The Cultural Meaning of Cardiac Illness and Self-Care Among Lebanese Patients With Coronary Artery Disease

BACKGROUND: Cardiac disease is the leading cause of death in Lebanon, accounting for 22% to 26% of total deaths in the country. A thorough understanding of perceptions of cardiac illness and related self-care management is critical to the development of secondary prevention programs that are specific to the Lebanese culture. PURPOSE: To explore the cultural perceptions of cardiac illness and the associated meaning of self-care among Lebanese patients. DESIGN: Using a qualitative descriptive method, semistructured interviews were conducted with a purposive sample of 15 Lebanese cardiac patients recruited from a medical center in Beirut, Lebanon. FINDINGS: The qualitative descriptive analysis yielded one overarching and two other themes describing perceptions of cardiac illness and self-care within the Lebanese cultural context. The overarching cultural theme was, Lebanese cardiac patients were unfamiliar with the term concept and meaning of self-care. Lebanese cardiac patients thanked God and accepted their fate (Theme I). The participants considered their cardiac incident a life or death warning (Theme II). IMPLICATIONS FOR PRACTICE: Health care providers need to consider patients' cultural perception of illness while planning and evaluating cardiac self-care programs

Explaining the Reduction in Child Undernutrition in the Indian State of Maharashtra Between 2006 and 2012: An Analysis of the Policy Processes

The Indian state of Maharashtra has been lauded as a ‘success story’ for its rapid and significant decline in undernutrition amongst children. Between 2006 and 2012, childhood stunting fell from 39 to 24%. Whilst the global policy and academic literature strongly emphasises the need to act on nutrition, there are still too few studies outlining the policy processes which been part of successful state-led strategies – particularly at a sub-national level. This study is intended to contribute to future policy via unpacking the unfolding story of policy and programme attention to nutrition. Stakeholder perceptions and opinions on the wider policy, political and contextual reasons for Maharashtra’s decline in child undernutrition were sought and used alongside documentary evidence to construct a chronology of key events. Key factors identified via this process include the way in which issue framing and evidence helped catalyse a political response; the particular governance structures employed in response (the State’s ‘Nutrition Mission’) and the way in which leadership and a focus on system-wide capacity combined in an innovative fashion to focus resources on pockets of deprivation in high-burden areas

Hearing Threshold of Korean Adolescents Associated with the Use of Personal Music Players

Purpose: Hearing loss can lead to a number of disabilities and can reduce quality of life. Noise-induced hearing losses have become more common among adolescents due to increased exposure to personal music players. We, therefore, investigated the use of personal music player among Korean adolescents and the relationship between hearing threshold and usage pattern of portable music players. Materials and Methods: A total of 490 adolescents were interviewed personally regarding their use of portable music players, including the time and type of player and the type of headphone used. Pure tone audiometry was performed in each subject. Results: Of the 490 subjects, 462 (94.3%) used personal music players and most of them have used the personal music player for 1-3 hours per day during 1-3 years. The most common type of portable music player was the MP3 player, and the most common type of headphone was the earphone (insert type). Significant elevations of hearing threshold were observed in males, in adolescents who had used portable music players for over 5 years, for those over 15 years in cumulative period and in those who had used earphones. Conclusion: Portable music players can have a deleterious effect on hearing threshold in adolescents. To preserve hearing, adolescents should avoid using portable music players for long periods of time and should avoid using earphones