Conectar
by Afsana Anwar, Mahmood Parvez, Farhan Azim, Uday Narayan Yadav, Saruna Ghimire, Ateeb Ahmad Parray, Shovon Bhattacharjee, ARM Mehrab Ali, Rashidul Alam Mahumud, Md Irteja Islam, Md Nazmul Huda, Mohammad Enamul Hoque, Probal Kumar Mondal, Abu Ansar Md Rizwan, Suvasish Das Shuvo, Sabuj Kanti Mistry
BackgroundFrailty and disability often emerge with ageing and affect quality of life. Older adults residing in Rohingya refugee camp in Bangladesh are particularly susceptible to frailty and disability due to adverse physical and social environment along with limited health and social care services available in the camp. This study aimed to investigate the prevalence and factors associated with frailty and disability among Rohingya older adults living in Bangladesh.
MethodsThis cross-sectional study was conducted among older adults aged ≥60 years residing in the Rohingya refugee settlement in Bangladesh. The primary outcomes were frailty and disability, explored using the ‘Frail Non-Disabled (FiND) questionnaire. Data were collected face-to-face during November-December 2021, using a semi-structured questionnaire. A multinomial logistic regression model was used to identify the factors associated with frailty and disability.
ResultsThe majority of participants (n = 864) were aged 60–69 years (72.34%), male (56.25%), married (79.05%), and without formal education (89.0%). The study revealed a high prevalence of frailty (36.92%) and disability (55.21%) among the participants. The multinomial regression analysis showed that the likelihood of experiencing disability was significantly higher among participants who were aged 70–79 years (RRR = 2.65, 95% CI: 1.25, 5.66) and ≥80 years (RRR = 8.06, 95% CI: 1.05, 61.80), were female (RRR = 3.93, 95% CI: 1.88, 8.1.9), had no formal education (RRR = 4.34, 95% CI: 2.19, 8.63), were living in a large family (RRR = 1.82, 95% CI: 1.05, 3.18) and were suffering from non-communicable diseases (RRR = 2.36, 95% CI: 1.32, 4.22) compared to their respective counterparts. The regression analysis also revealed that frailty was significantly higher among participants who were female (RRR = 2.82, 95% CI: 1.34, 5.94), were suffering from non-communicable diseases (RRR = 2.28, 95% CI: 1.27, 4.09), and had feeling of loneliness (RRR = 2.16, 95% CI: 1.11, 4.22).
ConclusionsThe findings underscore the need for long-term care and health promotion activities to alleviate the burden of frailty and disability among older adults in humanitarian settings. Efforts should particularly target the most vulnerable groups- older individuals (≥80 years), women, those without formal education, those living in large families, and those with non-communicable diseases.
Technology-assisted interventions offer a promising alternative to conventional cardiac rehabilitation. However, there is limited evidence on their effectiveness, particularly in non-Western settings with emphasis on exercise self-efficacy.
To evaluate the effects of a 12-week, technology-assisted hybrid cardiac rehabilitation (TecHCR) program on physical, physiological, and psychological outcomes of patients with coronary heart disease.
A two-arm parallel randomized controlled trial including 160 participants was randomly assigned to either TecHCR or usual care. TecHCR was underpinned by the Health Belief Model, consisting of three supervised exercise training and occupational therapy sessions, a fitness watch for exercise self-monitoring, six audio-visual educational videos, and a weekly video call follow-up. Data were collected at baseline, immediately post-intervention, and at 24 weeks post-intervention.
Participants in TecHCR demonstrated significantly greater improvement in exercise self-efficacy (β = 5.909, 95% CI [3.146, 8.672]; p < 0.001), health-promoting behaviors (β = 9.058, 95% CI [5.524, 12.591]; p < 0.001), and perceived anxiety levels (β = −1.255, 95% CI [−1.893, −0.616]; p < 0.001) at immediate post-intervention and (β = 8.506, 95% CI [4.951, 12.061]; p < 0.001, β = 14.563, 95% CI [8.809, 20.317]; p < 0.001, β = −1.145, 95% CI [−1.975, −0.315]; p = 0.007, respectively) 24 weeks post-intervention when compared with the control group. No statistically significant improvements were observed in perceived depression and cardiovascular risk factors.
The TecHCR program, combining supervised sessions with technology-assisted components, is an effective approach for significantly improving exercise self-efficacy, health-promoting behaviors, and anxiety in patients with coronary heart disease. Healthcare institutions should consider implementing hybrid programs to overcome barriers to traditional cardiac rehabilitation, leveraging technology to extend support and maintain patient engagement beyond supervised sessions.
clinicaltrials.gov identifier: NCT04862351
This study investigates how environmental and household variables relate to groundwater quality in Indonesia.
The research uses data from the 2020 Cross-sectional Household Drinking Water Quality Study, the National Socioeconomic Survey 2020, and climate records.
Indonesia.
The study includes 5965 households across 34 provinces, using descriptive and path analysis techniques.
The microbiological quality of drinking water was primarily focused on Escherichia coli as an indicator of microbial contamination.
Out of 5965 households, only 5.15% had emptied faecal sludge (FS) in the last 3 years, while E. coli contamination was detected in 71.21% of the samples. Improved drinking water sources and proper FS emptying practices were associated with better water quality.
These findings highlight the urgent need for enhanced surveillance and evidence-based policymaking to safeguard both drinking water quality and sanitation practices, which are crucial for public health and environmental sustainability.
Pneumonia and diarrhoea are two of the major causes of child mortality globally. Countries affected by conflict and other humanitarian emergencies, such as Somalia, have a particularly high burden of these diseases. Published reports from UNICEF and WHO have shown that various factors, including social, economic and environmental factors, are all associated with the occurrence of childhood pneumonia and diarrhoea. The objective of this study was to determine the prevalence, burden and associated sociodemographic determinants of pneumonia and diarrhoea among children younger than 5 years (under-5 children) in Somalia.
A community-based survey using an interviewer-administered questionnaire was conducted employing a modified WHO Expanded Program on Immunization (EPI) 30-Cluster sampling technique to identify households and respondents in nine selected districts across six member states in Somalia. The interviewers began selecting households starting from house number 1 and continued until 75 households were surveyed in each cluster.
We considered the catchment areas of 12 target maternal and child health (MCH) centres as our study areas. Villages were considered as primary sampling units (PSU) while households within villages were considered as secondary sampling units, where women (with under-5 children) within households were the respondents.
A total of 36 clusters (villages) were selected from the catchment areas of 12 target MCH centres. All households within the selected villages’ PSUs were listed. The interviewer started interviewing from house number 1 and continued till 75 households were covered to conduct interviews with mothers of under-5 children. Data collection took place between October and December 2023.
The prevalence and burden of childhood pneumonia and diarrhoea were estimated. A logistic regression model was employed to examine the determinants of childhood pneumonia and diarrhoea.
A total of 2483 under-5 morbidities were reported, 1712 probable pneumonia cases and 825 diarrhoea cases. Our calculations suggest that the prevalence of overall under-5 morbidity was 458.4 per 1000 children (95% CI 444.3 to 472.6) in the last 90 days. The prevalence of pneumonia and diarrhoea was 316.0 (95% CI 303.5 to 328.8) and 152.3 (95% CI 142.2 to 162.8) per 1000 under-5 children, respectively. A total of 70 under-5 deaths occurred in the past year, of which 37 were infants. Our exploration depicts an under-5 mortality rate of 39.3 deaths per 1000 live births per year (95% CI 30.6 to 49.7), and the infant mortality rate was 20.8 per 1000 live births per year (95% CI 14.8 to 28.6) in the study area, which is much lower than earlier estimates. The crude birth rate was 106.6 per 1000 population, and the stillbirth rate was 149.8 per 1000 births (95% CI 134.9 to 165.7), which is very high. We explored probable causes of 70 under-5 deaths and found that the highest proportion of under-5 deaths (22.9%) was due to acute respiratory infections (ARI), and about 15.7% were due to diarrhoea. Among other probable causes, congenital diseases (12.9%), accidents (11.4%) and measles (8.6%) were noteworthy.
This study revealed a high burden of pneumonia and diarrhoea among the studied population in Somalia. The study also identified important sociodemographic and environmental determinants that tend to increase the risk of pneumonia and diarrhoea among under-5 children.
Despite having more medical and social vulnerabilities than men with substance use disorder (SUD), women with SUD are underrepresented in addiction healthcare structures. This is because they experience double stigma—from society (including the medical community) and from themselves—which hinders them from accessing healthcare.
Using a mixed-methods approach, the main objective of the Calliope study is to explore and compare healthcare satisfaction among women with SUD according to the category of healthcare structure they attend: specialised addiction centres versus primary care centres called ‘microstructures’. A total of 240 women receiving care for SUD will be included in the study, with equal representation from specialised addiction centres and ‘microstructures’. All participants will complete a standardised questionnaire to collect quantitative data. Additionally, a subsample of 40 women will be selected to participate in in-depth, semistructured interviews to gather qualitative data. Additionally, focus groups will be conducted with healthcare professionals to explore their perspectives and practices.
Calliope was reviewed and approved by the institutional ethics committee of Paris Cité University (IRB: 00012024–02). The study’s findings will provide a greater understanding of the characteristics, needs and satisfaction with healthcare of women with SUD living in France. Moreover, they will help guide the development of tailored therapeutic interventions for this population.
Monkeypox (Mpox) is an emerging public health concern globally as well as in Pakistan, with over 100 000 confirmed cases reported across 120 countries as of July 2024.
To assess healthcare professionals’ knowledge and preparedness regarding Mpox and examine its association with demographic factors.
Quantitative, descriptive, cross-sectional study.
Conducted in tertiary care public sector hospitals of Rawalpindi district, Pakistan, from October 2024 to February 2025.
A total of 230 healthcare professionals of either gender, aged over 18 years, currently working in the public sector tertiary care hospitals of Rawalpindi district for at least 6 months were included.
The mean age of the respondents was 29.13±6.55 years. The majority were women (147, 63.9%), post-graduate trainees (106, 46.1%), with 1–5 years of experience (184, 80%) and from medicine and allied disciplines (131, 57%). Most participants had an average level of knowledge regarding Mpox (137, 59.6%), with only a few demonstrating good knowledge (40, 17.4%). Half of the participants reported that their healthcare facilities lacked proper protocols for managing Mpox cases (97, 42.2%). Significant associations were observed between Mpox knowledge scores and participants’ field of specialty (p=0.007); notably, respondents from basic sciences had a higher proportion of good knowledge scores.
Overall, the level of knowledge and preparedness regarding Mpox among healthcare professionals was average. There is an urgent need for standardised Mpox preparedness protocols, outbreak response planning and comprehensive training programmes to enhance readiness for future outbreaks.
Background
Electronic nicotine delivery systems (ENDS), also known as e-cigarettes, are the most commonly used tobacco products among young adults in the United States. Young adults in rural areas have a higher prevalence of ENDS use compared to their urban counterparts, yet there is limited evidence regarding the in-depth understanding of experiences and perspectives directly from young adults.
Objectives
The aim of this study was to explore individual experiences and perspectives about use and cessation of ENDS from young adults in rural areas.
Methods
This was a qualitative study using interpretive description for analysis. Young adults (18–24 years) who used ENDS every day but not other tobacco products (cigarettes, smokeless, etc.) in the past month and had an address in a rural county of Wisconsin were eligible; there were nine participants interviewed using Zoom. Interview questions focused on initial use, maintenance of use, experiences of quitting, and social and rural environmental contexts regarding ENDS.
Results
Three themes emerged with eight categories: (a) addiction to ENDS and health, (b) cessation and resources, and (c) rural environment and culture in ENDS addiction.
Discussion
Findings have implications for ENDS cessation interventions targeting young adults in rural areas. 
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