Association of Obesity With Health Literacy and Weight Perception Among Women Merchants in Abidjan, Côte d'Ivoire: A Cross-Sectional Study.

BACKGROUND: In Abidjan, Côte d'Ivoire's largest city, obesity rates among women are increasing, posing a major health challenge, especially for the working generation. Merchants represent 64.3% of working women and are a typical occupation for women with low- and middle-income. Health literacy is used to prevent and overcome chronic diseases and can be used as anti-obesity measures. OBJECTIVE: The aim of this study was to examine the relationship between obesity, health literacy, and weight perception among women merchants in Abidjan. METHODS: In this cross-sectional study, we conducted a complete enumeration survey among women merchants in a market in Abidjan from December 2020 to December 2021. In addition to anthropometric measurements, structured face-to-face interviews were conducted. The participants were asked about their weight perception, weight management behaviors, and sociodemographic attributes. They also responded to the Health Literacy Questionnaire (HLQ). Data were tabulated using descriptive statistics, and multiple logistic regression analysis was performed to examine obesity's association with HLQ scales, weight perception, and weight management behaviors. KEY RESULTS: Of the 873 participants, 259 (29.7%) were obese; 82% of them underestimated their weight. Obesity was associated with a higher rate of HLQ1 (Feeling understood and supported by health care providers) (odds ratio [OR] = 2.926, confidence interval [CI]:1.450-5.901, p = .03), a lower score of HLQ3 (Actively managing my health) (OR = 0.343, CI:0.165-0.716, p = 0.004), a lower rate of accurate weight perception (OR = 0.145, CI: 0.093-0.224, p < .001), and a lower rate of eating at least three meals per day (OR = 0.401, CI:0.260-0.617, p < .001). CONCLUSIONS: Findings from this study of Abidjan women merchants include obese participants' lack of a proactive attitude toward personal health management, and the association of factors such as inaccurate weight perception and eating fewer than three meals per day with obesity. These finding have important implications for future anti-obesity measures. [HLRP: Health Literacy Research and Practice. 2024;8(2):e102-e112.].

PLAIN LANGUAGE SUMMARY: We found the relationship between obesity and health literacy among women merchants, Abidjan in Côte d'Ivoire. The results showed that participants with obesity lacked proactive attitude toward personal health management among health literacy skills. Anti-obesity measures in Abidjan need to incorporate this aspect of the health literacy skills.

Lifestyle behaviors that reduce food and fat intake in patients with type 2 diabetes within 3 months of diagnosis lead to a reduction in the HbA1c level after 12 months.

It is important to provide "Diabetes Self-Management Education and Support," the ongoing process of facilitating the knowledge, skills, and ability necessary for diabetes self-care, immediately after diagnosis. In this 12-month (12 M) longitudinal observational study, outpatients within 3 months of their first diagnosis of type 2 diabetes mellitus (T2DM) were surveyed at baseline (BL) and 12 M using a self-administered questionnaire used in the "Lifestyle Intervention Support Software for Diabetes Prevention" and medical record survey. To explore factors associated with the change extent in HbA1c level during the 12 M post-diagnosis, hierarchical multiple regression analysis was performed with sex, age, HbA1c level at BL, medication in the first 12 M post-diagnosis, and lifestyle behaviors related to diet and exercise therapy as independent variables. The HbA1c level of the 89 participants was 8.4% ± 2.2% at BL and 6.7% ± 1.0% at 12 M. "ND06 I add milk to coffee or tea (reverse item)" (ß = -0.110, p = 0.015), "RD15 I eat vegetable dishes such as a vegetable side dish and/or a vinegar or pickle dish" (ß = 0.151, p = 0.003), "ND02 I eat until I feel full (reverse item)" (ß = -0.115, p = 0.024), and "RD14 I select udon or soba instead of Chinese noodles in soups" (ß = -0.113, p = 0.007) were associated with the change extent in the HbA1c level during the 12 M post-diagnosis. Overall, it may be useful to support patients with T2DM early post-diagnosis to improve lifestyle behaviors associated with the extent of change in HbA1c level during the 12 M post-diagnosis.

Analysis of COVID-19 mortality in patients with comorbidities in Côte d'Ivoire.

Background: Although COVID-19 has spread in Côte d'Ivoire, there is no report that summarizes the comorbidities of COVID-19 death cases. Objective: To verify the types and prevalence of commodities associated with recorded COVID-19 deaths compared with the general adult population in Côte d'Ivoire. Methods: Data on the comorbidities of COVID-19 deaths and the country's disease structure were collected from official government reports and WHO's reports. Results: Among 67 patients studied, the biggest age group was 60-69 years old with 23 people (34%). Fifty-four patients (81%) had non-communicable diseases (NCDs) as comorbidities. The prevalence ratio between COVID-19 deaths and general adult population was 8.96 [95% Confidence Interval: 6.86-11.68] for diabetes, 1.74 [1.27-2.37] for hypertension, and 2.16 [1.32-3.51] for obesity. Conclusions: To reduce the risk of death from COVID-19 in Côte d'Ivoire, focused infection prevention measures for elderly and diabetic patients are needed.

Objective and Personalized Assessment of Disease-Related Knowledge Among Patients With Congenital Heart Disease　- Development and Validation of the Japanese Version of the Leuven Knowledge Questionnaire for Congenital Heart Disease.

Background: Disease understanding in patients with congenital heart disease is important in transitional and lifelong care. This study aimed to develop the Japanese version of the Leuven Knowledge Questionnaire for Congenital Heart Disease (LKQCHD) and identify factors associated with disease-related knowledge. Methods and Results: After confirming the content and face validity of the scale, a questionnaire including the LKQCHD was distributed to 59 eligible patients aged >16 years attending a university hospital. For the 58 participants who responded (30 males, 28 females; median age 22 years), the mean (±SD) LKQCHD total score was 53.7±15.4, with mean (±SD) scores for each domain as follows: Disease and Treatment, 68.3±19.7; Preventing Complications, 45.8±19.0; Physical Activity, 74.1±34.1; Sex and Heredity, 37.9±35.4; and Contraception and Pregnancy, 40.2±29.1. Regarding known-groups validity, we found a positive correlation between the LKQCHD score and age (ρ=0.268, P=0.042), and a significantly low LKQCHD score in the moderate/severe disease group (η2=0.131, P=0.021). Regarding convergent validity, the LKQCHD score was positively correlated with the total and subscale scores of the Resilience Assessment Tool (r=0.213 [P=0.109] and r=0.405 [P=0.002], respectively). Conclusions: We confirmed the validity of the Japanese version of the LKQCHD, concluding that patient education regarding long-term complications, prevention methods, heredity, pregnancy, and childbirth is needed.

Gender differences in HIV testing service visits and its related factors among adults: a cross-sectional study in Homa Bay, Kenya.

INTRODUCTION: at least 90% of people living with human immunodeficiency virus (HIV) were expected to know their HIV status by 2020. However, only 84% are aware of their status. This study determined the frequency of HIV testing services visits (HTS) and its related factors to HTS visits among adults in Homa Bay County, Kenya. METHODS: this was a cross-sectional study. Quantitative and qualitative data were collected. A backward stepwise logistic regression analysis was conducted for quantitative data by gender. Qualitative data were thematically categorised into factors of HTS visits by gender. RESULTS: a total of 645 adults participated in quantitative survey and 17 in qualitative survey. There were no gender differences in the frequency of HTS visits (males=56.3%; females= 58.7%, P=0.785). The frequency of visits was however significantly different between the rural-based (Rachuonyo North=87.5%; Ndhiwa=58.7%) and urban-based (Homa Bay Town=36.8%) facilities at P<0.001. In males, HTS visits were positively associated with ´being in Protestant church´, ´partner´s attitude´, and ´being accompanied by a friend to HTS´. ´Distance to HTS´ was negatively associated with HTS visits in males. For females, 'sexual intercourse in the past 2-5 months´ was positively associated with HTS visits. ´Being in a polygamous marriage´, ´not married´, ´community HIV testing´, and ´affordability of transport cost to HTS centre´ were negatively associated with HTS visits. CONCLUSION: there were no gender differences in the frequency of HTS visits. Social position for males and position in the family for females are suggested as the factors influencing HTS visits in Homa Bay County.

Incidence and Prevalence of Infectious Diseases and Their Risk Factors among Patients Who Use Visiting Nursing Services in Japan.

This study aimed to clarify the incidence of infectious diseases and the associated risk factors among patients who use visiting nursing services in Japan. We conducted a one-year follow up cohort study with 419 participants. The incidence and period prevalence rate of infectious diseases were 0.63 and 15.0%, respectively. In the multiple logistic regression analysis, the presence of chronic respiratory failure, Parkinson's disease, dermatosis other than pressure ulcers, and the inability to perform oral self-care were significantly related to the contraction of an infectious disease.

Perceptions of physicians and nurses concerning advanced care planning for patients with heart failure in Japan.

BACKGROUND: The importance of advance care planning (ACP) has been recognized in the palliative care of patients with heart failure. It is necessary for dissemination of ACP to characterize the perceptions of physicians and nurses towards ACP and to promote mutual understanding. The aim of this study is to investigate the perceptions of physicians and nurses concerning ACP for patients with heart failure. METHODS: We conducted a self-administered questionnaire survey with physicians and nurses who belonged to the 427 certified institutions for implantable cardioverter defibrillator (ICD) and/or cardiac resynchronization therapy (CRT) in Japan. The self-administered questionnaire was originally designed based on the guidelines on palliative care or ACP and previous studies on the barriers of ACP. We asked the participants the recognition about condition/timing to implement ACP, Content of care to be implemented in ACP, and barriers against implementing ACP. A Mann-Whitney U test was performed and r value was calculated an effect size (ES) in order to evaluate the characteristic perceptions among physicians and nurses. RESULTS: Valid responses were obtained from 163 physicians (38.2%) and 208 nurses (48.7%). Regarding the condition/timing, nurses tended to recognize that ACP should be implemented from earlier clinical stages than physicians. Regarding the contents of ACP, both physicians and nurses placed emphasis in assessing the patient's perception of disease progression. The biggest difference was found in the item "Ask patient about what has been important in life so far"; 78.6% of physicians but 94.2% of nurses chose "it must/should be implemented" (Cohen's r=0.31). Regarding the barriers, both physicians and nurses recognized the difficulty in prognosis prediction. The biggest differences were found in the items "Medical staff does not know how to implement ACP for patients and their families" (45.6% of physicians and 70.4% of nurses chose "strongly agree/agree", r=0.27), and "There is disagreement regarding care goals among team members of different professions" (18.5% in physicians and 43.3% in nurses, r=0.27). CONCLUSIONS: It is suggested that discussions and further studies are necessary concerning the condition/ timing of implementing ACP from early stages, specific manuals/protocols and recommendation on rolesharing within a multidisciplinary team.

Experiences of patients with HIV/AIDS receiving mid- and long-term care in Japan: A qualitative study.

PURPOSE: In the era of antiretroviral treatment (ART), treatment of HIV has become more manageable, and most patients with HIV benefit from long-term therapy in Japan. The aim of this qualitative study was to examine the experiences of patients with HIV/AIDS receiving mid- and long-term care in Japan. METHODS: A qualitative study was performed using semi-structured interviews at an outpatient clinic of a university hospital in the Greater Tokyo area. A total of 31 Japanese patients with HIV who had been receiving treatment for at least a year were interviewed in Japanese. Data from these interviews were analyzed by 'content analysis' (Krippendorff, 1980). RESULTS: The data were organized into the following seven themes: "feelings toward diagnosis of HIV infection"; "perceptions and behavior after diagnosis of HIV"; "attitudes toward HIV therapy"; "fear and hope for the future"; "feelings toward professional support"; "life changes after HIV therapy"; and "struggles in relationships with others". CONCLUSIONS: Some participants accepted themselves as HIV-positive, some did not when they were diagnosis. This difference of reaction had effect on attitudes toward HIV therapy. But all participants continued mid- and long-treatments owing to feeling well and receiving support from professionals. Additionally, it found that patients were felt stigma of HIV-positive similarly to another Asian countries. Therefore, we should provide the entire Japanese society with knowledge about HIV/AIDS and be early and constant intervention by professional teams after being infected.

The degree of apoptosis as an immunostimulant for a DNA vaccine against HIV-1 infection.

To regulate the expression of the apoptotic gene, we constructed bicistronic DNA vaccines that encode for HIV env and caspase-3 mutant (casp 3m) that are expressed via the encephalomyocarditis virus internal ribosomal entry site (IRES) or cytomegalovirus (CMV) promoter-dependent translations. While IRES-casp 3m induced weak apoptosis and caused little reduction in antigen expression, CMV-casp 3m elicited strong apoptosis and led to a marked decrease in the antigen expression. Therefore, IRES-casp 3m augmented HIV-specific immune responses, and IRES-casp 3m induced significant protection against the vaccinia-HIV chimeric virus. These results suggest that the appropriate level of apoptosis is important for DNA vaccine development.

[DNA vaccination].

No one knows the timing when influenza pandemic will occur, but that catastrophe will undoubtedly happen. Current vaccines elicit antibodies to membranes of viruses effective against highly specific strains, however they are not effective against multiple strains. New strategies are urgently needed for the protection against multiple strains. It is necessary to develop immunologically superior vaccines. DNA vaccination is an established immunization method in animal models. DNA vaccines are gaining importance due to the induction of a strong cellular immunity. Moreover, the protection against multiple strains of influenza A virus has already been achieved. But their immunogenicity is not so strong that to improve the efficacy of this method is very important. This article highlights some of the recent developments in investigational DNA vaccines. Various tactics for enhancement of their immunity are considered. DNA vaccines together with DNA encoding various cytokines showed better immunological responses in several animal models. Alteration in the vector, inclusion of CpG-ODN motifs, addition of transcriptional factor and appropriate vaccine delivery mechanisms are expected to further improve the efficacy of these vaccines.