Three Wishes for Sickle Cell Disease: Results from a multi-stakeholder vision-casting project in Tennessee

Although sickle cell disease (SCD) is one of the most common genetic disorders in the US, disparities in research and funding persist. To better understand stakeholder priorities, we conducted a virtual vision-casting session utilizing a graphic recorder and content analysis. Stakeholders responded to the question: “If you had three magic wishes for SCD in TN, what would they be?”. Wishes for SCD centered around information and data, care and policy, and community. Better patient-centered information about treatments and modernization of data were high priorities. Stakeholders identified a need for heath equity, starting with lifetime continuity of care and access to curative treatment for all persons with SCD. Key points concerning the community included better patient inclusion in research, increased awareness, and greater public knowledge. SCD patients expressed a desire for honesty, transparency, compassion, and trust. Key areas to address in SCD include better data coordination, more influence on health policy, broader access to care and more community awareness, with the ultimate goal of improving the lives of persons with SCD. Using data to improve care and address health disparities will require researchers listening to stakeholders and understanding multiple perspectives to form unified goals.

Stroke Rehabilitation in Nigeria: Challenges and Opportunities

Stroke rehabilitation offers opportunity for people with impairments and disabilities secondary to stroke. In this regard, there are many advances particularly in the developed countries. Whereas, in the developing countries such as Nigeria there are still many challenges such as lack of guidelines to guide clinicians and other stakeholders, dearth of the neurological rehabilitation professionals, inadequate training of the existing rehabilitation professionals, poor infrastructure, and lack of policies for stroke rehabilitation. However, there are also opportunities as well such as increased national and global focus on non-communicable diseases, partnership with stakeholders in national and global health, leveraging on democratic governance, leveraging on Sustainable Development Goals (SDGs), and leveraging on the systems through which communities deal with stroke. When these opportunities are harnessed, they can help to improve stroke rehabilitation in the country. Additionally, tackling the challenges headlong can help to improve stroke rehabilitation in Nigeria.

Children’s Right to Health: Theory versus Practice

Introduction A research was conducted from 2014 to 2018 to understand the reasons behind the gap between the theoretical affirmation of children’s right to health and its practical realization. Hospitals and healthcare services were chosen as possible settings to understand these reasons and identify the gap. Methods Questionnaires (open-ended questions) were completed throughout the year 2017 with experts working at International level in the field of children’s rights. A survey was set up using a structured multiple-choice questionnaire in Italian, English, and French. The survey was addressed to hospital staff (professionals; managers and administrative staff). All the results from the experts’ questionnaires and from the survey were elaborated using Excel. Result Experts concluded that professionals still have to understand the full value of implementing children’s rights in hospitals and that the United Nations should empower their own action in order to push states towards the respect and full realization of the Convention on the Rights of the Child. The survey results seem to confirm that in healthcare settings professionals’ have difficulties in understanding how to relate to children in order to facilitate the full realization of their right to health. Conclusion The investigation confirmed the existence of a ‘perceptive astigmatism’ as guiding factor for professionals’ behaviour towards children.

Reliability of Clinical Rating Scale in Evaluation of Head Control in children with Cerebral Palsy

Introduction The clinical rating scale for head control assesses control of head/neck in children with neurological conditions. Head control is important for activities of daily living and quality of life in children. Objectives The aim of the study was to determine the intra-rater and inter-rater reliability of the scale in children with Cerebral Palsy. Method The study was a cross-sectional study approved by Research ethics committees of Kano State Ministry of Health and Aminu Kano Teaching Hospital involving children with CP. Three independent raters assessed the children using Clinical Rating Scale for Head Control at two different times, and the intra-rater and inter-rater reliabilities were analyzed using kappa statistics and Bland-Altman analysis. Results Fifty children with CP with mean age, 24.17±12.17 months participated in the study. The result of the study showed that there were very good agreement in all the test positions for the three raters and between the first and the second ratings and in all the test positions between the three raters respectively (k>0.8). Similarly, there was no proportional bias between ratings in 24 of the measurements (p>0.05). Conclusion Clinical rating scale for head control seems to be a reliable instrument. Thus, it can be used to monitor the progress of rehabilitation in CP patients to help improve their quality of life.

Sedentary behavior associates with young adult smoking prevalence: Short communication

Background Sedentary behavior and smoking prevalence in young adults, both prominent population health risks, are high value health promotion targets. Methods Cross sectional design: Public-use data drawn from Wave 3 of the 2001-2002 National Longitudinal Study of Adolescent and Adult Health (Add Health), representing 18-26 year-old young adults, n = 4203. This study examined the association of sedentary behavior and educational attainment with young adult smoking status (smoker versus nonsmoker), using logistic regression analysis. Sedentary behavior was approximated by self-reported hours spent weekly watching television. Follow-up analysis examined the association of nicotine dependence, measured by the Heaviness of Smoking Index (HSI), and sedentary behavior in young adult smokers, using General Linear Modeling. Results Comparing sedentary behavior quartiles (1 and 4, least and most), smoking prevalence was 30% lower in quartile 1 (OR=0.698 [CI=0.566-0.862] (p=0.001), and 19% lower in quartile 2 (OR=0.813 [CI=0.662-0.998] (p=0.048). Young adult smoking prevalence was increased among young adults with high school education or less compared to those having attended at least some college (OR=2.22 [CI=1.876-2.635], p=0.001). Follow-up General Linear Modeling showed no effect of sedentary behavior on the Heaviness of Smoking Index (HSI) among young adult smokers, p=0.065. Conclusion Although sedentary behavior and lower educational attainment associate with greater young adult smoking prevalence, more sedentary young adult smokers are no more nicotine dependent. Potential benefits of incorporating measures to increased daily movement in into smoking cessation programs are discussed.

A Scoping Review of Health Promotion in the Nursing Home Setting

Background Nursing homes in many countries continue to follow a traditional medical model of care. This study explored health promotion approaches in the nursing home setting, partly in order to move away from a medical model and to improve the well-being of residents and staff. Methods A scoping study was conducted to review the scientific literature. The Integrated Model of Population Health and Health Promotion was adapted for utilization with the literature analysis. Result A total of 64 publications met the inclusion criteria and were analysed. Five main approaches were shown to have applied health promotion in nursing homes, although gaps were present in the usage of systematically applied health promotion. Conclusion A variety of approaches do exist for the nursing home setting which apply health promotion; however, their usage is fragmented. This study revealed that a framework designed to support nursing homes in the systematic usage of health promotion, could improve the well-being for both residents and staff.