This first, large-scale study on complementary feeding in Lebanon analysed the timing and types of food introduced to infants according to mothers' demographic and socioeconomic and infants' characteristics. A cross-sectional survey over 10 months found that the majority of infants were introduced to solid foods at or after 4 months of age. A large number of infants were given liquids other than breast or formula milk earlier. Women in employment outside the home were almost twice as likely to introduce solid foods before age 4 months. The most common starting food was cereals. More than half the children consumed starchy foods and fruits every day, but not meats and fish. Alimentation de complément dans un pays en voie de développement : une étude transversale au LibanRÉSUMÉ Cette première étude à grande échelle sur l'alimentation de complément, menée au Liban, analysait le moment d'introduction et le type de nourriture proposé aux nourrissons en fonction des caractéristiques démographiques et socio-économiques de la mère et des spécificités du nourrisson. Une étude transversale menée sur 10 mois a montré que chez la majorité des nourrissons, les aliments solides étaient introduits à partir de l'âge de quatre mois ou au-delà. Un grand nombre de nourrissons était alimenté avant quatre mois avec des liquides autres que du lait maternel ou du lait pour nourrissons. La probabilité que les femmes ayant un emploi en dehors de la maison introduisent des aliments solides avant l'âge de quatre mois était près de deux fois supérieure. Le plus souvent, les premiers aliments introduits étaient les céréales. Plus de la moitié des enfants consommait des féculents et des fruits chaque jour ; par contre, ils ne mangeaient ni viande, ni poisson.
Background Self-monitoring of blood pressure has been shown to optimize the management of blood pressure in high-income settings, but there is less evidence from low-to-middle income countries. We designed a proof-of-concept pilot trial to assess the feasibility and acceptability of an intervention built around self-monitoring of blood pressure and health education, and to measure its association with reduced blood pressure among hypertensives. The study was conducted in Lebanon, a country where the management of hypertension presents challenges similar to those faced in countries of the Arab region and other middle-income countries. Methods We conducted a parallel two-arm pilot trial with a mixed-method approach to investigate the effect of the intervention on patient experience. Hypertensive patients (n = 80) were recruited at two primary and one tertiary health centers in Beirut, and were randomly allocated (1:1) to either an intervention group where patients received blood pressure devices, diaries and educational sessions, or a control group where patients received standard of care as practiced in their health centers. The main outcomes were feasibility (recruitment, retention and adherence), acceptability, and changes in systolic blood pressure. Quantitative and qualitative data were obtained at baseline and 6 weeks later. Results The recruitment rates for the study was 52% and retention was 95%. Most participants in the self-monitoring group (33/38) reported that the device was convenient and easy to use. Complete case analysis showed that blood pressure monitoring was associated with a greater reduction in systolic (-6.3 mmHg, 95%CI [-12.4; − 0.17]) and diastolic (-1.9 mmHg, 95%CI [-6.34; 2.58]) blood pressure in the self-monitoring group (n = 36) as compared to the standard of care group (n = 36). Improved knowledge of hypertension was also observed in the self-monitoring group. There were no adverse events related to study participation. Conclusions Self-monitoring is acceptable and feasible and has the potential to improve hypertension management. Our results should be further tested in trials with adequate statistical power and longer follow-up periods to examine the effectiveness of the intervention on blood pressure levels. Trial Registration and funding: Retrospectively Registered on April 3, 2020. ISRCTN 16450193. Funded by the Harvard Medical School Center for Global Health Delivery.
Background: The WHO Region for the Eastern Mediterranean has had a history of complex migration patterns, with high levels of migration to, from and within the Region, overlaid by massive recent forced displacement. Relatively little is known about the health system response to this large-scale mobility. Aims: To review the literature on the Region critically, identify gaps and suggest areas needing research and policy attention. Method: A search of the published literature using MEDLINE and POPLINE was conducted on health and migration focusing on the WHO health system building blocks with no date or language limitations. Results: Out of 4679 retrieved articles published between 1964 and January 2019, 140 met our inclusion criteria; 45 additional articles were included in a December 2020 update. Most publications focused on refugees and on the delivery of services. Conclusions: Few studies explored the responsiveness of health system to refugees and migrants compared with those for host communities, or assessed the quality of services or refugees’/migrants’ perceptions of available health services. Few suggested new approaches to financing health care access for these populations or new governance arrangements.
We calculated the difference between the observed number of hip fractures in 2019 and the expected number of hip fractures given stable fracture rates. IFPPs in 2019 attributable to changes in prevalences of BMI > 25 were estimated according to sex and 5-year age groups from 50 to 85+. Results Hip fracture rates decreased by 28% from 1999 to 2019 with 2,549 fewer hip fractures observed than expected in 2019. The prevalences of BMI > 25 had increased in all age groups in both men and women over the time period. Unadjusted estimates showed that the increased prevalences of BMI > 25 accounted for~30% of the decline. Increased BMI explained~50% of the total number of IFFPs in men and~25% of the total IFPPs in women. ConclusionThe incident hip fracture rates in Norway declined between 1999 and 2019. These preliminary results suggest that increased BMI in the population, reflecting a shift in the population BMI distribution, has significantly contributed to the declining hip fracture incidence, particularly in men.
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