Journal of Ideas in Health
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Empirical evidence from a few selected emerging economies on the impact of governance and health spending on health outcomes
Get PDFBackground: Adverse effects of weak governance on health, is a serious policy subject matter for policymakers, health experts, and researchers. Therefore, this study examines the effect of governance and health expenditure on under-five and adult mortality in emerging economies between 2000 and 2016.
Methods: Employing data from World Bank World Development Indicators, the study applied panel procedures namely cross-sectional dependence test, Westerlund cointegration, and cross-section augmented Dickey-Fuller (CADF) panel unit root test that can deal with the effects of cross-sections in the series. The study examined the long-run relationship between governance and health outcomes by using the panel fully modified least squares (FMOLS) and the fixed effects model for a robust check.
Results: The Westerlund cointegration confirmed that the variables are cointegrated. The panel fully modified least squares (FMOLS) and the fixed effects estimation results show that poor governance (corruption) induces adult mortality in most of the panels. However, good governance (political stability) reduces mortality among children under five and adults in all four panels.
Conclusion: The study supports the hypothesis that governance has inordinate consequences on under-five and adult mortality and therefore it has a huge impact on the health outlook of a population. The findings indicate that health expenditure and urbanization affect health outcomes in lower, upper, and high-income countries in changing economies. Different policy implications are therefore offered based on the study outcome
Investigation of the effects of kinesiophobia level on physical activity and quality of life in university students
Get PDFBackground: Kinesiophobia, which is called activity avoidance, is a condition that may cause university students to stay away from physical activity more. This study aimed to understand how physical activity and quality of life levels of university students with different levels of kinesiophobia are affected.
Methods: Our study included 395 students who were studying at Ankara Medipol University in the 2022-2023 academic year and were accepted to participate in our study. The kinesiophobia, physical activity, and quality of life levels of the students were evaluated with questionnaires. The Demographic Characteristics of Students were analyzed using Chi-Square and Mann-Whitney U tests. Spearman correlation analysis was used for the correlation between the scores of the scales, and Mann-Whitney U was used for comparing physical activity levels and quality of life according to kinesiophobia levels. Statistical significance was set as p<0.05.
Results: Among the students who participated in our study, 226 (57.22%) students had high kinesiophobia levels and 169 (42.78%) had low kinesiophobia levels. While 74.3% of people with high kinesiophobia levels were women, 67.5% of participants with low kinesiophobia levels were women. The age and BMI levels of the participants in both groups were similar (p>0.05). In our study, while all parameters of WHOQOL and TKS were correlated with each other, only physical and psychosocial sub-parameters of WHOQOL and IPAQ were correlated (p<0.05). According to the results obtained from the study, the physical activity amount and quality of life scores of the students with lower kinesiophobia levels were found to be higher (p<0.05).
Conclusion: As a result, different levels of kinesiophobia in university students can affect the amount of physical activity and quality of life of students. It is essential to keep students away from the vicious circle of kinesiophobia and lack of physical activity and to direct them to physical activities
A case report on generalized pemphigus vulgaris treated with rituximaba
Get PDFBackground: Pemphigus vulgaris has an obscure etiology; the presence of autoantibodies is coherent with an autoimmune disease. Rituximab a monoclonal antibody that specifically targets the CD20 antigen of B lymphocytes, has arisen as a novel treatment approach for pemphigus vulgaris.
Case presentation: A 39-year-old male patient presented with a three-month history of mouth ulcers, poor oral hygiene accompanied with heavy tobacco smoking and alcohol consumption. He was diagnosed with pemphigus vulgaris. The disease gradually progressed to involve other body parts. The patient had shown partial improvement after conventional therapy (oral cefuroxime, oral prednisolone with azathioprine) and was later on successfully treated with rituximab. After 90 days of follow-up, no future recurrence was observed.
Conclusion: With this case, the authors would like to aware other clinicians of the potential use of rituximab in treating pemphigus vulgaris, especially when the conventional therapy fails
Intersecting paths: A rare case report of malignant melanoma in a patient with body dysmorphic disorder
Get PDFBackground: Body dysmorphic disorder (BDD) characterized by excessive and persistent preoccupation with perceived defects or flaws in appearance and has a prevalence of 1.7-2.9%. It is a disorder with a relatively unclear etiology.
Case presentation: A 36-year-old unmarried female presented to the surgery department with a self-inflicted lesion on her right ankle. The patient underwent fine needle aspiration cytology, and later, a wide local excision of the lesion was done. The final histological diagnosis of malignant melanoma was established. On careful psychiatric evaluation, the patient had an excessive and persistent preoccupation with her appearance, which caused severe psychological and social morbidity and drove her to her actions. Thus, the final diagnosis of body dysmorphic disorder (DSM V) was established. The patient was put on Fluoxetine and cognitive behavioral therapy.
Conclusion: Given the significantly reduced functionality and quality of life, BDD should be recognized and accurately diagnosed
Perceived stigmatization, psychosocial well-being and self-esteem among individuals living in leprosy center in south-west, Nigeria
Get PDFBackground: Leprosy has over time been seen as a symbol of shame and stigmatization as people affected by leprosy continue to be stigmatized and discriminated against even after they have been cured. The study aimed to assess the perceived levels of stigmatization, psychosocial well-being, and self-esteem among individuals living at a leprosy center in South-West, Nigeria.
Methods: A descriptive cross-sectional design of face-to-face research was conducted in a leprosy center using a simple random technique. The study instrument was a self-structured questionnaire containing sociodemographic details, questions on stigmatization towards the individual affected by leprosy and their family members, and questions regarding their psychosocial well-being adapted from literature, as well as questions adapted from the validated Rosenberg Self Esteem Scale (RSES) by Morris Rosenberg to assess their self-esteem. Data were analyzed with the aid of SPSS version 26 software.
Results: A total of 134 participants were included in the study. Most of the participants were females (61.2%) within the age range of 21- 40 years old (32.8%), and are students (25.4%). Out of the 134 participants, 29.1% (39) of them were affected by leprosy. The participants perceived a high level of stigmatization (37.3%), a high level of psychosocial well-being (38.8%), and demonstrated a moderate level of self-esteem (50.7%). The male gender perceived both low (B = -3.054, p = 0.004) and high (B = -1.84, p = 0.049) stigmatization at p< 0.05. The married (B = -5.421, p = 0.004), the Christians (B = 5.424, p = 0.043) and Islamic (B = 7.743, p = 0.011) participants perceived low stigmatization at p< 0.05. The participants within the age range 21 - 40 (B = 6.25, p = 0.019) and 61 – 80 years (B = 7.29, p = 0.017) perceived high psychosocial well-being while the single (B = -4.43, p = 0.049) and married (B = -5.26, p = 0.017) participants perceived low psychosocial well-being at p< 0.05. None of the demographic factors had relationships with self-esteem at p< 0.05. The perceived levels of stigmatization (r= 0.314, p= 0.0001) and psychosocial well-being (r= 0.225, p= 0.009) are associated with the level of self-esteem at p< 0.05.
Conclusion: This study concludes that the individuals affected by leprosy and their family members living at the leprosy center experienced a high level of stigmatization and, a high level of psychosocial well-being but had moderate self-esteem
Seroprevalence of Leptospira infection in slaughtered cattle in Unguja Island, Zanzibar, Tanzania
Get PDFBackground: Leptospirosis is an important disease of global distribution affecting humans and animals in the tropical and subtropical regions caused by pathogenic Leptospira serovars. It’s an occupational disease with little information in Unguja Island, Zanzibar.
Methods: A cross-sectional study was conducted in four selected slaughter facilities to determine the seroprevalence for Leptospira infection in slaughtered cattle in Unguja Island, Zanzibar. The blood samples and demographic data from 355 slaughtered cattle were collected and sera were separated for the Microscopic Agglutination Test (MAT) by using five types of Leptospira serovars; Hebdomadis, Sokoine, Lora, Grippotyphosa and Pomona with cutoff titer ≥ 1:40. The Chi-square test at p < 0.05 was used to assess the association between the variables and seropositivity of Leptospira infection.
Results: The overall seroprevalence of Leptospira infection in the slaughtered cattle sampled was 13.0% (46/355). The predominant serovars from the tested serogroups were Hebdomadis (3.9%), followed by Pomona (2.8%), Grippotyphosa (2.8%), and Lora (2.3%); while the least reacted was Sokoine (1.1%). The body condition score was the only significant significant variable (χ2=103.9038, p=0.00001) associated with Leptospira infection seropositivity.
Conclusion: The study offers the first report on the Leptospira seroprevalence in slaughtered cattle on Unguja Island. This might be a probable source of infection to slaughter facilities workers and other animals encroaching on the area. Therefore, precautions should be observed to prevent infection, especially for slaughter facility workers in Unguja.
An automated approach for the kidney segmentation and detection of kidney stones on computed tomography using YOLO algorithms
Get PDFBackground: For effective diagnosis and treatment planning, accurate segmentation of the kidneys and detection of kidney stones are crucial. Traditional procedures are time-consuming and subject to observer variation. This study proposes an automated method employing YOLO algorithms for renal segmentation and kidney stone detection on CT scans to address these issues.
Methods: The dataset used in this study was sourced from the GitHub. The dataset contains a total of 1799 images, with 790 images labeled as \u27containing kidney stones\u27 and 1009 images labeled as \u27not containing kidney stones\u27. U-Net architecture was utilized to precisely identify the region of interest, while YOLOv5 and YOLOv7 architecture was utilized to detect the stones. In addition, a performance comparison between the two YOLO models and other contemporary relevant models has been conducted.
Results: We obtained a kidney segmentation IOU of 91.4% and kidney stone detection accuracies of 99.5% for YOLOv7 and 98.7% for YOLOv5. YOLOv5 and YOLOv7 outperform the best existing models, including CNN, KNN, SVM, Kronecker CNN, Xresnet50, VGG16, etc. YOLOv7 possesses superior accuracy than YOLOv5. The only issue we encountered with the YOLOv7 model was that it demanded more training time than the YOLOv5 model.
Conclusion: The results demonstrate that the proposed AI-based method has the potential to improve clinical procedures, allowing radiologists and urologists to make well-informed decisions for patients with renal pathologies. As medical imaging technology progresses, the incorporation of deep learning techniques such as YOLO holds promise for additional advances in automated diagnosis and treatment planning
Determinant factors of treatment adherence of hypertensive patients in a rural area of Indonesia
Get PDFBackground: The surging prevalence of hypertension due to lifestyle brought forth an increase in degenerative diseases. Adherence is important in achieving the effectiveness of therapy. This study aims to analyze the factors affecting medication adherence in patients with hypertension.
Methods: A cross-sectional study was conducted between 20-24 February 2023 at Turirejo Village, Lawang District, Malang, Indonesia. Participants were hypertensive patients currently receiving treatment. The MMAS-8 questionnaire was used to classify adherence to medication for hypertension. Analysis with binary logistic regression test was performed on variables to display odds ratio values was conducted at a significance level of p<0.05.
Results: A total of 37 adults diagnosed with hypertension participated in this study. Patients were dominantly consisting of elderly (≥ 56 years old; 73.0%) and females (86.0%). Seventy-six percent of patients have low adherence, twenty-four percent of patients have moderate adherence, and no patient has high adherence. Duration of illness, knowledge, and attitude variables significantly affect adherence (low and moderate) to medication for hypertension. Multivariate analysis showed that patients with a duration of illness above 10 years (Adjusted OR 18.27; 95% CI 1.72-194.47; p-value 0.016) and positive attitude towards treatment (Adjusted OR 12.76; 95% CI 1.25-130.40; p-value 0.032, respectively) increase the possibility of moderate adherence towards the medication of hypertension.
Conclusion: Improvements in factors that affect adherence to hypertension treatment are needed to increase the success of the Non-Communicable Disease Prevention Program. Further research in identifying factors of economic capacity and access to health service providers is needed to validate the results of this study
How organizational climate of silence affects job performance: the role of work engagement and supervisor support among frontline nurses
Get PDFBackground: The growing body of evidence demonstrates both the desirable and undesirable consequences of organizational silence. This study aims to explore the influence of the organizational climate of silence on job performance through the mediating effects of work engagement (WE). Further, the degree to which supervisor support (SS) and work engagement moderate job performance are examined.
Methods: A quantitative cross-sectional design was used for the study. Survey data from 14 hospitals and 15 health centers and community-based health planning services (CHPS) compounds in the Western Region of Ghana. We used the variable-to-sample ratio to determine an appropriate and sufficient sample size of 565 respondents. The hierarchical regression technique was employed in estimating the relationship between the variables.
Results: In selecting an adequate and appropriate sample size for this current study, we relied on the variable-to-sample ratio. Results from the study showed that top management\u27s attitude to silence and the supervisor\u27s attitude to silence had a significant adverse effect on task performance (β=-.090, p< 0.05) and (β=-.110, p< 0.01). Work engagement had no role in mediating top managers\u27 and supervisors\u27 attitudes toward silence, communication opportunities, and task performance. Supervisor support acted as a moderating factor in the relationship between job engagement and task performance. In contrast, despite the direct positive relationship between supervisor support and contextual performance, it failed to moderate the relationship between work engagement and contextual performance.
Conclusion: The study\u27s findings demonstrate the need for health managers and supervisors to become more conscious of silence. The results offer diverse recommendations for encouraging the sharing of relevant ideas, facts, and opinions within the health sector
Evaluation of biochemical parameters in acute myocardial infarction and angina patients
Get PDFBackground: Early and accurate detection of acute myocardial infarction (AMI) is an important unmet clinical requirement. The present study sought to evaluate the levels of N-terminal pro-brain natriuretic peptide (NTproBNP), cardiac troponin I (cTnI), fasting lipid profile, random blood sugar, and serum creatinine in AMI patients compared to angina patients.
Methods: In a single-center, hospital-based, cross-sectional, observational, prospective study conducted at Gandhi Medical College, Secunderabad, from October-2018 to September-2019. A total of 150 patients aged above 40 years with acute chest pain (within 2-6 hours) and who were clinically susceptive of AMI and angina were investigated. The patients were divided into group I (50 AMI patients) and group II (100 angina patients). Levels of all biochemical parameters of blood were assessed. The statistical analyses were performed using the SPSS statistical software, version 15. A student t-test was used to compare the continuous variables between the two groups.
Results: Out of 150 patients, higher male prevalence was found in both the groups (60% and 63%, respectively). Group I had higher levels of NTproBNP (2909±273pg/ml vs. 110±20.74pg/ml, P<0.01), cTnI (2.06±1.3ng/ml vs. 0.006±0.002ng/ml, P<0.01), and fasting lipid profile (total cholesterol:216±41.2mg/dl vs.201±32.5mg/dl, P<0.05, triglycerides:217.7±63.6 mg/dl vs. 175.3±48.8 mg/dl, P<0.01, low-density lipoprotein:141.7mg/dl±41.5 vs. 127.1±30.24 mg/dl, P<0.05, very low-density lipoprotein:43.4±12.8mg/dl vs. 35.1±9.8mg/dl, P<0.01) than group II, except low levels of high-density lipoprotein (31.2±3.83mg/dl vs. 38.9±4.32 mg/dl, P<0.01).
Conclusion: Assessment of NTproBNP, cTnI, and fasting lipid profile may aid in the early diagnosis of AMI and its management