Economic Status Research Articles

Wealth is health: High economic status in Cameroon correlates with protective gear use in traffic injuries and improved clinical outcomes.

Africa is the least motorized populated continent, yet it experiences the highest traffic fatality rate. Despite laws mandating helmet and seatbelt use, data on protective gear use among Cameroonian road traffic injury (RTI) patients remains sparse. We extracted Cameroon Trauma Registry data prospectively collected from 10 hospitals during July 2022 to December 2023. Protective gear users wore helmets in motorcycle and seatbelts/car seats in vehicle crashes. We categorized patients into five economic clusters based on ownership of durable goods using parallel distance matrix computation. We analyzed associations between continuous variables with Wilcoxon rank-sum and categorical variables with χ2 and multivariate logistic regression. Our primary outcome was in-hospital death or major disability at discharge. Among 3,554 RTI patients, 303 (9%) used protective gear. A larger proportion of patients who did not use protective gear were designated as majorly disabled or dead (20% vs. 16%, p < 0.001). The greatest percentage of protective gear users belonged to the richest cluster, while the poorest cluster patients comprised the smallest proportion of protective gear users (13% vs. 3%, p < 0.001). The richest cluster demonstrated the smallest percentage of major disability or death (13%), while the poorest cluster had the greatest percentage (28%, p < 0.001). When controlling for age, protective gear use, and injury severity, the three poorest clusters showed the greatest odds of major disability or death (cluster 3: adjusted odds ratio [AOR], 2.34; 95% confidence interval [CI], 1.58-3.46; cluster 4: AOR, 2.09; 95% CI, 1.59-2.74; cluster 5: AOR, 2.38; 95% CI, 1.24-4.58). Greater economic status is associated with increased protective gear use during RTIs in Cameroon. Despite suffering the most severe outcomes, the poorest patients remain less likely to use protective gear. Enforcement of protective gear laws and economic incentives such as price subsidies for helmets and seatbelts would particularly benefit the most vulnerable population. Retrospective Comparative Study; Level IV.

Academic Burden and Emotional Problems Among Adolescents: A Longitudinal Mediation Analysis.

Existing research indicates high prevalence of emotional problems among adolescents with excessive academic burden, yet the underlying reasons are not well understood. This study aimed to explore loneliness, physical activity, and sleep as potential mediating pathways between academic burden and emotional problems in adolescents. A longitudinal cohort study was conducted among middle and high school students in Taizhou City, Zhejiang Province, China, with data collected at three time points. The study included 2965 adolescents, with a mean age of 15.2 years (SD = 1.7), of whom 48.0% were female. Most participants came from families with middle to high economic status (94.8%). Structural equation modeling was employed to analyze the direct associations between academic burden (measured by study time and academic stress) and depressive and anxiety symptoms. Additionally, the indirect associations were explored through three mediators: loneliness, physical activity, and sleep. Higher academic stress at T1 was directly associated with more severe depressive symptoms at T3. Sleep (indirect effect 0.11, 95% CI 0.09-0.13), loneliness (0.10, 0.08-0.11) and physical activity (0.01, 0.002-0.012) at T2 mediated the relationship, accounting for 31.0%, 26.8%, and 1.8% of the total association of academic stress, respectively. For anxiety symptoms, sleep (0.11, 0.09-0.14) and loneliness (0.07, 0.05-0.08) mediated the association of academic stress with longitudinal mediation effect sizes of 34.1% and 20.6%, respectively. Study time was only associated with the outcomes indirectly via academic stress. Our results highlight the importance of behavioral and psychosocial differences related to academic burden in understanding the severity of mental health problems in adolescents.

A Comprehensive Systematic Review of Etiology and Risk Factors of Surgical Site Infections

Introduction: Surgical wound infections (SWIs) remain a significant risk to patients due to their high morbidity and mortality rates. Moreover, they pose substantial economic challenges for both developing and developed countries. The global impact of these infections is staggering, with the World Health Organization (WHO) reporting that millions of patients worldwide are affected by hospital-acquired infections annually, with many succumbing to these infections. This study aims to analyze the incidence of surgical site infections (SSIs) based on the type of surgical intervention, identify the most frequent causes of these infections, and explore effective management strategies. The findings of this study will provide valuable insights into the prevention and management of SSIs, thereby enlightening the medical community and empowering them to improve patient outcomes. Material and Methods: This study, conducted with meticulous attention to detail, focuses on patients operated on in our clinic from January to October 2024. It will reflect the incidence of SSI according to the type of surgical intervention, the most frequent causes of these infections, and the way of their treatment. Results: From January 2023 to June 2024, 788 patients were hospitalized, and 408 were operated on in the Surgery Department of the Clinical Hospital of Tetovo. Three hundred fifty were male, and 438 were female. The ages of the patients included in the study ranged from 21 to 81. Most of the patients were operated on because of cholecystolithiasis, inguinal, ventral, and umbilical hernias, breast cancer, acute appendicitis, and neoplasia of the colon and ileus. From the total number of operated patients (408), the infection of operative wounds was recorded in 49, representing an incidence of 11.76 %. Conclusion: The findings of this study underscore the serious global implications of SSIs, including increased morbidity and mortality rates and the strain on healthcare budgets. Therefore, the prevention and reduction of these infections should be a priority for all countries, irrespective of their economic status.

Residents’ Internet use, family economic status, and self-rated health: gender-based differences

BackgroundPeople’s health is an important foundation for national development.MethodsThis study uses data from the 2021 Chinese General Social Survey (CGSS) to empirically test the impact of residents’ Internet use and family economic status on self-rated health.ResultsThe empirical research results show that, first, residents’ Internet use and family economic status significantly promote their self-rated health. Second, a gender difference exists in how Internet use and family economic status affect residents’ self-rated health. Third, after introducing the interaction term between residents’ Internet use and family economic status, it is found that family economic status negatively regulates the promotion of Internet use on residents’ self-rated health, suggesting a substitution effect between these two factors. Finally, the heterogeneity test finds that the effects of Internet use and family economic status vary by region, registered residence, and age group.ConclusionsThis study suggests that the government can further improve Internet penetration, create a good Internet access environment, strengthen skills training, and enhance Internet content construction. These measures can amplify the positive effects of Internet use and family economic status on residents’ self-rated health.

Water, Sanitation and Hygiene in a Conflict Area: A Cross-Sectional Study in South Kordofan, Sudan

BackgroundThe UN General Assembly recognised the human right to water and sanitation through the sixth SDG in 2010. South Kordofan, a state in southern Sudan, faces WASH challenges due to conflict, geographical factors, and inadequate services, impacting over 600,000 residents. Such conflicts are well known for spreading diseases and disrupting WASH-related practices among displaced individuals.ObjectivesThe study aimed to evaluate the quality and availability of drinking water, as well as sanitation and hygiene practices in rural South Kordofan. It also sought to identify factors affecting community satisfaction with WASH services and to establish a data-driven basis for future interventions addressing these issues.MethodsA cross-sectional study accompanied a medical mission to South Kordofan, selecting 33 villages from South Kordofan based on healthcare, population, and accessibility. Water samples, patient forms and questionnaires were collected using convenient sampling for targeted villages and for attendants of mobile clinics. Laboratory analyses were conducted on water samples. Descriptive statistics, univariate analysis and logistic regression were used to analyse the data. The used level of significance was 0.05.ResultsOut of 784 participants, 60.2% were female. Tube wells/boreholes were the primary water source (68.1%), and most participants (70.9%) lived near their water source (less than 30 min). Dissatisfaction with water services was reported by 56.8%, and satisfaction associated with method of delivery (OR = 0.081, CI = 0.024–0.276)), appearance (OR = 0.299, CI = 0.182–0.489), distance (OR = 0.264, CI = 0.099–0.705), water unavailability (OR = 0.477, CI = 0.297–0.765), and obligation to pay (OR = 0.351, CI = 0.185–0.665). Samples showed high levels of contamination, both microbial and physicochemical. Regarding sanitation, over a third of the participants (41.5%) disposed of children’s stool by leaving it outdoors. About 10% of the participants reported having diarrhea during the week before the study. However, about two-thirds of the participants (68.1%) showed good hygienic practices by using soap or detergents for hand washing.ConclusionThe study revealed inadequate WASH services, high microbial contamination, and poor water treatment practices. Paradoxically, many participants expressed satisfaction with water services. Sanitation issues and open defecation persist, emphasizing the need for comprehensive interventions. All these negative consequences can be attributed to the armed conflict which resulted in poor awareness about the safety of drinking water, what safe water looks like and proper hygiene practices. Moreover, these conflicts led to disruption of the economical status leading to the absence of proper water purification infrastructure.

Strategi Utama Desa Adat Kutuh Kabupaten Badung untuk Meningkatkan Pariwisata sebagai Andalan Ekonomi

Kutuh Traditional Village is one of the villages in Badung Regency, Bali province. Kutuh Traditional Village has succeeded in changing its economic status from a poor village to a successful tourist village through various strategies. By utilizing village funds effectively, Kutuh Village developed nine tourism business units and three supporting service units, such as Village Credit Institutions and tourist attractions. Collaboration between traditional leaders and local governments also plays an important role in managing tourism, which now attracts around 3,000 tourists per day and generates annual revenues of up to 50 billion. This success is what makes Kutuh Traditional Village an example of other villages in Indonesia. This study employs qualitative research methods, gathering data through field lecture materials delivered directly by presenters serving as informants. For other supporting data, use journals, articles, books and others that are relevant to this research. This research shows that the Kutuh Traditional Village has implemented various strategies to increase tourism as an economic mainstay by utilizing village funds and has succeeded in developing nine tourism business units, including the Village Credit Institution (LPD).

Posttraumatic stress symptoms among Chinese university students during the COVID-19 pandemic: Prevalence, correlates, and mental health help-seeking.

Revisiting the epidemiology of posttraumatic stress symptoms (PTSSs) among university students during the coronavirus disease 2019 (COVID-19) pandemic as well as understanding the mental health help-seeking behavior of individuals with PTSSs has critical implications for public mental health strategies in future medical pandemics. To investigate the prevalence and correlates of PTSSs among university students during the first wave of the COVID-19 pandemic in China and to examine mental health help-seeking behaviors among these students. A total of 2507 Chinese university students were recruited via snowball sampling. The students completed the Seven-item Screening Scale for Post-traumatic Stress Disorder during the first wave of the COVID-19 pandemic in China. Sociodemographic characteristics, pandemic-related characteristics, and mental health help-seeking behaviors of students with PTSSs were also collected. The prevalence of PTSSs among the participants was 28.0%. Seven significant correlates of PTSSs were identified (odds ratio = 1.23-3.65, P ≤ 0.024): Female sex, being 19 years old or older, living with others or alone, a low level of family economic status, fair or poor interpersonal relationships, severe or very severe local pandemic, and having family members diagnosed with COVID-19. However, only 3.28% of the students with PTSSs reported seeking help from mental health specialists. Among the 23 students who sought help from mental health specialists, 13 opted for online or telephone-based psychological consultation. Our data suggest that there was a high risk of PTSSs among university students and a high level of unmet mental health needs during the COVID-19 pandemic. The delivery of mental health services online or via telephone is a promising approach to address these unmet needs.

A machine learning interpretation of the correlation between poverty and air pollution in the contiguous United States

The correlation between poverty and air pollution in the contiguous United States is a widely debated issue, often suggesting that impoverished areas suffer higher pollution levels due to socioeconomic disparities. However, existing studies frequently lack the integration of advanced analytical techniques and fail to account for a comprehensive range of variables. This research paper addresses these gaps by employing sophisticated machine learning models to analyze an extensive dataset encompassing various socioeconomic and environmental metrics. Utilizing linear regression, decision trees, and neural networks, we rigorously examined the data. While the variables were able to predict county-wide poverty rates to reasonably low RMSE and MAE values, our results indicate no significant correlation between poverty levels alone with air pollution indices. The latter finding challenges conventional understanding and highlights the complexity of the relationship between socioeconomic status and environmental quality. By offering a data-driven perspective, our study encourages policymakers to reconsider the factors influencing environmental justice and to look beyond economic status alone. Our work underscores the necessity for further investigation into other potential determinants of pollution, contributing to the discourse on environmental equity. This research provides a fresh, nuanced view that questions established beliefs and underscores the multifaceted nature of socioeconomic-environmental interactions.

Impact of Socioeconomic Status on Oral Health-Associated Quality of Life of Pregnant Women Visiting a Public Sector Hospital

Objectives: To evaluate impact of socio economic status on oral health associated quality of life among pregnant ladies Methodology: This cross sectional study was conducted in hospital of Islamabad from April-May 2024. Pregnant women between 18-49 years of age coming for antenatal care visit, without any systemic illness were recruited via simple random sampling. Oral health-related quality of life amongst pregnant women was checked. Oral-clinical assessment of pregnant patients was done by using Oral health- impact profile questionnaire (OHIP-14). Approval from HSA ethical clearance committee &amp; inform consent from patients was taken for this study. Chi-square test was applied to determine probable association b/w variables, with considering a p-value of 0.05 as significant. Results: About one-third population of this study was bachelor degree holder or above. Almost one-third (30%) participants had a family income per month ranging between 31000 to 50000 rupees. There was no significance found between OHIP-14 scores with level of education and occupation where p-values were 0.256 &amp; 0.075 respectively. The Oral Health Impact Profile (OHIP-14) is the most commonly used scale for measuring OHRQoL of pregnant women. Chi-Square test revealed statistical insignificance of OHIP-14 score with socioeconomic status/monthly income (p-value 0.79). Chi-Square test was applied to find significance between OHIP-14 score and area of living and 1st pregnancy where p-values were 0.514 &amp; 0.479 respectively. Conclusion: Socio-economic status do not has significant association and impact on oral health related quality of life of pregnant women. Providing dental services at a subsidized rate is the need of hour.

Effects of Shared Decision-Making, Health Literacy, and Self-Care Knowledge on Self-Care Behavior Among Hemodialysis Patients in Korea: A Cross-Sectional Survey.

Patients undergoing hemodialysis for chronic kidney failure experience various complications and physical and emotional difficulties, leading to decreased quality of life. Self-care behaviors are essential for preventing complications and reducing mortality rates. Effective self-care behaviors significantly depend on shared decision-making, health literacy, and self-care knowledge, each critical in patient self-care performance and disease management. This study aimed to determine the importance and relevance of shared decision-making, health literacy, and self-care knowledge. In particular, it enhances self-care behaviors among hemodialysis patients. Participants were 108 adult hemodialysis patients from the hemodialysis centers of three medical institutions in Cheongju City, Korea. Moreover, the study utilized a descriptive survey research design. Data were analyzed using descriptive statistics, independent t-tests, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analyses. The average score for self-care behaviors was 125.28 out of 175 points, with high scores for medication and vascular management. Furthermore, there were low scores for social activities and dietary management. Factors influencing self-care behaviors in hemodialysis patients were identified as sex, age, economic status, health literacy, and self-care knowledge. These factors explained 45.2% of the variance in self-care behaviors. To promote self-care behaviors in hemodialysis patients, it is essential to improve health literacy and self-care knowledge, strengthen tailored educational programs, and promote the explanatory role of nurses and shared decision-making. Additionally, comprehensive interventions, including economic support, are necessary.

Economic Status and Decision Making Power of Tribal Women: An Overview of Backyard Poultry Rearer in Khagrachari District of Bangladesh

Economic Status and Decision Making Power of Tribal Women: An Overview of Backyard Poultry Rearer in Khagrachari District of Bangladesh

The status of serum 25(OH)D levels is related to breast cancer.

Breast cancer is the second most common cancer among women and the leading cause of cancer-related mortality in this population. Numerous factors have been identified as either risk factors or protective factors for breast cancer. However, the role of Vitamin D (Vit. D) in breast cancer remains contentious, with conflicting findings in the literature. The present study aimed to compare serum Vit. D levels between women with and without breast cancer. This cross-sectional study included 40 women diagnosed with breast cancer, referred to the Mahdia Hamadan Radiotherapy Center in 2022. These participants were matched with 40 age- and Vit. D serum level-matched women without breast cancer. Serum Vit. D levels were measured using the ELISA method. Statistical analysis was performed using SPSS version 26, with a significance threshold set at a 95% confidence level. The mean ± standard deviation of serum Vit. D levels in women with and without breast cancer were 31.9 ± 28.27 ng/mL and 37.98 ± 15.89 ng/mL, respectively (P = 0.024). The prevalence of Vit. D insufficiency was 50% in the breast cancer group and 27.5% in the control group, while 50% of the breast cancer group and 72.5% of the control group had sufficient Vit. D levels (P = 0.008). In women with breast cancer, lower Vit. D levels were significantly associated with lower educational (P < 0.001), economic (P < 0.001), and social status (P < 0.001). A weak positive correlation was observed between serum Vit. D levels and patient age (r = 0.162, P = 0.152). The significant difference in serum Vit. D levels between women with and without breast cancer suggests that Vit. D deficiency may be associated with breast cancer risk. These findings support the hypothesis that improving Vit. D status in women could potentially reduce the incidence of breast cancer.

Multilevel analysis of prevalence and determinants of diarrhea among under-five children in Somalia: insights from the Somalia demographic and health survey 2020

BackgroundDiarrheal diseases remain a critical public health challenge, particularly for children under five in low- and middle-income countries such as Somalia. This study aimed to assess the prevalence and determinants of diarrhea in this vulnerable population, utilizing data from the 2020 Somalia Demographic and Health Survey.MethodsThis investigation employed secondary data from the 2020 Somalia Demographic and Health Survey. The analysis involved the extraction and cleaning of variables using STATA version 17. The primary outcome variable was childhood diarrhea, analyzed alongside 19 explanatory variables encompassing sociodemographic and environmental factors. Descriptive statistics, chi-square tests, and multilevel logistic regression models were employed to elucidate associations.ResultsThe study identified a diarrhea prevalence of 5.24%. Notably, sociodemographic factors significantly influenced this prevalence. Families within the second wealth category exhibited reduced odds of diarrhea (AOR = 0.699; 95% CI: 0.522–0.936), with those in the middle wealth category experiencing even lower odds (AOR = 0.524; CI: 0.391–0.702). Vitamin A supplementation was found to be critical; children lacking recent supplementation had increased odds of diarrhea (AOR = 1.790; CI: 1.440–2.225). Furthermore, feeding practices indicated that children not using bottle nipples faced higher odds of diarrhea (AOR = 1.377; CI: 1.172–1.617). Maternal age also played a significant role, with mothers aged 45–49 presenting higher odds of their children experiencing diarrhea (AOR = 7.650; CI: 1.762–33.184). Institutional births were associated with lower odds of diarrhea (AOR = 0.693; CI: 0.568–0.847), while children of educated fathers exhibited increased odds (AOR = 1.414; CI: 1.090–1.833). Additionally, lack of deworming medication significantly heightened the odds of diarrhea (AOR = 4.450; CI: 3.619–5.482).ConclusionThe prevalence of diarrhea among children under five relatively high in Somalia. Key determinants include vitamin A supplementation, feeding with bottle, household wealth, age of mothers, place of delivery, paternal education, and deworming medication. Public health interventions should focus on enhancing household economic status, and ensuring regular deworming. Increasing the coverage and frequency of vitamin A supplementation could enhance children’s immune systems and reduce diarrhea incidence. Moreover, targeted economic support, health care programs for older mothers are essential to mitigate the adverse effects of socioeconomic factors on child health, ultimately leading to a substantial reduction in diarrheal diseases among young children.

Measurement and determinants of economic inequality between migrants and non-migrants: evidence from Oaxaca-Blinder decomposition analysis of Uttar Pradesh, India

This paper investigates the economic inequality between migrants and non-migrants employing Gini inequality index and Lorenz curve based on household consumption expenditure from the Periodic Labor Force Survey (PLFS) for 2020–2021. The findings indicate a significant economic inequality gap between migrants and non-migrants across the geographical regions of Uttar Pradesh, India. Additionally, highlights the effect of caste and religious affiliation on migratory patterns and living standards. Based on the Ordinary Least Squares regression results with Oaxaca-Blinder decomposition, the demographic and socioeconomic factors such as education, gender, religion, caste and households’ size significantly identify the economic inequality gap between migrants and non-migrants. Our findings provide significant evidence for effective delivery of social protection policies at regional level. Moreover, intra-government and inter-government cooperation should be taken into the consideration for migrant workers in bringing their healthy economic and social status in both origin and destination places.

Predictors of Academic Anxiety among Secondary School Students

Background: Academic anxiety is a feeling of worry, tension, or dread that's related to schoolwork, exams, assignments, or subjects. It can also be caused by social pressures from peers or parents, or by feeling uneasy about studying or working in groups. Academic anxiety is a prevalent issue that students must address to achieve academic success. It becomes a critical problem requiring immediate attention when it intensifies to the point where a student can no longer function productively. While feelings of anxiety are not inherently abnormal, they can become so severe in some individuals that they impair day-to-day functioning, potentially leading to the diagnosis of one or more anxiety disorders. This investigation focuses on identifying the factors that trigger academic anxiety among students. The pressure of competition is particularly evident during adolescence, especially when students transition to secondary school. At this stage, streams such as science and non-science are often allocated based on students' preferences and academic performance in previous classes. Science students frequently aspire to pursue engineering or medical courses after secondary schooling, while arts students aim for admission to prestigious colleges and universities. The intense competition for admission to these programs can heighten anxiety levels. Recognizing the impact of this issue, the researcher has sought to explore the various factors contributing to academic anxiety among secondary school students and to identify strategies for reducing it to manageable levels. Aim: The study aimed to determine the influence of intelligence, study habits, socio economic status and school environment on academic anxiety of total sample, male &amp; female samples. Method &amp; Procedure: A Descriptive research design was adopted and subsequently stratified random sampling technique was adopted to select 677 students from both science and non-science streams were chosen for the present investigation. Results: The results of the present investigation have revealed that personal factors like intelligence, study habits familial factors like Socio-Economic Status and institutional factors like school environment have a significant impact on academic anxiety among all sampling groups under study.

Associations between cardiovascular-kidney-metabolic syndrome and disability in activities of daily living: a nationwide longitudinal study among the middle-aged and older adults in China

BackgroundActivities in daily living (ADLs) disability triggered by aging population and chronic diseases in the middle-aged and older adults has become a major public health challenge. Cardiovascular-kidney-metabolic (CKM) syndrome, as a combination of several chronic conditions, has not yet been studied to explore its association with ADLs disability. We examined the association between CKM syndrome and ADLs disability among middle-aged and older adults in China and whether it varied by age and socioeconomic status.MethodsParticipants were from China Health and Retirement Longitudinal Study (CHARLS), which conducted four waves of surveys from 2011 to 2018. CKM stage was calculated through disease and physical examination data from CHARLS database. Meanwhile, the degree of disability was assessed through the ADL scale. Generalized linear mixed model was used to perform multivariate analysis to explore the association between CKM syndrome and the risk of ADLs disability.ResultsThe proportion of CKM stage 0, 1, 2, and 3 among the 5,898 eligible participants (median age 60 years, 60.27% women) in 2011 were 14.70, 30.23, 41.39, and 13.68%. The risk of ADL disability was increased by 16% (odds ratio [95% confidence interval]; 1.16 [1.00–1.33]) and 33% (1.33 [1.12–1.58]) in CKM stages 2 and 3 compared with stage 0. In addition, there was a greater risk of BADL disability in 75+ age group compared to other age groups, but no significant association with IADL disability. In the subgroup aged 75+, the risk of BADL disability was increased for CKM stage 2/3 (1.48 [1.01–2.18]/1.67 [1.06–2.64]) compared with stage 0. Only in the lowest quartile of socioeconomic status group CKM stage rise was strongly associated with the risk of disability. The risk of ADL disability was greater for CKM stage 2/3 (1.45 [1.15–1.83]/1.48 [1.11–1.98]) compared to CKM stage 0 in the lowest economic status quartile.ConclusionFor middle-aged and older adults in China, CKM syndrome is a key risk factor for ADLs disability. Therefore, effective measures should be taken to manage CKM stage at the lowest possible level, especially in older and economically disadvantaged populations.

Factors influencing childbirth fear among Asian women: a scoping review

Fear of childbirth (FOC) or tokophobia adversely affects women during pregnancy, delivery, and postpartum. Childbirth fear may differ across regions and cultures. We aimed to identify factors influencing the fear of childbirth among the Asian population. A systematic literature search was performed using the PubMed, Scopus, and Web of Science databases in November 2023. Original articles in English with research conducted in Asian countries were included. The independent factors associated with childbirth fear, from the relevant studies were identified and discussed. Forty-six papers met the eligibility criteria but only 26 studies were discussed in this review. The significant factors were categorized into (1) demographics, (2) clinical, (3) healthcare service, (4) childbirth education &amp;amp; information, and (5) COVID-19 pandemic. The prevalence of childbirth fear among Asians ranged between 56.6 and 84.8%. Significant demographic factors included age, education, marital status, economic status, and area of residence. Greater levels of tokophobia were linked to nulliparity, unplanned pregnancy, infertility, miscarriage, and pregnancies at risk. Effective doctor-patient communication and more frequent antenatal visits were shown to alleviate maternal childbirth fear. There was consistent evidence of prenatal childbirth education’s benefit in reducing FOC. The usage of smartphone apps and prolonged exposure to electronic devices were linked to a higher degree of tokophobia. Nulliparas who received too much pregnancy-related information also reported increased childbirth fear. There was a positive correlation between maternal fear of COVID-19 infection and FOC. Keeping updated with COVID-19 information increased the maternal childbirth fear by two-fold. In conclusion, a stable economy and relationship contribute to lesser childbirth fear among Asian women. Poor maternal health and pregnancy complications were positive predictors of FOC. Health practitioners may reduce maternal childbirth through women’s education, clear communication as well as accurate information and guidance to expectant mothers. Further study is required into the content of childbirth fear among Asian women. These research findings hopefully will lead to the development of culturally adapted screening tools and interventions that reduce the burden of FOC among expectant mothers.

Bullying in Undergraduate Medical Education of Bangladesh : Situation Analysis

This was descriptive type of cross sectional study. Both quantitative and qualitative approaches were applied to explore current situation of bullying among undergraduate medical students of Bangladesh. Study was designed to find out categories of bullying occurred, persons involved in bullying, factors contributing for the occurrence of bullying, effects of bullying on the students and steps to be taken against the bullying. The study was carried out in eight (five government and three non government) medical colleges in Bangladesh over a period from July 2023 to June 2024. Undergraduate medical students and teachers of medical colleges were the study population. Sample size was 632 for administering questionnaire to the students, 16 for focus group discussion to the students and 16 for in-depth interview of the teachers. Convenience sampling technique was adopted to enroll the respondents and to select medical colleges. Data was collected from those who were present at the time of data collection and respondents willing to participate in the study as respondents. One self administered semi structured questionnaire was used for data collection. A schedule for focus group discussion was used to collect data from two groups of undergraduate medical students and a schedule for in-depth interview was used to collect data from the teachers of medical colleges. Prior informed consent from the respondents was taken. Study revealed that verbal bullying was most common type of bullying. Other types of bullying were physical, political, economical and cyber bullying. According to gender, male, students are more involved in bullying than female students. According to residence status, majority of the students involved in bullying behavior were residing in the hostel. According to economical status, students belongs to middle class family were involved more in bullying activities. Senior students were involved more in bullying, other persons were peer students, teachers, staff of medical college and hospitals administrators of medical colleges and hospitals, was also involved to some extent. Study also revealed that environment of college campus and hostels play important roles in occurrence of bullying. Other factors involved in bullying are weak administration, student politics, teachers politics and lack of monitoring by the authority. Anxiety, depression, academic regression were common effects of bullying on the students. Other effects were physical illness, leave hostel, leave medical colleges and suicidal tendency. Several steps to be taken to prevent bullying in medical colleges. Most important steps are staying of super in the hostel, taking appropriate action by local authority, and counseling and motivation to the students, opportunity of the students to inform local and higher authority and action taken to prevent recurrence of bullying. Study recommend supporting undergraduate medical students by preventing bullying. This could be achieved by launching educational program, establishing students support system, increasing cultural program among medical students, developing awareness among medical students, teachers and ensuring punishment of liable individual as per policy. BJME, Volume-16, Issue-01, January 2025: 2-14

Potential Socioeconomic Impacts of the Grand Ethiopian Renaissance Dam Operation on Inland Fisheries in the High Aswan Dam Reservoir

ABSTRACTThe High Aswan Dam (HAD) reservoir is considered as the most vital reservoir in Egypt and as a source of freshwater fish. It contributes 69% of the total inland fisheries production. The annual fish production from the HAD reservoir is estimated by the General Authority for Fishery Resources Development (GAFRD) as 12,000 ton/year. The HAD reservoir is the main source of freshwater fisheries in Egypt. That amount of fish in the reservoir guarantees a constant source of income and employment since the HAD establishment. Fish production is significantly affected by three environmental key parameters: water level fluctuation, water temperature change, and sedimentation amount. Any alteration in these three parameters will significantly affect the social and economic status of the HAD reservoir fisheries. This study aims to quantify the potential socioeconomic consequences of the Grand Ethiopian Renaissance Dam (GERD) operation on the HAD reservoir fishery. To quantify these potential impacts, this research utilizes pre‐GERD socioeconomic data gathered by national and international organizations such as WorldFish (https://worldfishcenter.org/) and GAFRD, to establish baseline data. The change in predicted socioeconomic assessment is carried out based on the water level, temperature change, and sedimentation, after the GERD operation. A significant reduction in fish production is anticipated, with an estimated average decline by 48.5% compared to current production rates. This decline is expected to lead to a decrease in the overall socioeconomic value of the HAD reservoir fishery, potentially resulting in job losses for 25% to 72% of the fishermen and distributors employees. The total fishing income is expected to decrease, because of the decrease in fish production. The research findings highlight the importance of policy considerations to mitigate the possible socioeconomic impacts. Potential policy interventions could include stricter fishing regulations, alternative livelihood programs for affected communities, and collaborative management strategies with upstream dam operators.

The Effect of an Individualized Informational Intervention on the Quality of Life, Adherence and Psychosocial Economic Status of Patients with COPD: A Research Protocol

Introduction: Chronic obstructive pulmonary disease (COPD) has a diverse negative impact on patients, affecting them both physically and mentally. Psychosocial factors such as anxiety, depression, social isolation, and financial stress have been found to be positively associated with more exacerbations, hospital readmissions, poor adherence to medication, and lower quality of life among patients with COPD. However, healthcare professionals, who have a crucial role in diagnosing and managing COPD, often overlook these psychosocial factors of the disease, despite growing evidence suggesting their crucial role in improving disease outcomes. Consequently, this study will evaluate the effectiveness of a personalized individualized informational intervention on the quality of life, adherence, and psychosocial economic status of patients with COPD in healthcare settings of Greece. Methods: A prospective, mixed-methods design will be used, incorporating both quantitative data through questionnaires, including the Short Form (SF-12), Clinical COPD Questionnaire (CCQ), Test of Adherence to Inhalers (TAI), Patient Health Questionnaire (PHQ-4), Multidimensional Scale of Perceived Social Support (MSPSS), and Financial Ability Scale (FAS), alongside qualitative data with questions exploring themes such as general health perception, treatment adherence, mental status, socioeconomic status, and disease management. Participants will consist of patients receiving care at primary healthcare facilities and respiratory hospital departments in Crete, Greece. The intervention will involve providing structured information on social, financial, and psychological support services, along with psychosocial counseling over a six-month period. The impact of the intervention will be measured using validated tools to assess health status, quality of life, treatment adherence, mental health, and socioeconomic status before and after the intervention. Conversely, qualitative interviews will be conducted to gain deeper insights into the impact of the intervention. Finally, when the analyses of both data types are finalized, they will be triangulated to achieve convergence. This procedure entails the creation of a figure or illustration that demonstrates the convergence or divergence of both data types. Conclusions: The findings of this study are expected to highlight the importance of integrating an individualized informational intervention into the management of COPD. Thus, this study could guide healthcare professionals and policymakers in improving COPD care and patient outcomes.