The Lived Experience of COVID-19 Survivors During the Third Wave of the Pandemic and the Political Crisis in Myanmar: A Qualitative Study.

When the third wave of the COVID-19 epidemic broke out, the double burden of the pandemic and political instability meant that people in Myanmar did not have access to adequate hospital care. The aim of this study was to explore the lived experience of COVID-19 survivors in the community. A qualitative, descriptive, phenomenological approach was used, and participants were selected through purposive sampling. Fifteen individuals described their experiences using four themes and 17 categories. The main themes were the aggressive natures of the pandemic, suffering from the disease, receiving vital support for survival, and the hardships due to political pressure. The pandemic and subsequent waves of different variants should not be underestimated, and people's health should take priority over economic development and political crisis. Knowledge and practices of family members and society should be promoted by providing timely and comprehensive information regarding pandemic diseases.

Prevalence of metabolic syndrome, its risk factors and associated lifestyles in Myanmar adult people: A community based cross-sectional study.

OBJECTIVES: Metabolic syndrome (MetS) is the constellation of cardio-metabolic risk factors, and it can illustrate the coming burden of cardiovascular diseases and diabetes mellitus. Myanmar faces larger pressure from cardio-metabolic diseases and there is no existing data to understand the magnitude of MetS in adult population. This study aimed to investigate the extent of existing people with MetS in the community and to know the related lifestyle factors to MetS. METHODS: A community based cross-sectional study was performed in convenient sample of 302 Myanmar adult people. Prevalence of MetS and associated risk factors were identified by collecting sociodemographic information, anthropometric measurements, and blood investigation of glucose and lipid profiles. Logistic regression analysis was performed for developing statistical models to estimate the odd ratios (OR) and confidence intervals (CI). RESULTS: Prevalence of MetS is 29.1%, and there is no significant difference between male and female prevalence. Abdominal obesity is the highest component of MetS (OR: 28.37, CI: 12.41-64.85, p < 0.001) especially for female (OR: 44.52, CI: 17.19-115.31, p < 0.001), and hypertriglyceridemia (OR: 11.05, CI: 6.20-19.66, p < 0.001) is the commonest in male. Age is the constant risk for developing MetS (OR: 4.06, CI: 1.91-8.64, p < 0.001) whereas the practice of midday nap is the behavior related to increased occurrence of MetS (OR: 1.97, CI: 1.16-3.38, p < 0.05). Dietary pattern, smoking status, drinking alcoholic beverages and physical activity involvement do not impact on the development of MetS. Education, occupation, income and other sociodemographic factors do not produce significant effect on cardio-metabolic status. Obesity, diabetes, and hypertensive conditions of community residents are also explored. CONCLUSIONS: Modifiable pathophysiological conditions such as abdominal obesity, and obesity play a vital role in preventing MetS before it occurs while unmodifiable risk factor such as getting older and female sex are not as much important as changeable lifestyle habits.

Challenges faced by community health nurses to achieve universal health coverage in Myanmar: A mixed methods study.

OBJECTIVE: This study aimed to identify the challenges of community health nurses (CHNs) in delivering effective community health care to achieve universal health coverage (UHC) in Myanmar. METHODS: A total of 30 CHNs from township health centers in the northeastern, southern, and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews. Quantitative data were processed using Microsoft Excel software, and qualitative data were analyzed using thematic analysis. This study is registered with researchregistry6201. RESULTS: Around the country, 30 CHNs uncovered their hardships in implementing primary health care to achieve UHC. Over 90% of the participants agreed to the problem of inadequate health infrastructure, while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion. Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services. Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidence-based practices. Insecure work and living conditions, unsupportive community relationships, and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC. Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs. CONCLUSION: Myanmar's CHNs face many challenges in achieving UHC. These challenges are not confined to the health sector. Some situations, such as geographical barriers and transportation problems, remain persistent challenges for healthcare providers. This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure. Meanwhile, public empowerment plays a critical role in promoting health development.

Effect of a 2-hour interval between dinner and bedtime on glycated haemoglobin levels in middle-aged and elderly Japanese people: a longitudinal analysis of 3-year health check-up data.

INTRODUCTION: There is a need for evidence-based measures to examine the risk factors for lifestyle-related diseases. In Japan, a 2-hour interval between dinner and sleep is recommended as a healthy practice. However, the effect of an appropriate duration between dinner and bedtime on glycated haemoglobin (HbA1c) levels remains unclear. This study aimed to identify the effect of a duration of 2 hours or shorter between dinner and bedtime on HbA1c levels in middle-aged and elderly Japanese individuals. METHODS: A longitudinal analysis of health check-up data (2012, 2013 and 2014) was performed. Lifestyle and anthropometric data of individuals aged 40-74 years who did not have any pre-diabetic and diabetic conditions were collected for multilevel analysis. Univariate analysis was performed to assess the influence of each lifestyle variable. Then, two-level random intercept models were created using statistical software SAS 9.3 (SAS Institute Inc, Cary, NC, USA). RESULTS: The cohort comprised 1573 individuals in 2012, two-thirds of whom were women. The mean HbA1c level was 5.20% in 2012 and 5.58% in 2013 and 2014. A total of 83 (16.1%) men and 70 (7.5%) women fell asleep within 2 hours after dinner. The influence of ensuring a 2-hour interval between dinner and bedtime did not have a remarkable effect on increasing HbA1c levels. The regression coefficient of 2-hour interval and HbA1c levels over time was -0.02 (p=0.45). Smoking (p=0.013), alcohol consumption (p=0.010) and higher body mass index (BMI) (p<0.001) may have influenced HbA1c trends. CONCLUSION: Durations of 2 hours or shorter between dinner and bedtime did not influence HbA1c changes in middle-aged and elderly Japanese people. Instead, the focus should be on maintaining a normal BMI and abstaining from smoking and consuming alcohol to ensure stable HbA1c patterns in the long term.