Table of Contents
Editorial in Pandemic Crisis
COVID-19 – if the cure is worse than the disease. The Italian chaos
Author: Giuseppe FERRARI1
1 PhD, Italian Society for Psychotherapy and Social Development (SIPISS)
Keywords: Covid-19, lockdown, social crisis, psychiatric disease, north of Italy, primary needs and Covid-19.
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Viewpoint in Occupational Health
Workplace violence: Prevalence, risk factors and preventive measures across the globe
Author: Daniela ACQUADRO MARAN1
1 PhD, Assistant Professor, Department of Psychology, University of Turin, Turin, Italy
Workplace violence is a term referred both to physical and psychological violence that occurs at work. The investigation of this phenomenon is essential, because the knowledge about the nature of the prior relationship victim-perpetrator, the behaviour acted by the perpetrator and the strategies adopted by the victim to cope with the experience of victimization, the consequences on individuals, society and organization, give to scholars and practitioners significant information that could be useful to improve the organizational prevention and intervention.
This viewpoint described prevalence of workplace violence across the globe, as well as risk factors and preventive measures that employers may put in place in order to contrast this widespread phenomenon. Direct and indirect costs of workplace violence are high, thus governments and policymakers should address this issue with legislative interventions, supporting employers who have the task to carefully consider this psychosocial risk factor in their risk assessment process as well.
Keywords: Healthcare, occupational health; risk factors; prevention; psychology; workplace violence.
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Viewpoint in Culture and Mental Health
Culture and mental health: Towards cultural competence in mental health delivery
Author: Temitope OGUNDARE1
1 MD, Boston University School of Public Health, Boston, MA, USA
The purpose of this paper is to highlight the role of culture in the conceptualization of mental illness and the phenomenology of mental illness across cultures. Mental health professionals are increasingly dealing with a multicultural patient population and there is an urgent need for awareness of the influence of culture in understanding patient’s expression of distress, assigning symptoms to a diagnostic category and planning treatment in culturally appropriate ways. Cultural bias can lead to misdiagnosis and have devastating consequences on patients. This paper highlights the need for cultural competency in mental health service delivery and outlines ways mental health professionals can think about the issue of culture in their practice.
Keywords: Culture; cultural competency; mental health.
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Perspective in Public Health
Strengthening Maternal and Infant Health in an impoverished peri urban community in Lima, Peru: The SAMI Project
Authors: Anna KOHLER-SMITH1*, Karen RAMOS2*, Carmen CONTRERAS3, Milagros DUEÑAS4, Leonid LECCA5, Jerome T. GALEA6,7
1 MPH, Maternal Child Health, Socios en Salud, Lima, Peru.
2 MPH, Project Manager, Maternal Child Health, Socios en Salud, Lima, Peru
3 MPH, Mental Health Programs, Socios en Salud, Lima Peru
4 Midwife, Project Coordinator, Maternal Child Health, Socios en Salud, Lima, Peru
5 MD, Director, Socios en Salud, Lima, Peru
6 PhD, School of Social Work, College of Behavioral and Community Science, University of South Florida, USA
7 College of Public Health, University of South Florida, USA
* These authors contributed equally as first authors
While Peru has made strides in preventing maternal mortality, a more comprehensive and systematic approach towards reducing maternal morbidity and improving infant health is critical. In this paper, we present the preliminary results of the ‘Strengthening Maternal and Child Health in the District of Carabayllo’ or SAMI Project, developed by non-governmental organization Socios en Salud (Partners in Health).The project offers an innovative and multifaceted community approach to preventing maternal morbidity through management of the clinical, emotional, and nutritional health needs of pregnant women, postpartum women and infants in Lima, Peru. In collaboration with local stakeholders and the Peruvian Ministry of Health, the intervention utilizes the critical role of Community Health Workers as project collaborators. Local NGO team members include project coordinator, psychologists, nutritionists, and midwifes. Women are enrolled during pregnancy, give birth during the project, and are monitored alongside their infants until 1-year post birth. Project activities include accompaniment to clinical health appointments by community health workers for women until 45 days post birth, birth education classes in the second trimester, birth planning, depression screening, and the World Health Organization’s (WHO) ‘Thinking Healthy Programme’ to reduce symptoms of mild to moderate perinatal depression. Between August 2016 to August 2018, 89 pregnant women were screened for SAMI participation and until August 2018, 59 women participated in the intervention. 75% had completed 6 or more prenatal visits. 35% had anemia at some point during their pregnancy and 24% of participants screened positive for depression and participated in the Thinking Healthy Programme. Of the 40 participants who had given birth, 92.5% of newborns had normal birthweight between 2.5 to 4 kilos. These initial results are encouraging, and the project anticipates positive results in new communities where it will be extended in the future. Additionally, the project serves as a model for comprehensive maternal infant health services in low-income communities.
Keywords: Breast Feeding; Comprehensive Health Care; Depression; Maternal-Child Health Services, Maternal Health, Depression, Postpartum.
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Viewpoint in Global Public Health
Violence on street children: Looking through Erikson’s psychosocial development theory
Author: Elma KAISER1
1 Ph.D., Assistant professor of Social Work, Stockton University, NJ, USA
Poverty, family breakdown, neglect, abuse or abandonment, are the common triggers for children to run away or be forced to leave their homes. This is a common phenomenon across the globe. While trying to survive on the streets, the children are often re-exposed to violence. To survive on the street, they must make decisions with significant implications for life, which is not usual for a child and or adolescents. Erikson, the developmental psychologist and psychoanalyst, explains development as a lifelong project, proceeding from birth to death through the eight psychological stages. It is important to understand the life stages and the distinctive characteristics that comes along. However, it is also important to understand the life stages of street children which do not always align with the theory. This article aims to depict a global picture of street children. The examples from various parts of the world regarding the reason for moving to the streets and violence that they encounter. Furthermore, this paper looks through the lens of Erik Erikson’s psychosocial development theory and describe how these experiences can shape the life stages of street children. There are stark contrasts between the parameters of the theory when compared with children with conventional settings and the children living in an unprotected environment.
Keywords: Global health; missing stage; psychosocial development theory; street children; violence.
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Scoping Review in Complementary Medicine
A scoping review of conventional and laser acupuncture as a modality of treatment for migraine
Authors: Chizoba ANYIMUKWU1, Vinayak K. NAHAR2, Sunita KAPUR3, Manoj SHARMA4
1 MPH, Department of Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA
2 MD, PhD, MS, FRSPH, Department of Dermatology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA; Department of Preventive Medicine, School of Medicine/John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA
3 MD, Kapur Acupuncture Clinic, New Delhi, India
4 PhD, Department of Behavioral & Environmental Health, School of Public Health, Jackson State University, Jackson, MS, USA; School of Health Sciences, Walden University, Minneapolis, MN, USA; Health for All, Omaha, NE, USA
Introduction: Migraine is a common neurological disorders that typically manifests with repeated episodes of unilateral frequent throbbing headaches. Globally, the prevalence of migraine is around 10%. Despite the wide variety of pharmacological medications, patients still experience frequent attacks or are unable to get complete relief from the prescribed medications. Conventional and laser acupuncture are alternative therapeutic treatment modalities that have been widely used for people with migraine. The purpose of this study was to review the collective evidence on the role of acupuncture in alleviating the symptoms of migraine.
Methods: A scoping review of current literature was performed. The inclusion criteria for including interventions in this study were: (a) published in English language between 2013 and January 2018; (b) indexed in MEDLINE/PubMed, CINAHL, AltHealthWatch, and SCOPUS; (c) quantitative evaluations of acupuncture as a modality of treatment; (d) original, peer-reviewed research articles; and (e) utilized patients diagnosed with migraine.
Results: A total of 23 interventions with a combined total of 1,714 study participants met the inclusion criteria. Findings indicate that acupuncture is a promising approach in the treatment of migraines accompanied with or without an aura. Limitations of this review included varied dosage of acupuncture among different studies, small sample sizes, and lack of behavioral theory-based approaches in promoting this modality.
Discussion and Conclusion: The present evidence indicates that acupuncture may provide symptomatic relief and improvement in quality of life among migraine patients. It has a promising role as an adjuvant to conventional drug therapy. More randomized controlled trials for efficacy and effectiveness testing are needed.
Keywords: Acupuncture; alternative and complementary health; headache; migraine; public health research; review
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Narrative Review in Public Health and Infectious Diseases
Traditional funeral and burial rituals and Ebola outbreaks in West Africa: A narrative review of causes and strategy interventions
Author: Chulwoo PARK1
1 MSPH, Department of Global Health, The George Washington University Milken Institute School of Public Health
Introduction: In West Africa, traditional funerals and burials have proven main contributors to the spread of infectious diseases, such as Ebola, plague, the Marburg virus, and others. Although the World Health Organization has provided guidelines for the safe burial process after learning of the culture of the afterlife in Ebola-affected areas, little effort has been made to integrate theoretical interventions and models for changing West Africans’ funeral behavior. This research was conducted to study 1) the background of traditional burial rituals, 2) interventions to contain Ebola outbreaks in West Africa, and 3) a strategic approach to future disease outbreak in the region.
Methods: A narrative review was conducted by using four electronic databases—PubMed, Medline, Web of Science, and Scopus—using search key terms and a manual search of Google Scholar and gray literature. A date range was open to all years, up to 2017 to include a historical aspect of Africans’ funerary rituals and 2014–2016 Ebola outbreak in West Africa.
Results: West Africans believe that performing funeral rituals enables them to cement unity between the living and ancestral spirits and to receive spiritual gifts from deaths. Funeral rituals include several actions, such as washing and cleaning the body, washing one’s hands in a common bowl after touching the face of the deceased, and lying over the corpse of a prominent person. Although Ebola-affected countries created national Ebola response and communication strategies in 2014, the efforts at the government level were not sufficiently effective to contain the disease’s outbreak.
Conclusion: Traditional funeral and burial practices are a part of the culture in West Africa and should be evaluated and respected. Policymakers should design a theory- and practice-based socioecological model based on social and behavioral strategies for villagers in remote areas to prevent the spread of infectious diseases via traditional burial practices.
Keywords: Africa, Western; anthropology, cultural; burial; cemeteries; communicable diseases; communication; disease outbreaks; ebolavirus; health services; mortuary practice; social behavior.
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Narrative Review in Geriatrics and Public Health
Time to speed up, not slow down: A narrative review on the importance of community-based physical activity among older people
Authors: Robyn HAMBROOK1, Geoff MIDDLETON2, Daniel C BISHOP3, Lee CRUST4, David R BROOM5
1 Masters by Research Student, School of Sport and Exercise Science, College of Social Sciences, University of Lincoln, Lincoln, UK
2 Associate Professor, School of Sport and Exercise Science, College of Social Sciences, University of Lincoln, Lincoln, UK
3 Associate Professor, School of Sport and Exercise Science, College of Social Sciences, University of Lincoln, Lincoln, UK
4 Senior Lecturer, School of Sport and Exercise Science, College of Social Sciences, University of Lincoln, Lincoln, UK
5 Reader, Academy of Sport and Physical Activity, Faculty of Health and Wellbeing, Sheffield Hallam University, Collegiate Hall, Collegiate Crescent, Sheffield, UK
Introduction: There is now substantial evidence that physical activity reduces the risk of falls and physical disability in later life. Despite encouragement, many older adults are not accruing the health benefits of an active lifestyle. The purpose of this review is to provide an update on the literature specifically highlighting the benefits of regular physical activity (PA) for older adults in the community setting.
Methods: An exploratory, narrative review was constructed from peer-reviewed journal articles after a literature database search involving Google Scholar, SPORTDiscus, and PubMed. We considered all types of article and study design written in English language and published with a date range set between 2002 to 2018.
Results: A multitude of benefits related to the effects of physical activity with older adults were recognised in the literature search. Two overarching thematical dimensions were formed to represent the findings of this review: 1) functional ability and independence, and 2) psychological health and social connectedness. Our findings showed that community-based group exercise programmes have been found to positively enhance older adult’s physical function, improving mobility and flexibility. The primary components related to successful ageing are: 1) The absence of disease and disability, 2) the maintenance of physical and cognitive function, and 3) continued involvement in social activities.
Discussion: While the prescription and community-based programmes for older adults vary in format, structure and effectiveness, it is perhaps more important to promote the general concept of encouraging as many individuals to participate and adhere to sustained PA in later life, particularly as so many benefits are accrued from simply taking part.
Keywords: Functional independence; Non-systematic literature review; physical activity; psychological health; older adults.
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Original Article in Public Health
The effect of nutrition-related patterns on primary infertility among couples in Gaza Strip: A case-control study
Authors: Amal DHAIR1, Maha NUBANI HUSSEINI2, Yehia ABED3
1 MPH, Deputy Head Health Center, Health Department, UNRWA, Gaza Strip, Palestine
2 PhD, Faculty of Public Health, Al-Quds University, Jerusalem, Palestine
3 Prof, Faculty of Public Health, Al-Quds University, Gaza Strip, Palestine
Introduction: Nutritional health is one of the most controversial themes that had long been investigated against reproductive health. This study aimed to explore the relationship between different diet components and behaviour among infertile and fertile couples.
Methods: A case-control study was conducted in Gaza Strip with the participation of 160 infertile couples matched residentially with 160 fertile ones. Infertile couples were chosen from patients who were registered in five fertility centers from 2016 to 2018. Data were collected through a self-administered questionnaire extended by the WHO STEP wise diet questionnaire and analyzed through SPSS program version 22 by using descriptive analysis, independent T-test, cross-tabulation, and logistic regression.
Results: Our findings revealed that more infertile couples than fertile ones consume vegetables for less than 4 days/week (P = 0.001, females and males), less than 3 servings in each of these days (P < 0.001, females and males), less than 5 total servings of fruits and vegetables (P = 0.004 females, P = 0.010 males) and more red meat in main meals (P = 0.010 females, P = 0.042 males). Regular consumption of sweets and/or chips, soda and/or canned juice and using vegetable oil rather than olive oil also provided significant positive association (P = 0.031, P = 0.022, P = 0.020 respectively). Adjusting covariates showed that 65% of the risk is reduced by consumption of vegetables for more than 3 days/week (P = 0.007) and 54% reduction is achieved with every additional serving of vegetables consumed per day (P = 0.029).
Conclusion: The study provides credible evidence for the importance of following healthy nutritional patterns that seems to offer remarkable protection against primary infertility.
Keywords: Diet Behaviour; diet component; Gaza Strip; nutritional health; primary infertility.
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Original Article in Public Health
Predictors of physical and mental health among unemployed people in Greece
Authors: Dimitra LATSOU1, Mary GEITONA2
1 P.h.D., Research Fellow, Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece
2 Professor, Department of Social and Educational Policy, University of Peloponnese, Corinth, Greece
Introduction: Unexpected changes such as unemployment are harmful to an individual’s physical and mental health. The aim of this study is to examine the socio-demographic factors affecting the health status of unemployed people in Greece.
Methods: A cross-sectional study was conducted in the Manpower Employment Organization entities in the region of Attica, from June 2016 to September 2017. A random sample of 830 unemployed people participated in the study. A self-completion questionnaire was structured including questions on socioeconomic characteristics, physical health based on the Visual Analogue Scale (VAS) and mental health using the CES-D scale. Descriptive and inferential statistics were performed using SPSS 25.
Results: The mean age of participants was 35.8 ± 10.3 years, 66.1% were women and 71.8% was short-term unemployed. The mean VAS before unemployment was 85 ±13.6, which decreased to 68.3 ±23.1 during unemployment (P = 0.001) and 55.2% of the sample suffered from depressive symptoms. As far as the sociodemographic characteristics, women (b = -8,011), predisposed individuals to depression (b = -0.610,) and long-term unemployed (b = -1.541) tended to declare poor physical health. In addition, women (b = 1.795), older people (b = 0.179) and long-term unemployed (b = 2,658) were more likely to present predisposition to depression, while parents (b = -4,511) and those who reported good physical health (b = -0.150) did not show depressive symptoms.
Discussion and Conclusion: Socio-demographic factors, such as gender, age, existence of children and duration of unemployment appeared to significantly influence unemployed individuals’ health status. Policymakers should continuously support unemployed people through the development of innovative labor and unemployment policies as well as the expansion of their health coverage and access to healthcare in order to improve their overall health status.
Keywords: Greece; mental health; physical health; sociodemographic factors; unemployment
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Original Article in Health Economics
Testing the Dual-State-Process assumption in the preventive care services use
Author: Dimitris ZAVRAS1
1 Assistant Professor, University of West Attica, Athens, Greece
Introduction: Health services use is often measured as a count variable that is characterized by an excess of zeros. Zeros are generally considered to be generated from a dual-state process, i.e., sampling zeros concern a group of at-risk individuals, while structural zeros concern a group of not-at-risk individuals. However, in several studies, especially those regarding preventive services use, the dual-state-process assumption is questionable. In this sense, the objective of this paper is to investigate whether the dual-state-process assumption holds in the case of preventive services use.
Methods: For the purpose of this study, we analyzed data from a Panhellenic cross-sectional survey that was conducted in 2017. The survey used stratified random sampling, and the sample selection strata were defined by age, gender, urbanity status of permanent residence and prefecture. The sample consisted of 2003 adults. A computer-assisted telephone interviewing method was used for the data collection. Since the outcome variable was the number of times that preventive health services were used, the analysis was based on the comparison between a zero-inflated negative binomial model and a standard negative binomial model through the corrected Vuong test. Several health, socioeconomic, demographic and structural factors of the Greek health care system were used as independent variables.
Results: According to the analysis, the dual-state-process assumption does not hold in the case of preventive services use and since the need for receiving preventive care exists in most age and gender groups, this is probably due to the fact that preventive services use is infrequent, meaning that the majority of zeros are sampling zeros.
Discussion and Conclusion: The results highlight the need for testing the assumption if zero-inflated count models are to be used.
Keywords: Dual-state-process assumption; economics; Greece; preventive health services; sampling zeros, statistics; structural zeros, Vuong test; zero-inflated negative binomial model.
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Case Report in Internal Medicine and Immunology
Peripheral neuropathy as initial manifestation of Churg-Strauss Syndrome
Authors: Antonio VILLA1, Marianna GREGORIO2, Francesca BASSI3, Ignazio SANTILLI3
1 MD, Department of Emergency, ASST Monza, Desio Hospital, Monza, Italy
2 MD, Department of Internal Medicine, ASST Monza, Desio Hospital, Monza, Italy
3 MD, Department of Neurology, ASST Monza, Desio Hospital, Monza, Italy
Peripheral neuropathy is a well-known complication of primary systemic vasculitides that are characterized by inflammatory cell infiltration causing necrosis of blood vessels. Neurological complications in eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg-Strauss syndrome, can be seen in 60-70% of cases, and in a portion of them neurological dysfunction may precede the involvement of other organs. An early recognition of this entity is the key to successful treatment and positive outcome. We report a case of Churg-Strauss syndrome in a young man with signs of rapidly evolving peripheral neuropathy. The diagnosis was established based on the hypereosinophilia, nasal polyposis, a positive biopsy and ANCA serology, without a history of asthma. In this case report, the peripheral neuropathy was the initial manifestation of the Churg-Strauss syndrome.
Keywords: Churg-Strauss syndrome; eosinophilic granulomatosis with polyangiitis; eosinophilic vasculitis; peripheral neuropathy.
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