9 research outputs found
Socio-economic factors explain differences in public health-related variables among women in Bangladesh: A cross-sectional study
No full textKhan MH, Krämer A. Socio-economic factors explain differences in public health-related variables among women in Bangladesh: A cross-sectional study. BMC Public Health. 2008;8(1): 254.Background: Worldwide one billion people are living in slum communities and experts projected that this number would double by 2030. Slum populations, which are increasing at an alarming rate in Bangladesh mainly due to rural-urban migration, are often neglected and characterized by poverty, poor housing, overcrowding, poor environment, and high prevalence of communicable diseases. Unfortunately, comparisons between women living in slums and those not living in slums are very limited in Bangladesh. The objectives of the study were to examine the association of living in slums (dichotomized as slum versus non-slum) with selected public health-related variables among women, first without adjusting for the influence of other factors and then in the presence of socio-economic variables. Methods: Secondary data was used in this study. 120 women living in slums (as cases) and 480 age-matched women living in other areas (as controls) were extracted from the Bangladesh Demographic and Health Survey 2004. Many socio-economic and demographic variables were analysed. SPSS was used to perform simple as well as multiple analyses. P-values based on t-test and Wald test were also reported to show the significance level. Results: Unadjusted results indicated that a significantly higher percent of women living in slums came from country side, had a poorer status by household characteristics, had less access to mass media, and had less education than women not living in slums. Mean BMI, knowledge of AIDS indicated by ever heard about AIDS, knowledge of avoiding AIDS by condom use, receiving adequate antenatal visits (4 or more) during the last pregnancy, and safe delivery practices assisted by skilled sources were significantly lower among women living in slums than those women living in other areas. However, all the unadjusted significant associations with the variable slum were greatly attenuated and became insignificant (expect safe delivery practices) when some socio-economic variables namely childhood place of residence, a composite variable of household characteristics, a composite variable of mass media access, and education were inserted into the multiple regression models. Taken together, childhood place of residence, the composite variable of mass media access, and education were the strongest predictors for the health related outcomes. Conclusion: Reporting unadjusted findings of public health variables in women from slums versus non-slums can be misleading due to confounding factors. Our findings suggest that an association of childhood place of residence, mass media access and public health education should be considered before making any inference based on slum versus non-slum comparisons
Prevalence and correlates of smoking among urban adult men in Bangladesh: slum versus non-slum comparison
No full textKhan MH, Khan A, Krämer A, Mori M. Prevalence and correlates of smoking among urban adult men in Bangladesh: slum versus non-slum comparison. BMC Public Health. 2009;9(1):149.Background: Smoking is one of the leading causes of premature death particularly in developing countries. The prevalence of smoking is high among the general male population in Bangladesh. Unfortunately smoking information including correlates of smoking in the cities especially in the urban slums is very scarce, although urbanization is rapid in Bangladesh and slums are growing quickly in its major cities. Therefore this study reported prevalences of cigarette and bidi smoking and their correlates separately by urban slums and non-slums in Bangladesh. Methods: We used secondary data which was collected by the 2006 Urban Health Survey. The data were representative for the urban areas in Bangladesh. Both slums and non-slums located in the six City Corporations were considered. Slums in the cities were identified by two steps, first by using the satellite images and secondly by ground truthing. At the next stage, several clusters of households were selected by using proportional sampling. Then from each of the selected clusters, about 25 households were randomly selected. Information of a total of 12,155 adult men, aged 15 59 years, was analyzed by stratifying them into slum (= 6,488) and non-slum (= 5,667) groups. Simple frequency, bivariable and multivariable logistic regression analyses were performed using SPSS. Results: Overall smoking prevalence for the total sample was 53.6% with significantly higher prevalences among men in slums (59.8%) than non-slums (46.4%). Respondents living in slums reported a significantly (P < 0.001) higher prevalence of smoking cigarettes (53.3%) as compared to those living in non-slums (44.6%). A similar pattern was found for bidis (slums = 11.4% and non-slums = 3.2%, P < 0.001). Multivariable logistic regression revealed significantly higher odds ratio (OR) of smoking cigarettes (OR = 1.12, 95% CI = 1.03-1.22), bidis (OR = 1.90, 95% CI = 1.58-2.29) and any of the two (OR = 1.23, 95% CI = 1.13-1.34) among men living in slums as compared to those living in non-slums when controlled for age, division, education, marital status, religion, birth place and types of work. Division, education and types of work were the common significant correlates for both cigarette and bidi smoking in slums and non-slums by multivariable logistic regressions. Other significant correlates of smoking cigarettes were marital status (both areas), birth place (slums), and religion (non-slums). Similarly significant factors for smoking bidis were age (both areas), marital status (slums), religion (non-slums), and birth place (both areas). Conclusion: The men living in the urban slums reported higher rates of smoking cigarettes and bidis as compared to men living in the urban non-slums. Some of the significant correlates of smoking e. g. education and division should be considered for prevention activities. Our findings clearly underscore the necessity of interventions and preventions by policy makers, public health experts and other stakeholders in slums because smoking was more prevalent in the slum communities with detrimental health sequelae
Factors associated with high prevalence of coughs, colds and fever among urban slum dwellers in Dhaka, Bangladesh
No full textZanuzdana A, Khan MMH, Brinkel JK, Kraemer A. Factors associated with high prevalence of coughs, colds and fever among urban slum dwellers in Dhaka, Bangladesh. South East Asia Journal of Public Health. 2014;3(2):58-65
A spatial epidemiological analysis of self-rated mental health in the slums of Dhaka
No full textGrübner O, Khan MH, Lautenbach S, et al. A spatial epidemiological analysis of self-rated mental health in the slums of Dhaka. International Journal of Health Geographics. 2011;10(1): 36.Background: The deprived physical environments present in slums are well-known to have adverse health effects on their residents. However, little is known about the health effects of the social environments in slums. Moreover, neighbourhood quantitative spatial analyses of the mental health status of slum residents are still rare. The aim of this paper is to study self-rated mental health data in several slums of Dhaka, Bangladesh, by accounting for neighbourhood social and physical associations using spatial statistics. We hypothesised that mental health would show a significant spatial pattern in different population groups, and that the spatial patterns would relate to spatially-correlated health-determining factors (HDF). Methods: We applied a spatial epidemiological approach, including non-spatial ANOVA/ANCOVA, as well as global and local univariate and bivariate Moran's / statistics. The WHO-5 Well-being Index was used as a measure of self-rated mental health. Results: We found that poor mental health (WHO-5 scores = 15) was prevalent in all slum settlements. We detected spatially autocorrelated WHO-5 scores (i.e., spatial clusters of poor and good mental health among different population groups). Further, we detected spatial associations between mental health and housing quality, sanitation, income generation, environmental health knowledge, education, age, gender, flood non-affectedness, and selected properties of the natural environment. Conclusions: Spatial patterns of mental health were detected and could be partly explained by spatially correlated HDF. We thereby showed that the socio-physical neighbourhood was significantly associated with health status, i.e., mental health at one location was spatially dependent on the mental health and HDF prevalent at neighbouring locations. Furthermore, the spatial patterns point to severe health disparities both within and between the slums. In addition to examining health outcomes, the methodology used here is also applicable to residuals of regression models, such as helping to avoid violating the assumption of data independence that underlies many statistical approaches. We assume that similar spatial structures can be found in other studies focussing on neighbourhood effects on health, and therefore argue for a more widespread incorporation of spatial statistics in epidemiological studies
Institutions, Inequality and Growth: A review of theory and evidence on the institutional determinants of growth and inequality
No full textThe difference in the development experiences between the most developed countries and the least developed countries of today is vast. Luxembourg’s per capita income is 200 times larger than Liberia’s. Even within the developing world, growth is very unequal. East Asia and parts of Latin America are growing at impressive rates, while many other countries - especially in Sub-Saharan Africa - struggle with sluggish and volatile growth. This study discusses the theoretical challenge posed in identifying the mechanisms that link institutions and equitable economic growth at various levels of aggregation. The relationship between governance modes and institutions on the one hand, and economic growth and development on the other hand, may take very different forms. This relates to the question of whether a single and unique combination of institutions and governance modes is optimal for (equitable) growth, or whether different governance modes and institutions may lead to good or equitable growth performance in different locations and historical contexts.development administration; growth policy; institutional framework;
Application of statistical physical, DFT computation and molecular dynamics simulation for enhanced removal of crystal violet and basic fuchsin dyes utilizing biosorbent derived from residual watermelon seeds (Citrullus lanatus)
No full textThis study investigates the use of watermelon seeds (Citrullus lanatus), a plentiful and cost-effective biosorbent, for the removal of basic fuchsin (BF) and crystal violet (CV) dyes from aqueous solutions. Characterization of the biosorbent was conducted using Fourier Transform Infrared Spectroscopy (FT-IR), X-Ray Diffraction (XRD), and Scanning Electron Microscopy (SEM), while Brunauer–Emmett–Teller (BET) analysis revealed a specific surface area (SBET) of 54.50 m² g−1, highlighting its mesoporous structure advantageous for adsorption. Adsorption isotherms were best described by the Langmuir model, indicating monolayer adsorption with high correlation coefficients (R² values of 0.9959 for CV and 0.9978 for BF) and notable adsorption capacities of 139.2493 mg g−1 for CV and 238.80501 mg g−1 for BF. Thermodynamic analysis confirmed the spontaneous and exothermic nature of the adsorption, driven by molecular interactions. To elucidate the adsorption mechanism at the molecular level, we employed Density Functional Theory (DFT) calculations, Molecular Dynamics (MD) simulations, and Non-Covalent Interaction (NCI) analysis. These computational methods provided insights that closely aligned with experimental data, establishing a robust theoretical-experimental framework for understanding dye adsorption by watermelon seed biosorbent. The practical implications of our findings are significant, suggesting that watermelon seed biosorbent can be effectively scaled up for industrial effluent treatment in continuous systems. The study underscores the potential of utilizing this sustainable and economically viable biosorbent for environmental remediation, offering a promising alternative to conventional adsorbents with its high efficiency and lower sensitivity to environmental conditions such as pH and temperature
The contingent factors that affect the use of performance measurement systems in the Egyptian medium and large sized manufacturing companies
No full textEThOS - Electronic Theses Online ServiceGBUnited Kingdo
Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study
No full textBackground: Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods: We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung's disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings: We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung's disease) from 264 hospitals (89 in high-income countries, 166 in middle-income countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in low-income countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation: Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between low-income, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030. Funding: Wellcome Trust
Lecciones aprendidas para la atención en salud mental en la gestión de riesgo de desastres y emergencia por COVID 19 en Colombia.
No full textIn this document, we present an analysis of the decrees issued by the national government of Colombia from March 15º to December 31º in 2020. We also analyzed the Colombian risk and disaster management law (Law 1523 of 2012) to estimate whether the approach to the COVID19 pandemic from a comprehensive risk management perspective and incorporating elements related to mental health due to its possible psychosocial impacts. The decrees evidenced the measures taken by the national government facing the COVID-19 emergency and how biological risks were managed. We explored keywords in the text of the decrees, such as mental health, well-being, and psychological well-being. Next, we analyzed the characteristics of law 1523, its actors, and responsibilities in case of disasters, all to determine how much mental health is taken into account in the laws in Colombia. Once the analysis was carried out, gaps were established such as the non-consideration of biological threats explicitly in the law and the low relevance of mental health in both the risk management law and the presidential decrees issued for the management of the pandemic in 2020. It is considered important to make mental health visible in Colombian laws as well as the implementation of measures that guarantee their attention, taking into account the articulation of the decisions of the Ministries of Education, Health and Social Protection in the implementation of mitigation and knowledge of the risks, guaranteeing the collective well-being of ColombiansEn el presente documento se hace un análisis sobre los decretos emitidos por el gobierno nacional de Colombia desde el 15 de marzo hasta el 31 de diciembre del año 2020, así como la ley de gestión de riesgos y desastres de Colombia (ley 1523 del 2012) con el fin de estimar si el abordaje de la pandemia por COVID19 se realizó desde una perspectiva integral de la gestión de riesgos y si incorporó elementos relacionados con la salud mental debido a sus posibles impactos psicosociales. En los decretos se evidenciaron las medidas tomadas por el gobierno nacional ante la emergencia por COVID-19 además de cómo han sido tomados los riesgos biológicos; para esto se buscaron palabras claves en el texto de los decretos como lo fueron: salud mental, bienestar y bienestar psicológico; en segundo lugar, se analizaron las características de la ley 1523, los actores y responsabilidades de estos en caso de emergencias y desastres, todo esto con el objetivo de determinar el papel de la salud mental en las leyes en Colombia. Una vez realizado el análisis, se establecieron los vacíos tales como la no consideración de las amenazas biológicas explícitamente en la ley y la poca relevancia de la salud mental tanto en la ley de gestión de riesgo como en los decretos presidenciales expedidos para el manejo de la pandemia en 2020. Se considera importante visibilizar la salud mental en las leyes colombianas al igual que la implementación de medidas que garanticen su atención, teniendo en cuenta la articulación de las decisiones de los ministerios de Educación, de Salud y Protección Social en la implementación de mitigación y conocimiento de los riesgos, garantizando el bienestar colectivo de los colombianos
