| 1. |
- Andersén, Heidi, et al.
(författare)
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Is there still a social gradient in respiratory symptoms? A population-based nordic EpiLung-study
- 2024
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Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 223
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Tidskriftsartikel (refereegranskat)abstract
- Background: Respiratory symptoms are a common public health issue that can partly be attributed to preventable risk factors, such as tobacco smoking and occupational exposure, which are more common in individuals with lower socioeconomic status.Objective: Our aim was to evaluate the social gradient in respiratory symptoms in Nordic countries.Methods: This study included participants aged 30–65 years from five cross-sectional population-based questionnaire surveys in 2016 in Finland and Sweden (N = 25,423) and in 2017–2019 in Norway (N = 27,107). Occupational skill levels 1 and 2 (occupations requiring compulsory education) were combined and compared to skill levels 3 and 4 (occupations requiring upper secondary and tertiary education). Meta-analysis was conducted to obtain pooled age- and sex adjusted odds ratios (aORs) of associations between occupational skill and the respiratory symptoms including recurrent wheeze, dyspnoea, and productive cough.Results: In the meta-analysis, recurrent wheeze, dyspnoea, and productive cough showed a social gradient. The participants with occupational skill 1 and 2 had higher risk for recurrent wheeze (aOR 1.78, 95% CI 1.34–2.22) and dyspnoea (aOR 1.59, 95% CI 1.29–1.90) compared to occupational skill 3 and 4 in Sweden and Finland. Similarly increased risk was observed for combined assessment of dyspnoea and wheeze (aOR 1.05, 95% CI 1.03–1.07) in Norway. In a meta-analysis including all three countries, the aOR for productive cough was 1.31 95% CI 1.07–1.56.Conclusions: Occupations with lower, compared to higher, skill levels were associated with an increased risk of recurrent wheeze, dyspnoea, and productive cough.
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| 2. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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Cerebrovascular disease in Sudan: a huge gap to be bridged
- 2018
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Ingår i: South Africa Journal of Diabetes & Vascular Disease. ; :15, s. 29-31
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Tidskriftsartikel (refereegranskat)abstract
- Organised national structural and research efforts are crucial to minimising the high morbidity and mortality burdens attributed to cerebrovascular disease in Sudan. The dearth of quality research evidence to guide decision making in neurological services, and the lack of political will and resources have accounted for the uncertainty regarding this major health problem in Sudan. This article reviews the research efforts on cerebrovascular diseases in Sudan from an epidemiological and health-service point of view, highlighting areas of information deficiency and recommending health-system and research-based interventions to improve cerebrovascular disease status in Sudan.
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| 3. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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Computational phenotyping of obstructive airway diseases: protocol for a systematic review
- 2022
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Ingår i: Systematic Reviews. - : Springer Nature. - 2046-4053. ; 11:1
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Forskningsöversikt (refereegranskat)abstract
- Background: Over the last decade, computational sciences have contributed immensely to characterization of phenotypes of airway diseases, but it is difficult to compare derived phenotypes across studies, perhaps as a result of the different decisions that fed into these phenotyping exercises. We aim to perform a systematic review of studies using computational approaches to phenotype obstructive airway diseases in children and adults.Methods and analysis: We will search PubMed, Embase, Scopus, Web of Science, and Google Scholar for papers published between 2010 and 2020. Conferences proceedings, reference list of included papers, and experts will form additional sources of literature. We will include observational epidemiological studies that used a computational approach to derive phenotypes of chronic airway diseases, whether in a general population or in a clinical setting. Two reviewers will independently screen the retrieved studies for eligibility, extract relevant data, and perform quality appraisal of included studies. A third reviewer will arbitrate any disagreements in these processes. Quality appraisal of the studies will be undertaken using the Effective Public Health Practice Project quality assessment tool. We will use summary tables to describe the included studies. We will narratively synthesize the generated evidence, providing critical assessment of the populations, variables, and computational approaches used in deriving the phenotypes across studiesConclusion: As progress continues to be made in the area of computational phenotyping of chronic obstructive airway diseases, this systematic review, the first on this topic, will provide the state of the art on the field and highlight important perspectives for future works.Ethics and dissemination: No ethical approval is needed for this work is based only on the published literature and does not involve collection of any primary or human data.
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| 4. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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Interaction of smoking and social status on the risk of respiratory outcomes in a Swedish adult population : A Nordic Epilung study
- 2023
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Ingår i: Respiratory Medicine. - : Elsevier. - 0954-6111 .- 1532-3064. ; 211
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence abounds on the independent roles of social class and smoking in relation to obstructive airway diseases, but data are sparse on the impact of their interaction. We evaluated whether and to what extent social class and smoking interact in relation to risk of respiratory diseases in adults.Methods: Data from the population-based studies, West Sweden Asthma Study (WSAS, n = 23,753) and Obstructive Lung Disease in Northern Sweden studies (OLIN, n = 6519), were used, constituting randomly selected adults aged 20–75 years. Bayesian network analysis was used to estimate the probability for the interaction between smoking and socioeconomic status in relation to respiratory outcomes.Results: Occupational and educational SES modified the association between smoking and the probability of allergic and non-allergic asthma. Former smokers who were at intermediate non manual employees and manual workers in service had higher probability of allergic asthma compared to professionals and executives. Furthermore, former smokers with primary education had higher probability of non-allergic asthma than those with secondary and tertiary education. Similarly, former smokers among professionals and executives had higher probability of non-allergic asthma than manual and home workers and primary educated. Likewise, allergic asthma due to former smoking was higher among highly educated compared to low educated.Conclusions: Beyond their independent roles, socioeconomic status and smoking interact in defining the risk of respiratory diseases. Clearer understanding of this interaction can help to identify population subgroups at most need of public health interventions.
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| 5. |
- Bashir, Muwada Bashir Awad
(författare)
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Phenotypes of Airway Diseases in Adults and Variation by Socioeconomic Status
- 2024
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: Lately, global prevalence of chronic obstructive airway diseases has risen, though some regions have seen stability. These diseases are heterogenous, have diverse manifestations and varying phenotypes. Ongoing research aims to identify and characterize phenotypes of obstructive airway diseases to enhance understanding of risk factors and improve treatments. The breadth and diversity of currently uncovered phenotypes of obstructive airway diseases are unclear. In the Nordic countries, there are social disparities in airway diseases, with those at lower socioeconomic status facing higher morbidity and mortality. Various socioeconomic indicators have been used to link socioeconomic status (SES) to airway diseases, but their impact on distinct asthma phenotypes remains unclear. Smoking is a risk factor for COPD, but its role in asthma remains controversial. While much is known about the independent impact of SES and smoking on obstructive airway diseases, their mutual synergism is unclear, particularly in relation to phenotypes of obstructive airway diseases. The goal of this thesis was to summarize the phenotypes of obstructive airway diseases and explore the connections between SES and phenotypes of airway diseases. Objectives: The overarching aim of the thesis was to characterize phenotypes of obstructive airway diseases and determine their variation by SES. The thesis consisted of 6 papers: (1) a study of association of level of education and asthma control in adult-onset asthma; (2) a study on the effect modification between smoking and socioeconomic status towards risk of obstructive airway diseases; and (3) a systematic review of studies on computational phenotyping of airway disease using unsupervised computational methods; (4) a study on association between social status and forms/phenotypes of rhinitis; (5) a study on phenotyping asthma in general population using machine learning approach and (6) a study on association between socioeconomic status and phenotypes of asthma. Methods: In Paper 1, individuals with adult-onset asthma were examined in three studies: the Obstructive Lung Disease In Northern Sweden (OLIN) (n = 593), Seinäjoki Adult Asthma Study (SAAS) (n = 200), and West Sweden Asthma Study (WSAS) (n = 301) during 2009-2014. Education levels were primary, secondary, or tertiary, with uncontrolled asthma defined as asthma control test (ACT) score ≤19. Eight hundreds ninety-six participants with complete data were included (OLIN n = 511, SAAS n = 200, WSAS n = 185). Paper 2 analyzed data from WSAS (23,753 participants) and OLIN (6,519 participants) aged 20-75. Bayesian analysis explored smoking and socioeconomic status effect modification on respiratory outcomes. Paper 3 was a systematic review that synthesized studies on computational phenotyping of airway disease published 2010-2020. In Paper 4 and 6, estimated the association between education and occupational classes and risk of forms of rhinitis and asthma phenotypes, respectively. Paper 5 employed a deep clustering algorithm for clustering asthma, that was defined based on self-report from general population. Results: In Paper 1, the odds ratio (OR) for primary education in relation to uncontrolled asthma was 1.92 (95% CI 1.15-3.20) in daily ICS users and 3.42 (95% CI 1.30-8.96) in non-atopic subjects. In Paper 2, SES and smoking had marginal synergistic effect on respiratory outcomes, with more pronounced effect-modification seen among lower occupational classes regarding smoking effect on allergic asthma, while among professionals, it affected non-allergic asthma. In Paper 3, there were variations in the literature regarding computational phenotyping of obstructive airway diseases, particularly in study design and methods, study settings, participant profiles, and variables used to perform the phenotyping exercise, altogether leading to differences in characterized phenotypes. In paper 4, higher education and occupation levels were identified to be risk factors for allergic and chronic rhinitis. Paper 5 identified four asthma phenotypes that were distinguishable by age of onset, severity, risk factors, and prognosis. Paper 6 showed an association between high and low education levels and presenting certain asthma phenotypes. Conclusion: In affluent Nordic countries, classical phenotypes of asthma are present in the general population. Lower education poses a risk for uncontrolled adult-onset asthma, while high education levels were linked to high risk of allergic and chronic forms of rhinitis, suggesting the significance of incorporating social aspect into management and prevention of airway diseases.
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| 6. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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Predictors and correlates of examination anxiety and depression among high school students taking the Sudanese national board examination in Khartoum state, Sudan: a cross-sectional study
- 2019
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Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: test anxiety and depression are of the major challenges experienced in students' life, considering the inverse associations they have on their mental wellbeing and academic performance. Evidence from Sudan have reported high figures of adolescent's mental health problems of depression and anxiety. However, studies investigating its association with academic exam stress are lacking. We investigated the prevalence of exam anxiety and depression severity among student setting for Sudan national boarding examination, aiming at identifying possible predictors related to student's socio-demographic and academic status and measuring correlation between exam anxiety and depression severity status among students. Methods: using cross-sectional design, data obtained using standardized west side anxiety scale for measuring test anxiety; and patient's health questionnaire (PHQ9) of nine items for measuring depression was presented in percentages. Association with sociodemographic and academic factors was measured using logisticregression models. Analysis was run at 0.05 level of significance. Results: depression and exam anxiety were found to be highly correlated. The highest fractions of students are those with high levels of test anxiety and moderate to severe depression. Gender, maternal level of education, previous exam experience and academic performance are significant predictor for student's exam anxiety status. Conclusion: high figures of exam anxiety and depression are there among Sudanese students setting for their third years boarding exam. Males, low academic performance and maternal low education are risk factors. school mental health services and programs addressing such group of students are highly demanded in line with more elaborative research efforts in this arena.
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| 7. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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Socioeconomic status and different forms of rhinitis in Swedish adults
- 2024
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Ingår i: Clinical and Translational Allergy. - : John Wiley & Sons. - 2045-7022. ; 14:6
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Tidskriftsartikel (refereegranskat)abstract
- Rhinitis encompasses diverse forms. Each form has distinct pathophysiology and clinical manifestations and may be influenced by differential risk factors. The association between socioeconomic status (SES) and different forms of rhinitis remains poorly understood. Our aim was to examine SES variations in allergic rhinitis, chronic rhinitis, and chronic rhinosinusitis in adults.Based on a 2016 postal questionnaire survey within the West Sweden Asthma Study, we analyzed data from 36,213 subjects aged 16-75years. The measures of SES were levels of education and occupation. Adjusted logistic regression was used to examine associations between SES and the rhinitis outcomes.Attaining a secondary school and tertiary education, compared to a primary school, were associated with increased risk of allergic rhinitis (secondary OR 1.33, 95% CI 1.22-1.45; tertiary 1.54, 1.41-1.69) and chronic rhinitis (secondary 1.18, 1.08-1.29; tertiary 1.17, 1.06-1.28). The influence of occupation was consistent with respect to allergic rhinitis. For instance, compared to the lowest occupational skill level, the highest level (OR 1.24, 95% CI 1.04-1.48) and the lower high occupation levels (1.24, 1.04-1.49) were associated with an increased risk of allergic rhinitis. No significant link was found between education and chronic rhinosinusitis or between occupation levels and risk of either chronic rhinitis or chronic rhinosinusitis.Individuals with higher education and those at higher occupational levels may be at higher risk of having different forms of rhinitis than those at lower education and occupation levels. Assessment of rhinitis burden via SES can be one strategy to develop preventive strategies.
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| 8. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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Socioeconomic status and different forms of rhinitis in Swedish adults
- 2024
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Ingår i: Clinical and Translational Allergy. - : John Wiley & Sons. - 2045-7022. ; 14:6
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Tidskriftsartikel (refereegranskat)abstract
- Background: Rhinitis encompasses diverse forms. Each form has distinct pathophysiology and clinical manifestations and may be influenced by differential risk factors. The association between socioeconomic status (SES) and different forms of rhinitis remains poorly understood. Our aim was to examine SES variations in allergic rhinitis, chronic rhinitis, and chronic rhinosinusitis in adults.Methods: Based on a 2016 postal questionnaire survey within the West Sweden Asthma Study, we analyzed data from 36,213 subjects aged 16–75 years. The measures of SES were levels of education and occupation. Adjusted logistic regression was used to examine associations between SES and the rhinitis outcomes.Results: Attaining a secondary school and tertiary education, compared to a primary school, were associated with increased risk of allergic rhinitis (secondary OR 1.33, 95% CI 1.22–1.45; tertiary 1.54, 1.41–1.69) and chronic rhinitis (secondary 1.18, 1.08–1.29; tertiary 1.17, 1.06–1.28). The influence of occupation was consistent with respect to allergic rhinitis. For instance, compared to the lowest occupational skill level, the highest level (OR 1.24, 95% CI 1.04–1.48) and the lower high occupation levels (1.24, 1.04–1.49) were associated with an increased risk of allergic rhinitis. No significant link was found between education and chronic rhinosinusitis or between occupation levels and risk of either chronic rhinitis or chronic rhinosinusitis.Conclusion: Individuals with higher education and those at higher occupational levels may be at higher risk of having different forms of rhinitis than those at lower education and occupation levels. Assessment of rhinitis burden via SES can be one strategy to develop preventive strategies.
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| 9. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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Stigma on epileptic patients attending the outpatient clinic of Soba University Hospital and the National Center for Neurological Science (NCNS) Khartoum, Sudan
- 2019
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Ingår i: The Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 32
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: epilepsy is one of the most prevalent neurological conditions for people of different age group, race, gender and socio-economic status in various nations, affecting 50 million people around the world; 80% of them living in developing countries. In Sudan, literature has well documented epilepsy stigma and it related elements of labelling, negative typecasting, isolation, devaluing and discrimination that are significantly affecting patients living standards and social life. This study focuses on understanding the prevailing, different types of stigma among people living with epilepsy (PWE) in Sudan and to determine its frequency in connection with demographic factors and patients coping ability of PWE. Methods: a health facility-based cross-sectional descriptive study was conducted on 270 people between the ages of 16-70years who are affected by epilepsy in an outpatient clinic. Standardized questionnaires were used to interview the patients with assistance gotten from their relative where necessary. The data is analyzed using SPSS version 20. The study was conducted in the outpatient clinic of The National Center for Neurological Sciences (NCNS), Ibrahim-Malik Teaching Hospital Sudan. Results: the study realized that 16.6% of the patient had a positive self-stigma score, half of them having coaching stigma and 25% courtesy stigma. One third of people with epilepsy had poor coping score that was strongly determined by self- stigma and courtesy stigma score. Conclusion: parents and relatives related sigma is a major problem facing people of epilepsy in Sudan; thus, raising such group awareness and education about the disease can markedly improve the quality of life of people with epilepsy in Sudan.
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| 10. |
- Bashir, Muwada Bashir Awad, et al.
(författare)
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The quality of life and inequalities in health services for epilepsy treatment among patience in the urban cities of Sudan
- 2019
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Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 33
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Epilepsy in Sudan accounts for 1.6 annual mortality rates and 238.7 disability adjusted life years per 100 000. These figures are higher among females; children and young adults. It is associated with notable stigma and social burdens. Patients of epilepsy are subjected to various forms of social discrimination that affect their quality of life. They are isolated, neglected and deprived of their education and employments rights and not able to achieve normal social and family life. Aiming at highlighting social implications of epilepsy among Sudanese patients, this study found that social encumbrances due to epilepsy in Sudan are more prevalent among highly vulnerable groups like women, children and poor populations living in remote areas. Lack of trained medical personnel in neurology and the medical equipment's required for proper diagnosis and treatment of epilepsy in Sudan are key reasons aggravating social and health burden of epilepsy both among patients and their caregivers.
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