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Salt intake across the hypertension care cascade in the Bangladeshi adult population: a nationally representative cross-sectional study

Por: Monower · M. M. · Abid · S. U. A. · Abrar · A. K. · Choudhury · S. R.
Objectives

This study aimed to examine the distribution of daily salt intake across the hypertension care cascade and assess the proportional distribution of these care cascade categories across various salt consumption level.

Design

A population-based national cross-sectional study.

Settings

Data from the Bangladesh STEPS 2018 survey were used, encompassing both urban and rural strata within all eight divisions. National estimates were generated from weighted data.

Participants

A diverse population of 6754 men and women aged 18–69 years was included in the study.

Outcome measures

Daily salt consumption was estimated using the spot urine sodium concentration following Tanaka equation. Distribution of salt intake among different categories of hypertension care cascade, including hypertensives, aware of hypertension status, on treatment and under control, was assessed.

Results

Individuals with hypertension consume more salt on average (9.18 g/day, 95% CI 9.02 to 9.33) than those without hypertension (8.95 g/day, 95% CI 8.84 to 9.05) (p

Conclusions

Individuals with hypertension consume significantly more salt than those without, with no significant variations in salt intake based on aware, treated and controlled hypertension. Adhering to WHO salt intake guidelines aids better blood pressure management. By addressing salt consumption across hypertension care cascade, substantial progress can be made in better blood pressure control.

Validation of CHERG’S Verbal Autopsy-Social Autopsy (VASA) tool for ascertaining determinants and causes of under-five child mortality in Pakistan

by Muhammad Bilal Siddiqui, Chiu Wan Ng, Wah Yun Low, Khadijah Abid

The majority (40%) of the world’s under-five mortality burden is concentrated in nations like Nigeria (16.5%), India (16%), Pakistan (8%), and the Democratic Republic of the Congo (6%), where an undetermined number of under-five deaths go unrecorded. In low-resource settings throughout the world, the Verbal Autopsy-Social Autopsy (VASA) technique may assist assess under-five mortality estimates, assigning medical and social causes of death, and identifying relevant determinants. Uncertainty regarding missing data in high-burden nations like Pakistan necessitates a valid and reliable VASA instrument. This is the first study to validate Child Health Epidemiology Reference Group-CHERG’s VASA tool globally. In Pakistan, data from such a valid and reliable tool is vital for policy. This paper reports on the VASA tool in Karachi, Pakistan. Validity and reliability of the CHERG VASA tool were tested using face, content, discriminant validation, and reliability tests on one hundred randomly selected mothers who had recently experienced an under-five child death event. Data were computed on SPSS (version-21) and R software. Testing revealed high Item-content Validity Index (I-CVI) (>81.43%); high Cronbach’s Alpha (0.843); the accuracy of between 75–100% of the discriminants classifying births to live and stillbirths; and I-CVI (>82.07% and 88.98% respectively) with high accuracy (92% and 97% respectively) for assigning biological and social causes of child deaths, respectively. The CHERG VASA questionnaire was found relevant to the conceptual framework and valid in Pakistan. This valid tool can assign accurate medical and non-medical causes of child mortality cases occurring in Pakistan.

A cross‐sectional study on social determinants of mental health during COVID‐19 among adults in California

Abstract

Aim

To explore the impact of structural and intermediary social determinants of health (SDoH) on Californian adults' mental health during the early phase of the COVID-19 pandemic.

Design

This cross-sectional study used data from the 2020 cycle of the California Health Interview Survey, the largest US state-level population health survey.

Methods

Descriptive statistics and logistic regression were used to analyse the data. Using a general social determinant of health framework, we operationalized different survey questions to measure structural and intermediary determinants of mental health.

Results

Mental health during the early phase of COVID-19 among adults in California was associated with age, gender, health conditions, delayed care, employment status (loss of job or reduced income) and discrimination. People in higher social strata were more likely to have better mental health for many of these factors.

Conclusion

This study supports the assertion that material circumstances (such as employment status) and discrimination are associated with experiencing mental health issues among adults in California during COVID-19. Racism is a public health issue, and as nurses, addressing racism is critical. In addition, much work is needed to address SDoH to improve health outcomes, especially among marginalized populations.

Impact

This study addressed the knowledge gap concerning the social determinants of mental health among Californian adults during the early phase of the COVID-19 pandemic. Those who had reduced income and those who lost their jobs during the COVID-19 pandemic were 46% and 56%, respectively, more likely to report mental health problems. Those who experienced discrimination in healthcare were 304% more likely to report mental health issues. This research will increase the understanding of the social determinants of health, particularly for those with chronic illnesses and mental health issues during the COVID-19 pandemic.

Patient or Public Contribution

No patient or public contribution, as we used an existing US state dataset. However, California Health Interview Survey is the largest state health survey in the United States and interviews more than 20,000 households each year representing the health care needs of Californians.

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