Place Of Residence Research Articles

Epithelioid Hemangioendothelioma of the Azygos Vein

Background. Epithelioid hemangioendothelioma (EHE) is a malignant vascular tumor of mesenchymal origin. In the mediastinum, EHE originates from the large venous vessels of the superior vena cava.The purpose of the study was to describe a rare clinical case of EHE of the unpaired vein and analyze literature data to improve diagnosis and treatment of this disease.Case presentation. We present a rare case of EHE of the unpaired vein in a 23-year-old male patient who admitted to the Herzen Moscow Oncology Research Institute with a posterior mediastinal tumor detected in August 2022. It was known from the medical history that the patient had undergone diagnostic right-sided thoracotomy and tumor biopsy at the place of residence. Morphologically, the tumor was an epithelioid hemangioendothelioma. The histological re-assessment of biopsy specimens at the Herzen Moscow Oncology Research Institute confrmed the diagnosis of EHE. Computed tomography of the chest organs revealed a mass in the posterior mediastinum (in the projection of the lumen of the unpaired vein), measuring 16×14×41 mm, with relatively clear even contours, close to the posterior wall of the trachea at the bifurcation level, the posterior wall of the right main bronchus, the left semicircle of the esophagus (without signs of invasion). Based on the data on the presence of a vascular tumor in the posterior mediastinum on the right, a multidisciplinary medical consilium recommended surgical treatment: right thoracotomy, removal of a posterior mediastinal tumor with resection of the azygos vein, marginal resection of the superior vena cava, and thrombectomy from its lumen. The duration of surgery was 180 minutes, blood loss was 200 ml. Morphological examination confrmed EHE of the unpaired vein. No complications were observed in the postoperative period. The patient was discharged from the hospital on the 8th day after surgery in a satisfactory condition.Conclusion. EHE of the unpaired vein is an extremely rare vascular tumor. The clinical feature of EHE of the unpaired vein is the absence of any pathognomonic signs, which complicates differential diagnosis of mediastinal tumors. Surgery is currently the optimal treatment approach.

Study of the Mental Health of the Elderly and Related Factors

Background: Aging and increase in the elderly population are the most important issues in recent years in developed countries and some developing countries. Mental health is one of the crucial aspects of elderly well-being and must be addressed to improve community health. This study is conducted to examine the mental health of the elderly and the related factors in Gorgan city, 2022. Methods: The present study is descriptive-analytical and was conducted using a two-stage cluster random sampling method. First, four comprehensive health service centers were selected as a cluster from among the centers of Gorgan city, and then 263 people were randomly selected from the chosen centers, proportionate to the number of registered elderly individuals in the electronic service system. The standard depression questionnaire for the elderly was utilized for assessment. Data were then entered into SPSS software version 18 and with descriptive and analytical statistical tests, including the Mann-Whitney test, Chi-square test, and logistic regression (The significance level was less than 0.05(. Results: A total of 263 elderly people were evaluated with a mean age of 68.64 ± 7.2 . 143 (54.4%) were male and 120 (45.6%) were female. The prevalence of depression was reported to be 27.8. The occurrence of depression was significantly associated with age, marital status, and the presence of underlying disease conditions (p < 0.05). However, gender, place of residence, and BMI did not show a statistically significant relationship with the occurrence of depression. Aging, underlying diseases, and not being married increase the chance of depression in the elderly. Conclusion: Although the prevalence of depression in the elderly is lower than the average of the whole country in this study, they are in a better condition. However, due to the fact that they are a special target group, as well as the various risk factors of the disease, including age, lack of marriage, and the presence of an underlying disease in this group, it is suggested that more appropriate planning be done to improve their mental health status.

The prevalence and clinical correlation factors of cognitive impairment in patients with major depressive disorder hospitalized during the acute phase

ObjectiveThis study aimed to investigate the prevalence of cognitive impairment among patients with major depressive disorder (MDD) hospitalized during the acute phase and to analyze the in-depth association between this cognitive impairment and clinical correlation factors.MethodsIn this cross-sectional study, we recruited 126 patients aged between 18 and 65 years who were diagnosed with MDD. All these patients were inpatients from the Department of Psychiatry at the Second People’s Hospital of Hunan Province. We employed a series of assessment tools, including the Pittsburgh Sleep Quality Index (PSQI), the 16-item Dysfunctional Beliefs and Attitudes about Sleep Scale (DBAS-16), the Pre-sleep Arousal Scale (PSAS), the Morningness-Eveningness Questionnaire (MEQ), the Hamilton Anxiety Rating Scale (HAMA), and the 17-item Hamilton Depression Rating Scale (HAMD-17). The patients were divided into a cognitive impairment group and a non-cognitive impairment group based on their scores on the Montreal Cognitive Assessment Scale (MoCA). Through Spearman’s correlation analysis, we explored the correlation between the total MoCA score and the score of each factor. Additionally, we utilized binary logistic regression analysis to investigate the relationship between cognitive impairment and clinically relevant factors in MDD patients hospitalized during the acute phase and plotted ROC curves to evaluate their clinical efficacy.ResultsIn this study, we found that the prevalence of cognitive impairment among MDD patients hospitalized during the acute phase was as high as 63.49%. Through statistical analysis, we observed significant differences between the cognitive impairment group and the non-cognitive impairment group in terms of age, place of residence, education level, and HAMD-17 scores. In the Spearman correlation analysis, we noted the following trends: visuospatial and executive abilities were negatively correlated with the HAMD-17 score (P < 0.05); naming ability was positively correlated with the PSAS score but negatively correlated with the MEQ score (P < 0.05); memory was also negatively correlated with the MEQ score (P < 0.05); attention was negatively correlated with the HAMA score; and abstract cognitive ability was negatively correlated with the MEQ score (P < 0.05). Through binary logistic regression analysis, we further revealed the relationship between cognitive impairment and factors such as living in a rural area (OR = 2.7, 95% CI = 1.083-6.731, P < 0.05), increased age (OR = 1.049, 95% CI = 1.013-1.087, P < 0.01), and the HAMD-17 score (OR = 1.10295, 95% CI = 1.031-11.79, P < 0.01). Additionally, ROC curve analysis demonstrated a significant correlation between the HAMD-17 score and the prediction of cognitive function in MDD patients hospitalized during the acute phase (P < 0.001). Specifically, the AUC for the HAMD-17 score was 0.73, with an optimal cut-off value of 19.5, sensitivity of 70.0%, and specificity of 63.0%. Furthermore, the AUC for age was 0.71, with an optimal cut-off value of 33.5, sensitivity of 59.0%, and specificity of 80.0%.ConclusionsThis study indicates that MDD patients hospitalized during the acute phase have a higher prevalence of cognitive impairment. This phenomenon reflects a significant correlation between clinical factors such as age, sleep-related characteristics, and the severity of depression with cognitive impairment. Therefore, regular assessment of cognitive function in MDD patients and early intervention may be crucial for the treatment and prognosis of the disease.

Between east and west, between past and future: The effects of exclusive historical victimhood on geopolitical attitudes in Hungary and Serbia.

In Eastern Europe, collective victim beliefs have become integral elements of national ideologies, especially amid rising geopolitical polarization. In this study, we investigated how exclusive victimhood was related to geopolitical attitudes in Hungary and Serbia. The study involved Serbian (N = 630) and Hungarian (N = 471) adult national samples stratified by gender, age, political orientation, and place of residence. As expected, exclusive victimhood predicted higher support for a geopolitical shift from the West (i.e., EU and US) to the East (i.e., Russia and China) via Euroscepticism in both samples. In Serbia, the strongest indirect effect was observed among participants with neutral attitudes towards the war in Ukraine. In Hungary, there was no expected moderated mediation while the direct effect of exclusive victimhood on the West-to-East geopolitical shift was largest for pro-Russian participants and non-significant for pro-Ukrainian participants. Different measures of ethnic identity showed no expected moderation effect, but an exploratory analysis revealed that exclusive victimhood partially mediated the relationship between identity measures (superiority and attachment) and support for a pro-Eastern (vs. pro-Western) geopolitical orientation. We discuss how the construals of the past based on exclusive victimhood shape future geopolitical preferences of the public in Hungary and Serbia.

Poverty induced inequality in nutrition among children born during 2010-2021 in India.

Almost two-fifth of the children in India is stunted and among various factors, poverty differential in child undernutrition is the largest. Using the latest population-based survey of National Family Health Survey, 2015-16 and 2019-21 this paper examined the poverty induced inequality in child stunting across the sub-populations of India. A sample of 213,136 children aged between 0-5 years from NFHS fourth round and 98,222 children in the same age group from the NFHS fifth round constitute the study sample. The wealth index is used as the proxy of household's economic wellbeing and height-for-age (HAZ) z-score of a child is used to identify the stunting status of the child. Box plots are drawn to understand the distributional characteristics of the HAZ score for both the study sample. We calculate the Erreygers corrected concentration index and decomposed the concentration indices using Gonzalo-Almorox and Urbanos-Garrido method. During 2015-16, more than half of the children from the poorest wealth quintile were stunted (52%), compared to 22% among the children from richest wealth quintile. In 2015-16, stunting was as high as 65% among the children of mothers with low stature (height less than 145 cm) and from the poorest wealth quintile whereas, the prevalence was observed 56% from the same sub-population during 2019-21. Among various factors, the concentration index of stunting was observed highest among the children of 36-47 months (-0.28) followed by children of age 48-59 months (-0.27) and among the fully immunized children (-0.25). Similar to NFHS-4, NFHS-5 also shows a predominantly higher socio-economic inequality among 24+ months children and among the fully immunised children. Factors like child age, birth order and sanitation showed positive elasticity. Decomposition analysis of NFHS-4 data shows that due to uneven distribution of wealth, mother's education as a determinant of child stunting solely explained 33% of the overall inequality followed by improved access to sanitation (24%), mother's height (8%) and place of residence (5%). Similar to NFHS-4, NFHS-5 data also shows that mother's education, sanitation, mother's height and place of residence predominantly contributes to the overall wealth inequality in child stunting. In India, poverty differential in child undernutrition is acute among the different sub-population of children. And the concentration of stunted children is higher among the different sub-population with higher wealth poverty. Mother's education, improved sanitation and mother's height explained larger variation in the overall inequalities in child nutrition across India.

Assessing Barriers and Difficulties to Healthcare Access Among Syrian Refugees in Jordan: An Observational Study

(1) Background: Worldwide, refugees may have some difficulties in accessing healthcare services. However, little is known about the factors that may predict the level of accessibility to the public healthcare system in the host countries. (2) Aim: To examine the level of accessibility of Syrian refugees to the public healthcare system in Jordan and further to identify the prediction of socioeconomic factors and barriers to healthcare access. (3) Methods: A cross-sectional study was conducted with a convenient sample of 356 Syrian refugees residing outside camps (Irbid, Ajloun, and Jarash). Data were collected using the Access to Healthcare Services Scale instrument (adopted from the Canadian Community Health Survey), which is composed of 2 sections: the general access scale (8 items) and the difficulties scale (20 items). One-way ANOVA test and independent t-test were used to examine epidemiological correlations among variables, whereas a hierarchical linear regression model was used to examine the predictability of socioeconomic factors and barriers to overall access to the public healthcare system by exploring the incremental impact of additional predictors. (4) Results: the mean age of the 356 participants was 35.22 years old, 56.5% were female, 67.4% were married, most of them 46.1% have secondary education, and non-employed 69.9%. Significant associations were observed among participants with different marital status (p < 0.001), educational level (mean 11.85 vs. 19.85, p < 0.001), working status (15.47 vs. 17.93, p < 0.001), family household number (16.42 vs. 17.0, p < 0.001), and health insurance (none: 15.50 vs. governmental 24.50, p < 0.001). Multivariate analysis revealed that the most important factors that may predict the overall access to healthcare services were: family monthly income (beta −0.19, p < 0.001), household family number (beta 0.17, <0.001), health insurance (beta −0.09, p = 0.047), and barriers (beta −0.43, <0.001), even after adjusting for potential confounding effects: sex, age, educational level, and place of residence. (5) Conclusions: Our findings indicate that socioeconomic factors and barriers may considerably predict overall access to public healthcare in Jordan. It is crucially important, therefore, for the Jordanian government and international organizations to create and develop strategic plans and programs that enhance refugees’ access to health services, positively impacting their health and wellness.

Homesickness in First-Year Students at a Costa Rican Public University

During the first year of university, students from rural areas in Costa Rica might have to leave home and settle down in a different city to attain a higher-education degree. These students go through diverse challenges due to the changes they have to face during the adaptation to this new life. One of the major aspects that students cope with is the phenomenon of homesickness since it can affect their emotions, motivation, and, subsequently, their academic achievement. The purpose of this study was to explore this phenomenon among first-year students enrolled in the majors of English as a Foreign Language, Computer Sciences, and Business Administration, study plans offered by Universidad Nacional (UNA) at Sede Interuniversitaria de Alajuela, in Costa Rica. During the first term in 2019, the researchers diagnosed the level of homesickness in this population. Through a mixed method approach, the likeliness, level, and traits of homesickness were determined. First, a demographic questionnaire informed on what regions these students came from and place of residence back then. On a second research stage, the students who had to move far from home completed a self-report scale to measure their level of homesickness; also, these students were interviewed to gather data on the strategies implemented at a personal level and social support given by university agents. Main findings revealed that all students changing their place of residence to start university studies were more likely to display some degree of homesickness. Results suggest that more emphasis on the phenomenon and follow-up of students’ cases is suggested to prevent and approach academic failure and eventual dropping out.

Innovative Production and Innovative Agricultural Products in the Food Economy in the Context of Selected Lifestyle Elements of the Inhabitants of South-Eastern Poland: Case Study

Sustainable development in the agriculture of the future will lead to innovative production, providing the possibility of obtaining better quality agricultural products. In turn, these innovative agricultural products will fit into new social lifestyles. Therefore, in this study, the authors asked the following research questions: (i) How do respondents perceive innovative agricultural production and innovative products in the area of food economy?; (ii) what is the relationship between selected lifestyle elements and the perception of innovative agricultural production and products? The research tool was a survey questionnaire. The diagnostic study was conducted using the CAWI (Computer-Assisted Web Interview) technique. The study was partial and non-probabilistic in nature. Participation in the study was voluntary and anonymous, and completion of the form could be interrupted at any time. The target group were adults aged ≥ 18 years. They were residents of south-eastern Poland, from the Podkarpackie and Lublin provinces. The study was of a correlational nature, as it sought relationships between the elements studied, without the possibility of influencing the level of individual variables. A five-point Likert scale with a neutral value was used for the assessment. Spearman correlation analysis (rS) was performed to find the relationship between the items. This type of correlation was chosen because the variables subjected to calculations were on an ordinal scale. The Kruskal–Wallis H test was also calculated to determine the effect of independent variables (lifestyle elements) on dependent variables (perception of innovative production and food products). The Mann–Whitney U test was utilized to calculate and identify differences between groups (sex and place of residence). Statistical significance was assessed at the level of α = 0.05. To illustrate these differences more clearly, categorized graphs of the average ratings of the items studied were also drawn up. The research results indicate a different approach from men and women to the issues studied. The place of residence and the approach of the respondents from south-eastern Poland to the studied lifestyle elements influenced their perception of sustainable agricultural production and innovative features of agricultural products. The examined lifestyle elements demonstrated a varied impact on the perception of innovative production and innovative food products.

Institutions matter: The role of institutions in the relationship between decision-making power and contraceptive autonomy.

Several academic papers have shown that the distribution of household decision-making power has a positive influence on women's contraceptive autonomy. This paper considers the role of the social or institutional environment (as captured by place of residence) in ameliorating or contributing to this relationship. Our study focuses on the context of Nigeria, a country with diverse gender norms and religious practices, often determined by geographic location. For example, Western common law is more prevalent in the southern Nigeria, while Sharia law is largely practiced in the North of the country. The analysis uses the Performance and Monitoring for Action (PMA) dataset (2019-2020), and analysis is done using logistic regressions. We find evidence that the relationship between household decision-making power and contraceptive autonomy is mediated by institutions (city). More specifically, we show that in Lagos-a state characterised by the increasing empowerment of women-women have more contraceptive autonomy as they gain decision-making power in the household. The opposite is true in Kano-household decision-making power has no bearing on contraceptive autonomy.

Information communication technologies and intimate partner violence among women in sub-Saharan African countries

Intimate partner violence is widespread in sub-Saharan Africa with women the usual victims. Efforts to address intimate partner violence (IPV) include interventions with information communication technologies (ICT) that are being used to raise awareness and promote the empowerment of women. Thus, there is a need to examine the relationship between ICT ownership and IPV among women in sub-Saharan Africa. We conducted a cross-sectional study of four countries in sub-Saharan Africa using the Demographic and Health Survey data. Ownership of ICT was the main predictor variable that was measured by ownership of a radio, television, mobile phones, and access to the Internet. The outcome variable was IPV, which was measured in two forms: physical and sexual violence. A multivariable analysis using binary logistic regression was used to examine the association between ownership of ICT devices and intimate partner violence (IPV) among women. In Zambia and Mali, women who own ICT devices were significantly less likely to experience sexual violence than those who did not own ICT devices. Predictors such as age, place of residence, education, wealth status, employment status, number of children and age at first marriage were significantly associated with experiences of IPV, even though the strength of this relationship varied across countries and types of IPV. Access to ICT should be promoted among women because ICT can raise awareness and offer women a platform for receiving social support and advice about coping with intimate partner violence.

SURGICAL TREATMENT OF CYSTIC FILTRATION BLEBS AFTER SINUSTRABECULECTOMY: CASES FROM PRACTICE

The article presents two similar clinical cases. Patients with complaints of bulbar conjunctiva neoplasm, which grew on the cornea, caused a pronounced feeling of discomfort and partially impaired visual functions, turned to the department of surgical treatment of glaucoma of the MNTC “Eye Microsurgery”. It should be noted that previously these patients underwent a sinustrabeculectomy at their place of residence in order to reduce intraocular pressure. After examination and additional instrumental research methods, the presence of a cystic filtration bleb was diagnosed and the area of anti-glaucoma surgery was revised with individual characteristics in each case. As a result of the treatment, a positive effect was achieved. At a repeat visit a month after surgery, patients did not complain, intraocular pressure was compensated, and there were no relapses.

Inequalities in measles immunization coverage among two-year-olds in Sierra Leone, 2008-2019.

Measles, a highly contagious and potentially fatal disease, remains a significant public health concern, particularly in low- and middle-income countries. Vaccination is the most effective way to prevent measles and achieving high immunization coverage is crucial for protecting children and communities. This study investigated the trends and inequalities in measles immunization coverage among two-year-olds in Sierra Leone between 2008 and 2019. The study utilized data from the Sierra Leone Demographic Health Surveys conducted in 2008, 2013, and 2019. The World Health Organisation Health Equity Assessment Toolkit was used to calculate various inequality measures, including Difference(D), Ratio(R), Population Attributable Risk (PAR), and Population Attributable Fraction (PAF). An inequality assessment was conducted for six stratifiers: age, economic status, level of education, place of residence, sex of the child, and sub-national province. In Sierra Leone, measles immunization coverage increased between 2008 and 2013 and decreased slightly in 2019. In 2008, 66.2% of two-year-olds were immunized, which increased to 86.2% in 2013 and then fell slightly to 82.2% in 2019. There was a decrease in inequality for age from 4.2 percentage points in 2008 to 3.0 percentage points in 2019(D = 4.2 in 2008 and 3.0 in 2019). Economic-related inequality decreased from 8.1 percentage points in 2008 to 7.5 percentage points in 2019(D = 8.1 in 2008 and 7.5 in 2019). Inequality in education decreased from 10.3 percentage points in 2008 to 7.4 percentage points in 2019based on results from the inequality measure D. For place of residence, inequality decreased from 6.0 percentage points in 2008 to 4.0 percentage points in 2019. For the child's sex, the inequality increased from 1.9 percentage points in 2008 to 4.5 percentage points in 2019. The PAF revealed that the setting average could have been 1.4% higher in 2008 and 2.7% higher in 2019 without the child's sex inequality. Provincial inequality decreased from 19.4 percentage points in 2008 to 16.9 percentage points in 2019(D = 19.4 in 2008 and 16.9 in 2019). The observed fluctuations in national measles immunization coverage for children under two underscore the need for sustained efforts in vaccination programs. While improvements in access based on age, socioeconomic status, education level, and place of residence suggest progress in reducing inequalities, the persistent provincial disparities, with a significant gap in 2019, highlight ongoing challenges that must be addressed to ensure equitable health outcomes. Additionally, the increase in inequalities based on the child's sex during the study period raises concerns about targeted interventions that may inadvertently neglect specific groups. These findings imply that policymakers must prioritize strategies that maintain high vaccination rates and focus on closing the geographical and sex-based gaps, particularly in underserved provinces and among vulnerable populations.

Challenges of Polish families related to caring for a disabled child at home: a cross-sectional study.

A family with a disabled child has major changes and challenges. The difficulties experienced by the whole family are of various natures and relate to emotional, psychological, caring, and financial problems. The aim of the study is to learn about the challenges and involvement of Polish families in caring for a disabled child in the home environment. A cross-sectional pilot study was conducted in a group of 103 parents of disabled children. The proprietary questionnaire and a standardized scale for the Generalized Self-Efficacy Survey (GSES) were used as a research tool. The material for the study was collected online, using Google Forms software, and statistically processed. Emotional contact with a disabled child turned out to be the most difficult aspect of care for almost half of the respondents (42.7%). The vast majority of respondents (75.7%) described the level of difficulty in caring for a disabled child as much higher than the level of difficulty in caring for a healthy child. Most parents (87%) spend between 10 and 20% of their family income on the treatment and rehabilitation of disabled children. A significant relationship was noted between the assessment of the family's economic situation and place of residence (χ2P = 27.32; p < 0.0001; Vc 0.51). Parents of children with disabilities who live in rural areas and have less education are less well off financially. The average GSES score was 24.54 and was in 4 sten. The biggest care challenge for parents of disabled children turned out to be emotional contact with the child. The GSES index for parents of children with disabilities is lower than the average values obtained in Polish studies, which translates into worse coping with problems.

Mixed-methods to explore barriers to the use of food security initiatives in a historically black college and university (HBCU).

To assess students' use and perception of the initiatives to tackle food insecurity (FI) in a Texas historically black college and university (HBCU). HBCU students > 18 years (288 students). A mixed-methods approach involving an online survey, focus group discussions and key informant interviews were conducted among the students and major stakeholders to evaluate the prevalence of FI, and gain insights into the challenges to accessing, utilizing and effectively implementing food security (FS) initiatives. FI affected 63.5% of the participants. The awareness and utilization of the food pantry were 27.9% and 8.1% respectively while for the meal share programs, awareness and utilization were 30.1% and 15.0%, respectively. A significant association was found between FI and the place of residence (p = 0.027). Binary logistic regression model showed that students' school year was a predictor of food pantry awareness (p < 0.05), residence and FI status were predictors of the meal share program utilization (p < 0.05). Five themes, including poor awareness and visibility of campus resources, bureaucratic process and logistics, insufficient funds, personnel and other resources to run the initiatives, ineffective communication, and stigma due to location emerged as the main barriers to the use of the resources. This study emphasizes the necessity for HBCUs to address these hurdles in order to successfully help students in need with FI resources.

Dietary patterns as predictors of adverse antidiabetics reactions - A cross-sectional study of polish diabetes sufferers

Background: Diabetes mellitus (DM) is a multifaceted problem. There is a need to coordinate the diet with pharmacological interventions, because of the possible interaction between the two. The present study aimed to identify the factors related to the dietary habits of people suffering with diabetes that may increase the risk of adverse reactions to anti-diabetic medication. Methods: Between 2019 and 2020, patients with DM (N=203), aged 18-65, were enrolled for analysis. A quantitative and cross-sectional survey was applied. The study employed a Dietary Habits and Nutrition Beliefs Questionnaire devised in Poland for people aged 15–65 years (KomPAN) and a self-designed questionnaire as research tools. Results: The majority of the patients with DM studied confirmed the use of a low carbohydrate diet in relation to their disease (87.7%). The mean pHDI-10 score for the study group was 22.55±8.67 points and the mean nHDI-14 score was 15.00±9.88 points. The place of residence, education and general financial situation of the subjects had a statistically significant effect on the results (p&lt;0.05). The majority of subjects reported regular use of anti-diabetic medication (77.8%). Of those treated with oral medication, 61.1% had experienced adverse effects and 49.3% had been hospitalized as a result. Of those treated with insulin, 40.9% reported adverse effects. Conclusions: Health professionals should be proactive in giving people with DM, particularly those who are less educated, financially disadvantaged, aged 41-55 and are working, adequate counseling about dietary recommendations from the very onset of their illness.

Multicentric study of adherence to antiseizure medications among adults with epilepsy attended in neurology departments in Burkina Faso.

To study the adherence of antiseizures medication in neurology in the city of Ouagadougou. We conducted a multicentric cross-sectional study on adherence to antiseizure medications among adult patients with epilepsy followed by outpatient neurology consultations. The patients were recruited from November 22, 2021 to February 22, 2022 in four departments of neurology. Adherence to antiseizure medications (ASM) was measured using the Morisky Medication Adhesion Scale (MMAS). Logistic regression analysis was used to investigate factors associated with adherence. One hundred and seven patients with a mean age of 38.92 ± 16.06 years were included in the study. Most of the patients were men (52.34%). Twenty-eight patients complied well with ASM (26.17%). The main causes of nonadherence to treatment were forgetfulness and lack of financial means. Factors associated with nonadherence were rural residence (p = 0.023), celibacy or divorce (p = 0.002), low level of education (p = 0.028), perception of stigma (p = 0.026), duration of epilepsy <5 years (p = 0.009). Adherence to ASM is low in Burkina Faso. The main causes of nonadherence were forgetting and insufficiency of financial resources. Rural residence, celibacy, or divorce, low level of education, perception of stigmatization, and short duration of epilepsy were associated with non-adherence. Studies on adherence to antiseizure medications are rare in Africa while patients do not have access to adequate treatment. The aim of our study was to evaluate the adherence to antiseizure medications among patients with epilepsy followed by the neurology departments in the city of Ouagadougou. Forgetfulness and financial insufficiency were the main causes of treatment interruption. Our study showed that most of the patients were non adherent. Several factors such as place of residence, level of education, and duration of epilepsy influence the level of compliance.

Successful experience of hip arthroplasty with a unipolar endoprosthesis

Introduction. Fractures of the femoral neck occupy a significant place in traumatology and orthopedics and represent a serious pathological problem. Without surgical treatment, this pathology leads to complications and death of the patient within a year. Hip replacement is the choice of treatment method that allows the injured patient to be mobilized as early as possible. This promotes and has a positive effect on the timing and effectiveness of rehabilitation measures and minimizes the risk of developing possible complications. The purpose of this publication is to demonstrate the successful experience of treating a patient with a fracture of the right femoral neck with displacement of fragments using endoprosthetics. Materials and methods. To write the article, we used medical documentation data from a trauma hospital, the results of instrumental research and dynamic observation of the patient. A search was also carried out in the open electronic scientific databases PubMed of the US National Electronic Medical Library and the databases of the Russian scientific electronic library elibrary, using keywords and phrases: Results. Endoprosthesis replacement of the hip joint with a unipolar endoprosthesis was performed. On the sixth day after the surgical intervention, the patient was discharged in satisfactory condition for outpatient treatment by a traumatologist at his place of residence. The wound and sutures have no signs of inflammation, sensitivity and blood supply to the limb are preserved. The patient moves independently using a walker. Discussion. Analyzing the results of surgical treatment in the described clinical case, we can conclude that the method of hip replacement is highly effective in elderly people. Conclusion. Endoprosthesis replacement surgery is low-traumatic and allows the patient to be mobilized early. Our experience allows us to believe that treatment with endoprosthetics is effective for fractures of the femoral neck and allows us to achieve positive results in the early stages.

Social determinants and socioeconomic inequalities in adherence to antenatal iron-folic acid supplementation in urban and rural Indonesia.

Adherence to iron-folic acid supplementation (IFAS) has been linked with maternal anaemia. While findings about determinants of IFAS adherence have been mixed across different research, there is inadequate evidence in relation to socioeconomic inequalities. This study aims to examine social determinants and socioeconomic inequalities of adherence to IFAS in urban and rural Indonesia. We conducted a secondary analysis of the 2017 Indonesia Demographic and Health Survey by including a total of 12 455 women aged 15-49 years. The outcome was adherence to IFAS for at least 90 days. We used multiple logistic regression analysis adjusted for the survey design to analyse factors associated with IFAS adherence. We estimated socioeconomic inequalities using the Wagstaff normalized concentration index and plotted them using the concentration curve. About half of women consumed IFAS for at least 90 days, with a higher proportion in urban areas (59.0%) than in rural areas (47.8%). Social determinants of adherence to IFAS were similar for urban and rural women. Overall, being an older woman, having weekly internet access, antenatal care for at least four visits, and residing in Java and Bali were significantly linked to IFAS adherence. Higher maternal education was significantly linked to IFAS adherence in urban settings, but not in rural settings. There were interactions between place of residence and woman's education (p<0.001) and household wealth (p<0.001). Concentration indices by woman's education and household wealth were 0.102 (p<0.001) and 0.133 (p<0.001), respectively, indicating pro-educated and pro-rich inequalities. However, no significant education-related disparity was found among rural women (p=0.126). Women (age, education, occupation, birth number, internet access, involvement in decision-making), household (husband's education, household wealth), health care (antenatal care visit) and community (place of residence, geographic region) factors are associated with overall adherence to IFAS. These factors influence the adherence to IFAS in a complex web of deep-seated socioeconomic inequalities. Thus, programs and interventions to improve adherence to IFAS should target women of reproductive age and their families, particularly those from socioeconomically disadvantaged groups residing in rural areas.

Trends and inequalities in anaemia prevalence among children aged 6–59 months in Ghana, 2003–2022

BackgroundAnaemia, characterised by a deficiency in red blood cells or haemoglobin, is a public health issue in Ghana, particularly among children. The prevalence of anaemia in this age group has been a longstanding concern due to its adverse effects on cognitive development, physical growth, and well-being. This study examined the trends and inequalities in anaemia prevalence among children aged 6–59 months in Ghana between 2003 and 2022.MethodsData from the Ghana Demographic Health Survey conducted between 2003 and 2022 was used to analyse the prevalence of anaemia in children aged 6–59 months. The World Health Organization’s Health Equity Assessment Toolkit software calculated several inequality measures, including difference, ratio, population-attributable risk, and population-attributable percentage. An inequality assessment was performed for six stratifiers: child’s age, mother’s economic status, maternal educational level, place of residence, child’s sex, and sub-national region.ResultsAnaemia prevalence among children aged 6–59 months in Ghana declined from 76.1% in 2003 to 48.9% by 2022. The results revealed an age-related inequality in anaemia prevalence among children in Ghana, with younger age group ( 6–11 months) consistently showing higher rates. The age-related inequality Difference was 24.6 percentage points in 2022, indicating that age is crucial to understanding anaemia risk. Economic-related inequality between children of mothers in Quintile 5 (richest) and Quintile 1 (poorest) increased from a Difference of 21.1 percentage points in 2003 to 32.7 percentage points in 2022 highlighting the stark inequalities across wealth quintiles. Education inequality between children of mothers with higher education and no education decreased from a Difference of 29.4 percentage points in 2003 to 25.3 percentage points in 2022, suggesting that children from less educated households are still at higher risk. Place of residence inequality between children of mothers living in urban areas and rural areas increased from a Difference of 12.3 percentage points in 2003 to 14.8 percentage points in 2022 reflecting urban-rural disparities. Sex-related inequality between male and female children decreased from a Difference of -0.3 percentage points in 2003 to -5.5 percentage points in 2022 indicating the absence of inequality based on sex of the child. Lastly, regional inequalities are pronounced, as indicated by an increase in the Difference from 21.2 percentage points in 2003 to 34.0 percentage points in 2022, highlighting that children in certain regions like the Northern and Upper East are more affected by anaemia.ConclusionThe decline in anaemia prevalence among children aged 6–59 months in Ghana, reflects substantial progress; however, notable inequalities persist across age, economic status, education, place of residence, and region. To address these disparities, strategies such as enhancing access to healthcare services in underserved regions, implementing community education programs to raise awareness about nutrition and health, and promoting economic empowerment initiatives can be effective. Additionally, community education can play a crucial role in offsetting the effects of low household education levels, fostering a more informed population that can advocate for better health practices and policies. By addressing these key areas, we can work towards reducing anaemia prevalence and improving child health outcomes across all populations in Ghana.

Determinants of Poor Health Outcome Among Older Adults in India

Self-rated health (SRH) is a crucial indicator of overall health status, functionality, and mortality among older adults. This study examines the socio-economic correlates of health outcomes among older adults aged 45-59 in India using data from the Longitudinal Ageing Study of India Wave-I. Descriptive analysis, bi-variate analysis, and multivariate logistic regression were performed to investigate the factors that best explain and predict SRH. The results show that age, gender, place of residence, education, marital status, religion, social category, living arrangements, work status, income, multimorbidity, functional limitations, nutritional status, and health behaviours are significant determinants of poor SRH. Multimorbidity and functional limitations were found to be the principal determinants of poor SRH. The likelihood of reporting poor SRH increases with age, being female, living in rural areas, having lower education, being unmarried, divorced, or widowed, belonging to disadvantaged social categories, living with a spouse or others, not currently working, having lower income, being underweight, and engaging in risky health behaviours. The findings highlight the need to strengthen healthcare services for older adults in India, considering the ongoing demographic transition and the substantial proportion of poor SRH in this age group. Addressing the needs of older adults aged 45-59 can help the nation benefit from the demographic dividend.