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  1. Marzo RR, Bhattacharya S
    J Family Med Prim Care, 2022 Nov;11(11):6772-6777.
    PMID: 36993001 DOI: 10.4103/jfmpc.jfmpc_271_19
    INTRODUCTION: Globally, mental health today poses a significant hazard to all of us. It is more vital for students, whose survival in a highly competitive atmosphere places them under enormous pressure.

    AIM AND OBJECTIVE: This qualitative study sought to determine how mental health counsellors now address the mental health concerns of their pupils. To achieve this objective, two research questions were developed to direct this study: (1) What are the experiences of counsellors who provide support to students with mental health issues? (2) How might guidance and counselling services and programmes enhance the academic success of students with mental health issues?

    METHODOLOGY: Participants were selected from a university in a northern Malaysian neighbourhood. Several semi-structured, in-depth interviews were conducted with two counsellors to collect data.

    RESULTS: Overall, the counsellors regarded multitasking to be a hindrance to their job performance. Participants felt that their caseloads prevented them from being proactive with each student, resulting in irritation. According to the participants, the job's requirements have changed, but the number of tasks and caseload have not. This has led to feelings of exhaustion and frustration. The study revealed two important research's findings: first, there has been an increase in the number of mental health concerns, particularly anxiety and depression, among students; second, counsellors would be able to effectively support children intellectually and personally if they had appropriate staffing and professional development.

    CONCLUSION: It was concluded that the counselors regarded multitasking was a hindrance to their job performance. Participants reported an increase in the frequency of anxiety and depression exhibited by their students and they felt that additional programming with friends, family, and professors could increase students' social well-being.

  2. King I, Heidler P, Marzo RR
    Vaccines (Basel), 2021 Jul 15;9(7).
    PMID: 34358206 DOI: 10.3390/vaccines9070790
    Acceptance of the COVID-19 vaccine will play a crucial role in combating the current pandemic. Vaccine rollouts have started in most countries. To reach the desirable vaccine coverage and to enhance its uptake, it is imperative to assess vaccine hesitancy.

    METHODS: To assess the current vaccine acceptability in Austria and its influencing factors, an online survey was created and comprised fifteen questions segmented into a sociodemographic part and the acceptance and influencing factors of the approval of the COVID-19 vaccine.

    RESULTS: In total, 70% of the 1350 respondents thought that the COVID-19 vaccine is an effective way to prevent and control the virus, while 13% disagreed and 17% were uncertain. Further, 71% approved the rapid development and rollout of the vaccine, while 55% were willing to accept the vaccine as soon as it became available, 18% did not want to get the vaccine, 17% wanted to delay, and 10% were already vaccinated.

    CONCLUSIONS: The results show a generally positive attitude towards the new COVID-19 vaccine. The doctor's recommendation greatly influences the decision-making process, and tailored vaccine information can support a higher vaccine coverage.

  3. Marzo RR, Singh A, Mukti RF
    PMID: 33462563 DOI: 10.1016/j.cegh.2020.100693
    INTRODUCTION: Previous studies conducted on the psychological impact of infectious outbreaks have found heavy psychological burdens among general population with more severe affect in the current pandemic. The main aim of this study is to examine the level of psychological distress during COVID-19 in Bangladesh and explore factors associated with higher psychological distress.

    METHODS: An internet-based, cross-sectional survey was conducted from March to April 2020 in Bangladesh among adults 18 years old and above using structured online questionnaires distributed through emails and other social media throughout Bangladesh with an overall response rate of 34%. Modified version of the Covid19 peritraumatic distress index (CPDI) was used to measure distress. Univariate and Bivariate analysis was used to estimate prevalence of CPDI symptoms and test for the associations between CPDI and the exposure variables. Logistic regression analyses were used to estimate the odds ratios of our outcome variable by exposure variables.

    RESULTS: Overall, 44.3% of respondents were suffering from mild to moderate distress and 9.5% were suffering from severe distress. Female respondents were 2.435 times more likely to suffer from CPDI mild to severe distress than males. As compared to Dhaka and Mymensing region of Bangladesh, odds of distress was 1.945 times more in Chittagong/Sylhet region (p-value = 0.035).

    CONCLUSION: Large proportion of adult population in Bangladesh are experiencing psychological distress, with level of distress varies by different symptoms and predictors. This study suggest the need to develop comprehensive crisis prevention system including epidemiological monitoring, screening, and referral with targeted intervention to reduce psychological distress.

  4. Bhattacharya S, Heidler P, Saleem SM, Marzo RR
    Front Public Health, 2022;10:945082.
    PMID: 36033797 DOI: 10.3389/fpubh.2022.945082
    INTRODUCTION: Digital eye strain, which is often ignored by the public, has emerged as a "Shadow Pandemic" in the era of the COVID-19 pandemic.

    AIM: The current paper is aimed at discussing the ill effect of digital screens on eyes in the wake of the COVID-19 pandemic.

    METHODOLOGY: A literature search was done using "PubMed," "Google scholar", and "Scopus" using key terms like "Digital Eye Strain," "Eyestrain," or "Computer Vision Syndrome." Relevant articles were identified and included to support the argument for this narrative review.

    RESULTS: Studies conducted in the UK reported that 68% of children extensively use computers, while 54% undertake online activities after the age of 3. Similar studies estimated 4 h and 45 min per day of screen exposure time among adults in the UK. Indian studies reveal that the prevalence of DES is 69% in adults and 50% in children respectively. Indian ophthalmologists found that computer-using and specialized ophthalmologists were more informed of symptoms and diagnostic signs but were misinformed about treatment modalities. The use of social media and multitasking is particularly prominent among younger adults, with 87% of individuals aged 20-29 years reporting the use of two or more digital devices simultaneously. It has been observed that the use of computer glasses corrects refractive errors and helps in the reduction of symptoms, while precision spectral filters help in reducing symptoms of micro-fluctuation of accommodation.

    CONCLUSION: We concluded that DES is emerging globally as a "Shadow Pandemic" and it is high time to respond. Community ophthalmologists, public health authorities, and educational sectors especially should be involved to prevent this.

  5. Bhattacharya S, Bhattacharya S, Vallabh V, Marzo RR, Juyal R, Gokdemir O
    Int J MCH AIDS, 2023;12(1):e588.
    PMID: 36683649 DOI: 10.21106/ijma.588
    "No man is an island unto himself" - John Donne According to the World Health Organization, health is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity." Our healthcare industry, public behaviors, and environment have grown exponentially with digital technologies in the era of the 4th industrial revolution. Due to rapid digitalization and easy availability of the internet, we are now online round the clock on our digital devices, leaving behind digital traces/information. These digital footprints serve as an increasingly fruitful data source for social scientists, including those interested in demographic research. The collection and use of digital data (quantitative and qualitative) also present numerous statistical and computational opportunities, further motivating the development of new research approaches to address health issues. In this paper, we have described the concept of digital well-being and proposed how we can use digital information for good health.
  6. Bhattacharya S, Saleem SM, Singh DK, Marzo RR, Singh A
    PMID: 33688550 DOI: 10.4103/jehp.jehp_280_20
    INTRODUCTION: We know that risk communication is equally important as risk identification, which is usually not communicated properly to the patients and resulting in poor outcomes, especially in hypertensive patients.

    OBJECTIVE: Our study objective was to evolve and test a colour coded client segmentation based public health approach to educate the community to deal with problem of hypertension.

    METHODOLOGY: This cross-sectional pilot study was done in March 2020 among purposively approached in a primary health centre to 100 people aged above 18 years, among them 41 gave written consent for the study and their demographic information was noted. They were given colour coded cards as per the current blood pressure level and previous history of hypertension. On each colour coded card, specific advice was written for that category. For all the participants, blood pressure and treatment seeking behaviour was noted. For hypertensive patients, adherence to medication and non-pharmacological measures was noted.

    RESULTS: Mean age of the participants was 46.5 ± 13.06 years. Mean systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the participants were 135 ± 16.85 mm Hg and 86 ± 11.42 mm Hg, respectively. Among the participants, 10 (24.39%) had a known history of hypertension. Among them, as per the blood pressure levels measured on the day of the study 50% (5) had their blood pressure levels under control. Interestingly 16 (39%) participants were found hypertensive incidentally.

    DISCUSSION: It is evident from the studies that colour coded approach is used in multiple ways, in multiple settings, for multiple diseases. To our knowledge, little focus has been given for hypertensive disorders in the community level. We merely bother about making their risk profiling, even in the digital age. Sometimes physicians in emergency become puzzled whenever patients collapsed in front of them and we missed the "Golden Hour" for the treatment by searching patients' medical details.

    CONCLUSION AND RECOMMENDATIONS: The above problem can be solved by risk profiling of chronic patients by colour coded OPD/Health cards.

  7. Bhattacharya S, Tripathi S, Marzo RR, Gokdemir O, Borocco M
    J Family Med Prim Care, 2023 Feb;12(2):397-399.
    PMID: 37091001 DOI: 10.4103/jfmpc.jfmpc_1218_22
    "Health for All" will never be attained if sociocultural bias and pervasive hypocrisy are not eliminated. The patient mentioned in this case study had difficulty gaining access to health care for more than two decades. The seizure history was modified due to social pressure. The primary healthcare workers' ability to provide timely access to healthcare regardless of caste, religion, or gender, even in the most remote regions of the country, is of paramount importance. The patient was diagnosed with hypoparathyroidism and treated with calcium and vitamin D in high oral doses. The case also illustrates the significance of medical examination in preventing future difficulties in patients with presenile cataract.
  8. Shikha D, Kushwaha P, Gokdemir O, Marzo RR, Bhattacharya S
    Front Public Health, 2023;11:1128257.
    PMID: 37056654 DOI: 10.3389/fpubh.2023.1128257
  9. Daniyal M, Qureshi M, Marzo RR, Aljuaid M, Shahid D
    BMC Health Serv Res, 2024 May 09;24(1):587.
    PMID: 38725039 DOI: 10.1186/s12913-024-10928-x
    BACKGROUND OF STUDY: Over the past few decades, the utilization of Artificial Intelligence (AI) has surged in popularity, and its application in the medical field is witnessing a global increase. Nevertheless, the implementation of AI-based healthcare solutions has been slow in developing nations like Pakistan. This unique study aims to assess the opinion of clinical specialists on the future replacement of AI, its associated benefits, and its drawbacks in form southern region of Pakistan.

    MATERIAL AND METHODS: A cross-sectional selective study was conducted from 140 clinical specialists (Surgery = 24, Pathology = 31, Radiology = 35, Gynecology = 35, Pediatric = 17) from the neglected southern Punjab region of Pakistan. The study was analyzed using χ2 - the test of association and the nexus between different factors was examined by multinomial logistic regression.

    RESULTS: Out of 140 respondents, 34 (24.3%) believed hospitals were ready for AI, while 81 (57.9%) disagreed. Additionally, 42(30.0%) were concerned about privacy violations, and 70(50%) feared AI could lead to unemployment. Specialists with less than 6 years of experience are more likely to embrace AI (p = 0.0327, OR = 3.184, 95% C.I; 0.262, 3.556) and those who firmly believe that AI knowledge will not replace their future tasks exhibit a lower likelihood of accepting AI (p = 0.015, OR = 0.235, 95% C.I: (0.073, 0.758). Clinical specialists who perceive AI as a technology that encompasses both drawbacks and benefits demonstrated a higher likelihood of accepting its adoption (p = 0.084, OR = 2.969, 95% C.I; 0.865, 5.187).

    CONCLUSION: Clinical specialists have embraced AI as the future of the medical field while acknowledging concerns about privacy and unemployment.

  10. Bhattacharya S, Pradhan KB, Bashar MA, Tripathi S, Semwal J, Marzo RR, et al.
    J Family Med Prim Care, 2019 Nov;8(11):3461-3464.
    PMID: 31803636 DOI: 10.4103/jfmpc.jfmpc_155_19
    In this paper, we have described the health care problem (maldistribution of doctors) in India. Later, we have introduced the concept of artificial intelligence and we have described this technology with various examples, how it is rapidly changing the health care scenario across the world. We have also described the various advantages of artificial intelligence technology. At the end of the paper, we have raised some serious concerns regarding complete replacement of human based health care technology with artificial intelligence technology. Lastly, we concluded that we have to use artificial intelligent technology to prevent human sufferings/health care problems with proper caution.
  11. Marzo RR, Bhattacharya S, Ravichandran S, Lakshmanan P, Jeffery VR, Moralitheran P, et al.
    PMID: 32002422 DOI: 10.4103/jehp.jehp_192_19
    INTRODUCTION: Smoking is one of the leading factors of mortality in Malaysia. Most youngsters start at adolescence, fascinated by the concept of smoking. Interventions that harness the broad availability of mobile phones, as well as adolescents' interest in their appearance, may be an innovative way to advance school-based prevention. This study aims to determine the perceptions of facial-aging apps among secondary school students.

    METHODOLOGY: For this research, descriptive cross-sectional study using simple random sampling method was used. Population sampling was targeted toward three government schools. The total number of respondents is 383, with all of them aged between 13 and- 16 years of age. Legal considerations were taken to maintain the confidentiality of respondents. The specific objectives are: 1. To determine the level of change of intention on smoking, 2. To know the perceived reactions of the peer groups on the appearances of students as nonsmokers, 3. To determine whether the students learned new benefits of nonsmokingand, 4. To measure the impact of a facial-aging app among students.

    RESULTS: The number of respondents who smoke was 40 (10.4%), while the number of respondents who do not smoke was 343 (89.6%). About 89% of the respondents agree that their three-dimensional selfie image motivates them not to smoke. In addition, 87.8% of respondents admit that the perceived reactions of their classmates make them think that they look better as nonsmokers. After learning the effects of smoking, about 86.4% of the respondents acknowledged that they would educate their peer groups. Furthermore, 85.9% of the respondents found this "Smokerface" app enjoyable.

    CONCLUSION: The facial-aging intervention was effective in motivating Malaysian pupils to stay away from tobacco use. Thus, the analysis on the study of facial app usage in smoking prevention among youngsters concludes that most of the adolescents concur that the "Smokerface" app helps in the prevention of smoking among youths.

  12. Bhattacharya S, Singh A, Semwal J, Marzo RR, Sharma N, Goyal M, et al.
    PMID: 32154300 DOI: 10.4103/jehp.jehp_423_19
    INTRODUCTION: Disaster can occur at any time any place. Disaster preparedness plays an important role to reduce the loss of a community/country. The aim of this interventional study was to ascertain the impact of a video-based educational intervention program on improvement in knowledge and attitude of paramedical students in a hospital.

    MATERIALS AND METHODS: A pre-post study (interventional study design) was conducted on paramedic students. Our study period was 6 months which was divided into Phases I, II, and III. For administrative purpose, we included all paramedical students, and our sample size was 119. The baseline assessment of knowledge and attitude of paramedic students was done by a pretested questionnaire (Observation 1) with having a baseline scoring. After that, intervention Phase 1 was implemented, and later, end line observation (Observation 2) was made. Changes in knowledge and attitude were observed by the score difference (Observation 2-Observation 1). Descriptive statistics were calculated, and the mean of cumulative score was compared using the Wilcoxon signed-rank test. We applied Mann-Whitney U-test for finding associations between dependent variables with an independent variable using SPSS version 22 (IBM, Chicago, USA) software.

    RESULTS: Our baseline results showed that most of our participants had average knowledge (54.6%), followed by poor knowledge (24.4%). Approximately one-fifth (21.0%) of the participants had good knowledge regarding disaster preparedness. A significant improvement was observed in cumulative score (P < 0.005). A significant difference was observed in knowledge and attitude with respect to age and courses (P < 0.05). Forty percent of the students responded that they would like to get trained by that mock drill, and 26.1% were interested in disaster preparedness workshops in the future.

    CONCLUSION: Our present study results indicate that the overall knowledge and attitude level of the students was average and required improvement. A similar result was reported in some studies conducted globally for the same purpose. All of our students perceived that training for disaster preparedness is necessary for all health facilities, and it is important to have an emergency plan and disaster management committee. Regarding training methods, most of our students liked our interactive audiovisual method. However, their preferred methods were mock drill and workshops. It can be arranged in the future for them.

  13. Pervin MR, Parvin R, Babu MA, Ahmmed MM, Marzo RR
    J Public Health Res, 2021 Nov 08;10(s2).
    PMID: 34751531 DOI: 10.4081/jphr.2021.2271
    BACKGROUND: Bangladesh has been going through the austerity of the unique COVID-19 for more than a year like several other nations in the world in spite of concerted efforts taken by the government along with other concerned authorities who have advocated compulsory guidelines involving social distancing procedures accompanied by lockdown to have control over the pandemic. In this paper, the barriers faced by the government to protect people from the COVID-19 pandemic have been investigated. Also, the number of daily infected people against the number of daily tests has been underlined to comprehend the overall pandemic picture in Bangladesh.

    DESIGN AND METHODS: A descriptive study has been carried out to investigate the obstacles to tackle the COVID-19 pandemic for this country. The intensity of the outbreaks of the pandemic in this country is stated from March 8, 2020, to February 12, 2021. Secondary data have been employed from different sources to serve the goals of the study.

    RESULTS: The poor management in the health sector of Bangladesh has been an issue of major concern during the early stage of COVID-19 which incorporates deficiency of medical equipment, lack of facilities for testing COVID-19, poor patient management, and uncertainty in the medication system. Finally, some recommendations have been proposed for the concerned organizations to tackle the current pandemic and as well in the future.

    CONCLUSIONS: To control this COVID-19 pandemic, it is necessary to find the difficulties and discover the remedies which have been done in this paper for the Bangladesh perspective.

  14. Qureshi M, Khan S, Bantan RAR, Daniyal M, Elgarhy M, Marzo RR, et al.
    J Clin Med, 2022 Nov 04;11(21).
    PMID: 36362783 DOI: 10.3390/jcm11216555
    BACKGROUND: Monkeypox virus is gaining attention due to its severity and spread among people. This study sheds light on the modeling and forecasting of new monkeypox cases. Knowledge about the future situation of the virus using a more accurate time series and stochastic models is required for future actions and plans to cope with the challenge.

    METHODS: We conduct a side-by-side comparison of the machine learning approach with the traditional time series model. The multilayer perceptron model (MLP), a machine learning technique, and the Box-Jenkins methodology, also known as the ARIMA model, are used for classical modeling. Both methods are applied to the Monkeypox cumulative data set and compared using different model selection criteria such as root mean square error, mean square error, mean absolute error, and mean absolute percentage error.

    RESULTS: With a root mean square error of 150.78, the monkeypox series follows the ARIMA (7,1,7) model among the other potential models. Comparatively, we use the multilayer perceptron (MLP) model, which employs the sigmoid activation function and has a different number of hidden neurons in a single hidden layer. The root mean square error of the MLP model, which uses a single input and ten hidden neurons, is 54.40, significantly lower than that of the ARIMA model. The actual confirmed cases versus estimated or fitted plots also demonstrate that the multilayer perceptron model has a better fit for the monkeypox data than the ARIMA model.

    CONCLUSIONS AND RECOMMENDATION: When it comes to predicting monkeypox, the machine learning method outperforms the traditional time series. A better match can be achieved in future studies by applying the extreme learning machine model (ELM), support vector machine (SVM), and some other methods with various activation functions. It is thus concluded that the selected data provide a real picture of the virus. If the situations remain the same, governments and other stockholders should ensure the follow-up of Standard Operating Procedures (SOPs) among the masses, as the trends will continue rising in the upcoming 10 days. However, governments should take some serious interventions to cope with the virus.

    LIMITATION: In the ARIMA models selected for forecasting, we did not incorporate the effect of covariates such as the effect of net migration of monkeypox virus patients, government interventions, etc.

  15. Eltewacy NK, Nabil S, Sweedy R, Marzo RR, Hamza N, EARG Group
    Front Public Health, 2022;10:1018757.
    PMID: 36324469 DOI: 10.3389/fpubh.2022.1018757
    INTRODUCTION: During the COVID-19 lockdown, people's lifestyles have changed including their habits and physical activities. There has been an increase in anabolic hormones and nutritional supplement use among people who regularly do exercise in the MENA region. This study aims to assess knowledge, practice, and attitude toward the use of anabolic hormones and nutritional supplements among people who regularly exercise in the Middle East and North Africa (MENA) region and to compare their exercise habits and hormones and supplements usage between before and during COVID-19 lockdown.

    METHODS: A self-administrated online Google form survey was carried out between February 2021 and April 2021. Five thousand eight hundred forty-five participants who regularly exercise and aged ≥18 years responded to the questionnaire. The questionnaire was distributed through social media platforms and included five sections: demographic, training characters, knowledge, practice, and attitude.

    RESULTS: The participants mean age was 27.4 ± 8.6 years. Males represented 58.2 % of participants. 75.3% of the study participants had not used either hormones or supplements, and about 19% used supplements only. The mean percent score for knowledge, practice, and attitude were 39.3 ± 30.5, 1.1 ± 9.5, and 21.3 ± 23.8, respectively. Level of knowledge was higher among participants who worked in the medical field or as sports coaches. The practice was higher among male participants. The most commonly used anabolic hormones and nutritional supplements were steroids and proteins with bodybuilding being the most common purpose. Internet was the main source of information and pharmacy was the main source for procuring these substances. There was a significant decrease in proteins, carbohydrates, and sports drinks used during the COVID-19 lockdown compared to before the COVID-19 lockdown, while a statistically significant increase in vitamins used during the COVID-19 lockdown compared to before COVID-19 lockdown.

    DISCUSSION: In the MENA region, there has been an increase in the use of anabolic hormones and nutritional supplements. Most of the population has low knowledge of the harmful effect of uncontrolled, uninformed and unmonitored use of these substances Therefore, increasing the awareness level of participants and sports coaches should be a priority to limit the unsupervised use of hormones and supplements.

  16. Brackstone K, Marzo RR, Bahari R, Head MG, Patalinghug ME, Su TT
    PLOS Glob Public Health, 2022;2(10):e0000742.
    PMID: 36962550 DOI: 10.1371/journal.pgph.0000742
    With the emergence of the highly transmissible Omicron variant, large-scale vaccination coverage is crucial to the national and global pandemic response, especially in populous Southeast Asian countries such as the Philippines and Malaysia where new information is often received digitally. The main aims of this research were to determine levels of hesitancy and confidence in COVID-19 vaccines among general adults in the Philippines and Malaysia, and to identify individual, behavioural, or environmental predictors significantly associated with these outcomes. Data from an internet-based cross-sectional survey of 2558 participants from the Philippines (N = 1002) and Malaysia (N = 1556) were analysed. Results showed that Filipino (56.6%) participants exhibited higher COVID-19 hesitancy than Malaysians (22.9%; p < 0.001). However, there were no significant differences in ratings of confidence between Filipino (45.9%) and Malaysian (49.2%) participants (p = 0.105). Predictors associated with vaccine hesitancy among Filipino participants included women (OR, 1.50, 95% CI, 1.03-1.83; p = 0.030) and rural dwellers (OR, 1.44, 95% CI, 1.07-1.94; p = 0.016). Among Malaysian participants, vaccine hesitancy was associated with women (OR, 1.50, 95% CI, 1.14-1.99; p = 0.004), social media use (OR, 11.76, 95% CI, 5.71-24.19; p < 0.001), and online information-seeking behaviours (OR, 2.48, 95% CI, 1.72-3.58; p < 0.001). Predictors associated with vaccine confidence among Filipino participants included subjective social status (OR, 1.13, 95% CI, 1.54-1.22; p < 0.001), whereas vaccine confidence among Malaysian participants was associated with higher education (OR, 1.30, 95% CI, 1.03-1.66; p < 0.028) and negatively associated with rural dwellers (OR, 0.64, 95% CI, 0.47-0.87; p = 0.005) and online information-seeking behaviours (OR, 0.42, 95% CI, 0.31-0.57; p < 0.001). Efforts should focus on creating effective interventions to decrease vaccination hesitancy, increase confidence, and bolster the uptake of COVID-19 vaccination, particularly in light of the Dengvaxia crisis in the Philippines.
  17. Patil M, Hedaoo RP, Shah RP, Tauseef SM, Marzo RR, Ching SM, et al.
    Inquiry, 2023;60:469580231167010.
    PMID: 37029552 DOI: 10.1177/00469580231167010
    The burden of hypertension has been growing over recent decades. In addition to risk of stroke and cardiovascular disease development, data indicates that hypertension may also pose a hazard to the quality of life (QoL) of individuals. Patient reported outcomes such as QoL are often overlooked, with physicians and healthcare professionals not routinely evaluating or customizing treatments according to QoL. In this study we aimed to assess the QoL of hypertensive men (n = 500) undergoing treatment who visited a charitable hospital in Pune, India. Clinic blood pressure was determined and the Mini Cuestionario de Calidad de Vida en Hipertensión Arterial (MINICHAL) scale was used to assess the health-related (HR)-QoL of patients. More than half of the participants (62%) had uncontrolled hypertension, with a mean systolic blood pressure (BP) of 151 ± 12 mmHg and diastolic blood pressure of 87 ± 6 mmHg as compared to those with controlled blood pressure (mean systolic blood pressure 123 ± 6 mmHg and diastolic blood pressure 84 ± 5 mmHg; P 
  18. Marzo RR, Khanal P, Shrestha S, Mohan D, Myint PK, Su TT
    Front Public Health, 2023;11:1193789.
    PMID: 37435519 DOI: 10.3389/fpubh.2023.1193789
    INTRODUCTION: Population demography across the globe shows an increasing trend in the aging population due to better healthcare, improved nutrition, advanced health-related technology, and decreased fertility rate. Despite these advancements, there remains a knowledge gap in understanding the association between active aging determinants and quality of life (QoL) among older adults, particularly within diverse cultural contexts, which has not been adequately explored in previous research. Therefore, understanding the association between active aging determinants and QoL can help policymakers plan early interventions or programs to assist future older adults in both aging actively and optimizing their quality of life (QoL), as these two factors have a bidirectional relationship.

    OBJECTIVE: This study aimed to review evidence regarding the association between active aging and quality of life (QoL) among older adults and to determine the most widely used study designs and measurement instruments in studies conducted between 2000 and 2020.

    METHODS: Relevant studies were identified by a systematic search of four electronic databases and cross-reference lists. Original studies examining the association between active aging and QoL in individuals aged 60 years or older were considered. The quality of the included studies and the direction and consistency of the association between active aging and QoL were assessed.

    RESULTS: A total of 26 studies met the inclusion criteria and were included in this systematic review. Most studies reported a positive association between active aging and QoL among older adults. Active aging had a consistent association with various QoL domains including physical environment, health and social services, social environment, economic, personal, and behavioral determinants.

    CONCLUSION: Active aging had a positive and consistent association with several QoL domains among older adults, backing the notion that the better the active aging determinants, the better the QoL among older adults. Considering the broader literature, it is necessary to facilitate and encourage the active participation of older adults in physical, social, and economic activities for the maintenance and/or improvement of QoL. Identifying other possible determinants and enhancing the methods to improve those determinants may help improve the QoL among older adults.

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