Category: Nevin Manimala

Hum Resour Health. 2022 Jun 23;20(1):56. doi: 10.1186/s12960-022-00753-w.

ABSTRACT

BACKGROUND: Retention of human resources in the healthcare system, particularly doctors at district level is a great challenge faced by the decentralized health systems in poorly resourced countries. Medical Officers of Health (MOH), medical doctors who provide preventive health services, are a particularly important human resource in the preventive health sector in Sri Lanka. This study explores the relative importance of different factors affecting the retention of MOHs in the preventive health sector of Sri Lanka.

METHODS: A descriptive cross-sectional study was carried out among Medical Officers of Health in the Colombo district with 18 MOH Offices with 74 medical officers. A pre-tested self-administered questionnaire was used as the study instrument. Data were analyzed using descriptive statistics, correlation and regression analyses.

RESULTS: Of the 74 medical officers 64 responded with a response rate of response rate of 86.5%. Regression analysis showed that all four variables; recognition, work schedule, remuneration and responsibility are positively and significantly correlated with retention of Medical Officers of Health in the preventive health sector. The variable ‘work schedule’ showed the highest impact on the retention of Medical Officers of Health.

CONCLUSIONS: In order to retain trained Medical Officers of Health in the Sri Lankan preventive health sector, health authorities should address the factors identified in this study. If policymakers fail to address these factors, preventive health services will face negative implications due to the shortage of key service providers.

PMID:35739538 | DOI:10.1186/s12960-022-00753-w

Reprod Health. 2022 Jun 23;19(1):146. doi: 10.1186/s12978-022-01431-9.

ABSTRACT

BACKGROUND: Several studies were carried out on prevalence and associated factors of physical, emotional, and sexual violence against women. However, little attention was given to a comprehensive study that assesses the association between physical, emotional, and sexual violence against women. Thus, this study aimed to assess the association between physical, emotional, and sexual violence against women and their prevalence.

METHODS: A retrospective cross-sectional design was implemented based on the 2018 Nigeria Demographic and Health Survey involving 8061 married women aged 15-49. A log-linear statistical model for the three-way table was used to assess the association between emotional, physical, and sexual violence. SAS statistical software was used for data management and parameter estimation.

RESULTS: Among a total of 8061 women considered in the study 3022 (37.49%), 4216 (52.3%) and 1186 (14.71%) women have experienced physical, emotional, and sexual violence, respectively. The estimated odds of the interaction between emotional and physical violence (e^1.9281 = 6.876); physical and sexual violence (e^-2.0529 = 0.128) were significantly differ from 1.0 with p-values < 0:0001 and 0.0201, respectively.

CONCLUSION: Over 33 percent of women experienced at least one incident of physical, emotional, or sexual violence in their lifetime. Physical violence against women has a significant association with emotional and sexual violence. However, it does not imply physical violence causes the other violence since cross-sectional data used for the analysis and other factors were not taken into consideration. The lack of a three-way association between emotional, physical, and sexual violence was also perceived. Therefore, as the prevalence of intimate partner violence against women s high, Nigeria as a country needs to strive to reduce it with the collaboration of other nations in the world to achieve Sustainable Development Goal (SDG). Design and apply guidelines to aware of the community about intimate partner violence against women and besides, take appropriate sentencing on those who commit the violence are the better approaches to prevent violence. Traditional habits that might be the cause of violence should be avoided to reduce or prevent the burden of women due to violence.

PMID:35739537 | DOI:10.1186/s12978-022-01431-9

AIDS Res Ther. 2022 Jun 23;19(1):26. doi: 10.1186/s12981-022-00454-3.

ABSTRACT

We conducted a pilot trial of an intervention targeting intersectional stigma related to being pregnant and living with HIV while promoting capabilities for achieving ‘respected motherhood’ (‘what matters most’) in Botswana. A pragmatic design allocated participants to the intervention (N = 44) group and the treatment-as-usual (N = 15) group. An intent-to-treat, difference-in-difference analysis found the intervention group had significant decreases in HIV stigma (d = – 1.20; 95% CI – 1.99, – 0.39) and depressive symptoms (d = – 1.96; 95% CI – 2.89, – 1.02) from baseline to 4-months postpartum. Some, albeit less pronounced, changes in intersectional stigma were observed, suggesting the importance of structural-level intervention components to reduce intersectional stigma.

PMID:35739534 | DOI:10.1186/s12981-022-00454-3

BMC Health Serv Res. 2022 Jun 24;22(1):817. doi: 10.1186/s12913-022-08221-w.

ABSTRACT

BACKGROUND: With the rapid development of science and technology, telemedicine diagnosis and treatment systems have gradually attracted increased attention and applications.5G ultrasound is an important branch of telemedicine, connecting grassroots hospitals at one end and provincal hospitals at the other, which provides remote guidance to grassroots doctors for ultrasound examination and image diagnosis. It is convenient for villagers obtaining diagnosis and advice from provincial ultrasound experts, saving time and economic costs, as well as benefiting from high-quality ultrasound medical resources. In this study, taishun County community grassroot hospitals were selected as the pilot study of 5G ultrasound application, to explore the effectiveness of their theory and practice, and gradually improve the remote ultrasound diagnosis and treatment standards, so as to improve their quality of grassroots hospitals and benefit grassroots people. METHODS: This is a descriptive study. The Provincal Hospital will conduct ultrasonic theory and practice training for grassroot hospitals. The training subjects included 43 doctors in grassroots hospitals who were willing to carry out ultrasound examinations. Theories, skills training scores and trainees’ questionnaires on teaching content were collected and analyzed. After passing theoretical and practical training, they will conduct ultrasound examinations in their respective communities and collect relevant cases. There are 148 cases thus far for analysis. It mainly included the type of disease, whether the patient was out-patient or inpatient, frequency of ultrasound visits in recent 5 years, and follow-up treatment measures.

RESULTS: It mainly included three aspects: (1) Through theoretical and practical training, the ultrasonic diagnosis level of grassroot doctors was significantly improved. The difference in scores between the two practical trainings was statistically significant. (2) Forty-three questionnaires were sent out, feedback from trainees was very high. Most of them was very satisfied with our training. The total score of the questionnaire was 10, and 97.67% of them score more than 8. (3) In total, there were 148 remote consultation cases, including 67 males and 81 females, who were aged 21 to 101 years old (62.40 ± 15.73).mainly abdominal ultrasound, and typical cases involve fatty liver, hepatic cyst, gallbladder stone, kidney stone and so on. We analyzed case data and provided follow-up treatment recommendations.

CONCLUSION: As a “visual apparatus”, 5G ultrasound can be routinely carried out in grassroot hospitals, which can provide mutual benefit between doctors and patients and comprehensively promote healthy villages.

PMID:35739530 | DOI:10.1186/s12913-022-08221-w

BMC Cancer. 2022 Jun 24;22(1):695. doi: 10.1186/s12885-022-09778-9.

ABSTRACT

BACKGROUND: The role of elevated pre-diagnostic C-reactive protein (CRP) concentrations on mortality in individuals with colorectal cancer (CRC) remains unclear.

METHODS: We investigated the association between pre-diagnostic high-sensitivity CRP concentrations and CRP genetic variation associated with circulating CRP and CRC-specific and all-cause mortality based on data from 1,235 individuals with CRC within the European Prospective Investigation into Cancer and Nutrition cohort using multivariable-adjusted Cox proportional hazards regression.

RESULTS: During a median follow-up of 9.3 years, 455 CRC-specific deaths were recorded, out of 590 deaths from all causes. Pre-diagnostic CRP concentrations were not associated with CRC-specific (hazard ratio, HR highest versus lowest quintile 0.92, 95% confidence interval, CI 0.66, 1.28) or all-cause mortality (HR 0.91, 95% CI 0.68, 1.21). Genetic predisposition to higher CRP (weighted score based on alleles of four CRP SNPs associated with higher circulating CRP) was not significantly associated with CRC-specific mortality (HR per CRP-score unit 0.95, 95% CI 0.86, 1.05) or all-cause mortality (HR 0.98, 95% CI 0.90, 1.07). Among four investigated CRP genetic variants, only SNP rs1205 was significantly associated with CRC-specific (comparing the CT and CC genotypes with TT genotype, HR 0.54, 95% CI 0.35, 0.83 and HR 0.58, 95% CI 0.38, 0.88, respectively) and all-cause mortality (HR 0.58, 95% CI 0.40, 0.85 and 0.64, 95% CI 0.44, 0.92, respectively).

CONCLUSIONS: The results of this prospective cohort study do not support a role of pre-diagnostic CRP concentrations on mortality in individuals with CRC. The observed associations with rs1205 deserve further scientific attention.

PMID:35739525 | DOI:10.1186/s12885-022-09778-9

BMC Oral Health. 2022 Jun 24;22(1):252. doi: 10.1186/s12903-022-02285-0.

ABSTRACT

BACKGROUND: In the clinic, most computer-aided design and manufacturing orthodontic mini-implant guides are suitable for the position between the tooth roots, and few templates are designed and used for the infrazygomatic crest zone. In this study, we took into account the structure of the infrazygomatic crest and 3D printing technology, developed two kinds of templates, and evaluated their clinical effects.

METHODS: Seventeen patients who accepted 30 mini-implant insertions in the infrazygomatic crest were selected. According to different implantation methods, three groups were divided. In Groups A and B, the mini-implants were positioned with an A-type or B-type template designed by EXOCAD software. In Group C, the mini-implants were inserted by an experienced orthodontist without any guides. We simulate the bucco-palatal, mesio-distal, and vertical head positions in the Segma implant guide software and measure the deviation from the virtual design position of the mini-implant. The linear deviation of the mini-implant tip and cap and the angular deviation of the long axis of the mini-implant in the bucco-palatal direction, mesio-distal direction, and vertical direction were also measured. The results were statistically analysed by SPSS software.

RESULTS: The deviations of Group A and Group C’s miniscrew cap in the bucco-palatal direction, Group A and Group B, Group A and Group C’s miniscrew tip in the mesio-distal direction, and Group B and Group C’s miniscrew tip and cap in the vertical direction were statistically significant (P < 0.05). There was a significant difference in the deviations of Group A and Group C’s miniscrew tip and cap in the vertical direction (P < 0.01).

CONCLUSIONS: In the vertical direction, the accuracy of implantation with the template is higher than that of the traditional method without the template to avoid piercing the maxillary sinus mucosa in the infrazygomatic crest zone.

PMID:35739518 | DOI:10.1186/s12903-022-02285-0

BMC Health Serv Res. 2022 Jun 23;22(1):816. doi: 10.1186/s12913-022-08203-y.

ABSTRACT

BACKGROUND: Emergency departments (EDs) experience an increasing number of patients. High patient flow are incentives for short duration of ED stay which may pose a challenge for patient diagnostics and care implying risk of ED revisits or increased mortality. Four hours are often used as a target time to decide whether to admit or discharge a patient.

OBJECTIVE: To investigate and compare the diagnostic pattern, risk of revisits and short-term mortality for ED patients with a length of stay of less than 4 h (visits) with 4-24 h stay (short stay visits).

METHODS: Population-based cohort study of patients contacting three EDs in the North Denmark Region during 2014-2016, excluding injured patients. Main diagnoses, number of revisits within 72 h of the initial contact and mortality were outcomes. Data on age, sex, mortality, time of admission and ICD-10 diagnostic chapter were obtained from the Danish Civil Registration System and the regional patient administrative system. Descriptive statistics were applied and Kaplan Meier mortality estimates with 95% CI were calculated.

RESULTS: Seventy-nine thousand three hundred forty-one short-term ED contacts were included, visits constituted 60%. Non-specific diagnoses (i.e. symptoms and signs and other factors) were the most frequent diagnoses among both visits and short stay visits groups (67% vs 49%). Revisits were more frequent for visits compared to short stay visits (5.8% vs 4.2%). Circulatory diseases displayed the highest 0-48-h mortality within the visits and infections in the short stay visits (11.8% (95%CI: 10.4-13.5) and (3.5% (95%CI: 2.6-4.7)). 30-day mortality were 1.3% (95%CI: 1.2-1.5) for visits and 1.8% (95%CI: 1.7-2.0) for short stay visits. The 30-day mortality of the ED revisits with an initial visit was 1.0% (0.8-1.3), vs 0.7% (0.7-0.8) for no revisits, while 30-day mortality nearly doubled for ED revisits with an initial short stay visit (2.5% (1.9-3.2)).

CONCLUSIONS: Most patients were within the visit group. Non-specific diagnoses constituted the majority of diagnoses given. Mortality was higher among patients with short stay visits but increased for both groups with ED revisits. This suggest that diagnostics are challenged by short time targets.

PMID:35739517 | DOI:10.1186/s12913-022-08203-y

BMC Cancer. 2022 Jun 24;22(1):696. doi: 10.1186/s12885-022-09771-2.

ABSTRACT

BACKGROUND: Esophageal microbiota may influence esophageal squamous cell carcinoma (ESCC) pathobiology. Therefore, we investigated the characteristics and interplay of the esophageal microbiota in ESCC.

METHODS: We performed 16S ribosomal RNA sequencing on paired esophageal tumor and tumor-adjacent samples obtained from 120 primarily ESCC patients. Analyses were performed using quantitative insights into microbial 2 (QIIME2) and phylogenetic investigation of communities by reconstruction of unobserved states 2 (PICRUSt2). Species found to be associated with ESCC were validated using quantitative PCR.

RESULTS: The microbial diversity and composition of ESCC tumor tissues significantly differed from tumor-adjacent tissues; this variation between subjects beta diversity is mainly explained by regions and sampling seasons. A total of 56 taxa were detected with differential abundance between the two groups, such as R. mucilaginosa, P. endodontalis, N. subflava, H. Pylori, A. Parahaemolyticus, and A. Rhizosphaerae. Quantitative PCR confirmed the enrichment of the species P. endodontalis and the reduction of H. Pylori in tumor-adjacent tissues. Compared with tumor tissue, a denser and more complex association network was formed in tumor-adjacent tissue. The above differential taxa, such as H. Pylori, an unclassified species in the genera Sphingomonas, Haemophilus, Phyllobacterium, and Campylobacter, also participated in both co-occurrence networks but played quite different roles. Most of the differentially abundant taxa in tumor-adjacent tissues were negatively associated with the epidermal growth factor receptor (EGFR), erb-b2 receptor tyrosine kinase 2 (ERBB2), erb-b2 receptor tyrosine kinase 4 (ERBB4), and fibroblast growth factor receptor 1 (FGFR1) signaling pathways, and positively associated with the MET proto-oncogene, receptor tyrosine kinase (MET) and phosphatase and tensin homolog (PTEN) signaling pathways in tumors.

CONCLUSION: Alterations in the microbial co-occurrence network and functional pathways in ESCC tissues may be involved in carcinogenesis and the maintenance of the local microenvironment for ESCC.

PMID:35739509 | DOI:10.1186/s12885-022-09771-2

BMC Musculoskelet Disord. 2022 Jun 23;23(1):606. doi: 10.1186/s12891-022-05512-5.

ABSTRACT

BACKGROUND: There is no much information about the entheseal involvement among hemodialysis (HD) patients. The aim of this study was to assess the frequency and distribution of ultrasonographic (US) entheseal alterations in HD patients and to evaluate the association between US abnormalities and both clinical and laboratory data.

METHODS: This study was conducted on 41 HD patients and 23 sex- and age- matched controls. All participants were evaluated clinically for any signs of enthesopathy. Six entheses sites were scanned bilaterally using grey scale (GS) and power Doppler (PD) US and were scored using Madrid Sonography Enthesitis Index (MASEI) scoring system.

RESULTS: In HD patients, at least one clinical sign suggestive of enthesopathy was found in 69 (14%) of 492 entheses. HD patients had statistically significant higher scores of structural tendon abnormalities (p < 0.001), enthesis thickening (p < 0.001), bone erosions (p < 0.001) and calcification (p = 0.037) than the healthy controls. Total MASEI score was higher in HD patients than healthy controls (median;18 vs 8, p < 0.001), also, MASEI-inflammatory (median;11 vs 3, p < 0.001) and damage scores (median;6 vs 0, p < 0.001). There was a statistically significant positive association between total MASEI score and both age (p = 0.032) and duration of HD (p = 0.037). Duration of HD was predictive for both MASEI-damage component (p = 0.004) and total MASEI score (p = 0.014).

CONCLUSION: There is a high prevalence of subclinical enthesopathy in HD patients. The entheseal US alterations is much higher in HD patients than in healthy subjects. The duration of HD is the significant predictor of enthesopathy in HD patients.

PMID:35739500 | DOI:10.1186/s12891-022-05512-5

BMC Geriatr. 2022 Jun 23;22(1):515. doi: 10.1186/s12877-022-03205-1.

ABSTRACT

BACKGROUND: Dignity and well-being are central concepts in the care of older people, 65 years and older, worldwide. The person-centred practice framework identifies dignity and well-being as person-centred outcomes. Older persons living in residential care facilities, residents, have described that they sometimes lack a sense of dignity and well-being, and there is a need to understand which modifiable factors to target to improve this. The aim of this study was to examine the associations between perceptions of dignity and well-being and the independent variables of the attitudes of staff, the indoor-outdoor-mealtime environments, and individual factors for residents over a three-year period.

METHODS: A national retrospective longitudinal mixed cohort study was conducted in all residential care facilities within 290 municipalities in Sweden. All residents aged 65 years and older in 2016, 2017 and 2018 were invited to responded to a survey; including questions regarding self-rated health and mobility, the attitudes of staff, the indoor-outdoor-mealtime environments, safety, and social activities. Data regarding age, sex and diagnosed dementia/prescribed medication for dementia were collected from two national databases. Descriptive statistics and ordinal logistic regression models were used to analyse the data.

RESULTS: A total of 13 763 (2016), 13 251 (2017) and 12 620 (2018) residents answered the survey. Most of them (69%) were women and the median age was 88 years. The odds for satisfaction with dignity did not differ over the three-year period, but the odds for satisfaction with well-being decreased over time. Residents who rated their health as good, who were not diagnosed with dementia/had no prescribed medication for dementia, who had not experienced disrespectful attitudes of staff and who found the indoor-outdoor-mealtime environments to be pleasant had higher odds of being satisfied with aspects of dignity and well-being over the three-year period.

CONCLUSIONS: The person-centred practice framework, which targets the attitudes of staff and the care environment, can be used as a theoretical framework when designing improvement strategies to promote dignity and well-being. Registered nurses, due to their core competencies, focusing on person-centred care and quality improvement work, should be given an active role as facilitators in such improvement strategies.

PMID:35739497 | DOI:10.1186/s12877-022-03205-1