Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically...Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.展开更多
In the paper,a class of functions with bounded turnings involving cardioid domain,are studied in the region of the unit disc.The bounds of|a_(5)|,|a_(6)|,|a_(7)|and the fourth Hankel determinant are obtained,which are...In the paper,a class of functions with bounded turnings involving cardioid domain,are studied in the region of the unit disc.The bounds of|a_(5)|,|a_(6)|,|a_(7)|and the fourth Hankel determinant are obtained,which are more accurate than those obtained by Srivastava.展开更多
Background: Erectile dysfunction (ED) is a common, bothersome and relatively under diagnosed complication of diabetes mellitus. This study was aimed to determine the prevalence of erectile dysfunction and its determin...Background: Erectile dysfunction (ED) is a common, bothersome and relatively under diagnosed complication of diabetes mellitus. This study was aimed to determine the prevalence of erectile dysfunction and its determinants. Methods: A cross-sectional hospital-based study was carried out in the Diabetology Units of the Buea and Limbe Regional Hospitals involving 332 male patients with diabetes and aged over 21 years. Data was analyzed using Stata and R version 3.5.3. Results: The mean age of the participants was 55years. Most participants (64.46%) were married. About half (50.60%) of the participants actively consumed alcohol, 11.45% were smokers and 57.83% were sedentary. 18 participants (5.42%) recorded high risk sexual behaviour. 54.32% of participants had a comorbidity and 43.90% were overweight. The prevalence of diabetic ED was 78.92%. Age, Fasting Blood Sugar and Glycated hemoglobin were found to be positive determinants of diabetic ED (odds ratio (OR) = 0.77, 95% CI −0.1 - 0.07). Conclusion: The prevalence of diabetic ED in this hospital population study is high, and both physician and patient—initiated measures are needed to reduce this prevalence and improve awareness, recognition and care of this condition.展开更多
Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and ...Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and to explore the determinants like geographic factor.Methods This study was conducted in women at mid-pregnancy, late-pregnancy and postpartum from southern, central and northern China. Approximately 132 women were included in each stratum by the three phases and regions. Plasma Hcy concentrations were assessed using high-performance liquid chromatography(HPLC), with hyperhomocysteinemia defined as > 10.0 μmol/L. Quantile regression was to estimate medians and interquartile ranges(IQRs), and logistic regression to examine the determinants of hyperhomocysteinemia.Results For 1,190 women included, the median(IQR) Hcy concentration was 5.66(4.62, 7.37) μmol/L.The adjusted median in mid-pregnancy, late-pregnancy and postpartum women was 4.75(4.13, 5.54),5.72(4.81, 6.85) and 7.09(5.65, 8.75) μmol/L, respectively, showing an increasing trend(P < 0.001). This increasing trend persisted across the three regions. Higher Hcy concentrations were observed in women residing in northern region and those with younger age or lower economic status. A total of 106(8.9%)women had hyperhomocysteinemia, with a higher prevalence in those residing in northern region(16.0%), or in postpartum women(16.5%).Conclusion Hcy levels, varying with geographic region, maternal age and economic status, are increased from mid-pregnancy to late-pregnancy and postpartum, indicating a need to monitor Hcy levels in pregnant and postpartum women to control potential risks related to elevated Hcy levels.展开更多
Objective To explore the health determinants of all-cancer mortality from a health-ecological perspective.Methods Using the health-ecological model,we identified 15 health determinants across five domains:personal inn...Objective To explore the health determinants of all-cancer mortality from a health-ecological perspective.Methods Using the health-ecological model,we identified 15 health determinants across five domains:personal innate,behavioral,interpersonal network,socioeconomic,and macroenvironmental characteristics.Data on cancer outcomes and health determinants from 185 countries,classified using the Human Development Index(HDI),were extracted from GLOBOCAN 2022,the World Health Organization Global Health Observatory,the Global Burden of Disease Study 2021,the United Nations,and the World Bank.A multivariate linear regression model was used to estimate the association between health determinants and cancer outcomes.Results A total of 153 countries with complete information on cancer outcomes and health determinants were enrolled in the study.A higher all-cancer age-standardized mortality rate(ASMR)was associated with current tobacco use,alcohol consumption,obesity,agricultural employment,and lag-distributed income.In women aged 15–49 years,being married or in a union was associated with a lower ASMR.Early-onset ASMR was positively associated with agricultural employment,lag-distributed income,and unsafe sanitation.Notable sex differences were observed,although tobacco use and obesity were identified as risk factors in both sexes.Conclusion We underscore the crucial need to incorporate cross-sectoral interventions within a resilient healthcare system to effectively mitigate the cancer mortality burden.展开更多
BACKGROUND Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety d...BACKGROUND Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety disorder(GAD).This comorbidity exacerbates breathing difficulties,activity limitations,and social isolation.While previous studies predominantly employed the GAD 7-item scale for screening,this approach is somewhat subjective.The current literature on predictive models for GAD risk in patients with COPD is limited.AIM To construct and validate a GAD risk prediction model to aid healthcare professionals in preventing the onset of GAD.METHODS This retrospective analysis encompassed patients with COPD treated at our institution from July 2021 to February 2024.The patients were categorized into a modeling(MO)group and a validation(VA)group in a 7:3 ratio on the basis of the occurrence of GAD.Univariate and multivariate logistic regression analyses were utilized to construct the risk prediction model,which was visualized using forest plots.The model’s performance was evaluated using Hosmer-Lemeshow(H-L)goodness-of-fit test and receiver operating characteristic(ROC)curve analysis.RESULTS A total of 271 subjects were included,with 190 in the MO group and 81 in the VA group.GAD was identified in 67 patients with COPD,resulting in a prevalence rate of 24.72%(67/271),with 49 cases(18.08%)in the MO group and 18 cases(22.22%)in the VA group.Significant differences were observed between patients with and without GAD in terms of educational level,average household income,smoking history,smoking index,number of exacerbations in the past year,cardiovascular comorbidities,disease knowledge,and personality traits(P<0.05).Multivariate logistic regression analysis revealed that lower education levels,household income<3000 China yuan,smoking history,smoking index≥400 cigarettes/year,≥two exacerbations in the past year,cardiovascular comorbidities,complete lack of disease information,and introverted personality were significant risk factors for GAD in the MO group(P<0.05).ROC analysis indicated that the area under the curve for predicting GAD in the MO and VA groups was 0.978 and 0.960.The H-L test yieldedχ^(2) values of 6.511 and 5.179,with P=0.275 and 0.274.Calibration curves demonstrated good agreement between predicted and actual GAD occurrence risks.CONCLUSION The developed predictive model includes eight independent risk factors:Educational level,household income,smoking history,smoking index,number of exacerbations in the past year,presence of cardiovascular comorbidities,level of disease knowledge,and personality traits.This model effectively predicts the onset of GAD in patients with COPD,enabling early identification of high-risk individuals and providing a basis for early preventive interventions by nursing staff.展开更多
Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-born...Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-borne parasitic diseases (VBPDs) transmission in Chad and provide recommendations for policy improvements. Methods: The study adopts the WHO Conceptual Framework of SDOH to compare two regions in Southern Chad: Kouh-Est, which has an ongoing vector control program, and Grand-Sido, which lacks such a program. The study includes both nomadic and sedentary populations to provide a comprehensive understanding of the SDOH influencing VBPDs. Households were randomly selected. Data on sociodemographic characteristics, literacy, knowledge of VBPDs and protective measures, and access to education and health facilities were collected. Results: A total of 202 households from 17 villages, including 820 participants, were surveyed. Agriculture, livestock, and fishing were the main occupations, involving 84.1% of participants. Literacy was low, with 36.7% non-educated, 47.7% completing primary school, 14.5% secondary school, and only 0.3% reaching tertiary education. Most villages lacked schools beyond the primary level, and nomadic populations were significantly less educated than sedentary ones (p Conclusion: Educational deficiencies, lack of protective measures against vectors, inadequate healthcare resources, and lifestyle conditions aggravated by poor road infrastructure, limited transportation, and economic constraints contribute to worsened VBPDs outcomes in these rural populations. Addressing these systemic issues in the surveyed communities is essential for improving health equity and VBPDs outcomes in these regions specifically and in similar populations settings more broadly.展开更多
BACKGROUND The global prevalence of diabetes among adults aged 29-79 years was found to be 10.5%.It is a global public health threat with a rising trend in morbidity and mortality.Poor glycemic control(GC)among patien...BACKGROUND The global prevalence of diabetes among adults aged 29-79 years was found to be 10.5%.It is a global public health threat with a rising trend in morbidity and mortality.Poor glycemic control(GC)among patients with type 2 diabetes mellitus(T2DM)is a major determinant of diabetes-related complications.There are limited data on GC and associated factors among patients with T2DM in South West Region,Cameroon.AIM To assess GC and identify contributing factors among patients with T2DM in a regional hospital in South West Region,Cameroon.METHODS A cross-sectional study was conducted from February 2022 to July 2022 among 131 participants in Limbe Regional Hospital who were selected by convenience.Glycated hemoglobin(HbA1c)was measured by ion-exchange chromatography.Sociodemographic,clinical,and lifestyle data were collected,entered into Excel,and exported to Statistical Package for Social Sciences version 22 for analysis.A multivariate logistic regression analysis was conducted to assess the association between explanatory variables and GC.The level of significance was set at P<0.05.RESULTS The mean age was 56±5.1 years.Eighty-eight(67.2%)patients were female.The mean HbA1c was 8.8%±1.8%.Poor GC(HbA1c≥7%)was registered in 106(80.9%;95%confidence interval:73.1%-87.3%)participants.Lack of self-monitoring of blood glucose at home was associated with poor GC(adjusted odds ratio:3.858,95%confidence interval:1.262-11.800;P=0.018).CONCLUSION The majority of patients with T2DM had poor GC.Absence of self-monitoring of blood glucose at home was the main contributing factor for poor GC.展开更多
IPO underpricing,the tendency for newly issued shares to trade above their offer price on the first day,is a persistent global phenomenon.Empirical evidence suggests that U.S.IPOs averaged an 18.8%first-day return fro...IPO underpricing,the tendency for newly issued shares to trade above their offer price on the first day,is a persistent global phenomenon.Empirical evidence suggests that U.S.IPOs averaged an 18.8%first-day return from 1980 to 2001,imposing significant indirect costs on issuers.This paper reviews key explanations for underpricing,including information asymmetry,signaling,agency conflicts,and behavioral factors.Empirical research highlights firm characteristics,underwriter reputation,market conditions,and regulatory factors as major determinants.While underpricing facilitates liquidity and market participation,it also reflects inefficiencies.This study synthesizes theoretical perspectives and empirical findings,emphasizing the need for improved disclosure,governance,and regulatory oversight.展开更多
BACKGROUND Social determinants of health are social and economic factors that influence health intervention outcomes.Type 2 diabetes is a highly prevalent disease,primarily affecting individuals in low-to-middle-incom...BACKGROUND Social determinants of health are social and economic factors that influence health intervention outcomes.Type 2 diabetes is a highly prevalent disease,primarily affecting individuals in low-to-middle-income countries.However,the association between social determinants and cardiovascular complications in type 2 diabetes has not been widely studied.AIM To examine the relationship between social determinants of health and cardiovascular complications in individuals with type 2 diabetes.METHODS We conducted a retrospective cohort study with an analytical component at a national-level referral hospital for military personnel in Bogota,Colombia.Patients treated at the diabetes clinic between September 2021 and December 2022 who met the inclusion criteria were included.A total of 583 patients participated in the study.We performed descriptive,bivariate,and binary logistic regression analyses,adjusting for confounding variables.RESULTS Among the 583 patients included,urban residency[odds ratio(OR)=3.05,95%confidence interval(CI):1.01-9.20]and a middle or high educational level(OR=2.33,95%CI:1.14-4.72)were associated with an increased risk of coronary artery disease.Additionally,receiving diabetes education beyond that provided by the clinic(OR=2.15,95%CI:1.14-4.05)and lack of access to spaces for physical activity(OR=4.05,95%CI:1.31-12.5)were associated with a higher risk of diabetic nephropathy and cerebrovascular disease,respectively.CONCLUSION Programs for diabetes management should account for social determinants of health that contribute to cardiovascular complications and increased healthcare costs.Population-based studies are needed to guide targeted interventions and clarify causal relationships.展开更多
Here we complete our work on the asymptotics of Hankel determinants studying the case wherein the entries are “ultrarapidly”-varying functions in the sense that their logarithms are rapidly varying. Moreover, the la...Here we complete our work on the asymptotics of Hankel determinants studying the case wherein the entries are “ultrarapidly”-varying functions in the sense that their logarithms are rapidly varying. Moreover, the last results in the paper highlight analogies between algebraic identities for Hankelians with special entries and asymptotic relations valid for large classes of entries.展开更多
Rhegmatogenous retinal detachment(RRD)is a sight threatening condition in which the neurosensory retina separates from the underlying retinal pigment epithelium.With an incidence of 6.3 to 17.9 per 100,000 persons(1),...Rhegmatogenous retinal detachment(RRD)is a sight threatening condition in which the neurosensory retina separates from the underlying retinal pigment epithelium.With an incidence of 6.3 to 17.9 per 100,000 persons(1),RRD is a condition frequently encountered by vitreoretinal specialists.Because the fovea is responsible for central visual acuity,foveal detachment is associated with poor presenting vision and is the strongest prognostic factor predicting poor visual outcome after RRD repair(2).展开更多
文摘Objectives:This scoping review aims to methodically identify and analyse the determinants which influence maternal mortality and healthcare utilization in women of childbearing years in Nigeria.The review specifically addresses the difficulties faced in assessing medical care,and the ongoing initiatives to lower the maternal mortality ratio.Methods:Primary studies(published after year 2000)focused on maternal mortality,health determinants,and the utilization of maternal healthcare services in Nigeria were retrieved following a systematic search across multiple databases,including Scopus,PubMed,Google Scholar,and Web of Science.These were screened using defined inclusion and exclusion criteria.Data from these studies were extracted and thematically analysed to identify common themes and trends.Results:A total of 21 publications were included in this review comprising 2 qualitative,17 quantitative,and2 mixed study designs.Major health determinants identified in these studies include hypertensive disorders of pregnancy,haemorrhage,and sepsis/septicaemia,contributing as much as 29%,24%,and 14.2%of maternal deaths respectively in over 10%of the reviewed studies.Similarly,social-economic determinants including poverty,maternal education,health system issues and culture significantly impacted the utilization of maternal healthcare services,inadvertently impacting maternal mortality.Despite various maternal health interventions such as the"Abiye"Safe Motherhood Initiative,the Integrated Maternal,Newborn,and Child Health Strategy and strengthening emergency obstetric care by governmental and non-governmental agencies,early childbearing,unemployment,large family sizes,and dependence on male spouses continued to result in suboptimal utilization of services and adverse maternal outcomes.Conclusion:This scoping review comprehensively integrated existing data from published studies to provide a detailed picture of maternal mortality,its health determinants,and factors influencing care utilization among women of childbearing age in Nigeria and approaches to reduce maternal mortality in the country and possibly in the West African sub-region.
基金Supported by the Natural Science Foundation of Anhui Provincial Department of Education(Grant Nos.KJ2020A 0993KJ2020ZD74)+2 种基金the High-Level Talent Research Start-Up Project(Grant No.DC2300000286)the Foundation of Guangzhou Civil Aviation College(Grant Nos.22X041824X4412).
文摘In the paper,a class of functions with bounded turnings involving cardioid domain,are studied in the region of the unit disc.The bounds of|a_(5)|,|a_(6)|,|a_(7)|and the fourth Hankel determinant are obtained,which are more accurate than those obtained by Srivastava.
文摘Background: Erectile dysfunction (ED) is a common, bothersome and relatively under diagnosed complication of diabetes mellitus. This study was aimed to determine the prevalence of erectile dysfunction and its determinants. Methods: A cross-sectional hospital-based study was carried out in the Diabetology Units of the Buea and Limbe Regional Hospitals involving 332 male patients with diabetes and aged over 21 years. Data was analyzed using Stata and R version 3.5.3. Results: The mean age of the participants was 55years. Most participants (64.46%) were married. About half (50.60%) of the participants actively consumed alcohol, 11.45% were smokers and 57.83% were sedentary. 18 participants (5.42%) recorded high risk sexual behaviour. 54.32% of participants had a comorbidity and 43.90% were overweight. The prevalence of diabetic ED was 78.92%. Age, Fasting Blood Sugar and Glycated hemoglobin were found to be positive determinants of diabetic ED (odds ratio (OR) = 0.77, 95% CI −0.1 - 0.07). Conclusion: The prevalence of diabetic ED in this hospital population study is high, and both physician and patient—initiated measures are needed to reduce this prevalence and improve awareness, recognition and care of this condition.
文摘Objective Data on homocysteine(Hcy) status and its determinants are limited among women during pregnancy and postpartum. This cross-sectional study aimed to investigate Hcy levels during pregnancy and postpartum, and to explore the determinants like geographic factor.Methods This study was conducted in women at mid-pregnancy, late-pregnancy and postpartum from southern, central and northern China. Approximately 132 women were included in each stratum by the three phases and regions. Plasma Hcy concentrations were assessed using high-performance liquid chromatography(HPLC), with hyperhomocysteinemia defined as > 10.0 μmol/L. Quantile regression was to estimate medians and interquartile ranges(IQRs), and logistic regression to examine the determinants of hyperhomocysteinemia.Results For 1,190 women included, the median(IQR) Hcy concentration was 5.66(4.62, 7.37) μmol/L.The adjusted median in mid-pregnancy, late-pregnancy and postpartum women was 4.75(4.13, 5.54),5.72(4.81, 6.85) and 7.09(5.65, 8.75) μmol/L, respectively, showing an increasing trend(P < 0.001). This increasing trend persisted across the three regions. Higher Hcy concentrations were observed in women residing in northern region and those with younger age or lower economic status. A total of 106(8.9%)women had hyperhomocysteinemia, with a higher prevalence in those residing in northern region(16.0%), or in postpartum women(16.5%).Conclusion Hcy levels, varying with geographic region, maternal age and economic status, are increased from mid-pregnancy to late-pregnancy and postpartum, indicating a need to monitor Hcy levels in pregnant and postpartum women to control potential risks related to elevated Hcy levels.
基金supported by the National Natural Science Foundation of China(No.82273722)Noncommunicable Chronic Diseases-National Science and Technology Major Project(2024ZD0520000)(2024ZD0520005)Central University Basic Research Fund of Peking Union Medical College(3332024216)。
文摘Objective To explore the health determinants of all-cancer mortality from a health-ecological perspective.Methods Using the health-ecological model,we identified 15 health determinants across five domains:personal innate,behavioral,interpersonal network,socioeconomic,and macroenvironmental characteristics.Data on cancer outcomes and health determinants from 185 countries,classified using the Human Development Index(HDI),were extracted from GLOBOCAN 2022,the World Health Organization Global Health Observatory,the Global Burden of Disease Study 2021,the United Nations,and the World Bank.A multivariate linear regression model was used to estimate the association between health determinants and cancer outcomes.Results A total of 153 countries with complete information on cancer outcomes and health determinants were enrolled in the study.A higher all-cancer age-standardized mortality rate(ASMR)was associated with current tobacco use,alcohol consumption,obesity,agricultural employment,and lag-distributed income.In women aged 15–49 years,being married or in a union was associated with a lower ASMR.Early-onset ASMR was positively associated with agricultural employment,lag-distributed income,and unsafe sanitation.Notable sex differences were observed,although tobacco use and obesity were identified as risk factors in both sexes.Conclusion We underscore the crucial need to incorporate cross-sectoral interventions within a resilient healthcare system to effectively mitigate the cancer mortality burden.
基金Supported by the Henan Provincial Health Commission,No.232102310145.
文摘BACKGROUND Patients with chronic obstructive pulmonary disease(COPD)frequently experience exacerbations requiring multiple hospitalizations over prolonged disease courses,which predispose them to generalized anxiety disorder(GAD).This comorbidity exacerbates breathing difficulties,activity limitations,and social isolation.While previous studies predominantly employed the GAD 7-item scale for screening,this approach is somewhat subjective.The current literature on predictive models for GAD risk in patients with COPD is limited.AIM To construct and validate a GAD risk prediction model to aid healthcare professionals in preventing the onset of GAD.METHODS This retrospective analysis encompassed patients with COPD treated at our institution from July 2021 to February 2024.The patients were categorized into a modeling(MO)group and a validation(VA)group in a 7:3 ratio on the basis of the occurrence of GAD.Univariate and multivariate logistic regression analyses were utilized to construct the risk prediction model,which was visualized using forest plots.The model’s performance was evaluated using Hosmer-Lemeshow(H-L)goodness-of-fit test and receiver operating characteristic(ROC)curve analysis.RESULTS A total of 271 subjects were included,with 190 in the MO group and 81 in the VA group.GAD was identified in 67 patients with COPD,resulting in a prevalence rate of 24.72%(67/271),with 49 cases(18.08%)in the MO group and 18 cases(22.22%)in the VA group.Significant differences were observed between patients with and without GAD in terms of educational level,average household income,smoking history,smoking index,number of exacerbations in the past year,cardiovascular comorbidities,disease knowledge,and personality traits(P<0.05).Multivariate logistic regression analysis revealed that lower education levels,household income<3000 China yuan,smoking history,smoking index≥400 cigarettes/year,≥two exacerbations in the past year,cardiovascular comorbidities,complete lack of disease information,and introverted personality were significant risk factors for GAD in the MO group(P<0.05).ROC analysis indicated that the area under the curve for predicting GAD in the MO and VA groups was 0.978 and 0.960.The H-L test yieldedχ^(2) values of 6.511 and 5.179,with P=0.275 and 0.274.Calibration curves demonstrated good agreement between predicted and actual GAD occurrence risks.CONCLUSION The developed predictive model includes eight independent risk factors:Educational level,household income,smoking history,smoking index,number of exacerbations in the past year,presence of cardiovascular comorbidities,level of disease knowledge,and personality traits.This model effectively predicts the onset of GAD in patients with COPD,enabling early identification of high-risk individuals and providing a basis for early preventive interventions by nursing staff.
文摘Background: Social determinants of health (SDOH) significantly influence diseases with environmental components, like vector-borne parasitic diseases. This study aims to examine how these factors influence vector-borne parasitic diseases (VBPDs) transmission in Chad and provide recommendations for policy improvements. Methods: The study adopts the WHO Conceptual Framework of SDOH to compare two regions in Southern Chad: Kouh-Est, which has an ongoing vector control program, and Grand-Sido, which lacks such a program. The study includes both nomadic and sedentary populations to provide a comprehensive understanding of the SDOH influencing VBPDs. Households were randomly selected. Data on sociodemographic characteristics, literacy, knowledge of VBPDs and protective measures, and access to education and health facilities were collected. Results: A total of 202 households from 17 villages, including 820 participants, were surveyed. Agriculture, livestock, and fishing were the main occupations, involving 84.1% of participants. Literacy was low, with 36.7% non-educated, 47.7% completing primary school, 14.5% secondary school, and only 0.3% reaching tertiary education. Most villages lacked schools beyond the primary level, and nomadic populations were significantly less educated than sedentary ones (p Conclusion: Educational deficiencies, lack of protective measures against vectors, inadequate healthcare resources, and lifestyle conditions aggravated by poor road infrastructure, limited transportation, and economic constraints contribute to worsened VBPDs outcomes in these rural populations. Addressing these systemic issues in the surveyed communities is essential for improving health equity and VBPDs outcomes in these regions specifically and in similar populations settings more broadly.
文摘BACKGROUND The global prevalence of diabetes among adults aged 29-79 years was found to be 10.5%.It is a global public health threat with a rising trend in morbidity and mortality.Poor glycemic control(GC)among patients with type 2 diabetes mellitus(T2DM)is a major determinant of diabetes-related complications.There are limited data on GC and associated factors among patients with T2DM in South West Region,Cameroon.AIM To assess GC and identify contributing factors among patients with T2DM in a regional hospital in South West Region,Cameroon.METHODS A cross-sectional study was conducted from February 2022 to July 2022 among 131 participants in Limbe Regional Hospital who were selected by convenience.Glycated hemoglobin(HbA1c)was measured by ion-exchange chromatography.Sociodemographic,clinical,and lifestyle data were collected,entered into Excel,and exported to Statistical Package for Social Sciences version 22 for analysis.A multivariate logistic regression analysis was conducted to assess the association between explanatory variables and GC.The level of significance was set at P<0.05.RESULTS The mean age was 56±5.1 years.Eighty-eight(67.2%)patients were female.The mean HbA1c was 8.8%±1.8%.Poor GC(HbA1c≥7%)was registered in 106(80.9%;95%confidence interval:73.1%-87.3%)participants.Lack of self-monitoring of blood glucose at home was associated with poor GC(adjusted odds ratio:3.858,95%confidence interval:1.262-11.800;P=0.018).CONCLUSION The majority of patients with T2DM had poor GC.Absence of self-monitoring of blood glucose at home was the main contributing factor for poor GC.
文摘IPO underpricing,the tendency for newly issued shares to trade above their offer price on the first day,is a persistent global phenomenon.Empirical evidence suggests that U.S.IPOs averaged an 18.8%first-day return from 1980 to 2001,imposing significant indirect costs on issuers.This paper reviews key explanations for underpricing,including information asymmetry,signaling,agency conflicts,and behavioral factors.Empirical research highlights firm characteristics,underwriter reputation,market conditions,and regulatory factors as major determinants.While underpricing facilitates liquidity and market participation,it also reflects inefficiencies.This study synthesizes theoretical perspectives and empirical findings,emphasizing the need for improved disclosure,governance,and regulatory oversight.
文摘BACKGROUND Social determinants of health are social and economic factors that influence health intervention outcomes.Type 2 diabetes is a highly prevalent disease,primarily affecting individuals in low-to-middle-income countries.However,the association between social determinants and cardiovascular complications in type 2 diabetes has not been widely studied.AIM To examine the relationship between social determinants of health and cardiovascular complications in individuals with type 2 diabetes.METHODS We conducted a retrospective cohort study with an analytical component at a national-level referral hospital for military personnel in Bogota,Colombia.Patients treated at the diabetes clinic between September 2021 and December 2022 who met the inclusion criteria were included.A total of 583 patients participated in the study.We performed descriptive,bivariate,and binary logistic regression analyses,adjusting for confounding variables.RESULTS Among the 583 patients included,urban residency[odds ratio(OR)=3.05,95%confidence interval(CI):1.01-9.20]and a middle or high educational level(OR=2.33,95%CI:1.14-4.72)were associated with an increased risk of coronary artery disease.Additionally,receiving diabetes education beyond that provided by the clinic(OR=2.15,95%CI:1.14-4.05)and lack of access to spaces for physical activity(OR=4.05,95%CI:1.31-12.5)were associated with a higher risk of diabetic nephropathy and cerebrovascular disease,respectively.CONCLUSION Programs for diabetes management should account for social determinants of health that contribute to cardiovascular complications and increased healthcare costs.Population-based studies are needed to guide targeted interventions and clarify causal relationships.
文摘Here we complete our work on the asymptotics of Hankel determinants studying the case wherein the entries are “ultrarapidly”-varying functions in the sense that their logarithms are rapidly varying. Moreover, the last results in the paper highlight analogies between algebraic identities for Hankelians with special entries and asymptotic relations valid for large classes of entries.
文摘Rhegmatogenous retinal detachment(RRD)is a sight threatening condition in which the neurosensory retina separates from the underlying retinal pigment epithelium.With an incidence of 6.3 to 17.9 per 100,000 persons(1),RRD is a condition frequently encountered by vitreoretinal specialists.Because the fovea is responsible for central visual acuity,foveal detachment is associated with poor presenting vision and is the strongest prognostic factor predicting poor visual outcome after RRD repair(2).
