Hemoglobin levels and anemia evaluation during pregnancy in the highlands of Tibet: a hospital-based study
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Anemia is regarded as a major risk factor for unfavorable pregnancy outcomes, but there have been no previous studies describing the pattern of hemoglobin concentration during pregnancy in Tibet and the relationship between altitude and Hb concentration in the pregnant women living in Tibet still has not been clearly established. The main objectives of this study were to study the hemoglobin levels and prevalence of anemia among pregnant women living in the highlands of Tibet and to evaluate potential associations of hemoglobin and anemia with women's characteristics.The hospital-based study was conducted in 380 pregnant women. Their blood samples were tested and related sociodemographic information was collected. Multiple linear regression model and multiple logistic regression model were used to assess the association of pregnant women's characteristics with hemoglobin level and the occurrence of anemia. Centers for Disease Control (CDC), Dirren et al. and Dallman et al. methods were used to adjust the hemoglobin measurements based on altitude for estimating the prevalence of anemia.The mean hemoglobin concentration was 127.6 g/L (range: 55.0-190.0 g/L). Prevalence rate of anemia in this study was 70.0%, 77.9% and 41.3%, respectively for three altitude-correction methods for hemoglobin (CDC method, Dirren et al. method, and Dallman et al. method). Gestational age, ethnicity, residence and income were significantly associated with the hemoglobin concentration and prevalence of anemia in the study population. Specially, the hemoglobin concentration of pregnant women decreased with increase in gestational age.The hemoglobin level was low and prevalence rate of anemia was high among pregnant women in Lhasa, Tibet. Gestational age, ethnicity, residence and income were found to be significantly associated with the hemoglobin level and the occurrence of anemia in the study population.Keywords:
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Worldwide one billion people are living in slum communities and experts projected that this number would double by 2030. Slum populations, which are increasing at an alarming rate in Bangladesh mainly due to rural-urban migration, are often neglected and characterized by poverty, poor housing, overcrowding, poor environment, and high prevalence of communicable diseases. Unfortunately, comparisons between women living in slums and those not living in slums are very limited in Bangladesh. The objectives of the study were to examine the association of living in slums (dichotomized as slum versus non-slum) with selected public health-related variables among women, first without adjusting for the influence of other factors and then in the presence of socio-economic variables. Secondary data was used in this study. 120 women living in slums (as cases) and 480 age-matched women living in other areas (as controls) were extracted from the Bangladesh Demographic and Health Survey 2004. Many socio-economic and demographic variables were analysed. SPSS was used to perform simple as well as multiple analyses. P-values based on t-test and Wald test were also reported to show the significance level. Unadjusted results indicated that a significantly higher percent of women living in slums came from country side, had a poorer status by household characteristics, had less access to mass media, and had less education than women not living in slums. Mean BMI, knowledge of AIDS indicated by ever heard about AIDS, knowledge of avoiding AIDS by condom use, receiving adequate antenatal visits (4 or more) during the last pregnancy, and safe delivery practices assisted by skilled sources were significantly lower among women living in slums than those women living in other areas. However, all the unadjusted significant associations with the variable slum were greatly attenuated and became insignificant (expect safe delivery practices) when some socio-economic variables namely childhood place of residence, a composite variable of household characteristics, a composite variable of mass media access, and education were inserted into the multiple regression models. Taken together, childhood place of residence, the composite variable of mass media access, and education were the strongest predictors for the health related outcomes. Reporting unadjusted findings of public health variables in women from slums versus non-slums can be misleading due to confounding factors. Our findings suggest that an association of childhood place of residence, mass media access and public health education should be considered before making any inference based on slum versus non-slum comparisons.
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MSc Student in Biostatistics, Department of Biostatistics, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran. Professor in Biostatistics, Department of Biostatistics, Faculty of Medicine, Tarbiat Modares University, Tehran, Iran. Assistant Professor in Biostatistics, Faculty of Medicine, Ardabil University of Medical Science, Ardabil, Iran. ___________________________________________________________________________ Abstract
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Overweight in childhood is a major public health concern that calls for immediate preventative action. An increasing number of reports suggest that gender specific approaches to prevention may be more effective. However, there is a paucity of information to guide gender-sensitive health promotion and population health interventions for the prevention of overweight in childhood. In the present study, we sought to determine gender-differentials in overweight and underlying behaviors, nutrition and physical activity, among pre-adolescents in Alberta, Canada, to inform the discussion on gender-focused interventions for chronic disease prevention. In 2008, we surveyed 3421 grade five students and their parents of 148 randomly selected schools. Students completed the Harvard food frequency questionnaire, questions on physical activities, and had their height and weight measured. Parents completed questions on socio-economic background and child's lifestyle. We applied multilevel regression methods to assess gender differentials in overweight, nutrition and physical activity. Overall, the prevalence of overweight was slightly higher among boys (29.1%) than girls (27.9%) with more pronounced differences in towns and urban geographies. Boys reported to be much more physically active relative to girls (OR = 2.12, 95% CI: 1.73-2.60). Diets of boys, relative to those of girls, reportedly constituted more fat and were less likely to meet the recommendation of 6 daily servings of vegetables and fruits (OR = 0.81, 95% CI: 0.71-0.93). Our findings confirm the existence of gender differences in physical activity and nutrition, and support gender-focused health promotion whereby priority is given to physical activity among girls and to healthy eating among boys.
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The aim of this study was to assess the level of importance, adequacy and need of biostatistics and biostatistics education regarding health sciences in Turkey.Within the scope of the study a survey (questionnaire) was applied to a total of 237 academicians (academicians holding various titles employed by different departments) officiating at medical, veterinary medicine and health sciences faculties of six universities (Afyon Kocatepe, Gazi, Ankara, Hacettepe, Marmara ve Düzce) in Turkey. With this survey were taken views of academics on the status of the training they had received regarding biostatistics, their need for biostatistics education, the importance of biostatistics education and its level of adequacy, the source and adequacy of current information on biostatistics, the solutions to meet biostatistics needs and the statistical techniques which were required.According to the results, 27.8% of the participants have not received biostatistics education. It was determined that the importance of biostatistics education was emphasized as "very and exactly important" by 88.19% of the participants. 14.35% of the participants reported that biostatistics education was far from adequate for post graduate. They needed biostatistics knowledge mainly in the analysis of researches data (χ̄=4.01). On the other hand, they met biostatistics knowledge needs mostly by "help from friends".The study revealed that most of the academicians found biostatistics education important but claimed it had been inadequate. They emphasized the need for the organization of courses, seminars, etc. regarding biostatistics at sufficient intervals. As a consequence of that, this study reveals the importance of biostatistics and biostatistics education once again in the data analysis process in health sciences.
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The launch of this new journal, Epidemiology, Biostatistics and Public Health (EBPH), enables us to embrace new challenges, and renew our commitment to our readers, our authors and fellow editors, and ultimately to the public health community worldwide.
EBPH is an open access journal streaming from two previous journals, one focused on public health (The Italian Journal of Public Health, http://ijphjournal.it/) [1-8], ...
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AffiliationsDonna Spiegelman is with the Department of Biostatistics, Yale School of Public Health, New Haven, CT, and professor emerita in the Departments of Epidemiology, Biostatistics, Nutrition and Global Health, Harvard T. H. Chan School of Public Health, Boston, MA. Xin Zhou is with the Departments of Epidemiology and Biostatistics, Harvard T. H. Chan School of Public Health.
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