Advances in Public Health

Background. Social support is an important determinant of the psychological health of women. Aim. To examine social support and its association with psychological distress among women in Saudi Arabia. Materials and Methods. Data were gathered between February and July 2023, using a cross-sectional, anonymous, online survey of women in Saudi Arabia above the age of 18 (n = 414). The multidimensional scale of perceived social support was utilized to gauge social support. The brief symptom rating scale, a 5-item measure, was used to measure psychological distress. Associations between social support and psychological distress were determined using linear regression considering potential covariates. Results. Results show high levels of psychological distress, with 38.1% of respondents scoring moderate to severe levels of psychological distress. The most commonly reported symptoms of distress were “feeling tense or high-strung” and “feeling easily annoyed or irritated,” with 39.4% and 34.5%, respectively, of respondents experiencing these symptoms moderately to extremely. Moderately high levels of social support were reported, with 77.1% of participants agreeing or strongly agreeing with the “my family really tries to help me” statement. Family/interpersonal relationships, however, were simultaneously the most commonly reported stressor over the past 3 years (59.4%). Unadjusted and adjusted analyses show social support was negatively correlated with psychological distress (β = −0.284, ; adjusted β = −0.145, p = 0.042), indicating higher levels of social support were correlated with reduced psychological distress. Conclusions. Findings indicate moderate-to-high levels of psychological distress as well as social support and an inverse association between them. This information can be used to inform intervention development. To better understand these domains as they relate to psychological distress, future research is warranted.

Background. The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing around 8 million people a year. The tobacco control program has been one of the priority programs in Nepal but still satisfactory results have not been achieved yet. The main objective of this study was to assess the tobacco smoke-free law compliance in public places of the provincial headquarters of Nepal. Materials and Methods. A cross-sectional observational study was conducted in 2019 in 560 public places of seven provincial headquarters of Nepal. Convinent samples were collected from at least three different clusters (wards) of each city. Indoor and outdoor locations of public places were observed. Observation tool was adopted from the Guide for Conducting Compliance Studies (John Hopkins School of Public Health). Data were entered in Epi Datav3.1, and analysis was done using IBM SPSS 26. Results. This study showed less use of no-tobacco signage which was 32% in the indoor areas and 13% in the outdoor areas in public places but they were placed in visible areas. Tobacco use in public places is still prevalent and it was higher (40%) in outdoor of public places. Three-fourths (76%) of public places was observed for buying and selling tobacco products within their 100 m premises. Tourist hotels, public toilets, and bus stops/ticket counters had low tobacco law compliance both in indoor and outdoor areas. Though public vehicles and cinema halls had high tobacco law compliance in indoor areas, law compliance in outdoor areas was low. Province-wise comparison showed that there was a similar pattern of tobacco law compliance in the indoor areas but outdoor law compliance was low in Madesh, Bagmati, and Karnali province. Conclusion. It is evident that while progress has been made in certain aspects of tobacco law compliance, there remains a compelling need for comprehensive and targeted interventions to ensure adherence to laws in public places across the country.

Background. The cost of health financing is an age-long social challenge in resource-constrained settings. Out-of-pocket (OOP) health spending adversely affects maternal healthcare provisions and use, making health insurance one of the most effective social interventions. Objective. The purpose of this research was to study the effect of OOP health expenditure on socioeconomic factors and health insurance coverage among Ghanaian women. Materials and Methods. Secondary statistical data pulled out from Ghana Demographic and Health Survey (GDHS)—2014 was investigated. A sample of 9,396 women whose ages ranged from 15 to 49 years was studied. We used marginal predictive model to examine the interaction effect between socioeconomic factors and health insurance coverage on OOP health expenditure. The significance level was determined at 5%. Results. Overall, about 41.9% (95% CI: 39.4%−44.4%) of Ghanaian women reported OOP health expenditure for drugs and services. Amongst those covered by health insurance, this was 37.9% (95% CI: 35.3%−44.4%). The marginal interaction effects of OOP health expenditure were higher for women in the lowest neighborhood socioeconomic disadvantage group (42.6%) than those in the highest neighborhood socioeconomic disadvantage group (26.0%) who were covered by health insurance. In addition, the marginal interaction effects of OOP health expenditure were found to be greater among women who had higher education (43.8%) compared with those who had no formal education (34.0%) who were covered by health insurance. Furthermore, the marginal interaction effects of OOP health expenditure were higher for rural (39.0%), than their urban counterpart (36.6.0%) who were under the covering of health insurance. Conclusion. There is a gap in health insurance coverage, which leads to increased OOP health expenditure. The OOP health expenditure effect was more concentrated among high socioeconomic women with health insurance. The healthcare system’s stakeholders should implement policies aimed at eliminating OOP health expenditure for maternal health services.

Background. The global strategy on infant and child feeding recommends the best pattern of feeding for infants and young child feeding (IYCF) from birth to 24 months. Practices of proper feeding of children up to 2 years of age contribute to a child’s survival, growth, and development because they can prevent micronutrient deficiencies, morbidity, and obesity in later life. This study aims to determine the risk factors for the failure of IYCF practice in urban and rural Indonesia. Materials and Methods. The study used Indonesia Demographic and Health Survey (IDHS) 2017 data with a cross-sectional research design. The sampling technique used systematic probability proportional to size sampling. The number of samples was 4,869 children consisting of 2,424 children in urban and 2,445 children in rural. Bivariate analysis using chi-square test. Multivariate analysis using multivariate logistic regression. Results. The study found that most of the children in urban (79.3%) and rural (97.2%) did not practice IYCF under the recommendations. There is a difference in the proportion of IYCF practices between urban and rural areas (). The risk factors for the failure of IYCF practice in urban areas are socioeconomic, maternal age, and age at first marriage. The poorest socioeconomic is at risk of 2.4 times, maternal age > 35 years are at risk of 1.5 times, age at first marriage is less than 21 years at risk of 2.1 times carrying out IYCF practices not according to recommendations compared to the comparison group. The risk factors for the failure of IYCF practice in rural are socioeconomic, maternal education, quantity, and quality of antenatal care (ANC). The poorest socioeconomic is at risk of 2.1 times, mothers with primary education are at 1.5 times, the quantity of ANC is not good at risk at 1.9 times, the quality of ANC is not good risk at 1.5 times practicing IYCF is not according to the recommendations compared to the comparison group. Conclusion. The practice of IYCF in Indonesia starting from giving early breastfeeding initiation, exclusive breastfeeding, and complementary feeding according to recommendations is still low. The priority of IYCF intervention through education and assistance to pregnant women needs to be a sustainable program.

Background. Thailand tends to have more access to online media. In 2020, the northeastern region had the highest usage rate. Especially school-age children have the highest usage rate. If misused for a long time, the consequences can adversely affect health in many aspects. Their parents should closely supervise and monitor them for this health problem. However, parents have limitations in caring because they have to work a lot. The aim was to study factors that influence working-age parents in holistic health care (HHC) of school-age children using online media in northeast Thailand. Materials and Methods. This research was a descriptive study, with a sample of parent amount 222. The questionnaire performed an item-objective congruence (IOC) = 0.60–1.00, the content validity index (CVI) = 0.90, and the Cronbach’s alpha coefficient was 0.93. The data collected then include the characteristics, use of online media, health problems, and health care. Finally, data were analyzed using descriptive statistics, frequency, percentage, standard deviation, and multiple regressions. Result. The results of the study are factors that influenced HHC with statistical significance () including the child’s gender, the child’s age, the child’s class, the type of internet, activities, the device, and the device owner. In addition, it was holistic health problems of school-age children such as physical, emotional, social, and intellectual. Importantly, these could explain the variation for HHC of 21.2% (adjusted R² = 0.212), and the standard error in the model estimation was 25.06 (SEE = 25.06). Conclusion. Factors that influence school-age children’s health care are beneficial to preventing and solving health problems by using online media. Parents or health care professionals can use it as a guide to develop more effective health care strategies and policies. Ultimately, it will help to promote better health for children in an ever-changing digital world.

Background. Copper is an essential trace element found in the human body in an oxidized (Cu II) and reduced (Cu I) form. It plays a crucial role in the integrity and function of proteins and enzymes. Short-term and long-term exposure to copper can result in harmful effects and lead to clinical manifestations in multiple bodily systems, including the gastrointestinal tract, liver, kidneys, eyes, respiratory, cardiovascular, central nervous, endocrine, and hematopoietic systems. Objective. The purpose of this study is the importance of early recognition and diagnosis of copper poisoning immediate and necessary measures and the use of chelators. Materials and Methods. In this review article, authors from Pub Med, Scopus, and a toxicologic emergencies reference book from 1996 to 2024 are used. Result. An excessive increase in copper level produces reactive oxygen species that can cause lipid peroxidation in cell membranes, direct oxidation of proteins, and the breakdown of DNA and RNA molecules. All of these can generally be reasons for cell death. Conclusion. Assessing levels of copper in whole blood, free serum copper, 24-hr urine copper, liver biopsy for copper concentration, and ceruloplasmin play a crucial role in the diagnosis. The blood copper concentration is directly related to the severity of poisoning. Treatment for copper poisoning typically involves removing the source of exposure and administering medications to help remove the excess copper from the body. Supportive care for copper intoxication usually includes managing vomiting, correcting fluids and electrolytes, and stabilizing vital signs. Chelators like D-penicillamine, succimer, trientine, tetrathiomolybdate, and PBT-2 have been utilized in treatment.