| 1. |
- Chalermsri, Chalobol, 1982-
(författare)
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Dietary diversity and its relation with health among the older population in Thailand
- 2023
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The role of dietary diversity (DD) in the health status among older people has been recognised. However, the evidence from lower-and-middle-income countries is scarce. The aim of this thesis was to explore the food choice, and dietary diversity, the associated factors and the health consequences of low dietary diversity among older people in Thailand.Study I was a qualitative study, using focus group discussions and individual interviews of people aged 60 years and older informal caregivers in Samut Sakhon Province, Thailand. A deductive thematic analysis approach was used. Studies II–IV acquired the data from the fifth Thai National Health Examination Survey, which was conducted between 2013 to 2015. Dietary diversity score (DDS) comprised eight food groups, including grains, white roots and tubers; pulse and beans, nuts and seeds; dairy products; meat, poultry, or fish; eggs; vegetables; fruits; and fats and oils. Socio-demographic characteristics included age, sex, educational level, wealth index, place of residence and living arrangement. The risk of cardiovascular disease (CVD) was determined using the Thai CV risk score. The cardiometabolic risk factors included hypertension, diabetes mellitus (DM) and lipid profiles. The mortality data was extracted from the Vital Statistics System in 2021. The data analyses used linear, logistic and proportional hazard regressions, which were adjusted for the complex survey design. We found that older people’s food choices relied on several factors, including health, social factors, the food environment and the economic factors. Regarding DD, a higher educational level, a higher wealth index and living in an urban area had a positive association, whereas living alone had a negative association with DDS. Regarding health, DDS had a negative association with log-Thai CV risk score, hypertension, DM and log-TG levels, whereas DDS was positively associated with TC and LDL-C levels. Additionally, DDS was inversely associated with mortality. The association between DDS and mortality was stronger in people aged 70 years and older. Finally, there was an inverse association between DDS and mortality in the underweight subgroup, while there was a positive association between DDS and mortality in the overweight and obesity sub-groups.In conclusion, this thesis showed the associations between DD and several socio-demographic factors and health outcomes. However, the effect of DD on mortality varied, depending on the individual’s age and BMI. Thus, the nutritional policies aimed at improving DD should be focused on the specific target groups to reduce mortality.
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| 2. |
- Chalermsri, Chalobol, et al.
(författare)
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Dietary diversity associated with risk of cardiovascular diseases among community-dwelling older people : A national health examination survey from Thailand
- 2022
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Ingår i: Frontiers in Nutrition. - : Frontiers Media S.A.. - 2296-861X. ; 9
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Tidskriftsartikel (refereegranskat)abstract
- Background: Cardiovascular diseases (CVD) are the common comorbidities in older people. Healthy diet is an essential strategy to alleviate the risk of developing CVD. Dietary diversity (DD) is an indicator of diet quality. Currently, limited research exists regarding DD and CVD in older people in developing countries, such as Thailand, despite rapid growth of older population. Therefore, this study aims to determine associations of DD with the risk of CVD and the cardiometabolic risk factors among Thai older people.Methods: This cross-sectional study used the sub-sample of the fifth Thai National Health Examination Survey conducted from 2013 to 2015. A total of 6,956 older people aged 60 years and older and no pre-existing CVD were included. Dietary diversity score (DDS) was assessed the consumption of eight food groups using food frequency questionnaires. Each food group was scored from 0 to 4. The DDS was calculated as the sum of the scores (0-32). The risk of CVD was calculated by using a Thai cardiovascular (CV) risk score. The cardiometabolic risk factors included hypertension, diabetes mellitus (DM), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglyceride (TG) levels. Data were adjusted for a complex survey design and analysed using linear and logistic regression models. Results: In the adjusted model, DDS had a significant negative association with log-Thai CV risk score, with adjusted β (95% CI) values of -0.01 (-0.01, -0.01). Regarding the cardiometabolic risk factors, DDS had a significant negative association with hypertension, DM and log-TG levels, with adjusted OR (95% CI) values of 0.97 (95% CI 0.97, 0.98) for hypertension, 0.94 (0.93, 0.95) for DM, and adjusted β (95% CI) values of -0.002 (-0.004, -0.001) for log-TG level. DDS was positively associated with TC and LDL-C, with adjusted β (95% CI) values of 0.59 (0.38, 0.80) for TC and 0.59 (0.38, 0.79) for LDL-C levels, while DDS was not associated with HDL-C level. Conclusion: Higher DD was associated with a lower risk of CVD among Thai older people. The nutritional policies or interventions should encourage a diverse food intake for the prevention of CVD in this population.
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| 3. |
- Chalermsri, Chalobol, et al.
(författare)
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Dietary diversity predicts the mortality among older people : Data from the fifth Thai national health examination survey
- 2023
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Ingår i: Archives of gerontology and geriatrics (Print). - : Elsevier. - 0167-4943 .- 1872-6976. ; 110
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To examine the association between dietary diversity (DD) and mortality among Thai older people and to investigate whether age, sex, and nutritional status modify this association.Methods: The national survey conducted from 2013 to 2015 recruited 5631 people aged > 60 years. Dietary diversity score (DDS) was assessed for the consumption of eight food groups using food frequency questionnaires. The Vital Statistics System provided the data on mortality in 2021. The association between DDS and mortality was analyzed by Cox proportional hazard model and adjusted for the complex survey design. Interaction terms between DDS and age, sex, and BMI were also tested.Results: The DDS was inversely associated with mortality (HR adj 0.98, 95%CI: 0.96–1.00). This association was stronger in people aged > 70 years (HR adj 0.93, 95%CI: 0.90–0.96 for aged 70–79 years, and HR adj 0.92, 95%CI: 0.88–0.95 for aged > 80 years). Inverse association between DDS and mortality was also found in the underweight older population (HR adj 0.95, 95%CI: 0.90–0.99). A positive association was found between DDS and mortality in the overweight/obese group (HR adj 1.03, 95%CI: 1.00–1.05). However, the interaction between the DDS with sex to mortality was not statistically significant.Conclusion:Increasing DD reduces mortality among Thai older people, especially in those above 70, and underweight. In contrast, an increase in DD also meant an increase in mortality among the overweight/obese group. Focus should be placed on the nutritional interventions aimed to improve DD for those 70 and over and underweight to reduce mortality.
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| 4. |
- Chalermsri, Chalobol, et al.
(författare)
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Exploring the Experience and Determinants of the Food Choices and Eating Practices of Elderly Thai People : A Qualitative Study.
- 2020
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 12:11
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Tidskriftsartikel (refereegranskat)abstract
- Over the past decade, Thailand has experienced a rapid increase in its elderly population. Many unfavorable health outcomes among elderly people are associated with nutrition. Nutrition in elderly people is affected by physical, mental, and social factors. This study explored the food choices and dietary practices among community-dwelling elderly people in Thailand from the perspective of both caregivers and the elderly people themselves. Six focus group discussions and six semistructured interviews were conducted in the Samut Sakhon Province of Thailand. Deductive thematic analyses were conducted based on the "food choice process model framework." The results show that physical and mental factors and societal factors are important determinants of food choices. Moreover, a changing food environment and economic factors were found to affect food choices. Issues of trust in food safety and food markets were highlighted as growing issues. Therefore, fostering healthy food choice interventions that consider both environmental and societal aspects is necessary.
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| 5. |
- Chalermsri, Chalobol, et al.
(författare)
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Socio-demographic characteristics associated with the dietary diversity of Thai community-dwelling older people : results from the national health examination survey
- 2022
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Ingår i: BMC Public Health. - : Springer Nature. - 1471-2458. ; 22:1
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Tidskriftsartikel (refereegranskat)abstract
- Background Dietary diversity (DD) is an indicator of nutrient intake and is related to health outcomes in older people. Currently, limited research exists regarding factors associated with DD in older people in developing countries, such as Thailand, despite rapid growth in this population. Therefore, this study aims to examine the association between socio-demographic characteristics and DD in Thai older people. Methods A cross-sectional study based on the fifth Thai National Health Examination Survey (NHES-V) conducted between 2013 and 2015 was performed. A total of 7,300 nationally representative older participants aged >= 60 years were included. The individual-level dietary diversity score (DDS) was assessed as the frequency of consumption of eight food groups using food frequency questionnaires. Each food group was scored from 0 to 4 according to the frequency of consumption. The DDS was calculated as the sum of the scores, ranging from 0 to 32. Socio-demographic characteristics, including age, sex, highest education level, wealth index, living conditions, and residential area, were assessed. Data were analyzed using multiple linear regression and adjusted for complex survey design. Results The participants had a mean age of 69.7 (SD 7.6) years. The mean DDS of participants was 18.4 (SD 3.9). In the adjusted model, a higher educational level, a higher wealth index, and living in an urban area were positively associated with DDS, with adjusted beta (95% CI) values of 1.37 (1.04, 1.70) for secondary education or higher, 0.81 (0.55, 1.06) for the richest group, and 0.24 (0.10, 0.44) for living in an urban area. Nevertheless, living alone had negative associations with DDS, with a beta (95% CI) of - 0.27 (- 0.53, - 0.00). Conclusions This study showed that a higher educational level, a higher wealth index, and living in an urban area had a positive association, whereas living alone had a negative association with DD among Thai older participants. Interventions aiming to improve dietary diversity among older people might benefit from targeting more vulnerable groups, particularly those with less education and wealth, those living alone, or those in rural areas.
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| 6. |
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| 7. |
- Frith, Amy L, et al.
(författare)
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Breast-feeding counselling mitigates the negative association of domestic violence on exclusive breast-feeding duration in rural Bangladesh. The MINIMat randomized trial.
- 2017
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Ingår i: Public Health Nutrition. - : Cambridge University Press. - 1368-9800 .- 1475-2727. ; 20:15, s. 2810-2818
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To determine if exclusive breast-feeding counselling modifies the association of experience of any lifetime or specific forms of domestic violence (DV) on duration of exclusive breast-feeding (EBF).DESIGN: In the MINIMat trial pregnant women were randomized to receive either usual health messages (UHM) or usual health messages with breast-feeding counselling (BFC) in eight visits. During pregnancy (30 weeks), lifetime experience of any or specific forms of DV was measured. Infant feeding practice information was collected from 0 to 6 months at 15 d intervals.SETTING: Matlab, Bangladesh.SUBJECTS: Pregnant and postpartum women (n 3186) and their infants.RESULTS: Among women in the UHM group, those who had experienced any lifetime DV exclusively breast-fed for a shorter duration than women who did not experience any lifetime DV (P=0·02). There was no difference, however, in duration of EBF among women in the BFC group based on their experience of any lifetime DV exposure (P=0·48). Using Cox regression analysis, there was an interaction of exposure to any lifetime DV, sexual violence and controlling behaviour, and counselling group with duration of breast-feeding at or before 6 months (P-interaction≤0·08). Among the UHM group, experience of any lifetime DV, sexual violence or controlling behaviour was associated with fewer days of EBF (P<0·05). In contrast, among the BFC group, experience of DV was not associated with duration of EBF.CONCLUSIONS: The experience of DV compromises EBF and the support of breast-feeding counselling programmes could assist this vulnerable group towards better infant feeding practices.
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| 8. |
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| 9. |
- Hammarström, Anne, et al.
(författare)
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How do labour market conditions explain the development of mental health over the life-course? a conceptual integration of the ecological model with life-course epidemiology in an integrative review of results from the Northern Swedish Cohort
- 2024
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 24:1
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Tidskriftsartikel (refereegranskat)abstract
- Background: The aim of this study was to contribute to the theoretical development within the field of labour market effects on mental health during life by integrating Bronfenbrenner’s ecological model with mainly earlier theoretical work on life-course theory. Methods: An integrative review was performed of all 52 publications about labour market conditions in relation to mental health from the longitudinal Northern Swedish Cohort study. Inductive and deductive qualitative content analysis were performed in relation to Bronfenbrenner’s ecological framework combined with life-course theories. Results: The following nine themes were identified: 1. Macroeconomic recession impairs mental health among young people. 2. The mental health effects on individuals of youth unemployment seem rather insensitive to recession. 3. Small but consistent negative effect of neighbourhood unemployment and other work-related disadvantaged on individuals’ mental health over life. 4. Youth unemployment becomes embodied as scars of mental ill-health over life. 5. Weak labour market attachment impairs mental health over life. 6. Bidirectional relations between health and weak labour market attachment over life. 7. Macrolevel structures are of importance for how labour market position cause poor health. 8. Unequal gender relations at work impacts negatively on mental health. 9. The agency to improve health over life in dyadic relations. Unemployment in society permeates from the macrolevel into the exolevel, defined by Bronfenbrenner as for example the labour market of parents or partners or the neighbourhood into the settings closest to the individual (the micro- and mesolevel) and affects the relations between the work, family, and leisure spheres of the individual. Neighbourhood unemployment leads to poor health among those who live there, independent of their employment status. Individuals’ exposure to unemployment and temporary employment leads to poorer mental health over the life-course. Temporal dimensions were identified and combined with Bronfenbrenner levels into a contextual life-course model Conclusion: Combining the ecosocial theory with life-course theories provides a framework for understanding the embodiment of work-related mental health over life. The labour market conditions surrounding the individual are of crucial importance for the embodiment of mental health over life, at the same time as individual agency can be health promoting. Mental health can be improved by societal efforts in regulations of the labour market.
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| 10. |
- Kantner, Annabell C., et al.
(författare)
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Factors associated with measles vaccination status in children under the age of three years in a post-soviet context : a cross-sectional study using the DHS VII in Armenia
- 2021
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 21
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Tidskriftsartikel (refereegranskat)abstract
- Background; The resurgence of measles globally and the increasing number of unvaccinated clusters call for studies exploring factors that influence measles vaccination uptake. Armenia is a middle-income post-Soviet country with an officially high vaccination coverage. However, concerns about vaccine safety are common. The purpose of this study was to measure the prevalence of measles vaccination coverage in children under three years of age and to identify factors that are associated with measles vaccination in Armenia by using nationally representative data.Methods: Cross-sectional analysis using self-report data from the most recent Armenian Demographic Health Survey (ADHS VII 2015/16) was conducted. Among 588 eligible women with a last-born child aged 12-35months, 63 women were excluded due to unknown status of measles vaccination, resulting in 525 women included in the final analyses. We used logistic regression models in order to identify factors associated with vaccination status in the final sample. Complex sample analyses were used to account for the study design.Results: In the studied population 79.6% of the children were vaccinated against measles. After adjusting for potential confounders, regression models showed that the increasing age of the child (AOR 1.07, 95% CI: 1.03-1.12), secondary education of the mothers (AOR 3.38, 95% CI: 1.17-9.76) and attendance at postnatal check-up within two months after birth (AOR 2.71, 95% CI: 1.17-6.30) were significantly associated with the vaccination status of the child.Conclusions: The measles vaccination coverage among the children was lower than the recommended percentage. The study confirmed the importance of maternal education and attending postnatal care visits. However, the study also showed that there might be potential risks for future measles outbreaks because of delayed vaccinations and a large group of children with an unknown vaccination status.
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| 11. |
- Mohammadi, Soheila, et al.
(författare)
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Afghan Migrants Face more Suboptimal Care than Natives : a Maternal Near-Miss Audit Study at University Hospitals in Tehran, Iran
- 2017
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Ingår i: BMC Pregnancy and Childbirth. - : Springer Science and Business Media LLC. - 1471-2393 .- 1471-2393. ; 17
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Tidskriftsartikel (refereegranskat)abstract
- Background: Women from low-income settings have higher risk of maternal near miss (MNM) and suboptimal care than natives in high-income countries. Iran is the second largest host country for Afghan refugees in the world. Our aim was to investigate whether care quality for MNM differed between Iranians and Afghans and identify potential preventable attributes of MNM. Methods: An MNM audit study was conducted from 2012 to 2014 at three university hospitals in Tehran. Auditors evaluated the quality of care by reviewing the hospital records of 76 MNM cases (54 Iranians, 22 Afghans) and considering additional input from interviews with patients and professionals. Main outcomes were frequency of suboptimal care and the preventable attributes of MNM. Crude and adjusted odds ratios with confidence intervals for the independent predictors were examined. Results: Afghan MNM faced suboptimal care more frequently than Iranians after adjusting for educational level, family income, and insurance status. Above two-thirds (71%, 54/76) of MNM cases were potentially avoidable. Preventable factors were mostly provider-related (85%, 46/54), but patient-(31%, 17/54) and health system-related factors (26%, 14/54) were also important. Delayed recognition, misdiagnosis, inappropriate care plan, delays in care-seeking, and costly care services were the main potentially preventable attributes of MNM. Conclusions: Afghan mothers faced inequality in obstetric care. Suboptimal care was provided in a majority of preventable near-miss events. Improving obstetric practice and targeting migrants' specific needs during pregnancy may avert near-miss outcomes.
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| 12. |
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| 13. |
- Sserwanja, Quraish, et al.
(författare)
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Over-nutrition and associated factors among 20 to 49-year-old women in Uganda : evidence from the 2016 Uganda demographic health survey
- 2021
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Ingår i: Pan African Medical Journal. - : Pan African Medical Journal. - 1937-8688. ; 39
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Tidskriftsartikel (refereegranskat)abstract
- Introduction: low- and middle-income countries are currently faced with a double burden of malnutrition. There has, however, been little focus on research and interventions for women with over-nutrition. We aimed to determine the prevalence and factors associated with over-nutrition among 20 to 49-year-old women in Uganda.Methods: we used the Uganda demographic and health survey (UDHS) 2016 data of 4,640 women. We analysed data using SPSS (version 25), and we used multivariable logistic regression to determine factors associated with over-nutrition among 20 to 49-year-old women in Uganda.Results: the prevalence of over-nutrition was 28.2% (95% confidence interval (CI): 26.8-29.4) with overweight at 19.3% and obesity at 8.9%. Women belonging to the poorer (adjusted odds ratio (AOR)=1.63; 95% CI: 1.17-2.28), middle (AOR=2.24; 95% CI: 1.61-3.13), richer (AOR=3.02; 95% CI: 2.14-4.25) and richest (AOR=6.35; 95% CI: 4.52-8.93) wealth index quintiles were more likely to be over-nourished compared to women in the poorest wealth index quintile. Married women (AOR=1.52; 95% CI: 1.26-1.83) were more likely to be over-nourished compared to non-married women. Older women were more likely to be over-nourished compared to younger women. Women in the Western (AOR=2.12; 95% CI: 1.66-2.71), Eastern (AOR=1.40; 95% CI: 1.04-1.88) and Central (AOR=2.25; 95% CI: 1.69-2.99) regions were more likely to be over-nourished compared to women in the Northern region.Conclusion: the design of multi-faceted over-nutrition reduction programs with an emphasis on older, married, financially stable women, and those living in the Western, Eastern and Central regions of the country is needed.
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| 14. |
- Sserwanja, Quraish, et al.
(författare)
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Rural and Urban Correlates of Stunting Among Under-Five Children in Sierra Leone : A 2019 Nationwide Cross-Sectional Survey
- 2021
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Ingår i: Nutrition and Metabolic Insights. - : Sage Publications. - 1178-6388. ; 14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Undernutrition accounts for at least 50% of the annual global under-five mortality burden. Although disparities in the childhood stunting between urban and rural areas in Sierra Leone have been documented, information on factors associated with these differences is lacking. We aimed to determine rural-urban correlates of stunting among children under the age of 5 in Sierra Leone.METHODS: We analyzed data from 2019 Sierra Leone demographic and health survey (SLDHS) focusing on under-five children. We conducted multivariable logistic regression to examine rural-urban factors associated with childhood stunting.RESULTS: Prevalence of stunting was 31.6% (95% CI 29.8-33.2) in rural areas and 24.0% (95% CI 21.6-26.1) in urban areas. Within the rural areas, children of stunted mothers (aOR = 2.37; 95% CI 1.07-5.24, P < .05), younger mothers aged 15 to 19 years (aOR = 2.08; 95% CI 1.17-3.69, P < .05), uneducated mothers (aOR = 1.87; 95% CI 1.28-2.71, P < .01), as well as older children (24-59 months) (aOR = 1.83; 95% CI 1.48-2.27, P < .001), and boys (aOR = 1.37; 95% CI 1.12-1.66, P < .01) were more likely to be stunted compared to those of non-stunted, older, post-primary education mothers and those who were less than 24 months and girls respectively. While urban children whose fathers had lower education (aOR = 1.94; 95% CI 1.10-3.42, P < .05), whose mothers were more parous (para 2-4) (aOR = 1.74; 95% CI 1.03-2.95, P < .05), and boys (aOR = 1.48; 95% CI 1.06-2.08, P < .05) were more likely to be stunted compared to their counterparts with fathers that had tertiary education, mothers of low parity and girls, respectively.CONCLUSIONS: Stunting is more prevalent in the rural areas compared to the urban areas. Sex of the child was the only significant factor in both rural and urban areas. Our study findings suggest that programs designed to reduce stunting should aim for inYtegrated yet context specific interventions in rural and urban areas.
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| 15. |
- Sserwanja, Quraish, et al.
(författare)
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Women empowerment indices and utilization of health facilities during childbirth : evidence from the 2019 Sierra Leone demographic health survey
- 2023
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Ingår i: BMC Health Services Research. - : BioMed Central (BMC). - 1472-6963. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundWomen empowerment is recognized as a potential enabling factor to the utilization of health facilities during childbirth. However, the association between women empowerment and utilization of health facilities is poorly studied, especially in counties with high maternal mortality. Therefore, we investigated the association between women empowerment indices and the utilization of health facilities during childbirth in Sierra Leone.MethodsWe analyzed secondary data from the 2019 Sierra Leone Demographic and Health Survey (SLDHS). We included 5,997 married women who had given birth in the five years before the survey, and had been sampled for the women empowerment questionnaire. The study employed the gender roles framework developed by the Harvard Institute for International Development in the selection and classification of women empowerment indices, which include influencing, resource and decision-making factors. We conducted logistic regression analyses using SPSS version 25.0 complex samples package to determine the association between women empowerment indices and utilization of health facilities.ResultsThe overall prevalence of health facility utilization during childbirth was 84.1% (5,042/5,997): 95% CI: 83.6 to 85.4. Among the influencer domain variables, women from the southern (aOR = 2.25, 95% CI: 1.34–3.78), northern (aOR = 1.69,95% CI: 1.01–2.82) and eastern regions (aOR = 3.71, 95% CI: 2.03–6.77) had higher odds of health facility utilization compared to women in the western region, while women in polygamous marriages (aOR = 0.82, 95% CI: 0.69–0.98) had lower odds of utilizing health facilities compared to their counterparts in monogamous marriages. Furthermore, women who had their first birth when they were less than 18 years, had higher odds of utilizing health facilities (aOR = 1.22, 95% CI: 1.02–1.45) compared to those who were 18 years and above. Among the resource domain variables, women with post-primary education (aOR = 1.58, 95% CI: 1.21–2.06) had higher odds of utilizing health facilities compared to their counterparts with no education and women who belonged to the richest wealth quintile (aOR = 2.42, 95% CI: 1.31–4.46) had higher odds of utilizing health facilities compared to their counterparts belonging in the poorest quintile. None of the variables in the decision making domain was significantly associated with health facility utilization.ConclusionThese findings emphasize that, successful implementation of health facility utilization interventions should prioritize women empowerment with more pragmatic efforts. Policies and programme should aim at all women with more focus on those having lower education (primary and below), belonging to the poorest wealth quintile, give birth before reaching18 years and in polygamous marriages.
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| 16. |
- Wickramasinghe, Ayanthi, et al.
(författare)
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Ragging, a Form of University Violence in Sri Lanka-Prevalence, Self-Perceived Health Consequences, Help-Seeking Behavior and Associated Factors
- 2022
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Ingår i: International Journal of Environmental Research and Public Health. - : MDPI. - 1661-7827 .- 1660-4601. ; 19:14
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Tidskriftsartikel (refereegranskat)abstract
- Ragging is an initiation ritual practiced in Sri Lankan universities for generations, although research is scarce. This practice has several adverse consequences such as physical, psychological, and behavioral effects and increased university dropouts. The aim of this study was to investigate the prevalence of different types of ragging: emotional/verbal, physical and sexual ragging, self-perceived health consequences, help-seeking behavior, and factors associated with the experience of ragging. A cross-sectional study was conducted among 623, second- and third-year students from the medical, and technology faculties in Jaffna University. Bivariate associations were assessed using chi-squared tests. Logistic regression was used to evaluate factors associated with any type of ragging. Ragging was experienced by 59% of the students, emotional/verbal ragging being the most common. A total of 54% of students suffered one or more health consequences and mainly sought help from friends and family, with few seeking formal help. Factors associated with any type of ragging were faculty and year of study. This study emphasizes the urgent need to address this public health problem. It is important that there are adequate student support services, planning and implementation of effective interventions, as well as ensuring that existing policies are strengthened, to reduce or eliminate ragging in Sri Lanka.
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| 17. |
- Ziaei, Shirin, et al.
(författare)
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A Prenatal Multiple Micronutrient Supplement Produces Higher Maternal Vitamin B-12 Concentrations and Similar Folate, Ferritin, and Zinc Concentrations as the Standard 60-mg Iron Plus 400-μg Folic Acid Supplement in Rural Bangladeshi Women.
- 2016
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Ingår i: Journal of Nutrition. - : Elsevier BV. - 0022-3166 .- 1541-6100. ; 146:12, s. 2520-2529
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The effects of prenatal food and micronutrient supplementation on maternal micronutrient status are not well known.OBJECTIVE: We compared the efficacy and effectiveness of 3 different micronutrient supplements on maternal micronutrient status when combined with food supplementation.METHODS: In the MINIMat (Maternal and Infant Nutrition Intervention, Matlab) trial in Bangladesh, 4436 pregnant women were randomly assigned to daily intake of 3 types of micronutrient capsules: 30 mg Fe and 400 μg folic acid (Fe30F), 60 mg Fe and 400 μg folic acid (Fe60F), or multiple micronutrient supplements (MMNs) combined with early (week 9 of pregnancy) or usual (week 20 of pregnancy) food supplementation in a 2 by 3 factorial design. Plasma concentrations of vitamin B-12, folate, ferritin, and zinc were analyzed before the start of micronutrient supplementation (week 14) and at week 30 of pregnancy in 641 randomly selected women. An electronic monitoring device was used to measure the number of capsules taken. The effectiveness of food and micronutrient regimens as well as efficacy per capsule in maternal micronutrient status were analyzed by ANOVA and general linear models.RESULTS: At week 30 of pregnancy, women in the MMN group had higher geometric mean concentrations of vitamin B-12 than women in the Fe60F group (119 compared with 101 pmol/L, respectively); no other differences in effectiveness of micronutrient and food regimens were observed. A dose-response relation between the number of capsules taken and concentrations of folate and ferritin was observed for all micronutrient supplements. Fe30F had lower efficacy per capsule in increasing ferritin concentrations within the first tertile of capsule intake than did Fe60F and MMNs. Because ferritin reached a plateau for all types of micronutrient supplements, there was no difference between the regimens in their effectiveness.CONCLUSION: Compared with Fe60F, MMNs produced higher maternal vitamin B-12 and similar ferritin and folate concentrations in Bangladeshi women. The MINIMat trial was registered at isrctn.org as ISRCTN16581394.
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| 18. |
- Ziaei, Shirin, et al.
(författare)
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Experiencing Lifetime Domestic Violence : Associations with Mental Health and Stress among Pregnant Women in Rural Bangladesh: The MINIMat Randomized Trial
- 2016
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Ingår i: PLOS ONE. - : Public Library of Science (PLoS). - 1932-6203. ; 11:12
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Experience of domestic violence has negative mental health consequences for women. The association of cumulative and specific forms of domestic violence, particularly emotional violence and controlling behavior, with common mental disorders and stress has rarely been studied in pregnant women. The aim of this study is to evaluate associations of specific and multiple forms of lifetime domestic violence and controlling behavior with distress and cortisol level during pregnancy in rural Bangladeshi women.METHODS AND FINDINGS: In this observational sub-study of larger MINIMat trial, 3504 pregnant women were interviewed using a shortened Conflict Tactic Scale about their lifetime experience of domestic violence including physical, sexual, emotional domestic violence and controlling behavior. Women's levels of emotional distress were assessed using the self-reported questionnaire (SRQ-20) developed by WHO, and levels of morning salivary cortisol were measured in a subsample (n = 1300) of women during week 28-32 of pregnancy. Regression analyses were used to estimate the associations of lifetime physical, sexual, emotional domestic violence and controlling behavior with levels of distress and cortisol during pregnancy. The prevalence of lifetime domestic violence was 57% and emotional distress was 35% in these pregnant women. All forms of domestic violence were associated with higher levels of emotional distress. Women who experienced either emotional violence or controlling behavior had the highest levels of emotional distress. There was a dose-response relationship between cumulative number of the different forms of domestic violence and women's levels of emotional distress. There was no association between women's experience of domestic violence and level of morning salivary cortisol.CONCLUSION: Including emotional violence and controlling behavior as major types of violence in future research and health interventions is warranted. Furthermore, the extent of the negative impacts of domestic violence on pregnant women, multiple forms of violence and their cumulative effects need to be investigated.
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| 20. |
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| 21. |
- Ziaei, Shirin, 1980-, et al.
(författare)
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Maternal Experience of Domestic Violence, Associations with Children's Lipid Biomarkers at 10 Years : Findings from MINIMat Study in Rural Bangladesh
- 2019
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Ingår i: Nutrients. - : MDPI. - 2072-6643. ; 11:4
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Tidskriftsartikel (refereegranskat)abstract
- The consequences of maternal experience of Domestic Violence (DV) on their children's cardio-metabolic risk factors are unclear. We aimed to assess if maternal exposure to any or a specific form of DV (i.e., physical, sexual, emotional and controlling behaviors) before and after childbirth was associated with their children's lipid biomarkers at the age of 10 years. A current observational sub-study of a larger MINIMat trial included a cohort of 1167 mothers and their children. The conflict tactic scale was used to record women's experience of lifetime DV before and after childbirth at week 30 of pregnancy and at a 10-year follow up, respectively. Five ml of fasting blood sample was collected from the children to evaluate their lipid profile. Children of women who experienced any DV before childbirth had lower Apo A ((adj) -0.04; 95% CI: -0.08, -0.01). Women who experienced physical DV both before and after childbirth had children with higher triglycerides ((adj) 0.07; 95% CI: 0.01, 0.14). Children whose mother experienced sexual DV before birth had lower Apo A ((adj) -0.05; 95% CI: -0.08, -0.01) and High Density Lipoprotein (HDL) ((adj) -0.05; 95% CI: -0.10, -0.01) as well as higher Low Density Lipoprotein (LDL) ((adj) 0.17; 95% CI: 0.05, 0.29) and LDL/HDL ( 0.24; 95% CI: 0.11, 0.38). However, levels of LDL ((adj) -0.17; 95% CI: -0.28, -0.06), LDL/HDL ((adj) -0.12; 95% CI: -0.25, -0.00) and cholesterol ((adj) -0.13; 95% CI: -0.25, -0.02) were lower among the children of mothers who experienced controlling behavior after childbirth. Results from the current study suggest that maternal experience of physical or sexual DV might negatively affect their children's lipid profile at the age of 10 years.
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| 22. |
- Ziaei, Shirin, 1980-, et al.
(författare)
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Maternal experience of domestic violence before and during pregnancy and children's linear growth at 15 years : Findings from MINIMat trial in rural Bangladesh.
- 2021
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 17:3
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Tidskriftsartikel (refereegranskat)abstract
- Literature concerning negative impacts of domestic violence (DV) against women on their children's health is growing; however, little is known about the long-term effect of maternal exposure to DV before and/or during pregnancy on their children's growth. Using data from the MINIMat cohort, we have evaluated the association between maternal lifetime experience of DV, measured in late pregnancy, with their children's linear growth at 15 years (n = 2240) in rural Bangladesh. A modified version of conflict tactic scale was used to record the maternal experience of physical, sexual, emotional DV and controlling behaviour. Children's height was measured by trained nurses during their clinical visits at 15-year follow-up. Compared to the women with no experience of DV, children of women with experience of any physical, sexual or emotional DV before and/or during pregnancy had the significantly lower height for age Z-scores (HAZs) at the age of 15. No significant association between maternal experience of controlling behaviour and their children's linear growth was observed in terms of HAZ. Results from this study suggest that maternal experience of DV before and/or during pregnancy might be associated with impaired long-term linear growth within their children.
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| 23. |
- Ziaei, Shirin, et al.
(författare)
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The relationship between interpersonal violence in adulthood and mental health : a longitudinal study based on the Northern Swedish Cohort
- 2023
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Ingår i: BMC Public Health. - : BioMed Central (BMC). - 1471-2458. ; 23:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Longitudinal studies evaluating the negative effects of exposure to interpersonal violence in the adulthood on the mental health of both women and men are scarce. Using longitudinal data, we evaluated the relationship between the last year experience of violence and functional somatic and depressive symptoms at the ages of 30 and 43 among participants (n = 1006; 483 women and 523 men) in the Northern Swedish Cohort. Further, the relationship between cumulative exposure to violence over a decade and mental health symptoms among participants was evaluated.METHODS: Participants' experience of interpersonal violence and symptoms of functional somatic and depressive symptoms were evaluated with standard questionnaires at the ages of 30 and 43. General linear models were used to evaluate the relationship between the experience of interpersonal violence and mental health symptoms among the participants. The interactions between gender and violence on functional somatic and depressive symptoms were evaluated separately, and models in which the interaction was significant, were split by gender.RESULTS: We found that the last year experience of violence at the age of 30 was related to current functional somatic symptoms among all participants and depressive symptoms only among men, (β Adj for the experience of any violence among men: 0.21; CI: 0.12-0.29; Vs. among women: 0.06; CI: -0.04-0.16, p for interaction = 0.02). At the age of 43, last year experience of violence was related to both functional somatic and depressive symptoms in both genders. Finally, a cumulative relationship between the experience of violence over time and mental health symptoms was observed in all participants.CONCLUSIONS: Our findings revealed that while the relationship between the experience of interpersonal violence and mental health symptoms may differ among men and women and with age, the experience of violence can be negatively related to the mental health in both genders.
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| 24. |
- Ziaei, Shirin, et al.
(författare)
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What social determinants outside paid work are related to development of mental health during life? An integrative review of results from the Northern Swedish Cohort
- 2021
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Ingår i: BMC Public Health. - : BioMed Central. - 1471-2458. ; 21:1
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Despite global increase in burden of mental health conditions, longitudinal studies on factors related to development of mental health are scarce. Particularly integrated understanding of how factors at each level of ecological system interact to influence mental health of individuals during their life is missing. Both work and outside work (life beyond work) spheres are two important areas in human life which can have independent effects on mental health of individuals. In this integrative review, we aimed to synthesis findings about social determinants outside paid work that are related to development of mental health during life in a 27-year prospective Swedish Cohort study by using Bronfenbrenner's Ecological Systems Theory.METHODS: The material for this paper consists of all mental health related papers within Northern Swedish Cohort. Papers related to outside paid work exposures of life circumstances were selected. An integrative review was conducted on 27 papers and deductive qualitative content analysis in relation to Bronfenbrenner ecological framework was performed to identify the main themes.RESULTS: The results of this review showed that class structures and gender order at macro-level permeated into all other levels and finally became embodied in the individuals as symptoms of mental health during life. At the "exo-level" neighbourhood disadvantage was related to mental ill-health of individuals. The importance of parental interaction with other settings, like school, for mental health of individuals was highlighted at "meso-level". At "micro-level" poor social relationships; social and material adversities and inequality in gender relations during adult life were related to mental ill-health.CONCLUSION: We found mental health of individuals to be related to both unique and common factors manifesting at different socio-ecological levels. Social structures at the macro-level namely class structures and gender order permeate all other levels and eventually become embodied in the individuals as symptoms of mental health during life. Interventions addressing gender and class related inequalities might be of importance for improving mental health of individuals during their life.
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| 25. |
- Ziaei, Shirin, et al.
(författare)
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Women´s autonomy and social support and their associations with infant and young child feeding and nutritional status : community-based survey in rural Nicaragua
- 2015
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Ingår i: Public Health Nutrition. - 1368-9800 .- 1475-2727. ; 18:11, s. 1979-1990
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Tidskriftsartikel (refereegranskat)abstract
- ObjectiveTo evaluate the associations of women’s autonomy and social support with infant and young child feeding practices (including consumption of highly processed snacks and sugar-sweetened beverages) and nutritional status in rural Nicaragua.DesignCross-sectional study. Feeding practices and children’s nutritional status were evaluated according to the WHO guidelines complemented with information on highly processed snacks and sugar-sweetened beverages. Women’s autonomy was assessed by a seventeen-item questionnaire covering dimensions of financial independence, household-, child-, reproductive and health-related decision making and freedom of movement. Women’s social support was determined using the Duke-UNC Functional Social Support Questionnaire. The scores attained were categorized into tertiles.SettingLos Cuatro Santos area, rural Nicaragua.Subjects A total of 1371 children 0–35 months of age.ResultsChildren of women with the lowest autonomy were more likely to be exclusively breast-fed and continue to be breast-fed, while children of women with middle level of autonomy had better complementary feeding practices. Children of women with the lowest social support were more likely to consume highly processed snacks and/or sugar-sweetened beverages but also be taller.ConclusionsWhile lower levels of autonomy and social support were independently associated with some favourable feeding and nutrition outcomes, this may not indicate a causal relationship but rather that these factors reflect other matters of importance for child care.
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| 26. |
- Ziaei, Shirin, 1980-, et al.
(författare)
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Women's exposure to intimate partner violence and child malnutrition : findings from demographic and health surveys in Bangladesh
- 2014
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Ingår i: Maternal and Child Nutrition. - : Wiley. - 1740-8695 .- 1740-8709. ; 10:3, s. 347-359
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Tidskriftsartikel (refereegranskat)abstract
- Domestic violence, in particular intimate partner violence (IPV), has been recognized as a leading cause of mortality and morbidity among women of reproductive age. The effects of IPV against women on their children's health, especially their nutritional status has received less attention but needs to be evaluated to understand the comprehensive public health implications of IPV. The aim of current study was to investigate the association between women's exposure to IPV and their children's nutritional status, using data from the 2007 Bangladesh Demographic and Health Survey (BDHS). Logistic regression models were used to estimate association between ever-married women's lifetime exposure to physical and sexual violence by their spouses and nutritional status of their children under 5 years. Of 2042 women in the BDHS survey with at least one child under 5 years of age, 49.4% reported lifetime experience of physical partner violence while 18.4% reported experience of sexual partner violence. The prevalence of stunting, wasting and underweight in their children under 5 years was 44.3%, 18.4% and 42.0%, respectively. Women were more likely to have a stunted child if they had lifetime experience of physical IPV [odds ratio n = 2027 (OR)adj, 1.48; 95% confidence interval (CI), 1.23–1.79] or had been exposed to sexual IPV (n = 2027 ORadj, 1.28; 95% CI, 1.02–1.61). The present findings contribute to growing body of evidence showing that IPV can also compromise children's growth, supporting the need to incorporate efforts to address IPV in child health and nutrition programmes and policies.
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| 27. |
- Ziaei, Shirin
(författare)
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Women’s status and child nutrition : Findings from community studies in Bangladesh and Nicaragua
- 2016
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- The importance of women’s status for child nutrition has recently been recognized. However, pathways through which women’s status can affect their caretaking practices and child nutrition have not been fully determined. The aim of this thesis was to evaluate associations between aspects of women’s status – including exposure to domestic violence and level of autonomy and social support – with their level of stress, feeding practices and child nutritional status in two different cultural settings: Bangladesh and Nicaragua.Data were acquired from population-based studies. For Study I we used data from the Bangladesh 2007 Demographic and Health Survey, and Study II was embedded in the 2009 Health and Demographic Surveillance System conducted in Los Cuatro Santos, rural Nicaragua. Studies III and IV were part of the MINIMat study, conducted in rural Bangladesh. In-person interviews were conducted and validated questionnaires were used in each of the studies. Anthropometric characteristics of the children were recorded based on standardized World Health Organization techniques.In Bangladesh, we found women with lifetime experience of domestic violence to be more likely to report emotional distress during pregnancy, cease exclusive breastfeeding before 6 months and have a stunted child. Further, we found a negative association between experience of domestic violence and duration of excusive breastfeeding to be mitigated with breastfeeding counseling. In Nicaragua, a lower level of maternal autonomy was associated with more appropriate breastfeeding practices such as higher odds of exclusive breastfeeding and longer continuation of breastfeeding. Further, a maternal lower level of social support was associated with better child nutritional status.In conclusion, this investigation showed that different dimensions of women’s status were associated with their feeding practices and child nutritional status and also revealed that the strength and direction of these associations may vary by the child’s age, setting and other contextual factors. These findings suggest that women’s status might have an important public health impact on child health and its role should be considered in programs and policies aiming to improve child health and nutrition.
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