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Clinical inertia was evident in this cohort of patients as they had suboptimal glycaemic control at the time of enrolment and the initiation of second-line therapy. Treatment intensification is required to reduce diabetes-related adverse outcomes.

Clinical inertia was evident in this cohort of patients as they had suboptimal glycaemic control at the time of enrolment and the initiation of second-line therapy. Treatment intensification is required to reduce diabetes-related adverse outcomes.

Child labourers are exposed to an insecure environment and higher risk of violence. Violence among child labourers is an under-studied phenomenon which requires contextual assessment.

We applied Bronfenbrenner’s ecological model (micro-, exo- and macro-system) to understand the interplay of individual, community, societal and policy context fuelling violence.

Focus group discussions and family ethnographies of child-labourers working in common occupational sectors of suburban areas of Sindh were carried out to gain in-depth understanding of their immediate environment and abuse (micro-system). selleck Frequency of emotional, physical and sexual violence (5-14 years; n = 634) was also determined. Indepth interviews with employers (exo-system, n = 4) and key-informant-interviews of prominent stakeholders in Pakistan (macro-system, n = 4) working against labour/violence were carried out Thematic-content analysis was performed using MAXQDA, version 8.0.

We estimated that 21%, 19% and 9% of children suffered from emotional, physical and sexual violence respectively. Child labourers’ interviews indicated the existence of all forms of abuse at home and in the workplace; sexual violence by grandfathers was highlighted (micro-system). Children reported frequent scolding and insults in the workplace along with physical violence that could be fatal (exo-system). The legal environment of violence in Pakistan was considered deficient as it did not address the hidden forms (touching, kissing, etc.; macro-system).

We documented that all forms of violence were rampant among the child labourers, and improved efforts and comprehensive legislation is direly needed to alleviate the situation.

We documented that all forms of violence were rampant among the child labourers, and improved efforts and comprehensive legislation is direly needed to alleviate the situation.

The chronic use of khat, a plant with psychostimulant properties, has been associated with physical and mental health problems. Previous research found that non-khat users were more likely than khat users to perceive its use to be associated with poor health.

We aimed to identify differences in the perception of specific khat-associated health problems between khat users and non-users.

In 2012, 133 adults (≥ 18 years) from African migrant communities in 4 state capital cities in Australia completed questionnaires to ascertain their perception of whether specific health problems were associated with khat use. Multivariable log-linked Poisson regression was used to compare the perceptions of the 2 groups and identify differences, adjusting for sociodemographic factors, tobacco use and years living in Australia.

Overall, 58 (44%) and 75 (56%) participants reported current khat use and no use respectively. Adjusted log-linked Poisson regression showed that people who use khat were less likely than non-users to perceive certain health and related problems were associated with khat use, including, poor health in general [prevalence risk ratio (PRR) = 0.86; 95% CI 0.75, 1.00]; laziness (PRR = 0.86; 95% CI 0.75, 0.99); stomach and throat problems (PRR = 0.83; 95% CI 0.72, 0.96); and teeth, gum and mouth problems (PRR = 0.81; 95% CI 0.67, 0.99).

Khat users are less likely to perceive use being associated with health problems than non-users. Providing information on the health problems associated with khat use may be an important component of health promotion strategies and interventions aimed at minimising khat-related harm.

Khat users are less likely to perceive use being associated with health problems than non-users. Providing information on the health problems associated with khat use may be an important component of health promotion strategies and interventions aimed at minimising khat-related harm.

Substance use and bullying are prevalent among adolescents and have a wide range of adverse outcomes. The association of bullying with substance use has not been examined in Kurdistan and Iraq, which have suffered from the effects of long-term conflict and economic hardship.

To examine the association between each form of bullying among adolescents and substance use.

This cross-sectional study was conducted in a sample of public schools in Erbil City, Iraq in 2017. The study involved 1070 adolescents selected from 35 schools using a multistage cluster sampling method. A self-reported close-ended questionnaire was used for data collection. Male and female students attending grades 7-12 and aged 13-18 years were included.

The overall prevalence of bullying behaviour was 60.0%; 30.8% were victims, 26.2% were bully-victims, and 3.0% were bullies. There was a significant association between different forms and categories of bullying and substance use. The strongest association was with the students involved in sexual bullying, followed by racial and cyber bullying. The strongest association between bullying and substance use was found in the bully-victim category, followed by victims and bullies.

Substance use and bullying behaviour seem to be widespread problems among adolescents in Erbil schools. Substance use is significantly associated with different categories of bullying behaviour. There is a need for effective school-based preventive interventions to tackle these problems. Future research needs to examine the likely direction of the association between bullying and substance use.

Substance use and bullying behaviour seem to be widespread problems among adolescents in Erbil schools. Substance use is significantly associated with different categories of bullying behaviour. There is a need for effective school-based preventive interventions to tackle these problems. Future research needs to examine the likely direction of the association between bullying and substance use.