Tobacco advertising, promotion and sponsorship in entertainment media: a phenomenon requiring stronger controls in the Eastern Mediterranean Region

Tobacco use and placement of tobacco products in television [TV] productions and movies is a way to promote tobacco use while avoiding tobacco advertising bans that exist in most countries. The fact that such productions are broadcast widely and viewed by millions, including children and young people, is of concern. This paper reviews the evidence on the use of tobacco advertising, promotion and sponsorship [TAPS] in TV and films in the Eastern Mediterranean Region and the ways to combat it. Evidence from Egypt shows considerable and increasing use of tobacco products by actors on screen, including female actors, in programmes aired during Ramadan in 2015–2017. A study of Iranian movies in 2015 showed that tobacco scenes in Iranian movies were increasing. In 2014, the WHO Regional Office for the Eastern Mediterranean held a consultative meeting on TAPS in drama. The consultation recommended regulating the tobacco presence in movies and TV through complete implementation of Article 13 of the WHO FCTC, and raising the issue to the WHO FCTC Conference of the Parties. In 2016, the Conference of the Parties called on parties to consider scaling up the implementation of WHO FCTC Article 13 and monitoring the use of TAPS in entertainment media in accordance with national legislation. A comprehensive approach is essential to end the tobacco industry's use of TV productions and movies to promote their products

Predictors of in-hospital mortality in Kuwait

Background: Many factors affect mortality among hospitalized patients. These include; age, sex, principal diagnosis. presence of co-morbidity, performance of surgical operation, emergency admission and length of hospital stay. Identification of all these factors especially those, which are amenable to improvement would require collection and analysis of data to be able to determine risky patients and give them more attention. This would reduce death rate among those at high risk of dying after hospital admission

Objective: To determine the factors predicting patients' in-hospital mortality and to answer the question "who is at high risk of dying after hospital admission? "

Methods: A case-control study was carried out in Kuwait general hospitals. Data were collected from discharge records of all patients discharged either dead [cases] or routinely alive [controls] from Kuwait six general hospitals in the year 2004. A total of 1980 hospital deaths compared to an equal number of controls discharged alive were enrolled in the present study

Results: The results of the logistic regression revealed that, patients 65 years old and above, non Kuwaitis, widowed and divorced, admitted from emergency department with injury as external cause, having the principal diagnosis septicemia. injury or stroke associated with one of the common comorbid conditions were at higher risk of hospital death than those without these characters. While, patients performing surgical operations were at lower risk of hospital death than non operated patients

Conclusion: To reduce in-hospital mortality. hospitals must pay more attention and aggressive care to old patients, with primary diagnosis of septiceamia, injury and stroke, admitted from emergency department, with comorbid condition as sub-diognosis. as they are more susceptible to dye after hospital admission than other patients

Cellular phones: are they detrimental?

The issue of possible health effects of cellular phones is very much alive in the public's mind where the rapid increase in the number of the users of cell phones in the last decade has increased the exposure of people to the electromagnetic fields [EMFs].Health consequences of long term use of mobile phones are not known in detail but available data indicates the development of non specific annoying symptoms on acute exposure to mobile phone radiations. In an attempt to determine the prevalence of such cell phones associated health manifestations and the factors affecting their occurrence, a cross sectional study was conducted in five randomly selected faculties of Alexandria University. Where, 300 individuals including teaching staff, students and literate employee were equally allocated and randomly selected among the five faculties. Data about mobile phone's users and their medical history, their pattern of mobile usage and the possible deleterious health manifestations associated with cellular phone use was collected. The results revealed 68% prevalence of mobile phone usage, nearly three quarters of them [72.5%] were complainers of the health manifestations. They suffered from headache [43%], earache [38.3%], sense of fatigue [31.6%], sleep disturbance [29.5%], concentration difficulty [28.5%] and face burning sensation [19.2%]. Both univariate and multivariate analysis were consistent in their findings. Symptomatic users were found to have significantly higher frequency of calls/day, longer call duration and longer total duration of mobile phone usage/day than non symptomatic users. For headache both call duration and frequency of calls/day were the significant predicting factors for its occurrence [X[2]=18.208, p=0.0001]. For earache, in addition to call duration, the longer period of owning the mobile phone were significant predictors [X[2]=16.996, p=0.0002]. Sense of fatigue was significantly affected by both call duration and age of the user [X[2]=24.214, p=0.0000], while burning sensation was only affected by frequency of calls/day [X[2]=5.360, p=0.020]. According to the 95% confidence interval of frequency and duration of calls, the study recommended not to increase the call duration more than four minutes and limit their frequency to less than seven calls/day with total duration of exposure less than 22 min/day

Evaluation of vitamin a supplementation program to underfive children and nursing mothers in Alexandria

The elimination of vitamin A deficiency [VAD] as a public health problem with all its health consequences was adopted as a goal of the year 2010. In many countries, including Egypt, vitamin A supplementation is the main component of multiple approaches being employed. The present study was conducted to calculate coverage rate of vitamin A supplementation for infants, preschool children and nursing mothers [1999-2002], to assess knowledge and attitude of PHC physicians, nurses and nursing mothers on vitamin A and its supplementation program, also to assess PHC nurses' practices in this respect. Interviewing questionnaires were developed by the researchers and completed by 300 physicians, nurses and nursing mothers [100 each] interviewed from eight randomly selected PHC units [MCH/HO] representing three medical zones of Alexandria. The average coverage rates were 97.4%, 95.6% and 51.8% for infants, preschool children and nursing mothers respectively. PHC physicians had a significantly higher mean general knowledge score than PHC nurses and nursing mothers. However, their knowledge as regards specific issues related to vitamin A and its supplementation program was satisfactory in only 1.0% of them. Also, a minority [7.0%] of PHC nurses had satisfactory level of knowledge on administrative and technical aspects of vitamin A supplementation program. Positive attitude towards vitamin A Supplementation program was encountered among high percentage of the study groups. PHC physicians' knowledge was significantly associated with long duration of experience, formal training and postgraduate qualification. However, their attitude was only significantly associated with the long duration of eXperience. PHC nurses' knowledge was significantly associated with their long duration of experience and formal training. However, these factors were insignificantly associated with their practices. Old age of mothers and their education were significantly associated with their knowledge and attitude.Health education of mothers, continuous training of PHC physicians and dissemination of teaching materials developed by international organizations to PHC workers at all levels are extremely needed for Providers of PHC services and users of such services. In order to correct misconceptions and provide correct information on vitamin A and its supplementation program