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☐ ☆ ✇ BMJ Open

Examining tobacco consumption: prevalence and associated factors among Cambodians aged 15-49 from the 2021-2022 Demographic and Health Survey

Por: Oo · M. Z. · Tint · S. S. · Rerkasem · A. · Leakhena · P. · Wiwatkunupakarn · N. · Angkurawaranon · C. · Rerkasem · K. — Diciembre 15th 2025 at 06:41
Objectives

Tobacco consumption is a significant preventable cause of death worldwide. This study aimed to assess the prevalence and associated factors of tobacco consumption among Cambodian individuals aged 15–49, utilising data from the 2021–2022 Cambodia Demographic and Health Survey (CDHS).

Design

Cross-sectional study based on secondary analysis of the 2021–2022 CDHS.

Setting

Nationwide household survey conducted across urban and rural areas of Cambodia.

Participants

A total of 28 321 respondents aged 15–49 years were included in the analysis.

Outcome measures

Tobacco consumption categorised as no use, smoking tobacco, smokeless tobacco and dual use. Descriptive statistics, 2 tests and multinomial logistic regression were used to assess associations between background characteristics and tobacco consumption, with ‘no consumption’ as the reference category. Statistical significance was set at p

Results

Among the 28 321 respondents (68.8% female), 91.8% were non-users of tobacco (reference group), while 6.9% reported smoking (predominantly males; adjusted relative risk ratios (ARRR)=39.29, 95% CI 29.70 to 51.96, p

Conclusions

While Cambodia has made notable progress in reducing tobacco consumption, the persistent challenges highlighted by the prevalence of smoking, particularly among specific demographics, indicate the need for targeted public health interventions.

☐ ☆ ✇ BMJ Open

Knowledge, perceptions and practices of informal medicine vendors regarding over-the-counter distribution of antibiotics and antibiotic resistance in Nanoro District, Burkina Faso: an exploratory qualitative study

Por: Kouanda · J. S. · Campbell · L. · Meudec · M. · Welgo · A. · Diagne · P. M. · Ingelbeen · B. · van Kleef · E. V. · Valia · D. · van der Sande · M. A. · Tinto · H. · Wouters · E. — Diciembre 4th 2025 at 09:48
Objectives

This study aimed to understand the knowledge possessed by informal medicine vendors regarding antibiotics and antibiotic resistance, identify the perceptions held by informal medicine vendors about antibiotics and their uses and examine the practices employed by informal medicine vendors in the sale and distribution of antibiotics.

Design

Exploratory qualitative study using semi-structured interviews and direct observations.

Setting

Markets and shops across 11 villages in the Nanoro health district, Burkina Faso.

Participants

23 informal medicine vendors, aged between 25 and 55 years and with 8–30 years of experience, were recruited through snowball sampling in the Nanoro health district of Burkina Faso.

Results

Informal medicine vendors exhibited a limited understanding of antibiotics, often confusing them with other treatments and referring to them using local terminologies based on perceived use and effectiveness. Antibiotics were perceived as universal remedies, supported by therapeutic belief, empirical reasoning and community solidarity, with empirical diagnosis, approximate dosing and informal preparation techniques passed on through imitation. These findings emerged across themes including perceptions, symbolic attributes and sales practices.

Conclusion

Informal medicine vendors in rural Burkina Faso demonstrated limited understanding of antibiotics and antimicrobial resistance, with practices shaped by local beliefs and empirical experience. These findings underscore the need for context-sensitive interventions that include tailored education and regulatory engagement to improve antibiotic stewardship and mitigate the spread of resistance.

☐ ☆ ✇ BMJ Open

Is exposure to cement dust and heavy metals associated with reduced pulmonary function? A cross-sectional study among cement factory workers in Türkiye

Por: Cetintepe · S. P. · Demirbas · O. B. · Dinke · B. · Ilhan · M. N. — Julio 9th 2025 at 03:44
Objectives

To assess the relation of exposure to cement dust and heavy metal (aluminium, cadmium and lead) exposures to pulmonary function among male cement plant workers. The study also aimed to evaluate dose–response relationships and prevalence and severity of respiratory symptoms among exposure categories compared with a control group.

Design

Cross-sectional study.

Setting

Secondary-level occupational health clinic in Ankara, Türkiye.

Participants

461 male non-smoking cement plant employees were included in total. Participants were categorised into packaging (n=101), milling (n=162) and office unexposed workers (n=198). Inclusion criteria were more than 70% work history in the cement industry and exclusion of pre-existing respiratory disease and missing data from the participants.

Interventions

Not applicable.

Primary and secondary outcome measures

Pulmonary function tests (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC and peak expiratory flow (PEF)) and urinary, cadmium and blood lead concentrations were measured. Lung function impairment was the primary outcome measure; secondary outcomes included metal exposure—pulmonary measure correlations.

Results

Significant negative correlations existed between FEV1 and urine aluminium (r=–0.622, p

Conclusions

Occupational cement dust and heavy metal exposure is closely linked to impaired pulmonary function in cement plant employees, particularly those who work in higher exposure jobs. The implications are robust endorsement of targeted monitoring and preventive interventions. Long-term longitudinal research is necessary to identify long-term outcome and efficacy of exposure reduction approaches.

☐ ☆ ✇ Nursing Research

Urine Metabolites as Indicators of Chronic Pain and Related Symptoms in Active-Duty Service Members: A Secondary Data Analysis of a Pragmatic Clinical Trial With SMART Design

imageBackground Chronic pain is a major cause of distress and disability, and biomarkers may aid in the assessment and treatment of it. Urine metabolites may be valuable bioindicators that can provide biological insight regarding chronic pain. Objectives To investigate the relationship between a multimarker composite measure of metabolites and patient-reported outcomes scores in adults with chronic pain, using data from a pragmatic clinical trial with a sequential, multiple-assignment randomized trial design. Methods Self-reported measures and urine samples from 169 active-duty service members with chronic pain were collected. Urine was analyzed using a preestablished panel of metabolites, including four previously identified biomarkers of pain: kynurenic acid, pyroglutamic acid, ethylmalonic acid, and methylmalonate. Multivariable linear regression models—adjusted for participant characteristics such as age and sex—were used to cross-sectionally examine the relationship between 11 patient-reported outcomes (fatigue, sleep-related impairment, anxiety, depression, anger, pain catastrophizing, physical function, pain interference, satisfaction with participation with social roles, pain intensity, and pain impact score) and the four urine metabolites both individually and as a composite (urine metabolite pain indicator, or UMPI). Given the study’s small sample size and exploratory nature, a significance threshold of p ≤ .10 was used for all analyses. Results The UMPI showed statistically significant associations with five self-reported measures (fatigue, anxiety, depression, physical functioning, and pain impact score); adjusted Pearson correlations ranged from .18 to .25. Individual metabolite analyses supported these findings, with all relationships between individual metabolites and self-reported measures showing positive associations. Kynurenic acid and ethylmalonic acid showed the strongest associations, each having statistically significant relationships with four individual self-reported measures, while pyroglutamic acid had statistically significant relationships with three self-reported measures and methylmalonate with none. The UMPI demonstrated feasible reliability. Discussion Our finding of associations between the UMPI and components of the self-reported measures supports the development of the UMPI and these four urine metabolites as biomarkers for chronic pain outcomes. Further research is planned and will be essential for establishing mechanistic insight and guiding biomarker development within the context of pain management.
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