Category: Nevin Manimala

Ig Sanita Pubbl. 2022 May-Jun;80(3):124-135.

ABSTRACT

Background Palliative care is a key approach in improving the quality of life of patients and their families facing the end-of-life care process. It is widely regarded as a public-health concern, especially considering the rapidly increasing end-of-life care needs worldwide. Its provision has been highly challenged by the COVID-19 pandemic emergency. Objective This study aims to analyse whether and to what extent the provision of Palliative Care to non-COVID patients provided by a hospital-based unit has changed during the COVID-19 pandemic. Material and methods A retrospective observational study was performed. All non-COVID patients admitted from October 1, 2019 to September 30, 2020 and evaluated by the hospital-based Palliative Care team were considered. Three time periods were considered: pre-lockdown, lockdown and post-lockdown. A trend analysis and multiple linear and logistic regressions to study and quantify the statistical significance of the associations were performed. Results A statistically significant positive linear trend of the number of hospitalized patients in need of Palliative Care was found over the study period. Compared to pre-lockdown, the rest of the study period presented more female and elderly patients, the length of stay and the number of patients discharged to a Hospice setting were significantly reduced. The waiting time did not change in lockdown but decreased in post-lockdown and the mortality rate was not significantly different. Also, the average number of Palliative Care consultations per patient significantly increased in the lockdown and post-lockdown. Discussion First, the significant admissions drop between the start of the pandemic and the following study period is in line with recent literature. The consequent rebound registered may be attributed to the high pressure from outside requiring admission and care. Second, the significantly older age of patients found during the lockdown than before the lockdown could be attributed to a “selection effect” of young patients, more able to delay hospitalization than the elderly, also in line with recent literature. Third, the shorter waiting time for Palliative Care activation the post-lockdown compared to the pre-lockdown period could be due to both increased hospital efficiency and to the greater pressure to discharge patients during the post-lockdown period. Also, the significant reduction in the lockdown and post-lockdown of the length of stay after Palliative Care activation could be explained considering both the greater receptivity of healthcare services outside the hospital, such as Hospices, and the greater pressure on hospital wards to discharge. Fourth, the unchanged in-hospital mortality rate remained over the entire period could be an indication of the high quality of care provided by this hospital setting to fragile patients, which is to be noted especially considering the average mortality rate registered during pandemic context in healthcare facilities. Conclusions The study aimed to quantify the impact of the COVID-19 on the provision of Palliative Care by a hospital-based team. We believe it might represent an innovative contribution and we hope similar research will be produced in order build the evidence for future challenges in this field.

PMID:36453205

Scand J Urol. 2022 Dec 1:1-6. doi: 10.1080/21681805.2022.2151644. Online ahead of print.

ABSTRACT

OBJECTIVE: To evaluate the effect of pre-biopsy povidone-iodine rectal cleansing on post-biopsy hospitalization rates due to prostate biopsy-related infectious complications.

MATERIAL AND METHODS: In this retrospective study, we reviewed 552 patients who underwent ultrasonography-guided transrectal prostate biopsy between 2014 and 2022. Group 1, 361 patients (January 2014-October 2020) were not applied povidone-iodine rectal cleansing, and group 2, 191 patients (November 2020-January 2022) were applied povidone-iodine rectal cleansing since we changed our biopsy protocol. All patients were given the same antibiotic prophylaxis, ciprofloxacin 500 mg, and ornidazole 500 mg twice daily starting 24 h before the biopsy and lasting a total of 5 days. Sodium phosphate enema was applied to all patients in the biopsy morning. The outcome was the hospitalization rates of patients because of infectious complications a month after the biopsy.

RESULTS: No patients were hospitalized in the povidone-iodine rectal cleansing group because of biopsy related complications. The hospitalization rate of group 1 was 3% and there was a statistical difference between groups.

CONCLUSION: The povidone-iodine solution is cheap, safe and easy to apply. The povidone-iodine rectal cleansing method seems to decrease infectious complications related to prostate biopsy procedure, but we need a randomized controlled trial to confirm our study.

TRIAL REGISTRATION: We got permission for this retrospective study from the Karabuk university ethics council with the number 2021/649 on 1 October 2021.

PMID:36453188 | DOI:10.1080/21681805.2022.2151644

Sports Biomech. 2022 Dec 1:1-19. doi: 10.1080/14763141.2022.2151932. Online ahead of print.

ABSTRACT

Research in sports biomechanics often relies on the use of ordinary least squares (OLS) regression. However, since sports biomechanics research is often characterised by high-dimensional data sets with many predictor variables and few observations, use of OLS regression can sometimes be problematic from a statistical perspective. Statistical learning methods may provide alternate ways to deal with high-dimensional data sets and partially address these problems. For example, regularisation adds penalties to the cost function of OLS regression models, which shrinks large regression coefficients and decreases the model’s sensitivity to noise in the data. Regularised regression models also protect against overfitting, improve generalisability, and can be used for variable selection. A short review of biomechanics research studies illustrates how these models provided ways to reduce the number of variables within a model and select only the primary predictors of performance, which helped with the interpretation of results and identified distinct combinations of key predictors of performance. In addition, we illustrate how these models are applied to two sports biomechanics datasets. Given the advantages, sports biomechanists may want to consider the use of regularised regression models in their research design and statistical analyses. Careful consideration should be given, however, to the construction, validation, and interpretation of these models considering their underpinning assumptions and limitations.

PMID:36453176 | DOI:10.1080/14763141.2022.2151932

BMC Med. 2022 Nov 30;20(1):467. doi: 10.1186/s12916-022-02613-9.

ABSTRACT

BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death in China. No previous study has reported CVD mortality at county-level, and little was known about the nonmedical ecological factors of CVD mortality at such small scale in mainland China. Understanding the spatiotemporal variations of CVD mortality and examining its nonmedical ecological factors would be of great importance to tailor local public health policies.

METHODS: By using national mortality registration data in China, this study used hierarchical spatiotemporal Bayesian model to demonstrate spatiotemporal distribution of CVD mortality in 2844 counties during 2006 to 2020 and investigate how nonmedical ecological determinants have affected CVD mortality inequities from the spatial perspectives.

RESULTS: During 2006-2020, the age-standardized mortality rate (ASMR) of CVD decreased from 284.77 per 100,000 in 2006 to 241.34 per 100,000 in 2020. Among 2844 counties, 1144 (40.22%) were hot spots counties with a higher CVD mortality risk compared to the national average and located mostly in northeast, north central, and westernmost regions; on the contrary, 1551 (54.53%) were cold spots counties and located mostly in south and southeast coastal counties. CVD mortality risk decreased from 2006 to 2020 was larger in counties where CVD mortality rate had been higher in 2006 in most of the counties, vice versa. Nationwide, nighttime light intensity (NTL) was the major influencing factor of CVD mortality, a higher NTL appeared to be negatively associated with a lower CVD mortality, with one unit increase in NTL, and the CVD mortality risk will decrease 11% (relative risk of NTL was estimated as 0.89 with 95% confidence interval of 0.83-0.94).

CONCLUSIONS: Substantial between-county discrepancies of CVD mortality distribution were observed during past 15 years in mainland China. Nonmedical ecological determinants were estimated to significantly explain the overall and local spatiotemporal patterns of this CVD mortality risk. Targeted considerations are needed to integrate primary care with clinical care through intensifying further strategies to narrow unequally distribution of CVD mortality at local scale. The approach to county-level analysis with small area models has the potential to provide novel insights into Chinese disease-specific mortality burden.

PMID:36451190 | DOI:10.1186/s12916-022-02613-9

BMC Health Serv Res. 2022 Nov 30;22(1):1458. doi: 10.1186/s12913-022-08815-4.

ABSTRACT

BACKGROUND: The study aim was to analyse how mental health services are used in different parts of the Kainuu region in Finland and whether travel time to primary health care services is associated with the use of different contact types (in-person visits, remote contacts, home visits).

METHODS: The study population included adults who had used mental health services under primary health care (N = 7643) between 2015 and 2019. The travel times to the nearest health centre in a municipality were estimated as the population-weighted average drive time in postal code areas. The Kruskal-Wallis test and pairwise comparisons with Dunn-Bonferroni post hoc tests were used to assess the differences in mental health service use between health centre areas. A negative binomial regression was performed for the travel time categories using different contact types of mental health service use as outcomes. Models were adjusted for gender, age, number of mental health diseases and the nearest health centre in the municipality.

RESULTS: Distance was negatively associated with mental health service use in health centre in-person visits and in home visits. In the adjusted models, there were 36% fewer in-person visits and 83% fewer home visits in distances further than 30 min, and 67% fewer home visits in a travel time distance of 15-30 min compared with 15 min travel time distance from a health centre. In the adjusted model, in remote contacts, the incidence rate ratios increased with distance, but the association was not statistically significant.

CONCLUSIONS: The present study revealed significant differences in mental health service use in relation to travel time and contact type, indicating possible problems in providing services to distant areas. Long travel times can pose a barrier, especially for home care and in-person visits. Remote contacts may partly compensate for the barrier effects of long travel times in mental health services. Especially with conditions that call for the continuation and regularity of care, enabling factors, such as travel time, may be important.

PMID:36451184 | DOI:10.1186/s12913-022-08815-4

BMC Public Health. 2022 Nov 30;22(1):2232. doi: 10.1186/s12889-022-14541-7.

ABSTRACT

BACKGROUND: The health and development of children during their first year of full time school is known to impact their social, emotional, and academic capabilities throughout and beyond early education. Physical health, motor development, social and emotional well-being, learning styles, language and communication, cognitive skills, and general knowledge are all considered to be important aspects of a child’s health and development. It is important for many organisations and governmental agencies to continually improve their understanding of the factors which determine or influence development vulnerabilities among children. This article studies the relationships between development vulnerabilities and educational factors among children in Queensland, Australia.

METHODS: Spatial statistical machine learning models are reviewed and compared in the context of a study of geographic variation in the association between development vulnerabilities and attendance at preschool among children in Queensland, Australia. A new spatial random forest (SRF) model is suggested that can explain more of the spatial variation in data than other approaches.

RESULTS: In the case study, spatial models were shown to provide a better fit compared to models that ignored the spatial variation in the data. The SRF model was shown to be the only model which can explain all of the spatial variation in each of the development vulnerabilities considered in the case study. The spatial analysis revealed that the attendance at preschool factor has a strong influence on the physical health domain vulnerability and emotional maturity vulnerability among children in their first year of school.

CONCLUSION: This study confirmed that it is important to take into account the spatial nature of data when fitting statistical machine learning models. A new spatial random forest model was introduced and was shown to explain more of the spatial variation and provide a better model fit in the case study of development vulnerabilities among children in Queensland. At small-area population level, increased attendance at preschool was strongly associated with reduced physical and emotional development vulnerabilities among children in their first year of school.

PMID:36451182 | DOI:10.1186/s12889-022-14541-7

Addict Sci Clin Pract. 2022 Nov 30;17(1):68. doi: 10.1186/s13722-022-00349-8.

ABSTRACT

BACKGROUND: Opioid use disorder (OUD) as a common drug use disorder can affect public health issues, including the COVID-19 pandemic, in which patients with OUD may have higher risk of infection and severe disease. This systematic review and meta-analysis was conducted to investigate the risk of COVID-19 and the associated hospitalization, intensive care unit (ICU) admission, and mortality in patients with OUD.

MATERIALS AND METHODS: A comprehensive systematic search was performed on PubMed, Scopus, Embase, and Web of Science to find studies which compared the infection rate and outcomes of COVID-19 in OUD patients in comparison with the normal population. A random effects meta-analysis model was developed to estimate odd ratios (OR) and 95% confidence interval (CI) between the outcomes of COVID-19 and OUD.

RESULTS: Out of 2647 articles identified through the systematic search, eight were included in the systematic review and five in the meta-analysis. Among 73,345,758 participants with a mean age of 57.90 ± 13.4 years, 45.67% were male. The findings suggested no significant statistical relationship between COVID-19 infection and OUD (OR (95% CI): 1.18 (0.47-2.96), p-value: 0.73). Additionally, patients with OUD had higher rate of hospitalization (OR (95% CI) 5.98 (5.02-7.13), p-value<0.01), ICU admission (OR (95% CI): 3.47 (2.24-5.39), p-value<0.01), and mortality by COVID-19) OR (95% CI): 1.52(1.27-1.82), pvalue< 0.01).

CONCLUSION: The present findings suggested that OUD is a major risk factor for mortality and the need for hospitalization and ICU admission in patients with COVID-19. It is recommended that policymakers and healthcare providers adopt targeted methods to prevent and manage clinical outcomes and decrease the burden of COVID-19, especially in specific populations such as OUD patients.

PMID:36451181 | DOI:10.1186/s13722-022-00349-8

BMC Oral Health. 2022 Nov 30;22(1):545. doi: 10.1186/s12903-022-02542-2.

ABSTRACT

BACKGROUND: The aim of this study was to evaluate the indirect effects of residual silver nanoparticles (AgNPs) gel on human dental pulp stromal cells (DPSCs).

METHODS: Ninety-five dentin discs (4x4x1 mm) were prepared from freshly extracted human single-rooted teeth following institutional ethical approval and informed consent. Samples were cleaned, autoclaved, and treated with: 1.5%NaOCl, Saline and 17% EDTA then randomly assigned to 5 groups that received 50 μl of one of the following treatments: 0.01%AgNPs, 0.015%AgNPs, 0.02%AgNPs, Calcium hydroxide (Ca (OH)₂) or no treatment for 1 week. Discs were washed with Saline and 17%EDTA then seeded with DPSCs and incubated for 3 and 7 days. At 24 hours unattached cells were collected and counted. At each time point cytotoxicity (LDH assay), cell viability (live/dead staining and confocal microscopy) and cell proliferation (WST1 assay) were assessed. All experiments were repeated a minimum of 3 times using DPSCs isolated from 3 different donors for each time point assessed (n = 9/group). Statistical analysis was done using One-Way ANOVA followed by Tukey’s test and Kruskal Wallis followed by post-hoc comparisons with significance set at p ≤ 0.05.

RESULTS: After 24 hours, the percentage of DPSCs attachment ranged between 92.66% ±4.54 and 95.08% ±1.44 with no significant difference between groups (P = 0.126). Cell viability was ≥92% at 24 hours for all groups. However this percentage dropped to less than 60% at 3 days then started to rise again at 7 days. There was no significant difference in cytotoxicity between different groups at all time points except for 0.01%AgNPs group which had the highest cytotoxicity. DPSCs proliferation increased significantly from 3 to 7 days in all groups except for Ca (OH)₂ which showed lower proliferation rates at both 3 (45.89%) and 7 days (79.25%).

CONCLUSION: Dentin discs treated for 7 days with concentrations of AgNPs gel (0.01-0.02%) allowed more than 90% DPSCs cell attachment after 24 hours. The cytotoxicity and proliferation of DPSCs in response to AgNPs gel were comparable to those with calcium hydroxide. This suggests that AgNPs gel may represent a promising future candidate for clinical use in regenerative endodontics. However, its effects may be concentration-dependent warranting further investigation.

PMID:36451174 | DOI:10.1186/s12903-022-02542-2

BMC Public Health. 2022 Nov 30;22(1):2234. doi: 10.1186/s12889-022-14678-5.

ABSTRACT

BACKGROUND: Prevention of road traffic injuries (RTIs) as a critical public health issue requires coordinated efforts. We aimed to model influential factors related to traffic safety.

METHODS: In this cross-sectional study, the information from 384,614 observations recorded in Integrated Road Traffic Injury Registry System (IRTIRS) in a one-year period (March 2015-March 2016) was analyzed. All registered crashes from Tehran, Isfan, Fras, Razavi Khorasan, Khuzestan, and East Azerbaijan provinces, the six most populated provinces in Iran, were included in this study. The variables significantly associated with road traffic fatality in the uni-variate analysis were included in the multiple logistic regression.

RESULTS: According to the multiple logistic regression, thirty-two out of seventy-one different variables were identified to be significantly associated with road traffic fatality. The results showed that the crash scene significantly related factors were passenger presence(OR = 4.95, 95%CI = (4.54-5.40)), pedestrians presence(OR = 2.60, 95%CI = (1.75-3.86)), night-time crashes (OR = 1.64, 95%CI = (1.52-1.76)), rainy weather (OR = 1.32, 95%CI = (1.06-1.64)), no intersection control (OR = 1.40, 95%CI = (1.29-1.51)), double solid line(OR = 2.21, 95%CI = (1.31-3.74)), asphalt roads(OR = 1.95, 95%CI = (1.39-2.73)), nonresidential areas(OR = 2.15, 95%CI = (1.93-2.40)), vulnerable-user presence(OR = 1.70, 95%CI = (1.50-1.92)), human factor (OR = 1.13, 95%CI = (1.03-1.23)), multiple first causes (OR = 2.81, 95%CI = (2.04-3.87)), fatigue as prior cause(OR = 1.48, 95%CI = (1.27-1.72)), irregulation as direct cause(OR = 1.35, 95%CI = (1.20-1.51)), head-on collision(OR = 3.35, 95%CI = (2.85-3.93)), tourist destination(OR = 1.95, 95%CI = (1.69-2.24)), suburban areas(OR = 3.26, 95%CI = (2.65-4.01)), expressway(OR = 1.84, 95%CI = (1.59-2.13)), unpaved shoulders(OR = 1.84, 95%CI = (1.63-2.07)), unseparated roads (OR = 1.40, 95%CI = (1.26-1.56)), multiple road defects(OR = 2.00, 95%CI = (1.67-2.39)). In addition, the vehicle-connected factors were heavy vehicle (OR = 1.40, 95%CI = (1.26-1.56)), dark color (OR = 1.26, 95%CI = (1.17-1.35)), old vehicle(OR = 1.46, 95%CI = (1.27-1.67)), not personal-regional plaques(OR = 2.73, 95%CI = (2.42-3.08)), illegal maneuver(OR = 3.84, 95%CI = (2.72-5.43)). And, driver related factors were non-academic education (OR = 1.58, 95%CI = (1.33-1.88)), low income(OR = 2.48, 95%CI = (1.95-3.15)), old age (OR = 1.67, 95%CI = (1.44-1.94)), unlicensed driving(OR = 3.93, 95%CI = (2.51-6.15)), not-wearing seat belt (OR = 1.55, 95%CI = (1.44-1.67)), unconsciousness (OR = 1.67, 95%CI = (1.44-1.94)), driver misconduct(OR = 2.51, 95%CI = (2.29-2.76)).

CONCLUSION: This study reveals that driving behavior, infrastructure design, and geometric road factors must be considered to avoid fatal crashes. Our results found that the above-mentioned factors had higher odds of a deadly outcome than their counterparts. Generally, addressing risk factors and considering the odds ratios would be beneficial for policy makers and road safety stakeholders to provide support for compulsory interventions to reduce the severity of RTIs.

PMID:36451170 | DOI:10.1186/s12889-022-14678-5

BMC Psychol. 2022 Dec 1;10(1):283. doi: 10.1186/s40359-022-01000-6.

ABSTRACT

BACKGROUND: Prior research mainly focussed on the impact of the teacher-student relationship on teachers emotions and wellbeing. Current data shows a relationship between the quality of the teacher-student relationship and children’s mental health. Unfortunately, it has not yet been investigated whether meaningful experiences with teachers also have an impact on students’ well-being and whether an effect can still be found in adulthood. This work examines the impact of meaningful experiences with teachers during childhood and adolescence on the well-being of adults.

METHODS: The data in this study was collected by using a questionnaire. The current well-being of the participants was assessed with measures of life satisfaction, resilience, anxiety, stress, depressiveness, and self-esteem. Also, participants were asked to briefly write about their most meaningful experiences with teachers and rate them regarding their valence. These experiences were categorized into seven categories using a summarizing content analysis. We then conducted a statistical analysis with the data obtained.

RESULTS: The results showed a highly significant correlation between the participants’ self-esteem and the valence ratings of their experiences. Furthermore, the experience category had a substantial effect on individual self-esteem. Overall, this study demonstrated that a relationship exists between the well-being of adults and their experiences with teachers during childhood and adolescence.

CONCLUSION: The results of this study call for a reflective, fair, authentic, and empathetic approach to students. Accordingly, teachers should be intensively trained to establish a relationship with their students that is characterized by appreciation and empathy.

PMID:36451161 | DOI:10.1186/s40359-022-01000-6