Purpose: Pediatric acute appendicitis has a stable incidence rate in Western countries with an annual change of -0.36%. However, a sharp increase was observed in the Asian region. The Indonesian Health Department reveals appendicitis as the fourth most infectious disease, with more than 64,000 patients annually. Hence, there is an urgent need to identify and evaluate the risk factors and diagnostic modalities for accurate diagnosis and early treatment. This study also clarifies the usage of pediatric appendicitis score (PAS) for children <5 years of age. Methods: The current study employed a cross-sectional design with purposive sampling through demographic and PAS questionnaires with ultrasound sonography (USG) results. The analysis was performed using the chi-square and Mann-Whitney tests and logistic regression. Results: This study included 21 qualified patients with an average age of 6.76±4.679 years, weighing 21.72±10.437 kg, and who had been hospitalized for 4.24±1.513 days in Siloam Teaching Hospital. Compared to the surgical gold standard, PAS and USG have moderate sensitivity and specificity. Bodyweight and stay duration were significant for appendicitis (p<0.05); however, all were confounders in the multivariate regression analysis. Incidentally, a risk prediction model was generated with an area under the curve of 72.73%, sensitivity of 100.0%, specificity of 54.5%, and a cut-off value of 151. Conclusion: PAS outperforms USG in the sensitivity of diagnosing appendicitis, whereas USG outperforms PAS in terms of specificity. This study demonstrates the use of PAS in children under 5 years old. Meanwhile, no risk factors were significant in multivariate pediatric acute appendicitis risk factors.
Background: Research on the impact of psychosocial risks on well-being at work remains scarce in low- and middle-income countries, especially in the banking sector. This study sought to examine the relationships between job demands, job resources, well-being, job satisfaction, and work engagement in the Zimbabwean banking sector. Methods: An online survey was administered to 259 employees from five banks. Hierarchical multiple regression tested the relationships between job demands (quantitative demands, emotional demands, work pace, and work-family conflict), job resources (possibilities for development, social support from colleagues and supervisors, quality of leadership, and influence at work), well-being, work engagement, and job satisfaction. Interactions between all variables were tested. Results: Job demands were negatively related to well-being, work engagement, and job satisfaction. Job resources had positive relationships with the same. Work pace had positive relationships with well-being and work engagement. Influence at work moderated the relationship between emotional demands and work pace with well-being. Possibilities for development moderated the relationship between work-family conflict and well-being. Work-family conflict moderated the relationship between social support from colleagues and job satisfaction. Emotional demands, work pace, and quantitative demands moderated the relationship between influence at work with job satisfaction and work engagement. Conclusion: Job demands should be reduced where possible in order to enhance employee well-being, work engagement, and job satisfaction. The job resources that should be availed to facilitate a positive psychosocial work environment in the banking sector include social support from supervisors, influence at work, and possibilities for development.
The purpose of this research is to strengthen rural community empowerment by creating a tourism farm as a plan to reduce relative poverty and to improve the quality of life by creating jobs and increasing the income of local residents in underdeveloped countries. To do so, literature review, stakeholder interviews, on-site investigations, focus-group interviews, a project meeting for residents and a questionnaire survey were performed and analyzed and the results were as follows. First, Uganda has the potential to increase agricultural production based on its warm climate, fertile land and abundant natural resources. The quality of life of local residents is expected to be improved by realizing high-added values through the convergence of the conventional existing agricultural industry and other industries if the agricultural technology is properly transferred based on abundant labor force and low labor expenses. Opportunities for the success of the project can be spread to other rural villages across the country. Second, since local residents are now cultivating sugar cane, cassava, matoke, banana, coffee and so on as a farm owner, tourism agriculture with high-added values can be promoted by vitalizing communities based on farming technology to be transferred and a cooperative farm. It is also necessary to implement a rural community empowerment project to do so. Third, the university that is the cooperative partner of the project is positively considering to train experts by establishing a community development department, and, if necessary, a technical training center to educate the general public, which is expected to create synergic effects through the convergence of education, agriculture and tourism.
Journal of the Korean association of regional geographers
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v.10
no.2
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pp.407-427
/
2004
The rapid innovation of information and communication technology and its sharp falling prices have brought about the expansion of the Internet, integrating the world as one space under converged space and time. This rapid expansion of the Internet and its application in the economy have spurred the emergence of the digital economy. The Internet has influenced strongly on the changes of not only economic activities but also political, social and cultural activities. In this context, a rapidly increasing Internet expansion renders the rhetoric about the death of distance and about the meaningless of geographical place. However, the development and expansion of Internet induces a growing digital divide among nations and also a spatial inequality in a nation as the supply of the Internet has concentrated towards demand-affluent large cities. A large gap of digital access has been occurred between high income and low income countries according to a measurement of the international digital access index. In a national level, the Internet backbone has been built around large cities which favor a large amount of the Internet demand, and the affordable accessibility of these cities for the Internet services has influenced strongly on the agglomeration of Internet related industries, further inducing the construction and investment of the Internet backbone into large cities as cumulative causation effects. As a result, the expansion of the Internet affects immensely on the changes of spatial structure in a nation resulting in the new spatial phenomena such as centralization, concentration and splintering in the digitalized space-economy.
Background: Tobacco consumption has become pandemic, and is estimated to have killed 100 million people in the 20th century worldwide. Some 700,000 out of 5.4 million deaths due to tobacco use were from India. The era of global modernization has led to an increase in the involvement of women in tobacco consumption in the low income and middle-income countries. Tobacco consumption by females is known to have grave consequences. Objectives: To assess: (1) the tobacco use among urban and rural women; (2) the discrepancy in the knowledge, belief and behavior towards tobacco consumption among urban and rural women in Durg-Bhilai Metropolitan, Chhattisgarh, Central India. Materials and Methods: The study population consisted of 2,000 18-25 year old young women from Durg-Bhilai Metropolitan, Chhattisgarh, Central India, from both urban and rural areas. Data were collected using a pretested, anonymous, extensive face to face interview by a female investigator to assess the tobacco use among women and the discrepancy in the knowledge, belief and behavior towards tobacco consumption among urban and rural individuals. Results: The prevalence of tobacco use was found to be 47.2%. Tobacco consumption among rural women was 54.4% and in urban women was 40%. The majority of the women from urban areas (62.8%) were smokers whilst rural women (77.4%) showed preponderance toward smokeless tobacco use. Urban women had a better knowledge and attitude towards harms from tobacco and its use than the rural women. Women in rural areas had higher odds (1.335) of developing tobacco habit than the urban women. Conclusions: Increased tobacco use by women poses very severe hazards to their health, maternal and child health, and their family health and economic well-being. Due to the remarkably complex Indian picture of female tobacco use, an immediate and compulsory implementation of tobacco control policies laid down by t he WHO FCTC is the need of the hour.
Odukoya, Oluwakemi Ololade;Odeyemi, Kofoworola Abimbola;Oyeyemi, Abisoye Sunday;Upadhyay, Ravi Prakash
Asian Pacific Journal of Cancer Prevention
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v.14
no.3
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pp.1747-1753
/
2013
Background: It is projected that low and middle-income countries will bear a major burden of tobacco related morbidity and mortality, yet, only limited information is available on the determinants of smoking initiation among youth in Africa. This study aimed to assess the determinants of smoking initiation and susceptibility to future smoking among a population of high school school students in Lagos, Nigeria. Materials and Methods: Baseline data from an intervention study designed to assess the effect of an anti-smoking awareness program on the knowledge, attitudes and practices of adolescents was analyzed. The survey was carried out in six randomly selected public and private secondary schools in local government areas in Lagos state, Nigeria. A total of 973 students completed self-administered questionnaires on smoking initiation, health related knowledge and attitudes towards smoking, susceptibility to future smoking and other factors associated with smoking. Results: Of the respondents, 9.7% had initiated smoking tobacco products with the predominant form being cigarettes (7.3%). Males (OR: 2.77, 95%CI: 1.65-4.66) and those with more pro-smoking attitudes (OR: 1.44, 95%CI: 1.34-1.54) were more likely to have initiated smoking. Those with parents and friends who are smokers were 3.47 (95%CI: 1.50-8.05) and 2.26 (95%CI: 1.27-4.01) times more likely to have initiated smoking. Non-smoking students, in privately owned schools (OR: 5.08), with friends who smoke (5.09), with lower knowledge (OR: 0.87) and more pro-smoking attitudes (OR 1.13) were more susceptible to future smoking. In addition, respondents who had been sent to purchase cigarettes by an older adult (OR: 3.68) were also more susceptible to future smoking. Conclusions: Being male and having parents who smoke are predictors of smoking initiation among these students. Consistent with findings in other countries, peers not only influence smoking initiation but also influence smoking susceptibility among youth in this African setting. Prevention programs designed to reduce tobacco use among in-school youth should take these factors into consideration. In line with the recommendations of article 16 of the WHO FCTC, efforts to enforce the ban on the sales of cigarettes to minors should be also emphasised.
Lung cancer is the leading contributor to cancer deaths in the developing world. Within countries, significant variability exists in the prevalence of lung cancer risk, yet limited information is available whether some of the observed variability is associated with differences in the consumption pattern of local tobacco products with differing potency. We recruited 606 lung cancer cases and 606 controls from the B.P. Koirala Memorial Cancer Hospital in Nepal from 2009-2012. We estimated odds ratios (ORs) and 95% confidence intervals (CI) for lung cancer risk associated with different tobacco products, using unconditional logistic regression. Unfiltered cigarettes tended to be the most frequently used products across ethnic subgroup with about 53.7% of Brahmins, 60.1% of Chettris, and 52.3% of Rai/Limbu/Magar/others. In contrast, about 39.9% of Madishe/Tharu smokers reported using bidi compared with only 27.7% who smoked unfiltered cigarettes. Among those who only smoked one type of product, choor/kankat smokers had the highest lung cancer risk (OR 10.2; 95% CI 6.2-16.6), followed by bidi smokers (OR 5.6; 95% CI 3.6-8.7), unfiltered cigarettes (OR 4.9; 95% CI 3.4-7.2), and filtered cigarettes (OR 3.4; 95% CI 2.2-5.3). A clear dose-response relationship was observed between increased frequency of smoking and lung cancer risk across all ethnic subgroups. These results highlight the important role of traditional tobacco products on lung cancer risk in the low income countries.
Yasmeen, Roheela;Ali, Zulfiqar;Tyrrel, Sean;Nasir, Zaheer Ahmad
Safety and Health at Work
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v.11
no.1
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pp.118-124
/
2020
Background: The poultry industry in Pakistan has flourished since the 1960s; however, there are scarce data regarding the impact of occupational exposure on the pulmonary health of farm workers in terms of years working in the industry. The objective of the present study was to assess the effect of poultry environment on the health of occupationally exposed poultry farmers in countries of warm climatic regions, such as Pakistan. This study will also show the effect of exposure to poultry facilities on the health of poultry farmers in the context of low-income countries with a relatively inadequate occupational exposure risk management. Materials and methods: The lung function capacity of 79 poultry workers was measured using a spirometer. Along with spirometry, a structured questionnaire was also administrated to obtain information about age, height, weight, smokers/nonsmokers, years of working experience, and pulmonary health of farm workers. The workers who were directly involved in the care and handling of birds in these intensive facilities were considered and divided into four groups based on their years of working experience: Group I (3-10 months), Group II (1-5 years), Group III (6-10 years), and Group IV (more than 11 years). The forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and the FEV1/FVC ratio were considered to identify lung function abnormalities. Statistical analysis was carried out using independent sample t test, Chi-square test, Pearson's correlation, and linear regression. Results: Based on the performed spirometry, 68 (86 %) of workers were found normal and healthy, whereas 11 (14 %) had a mild obstruction. Of the 11 workers with mild obstruction, the highest number with respect to the total was in Group IV (more than 11 years of working experience) followed by Group III and Group II. Most of the workers were found healthy, which seems to be because of the healthy survivor effect. For the independent sample t test, a significant difference was noticed between healthy and nonhealthy farmers, whereas Chi-square test showed a significant association with height, drugs, and working experience. Linear regression that was stratified by respiratory symptoms showed for workers with symptoms, regression models for all spirometric parameters (FVC, FEV1, and FEV1/FVC) have better predictive power or R square value than those of workers without symptoms. Conclusion: These findings suggest that lung function capacity was directly related to years of working experience. With increasing number of working years, symptoms of various respiratory problems enhanced in the poultry workers. It should be noted that most of the poultry workers were healthy and young, the rationale being that there is a high turnover rate in this profession. The mobility in this job and our finding of 86% of the healthy workers in the present study also proposed healthy worker survivor effect.
This study aims to compare the role of the public sector in the U.S. and Korean medical security systems and study response measures in the social risk situation of the COVID-19 virus. The COVID-19 pandemic was a typical case of a 'disaster' that spread across the world across borders in a short period of time and caused serious social welfare losses by increasing the annual number of deaths by approximately 4% in 2020. Threats to health security, such as changes in social order, unpredictable endings, prolonged control of daily life, and deepening inequality, affected the economy, politics, and environment as a whole, and people had to experience anxiety and confusion due to mental and physical stress. Furthermore, developed countries failed to provide help to low-income countries in the face of global disasters. In this situation, the country's disaster management capacity to minimize harm and secure resilience, especially disaster response capacity in the health and medical field, is inevitably very important. Therefore, this study compares how the health insurance system, which is a system to guarantee citizens' right to life, differs from the United States, a liberal health care country, and raises the need to strengthen the role of the public sector.
John Ekman;Philip Quartey;Abdala Mumuni Ussif;Niklas Ricklund;Daniel Lawer Egbenya;Gideon Akuamoah Wiafe;Korantema Mawuena Tsegah;Akua Karikari;Hakan Lofstedt;Francis Tanam Djankpa
Annals of Occupational and Environmental Medicine
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v.35
/
pp.39.1-39.14
/
2023
Background: Diseases affecting the lungs and airways contribute significantly to the global burden of disease. The problem in low- and middle-income countries appears to be exacerbated by a shift in global manufacturing base to these countries and inadequate enforcement of environmental and safety standards. In Ghana, the potential adverse effects on respiratory function associated with occupational wood dust exposure have not been thoroughly investigated. Methods: Sixty-four male sawmill workers and 64 non-woodworkers participated in this study. The concentration of wood dust exposure, prevalence and likelihood of association of respiratory symptoms with wood dust exposure and changes in pulmonary function test (PFT) parameters in association with wood dust exposure were determined from dust concentration measurements, symptoms questionnaire and lung function test parameters. Results: Sawmill workers were exposed to inhalable dust concentration of 3.09 ± 0.04 mg/m3 but did not use respirators and engaged in personal grooming habits that are known to increase dust inhalation. The sawmill operators also showed higher prevalence and likelihoods of association with respiratory symptoms, a significant cross-shift decline in some PFT parameters and a shift towards a restrictive pattern of lung dysfunction by end of daily shift. The before-shift PFT parameters of woodworkers were comparable to those of non-woodworkers, indicating a lack of chronic effects of wood dust exposure. Conclusions: Wood dust exposure at the study site was associated with acute respiratory symptoms and acute changes in some PFT parameters. This calls for institution and enforcement of workplace and environmental safety policies to minimise exposure at sawmill operating sites, and ultimately, decrease the burden of respiratory diseases.
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