Nevin Manimala

BMC Public Health. 2024 Dec 18;24(1):3527. doi: 10.1186/s12889-024-20974-z.

ABSTRACT

BACKGROUND: Metabolically unhealthy non-obese (MUNO) individuals are at higher risk of cardiovascular diseases, while not receiving sufficient attention. This study was conducted to explore the association between BMI-adjusted CC and MUNO in non-obese US adults using the NHANES database.

METHODS: A total of 9,628 non-obese US adults (48.01% female and 51.99% male) were included in this cross-sectional study. The metabolically unhealthy phenotype was defined as ≥ 2 components of metabolic abnormalities. BMI-adjusted CC and BMI-adjusted skeletal muscle mass (SMM) were divided into quartiles. Weighted multiple logistic regression model was used to evaluate the study aims. The relation between BMI-adjusted CC and BMI-adjusted SMM was tested by Spearman correlation.

RESULTS: In the multivariate analysis, compared with the lowest quartile of BMI-adjusted CC and BMI-adjusted SMM, OR (95%CI) of the highest quartile was 0.30 (0.25, 0.35) (P < 0.001, P for trend < 0.001) and 0.39 (0.29, 0.53) (P < 0.001, P for trend < 0.001), respectively. BMI-adjusted CC was positively correlated with BMI-adjusted SMM for all participants (r = 0.48). A weak non-linear association was observed in BMI-adjusted CC and MUNO (P = 0.047). Similar results were observed in sex- and BMI-specific subgroup and sensitivity analysis.

CONCLUSION: BMI-adjusted CC was inversely associated with MUNO, suggesting more attention should be paid to monitoring BMI-adjusted CC for the public to ease the disease burden, especially for people without obesity.

PMID:39695513 | DOI:10.1186/s12889-024-20974-z

BMC Psychiatry. 2024 Dec 18;24(1):924. doi: 10.1186/s12888-024-06371-1.

ABSTRACT

INTRODUCTION: Depression is a common and debilitating mental health issue among refugees in East Africa, who face numerous challenges. However, there is a lack of systematic reviews and meta-analyses that have explored the pooled prevalence and associated factors of depression among refugees in East Africa. This study aims to investigate the pooled prevalence of depression and its associated factors among refugees living in East Africa.

METHODS: A systematic search was conducted across several databases, including PubMed/MEDLINE, CINAHL, ScienceDirect, African Journals of Online (AJOL), and Google Scholar. The quality of the included studies was assessed using a Joanna Briggs Institute (JBI) quality appraisal tool. Statistical analysis was carried out using STATA-17 software packages, and a meta-analysis was conducted using a random-effects model. Heterogeneity among the studies was assessed using the I² statistic. Publication bias was evaluated using the DOI plot, Luis Furuya Kanamori (LFK) index, and Egger’s test. For associated factors of depression, effect sizes (odds ratio) with 95% confidence intervals were analyzed.

RESULT: A total of eight studies involving 6,388 participants were included in this systematic review and meta-analysis, all of which were assessed to have a low risk of bias. The pooled prevalence of depression was 50.60%, with a 95% CI (35.49%, 65.71). Regarding factors associated with depression; being female [(OR = 2.01; 95% CI (1.06, 3.82)], having poor social support [OR 5.88; 95% CI (2.53, 13.67)], and experienced eight or more traumatic events [OR = 3.31;95% CI (1.74, 6.31) were positively associated factors with depression.

CONCLUSION: The pooled prevalence of depression among refugees in East Africa was found to be significantly high. Female participants, poor social support, and experienced eight or more traumatic events were factors affecting depression among refugees in East Africa. Therefore, policymakers and health personnel in East Africa should prioritize addressing the needs of female participants, individuals with poor social support, and those who have experienced eight or more traumatic events.

PMID:39695510 | DOI:10.1186/s12888-024-06371-1

BMC Public Health. 2024 Dec 18;24(1):3454. doi: 10.1186/s12889-024-20938-3.

ABSTRACT

This study examined the influence of socio-economic factors on the adoption of improved cookstoves (ICSs) and identified barriers to their dissemination in Wereta district, Amhara, Ethiopia. A structured cross-sectional approach was employed, surveying 308 households through questionnaires and interviews. Key socio-economic factors such as income level, family size, education, and age were found to significantly affect ICS adoption (p < 0.05), whereas cooking location, household decision-making, and involvement of societal stakeholders did not show a statistically significant impact (p > 0.05). The primary barriers to ICS adoption included limited awareness, high costs, and age-related factors. Addressing these challenges by targeting the significant socio-economic determinants is crucial for facilitating the transition from traditional to improved cookstoves. The findings offer valuable insights for policymakers, NGOs, research organizations, and manufacturers, highlighting potential areas for targeted intervention to enhance ICS adoption in the community.

PMID:39695509 | DOI:10.1186/s12889-024-20938-3

BMC Ophthalmol. 2024 Dec 18;24(1):536. doi: 10.1186/s12886-024-03807-w.

ABSTRACT

BACKGROUND: To compare the effectiveness of a brief binocular vision screening protocol to a comprehensive examination for detecting binocular vision anomalies before and after cataract surgery.

METHODS: A comprehensive binocular vision test battery as a gold standard were administered on recruited patients before the first surgery and at the third visit after surgery on the second eye. A receiver operating characteristic (ROC) curve was plotted to illustrate the diagnostic ability of each test. In addition, a univariate logistic regression analysis was performed to further determine the contribution of each preoperative test to the prediction of pre- and post-surgical binocular vision anomalies.

RESULTS: Significant differences were shown for the difference in phoria from distance to near measured by the cover test (Area Under Curve [AUC] = 0.96, P < 0.01), step vergence testing of positive fusional vergence at distance (AUC = 0.71, P < 0.01) and near (AUC = 0.77, P < 0.01). The other tests did not show statistically significant differences. The ROC curve generated by combining the difference in distance and near phoria with positive fusional vergence at both distance and near demonstrated a more robust measure of diagnostic accuracy. (AUC = 0.98, P < 0.01).

CONCLUSION: Distance and near phoria difference measured by cover test has similar effectiveness as a comprehensive binocular vision testing protocol for the diagnosis of binocular vision anomalies. Distance and near positive fusional vergence measured by step vergence testing also have significant predictive value. A combination of the two tests is an outstanding screening protocol for binocular vision anomalies before cataract surgery.

TRIAL REGISTRATION: The study was registered at ClinicalTrials.gov (NCT03592615, Date of registration: July 19, 2018).

PMID:39695508 | DOI:10.1186/s12886-024-03807-w

BMC Public Health. 2024 Dec 18;24(1):3468. doi: 10.1186/s12889-024-21054-y.

ABSTRACT

INTRODUCTION: Globally, there has been a decline in the age of menarche; the decline is higher in poorer countries than in richer ones. The measurement of the decline was based on the reported mean age at menarche (MAM) across the countries. There is a significant knowledge gap in investigating the generational decline in MAM in low- and median-income countries (LMC). In Nigeria, different studies have reported MAM, but none have attempted to investigate the generational shift in the reported MAM in girls residing in rural and urban areas. This review sought to understand if there is a rural-urban disparity in the MAM.

METHODS: Documents were searched in the relevant bibliometric database and Population intervention, comparison(s) and outcome (PICO) framework were used as eligibility criteria for extracting data from the documents based on some inclusion and exclusion criteria. The population are adolescent schoolgirls in rural and urban settlements in Nigeria. The comparator is the age of menarche of urban versus rural adolescent schoolgirls in Nigeria, while the mean age at menarche (MAM) is the outcome. Data quality assessment was done to critically appraise the included studies and enhance. Data were synthesized using narrative review, descriptive and inferential statistics.

RESULTS: Ten articles were included in the study, following the PRISMA framework. The overall mean evaluation of the risk of bias in the individual studies included in the review was computed to be 88%. Generally, there seems to be a decline in the age at menarche from 1976 to 2023. The rural MAM is higher than the urban MAM, and the gap between the two appears to be narrowing. The t-test showed no statistically significant mean differences between the rural and urban mean age at menarche (T = 2.1009, p value = 0.4679). The mean menarcheal age for girls in rural and urban areas is 13.44 and 13.04, respectively. There is a strong positive correlation between the rural and urban MAMs (Pearson = 0.93, p < 0.001). The Gaussian kernel estimated a bimodal distribution for rural girls, where they are most likely to experience menarche at 11 and 13 years, respectively, while urban girls are most likely to experience menarche at 13 years. In both locations, the incidence of menarche decreases just after the peak at 13 years.

CONCLUSION: Although rural girls have delayed menarche, there is no statistically significant mean difference between the age at menarche reported for rural and urban areas in Nigeria. Interventions in the form of counseling and reproductive education are recommended. The review provides a strong foundation for further research and policy development aimed at improving the health and well-being of adolescent girls in Nigeria and other similar settings.

PROSPERO REGISTRATION: CRD42024529497.

PMID:39695506 | DOI:10.1186/s12889-024-21054-y

BMC Ophthalmol. 2024 Dec 18;24(1):539. doi: 10.1186/s12886-024-03808-9.

ABSTRACT

BACKGROUND: Dry eye syndrome (DES) is common but lack of data in quality of life (QoL) of DES patients in Thailand. The primary outcome of this study was to determine QoL and health utility in patients of DES by EuroQol 5-domain (EQ-5D) of the 5-level version (5 L) instrument. The secondary outcome was comparison of the utility in the patients of DES classified by severity and causes including the autoimmune and non-autoimmune diseases.

METHOD: The study was a cross-sectional study at a hospital in the northern part of Thailand. The inclusions DES patients were followed by Tear Film and Ocular surface Society the Dry Eye WorkShop II definition. The EQ-5D-5 L (Thai version) descriptive system and the EQ visual analogue scale (VAS) was instrument for QoL evaluation.

RESULT: Total patients of DES were fifty-six. The most patients were female. The mean age was 57.7(± 13.9) years. The mean of EQ-5D-utility and EQ-VAS were 0.76 (± 0.18) and 72.56 (± 15.19), respectively. The mean of EQ-5D-utility in these patients who were classified by severity including mild, moderate and severe were 0.84 (± 0.16), 0.78 (± 0.14) and 0.71 (± 0.22), respectively. There is no statistic significant in the EQ-5D-utility and EQ-VAS among severity and the causes of these patients.

CONCLUSIONS: This study demonstrated the importance of assessing QoL in DES. The EQ-5D-utility was accorded with the severity of DES. However, no statistic significant was showed in the mean of EQ-5D-utility and EQ-VAS between the severity and between the causes including the autoimmune and non-autoimmune diseases of these patients.

PMID:39695504 | DOI:10.1186/s12886-024-03808-9

BMC Med Educ. 2024 Dec 18;24(1):1487. doi: 10.1186/s12909-024-06440-9.

ABSTRACT

BACKGROUND: A Bachelor’s degree in nursing is one of the most challenging programs in the field of medical sciences. As a result, maintaining students’ academic motivation at the desired level is a constant concern for policymakers and educational administrators. Furthermore, tackling complex ethical dilemmas is inherent in nursing, making the educational period an important moment to instill moral sensitivity and reinforce professional ethics in students. This study aimed to investigate the association between academic motivation and moral sensitivity among undergraduate nursing students.

METHODS: In this descriptive-correlational study, 265 undergraduate nursing students from the Abhar School of Nursing at Zanjan University of Medical Sciences in Iran were chosen using a census approach in 2024. The data collection tools included demographic surveys, the Academic Motivation Scale (AMS), and the Moral Sensitivity Questionnaire (MSQ), all completed online. The data were analyzed with SPSS version 16 software, which used descriptive statistics (frequency, percentage, mean, and standard deviation) and inferential statistics (independent t-test, ANOVA, Pearson correlation, and multiple regression) with a significance level of 0.05.

RESULTS: Nursing students had average academic motivation and moral sensitivity ratings of 79.24 ± 14.05 and 121.12 ± 16.33, respectively. Furthermore, a significant relationship was found between the overall scores and all dimensions of academic motivation and moral sensitivity (p < 0.001). Additionally, 29.1% of the variance in moral sensitivity was explained by the dimensions of the student’s academic motivation.

CONCLUSION: This study’s findings revealed a link between academic motivation and moral sensitivity among nursing students. As a result, it is advised that levels of academic motivation be continually checked during the program. This will assist in identifying students at danger of losing motivation and allow for the development and execution of effective initiatives to improve their academic engagement.

PMID:39695501 | DOI:10.1186/s12909-024-06440-9

BMC Infect Dis. 2024 Dec 18;24(1):1424. doi: 10.1186/s12879-024-10312-4.

ABSTRACT

BACKGROUND: Bacteremia is prevalent in neonates, largely attributed to factors inherent in the neonatal period. However, the prevalence of proven bacteremia in Ethiopian neonates has not been previously synthesized. Accordingly, this systematic review and meta-analysis aimed to analyze the prevalence of bacteremia and pathogen profiles in neonates hospitalized for clinical sepsis in Ethiopia.

METHODS: This systematic review and meta-analysis followed the preferred reporting items for systematic review and meta-analysis (PRISMA) 2020. The literature search was conducted across five databases including PubMed, Google Scholar, Web of Science, Science Direct, and Research for Life spanning from January 2015 to July 2023. The search strategy used MeSH terms and involved screening titles and abstracts, reviewing full-text articles, and including only observational studies published in English within the specified timeframe. Data extraction and quality assessment were performed by three experienced reviewers using a validated data collection tool and the Joanna Briggs Institute quality assessment tool, respectively. The prevalence of neonatal bacteremia was determined through a random effects model, with heterogeneity among studies assessed using the Q statistic and the I² statistic. Publication bias was evaluated using a funnel plot and Egger’s regression test, and STATA version 16.0 was used for all analysis at 95% confidence level.

RESULTS: A meta-analysis of nine studies revealed a bacteremia prevalence of 40.0% (95% CI: 34.0-46.0%). Subgroup analysis indicated variations in prevalence based on regions and study designs, with Oromia at 44.0% (95% CI: 28.0, 61.0%) and Amhara at 39.0% (95% CI: 27.0, 51.0%). Longitudinal studies exhibited a higher prevalence (47.0%, 95% CI: 27.0-68.0%) compared to cross-sectional designs (38.0%, 95% CI: 32.0-44.0%). Gram-negative bacteria were identified as the predominant etiological agents, representing 59.5% (95% CI: 56.8-62.3%) of cases. Among the bacterial species, Staphylococcus aureus emerged as the most prevalent (20.0%, 95% CI: 18.0%, 22.0%), followed by coagulase-negative staphylococci and Klebsiella pneumoniae, each contributing to 17.0% (95% CI: 15.0%, 20.0%) of bacteremia cases.

CONCLUSION: The study revealed a significant high prevalence of bacteremia, with differences noted across regions and study designs. Key pathogens identified were Staphylococcus aureus, Klebsiella pneumoniae and coagulase-negative staphylococci. It is advisable to implement surveillance systems, targeted prevention strategies, diagnostic stewardship, and further research on regional variations and bacterial profiles to effectively enhance the ominous future.

PMID:39695487 | DOI:10.1186/s12879-024-10312-4

BMC Public Health. 2024 Dec 18;24(1):3451. doi: 10.1186/s12889-024-20988-7.

ABSTRACT

INTRODUCTION: Cardiovascular diseases (CVDs) are a leading cause of mortality worldwide. Red blood cell indices (RBIs) are associated with CVD risk factors (CRFs) and easy to test, making them useful as a screening tool for early identification of individuals at high risk for CVDs.

METHODS: Data from 31,781 participants in the China National Health Survey conducted from 2012 to 2017 were analyzed. Linear and non-linear relationships between RBIs and CRFs (hyperuricemia, diabetes, dyslipidemia) were assessed using restricted cubic splines. Propensity score weighting was used to balance confounders between RBI groups in the multivariable logistic regression models.

RESULTS: Hemoglobin concentration, red blood cell count and hematocrit all showed a significant linear dose-response association with all CRFs (p values < 0.001). Higher RBIs levels were associated with increased risk of hyperuricemia, diabetes, high LDL, high triglycerides, and high total cholesterol, but decreased HDL. For example, compared to the lowest quantile of HGB, the highest quantile had a 26% (13-40%) higher risk for hyperuricemia, a 43% (25-63%) higher risk of diabetes, 87% (61%-1.18 fold) higher risk of high LDL, and 68% (52-85%) higher risk of high triglycerides. Non-linear relationships were revealed between RBIs and most CRFs except uric acid and glucose. Sex differences were observed, with stronger associations between RBIs and hyperuricemia in women but stronger links with high LDL in men.

CONCLUSIONS: Elevated RBIs indicated higher risk of multiple CRFs. These findings suggest incorporating RBIs into CVD screening strategies to facilitate early prevention efforts, with consideration of sex differences.

PMID:39695473 | DOI:10.1186/s12889-024-20988-7

BMC Geriatr. 2024 Dec 18;24(1):1001. doi: 10.1186/s12877-024-05607-9.

ABSTRACT

PURPOSE: This umbrella review aimed to summarise and synthesize the evidence on the outcomes reported and used to assess the value and or efficacy of geriatric assessments (GAs) for older adults with cancer.

METHODS: Six electronic databases, PsycINFO, MEDLINE, Embase, CINAHL, Cochrane Library and Web of Science databases, were searched to identify systematic reviews with or without meta-analyses that described the value or outcomes of GAs for older adults with cancer.

RESULTS: Twenty-six systematic reviews were included, of which six included a meta-analysis of the data. Thirteen associations and or outcomes were identified. Overall geriatric impairments predicted or were associated with majority of identified outcomes. However, the type of domains associated with outcomes differed within and across reviews. Only treatment toxicity was statistically significantly lower for patients allocated to the GA intervention group compared to standard care. Systematic reviews without meta-analyses demonstrated a positive impact of GA with management on treatment completion, communication and care planning and patient satisfaction with care.

CONCLUSION: There is evidence demonstrating the predictive value of GAs for older adults with cancer. GAs seems to be beneficial for older adults with cancer across some outcomes, with strong evidence demonstrating the impact of GA with management for treatment toxicity. However, there is mixed or limited evidence demonstrating the effect of GA in other treatment modalities, and on quality of life and economic outcomes.

PMID:39695448 | DOI:10.1186/s12877-024-05607-9