Knowledge, Health Beliefs and Osteoporosis Preventive Behaviour Among Women of Reproductive Age in Egypt

@#Introduction: : Osteoporosis is an important, global public health issue that is expected to become an epidemic by 2050, and particularly affect an increasing number of elderly women worldwide. The current study was designed to measure the current osteoporosis knowledge level among a sample population of women, to assess osteoporosis health beliefs, and assess osteoporosis preventive measures and factors related to those taking preventive measures. Methods: A cross-sectional study was conducted, using multistage sampling. A total of 265 women were randomly selected among those attending outpatient clinics in primary health care units. The study used a questionnaire to assess knowledge, health beliefs, in addition to osteoporosis preventive behaviour. Results: About 59% of the participants showed inadequate knowledge and 70.7% had inadequate osteoporosis preventive behaviour. Inadequate knowledge levels were more common among the younger participants, and those with a lower educational level, absence of osteoporosis in first degree relatives and no history of fractures. Significant differences were observed in the mean score of overall health beliefs and all its sub-scales, except for perceived exercise benefits and perceived health motivation. Sub-optimal calcium intake levels were noted, but were significantly higher among those with adequate osteoporosis preventive behaviour than among those with inadequate osteoporosis preventive behaviour (907.2 ± 187.6 and 810.7 ± 123.3, respectively, p < 0.001). Conclusions: The sample of women under investigation showed unsatisfactory levels of knowledge regarding osteoporosis, substandard health beliefs and sub-optimal levels of calcium consumption. Community-based interventions should be conducted to overcome the barriers to adopting preventive behaviours.

Assessment of compliance to standard precautions among surgeons in Zagazig University Hospitals, Egypt, using the health belief model

Although it is recommended that healthcare professionals should comply with the standard precautions to prevent acquiring blood-borne diseases [AIDS, hepatitis B and C], yet, they frequently do not comply with this recommendation. Understanding the reasons for compliance and noncompliance will help in designing educational programs for hospital staff and in determining a strategy for improving health behavior. The present study aimed to assess surgeons' compliance to standard precautions and determine surgeons' perceived beliefs affecting their compliance using the Health Belief Model. A cross-sectional study was carried out at surgical departments in Zagazig University Hospitals from December 2012 to May 2013. A questionnaire on various aspects of infection control and standard precautions practices was provided to 307 surgeons, with a response rate of 70%. Our findings indicated that 57.5% of the surgeons sampled in Zagazig University Hospitals were compliant with standard precautions. 59.8% of compliant surgeons had been exposed to at least one needle-stick injury in the previous 3 months, whereas slightly less than half of compliant surgeons [48.4%] had been exposed to splashes, with a highly significant difference compared with nonexposed surgeons. All Health Belief Model subscales were correlated directly with the surgeons' compliance, except perceived barriers. There is adequate compliance with standard precautions among surgeons in Zagazig University Hospitals, especially female surgeons, with a high level of knowledge among compliant compared with noncompliant surgeons. All Health Belief Model subscales were correlated directly with the surgeons' compliance, except perceived barriers. Adequate training of surgeons, provision of infection prevention equipment, regular reporting, follow-up, and assessment of occupational exposures need to be introduced

Cesarean section deliveries in one health insurance hospital in Alexandria

Cesarean section [CS] rates have been increasing world wide, raising the question of the appropriateness of the selection of cases for the procedure. The World Health Organization [WHO] states that no region in the world is justified in having a cesarean rate greater than 10 to 15 percent. The aim of the work was to determine the trend of cesarean section deliveries in Gamal Abdel Naser Hospital which is affiliated to the Health Insurance Organization [HIO]. The study was conducted through a descriptive retrospective approach. The study sample included the a] recorded deliveries between 1998-2005 [n=15917] for estimating the trend of cesarean section deliveries, and b] the medical records of CS deliveries at 2002 in the hospital [n=837] for identifying the indications of CS and their adequacy as a source of information for evaluation of CS deliveries. The study revealed that; cesarean section rate was high and increasing during the period from 1998 - 2005.The highest percent was in the year 2004 [57.9%]. The trend of increase was significant [c for linear trend = 162.717, p = 0.000].Thursdays accounted for the highest percent of both admissions and deliveries, while Fridays accounted for the lowest percent. More than one half of deliveries occurred between 2 pm to before 8 pm. More than three quarters of the study sample [77.9%] did not have trial labour. Only 12.8% of the total study sample had induction and the outcome of induction was dystocia in 85%.The main indication of cesarean section was previous CS [41.2%], fetal distress [17.6%], failed trial and failure to progress [11.4%], cephalo-pelvic disproportion [10.3%], abnormal presentation [5.6%] and ante-partum hemorrhage [3.2%]. Patient's records lack most of the essential information so it was not possible to verify recorded indication to justify caesarean section

new micro-method enumeration of lymphocytes subsets CD4 and CD8 in whole blood using immuno-magnetic beads

The aim of this study was a quick separation of CD4 and CD8 subsets in micro-technique; we purpose the procedure, which a dynabeads having low-cost whole blood lymphocytes is counting small volumes of blood and beads, with a shorter incubated times. We were studied the behavior of lymphocyte, we based on a different parameters including a blood dilution, temperature, beads target cells ratio, choice MAbs [affinity], using a comparaison of the dynabeads technic with others technics well known such as flow cytometry [FCM]. Then we monitor the depletion of blood samples by pre-treated IMS, we had been demonstrated the efficiency dynabeads coated with high affinity such as AMT8, AMT4, AMCD14, over 99% depletion. The target cells was obtained in 10 minutes at 4°C, monocytes were captured by CD4- beads leading to over-counting, CD4 + lymphocytes. This problem had been solved by monocytes pre-clearing using CD14 MAbs. To solve the problem we were proposed a procedure in two steps protocol including monocytes pre-clearing only 30 minutes operated at room temperature, without sophisticated instrument then we can counts directly the number of lymphocytes

Evaluating the indoor and outdoor environment: using a simple method

Housing is the conjunction of the dwelling, the home, the immediate environment and the community. Between 1960 and 1980, the urban population in developing countries more than doubled and is expected to reach 56% of the total population by the year 2025. In many cities, the development of squatter settlements and shanty towns had grown rapidly causing the destruction of green areas. The number of people living in urban slums and shanty towns is an indicator of conditions in the cities and the United Nations had estimated that about one-third of urban dwellers in developing countries live in such settlements. Poverty is highly prevalent among the residents of these areas. Outdoor environmental degradation, together with the social degradation affects the health of the urban population especially the poor causing a burden of ill-health, disability, poor indoor housing, and high maternal and infant mortality. The aim of the present study is to evaluate the indoor and outdoor environment using a simple method and to assess its reliability and validity. The scoring system, which was developed for the assessment of the indoor and outdoor environmental levels included 36 items [18 for the indoor and 18 for the outdoor] using a questionnaire. Results revealed that the proposed scoring system was able to reveal significance difference between served [water, electricity, and sewerage system were available] and unserved areas when using t-test, z-test, and chi-square testing. The proposed scoring system was reliable and valid especially in indoor assessment. Outdoor scores might need more modifications to improve its reliability

Maternal serum alpha fetoprotein among pregnant females in Alexandria

Maternal serum alpha fetoprotein [MSAFP] was introduced as a screening test for congenital malformations especially neural tube defects [NTDs] two decades ago. However, many factors were known to affect its level. From these are racial differences and maternal weight. The aim of the present work is to illustrate the normal distribution of MSAFP among working pregnant women in Alexandria in gestational age 16- 18 weeks, to identify some of its determinants, and to determine the specificity and sensitivity of MSAFP for the detection of congenital anomalies and adverse pregnancy outcome. A sample of 608 pregnant working women who were 16-18 week gestation was recruited for the study from the antenatal clinic affiliated to Gamal Abdel Nasser Health Insurance Hospital in Alexandria. The enrolled women were interviewed using a structured questionnaire and a blood sample was collected from each of them to measure the level of MSAFP. At the expected time of delivery, Gamal Abd el Nasser Health Insurance Hospital was visited to collect data about the outcome of pregnancy of the enrolled women. The median of MSAFP level for deliveries with no congenital anomalies were 25.5, 33.5, and 53.2 IU/ml, at gestational weeks 16, 17 and 18 respectively. The significant variables related positively to MSAFP level included abortion or stillbirth, congenital anomalies in the index pregnancy, gestational age, bleeding during pregnancy, gestational diabetes, twin pregnancy, consanguinity between maternal parents, history of congenital or genetic diseases in maternal family, and caesarian section deliveries. Fatigue score was negatively correlated to MSAFP level. Using MSAFP multiples of median [MOM], 42.9% of abortions and stillbirths, 57.1% of twin pregnancies, 31. 25% of preterm deliveries and 27.3% of low birth weight had levels of 3 MOM or more. One fourth of the congenital anomalies were below 0.5 MOM and 41.7% were at or above 3 MOM. The sensitivity of MSAFP test for the detection of NTDs [cutoff point 2.5+ MOM] or Down syndrome [cutoff point <0.5 MOM] among the study sample was 100% [Cl: 19.8-100%]. Specificity for NTDs was 92.7% [Cl: 90.3-94.6%], while the specificity for Down syndrome was 89.1% [86.3-91.4%]. The sensitivity for adverse pregnancy outcome [cutoff point <0.5 or 2.5+ MOM] was 41.6, and the specificity was 85.8%.In conclusion, the cutoff points of MSAFP of the study sample are different from those for other populations. Different factors affect the level of MSAFP including adverse pregnancy outcomes. It is recommended to introduce antenatal screening for congenital anomalies as a routine screening test during pregnancy using levels adapted from the local population for cutoff point determination

Teacher's perceptions about reproductive health education in schools

Reproductive health [RH] programs are increasingly aware of young adults needs. Success in implementing such programs in schools depends largely on adequate teachers' training. The aim of the present study was to identify teachers' knowledge about RH as well as their opinions and perceptions about teaching RH in schools. The studied sample included 432 teachers of both sexes representing different educational levels in three educational sectors in Alexandria. The techniques used were self-administered questionnaire and group discussion. Results revealed that about half of the sample had not heard about the synonym RH before [50.5%] and had poor knowledge about RH [49.1%]. Teachers' qualification, years of experience and type of teaching subject significantly affected their knowledge level. After discussing the concept of RH with the teachers, the great majority perceived importance of RH education and agreed that RH must be taught to their own children in schools. Schools were cited on the top of second preferred sources giving RH information to youth. The majority of the teachers suggested that all RH topics should be incorporated in the future school curriculum. About two-thirds of the sample showed positive attitude towards attending RH training courses. Also, nearly half of the sample expressed high perceived barriers for teaching RH in schools. It is recommended to integrate different topics of RH within formal and informal school programs. Preservice and inservice training of teachers about RH should be earned out

Malnutrition among children 6-24 months attending MCH centres in Alexandria an epidemiologic study Part I: Prevalence

A cross-sectional nutritional survey of children aged 6-24 months [weaning period] attending MCH centres in Alexandria governorate through the year 1988-1989 was conducted with the aim of determining the prevalence of protein calory malnutrition. The sample size was 1000 children chosen from 6 MCH centres in Alexandria [one centre for each zone]. The sample was distributed along the six centres in proportion to the total number of infants recorded to have attended those centres through 1985. The centres were visited during the period starting November 1988 through June 1989. Each centre continued to be visited until the number decided to be included was completed. The study included the determination of age and the measurement of height and weight-Anthropometric standards issued by WHO were used to classify the children's length for age, weight for age, and weight for length in terms of a cut off point of 2 SD below the median of that of reference [Waterlow system]. Gomez classification using weight/age as a parameter was used to diagnose undernutrition. The results of the study revealed a prevalence rate of undernutrition of 25.6% which was mostly of the first degree as expressed by Gomez categories. When expressed using waterlow system a prevalence of stunting of 29.7% was observed while wasting was observed in only 0.7% and concurrent wasting and stunting constituted 0.1%. These results were considered to be relatively lower in comparison to earlier similar studies. It was thus recommended that similar surveys for preschool age children in Alexandria and other regions of Egypt would be valuable

Infant, neonatal and postneonatal mortalities in Egypt and Alexandria Governorate: trends and prediction

This study aimed at determining the trend of infant mortality, neonatal mortality, postneonatal mortality and the ratio of postnenonatal mortality to neonatal mortality% during the last 27 years for Egypt as a whole and Alexandria Governorate with investigation of the trend change after eliminating the effect of National Control of Diarrheal Diseases Project and Predicting the expected situation of infant mortality profile for future years. The rates of Egypt were obtained form CAPMAS while rates of Alexandria Governorate were calculated using the original data. Time Series Analysis using the method of least squares for determining the slope of the best fitting straight line was carried out to calculate the trend and predicted the expected rate values. An evident on-going declining trend in infant mortality rate, postneonatal mortality rate and ratio of postneonatal mortality to neonatal mortality% was experienced in Egypt and Alexandria and it was faster in Alexandria. On eliminating the effect of the rehydration program a delayed lowest expected rates wee detected. The neonatal mortality ate decline showed the same slope even after elimination of the program effect. Prediction of future rates showed better chance of child survival of Egyptian infants and it would be observed faster in Alexandria

Comparative study between recorded and actual causes of maternal mortality in Alexandria governorate during 1985

This study was conducted to compare between recorded and actual causes of reporductive deaths among women in Alexandria governorate in the age group 15-49 years during the year 1985 and determine the extent to which it is maternal. Record review of six health offices in Alexandria governorate [chosen randomly so that each medical zone was represented by one health office] was done. Data about 158 deceased females were obtained. Home visits to 148 families of deceased females were performed to obtain information about the actual cause of death and the health condition of the deceased females before death. Results showed discripency between health offices records and home visits data regarding causes of death in the reproductive age and specifically causes of maternal mortality that was also under-reported

Effect of child loss on fertility behaviour 1 Replacement and biological effects of child mortality

This study was carried out with the aim of investigating the effect of replacement and biological effects of child mortality on fertility behavior in an urban and a rural setting in Alexandria governorate. The data were collected through a questionnaire interview. The study revealed the following results: - Child mortality leads to high fertility behavior in both areas as evidenced by positive replacement and biological effects

Effect of child loss on fertility behaviour: II effects of insurance motivation and societal response mechanisms on attitudes and practices towards family planning

The study was carried out with the aim of investigating the effect of insurance and societal effects of child mortality on the attitudes and practices towards family planning in an urban and a rural settlings in Alexandria governorate. The data were collected through a questionnaire interview. The sample was a purposive sample of 600 women, half of it from an urban area and the other half from a rural area. Each sample was classified into women who had experienced child loss of at least one among the first 3 live births [at least 100 women] and women without child loss as a control group [to complete the sample to 300]. The study revealed that child mortality leads to high fertility attitudes and practices in both areas as evidenced by positive insurance and societal effects