scholarly journals The role of tobacco and alcohol use in the interaction of social determinants of non-communicable diseases in Nepal: a systems perspective

2020 ◽  
Author(s):  
Sudesh Raj Sharma ◽  
Anna Matheson ◽  
Danielle Lambrick ◽  
James Faulkner ◽  
David W Lounsbury ◽  
...  
Keyword(s):  
Data Analysis ◽  
Alcohol Use ◽  
Health System ◽  
Health Systems ◽  
Social Determinants ◽  
Economic Status ◽  
Non Communicable Diseases ◽  
Causal Loop ◽  
Socio Economic Status

Abstract Background: Tobacco and alcohol use are major behavioural risks in developing countries like Nepal, which are contributing to a rapid increase in non-communicable diseases (NCDs). This causal relationship is further complicated by the multi-level social determinants such as socio-political context, socio-economic factors and health systems. The systems approach has potential to facilitate understanding of such complex causal mechanisms. The objective of this paper is to describe the role of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Method: The study was a qualitative study design guided by the Systemic Intervention methodology. The study involved key informant interviews (n=63) and focus group discussions (n=12) at different levels (policy, district and/or community) and was informed by the adapted Social Determinants of Health Framework . The data analysis involved case study-based thematic analysis using framework approach and development of causal loop diagrams. The study also involved three sense-making sessions with key stakeholders. Results: Three key interacting themes emerged during the data analysis. Widespread availability of tobacco and alcohol products contributed to the use and addiction of tobacco and alcohol. Low focus on prevention by health systems and policy influence of tobacco and alcohol companies were the major contributors to the problem. Gender and socio-economic status of families/communities were identified as key social determinants of tobacco and alcohol use. These interacting themes were utilised to develop causal loop diagrams and system archetypes. Conclusion: Tobacco and alcohol use facilitated interaction of the social determinants of NCDs in the context of Nepal. Socio-economic status of families was both driver and outcome of tobacco and alcohol use. Health system actions to prevent NCDs were delayed mainly due to lack of system insights and policy influence. A multi-sectoral response led by the health system is urgently needed.

scholarly journals The role of tobacco and alcohol use in the interaction of social determinants of non-communicable diseases in Nepal: a systems perspective

2020 ◽  
Author(s):  
Sudesh Raj Sharma ◽  
Anna Matheson ◽  
Danielle Lambrick ◽  
James Faulkner ◽  
David W Lounsbury ◽  
...  
Keyword(s):  
Data Analysis ◽  
Alcohol Use ◽  
Health System ◽  
Health Systems ◽  
Social Determinants ◽  
Economic Status ◽  
Non Communicable Diseases ◽  
Causal Loop ◽  
Socio Economic Status

Abstract Background: Tobacco and alcohol use are major behavioural risks in developing countries like Nepal, which are contributing to a rapid increase in non-communicable diseases (NCDs). This causal relationship is further complicated by the multi-level social determinants such as socio-political context, socio-economic factors and health systems. The systems approach has potential to facilitate understanding of such complex causal mechanisms. The objective of this paper is to describe the role of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Method: The study adopted a qualitative study design guided by the Systemic Intervention methodology. The study involved key informant interviews (n=63) and focus group discussions (n=12) at different levels (national, district and/or community) and was informed by the adapted Social Determinants of Health Framework. The data analysis involved case study-based thematic analysis using framework approach and development of causal loop diagrams. The study also involved three sense-making sessions with key stakeholders. Results: Three key themes and causal loop diagrams emerged from the data analysis. Widespread availability of tobacco and alcohol products contributed to the use and addiction of tobacco and alcohol. Low focus on primary prevention by health systems and political influence of tobacco and alcohol industries were the major contributors to the problem. Gender and socio-economic status of families/communities were identified as key social determinants of tobacco and alcohol use. Conclusion: Tobacco and alcohol use facilitated interaction of the social determinants of NCDs in the context of Nepal. Socio-economic status of families was both driver and outcome of tobacco and alcohol use. Health system actions to prevent NCDs were delayed mainly due to lack of system insights and commercial influence. A multi-sectoral response led by the health system is urgently needed.

scholarly journals The role of tobacco and alcohol use in the interaction of social determinants of non-communicable diseases in Nepal: a systems perspective

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sudesh Raj Sharma ◽  
Anna Matheson ◽  
Danielle Lambrick ◽  
James Faulkner ◽  
David W. Lounsbury ◽  
...  
Keyword(s):  
Data Analysis ◽  
Alcohol Use ◽  
Health System ◽  
Health Systems ◽  
Social Determinants ◽  
Economic Status ◽  
Non Communicable Diseases ◽  
Causal Loop ◽  
Socio Economic Status

Abstract Background Tobacco and alcohol use are major behavioural risks in developing countries like Nepal, which are contributing to a rapid increase in non-communicable diseases (NCDs). This causal relationship is further complicated by the multi-level social determinants such as socio-political context, socio-economic factors and health systems. The systems approach has potential to facilitate understanding of such complex causal mechanisms. The objective of this paper is to describe the role of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Method The study adopted a qualitative study design guided by the Systemic Intervention methodology. The study involved key informant interviews (n = 63) and focus group discussions (n = 12) at different levels (national, district and/or community) and was informed by the adapted Social Determinants of Health Framework. The data analysis involved case study-based thematic analysis using framework approach and development of causal loop diagrams. The study also involved three sense-making sessions with key stakeholders. Results Three key themes and causal loop diagrams emerged from the data analysis. Widespread availability of tobacco and alcohol products contributed to the use and addiction of tobacco and alcohol. Low focus on primary prevention by health systems and political influence of tobacco and alcohol industries were the major contributors to the problem. Gender and socio-economic status of families/communities were identified as key social determinants of tobacco and alcohol use. Conclusion Tobacco and alcohol use facilitated interaction of the social determinants of NCDs in the context of Nepal. Socio-economic status of families was both driver and outcome of tobacco and alcohol use. Health system actions to prevent NCDs were delayed mainly due to lack of system insights and commercial influence. A multi-sectoral response led by the health system is urgently needed.

scholarly journals The role of tobacco and alcohol use in the interaction of social determinants of non-communicable diseases in Nepal: a systems perspective

2020 ◽  
Author(s):  
Sudesh Raj Sharma ◽  
Anna Matheson ◽  
Danielle Lambrick ◽  
James Faulkner ◽  
David W Lounsbury ◽  
...  
Keyword(s):  
Data Analysis ◽  
Alcohol Use ◽  
Health System ◽  
Health Systems ◽  
Social Determinants ◽  
Economic Status ◽  
Non Communicable Diseases ◽  
Causal Loop ◽  
Socio Economic Status

Abstract Background: Tobacco and alcohol use are major behavioural risks in developing countries like Nepal, which are contributing to a rapid increase in non-communicable diseases (NCDs). This causal relationship is further complicated by the multi-level social determinants such as socio-political context, socio-economic factors and health systems. The systems approach has potential to facilitate understanding of such complex causal mechanisms. The objective of this paper is to describe the role of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Method: The study adopted a qualitative study design guided by the Systemic Intervention methodology. The study involved key informant interviews (n=63) and focus group discussions (n=12) at different levels (national, district and/or community) and was informed by the adapted Social Determinants of Health Framework . The data analysis involved case study-based thematic analysis using framework approach and development of causal loop diagrams. The study also involved three sense-making sessions with key stakeholders. Results: Three key themes and causal loop diagrams emerged from the data analysis. Widespread availability of tobacco and alcohol products contributed to the use and addiction of tobacco and alcohol. Low focus on primary prevention by health systems and political influence of tobacco and alcohol industries were the major contributors to the problem. Gender and socio-economic status of families/communities were identified as key social determinants of tobacco and alcohol use. Conclusion: Tobacco and alcohol use facilitated interaction of the social determinants of NCDs in the context of Nepal. Socio-economic status of families was both driver and outcome of tobacco and alcohol use. Health system actions to prevent NCDs were delayed mainly due to lack of system insights and commercial influence. A multi-sectoral response led by the health system is urgently needed.

scholarly journals 'Tobacco and alcohol use are playing critical role in the interaction of social determinants of non-communicable diseases in Nepal': a systems perspective

2019 ◽  
Author(s):  
Sudesh Raj Sharma ◽  
Anna Matheson ◽  
Danielle Lambrick ◽  
James Faulkner ◽  
David W Lounsbury ◽  
...  
Keyword(s):  
Data Analysis ◽  
Alcohol Use ◽  
Health System ◽  
Social Determinants ◽  
Systems Approach ◽  
Critical Role ◽  
Communicable Diseases ◽  
Causal Mechanism ◽  
Non Communicable Diseases ◽  
Causal Loop

Abstract Background: Tobacco and alcohol use are major behavioural risks in developing countries like Nepal contributing to rapid increase in non-communicable diseases (NCDs). This causal relationship is further complicated by the multi-level social determinants such as socio-political context, socio-economic factors and health system. Systems approach has potential to facilitate understanding of such complex causal mechanism. The objective of this paper was to describe the role of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Method: The study was a qualitative study design guided by the Systemic Intervention methodology. The study involved key informant interviews (n=63) and focus group discussions (n-12) at different levels (policy, district and/or community) and was informed by the adapted Social Determinants of Health Framework . The data analysis involved case study based thematic analysis using framework approach and development of causal loop diagram. The study also involved three sense making sessions with key stakeholders. Results: Five key interacting themes emerged during the data analysis. Habit and misconception relating to alcohol and tobacco use contributed to the use and addiction of tobacco and alcohol. Low focus on prevention by health system further contributed to the problem. Decline in community capital and gendered social constructs influenced tobacco and alcohol use. Socio-economic status of families/communities was discussed as a potential root cause of use and addiction of tobacco and alcohol. These interacting themes were utilized to develop iterative causal loop diagrams showing the influence of tobacco and alcohol use in the interaction of social determinants of NCDs in Nepal. Conclusion: Tobacco and alcohol use and addiction causally linked broader social determinants (social, economic and political) to NCD in the context of Nepal. These CLDs showed how socio-economic circumstances was influencing addiction and availability of tobacco and alcohol products in Nepal. A multi-sectoral response led by health system is urgently needed.

The Influence of Spiritual and Emotional Intelligence on Adult Well-Being

2017 ◽  
Vol 4 (3) ◽  
Author(s):  
Neethu George ◽  
Dr. Kishor Adhikari
Keyword(s):  
Emotional Intelligence ◽  
Data Analysis ◽  
Economic Status ◽  
Well Being ◽  
Spiritual Intelligence ◽  
Self Report ◽  
Socio Economic Status ◽  
Significant Difference ◽  
Emotional Intelligence Inventory

The aim of the research was to decide the role of spiritual intelligence and emotional intelligence in the well-being of adults. The population of this study consisted of 90, adults from Christian, Hindu, Muslim religion and urban Kerala were selected as the sample by purposive random sampling method. The tools used for the reearch was Spiritual Intelligence self-Report Inventory (2009), Mangal Emotional Intelligence Inventory(2001), Ryff’s Psychological Well-Being Scales (1989) and Kuppuswamy’s socioeconomic status scale -revision for 2015. For the data analysis correlation, regression and ANOVA were used. SPSS was used for data analysis. The result of this study points out that there is a positive relationship with spiritual intelligence, emotional intelligence and well-being of an adult. A linear regression established that spiritual intelligence and emotional intelligence could statistically significantly predict well- being. The result is pointing out that there is statistically no significant difference in spiritual intelligence between the different religions and socio- economic status, also no significant difference in emotional intelligence and well- being in different socio- economic status but statistically significant difference in emotional intelligence and well- being between the different religions.

scholarly journals Health system determinants of tuberculosis mortality in South Africa: a causal loop model

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Muhammad Osman ◽  
Aaron S Karat ◽  
Munira Khan ◽  
Sue-Ann Meehan ◽  
Arne von Delft ◽  
...  
Keyword(s):  
South Africa ◽  
Health System ◽  
Economic Status ◽  
Patient Empowerment ◽  
Causal Loop Diagram ◽  
Prevention Strategies ◽  
Loop Diagram ◽  
Causal Loop ◽  
Socio Economic Status ◽  
Related Mortality

Abstract Background Tuberculosis (TB) is a major public health concern in South Africa and TB-related mortality remains unacceptably high. Numerous clinical studies have examined the direct causes of TB-related mortality, but its wider, systemic drivers are less well understood. Applying systems thinking, we aimed to identify factors underlying TB mortality in South Africa and describe their relationships. At a meeting organised by the ‘Optimising TB Treatment Outcomes’ task team of the National TB Think Tank, we drew on the wide expertise of attendees to identify factors underlying TB mortality in South Africa. We generated a causal loop diagram to illustrate how these factors relate to each other. Results Meeting attendees identified nine key variables: three ‘drivers’ (adequacy & availability of tools, implementation of guidelines, and the burden of bureaucracy); three ‘links’ (integration of health services, integration of data systems, and utilisation of prevention strategies); and three ‘outcomes’ (accessibility of services, patient empowerment, and socio-economic status). Through the development and refinement of the causal loop diagram, additional explanatory and linking variables were added and three important reinforcing loops identified. Loop 1, ‘Leadership and management for outcomes’ illustrated that poor leadership led to increased bureaucracy and reduced the accessibility of TB services, which increased TB-related mortality and reinforced poor leadership through patient empowerment. Loop 2, ‘Prevention and structural determinants’ describes the complex reinforcing loop between socio-economic status, patient empowerment, the poor uptake of TB and HIV prevention strategies and increasing TB mortality. Loop 3, ‘System capacity’ describes how fragmented leadership and limited resources compromise the workforce and the performance and accessibility of TB services, and how this negatively affects the demand for higher levels of stewardship. Conclusions Strengthening leadership, reducing bureaucracy, improving integration across all levels of the system, increasing health care worker support, and using windows of opportunity to target points of leverage within the South African health system are needed to both strengthen the system and reduce TB mortality. Further refinement of this model may allow for the identification of additional areas of intervention.

scholarly journals Influence of socio-economic status on Shiga toxin-producing Escherichia coli (STEC) infection incidence, risk factors and clinical features

2019 ◽  
Vol 147 ◽  
Author(s):  
N. L. Adams ◽  
L. Byrne ◽  
T. C. Rose ◽  
G. K. Adak ◽  
C. Jenkins ◽  
...  
Keyword(s):  
Risk Factors ◽  
Escherichia Coli ◽  
Shiga Toxin ◽  
Economic Status ◽  
Care Seeking ◽  
Socio Economic Status ◽  
Accident And Emergency ◽  
Incidence Risk ◽  
Potential Risk Factors

Abstract Shiga toxin-producing Escherichia coli (STEC) infection can cause serious illness including haemolytic uraemic syndrome. The role of socio-economic status (SES) in differential clinical presentation and exposure to potential risk factors amongst STEC cases has not previously been reported in England. We conducted an observational study using a dataset of all STEC cases identified in England, 2010–2015. Odds ratios for clinical characteristics of cases and foodborne, waterborne and environmental risk factors were estimated using logistic regression, stratified by SES, adjusting for baseline demographic factors. Incidence was higher in the highest SES group compared to the lowest (RR 1.54, 95% CI 1.19–2.00). Odds of Accident and Emergency attendance (OR 1.35, 95% CI 1.10–1.75) and hospitalisation (OR 1.71, 95% CI 1.36–2.15) because of illness were higher in the most disadvantaged compared to the least, suggesting potential lower ascertainment of milder cases or delayed care-seeking behaviour in disadvantaged groups. Advantaged individuals were significantly more likely to report salad/fruit/vegetable/herb consumption (OR 1.59, 95% CI 1.16–2.17), non-UK or UK travel (OR 1.76, 95% CI 1.40–2.27; OR 1.85, 95% CI 1.35–2.56) and environmental exposures (walking in a paddock, OR 1.82, 95% CI 1.22–2.70; soil contact, OR 1.52, 95% CI 2.13–1.09) suggesting other unmeasured risks, such as person-to-person transmission, could be more important in the most disadvantaged group.

scholarly journals Values and Sex Behavior Attitude among Engineering College Students in Relation to Socio-economic Status

2017 ◽  
Vol 4 (2) ◽  
Author(s):  
Mr. Ashok B. Patil ◽  
Dr. G. B. Chaudhari
Keyword(s):  
College Students ◽  
Soft Skills ◽  
Economic Status ◽  
Skills Training ◽  
Sex Behavior ◽  
Age Group ◽  
Socio Economic Status ◽  
Attitude Inventory ◽  
Management Students

Chakraborty T, Gupta D, Saha R (2017), Role of Psychological Predisposition on Employability of Management Students: Moderation Analysis through Soft Skills Training, International Journal of Indian Psychology, Volume 4, Issue 2,DIP: 18.01.172/20170402, DOI: 10.25215/0402.172In this era, the value and sex behaviour attitude of the Youth plays important role for the healthy society. The present study is conducted to investigate the values and sex behaviour attitude among engineering college students of Jalgaon city. Kamal Dvivedi and Shagufta Hafeez (1995) Values Scale and Dr Yashvir Singh (2004) Sex Behavior Attitude Inventory is used for the for the sample of 40 students of age group 18-22 years from engineering college of  Jalgaon City.

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