International journal of environmental research and public health
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Int J Environ Res Public Health · Sep 2019
Pathways and Associations between Women's Land Ownership and Child Food and Nutrition Security in Pakistan.
Women's land ownership plays a noteworthy role in improving various development indicators, including her own wellbeing and children's food and nutrition security. However, the literature linking women's access to land rights to the nutritional security of children in Pakistan is limited, even though it is a country facing enormous challenges of childhood malnutrition and gender discrimination. This paper contributes to the existing literature on the benefits of empowering women by studying the association and pathways between women's land rights and child nutrition, using the 2012-2013 Pakistan Demographic and Health Survey. ⋯ The results of quantile regression (QR) show that these effects are more pronounced in cases of children with severe stunted growth. In addition, a structural equation model shows that the positive relationship between women's land ownership and child nutrition is partially mediated by women's increased decision-making power in large-scale household purchases. Our research concludes that ensuring women's land rights can improve women's autonomy, which can be an effective policy tool that not only improves women's welfare but also improves their children's nutritional security.
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Int J Environ Res Public Health · Sep 2019
Striving for Confidence and Satisfaction in Everyday Life with Chronic Obstructive Pulmonary Disease: Rationale and Content of the Tele-Rehabilitation Programme >C☺PD-Life>>.
Background: More feasible rehabilitation programmes for patients with chronic obstructive pulmonary disease (COPD) are warranted. Even so, still in its infancy, telerehabilitation to COPD patients reveals promising results, wherefore it is anticipated to contribute significant value to the current challenges of rehabilitation to these patients. To expand useful knowledge in the field, more sophisticated telerehabilitation interventions must be developed and appraised, but first and foremost, thoroughly described. ⋯ The programme was a six-month-long empowerment-based rehabilitation that aimed to support COPD patients in leading a satisfactory and confident life with appropriate physical activity and high disease management. Conclusions: A long-term interprofessional cross-sectoral telerehabilitation programme has been justified and described. The intervention was tested in 2017-2018 and the qualitative appraisal, along with an analysis of case-based measurements of development in physical capacity, COPD Assesment Test, and health management, is currently under production.
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Int J Environ Res Public Health · Sep 2019
Residents' Awareness of Family Doctor Contract Services, Status of Contract with a Family Doctor, and Contract Service Needs in Zhejiang Province, China: A Cross-Sectional Study.
In China, family doctor services originated in 2009. After two years, the Chinese government proposed the establishment of a family doctor contract system suitable for China's national conditions. Then, in 2016, a multi-department jointly issued an important document, which further clarified the development goals of family doctor contract services in the next five years. Zhejiang Province has been exploring responsible doctor contract services since 2012, which was promoted throughout the province in 2015.
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Int J Environ Res Public Health · Sep 2019
Multi-Service Programs for Pregnant and Parenting Women with Substance Use Concerns: Women's Perspectives on Why They Seek Help and Their Significant Changes.
Within Canada, several specialized multi-service prevention programs work with highly vulnerable pregnant and early parenting women with substance use issues. Experiences of trauma, mental health, poverty, and other factors associated with the social determinants of health complete the picture. Program evaluations have demonstrated their value, but less has been said as to women's reasons for choosing to seek help from these programs, what they were hoping to gain, or what difference they believe has occurred as a result. ⋯ Additional motivations included wanting information, support or assistance with: child welfare; pregnancy; housing; getting connected to health care or prenatal care; and opportunities for peer support. With respect to the most significant life change, themes included: reduced substance use; improved housing; stronger mother-child connection; and improved wellness and social connections. Findings demonstrated that vulnerable, marginalized pregnant and parenting women who are using substances will seek help when health and social care services are configured in such a way as to take into consideration and address their unique roles, responsibilities, and realities.
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Int J Environ Res Public Health · Sep 2019
ReviewDoes Rebound Pain after Peripheral Nerve Block for Orthopedic Surgery Impact Postoperative Analgesia and Opioid Consumption? A Narrative Review.
Regional anesthesia has been considered a great tool for maximizing post-operative pain control while minimizing opioid consumption. Post-operative rebound pain, characterized by hyperalgesia after the peripheral nerve block, can however diminish or negate the overall benefit of this modality due to a counter-productive increase in opioid consumption once the block wears off. We reviewed published literature describing pathophysiology and occurrence of rebound pain after peripheral nerve blocks in patients undergoing orthopedic procedures. ⋯ Multimodal strategies including preemptive analgesia before the block wears off, intra-articular or intravenous anti-inflammatory medications, and use of adjuvants in nerve block solutions may reduce the burden of rebound pain. Additionally, patient education regarding the possibility of rebound pain is paramount to ensure appropriate use of prescribed pre-emptive analgesics and establish appropriate expectations of minimized opioid requirements. Understanding the impact of rebound pain and strategies to prevent it is integral to effective utilization of regional anesthesia to reduce negative consequences associated with long-term opioid consumption.