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Abudayya A, Abu Ghali K, Hargreaves S, Blanchet K, Bjertness E, Bhopal AS, Agyemang C, Holmboe-Ottersen G, Bhopal RS, Krasnik A, Dias S, Lien L, Kapilashrami A, Kumar BN. An urgent call to save and protect lives of vulnerable populations in the Gaza Strip. Lancet Reg Health Eur 2023; 35:100767. [PMID: 38115959 PMCID: PMC10730323 DOI: 10.1016/j.lanepe.2023.100767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 10/18/2023] [Indexed: 12/21/2023]
Affiliation(s)
| | | | - Sally Hargreaves
- The Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Karl Blanchet
- Lancet Migration European Regional Hub, Europe
- Geneva Centre of Humanitarian Studies, Switzerland
| | - Espen Bjertness
- Department of Community Medicine and Global Health, University of Oslo, Norway
| | - Anand S. Bhopal
- Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Norway University of Bergen, Norway
| | - Charles Agyemang
- Department of Public Health Academic Medical Center, University of Amsterdam, the Netherlands
| | | | | | | | - Sonia Dias
- National School of Public Health, NOVA University of Lisbon, Portugal
| | - Lars Lien
- President of the Norwegian Psychiatric Association
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
| | - Anuj Kapilashrami
- Interdisciplinary Research and Practice Division School of Health and Social Care University of Essex, UK
| | - Bernadette N. Kumar
- Lancet Migration European Regional Hub, Europe
- Division of Health Services Research, Norwegian Institute of Public Health, Norway
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2
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Bucciardini R, Zetterquist P, Rotko T, Putatti V, Mattioli B, De Castro P, Napolitani F, Giammarioli AM, Kumar BN, Nordström C, Plantz C, Zarneh YS, Olsson G, Ahrne M, Kilpeläinen K, Lopez-Acuña D, Vantarakis A, Marra M, Nessi C, Costa G. Addressing health inequalities in Europe: key messages from the Joint Action Health Equity Europe (JAHEE). Arch Public Health 2023; 81:89. [PMID: 37170153 PMCID: PMC10173226 DOI: 10.1186/s13690-023-01086-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 04/11/2023] [Indexed: 05/13/2023] Open
Abstract
Health inequalities within and between Member States of the European Union are widely recognized as a public health problem as they determine a significant share of potentially avoidable mortality and morbidity. After years of growing awareness and increasing action taken, a large gap still exists across Europe in terms of policy responses and governance. With the aim to contribute to achieve greater equity in health outcomes, in 2018 a new Joint Action, JAHEE, (Joint Action Health Equity Europe) was funded by the third EU Health Programme, with the main goal of strengthening cooperation between participating countries and of implementing concrete actions to reduce health inequalities. The partnership led by Italy counted 24 countries, conducting actions in five policy domains: monitoring, governance, healthy living environments, health systems and migration, following a three-step implementation approach. Firstly, specific Policy Frameworks for Action (PFA) collecting the available evidence on what practice should be done in each domain were developed. Second, different Country Assessments (CAs) were completed to check the country's adherence to the recommended practice in each domain. The gap between the expected policy response (PFA) and the present policy response (CA) guided the choice of concrete actions to be implemented in JAHEE, many of which are continuing even after the end of JA. Final recommendations based on the best results achieved during JAHEE were elaborated and agreed jointly with the representatives of the involved Ministries of Health. The JAHEE initiative represented an important opportunity for the participating countries to work jointly, and the results show that almost all have increased their level of action and strengthened their capacities to address health inequalities.
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Affiliation(s)
| | | | - Tuulia Rotko
- Finnish Institute for Health and Welfare, Helsinki, Finland
| | | | | | | | | | | | | | | | | | | | | | - Malin Ahrne
- Public Health Agency of Sweden, Stockholm, Sweden
| | | | | | | | - Michele Marra
- Epidemiology Unit, ALSTO3, Piedmont Region, Turin, Italy
| | | | - Giuseppe Costa
- Dept Clinical and Biological Sciences, Turin University, Turin, Italy
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3
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Kumar BN, Eikemo TA, Diaz E. Migration and Health: Time for a new research agenda. Scand J Public Health 2023; 51:309-311. [PMID: 37283231 DOI: 10.1177/14034948231172320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Affiliation(s)
- Bernadette N Kumar
- Norwegian Institute of Public Health, Norway
- University of Bergen, Norway
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Kumar BN, Jamtvedt G, Diaz E. The road from knowledge to change - pandemics, diversity \and social inequality declaration, Bergen 2022. Scand J Public Health 2023:14034948231165084. [PMID: 37066899 PMCID: PMC10111135 DOI: 10.1177/14034948231165084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023]
Affiliation(s)
- Bernadette N Kumar
- Norwegian Institute of Public Health, Norway
- Pandemic Center, University of Bergen, Norway
| | - Gro Jamtvedt
- Faculty of Health Sciences, Oslo Metropolitan University, Norway
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5
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Lechner M, Liu J, Counsell N, Gillespie D, Chandrasekharan D, Ta NH, Jumani K, Gupta R, Rocke J, Williams C, Tetteh A, Amnolsingh R, Khwaja S, Batterham RL, Yan CH, Treibel TA, Moon JC, Woods J, Brunton R, Boardman J, Hatter M, Abdelwahab M, Holsinger FC, Capasso R, Nayak JV, Hwang PH, Patel ZM, Paun S, Eynon-Lewis N, Kumar BN, Jayaraj S, Hopkins C, Philpott C, Lund VJ. The burden of olfactory dysfunction during the COVID-19 pandemic in the United Kingdom. Rhinology 2023; 61:93-96. [PMID: 36286227 DOI: 10.4193/rhin22.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK; UCL Cancer Institute, University College London, London, UK; ENT Department, Barts Health NHS Trust, London, UK
| | - J Liu
- UCL Cancer Institute, University College London, London, UK
| | - N Counsell
- CRUK and UCL Cancer Trials Centre, University College London, London, UK
| | - D Gillespie
- UCL Cancer Institute, University College London, London, UK
| | - D Chandrasekharan
- Division of Surgery and Interventional Science, University College London, London, UK
| | - N H Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Jumani
- Division of Surgery and Interventional Science, University College London, London, UK
| | - R Gupta
- Division of Surgery and Interventional Science, University College London, London, UK
| | - J Rocke
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - C Williams
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - A Tetteh
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Amnolsingh
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Khwaja
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - R L Batterham
- Centre for Obesity Research, University College London, London, UK; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospitals NHS Trust, London, UK; National Institute for Health Research, UCLH Biomedical Research Centre, London, UK
| | - C H Yan
- Department of Otolaryngology, University of San Diego School of Medicine, San Diego, USA
| | - T A Treibel
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J C Moon
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J Woods
- The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - R Brunton
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - M Hatter
- Medical University of South Carolina, Charleston, SC, USA
| | - M Abdelwahab
- Medical University of South Carolina, Charleston, SC, USA
| | - F C Holsinger
- Medical University of South Carolina, Charleston, SC, USA
| | - R Capasso
- Medical University of South Carolina, Charleston, SC, USA
| | - J V Nayak
- Medical University of South Carolina, Charleston, SC, USA
| | - P H Hwang
- Medical University of South Carolina, Charleston, SC, USA
| | - Z M Patel
- Medical University of South Carolina, Charleston, SC, USA
| | - S Paun
- Division of Surgery and Interventional Science, University College London, London, UK
| | - N Eynon-Lewis
- Division of Surgery and Interventional Science, University College London, London, UK
| | - B N Kumar
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - S Jayaraj
- Division of Surgery and Interventional Science, University College London, London, UK
| | - C Hopkins
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - V J Lund
- Royal National ENT Hospital, University College London Hospitals NHS Trust, London, UK
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Kumar BN, Diaz E, Castaneda AE, Ahrne M, NØrredam ML, Puthoopparambil SJ. Migration health research in the Nordic countries: Priorities and implications for public health. Scand J Public Health 2022; 50:1039-1046. [PMID: 36245405 DOI: 10.1177/14034948221125037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The past 50 years have witnessed an increase in immigration to the Nordic countries from and beyond neighbouring countries in Europe. Diversity implies variations and differences in health status and health outcomes both within and across populations. Migrant health research has not been prioritized and health policies and practice, especially long-term national plans, often exclude migrants. In this article, we briefly trace the history, the groups, reasons for migration and the road to migrant health research in Norway, Sweden, Finland and Denmark. We discuss the case for data and research including needs, basis for data collection and the methodological challenges. We provide a brief snapshot of migrant health research, identify current gaps and discuss the implications for research. We recommend a regional Nordic strategy to promote intercountry exchange, sharing and learning. Finally, we reflect on the larger picture, implications for policy and practice that could enable societal conditions to reduce avoidable health inequalities.
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Affiliation(s)
| | | | | | - Malin Ahrne
- Public Health Agency of Sweden, Solna, Sweden
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Hasha W, Igland J, Fadnes LT, Kumar BN, Heltne UM, Diaz E. Effect of a self-help group intervention using Teaching Recovery Techniques to improve mental health among Syrian refugees in Norway: a randomized controlled trial. Int J Ment Health Syst 2022; 16:47. [PMID: 36068576 PMCID: PMC9450394 DOI: 10.1186/s13033-022-00557-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 08/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Mental health symptoms among refugees are common, often related to chronic pain disorders, and their management is usually challenging. Studies evaluating the effect of group therapies among adult refugees to improve mental health symptoms are scarce. Aims To assess the effect of Teaching Recovery Techniques (TRT) on mental health and to reduce pain disorder among adult Syrian refugees. Method A randomized controlled trial was designed to study the effect of a self-help group intervention using TRT. The outcomes, mental health symptoms measured by Impact of Event Scale-Revised (IES-R) and General Health Questionnaire (GHQ-12) and chronic pain measured by Brief Pain Inventory (BPI), were reported as regression coefficients (B) with 95% confidence intervals. Results Seventy-six adults participated: 38 in the intervention and 38 in the control groups. Intention-to-treat analyses showed a significant effect on general mental health as measured by GHQ-12 with B (95% CI) of -3.8 (-7.2, -0.4). There was no effect of TRT on mental health when assessed by IES-R (-1.3 (-8.7, 6.2)) or on pain levels assessed by BPI (-0.04 (-4.0, 3.9)). Conclusions This self-help group intervention significantly improved general mental health symptoms among adult refugees but had no effect on trauma symptoms or chronic pain. Higher participation rates might be necessary to achieve the full potential of TRT. Trial registration: The trial was registered with Clinical Trials.gov at https://clinicaltrials.gov/ct2/show/NCT03951909. To include user participation in the design of the interventions, the study was retrospectively registered on 19 February 2019. Supplementary Information The online version contains supplementary material available at 10.1186/s13033-022-00557-4.
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Affiliation(s)
- Wegdan Hasha
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009, Bergen, Norway
| | - Lars T Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.,Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Bernadette N Kumar
- Unit for Migration and Health, Norwegian Institute of Public Health, 222 Skøyen, 0213, Oslo, Norway
| | - Unni M Heltne
- Centre for Crisis Psychology, Møllendalsbakken 9, 5020, Bergen, Norway
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Årstadveien 17, 5009, Bergen, Norway.,Unit for Migration and Health, Norwegian Institute of Public Health, 222 Skøyen, 0213, Oslo, Norway
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8
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Lechner M, Liu J, Counsell N, Gillespie D, Chandrasekharan D, Ta NH, Jumani K, Gupta R, Rao-Merugumala S, Rocke J, Williams C, Tetteh A, Amnolsingh R, Khwaja S, Batterham RL, Yan CH, Treibel TA, Moon JC, Woods J, Brunton R, Boardman J, Paun S, Eynon-Lewis N, Kumar BN, Jayaraj S, Hopkins C, Philpott C, Lund VJ. The COVANOS trial - insight into post-COVID olfactory dysfunction and the role of smell training. Rhinology 2022; 60:188-199. [PMID: 35901492 DOI: 10.4193/rhin21.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Olfactory dysfunction is a cardinal symptom of COVID-19 infection, however, studies assessing long-term olfactory dysfunction are limited and no randomised-controlled trials (RCTs) of early olfactory training have been conducted. METHODOLOGY We conducted a prospective, multi-centre study consisting of baseline psychophysical measurements of smell and taste function. Eligible participants were further recruited into a 12-week RCT of olfactory training versus control (safety information). Patient-reported outcomes were measured using an electronic survey and BSIT at baseline and 12 weeks. An additional 1-year follow-up was open to all participants. RESULTS 218 individuals with a sudden loss of sense of smell of at least 4-weeks were recruited. Psychophysical smell loss was observed in only 32.1%; 63 participants were recruited into the RCT. The absolute difference in BSIT improvement after 12 weeks was 0.45 higher in the intervention arm. 76 participants completed 1-year follow-up; 10/19 (52.6%) of participants with an abnormal baseline BSIT test scored below the normal threshold at 1-year, and 24/29 (82.8%) had persistent parosmia. CONCLUSIONS Early olfactory training may be helpful, although our findings are inconclusive. Notably, a number of individuals who completed the 1-year assessment had persistent smell loss and parosmia at 1-year. As such, both should be considered important entities of long-Covid and further studies to improve management are highly warranted.
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Affiliation(s)
- M Lechner
- ENT Department, Barts Health NHS Trust, London, UK; UCL Cancer Institute, University College London, London, UK; Division of Surgery and Interventional Science, University College London, London, UK
| | - J Liu
- UCL Cancer Institute, University College London, London, UK
| | - N Counsell
- CRUK and UCL Cancer Trials Centre, University College London, London, UK
| | - D Gillespie
- UCL Cancer Institute, University College London, London, UK
| | | | - N H Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Jumani
- ENT Department, Barts Health NHS Trust, London, UK
| | - R Gupta
- ENT Department, Barts Health NHS Trust, London, UK
| | | | - J Rocke
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - C Williams
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - A Tetteh
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Amnolsingh
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Khwaja
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - R L Batterham
- Centre for Obesity Research, University College London, London, UK; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospitals NHS Foundation Trust, London, UK; National Institute for Health Research, UCLH Biomedical Research Centre, London, UK
| | - C H Yan
- Department of Otolaryngology-Head and Neck Surgery, University of San Diego School of Medicine, San Diego, USA
| | - T A Treibel
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J C Moon
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J Woods
- The Norfolk Smell and Taste Clinic, Norfolk
| | - R Brunton
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - S Paun
- ENT Department, Barts Health NHS Trust, London, UK
| | | | - B N Kumar
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - S Jayaraj
- ENT Department, Barts Health NHS Trust, London, UK
| | - C Hopkins
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - V J Lund
- Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, UK
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Kumar BN, James R, Hargreaves S, Bozorgmehr K, Mosca D, Hosseinalipour SM, AlDeen KN, Tatsi C, Mussa R, Veizis A, Kállayová D, Blanchet K, Machado RS, Orcutt M, Severoni S. Meeting the health needs of displaced people fleeing Ukraine: Drawing on existing technical guidance and evidence. Lancet Reg Health Eur 2022; 17:100403. [PMID: 35721694 PMCID: PMC9198835 DOI: 10.1016/j.lanepe.2022.100403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
The invasion of Ukraine has unleashed a humanitarian crisis and the impact is devastating for millions displaced in Ukraine and for those fleeing the country. Receiving countries in Europe are reeling with shock and disbelief and trying at the same time to grapple with the reality of providing for a large, unplanned, unprecedented number of refugees mainly women and children on the move. Several calls for actions, comments and statements express outrage, the risks, and the impending consequences to life and health. There is a need to constantly assess the situation on the ground, identify priorities for health and provide guidance regarding how these needs could be addressed. Therefore, the Lancet Migration European Regional Hub conducted rapid interviews with key informants to identify these needs, and in collaboration with the World Health Organization Health and Migration Programme, summarized how these could be addressed. This viewpoint provides a summary of the situation in receiving countries and the technical guidance required that could be useful for providing assistance in the current refugee crisis.
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Affiliation(s)
- Yulia Ioffe
- Institute for Risk and Disaster Reduction, University College London, London WC1E 6BT, UK.
| | - Ibrahim Abubakar
- Faculty of Population Health Sciences, University College London, London WC1E 6BT, UK
| | - Rita Issa
- Institute for Global Health, University College London, London WC1E 6BT, UK
| | - Paul Spiegel
- Johns Hopkins Bloomberg School of Public Health, Center for Humanitarian Health, Johns Hopkins University, Baltimore, MD, USA
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11
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Kumar BN, Hargreaves S, Agyemang C, James RA, Blanchet K, Gruer L. Reducing the impact of the coronavirus on disadvantaged migrants and ethnic minorities. Eur J Public Health 2021; 31:iv9-iv13. [PMID: 34751368 PMCID: PMC8576303 DOI: 10.1093/eurpub/ckab151] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Studies from several countries have shown that the COVID-19 pandemic has disproportionally affected migrants. Many have numerous risk factors making them vulnerable to infection and poor clinical outcome. Policies to mitigate this effect need to take into account public health principles of inclusion, universal health coverage and the right to health. In addition, the migrant health agenda has been compromised by the suspension of asylum processes and resettlement, border closures, increased deportations and lockdown of camps and excessively restrictive public health measures. International organizations including the World Health Organization and the World Bank have recommended measures to actively counter racism, xenophobia and discrimination by systemically including migrants in the COVID-19 pandemic response. Such recommendations include issuing additional support, targeted communication and reducing barriers to accessing health services and information. Some countries have had specific policies and outreach to migrant groups, including facilitating vaccination. Measures and policies targeting migrants should be evaluated, and good models disseminated widely.
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Affiliation(s)
- Bernadette N Kumar
- Norwegian Institute of Public Health, Folkehelseinstituttet, Oslo, Norway
| | - Sally Hargreaves
- Migrant Health Research Group, Institute for Infection and Immunity, St George's University of London, London, UK
| | - Charles Agyemang
- Department of Public Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
| | - Rosemary A James
- Lancet Migration European Regional Hub, Geneva Centre of Humanitarian Studies, Geneva, Switzerland
| | - Karl Blanchet
- Lancet Migration European Regional Hub, Geneva Centre of Humanitarian Studies, Geneva, Switzerland
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13
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Chu M, Gopikrishna D, Rocke J, Kumar BN. Implementing a COVID-19 specialist smell clinic: experience at the Wrightington, Wigan and Leigh Teaching Hospitals (WWL), NHS Foundation Trust, United Kingdom. Med J Malaysia 2021; 76:9-13. [PMID: 34558550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
INTRODUCTION It is clear that a proportion of patients continue to suffer long-lasting symptoms following acute infection with coronavirus disease 2019 (COVID-19). Persistent olfactory dysfunction is one of the commonest complaints reported in the condition colloquially known as long COVID (now known as post-acute sequelae of SARS-CoV-2 infection (PASC)). The prevalence, risk factors and clinical course of long COVID olfactory dysfunction are not yet well understood. At present, the main stay of treatment is olfactory training. Quantitative olfactory testing and impacts on patient quality of life have not been widely studied. This study describes our experiences at Wrightington, Wigan and Leigh Teaching Hospitals, UK (WWL) of establishing a COVID-19 smell clinic, along with preliminary data on patient demographics, baseline smell test scores and quality of life questionnaire scores before olfactory training. METHODS We piloted a COVID-19 smell clinic. We recorded patient demographics and clinical characteristics then performed clinical assessment of each patient. Quantitative measurements of olfactory dysfunction were recorded using the University of Pennsylvania Smell Identification Test (UPSIT). We measured the impact of olfactory dysfunction on patient quality of life using the validated English Olfactory Disorders Questionnaire (eODQ). RESULTS 20 patients participated in the clinic. 4 patients were excluded from analysis due to missing data. Median age was 35 years. 81% (n=13) of the participants were female. 50% (n=8) of patients suffered with a combination of anosmia/ageusia and parosmia, whilst 43% (n=7) of patients suffered with anosmia/ageusia without parosmia. Almost all the patients registered UPSIT scores in keeping with impaired olfaction. Patient scores ranged from 22 to 35, with the median score at 30. All patients reported that their olfactory dysfunction had an impact on their quality of life. The median eODQ score reported was 90, with scores ranging from 42 to 169 out of a maximum of 180. CONCLUSION We have demonstrated that it is simple and feasible to set up a COVID-19 smell clinic. The materials are inexpensive, but supervised completion of the UPSIT and eODQ is time-consuming. Patients demonstrate reduced olfaction on quantitative testing and experience significant impacts on their quality of life as a result. More research is needed to demonstrate if olfactory training results in measurable improvements in smell test scores and quality of life.
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Affiliation(s)
- M Chu
- Teaching Hospitals, Department of Otolaryngology, United Kingdom
| | - D Gopikrishna
- eaching Hospitals, Department of Otolaryngology, United Kingdom
| | - J Rocke
- eaching Hospitals, Department of Otolaryngology, United Kingdom
| | - B N Kumar
- eaching Hospitals, Department of Otolaryngology, United Kingdom.
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14
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Rocke J, Evans C, Kumar BN. Teaching and training in Otorhinolaryngology (ORL) during the pandemic and beyond, in the United Kingdom. Med J Malaysia 2021; 76:27-30. [PMID: 34558554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
No abstract provided.
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Affiliation(s)
- J Rocke
- Health Education England & Wrightington, Wigan and Leigh Teaching NHS Foundation Trust, United Kingdom
| | - C Evans
- Health Education England & Wrightington, Wigan and Leigh Teaching NHS Foundation Trust, United Kingdom
| | - B N Kumar
- Health Education England & Wrightington, Wigan and Leigh Teaching NHS Foundation Trust, United Kingdom.
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15
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Affiliation(s)
- Sally Hargreaves
- Institute for Infection and Immunity, St George's University of London, London, UK
| | | | - Martin McKee
- Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK
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Mbanya VN, Terragni L, Gele AA, Diaz E, Kumar BN. Barriers to access to the Norwegian healthcare system among sub-Saharan African immigrant women exposed to female genital cutting. PLoS One 2020; 15:e0229770. [PMID: 32187198 PMCID: PMC7080260 DOI: 10.1371/journal.pone.0229770] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 02/14/2020] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Millions of women and girls have been exposed to female genital cutting (FGC). The practice of FGC extends beyond countries in Africa and Asia in which it is traditionally practiced. Women living with FGC in Norway have been reported to be in need of healthcare, but there is evidence of suboptimal use of healthcare services among this group, and we lack the women's perspective about this problem. This study aims to explore the experiences and perceptions hindering access and use of the Norwegian healthcare system among sub- Saharan African (SSA) immigrant women exposed to FGC. METHOD This qualitative research was conducted using purposive and snowball sampling to recruit thirteen SSA immigrant women in Norway previously exposed to FGC. Interviews were conducted from October 2017 to July 2018. The Interpretative Phenomenological Analysis method was used. RESULTS The findings indicate that women experience barriers both in reaching out to the healthcare system and within the healthcare system. Barriers prior to contact with the healthcare system include lack of information, husband and family influence on healthcare, and avoiding disclosing health problems. Barriers within the healthcare system include care providers with insufficient knowledge and poor attitudes of care providers. CONCLUSION This study reveals multiple barriers to healthcare access that co-exist and overlap. This indicates that SSA immigrant women are 'left behind' in being able to access and use the Norwegian healthcare system. Therefore, appropriate interventions to improve access to healthcare should be considered in order to reach Universal Health Coverage, thus having a positive impact on the health of these women. Equitable healthcare should be reflected in policy and practice.
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Affiliation(s)
- Vivian N. Mbanya
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Abdi A. Gele
- Unit for Migration and Health, Norwegian Institute of Public Health Oslo, Oslo, Norway
| | - Esperanza Diaz
- Unit for Migration and Health, Norwegian Institute of Public Health Oslo, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bernadette N. Kumar
- Unit for Migration and Health, Norwegian Institute of Public Health Oslo, Oslo, Norway
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Hasha W, Fadnes LT, Igland J, Vårdal R, Giusti LM, Strømme EM, Haj-Younes J, Heltne U, Kumar BN, Diaz E. Two interventions to treat pain disorders and post-traumatic symptoms among Syrian refugees: protocol for a randomized controlled trial. Trials 2019; 20:784. [PMID: 31881990 PMCID: PMC6935096 DOI: 10.1186/s13063-019-3919-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/18/2019] [Indexed: 01/18/2023] Open
Abstract
Background There is a high prevalence of pain and post-traumatic symptoms among refugees and feasible interventions to manage these are needed. However, knowledge about the effect of physiotherapy and psychological group interventions among refugees is scarce. Our aim is to determine whether two different interventions, the Physiotherapy Activity and Awareness Intervention (PAAI) and Teaching Recovery Techniques (TRT), reduce pain and post-traumatic symptoms among refugees from Syria living in Norway. Methods/design Syrian adults with either pain disorders or post-traumatic symptoms, or both, will be recruited to this randomized control trial. The trial will include two separate interventions: participants with dominating pain symptoms will be assigned to the PAAI; and those with a predominance of post-traumatic symptoms will be assigned to the TRT intervention. Participants will be randomized to either the immediate intervention group or the delayed intervention group, for each of the interventions (PAAI and TRT). A minimum of 68 participants will be recruited for the PAAI and 78 participants for TRT, in order to detect clinically and statistically significant symptom improvement, assuming 25–30% attrition after recruitment. The main outcomes for the analyses will be pain intensity measured by the Brief Pain Inventory questionnaire and the scores of the Impact of Events Scale — Revised. The effect will be evaluated at the end of interventions lasting 8 weeks (PAAI) and 6 weeks (TRT) using the same instruments after the end of the intervention, and again 4–6 weeks later. Additionally, a qualitative evaluation will be conducted through an embedded process evaluation and personal interviews with participants after each of the interventions is finished. Discussion Our study will determine the feasibility of the implementation of two different interventions and the effect of these interventions among refugees from Syria with pain disorders and/or post-traumatic symptoms. Trial registration Clinical Trials.gov, NCT03951909. Retrospectively registered on 19 February 2019.
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Affiliation(s)
- Wegdan Hasha
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
| | - Lars T Fadnes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway
| | - Jannicke Igland
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | | | | | | | - Jasmin Haj-Younes
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Unni Heltne
- Centre for Crisis Psychology, University of Bergen, Bergen, Norway
| | - Bernadette N Kumar
- Unit for Migration and Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Unit for Migration and Health, Norwegian Institute of Public Health, Oslo, Norway
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18
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Mbanya VN, Terragni L, Gele AA, Diaz E, Kumar BN. Access to Norwegian healthcare system - challenges for sub-Saharan African immigrants. Int J Equity Health 2019; 18:125. [PMID: 31412853 PMCID: PMC6693278 DOI: 10.1186/s12939-019-1027-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/28/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Immigrants face barriers in accessing healthcare services in high-income countries. Inequalities in health and access to healthcare services among immigrants have been previously investigated. However, little is known on the sub-Saharan African immigrants' (SSA) access to the Norwegian healthcare system. METHODS The study had a qualitative research design. We used the snowball technique to recruit participants from networks including faith-based organizations and cultural groups. Forty-seven qualitative in-depth interview and two focus group discussions with immigrants from sub-Saharan African were conducted from October 2017 to July 2018 in Oslo and its environs. Interviews were conducted in Norwegian, English or French, audio-recorded and transcribed verbatim into English. The analysis was based on a thematic approach, using NVivo software. Interview data were analyzed searching for themes and sub-themes that emerged inductively from the interviews. RESULTS Our findings reveal barriers in two main categories when accessing the Norwegian healthcare services. The first category includes difficulties before accessing the healthcare system (information access, preference for doctors with an immigrant background, financial barriers, long waiting time and family and job responsibility). The second category includes difficulties experienced within the system (comprehension/expression and language, the black elephant in the room and dissatisfaction with healthcare providers). CONCLUSION Healthcare is not equally accessible to all Norwegian residents. This ultimately leads to avoidance of the healthcare system by those most in need. Lack of seeking healthcare services by immigrants from Sub Saharan Africa may have significant implications for the long-term health of this group of immigrants. Therefore measures to address the issues raised should be prioritized and further examined.
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Affiliation(s)
- Vivian N Mbanya
- Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Laura Terragni
- Department of Nursing and Health Promotion, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Abdi A Gele
- Unit for Migration Health, Norwegian Institute of Public Health Oslo, Oslo, Norway
| | - Esperanza Diaz
- Unit for Migration Health, Norwegian Institute of Public Health Oslo, Oslo, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - Bernadette N Kumar
- Unit for Migration Health, Norwegian Institute of Public Health Oslo, Oslo, Norway
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19
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Jahan N, Bano H, Ahmed Makbul S, Kumar BN, Mushir A. Effect of hydroalcoholic extract of Cyperus rotundus L. Rhizome against ethylene glycol and ammonium chloride-induced urolithiasis in male sprague-dawley rats. Urol Sci 2019. [DOI: 10.4103/uros.uros_136_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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20
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Htun HM, Edmiston R, Kaimal K, Kumar BN. Variable management of postoperative hypoparathyroidism at nine NHS trusts in north-west England: The need for a universal protocol. Clin Otolaryngol 2018; 43:1583-1587. [PMID: 30063291 DOI: 10.1111/coa.13205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2018] [Revised: 05/11/2018] [Accepted: 06/10/2018] [Indexed: 11/27/2022]
Affiliation(s)
- Hay Mar Htun
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - Rachel Edmiston
- Lancashire Teaching Hospitals NHS Foundation Trust, Preston, UK
| | - Krishna Kaimal
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - B N Kumar
- Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
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21
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Bano H, Jahan N, Makbul SAA, Kumar BN, Husain S, Sayed A. Effect of Piper cubeba L. fruit on ethylene glycol and ammonium chloride induced urolithiasis in male Sprague Dawley rats. Integr Med Res 2018; 7:358-365. [PMID: 30591890 PMCID: PMC6303358 DOI: 10.1016/j.imr.2018.06.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2018] [Revised: 06/19/2018] [Accepted: 06/21/2018] [Indexed: 11/04/2022] Open
Abstract
Background To investigate the antilithiatic effect of hydroalcoholic extract of Kabab Chini (Piper cubeba L.) fruit in male Sprague Dawley rats. Methods Rats were divided into six groups of six each. Group I received regular rat food and drinking water ad libitum. Groups II to VI were administered with ethylene glycol (EG) 0.75% (V/V) and ammonium chloride (AC) 1% (W/V) in drinking water for 7 days to induce urolithiasis. From 8th day Group I received 1 mL of 5% gum acacia. Group IV was treated with Cystone; V and VI groups with the hydro-alcoholic extract of Piper cubeba L. Treatment was continued for further 14 days, thereafter animals sacrificed. While Group II animals were sacrificed just after 7 days treatment with EG and AC. Group III was left untreated until 14 days and sacrificed on 22nd day. Crystalluria was analyzed on 8th and 22nd day while, urinary calcium, phosphorus, creatinine, sodium and magnesium on 22nd day. Biochemistry and histopathological studies of kidney were also carried out. Results Test groups showed significant reduction (p < 0.001) of crystals in urine. Serum creatinine and urea (p < 0.01) were also decreased significantly. Urine analysis showed significant increase in magnesium while calcium, sodium, chloride and phosphorus significantly decreased along with histopathological improvement in kidney tissue in treated groups. Conclusion From the above results it can be concluded that hydroalcoholic extract of P. cubeba L. fruit has significant inhibitory effect in calcium oxalate urolithiasis.
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Affiliation(s)
- Humaira Bano
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India
| | - Nasreen Jahan
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India
| | - Shaikh Ajij Ahmed Makbul
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India
| | - B N Kumar
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India
| | - Sadique Husain
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India
| | - Atiya Sayed
- Department of Obstetrics and Gynecology, National Institute of Unani Medicine, Bangalore, India
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22
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Syse A, Dzamarija MT, Kumar BN, Diaz E. An observational study of immigrant mortality differences in Norway by reason for migration, length of stay and characteristics of sending countries. BMC Public Health 2018; 18:508. [PMID: 29665802 PMCID: PMC5905163 DOI: 10.1186/s12889-018-5435-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 04/10/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Knowledge of mortality differentials in immigrant groups depending on their reason for migration, length of stay in host countries and characteristics of sending countries may be beneficial for policy interventions aimed to improve various immigrant groups' health and welfare. METHODS We employed discrete-time hazard regression models with time-varying covariates to compare the death risk of immigrants to those of Norwegian-born natives using linked register data on the Norwegian population aged 25-79 during 1990-2015. More than 492,000 deaths occurred in around 4.6 million individuals. All analyses were adjusted for sex, age, calendar time and sociodemographic characteristics. RESULTS Immigrants had an 11% survival advantage overall. Those immigrating due to work or education had the lowest death risk, whereas refugees had the highest death risk (albeit lower than that of natives). Death risks increased markedly with length of stay, and were most pronounced for those having spent more than 40% of their lives in Norway. Net of reason for migration, only minor differences were observed depending on Human Development Index characteristics of sending countries. CONCLUSION Independent of reason for migration and characteristics of sending countries, those who immigrate to Norway in adulthood appear to be particularly healthy. The higher death risk associated with prolonged lengths of stay suggests that disadvantageous 'acculturation' or stress factors related to the post-migration period may play a role in the long run. The health and welfare of long-term immigrants thus warrants further research.
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Affiliation(s)
| | | | - Bernadette N Kumar
- The Norwegian Centre for Minority Health Research, Norwegian Institute of Public Health, Oslo, Norway
| | - Esperanza Diaz
- The Norwegian Centre for Minority Health Research, Norwegian Institute of Public Health, Oslo, Norway.,Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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23
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Papadopoulos I, Zorba A, Koulouglioti C, Ali S, Aagard M, Akman O, Alpers LM, Apostolara P, Biles J, Martín-García Á, González-Gil T, Kouta C, Krepinska R, Kumar BN, Lesińska-Sawicka M, Lopez L, Malliarou M, Nagórska M, Nissim S, Nortvedt L, Oter-Quintana C, Ozturk C, Pangilinan SB, Papp K, Eldar Regev O, Rubiano FO, Tolentino Diaz MY, Tóthová V, Vasiliou M. International study on nurses' views and experiences of compassion. Int Nurs Rev 2018; 63:395-405. [PMID: 27557745 DOI: 10.1111/inr.12298] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND Compassion is considered the cornerstone of nursing practice. However, the recent failures in delivering high-quality compassionate nursing care in the UK's National Health Service have brought the topic of compassion to the attention of the public, service providers, policy makers and academics. AIM The aim of this study was to explore the nurses' views and experiences of a number of compassion-related issues in nursing and describe similarities and differences at an international level as well as from the different nursing roles of the participating nurses. METHODS An exploratory, cross-sectional descriptive study, using the International Online Compassion Questionnaire. A total of 1323 nurses from 15 countries completed the questionnaire. RESULTS The majority of participants (59.5%) defined compassion as "Deep awareness of the suffering of others and wish to alleviate it" but definitions of compassion varied by country. Of participants, 69.6% thought compassion was very important in nursing and more than half (59.6%) of them argued that compassion could be taught. However, only 26.8% reported that the correct amount and level of teaching is provided. The majority of the participants (82.6%) stated that their patients prefer knowledgeable nurses with good interpersonal skills. Only 4.3% noted that they are receiving compassion from their managers. A significant relationship was found between nurses' experiences of compassion and their views about teaching of compassion. CONCLUSION Our study is unique in identifying the views and experiences of nurses from 15 different countries worldwide. The findings reveal that compassion is neither addressed adequately in nursing education nor supported in the practice environment by managers. LIMITATIONS Self-report bias was inherent to our survey study design. Furthermore, the individual cultural differences and similarities in the findings are difficult to extrapolate owing to the fact that our analysis was at country level, as well as at the level of the participating nurses. IMPLICATIONS FOR NURSING POLICY Understanding the influence of culture on nurses' views about compassion is critical in the current multicultural healthcare environment and merits further research. This will potentially drive changes in nursing education (ensuring that compassion is taught to nurses) and in the way healthcare leaders and managers foster a compassionate culture within their organizations (e.g. by leading by example and compassionate to their staff).
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Affiliation(s)
- I Papadopoulos
- Research Centre for Transcultural Studies in Health, Middlesex University, London, UK
| | - A Zorba
- Middlesex University, London, UK
| | - C Koulouglioti
- Research and Innovation Department, Western Sussex Hospitals NHS Foundation Trust, Worthing, UK
| | - S Ali
- Research Centre for Transcultural Studies in Health, Middlesex University, London, UK
| | - M Aagard
- Walden University, Minneapolis, MN, USA
| | - O Akman
- Istanbul Sabahattin Zaim University, Istanbul, Turkey
| | - L-M Alpers
- Lovisenberg Diaconal Hospital/Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - P Apostolara
- National and Kapodistrian Univeristy of Athens, Athens, Greece
| | - J Biles
- Charles Sturt University, Abury, NSW, Australia
| | - Á Martín-García
- Centro de San Blas, Servicio Madrileño de Salud, Madrid, Spain
| | - T González-Gil
- Nursing Section Department, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - C Kouta
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
| | - R Krepinska
- School of Nursing, Havlíčkův Brod, Czech Republic
| | - B N Kumar
- Norwegian Centre for Minority Health Research, Oslo University Hospital, Oslo, Norway
| | | | - L Lopez
- Universidad Nacional de Colombia - Bogotá - Facultad de Enfermería., Colombia
| | - M Malliarou
- Technological Institution of Thessaly, Larisa, Greece
| | | | - S Nissim
- Wolfson Academic Nursing School, Tel Aviv University, Tel Aviv, Israel
| | - L Nortvedt
- Oslo and Akershus University College of Applied Sciences, Oslo, Norway
| | - C Oter-Quintana
- Nursing Section Department, Faculty of Medicine, Universidad Autónoma de Madrid, Madrid, Spain
| | - C Ozturk
- Istanbul Sabahattin Zaim University, Istanbul, Turkey
| | | | - K Papp
- Faculty of Health, University of Debrecen, Debrecen, Hungary
| | - O Eldar Regev
- The Max Stern Yezreel Valley College, Yezreel Valley, Israel
| | - F O Rubiano
- Bataan Peninsula State University, Balanga, Philippines
| | | | - V Tóthová
- Faculty of Health and Social Studies, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - M Vasiliou
- Department of Nursing, Cyprus University of Technology, Limassol, Cyprus
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Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Norway
| | - Bernadette N. Kumar
- Norwegian Center for Migration and Minority Health, Norwegian Institute of Public Health, Oslo, Norway
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25
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Hellings PW, Akdis CA, Bachert C, Bousquet J, Pugin B, Adriaensen G, Advani R, Agache I, Anjo C, Anmolsingh R, Annoni E, Bieber T, Bizaki A, Braverman I, Callebaut I, Castillo Vizuete JA, Chalermwatanachai T, Chmielewski R, Cingi C, Cools L, Coppije C, Cornet ME, De Boeck I, De Corso E, De Greve G, Doulaptsi M, Edmiston R, Erskine S, Gevaert E, Gevaert P, Golebski K, Hopkins C, Hox V, Jaeggi C, Joos G, Khwaja S, Kjeldsen A, Klimek L, Koennecke M, Kortekaas Krohn I, Krysko O, Kumar BN, Langdon C, Lange B, Lekakis G, Levie P, Lourijsen E, Lund VJ, Martens K, Mő Sges R, Mullol J, Nyembue TD, Palkonen S, Philpott C, Pimentel J, Poirrier A, Pratas AC, Prokopakis E, Pujols L, Rombaux P, Schmidt-Weber C, Segboer C, Spacova I, Staikuniene J, Steelant B, Steinsvik EA, Teufelberger A, Van Gerven L, Van Gool K, Verbrugge R, Verhaeghe B, Virkkula P, Vlaminck S, Vries-Uss E, Wagenmann M, Zuberbier T, Seys SF, Fokkens WJ. EUFOREA Rhinology Research Forum 2016: report of the brainstorming sessions on needs and priorities in rhinitis and rhinosinusitis. Rhinology 2017; 55:202-210. [PMID: 28501885 DOI: 10.4193/rhin17.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis. The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016.
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Affiliation(s)
- P W Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Christine-Kuhne Center for Allergy Research and Education, Davos, Switzerland
| | - C Bachert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - J Bousquet
- Department of Respiratory Disease, University Hospital Arnaud de Villeneuve, Montpellier, France
| | - B Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - G Adriaensen
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - R Advani
- Health Education North West, Manchester, UK
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - C Anjo
- Department of Otorhinolaryngology, Hospital Sao Jose, Hospital Centre of Central Lisbon, Lisbon, Portugal
| | - R Anmolsingh
- Department of Otorhinolaryngology, Wigan Wrightington and Leigh NHS Foundation Trust, Wigan, UK
| | | | - T Bieber
- Department of Dermatology and Allergy, Christine Kuhne-Center for Allergy Research and Education, Friedrich-Wilhelms-University, Bonn, Germany
| | | | - I Braverman
- Hillel Yaffe Medical Center, Hadera Technion Faculty of Medicine, Haifa, Israel
| | - I Callebaut
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | | | - T Chalermwatanachai
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - R Chmielewski
- Department of Otolaryngology, Military Institute of Aviation Medicine, Warsaw, Poland
| | - C Cingi
- Department of Otolaryngology, Head and Neck Surgery, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - L Cools
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - C Coppije
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - M E Cornet
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - I De Boeck
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - E De Corso
- Agostino Gemelli Hospital Foundation, Catholic University of the Sacred Heart, Head and Neck Surgery Area, Institute of Otorhinolaryngology, Rome, Italy
| | - G De Greve
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - M Doulaptsi
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - R Edmiston
- Health Education North West, Manchester, UK
| | - S Erskine
- Norwich Medical School, University of East Anglia, UK
| | - E Gevaert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - P Gevaert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - K Golebski
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - C Hopkins
- ENT Departments, Guys and St Thomas Hospitals NHS Trust, London and James Paget University Hospital, Gorieston, United Kingdom
| | - V Hox
- Departement Otorhinolaryngologie, Cliniques Universitaires Saint-Luc, Belgium
| | - C Jaeggi
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - G Joos
- Department of Respiratory Medicine, Ghent University, Belgium
| | - S Khwaja
- Department of Otolaryngology, University Hospital of South Manchester, Manchester, UK
| | - A Kjeldsen
- Department Of Otorhinolaryngology, Odense University Hospital, Denmark
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - M Koennecke
- University Hospital Schleswig-Holstein, Campus Lubeck, Department of Otorhinolaryngology, Lubeck, Germany
| | | | - O Krysko
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - B N Kumar
- Department of Otolaryngology-Head and Neck, WWL NHS Foundation Trust and NIHR CRN, Greater Manchester, UK
| | - C Langdon
- Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Clinical and Experimental Respiratory Immunology, IDIBAPS, Barcelona, Spain
| | - B Lange
- Department of Otolaryngology, University Hospital of South Manchester, Manchester, UK
| | - G Lekakis
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - P Levie
- ENT Clinic Messidor, Brussels, Belgium
| | - E Lourijsen
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, University College London Hospitals, London, United Kingdom
| | - K Martens
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - R Mő Sges
- Faculty of Medicine, Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - J Mullol
- Clinical and Experimental Respiratory Allergy, IDIBAPS, CIBERES. Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - T D Nyembue
- Department of OtoRhinoLaryngology, University of Kinshasa, Congo
| | - S Palkonen
- European Federation of Allergy and Airways Diseases Patients Associations (EFA), Brussels, Belgium
| | - C Philpott
- Norwich Medical School, University of East Anglia, UK
| | - J Pimentel
- Hospital de Egas Moniz and Hospital da Luz, Lisbon, Portugal
| | - A Poirrier
- ENT department, University Hospital of Liege, Belgium
| | - A C Pratas
- Norwich Medical School, University of East Anglia, UK
| | - E Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Greece
| | - L Pujols
- Clinical and Experimental Respiratory Allergy, IDIBAPS, CIBERES. Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - P Rombaux
- Departement d Otorhinolaryngologie, Cliniques Universitaires Saint-Luc, Belgium
| | - C Schmidt-Weber
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
| | - C Segboer
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - I Spacova
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - J Staikuniene
- Lithuanian Universitys of health sciences, Department of Immunology and allergology, Kaunas, Lithuania
| | - B Steelant
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - E A Steinsvik
- Department of Otorhinolaryngology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - A Teufelberger
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - L Van Gerven
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | | | | | - B Verhaeghe
- Department of Otorhinolaryngology, Sint-Jozefskliniek, Izegem, Belgium
| | - P Virkkula
- Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - S Vlaminck
- Department of Otorhinolaryngology, AZ St. Johns Hospital, Bruges, Belgium
| | | | - M Wagenmann
- Department of Otorhinolaryngology, University Hospital Dusseldorf, Dusseldorf, Germany
| | - T Zuberbier
- Comprehensive Allergy-Centre-Charite, Department of Dermatology and Allergy, Charite-Universitatsmedizin Berlin, Germany
| | - S F Seys
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
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Abstract
BACKGROUND Allergic fungal rhinosinusitis (AFS) is considered to part of the disease spectrum of chronic rhinosinusitis, which affects between five to fifteen per cent of the population. Currently, there is uncertainty relating to the pathological process and therefore optimal management of AFS. Studies assessing antifungal use have shown mixed results. The aim of this review is to assess the effect of antifungals on patients with AFS. METHODS A systematic review of the literature to include all published trials searching Pubmed, Medline (Ovid), CINAHL (EBSCO) and the Cochrane central register of controlled trials (CENTRAL) databases. RESULTS Sixteen studies (two systematic reviews, two meta-analysis, four randomised controlled trials, five prospective cohort studies and three retrospective studies) were included in this review. There was found to be no overall benefit of topical or oral antifungals upon endoscopic findings or patient reported outcome measures in AFS. There were no statistically significant differences in adverse effect profiles between treatment and control groups. CONCLUSION There is limited evidence to support the use of topical or oral antifungal agents in patients with AFS. Future research recommendations include large multicentre randomised trials with better matched patient groups and appropriate dosage and timing of antifungals.
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Kumar BN, Wadud A, Jahan N, Sofi G, Bano H, Makbul SAA, Husain S. Antilithiatic effect of Peucedanum grande C. B. Clarke in chemically induced urolithiasis in rats. J Ethnopharmacol 2016; 194:1122-1129. [PMID: 27825989 DOI: 10.1016/j.jep.2016.10.081] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Revised: 10/01/2016] [Accepted: 10/26/2016] [Indexed: 06/06/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Duqu (Peucedanum grande C. B. Clarke) has been used by Unani physicians since ancient times in retention of urine, renal and bladder calculi, nephritis and other associated disorders in different dosage forms. AIM OF THE STUDY The aim of the study was to evaluate the antiurolithiatic activity of Peucedanum grande C. B. Clarke in experimental model. MATERIALS AND METHODS The experiment was carried out in male Sprague Dawley rats divided into 5 groups of 8 animals each. Animals of negative control received 1ml of 5% Gum acacia throughout the study. Remaining four groups received Ethylene glycol 0.75% and Ammonium chloride 1% by adding in their drinking water for first seven days to induce urolithiasis. From 8th day, positive control received 1ml of 5% Gum acacia, standard control received Cystone in the dose of 750mg/kg while test groups A and B were treated with hydroalcoholic extract of test drug in the dose of 56mg/kg and 97mg/kg respectively up to 21 days, thereafter the animals were sacrificed. Number of CaOx crystals in urine, levels of serum calcium, phosphorus, creatinine, urea, urinary calcium and sodium were observed. Kidney homogenate analysis and histopathology were also carried out. RESULTS Test drug reduced number of CaOx crystals in urine (p<0.001); levels of serum calcium, phosphorus, creatinine, (p<0.001) urea, (p<0.05); urinary calcium (p<0.001) and sodium decreased significantly in standard and test groups. The urine volume increased significantly (p<0.05, 0.01) in both the test groups. Histopathology of kidney showed no CaOx crystal deposition in both the test groups. CONCLUSION On the basis of above findings, it can be concluded that the test drug possesses significant antiurolithiatic activity.
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Affiliation(s)
- B N Kumar
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | - Abdul Wadud
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | - Nasreen Jahan
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | - Ghulamuddin Sofi
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | - Humaira Bano
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
| | | | - Sadique Husain
- Department of Ilmul Advia (Pharmacology), National Institute of Unani Medicine, Bangalore, India.
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Zeegers Paget D, Azzopardi-Muscat N, Zeegers Paget D, Kumar BN, Jakab Z, Andriukaitis V, Zeegers Paget D, Krasnik A. European Public Health NewsEUPHA President’s ColumnEUPHA Office ColumnEUPHA section column: nothing about me without me—a need for a new migrant health agendaMessage from the WHO Regional Director for Europe: European Member States agree to develop a roadmap to implement the 2030 Agenda for Sustainable DevelopmentMessage from the EU Commissioner for Health and Food Safety: EU action to support refugees’ and migrants’ healthFrom Vienna 2016 to Stockholm 2017. Eur J Public Health 2016. [DOI: 10.1093/eurpub/ckw240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Diaz E, Poblador-Pou B, Gimeno-Feliu LA, Calderón-Larrañaga A, Kumar BN, Prados-Torres A. Multimorbidity and Its Patterns according to Immigrant Origin. A Nationwide Register-Based Study in Norway. PLoS One 2015; 10:e0145233. [PMID: 26684188 PMCID: PMC4684298 DOI: 10.1371/journal.pone.0145233] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Accepted: 11/30/2015] [Indexed: 11/18/2022] Open
Abstract
INTRODUCTION As the flows of immigrant populations increase worldwide, their heterogeneity becomes apparent with respect to the differences in the prevalence of chronic physical and mental disease. Multimorbidity provides a new framework in understanding chronic diseases holistically as the consequence of environmental, social, and personal risks that contribute to increased vulnerability to a wide variety of illnesses. There is a lack of studies on multimorbidity among immigrants compared to native-born populations. METHODOLOGY This nationwide multi-register study in Norway enabled us i) to study the associations between multimorbidity and immigrant origin, accounting for other known risk factors for multimorbidity such as gender, age and socioeconomic levels using logistic regression analyses, and ii) to identify patterns of multimorbidity in Norway for immigrants and Norwegian-born by means of exploratory factor analysis technique. RESULTS Multimorbidity rates were lower for immigrants compared to Norwegian-born individuals, with unadjusted odds ratios (OR) and 95% confidence intervals 0.38 (0.37-0.39) for Eastern Europe, 0.58 (0.57-0.59) for Asia, Africa and Latin America, and 0.67 (0.66-0.68) for Western Europe and North America. Results remained significant after adjusting for socioeconomic factors. Similar multimorbidity disease patterns were observed among Norwegian-born and immigrants, in particular between Norwegian-born and those from Western European and North American countries. However, the complexity of patterns that emerged for the other immigrant groups was greater. Despite differences observed in the development of patterns with age, such as ischemic heart disease among immigrant women, we were unable to detect the systematic development of the multimorbidity patterns among immigrants at younger ages. CONCLUSIONS Our study confirms that migrants have lower multimorbidity levels compared to Norwegian-born. The greater complexity of multimorbidity patterns for some immigrant groups requires further investigation. Health care policies and practice will require a holistic approach for specific population groups in order to meet their health needs and to curb and prevent diseases.
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Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Centre for Minority Health Research, Oslo, Norway
- * E-mail:
| | - Beatriz Poblador-Pou
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain
| | - Luis-Andrés Gimeno-Feliu
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- San Pablo Health Centre, Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
| | - Amaia Calderón-Larrañaga
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain
| | - Bernadette N. Kumar
- Norwegian Centre for Minority Health Research, Oslo, Norway
- Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Alexandra Prados-Torres
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas (REDISSEC), Carlos III Health Institute, Madrid, Spain
- University of Zaragoza, Zaragoza, Spain
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Diaz E, Kumar BN, Engedal K. Immigrant patients with dementia and memory impairment in primary health care in Norway: a national registry study. Dement Geriatr Cogn Disord 2015; 39:321-31. [PMID: 25823461 DOI: 10.1159/000375526] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/26/2015] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Immigrants comprise a growing proportion of the elderly population. However, knowledge about the diagnosis and management of dementia and memory impairment among immigrants is scarce in Norway and elsewhere. AIMS To compare proportions of Norwegians and immigrants aged ≥50 years with a diagnosis of dementia or memory impairment in primary health care and to study the demographic characteristics, utilization of primary health care services and pharmacological treatment of Norwegians and immigrants with either of the two diagnoses in 2008. METHOD This is a registry-based study using linked data at the individual level from 4 national Norwegian registers. RESULTS A significantly lower proportion of immigrants, especially those from other than high-income countries, had a diagnosis of dementia or memory impairment. Among patients with such diagnoses, anti-dementia medication was purchased 20-50% more often by Norwegians than by immigrants, although the differences remained significant only for immigrants from other than high-income countries after adjustment for several variables. CONCLUSION The lower proportions of immigrants with a dementia diagnosis and lower proportions of patients receiving treatment might indicate a lower prevalence or milder forms of dementia among immigrants. However, the cultural validity of the assessment tools, linguistic barriers and challenges for general practitioners should be further investigated.
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Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
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Diaz E, Kumar BN, Gimeno-Feliu LA, Calderón-Larrañaga A, Poblador-Pou B, Prados-Torres A. Multimorbidity among registered immigrants in Norway: the role of reason for migration and length of stay. Trop Med Int Health 2015; 20:1805-14. [PMID: 26426974 DOI: 10.1111/tmi.12615] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES International migration is rapidly increasing worldwide. However, the health status of migrants differs across groups. Information regarding health at arrival and subsequent periodic follow-up in the host country is necessary to develop equitable health care to immigrants. The objective of this study was to determine the impact of the length of stay in Norway and other sociodemographic variables on the prevalence of multimorbidity across immigrant groups (refugees, labour immigrants, family reunification immigrants and education immigrants). METHODS This is a register-based study merging data from the National Population Register and the Norwegian Health Economics Administration database. Sociodemographic variables and multimorbidity across the immigrant groups were compared using Persons' chi-square test and anova as appropriate. Several binary logistic regression models were conducted. RESULTS Multimorbidity was significantly lower among labour immigrants (OR (95% CI) 0.23 (0.21-0.26) and 0.45 (0.40-0.50) for men and women, respectively) and education immigrants (OR (95% CI) 0.40 (0.32-0.50) and 0.38 (0.33-0.43)) and higher among refugees (OR (95% CI) 1.67 (1.57-1.78) and 1.83 (1.75-1.92)), compared to family reunification immigrants. For all groups, multimorbidity doubled after a five-year stay in Norway. Effect modifications between multimorbidity and sociodemographic characteristics across the different reasons for migration were observed. CONCLUSIONS Multimorbidity was highest among refugees at arrival but increased rapidly among labour immigrants, especially females. Health providers need to ensure tailor-made preventive and management strategies that take into account pre-migration and post-migration experiences for immigrants in order to address their needs.
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Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
- Norwegian Centre for Minority Health Research, Oslo, Norway
| | - Bernadette N Kumar
- Norwegian Centre for Minority Health Research, Oslo, Norway
- Institute for Health and Society, University of Oslo, Oslo, Norway
| | - Luis-Andrés Gimeno-Feliu
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
- San Pablo Health Centre, Zaragoza, Spain
| | - Amaia Calderón-Larrañaga
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Carlos III Health Institute, Madrid, Spain
| | - Beatriz Poblador-Pou
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Carlos III Health Institute, Madrid, Spain
| | - Alexandra Prados-Torres
- EpiChron Research Group on Chronic Diseases, Aragón Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, Zaragoza, Spain
- University of Zaragoza, Zaragoza, Spain
- Red de Investigación en Servicios de Salud en Enfermedades Crónicas, Carlos III Health Institute, Madrid, Spain
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Nortvedt L, Hansen HP, Kumar BN, Lohne V. Caught in suffering bodies: a qualitative study of immigrant women on long-term sick leave in Norway. J Clin Nurs 2015; 24:3266-75. [DOI: 10.1111/jocn.12901] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Line Nortvedt
- Faculty of Health Science; Institute of Nursing; Oslo & Akershus University College of Applied Sciences; Oslo Norway
| | - Helle Ploug Hansen
- Institute of Public Health; University of Southern Denmark; Odense Denmark
| | - Bernadette N Kumar
- Norwegian Center for Minority Health Research; Oslo University Hospital; Oslo Norway
- Faculty of Medicine; Institute of Health and Society; University of Oslo; Oslo Norway
| | - Vibeke Lohne
- Faculty of Health Science; Institute of Nursing; Oslo & Akershus University College of Applied Sciences; Oslo Norway
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Diaz E, Kumar BN. Differential utilization of primary health care services among older immigrants and Norwegians: a register-based comparative study in Norway. BMC Health Serv Res 2014; 14:623. [PMID: 25424647 PMCID: PMC4245733 DOI: 10.1186/s12913-014-0623-0] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 11/19/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Aging in an unfamiliar landscape can pose health challenges for the growing numbers of immigrants and their health care providers. Therefore, better understanding of how different immigrant groups use Primary Health Care (PHC), and the underlying factors that explain utilization is needed to provide adequate and appropriate public health responses. Our aim is to describe and compare the use of PHC between elderly immigrants and Norwegians. METHODS Registry-based study using merged data from the National Population Register and the Norwegian Health Economics Administration database. All 50 year old or older Norwegians with both parents from Norway (1,516,012) and immigrants with both parents from abroad (89,861) registered in Norway in 2008 were included. Descriptive analyses were carried out. Immigrants were categorised according to country of origin, reason for migration and length of stay in Norway. Binary logistic regression analyses were conducted to study the utilization of PHC comparing Norwegians and immigrants, and to assess associations between utilization and both length of stay and reason for immigration, adjusting for other socioeconomic variables. RESULTS A higher proportion of Norwegians used PHC services compared to immigrants. While immigrants from high-income countries used PHC less than Norwegians disregarding age (OR from 0.65 to 0.92 depending on age group), they had similar number of diagnoses when in contact with PHC. Among immigrants from other countries, however, those 50 to 65 years old used PHC services more often (OR 1.22) than Norwegians and had higher comorbidity levels, but this pattern was reversed for older adults (OR 0.56 to 0.47 for 66-80 and 80+ years respectively). For all immigrants, utilization of PHC increased with longer stay in Norway and was higher for refugees (1.67 to 1.90) but lower for labour immigrants (0.33 to 0.45) compared to immigrants for family reunification. However, adjustment for education and income levels reduced most differences between groups. CONCLUSIONS Immigrants' lower utilization of PHC services might reflect better health among immigrants, but it could also be due to barriers to access that pose public health challenges. The heterogeneity of life courses and migration trajectories should be taken into account when developing public policies.
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Affiliation(s)
- Esperanza Diaz
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
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Abstract
We present the case of a 5-year-old boy with no personal or family history of bleeding disorders, who suffered from recurrent post-tonsillectomy bleeds. The patient required multiple separate emergency visits to theatre in the 2-week postoperative period to achieve haemostasis. Initial baseline coagulation tests were found to be normal. However more extensive clotting studies revealed that the patient had an undiagnosed 'mild' haemophilia A.
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Affiliation(s)
| | | | - B N Kumar
- Department of ENT, RAEI Hospital, Wigan, UK
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Achar P, Kumar BN. Can apneagraphy change our approach in management of snoring and sleep apnoea? Indian J Otolaryngol Head Neck Surg 2014; 66:110-4. [PMID: 24533368 DOI: 10.1007/s12070-011-0344-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2011] [Accepted: 11/09/2011] [Indexed: 11/30/2022] Open
Abstract
UNLABELLED To evaluate role of overnight domiciliary apneagraph in diagnosing severity of sleep apnoea. Prospective audit of 37 patients with Epworth sleepiness score over ten and all patients with history of sleep apnoea presenting to ENT outpatient clinic investigated with apneagraph. Data analysed initially with pulse oximetry findings alone followed by analysis with full apneagraph findings. RESULTS Data analysed with pulse oximetry alone showed 31 patients to be simple snorers, but on analysis with apneagraph, 11 of these were shown to be suffering from moderate and one with severe sleep apnoea. There was no correlation between Epworth sleepiness score and severity of sleep apnoea. CONCLUSION Management plan can be more evidence based by using apneagraph as a mini sleep study in investigating patients with history of obstructive sleep apnoea. Apneagraph could also be used in diagnosing the level of obstruction in snorers; however, this aspect needs further studying.
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Affiliation(s)
- Priya Achar
- Manchester Royal Infirmary, Oxford Road, Manchester, M13 9WL UK ; 10 Holme Avenue, Wigan, WN1 2EH UK
| | - B N Kumar
- Wrightington, Wigan & Leigh NHS Foundation Trust, Wigan lane, Wigan, WN1 2NN UK
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Ma Y, Du Q, Kumar BN, Næss O. Validation of the China's maternal and child mortality surveillance in the diagnosis of infant deaths in two counties in Guizhou Province. Chin Med J (Engl) 2014; 127:180-182. [PMID: 24384444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Affiliation(s)
- Yi Ma
- National Center for Women and Children's Health, China Center for Disease Control and Prevention, Beijing 100101, China.
| | - Qing Du
- Health Management College, Binzhou Medical University, Yantai, Shandong 264003, China
| | | | - Oyvind Næss
- Division of Epidemiology, Norwegian Institute of Public Health, Oslo, Norway
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Tennakoon SUB, Kumar BN, Selmer R, Mikram MJM, Meyer HE. Differences in Predicted Cardiovascular Risk in Sinhalese and Tamils in Sri Lanka Compared With Sri Lankans in Norway. Asia Pac J Public Health 2013; 25:452-62. [DOI: 10.1177/1010539511423958] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Using data from 3 cross-sectional studies, the authors compared the estimated risk of cardiovascular diseases between migrant Sri Lankans in Oslo, Norway, and Tamils and Sinhalese in Kandy, Sri Lanka. The authors found that Sri Lankans in Oslo had significantly lower Framingham coronary heart disease (CHD) risk. Among men, the prevalence with estimated 10-year risk of a CHD event ≥10% was 20.6% in Oslo, 31.1% in Kandy Tamils, and 44.2% in Kandy Sinhalese. The corresponding figures in women were 10.4% in Oslo, 19.2% in Tamils, and 14.9% in Sinhalese. Risk of fatal cardiovascular disease estimated by the SCORE model showed a similar pattern. The Oslo group had a higher body mass index (BMI), but the differences were observed in all BMI categories. In conclusion, despite a lower BMI, Tamils and Sinhalese in Sri Lanka had higher estimated cardiovascular risk compared with Sri Lankans in Norway, mainly because of poorer lipid profiles.
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Affiliation(s)
| | | | - Randi Selmer
- Norwegian Institute of Public Health, Oslo, Norway
| | | | - Haakon E. Meyer
- University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
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Tennakoon SUB, Kumar BN, Meyer HE. Differences in Selected Lifestyle Risk Factors for Cardiovascular Disease Between Sri Lankans in Oslo, Norway, and in Kandy, Sri Lanka. Asia Pac J Public Health 2013; 27:NP616-25. [DOI: 10.1177/1010539513485973] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sri Lankans in Oslo have previously been shown to have lower risk of cardiovascular disease compared with those in Kandy, Sri Lanka. Here we present lifestyle risk factors for cardiovascular diseases: frequency and type of fat consumed, frequency of fruit and vegetable intake, alcohol consumption, and leisure time physical activity between 1145 Sri Lankans living in Oslo and 678 Tamils and Sinhalese Sri Lankans living in Kandy as possible explanatory factors for the differences observed. Those in Oslo were consuming healthier fats and reported higher levels of physical activity but frequency of vegetable and fruit consumption was lower. Alcohol consumption among women was negligible. Type of fats consumed might be protective for Oslo group compared with predominantly saturated fat diet in Kandy. Higher leisure time physical activity may also be protective for the Oslo group. Higher frequency of consumption of vegetables and fruits may be beneficial in Kandy.
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Affiliation(s)
| | | | - Haakon E. Meyer
- University of Oslo, Oslo, Norway
- Norwegian Institute of Public Health, Oslo, Norway
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Charaklias N, Mamais C, Pothula V, Kumar BN. Laryngopharyngeal reflux and primary snoring: a pilot case-control study. B-ENT 2013; 9:89-93. [PMID: 23909114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023] Open
Abstract
STUDY OBJECTIVES Laryngopharyngeal reflux has been implicated as a causative factor in the aetiology of sleep related breathing disorders. However there are no reports on the association of this disorder and primary snoring in the absence of obstructive sleep apnoea. This study was undertaken to investigate any link between primary snoring and the presence of laryngopharyngeal reflux. METHODS A matched case-control study was performed in a district general Ear Nose Throat outpatient population in the United Kingdom. Twenty six patients referred for snoring without sleep apnoea (cases) were individually matched for gender, body mass index and age, to 26 patients referred for other otorhinolaryngological complaints (controls). Snoring was not an exclusion criterion for the controls. Exclusion criteria for both groups were previous referral or treatment for snoring and/or sleep apnoea, nasal obstruction symptoms (as a potential cause of snoring), and known history of gastrooesophageal reflux with medical treatment longer than two months. The main outcome measure was prevalence of laryngopharyngeal reflux based on the Reflux Symptom Index score. RESULTS Patients seeking medical advice for primary snoring are fourteen times more likely to report Reflux Symptom Index scores of more than 13 than controls. CONCLUSIONS Laryngopharyngeal reflux may also be implicated in the pathogenesis of primary snoring in the absence of sleep apnoea. This constitutes 3b level of evidence.
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Affiliation(s)
- N Charaklias
- Otolaryngology Department, Wrightington Wigan and Leigh NHS Trust, Wigan WN1 2NN, United Kingdom
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Abstract
BACKGROUND Acid reflux into the oesophagus, larynx, pharynx or nasopharynx has been suggested as a causal factor in chronic rhino-sinusitis (CRS), which can then be refractory to nasal treatments. The aim of this review was to conclude on the strength of the link between GORD, LPR, nasopharyngeal reflux, nasal symptoms and CRS. METHOD Medline and Embase search. RESULTS Nineteen papers describing varying studies on CRS, GORD, LPR and PPI therapy were found. Four adult case-controlled studies showed more acid reflux events/symptoms in refractory CRS patients. Paediatric cohort studies showed more reflux events in rhinosinusitis patients than the general paediatric population, but they are not conclusive. Many papers do not use robust CRS diagnostic criteria for inclusion into studies and take no confounding factors into consideration. CONCLUSION The evidence of a link is poor with no good randomised controlled trials available. The few adult studies that show any link between acid reflux and nasal symptoms are small case-controlled studies with moderate levels of potential bias. There is not enough evidence to consider anti-reflux therapy for adult refractory CRS and there is no evidence that acid reflux is a significant causal factor in CRS.
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Affiliation(s)
- E P Flook
- ENT Registrar North Western Deanery, Hope Hospital, Salford Royal Foundation NHS Trust, United Kingdom.
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Zahid N, Meyer HE, Kumar BN, Claussen B, Hussain A. High Levels of Cardiovascular Risk Factors among Pakistanis in Norway Compared to Pakistanis in Pakistan. J Obes 2011; 2011:163749. [PMID: 21773000 PMCID: PMC3136134 DOI: 10.1155/2011/163749] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2010] [Accepted: 05/03/2011] [Indexed: 12/31/2022] Open
Abstract
Objectives. Previous studies have shown that the Norwegian-Pakistanis had considerably higher prevalence for diabetes and obesity compared to Norwegians. We studied the additional risk of obesity, dyslipidemia, and hypertension among Pakistanis in Norway compared to Pakistanis living in Pakistan. Method. 770 Norwegian-Pakistani adults (53.9% men and 46.1% women) born in Pakistan from two surveys conducted in Norway between 2000 and 2002 were compared with a sample of 1230 individuals (29.1% men and 70.9% women) that participated in a survey in Pakistan in 2006. Results. Both populations had similar height, but Norwegian-Pakistanis had considerably higher mean weight. Of the Norwegian-Pakistanis, 56% of the males and 40% of the females had a BMI above 25 kg/m(2), as opposed to 30% and 56% in Pakistan, for males and females, respectively. Norwegian-Pakistanis had higher total cholesterol. Conclusion. Obesity and an unfavourable lipid profile were widely prevalent in both populations; the highest level was recorded amongst those living in Norway. The increased risk for obesity and dyslipidemia may be ascribed to change of lifestyle after migration.
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Affiliation(s)
- Naeem Zahid
- Department of Gastrointestinal Surgery, Akershus University Hospital, Akershus, 1478 Lørenskog, Norway
- Department of General Practice and Community Medicine, University of Oslo, 0316 Oslo, Norway
- *Naeem Zahid:
| | - Haakon E. Meyer
- Department of General Practice and Community Medicine, University of Oslo, 0316 Oslo, Norway
- Norwegian Institute of Public Health, 0403 Oslo, Norway
| | - Bernadette N. Kumar
- Department of General Practice and Community Medicine, University of Oslo, 0316 Oslo, Norway
| | - Bjørgulf Claussen
- Department of General Practice and Community Medicine, University of Oslo, 0316 Oslo, Norway
| | - Akhtar Hussain
- Department of General Practice and Community Medicine, University of Oslo, 0316 Oslo, Norway
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Tennakoon SUB, Kumar BN, Nugegoda DB, Meyer HE. Comparison of cardiovascular risk factors between Sri Lankans living in Kandy and Oslo. BMC Public Health 2010; 10:654. [PMID: 21029475 PMCID: PMC3091570 DOI: 10.1186/1471-2458-10-654] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2010] [Accepted: 10/29/2010] [Indexed: 11/30/2022] Open
Abstract
Background South Asians living in western countries are known to have unfavourable cardiovascular risk profiles. Studies indicate migrants are worse off when compared to those living in country of origin. The purpose of this study was to compare selected cardiovascular risk factors between migrant Sri Lankans living in Oslo, Norway and Urban dwellers from Kandy, Sri Lanka. Methods Data on non fasting serum lipids, blood pressure, anthropometrics and socio demographics of Sri Lankan Tamils from two almost similar population based cross sectional studies in Oslo, Norway between 2000 and 2002 (1145 participants) and Kandy, Sri Lanka in 2005 (233 participants) were compared. Combined data were analyzed using linear regression analyses. Results Men and women in Oslo had higher HDL cholesterol. Men and women from Kandy had higher Total/HDL cholesterol ratios. Mean waist circumference and body mass index was higher in Oslo. Smoking among men was low (19.2% Oslo, 13.1% Kandy, P = 0.16). None of the women smoked. Mean systolic and diastolic blood pressure was significantly higher in Kandy than in Oslo. Conclusions Our comparison showed unexpected differences in risk factors between Sri Lankan migrants living in Oslo and those living in Kandy Sri Lanka. Sri Lankans in Oslo had favorable lipid profiles and blood pressure levels despite being more obese.
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Affiliation(s)
- Sampath U B Tennakoon
- Department of General Practice and Community Medicine, University of Oslo, Oslo, Norway.
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Affiliation(s)
- Priya Achar
- ENT Department, Royal Albert Edward Infirmary, WWL NHS Trust, Wigan, UK.
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Singh H, Dulhani N, Kumar BN, Singh P, Tewari P, Nayak K. A pharmacovigilance study in medicine department of tertiary care hospital in chhattisgarh (jagdalpur), India. J Young Pharm 2010; 2:95-100. [PMID: 21331200 PMCID: PMC3035895 DOI: 10.4103/0975-1483.62222] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of the present study was to observe adverse drug reactions (ADRs) with respect to polypharmacy at tertiary care centre at Bastar, Jagdalpur (Government Medical College, Jagdalpur). A prospective, observational evaluation of the ADRs conducted over a period of 6 months in Department of Medicine in Government Medical College, Jagdalpur. During the study period, a total of about 4850 patients visited the OPD and inpatient ward of medicine department, and 154 ADRs events were reported. Out of 154 reports that were identified, a higher percentage of ADRs in females (51.29%) was observed as compared to males (48.7%). Of the 154 ADRs, 76 (49.35%) were found to be mild, 55 moderate (35.71%), and 23 severe (14.93%). A total of 99 (64.28%) ADRs were observed in patients receiving four or more medications concurrently. Conversely 55 (35.71%) ADRs were detected in patients using three or less medicines. The largest number of reports was associated with antimicrobial therapy (28.57%), followed by antihypertensive (24.02%) and antidiabetics (14.28%). Among the affected organ systems, gastrointestinal ADRs constituted a major component (39.61%) followed by skin reactions (28.57%). On causality assessment, nearly 36.36% ADRs were considered as probable, 31.16% possible, and 9.74% could not be categorized and were placed under unassessable. Expected, limited ADR are permissible in normal clinical setting, but the present study focuses on the result showing increased and amplified ADR associated with the polypharmacy practices, which may be curtailed with rational drug prescribing habit.
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Affiliation(s)
- H Singh
- Department of Pharmacology, Government Medical College, Jagdalpur, Chhattisgarh, India
| | - N Dulhani
- Department of Medicine, Government Medical College, Jagdalpur, Chhattisgarh, India
| | - BN Kumar
- Department of Pharmacology, Government Medical College, Jagdalpur, Chhattisgarh, India
| | - P Singh
- Department of Pharmacology, Government Medical College, Rewa, MP, India
| | - P Tewari
- Department of Anatomy, Government Medical College, Jagdalpur, Chhattisgarh, India
| | - K Nayak
- Department of Pharmacology, Government Medical College, Jagdalpur, Chhattisgarh, India
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Abstract
BACKGROUND The Internet is a rich source of medical information and the general opinion among doctors is that the number of patients attending clinics with information from a web search is increasing. The purpose of this study was to assess the demographics of those who access the Internet and their attitudes towards the quality and usefulness of information provided by the Internet. This study also looked at the various sources of health information and the satisfaction rates. DESIGN Cross-sectional observational study. The study group consisted of a cohort of women attending the gynaecology outpatient clinic at a district general hospital in the United Kingdom. In total, 484 patients attending the gynaecology outpatient clinic completed a questionnaire which included 13 structured questions regarding access to and attitudes towards the Internet and other health sources of information. SETTING Questionnaires were distributed to 564 women attending gynaecology outpatient clinics for 3 months from 1 June 2005. RESULTS A total of 484 patients (85.6%) completed the questionnaire. Age range was 41-65 years and the median education level was completion of General Certificate of Secondary Education (GCSE). In total, 360/484 (74%) had sought health information about their condition from a variety of sources before attending the outpatient clinic. In total, 399/484 (82.4%) respondents had access to the Internet. Of 399 with access, 107 (26.8%) of the patients used the Internet to find information about their condition before their appointment. General practitioners remain as the primary source of health information, mainly to improve the knowledge of the condition. A total of 78/107 (73.3%) who had used the Internet before their appointment would like to continue using the Internet as a health information resource. CONCLUSION A significant proportion of patients had access to the Internet to find health information. The widespread availability and increased usage of medical websites by patients raises important issues regarding the need for quality control and impacts on the doctor-patient relationship.
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Affiliation(s)
- Padmaja Neelapala
- Wrightington, Wigan and Leigh NHS Trust, Royal Albert and Edward Infirmary, Wigan, UK.
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Duvvi S, Walker T, Kumar BN. Masters degrees for ENT trainees. Clin Otolaryngol 2007; 32:493. [PMID: 18076444 DOI: 10.1111/j.1749-4486.2007.01527.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Lien N, Kumar BN, Lien L. [Overweight among adolescents in Oslo]. Tidsskr Nor Laegeforen 2007; 127:2254-8. [PMID: 17828322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND Socio-demographic factors affect the prevalence of overweight, and differences in lifestyle could be the cause. Possible consequences of overweight, such as mental health problems may also vary by socio-demographic factors. The aims of the study were to identify overweight and mental health problems by socio-demographic group and lifestyle and a possible association between overweight and mental health. MATERIAL AND METHODS A questionnaire survey (UngHUBRO) was conducted among 10th graders in Oslo in 2000 and 2001. The response rate was 88% (N = 7343). Self-reported height and weight were used to determine overweight/obesity according to international standards. The prevalence of overweight/obesity and mental distress by socio-demographic group was calculated, and associations between the two were adjusted for lifestyle (dietary habits, physical activity and inactivity) by logistic regression. RESULTS The prevalence of overweight/obesity was higher among boys (12%) than among girls (7%), and there was an inverse association with the length of parents' education for both genders. The association between overweight/obesity and mental distress was statistically significant for girls. The ethnic differences in overweight/obesity were large, but not statistically significant. INTERPRETATION The prevalence of overweight varied largely between socio-demographic groups. There was an association between mental distress and overweight among girls and there are marked differences in lifestyle between over- and normal weight adolescents.
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Affiliation(s)
- Nanna Lien
- Avdeling for ernaeringsvitenskap, Det medisinske fakultet, Universitetet i Oslo, Postboks 1046 Blindern, 0316 Oslo.
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Duvvi S, Gollapalli R, Sankar V, Walker T, Kumar BN, Reddy KTV. How we do it: Evaluation of nurse-led ENT services in the UK: a preliminary descriptive postal questionnaire survey. Clin Otolaryngol 2006; 31:552-5. [PMID: 17184468 DOI: 10.1111/j.1365-2273.2006.01270.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
There has been a steady growth in the volume and range of nurse led services in ENT practise in the UK. There was very little consistency in the titles of the nurses providing nurse led services but those nurses working in advanced practice roles now require courses, diplomas, degrees and study days related to ENT. Locally or nationally agreed practice guidelines can define nursing practice boundaries and ensure accountability. Monitoring and evaluation of nurse led services also requires attention.
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Glenday K, Kumar BN, Tverdal A, Meyer HE. Cardiovascular disease risk factors among five major ethnic groups in Oslo, Norway: the Oslo Immigrant Health Study. ACTA ACUST UNITED AC 2006; 13:348-55. [PMID: 16926663 DOI: 10.1097/01.hjr.0000214616.14361.51] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The levels of cardiovascular risk factors vary in different segments of a population. Our aim was to investigate ethnic differences in cardiovascular risk factors among five major immigrant groups in Oslo, Norway. DESIGN A population-based, cross-sectional study. METHODS The Oslo Immigrant Health study was conducted in 2002. All first-generation immigrants aged 31-60 years living in Oslo from Sri Lanka, Turkey, Iran, Vietnam, and a random sample of 30% of those from Pakistan, were invited. A total of 3019 individuals provided written consent and met the inclusion criteria. Participants had a clinical examination, blood test, and were asked to complete the study questionnaire. RESULTS Immigrants from Vietnam had the highest high-density lipoprotein (HDL) cholesterol, whereas immigrants from Sri Lanka and Pakistan, and men from Turkey, had the lowest HDL-cholesterol and highest triglycerides. Immigrants from Sri Lanka, Pakistan and Turkey had the highest blood pressure. Smoking was least prevalent among Sri Lankan immigrants and most common among Turkish immigrants. Ethnic differences in blood pressure and HDL-cholesterol, and triglycerides among women, were attenuated after adjusting for obesity measures. A moderate and higher (> or =10%) Framingham risk score was most common among Turkish and Pakistani immigrants. CONCLUSIONS We found ethnic differences in triglycerides, HDL-cholesterol and blood pressure; however, the differences in blood pressure were surprisingly small. Ethnic differences were partly explained by obesity. The prevalence of smoking also varied greatly between the different ethnic groups.
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Affiliation(s)
- Kathleen Glenday
- Institute of General Practice and Community Medicine, University of Oslo, Oslo, Norway.
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