Abstract Background The prevalence of waterpipe smoking among women in southern Iran is significantly higher than women in other regions of Iran. We aimed to explore the effect of several demographic factors, knowledge, attitude, self-efficacy and social norms on a successful cessation of waterpipe smoking in the marginalized women of Bandar Abbas city, in the south of Iran. Methods This case-control study was conducted in 2022 among 731 women (246 subjects who successfully quit waterpipe smoking in the case group and 485 who smoked waterpipe in the control group). A cluster sampling method was used to collect the required data through face-to-face interviews and a researcher-made questionnaire. The questionnaire consisted of demographic information, behavioral information about waterpipe smoking and knowledge, attitude, self-efficacy and social norms. The data were analyzed in STATA 14 using univariate and multivariate regression analyses. Results The mean and standard deviation of age was 39.24 ± 11.93 and 37.18 ± 13.57 in the control and case groups, respectively. With an increase of one score in social norm (OR: 1.046), the odds of cessation were increased for 4%. With an increase of one score in self-efficacy (OR: 1.152), the odds of cessation were increased for 15%. With an increase of one score in knowledge (OR: 1.064), the odds of cessation were increased for 6%. With an increase of one score in attitude (OR: 1.215) the odds of cessation were increased for 21%. Conclusion The present findings revealed personal and interpersonal influential factors in successful waterpipe cessation. Women’s knowledge can be increased and their attitude can be changed. Important people in women’s lives can be influenced to, consequently, affect women positively and improve their self-esteem.
Abstract Background The present research aimed to determine the effect of an educational intervention based on the extended theory of planned behavior (ETPB) on waterpipe (WT) smoking cessation in women. Methods The present quasi-experimental had a pre-test, post-test design with 3, 6 and 12 months follow-ups was conducted in Bandar Abbas city, south of Iran in December 2021-March 2023. A total of 448 women over the age of 15 (224 in the intervention group (IG), 224 in the control group (CG)), using a two-stage cluster sampling method participated. The educational intervention focused on WT smoking cessation implemented in 14 sessions. The educational methods in the training sessions were lectures, collaborative discussions, Q&As, brainstorming, role plays, and peer education. The main outcome was WT cessation behavior. Repeated measures ANOVA tests and post hoc were run to compare the IG and CG at baseline in terms of demographic variables, t-test and chi square test, and in the four points of time of data collection. The data were analyzed in Stata14. A p -value < 0.05 was considered as statistically significant. Results The mean and standard deviation of WT cessation behavior and all ETPB constructs in the IG was significantly higher than the CG. After the educational intervention, in the IG, the perceived behavioral control, attitude, subjective norm, intention and knowledge increased, and the weekly smoking and WT smoking habit decreased ( P < 0.001). The CG did not have any significant change in other variables except for the increased knowledge score. During the 12-month follow-up, the cessation rate was 43.81% ( P = 0.645) in the IG and 7.45% in the CG ( P = 0.081). Conclusions The educational intervention positively affected WT smoking reduction and cessation in women through influencing the ETPB constructs. It is strongly recommended to design theory-based interventions beyond the individual level with an emphasis on interpersonal relationships to facilitate WT cessation as far as possible.
During the start of the COVID-19 pandemic, shortages of personal protective equipment (PPE) necessitated unprecedented and non-validated approaches to conserve PPE at healthcare facilities, especially in high income countries where single-use disposable PPE was ubiquitous. Our team conducted a systematic literature review to evaluate historic approaches for conserving single-use PPE, expecting that lower-income countries or developing contexts may already be uniquely conserving PPE. However, of the 50 included studies, only 3 originated from middle-income countries and none originated from low-income countries. Data from the included studies suggest PPE remained effective with extended use and with multiple or repeated use in clinical settings, as long as donning and doffing were performed in a standard manner. Multiple decontamination techniques were effective in disinfecting single use PPE for repeated use. These findings can inform healthcare facilities and providers in establishing protocols for safe conservation of PPE supplies and updating existing protocols to improve sustainability and overall resilience. Future studies should evaluate conservation practices in low-resource settings during non-pandemic times to develop strategies for more sustainable and resilient healthcare worldwide.
Background: Sleep duration has emerged as a potential modifiable risk factor influencing both cardiovascular disease (CVD) and mental health outcomes. This study aimed to assess the prevalence of clinical depression among participants with CVD, examine sleep duration, and assess the association between sleep duration and clinical depression. Methods: We used data from six waves of the Behavioral Risk Factor Surveillance System (BRFSS) with available sleep assessments (2013, 2014, 2016, 2018, 2020, 2022). We restricted the analyses for people reporting having CVD, with the final analytical sample including 319,470 adults. We used two sets of guidelines to categorize sleep based on its duration: A) normative (7-9 hours), short (<7 hours), and long (≥9 hours); and B) Inadequate sleep (<6 hours/day) versus adequate (≥6 hours/day). Weighted multivariate logistic regression was used to assess the association of clinical depression with sleep duration among people with CVD. Results: Participants were mostly male (55.3%) and white (69.4%). Among the whole sample (N=319,470), 85,547 (28.5%) were diagnosed with clinical depression. Regarding sleep duration, 179,407 (54.1%) participants reported normative duration, 110,921 (38.9%) participants reported short duration, and 21,932 (7%) reported long duration. When examining sleep adequacy, 208,549 (61.9%) were classified as having adequate sleep, while 110,921 (38.1%) had inadequate sleep. Compared to those with normative sleep duration, both, participants with short and long sleep duration were more likely to have clinical depression (Adjusted Odds Ratio (aOR) =1.5, p<.001; aOR=1.7, p<.001 respectively). Additionally, participants with inadequate sleep were more likely to have clinical depression (aOR=1.37, p<.001) compared to those with adequate sleep. Conclusion: Regardless of the guidelines followed to categorize healthy sleep duration (whether 6 or 7 hours/day for adults) there was a significant association between insufficient sleep and clinical depression among people with CVD. Interventions aimed at improving sleep duration could play a vital role in the mental health wellbeing of individuals with CVD. This vulnerable population, having dual burden of clinical depression and CVD were more likely to experience inadequate sleep that may lead to poor treatment outcomes. Further research is needed to quantify the impact of sleep duration and outcomes on the co-morbidity of CVD and depression.
Abstract Background Cardiovascular disease (CVD) is the leading cause of death in the world. In the United Arab Emirates (UAE), it accounts for 40% of mortality. CVD is caused by multiple cardiometabolic risk factors (CRFs) including obesity, dysglycemia, dyslipidemia, hypertension and central obesity. However, there are limited studies focusing on the CVD risk burden among young Emirati adults. This study investigates the burden of CRFs in a sample of young Emiratis, and estimates the distribution in relation to sociodemographic and behavioral determinants. Methods Data was used from the baseline data of the UAE Healthy Future Study volunteers. The study participants were aged 18 to 40 years. The study analysis was based on self-reported questionnaires, anthropometric and blood pressure measurements, as well as blood analysis. Results A total of 5167 participants were included in the analysis; 62% were males and the mean age of the sample was 25.7 years. The age-adjusted prevalence was 26.5% for obesity, 11.7% for dysglycemia, 62.7% for dyslipidemia, 22.4% for hypertension and 22.5% for central obesity. The CRFs were distributed differently when compared within social and behavioral groups. For example, obesity, dyslipidemia and central obesity in men were found higher among smokers than non-smokers ( p < 0.05). And among women with lower education, all CRFs were reported significantly higher than those with higher education, except for hypertension. Most CRFs were significantly higher among men and women with positive family history of common non-communicable diseases. Conclusions CRFs are highly prevalent in the young Emirati adults of the UAE Healthy Future Study. The difference in CRF distribution among social and behavioral groups can be taken into account to target group-specific prevention measures.
Abstract This study aimed to estimate the trends in the body mass index (BMI) and prevalence of obesity among United States (U.S.) adolescents (10-19 years), and to examine the associations between sociodemographic factors and both BMI and obesity prevalence. The 2007-2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative repeated cross- sectional survey data (n = 9,826) were used. Outcomes included: 1) Mean BMI and 2) obesity (yes/no; defined as BMI ≥ 95% percentile). Sociodemographic variables included age, sex, race/ethnicity, and poverty income ratio (PIR; low-income <1.3, Middle-income ≥1.3 and <3.5, high-income ≥3.5). By accounting for the complex survey design, weighted generalized linear/Poisson models were used to conduct the analyses. Girls constituted 49 % of the sample. From 2007-2008 to 2017-2020, BMI and obesity prevalence increased across various subgroups, including Black and Hispanic adolescents, boys, and those from low- and middle-income families. Girls are a 12% lower likelihood of being obese than boys. Compared to White adolescents, Black and Hispanic adolescents had 22% and 19% greater risk of being obese. Compared to those from high-income families, adolescents from low- and middle-income families had 62% and 47% greater risk of being obese, respectively. The results indicated persistent disparities in obesity prevalence among different race/ethnic and sociodemographic groups. Future obesity intervention should address key disparities by targeting specific race/ethnic adolescents from low-income families and promoting health equality.
Introduction Asthma and polycystic ovarian syndrome (PCOS) are linked in several possible ways. To date, there has been no study evaluating whether pediatric asthma is an independent risk factor for adult PCOS. Our study aimed to examine the association between pediatric asthma (diagnosed at 0-19 years) and adult PCOS (diagnosed at ≥20 years). We further assessed whether the aforementioned association differed in two phenotypes of adult PCOS which were diagnosed at 20-25 years (young adult PCOS), and at >25 years (older adult PCOS). We also evaluated whether the age of asthma diagnosis (0-10 vs 11-19 years) modified the association between pediatric asthma and adult PCOS. Material and methods This is a retrospective cross-sectional analysis using the United Arab Emirates Healthy Future Study (UAEHFS) collected from February 2016 to April 2022 involving 1334 Emirati females aged 18-49 years. We fitted a Poisson regression model to estimate the risk ratio (RR) and its 95% confidence interval (95% CI) to assess the association between pediatric asthma and adult PCOS adjusting for age, urbanicity at birth, and parental smoking at birth. Results After adjusting for confounding factors and comparing to non-asthmatic counterparts, we found that females with pediatric asthma had a statistically significant association with adult PCOS diagnosed at ≥20 years (RR=1.56, 95% CI: 1.02-2.41), with a stronger magnitude of the association found in the older adult PCOS phenotype diagnosed at >25 years (RR=2.06, 95% CI: 1.16-3.65). Further, we also found females reported thinner childhood body size had a two-fold to three-fold increased risk of adult PCOS diagnosed at ≥20 years in main analysis and stratified analyses by age of asthma and PCOS diagnoses (RR=2.06, 95% CI: 1.08-3.93 in main analysis; RR=2.74, 95% CI: 1.22-6.15 among those diagnosed with PCOS > 25 years; and RR=3.50, 95% CI: 1.38-8.43 among those diagnosed with asthma at 11-19 years). Conclusions Pediatric asthma was found to be an independent risk factor for adult PCOS. More targeted surveillance for those at risk of adult PCOS among pediatric asthmatics may prevent or delay PCOS in this at-risk group. Future studies with robust longitudinal designs aimed to elucidate the exact mechanism between pediatric asthma and PCOS are warranted.
