identify psychological stress and provide more effective health education interventions to enhance medication adherence

THE RISING SCOURGE OF MENTAL ILLNESS AND INFODEMIC: AN OUTCOME OF SOCIAL MEDIA AND COVID-19

COVID-19 was accompanied with the increasing broadcast of fake news, misinformation and excessive information via social media platforms. This phenomenon has been termed “infodemic”, to describe an overwhelming amount of mostly fake, false or inaccurate information which spreads rapidly and impacts negatively on achieving a solution. It would therefore be desirable to use a cautious approach which utilizes culturally sensitive and country specific measures to deal with this occurrence. We aim to raise awareness, likewise draw the attention of global scientific community on this topic of public and mental health concern and it calls for further comments on this issue