Nevin Manimala

BMC Public Health. 2022 Jun 30;22(1):1276. doi: 10.1186/s12889-022-13643-6.

ABSTRACT

INTRODUCTION: This study investigated differences between rural Australian First Nations and non-First Nations survey respondents’ perceptions of COVID-19-related risks and analysed other variables that could predict an exacerbation of anxiety related to COVID-19 harms.

METHODS: A cross-sectional online and paper survey of rural residents from the western regions of NSW, Australia, was conducted. Descriptive and multivariate statistical analyses were used to assess links between First Nations status and demographic measures including postcode, age, gender, education, rural or town/village location, proximity to medical services and living situation. The analysis included five items related to perceptions about COVID-19: perceived likelihood of contracting COVID-19 in the next 12 months, perceived harmfulness of the virus, how often people felt afraid, perception about respondents’ ability to do something about the virus and perceived economic impacts of the pandemic.

RESULTS: There were significant differences between First Nations (n=60) and non-First Nations (n= 639) respondents across all sociodemographic categories. The results reflect a significantly higher level of anxiety among the First Nations Australians in the sample: they felt afraid more often, felt it was highly likely they would catch the virus and if they did catch the virus perceived that it would be very harmful. Living with children under eighteen years of age and in small rural towns were key factors linked to feeling afraid of COVID-19 and First Nations status.

CONCLUSION: Health risk communication in pandemic response should include an equitable focus on rural areas, recognising that First Nations Australians are a significant proportion of the rural population with different risk factors and concerns than those of non-First Nations Australians. This principle of First Nations-led design is critical to all health policy and planning. The Australian Government should include rural areas in planning pandemic responses, recognising that First Nations populations are a significant proportion of the rural population creating syndemic conditions.

PMID:35773669 | DOI:10.1186/s12889-022-13643-6

BMC Surg. 2022 Jun 30;22(1):254. doi: 10.1186/s12893-022-01685-x.

ABSTRACT

BACKGROUND: ACL (anterior cruciate ligament) reconstruction remains the gold standard surgical option for patients with ACL tears. There are many fixation devices available for ACL reconstruction. Recent ACL reconstruction strategies are aiming to reproduce the native anatomy and normal kinematics of the knee. This is a five years follow-up report of some of the new devices for graft fixation. A two years follow-up data was published previously.

METHODS: 120 patients were randomized into four different groups (30 each) for ACL reconstruction with hamstring tendons: group I femoral Rigidfix cross-pin and Intrafix tibial extension sheath with a tapered expansion screw; group II Rigidfix femoral and BioScrew interference screw tibial fixation; group III BioScrew femoral and Intrafix tibial fixation; group IV BioScrew fixation into both tunnels. The evaluation methods were clinical examination, knee scores, and instrumented laxity measurements.

RESULTS: In this 5 years follow-up there were 102/120 (85%) patients available, but only 77 (64,2%) attended the clinical examinations. No significant difference between the groups in the clinical results was detected. Between the 2 and 5 years follow-up there were 6 additional procedures in group I and one in group II. There was a significant difference in additional procedures between group I and the other groups (P = .041).

CONCLUSION: There was a statistically significant difference in the additional procedures, most in group I (six). The ACL grafts were intact. Other statistically or clinically significant differences in the 5 years follow-up results were not found.

STUDY DESIGN: Randomized controlled clinical trial; Level of evidence, 1. Trial registration ISRCTN registry with study ID ISRCTN34011837. Retrospectively registered 17.4.2020.

PMID:35773666 | DOI:10.1186/s12893-022-01685-x

BMC Health Serv Res. 2022 Jun 30;22(1):839. doi: 10.1186/s12913-022-08227-4.

ABSTRACT

BACKGROUND: There are different degrees of flaws in the knowledge structure of humanistic medicine of medical staff. The level of emotional intelligence of medical staff affects their career development as well as their relationship with patients. Currently, the research on humanistic care ability (HCA) and emotional intelligence of medical staff in China and other countries is rare. This study aimed to investigate the correlation between the level of HCA and level of emotional intelligence of the whole hospital staff.

METHODS: The questionnaire survey employed contained self-designed questions on the hospital staff members’ socio-demographic background, Caring Ability Inventory, and Wong and Law Emotional Intelligence Scale. The survey was conducted with the staff of West China Second University Hospital, Sichuan University in April 2020.

RESULTS: The hospital staff’s average CAI score was 197.77 ± 20.30, and their average WLEIS score was 84.21 ± 13.48. The CAI and WLEIS scores of the hospital staff who chose their college majors on their own interests were higher than those who chose their majors for other reasons (employability, suggestions from family or others, etc.). The CAI and WLEIS scores of the hospital staff who had received more comprehensive and in-depth humanistic care training were higher than those who did not. The CAI score of the hospital staff who had participated in volunteer service activities was higher than those who did not. The WLEIS score of the Pediatrics Department staff was higher than that of the Outpatient and Emergency Department staff, and the difference was statistically significant (P < 0.05). The scores of emotional intelligence, self-emotion assessment and expression, self-emotion management, self-emotion utilization, emotion recognition of others, and HCA of the hospital staff were positively correlated (P < 0.001).

CONCLUSION: There were different levels of development of internal factors of emotional intelligence among the hospital staff, and their humanistic care ability was at a low level. Emotional intelligence was positively correlated to humanistic care ability. The findings suggest in-service training and education by healthcare institutions to enhance healthcare staff’s emotional intelligence for promoting the general health of the population.

PMID:35773661 | DOI:10.1186/s12913-022-08227-4

BMC Endocr Disord. 2022 Jun 30;22(1):167. doi: 10.1186/s12902-022-01075-7.

ABSTRACT

OBJECTIVE: Polymorphisms of the fatty acid desaturase (FADS) gene cluster have been associated with obesity and its-related consequences. This cross-sectional study aimed to investigate whether the adherence to dietary non-enzymatic antioxidant capacity (NEAC), reflecting the antioxidant potential of the whole diet, modifies the association of FADS2 rs174583 polymorphism with cardio-metabolic risk factors in obese adults.

METHODS: The present study included 347 healthy obese adults (aged 20-50 years). Dietary NEAC was assessed by a validated food frequency questionnaire with 147 items and estimated through total radical-trapping antioxidant parameters (TRAP), oxygen radical absorbance capacity (ORAC), and ferric reducing ability of plasma (FRAP) with the use of published databases. FADS2 rs174583 polymorphism was characterized using PCR-RFLP. ANCOVA multivariate interaction model was used to analyze gene-diet interactions.

RESULTS: after adjustment for the confounding variables (age, physical activity, SES and WC), this study showed significant interactions between rs174583 polymorphism and adherence to dietary ORAC on the serum cholesterol (P _Interaction = 0.029), LDL-C (P _Interaction = 0.025) and HDL-C levels (P _Interaction = 0.049) among the male group; minor allele carriers who had the highest adherence to the NEAC (ORAC) showed a better metabolic profile (lower TG and LDL-C and higher HDL-C) (P < 0.05). Among women, the dietary ORAC-rs174583 interactions were statistically significant for the serum insulin concentration (P _Interaction = 0.020), QUICKI (P _Interaction = 0.023) and HOMA-IR (P _Interaction = 0.017); the highest QUICKI and the lowest HOMA-IR and serum insulin levels were observed in the CC homozygote carriers with the moderate compliance with the dietary ORAC (P < 0.05). In addition, the dietary TRAP modified the association between FADS2 variant and change in LDL-C levels (P _Interaction = 0.037); the homozygous wild-type (CC) women who placed in the top tertile of TRAP had significantly the lowest LDL-C levels than those in the second tertile (P < 0.05).

CONCLUSION: These data indicate that the FADS2 rs174583 polymorphism interacts with the dietary NEAC to influence cardio-metabolic risk factors in obese subjects. Replication in prospective cohort studies among other populations is required to confirm the results of our study.

PMID:35773659 | DOI:10.1186/s12902-022-01075-7

BMC Pediatr. 2022 Jun 30;22(1):384. doi: 10.1186/s12887-022-03415-x.

ABSTRACT

BACKGROUND: The impacts of socio-demographic and environmental risk factors on child growth have been widely documented. However, it remains unclear whether the impacts of such risk factors on child growth have remained static or changed with child’s age. The present study aims to assess the underlying age heterogeneities in child growth and its potential determinants over age in under-five children.

METHODS: Cross-sectional data on child height (measured as height-for-age z-score, i.e., HAZ) and weight (measured as weight-for-age z-score, i.e., WAZ) and potential confounding factors from India’s 2015-16 National Family Health Survey (NFHS) were used to construct anthropometric age-profiles by a number of bio-demographic and socioeconomic characteristics. Further, age-interacted multilevel regression analyses were performed to examine differential effects of such/those risk factors on child height and weight by age.

RESULTS: Faltered height and weight growth during first two years of life was noticed in children of all socioeconomic groups studied, albeit with varying magnitude. In case of child’s height, factors such as short birth interval, higher birth order, maternal education, household wealth, district level mortality rate have shown strong interaction with child’s age during the first 23 months, signifying their age-varying role in different developmental stages of child growth. These factors explain the observed upward and downward shifts in height curve during first two years. Some of these variables (e.g., household wealth) have shown even stronger age interactions after the second birthday of children. For child’s weight, interactive effects of most socio-demographic risk factors attenuated parabolically with child’s age.

CONCLUSIONS: The impacts of several risk factors, measured at the child, mother, community, and district levels, on child growth indicators varied significantly with the child’s age. Nutritional interventions aimed at preventing poor linear growth in children in India should consider these underlying age heterogeneities for growth determinants into account.

PMID:35773654 | DOI:10.1186/s12887-022-03415-x

BMC Geriatr. 2022 Jun 30;22(1):545. doi: 10.1186/s12877-022-03210-4.

ABSTRACT

BACKGROUND: This study aimed to investigate the durability of the effects of corrective exercises on the postural alignment and stability of hyperkyphotic elderly with a history of falls. Balance disturbance and recurrent falls are directly related to changes in the alignment of physical posture and function of the elderly, and effective methods with durable effects on improving the postural stability of the elderly have always been under the attention of researchers.

METHODS: This study was a randomized clinical trial, and the statistical population included the elderly referred to neurology clinics. According to the research inclusion criteria (hyperkyphotic elderly with a history of falls during the last six months), 30 elderly aged 60 to 75 years old were purposefully selected and randomly divided into two groups of corrective exercises and control. The experimental group performed an exercise program based on the Alexander posture correction technique. Both groups were evaluated with forward head angle, kyphosis, the timed up and go test, postural stability, and fear of falling tests in three phases. Data analysis was conducted using SPSS 21 software and the MANCOVA test and repeated-measures analysis of variance.

RESULTS: Data analysis showed significant improvements in the variables of forward head (p = 0.007), kyphosis(p = .001), balance(p = 0.002), postural stability(p = 0.001), and fear of falling(p = 0.001) in the experimental group. Post-test comparisons between the experimental and control groups showed significant differences in all variables except for kyphosis(p > .05), and follow-up analysis also revealed significant differences in all variables, except for the variables of forward head and kyphosis(p > .05).

CONCLUSIONS: Although the effects of corrective exercises in the elderly decreased regarding spinal alignment after three months, more lasting effects were seen in functional balance, postural stability, and fear of falling, suggesting this strategy as a stimulus for more mobility and a lower risk of falling in the elderly. Therefore, when using corrective exercises, it is possible to apply these exercises for a longer period of time to achieve more durable outcomes, especially regarding spinal alignment.

TRIAL REGISTRATION: This research was registered in the Iranian Registry of Clinical Trials ( IRCT2016081529373N1 , Date of registration: 19/04/2017).

PMID:35773652 | DOI:10.1186/s12877-022-03210-4

BMC Cardiovasc Disord. 2022 Jun 30;22(1):299. doi: 10.1186/s12872-022-02732-4.

ABSTRACT

BACKGROUND: Postoperative delirium is a common complication of cardiac surgery associated with higher morbidity, longer hospital stay, risk of cognitive decline, dementia, and mortality. Geriatric patients, patients undergoing cardiac surgery, and intensive care patients are at a high risk of developing postoperative delirium. Gold standard assessments or biomarkers to predict risk factors for delirium, cognitive decline, and dementia in patients undergoing cardiac surgery are not yet available.

METHODS: The FINDERI trial (FINd DElirium RIsk factors) is a prospective, single-center, observational study. In total, 500 patients aged ≥ 50 years undergoing cardiac surgery at the Department of Cardiovascular and Thoracic Surgery of the University of Göttingen Medical Center will be recruited. Our primary aim is to validate a delirium risk assessment in context of cardiac surgery. Our secondary aims are to identify specific preoperative and perioperative factors associated with delirium, cognitive decline, and accelerated dementia after cardiac surgery, and to identify blood-based biomarkers that predict the incidence of postoperative delirium, cognitive decline, or dementia in patients undergoing cardiac surgery.

DISCUSSION: This prospective, observational study might help to identify patients at high risk for delirium prior to cardiac surgery, and to identify important biological mechanisms by which cardiac surgery is associated with delirium. The predictive value of a delirium screening questionnaire in cardiac surgery might be revealed. Finally, the identification of specific blood biomarkers might help to predict delirium, cognitive decline, and dementia in patients undergoing cardiac surgery.

TRIAL REGISTRATION: Ethics approval for this study was obtained from the IRB of the University of Göttingen Medical Center. The investigators registered this study in the German Clinical Trials Register (DRKS; https://www.drks.de ) (DRKS00025095) on April 19th, 2021.

PMID:35773648 | DOI:10.1186/s12872-022-02732-4

BMC Prim Care. 2022 Jul 1;23(1):168. doi: 10.1186/s12875-022-01774-z.

ABSTRACT

BACKGROUND: To support its ageing population and the increasing need for chronic care in the community, Singapore needs to boost the number of doctors in its primary care workforce. To better understand how to improve doctor retention and build a more robust primary care system, we conducted a cross-sectional survey with doctors in general practice and family medicine to explore their career satisfaction, their career plans, factors related to their plans to leave, and their view on retaining GPs in primary care.

METHODS: An anonymous online survey was distributed to general practitioners working in the public and private sectors. The survey contained questions on career satisfaction, career plans in the next 5 years, and factors important for retaining doctors in primary care. In addition, there were open-ended questions for respondents to elaborate on retention initiatives and other factors that may improve engagement among primary care doctors. Quantitative data was analyzed with descriptive statistics, principal component analysis, χ² tests, t-tests, and Pearson’s correlations; qualitative data was analyzed thematically.

RESULTS: The survey was attempted by 355 general practitioners and completed in full by 303. The respondents were most satisfied with rapport with patients and their current professional role; they were least satisfied with the amount of paperwork and the status of general practice in society. In terms of their career plans in the next 5 years, 49/341 (14.4%) of the respondents plan to leave general practice permanently, 43/341 (12.6%) plan to take a career break, and 175/341 (51.3%) plan to reduce their clinical hours. Higher remuneration, recognizing general practice and family medicine as a medical specialty, and reducing the litigious pressures on medical practice were rated as the most important factors for retaining primary care. Free-text responses also revealed a growing dissatisfaction with the Third-Party Administrators that manage insurance arrangements.

CONCLUSION: While the proportion of doctors who intend to leave is smaller than that reported in overseas studies, our findings highlight an urgent need for targeted interventions to engage and retain primary care doctors. Increasing recognition and support for general practitioners and their professional practice may contribute to strengthening community care for the ageing population.

PMID:35773647 | DOI:10.1186/s12875-022-01774-z

BMC Prim Care. 2022 Jun 30;23(1):166. doi: 10.1186/s12875-022-01766-z.

ABSTRACT

BACKGROUND: In organ transplantation, all patients must follow a complex treatment regimen for the rest of their lives. Hence, patients play an active role in the continuity of the care process in the form of self-management tasks. Thus, the main objective of our study was to investigate the pragmatic solutions applied by different studies to enhance adherence to self-management behaviors.

METHOD: A systematic review was conducted in five databases from 2010 to August 2021 using keywords. Eligible studies were all English papers that developed self-management programs to enhance patient care in solid organ transplantation. The interventions were analyzed using thematic analysis to determine the main descriptive areas. The quality of the included articles was evaluated using the research critical appraisal program (CASP) tool.

RESULTS: Of the 691 retrieved articles, 40 met our inclusion criteria. Of these, 32 studies were devoted to the post-transplantation phase. Five main areas were determined (e-health programs for telemonitoring, non-electronic educational programs, non-electronic home-based symptom-monitoring programs, electronic educational plans for self-monitoring, and Telerehabilitation) according to thematic analysis. Most studies (72.5%) declared that developed programs and applied solutions had a statistically significant positive impact on self-management behavior enhancement in transplant patients.

CONCLUSION: The results showed that an effective solution for improving organ transplantation needs patient collaboration to address psychological, social, and clinical aspects of patient care. Such programs can be applied during candidate selection, waiting list, and after transplantation by putting the patient at the center of care.

PMID:35773642 | DOI:10.1186/s12875-022-01766-z

BMC Public Health. 2022 Jun 30;22(1):1277. doi: 10.1186/s12889-022-13625-8.

ABSTRACT

BACKGROUND: We aimed to develop and validate a tool to identify which pregnant/lactating young South African women (≤ 24 years) are at risk of HIV infection.

METHODS: Data from three national South African Prevention of Mother-to-Child Transmission (PMTCT) evaluations were used to internally validate three HIV acquisition risk models for young postpartum women. We used univariate and multivariable logistic regression analysis to determine which risk factors were significant. Model coefficients were rounded and stratified into risk groups and the area under the receiver operating curve (AUROC) was computed. Models were developed to determine which risk factors provided the most predictive accuracy whilst remining clinically meaningful.

RESULTS: Data from 9 456 adult and 4 658 young pregnant and lactating women were included in the development and validation data sets, respectively. The optimal model included the following risk factors: age (20-24 years old), informal house structure, two or more pregnancies, mothers who had knowledge of when they received their last HIV test result, no knowledge of the infant’s father’s HIV status, no knowledge of breastfeeding as a mode of MTCT and knowledge of PMTCT programme. The mean AUROC was 0.71 and 0.72 in the development and validation datasets respectively. The optimum cut off score was ≥ 27, having 84% sensitivity, 44% specificity, and identifying 44% of high-risk women eligible for PrEP.

CONCLUSION: The optimal model to be used as a possible risk scoring tool to allow for early identification of those pregnant/lactating women most at-risk of HIV acquisition included both statistically as well as clinically meaningful risk factors. A field-based study is needed to test and validate the effectiveness of this targeted approach.

PMID:35773638 | DOI:10.1186/s12889-022-13625-8