Tag: nevin manimala

Clin Optom (Auckl). 2023 Nov 2;15:261-270. doi: 10.2147/OPTO.S437044. eCollection 2023.

ABSTRACT

PURPOSE: The aim of this study was to examine hospitalisation profiles related to postprocedural disorders of eye and adnexa in England and Wales.

PATIENTS AND METHODS: This was an ecological study using publicly available data extracted from the “Hospital Episode Statistics (HES) database” in England and the “Patient Episode Database for Wales (PEDW)” for the period between April 1999 and April 2020. Diagnostic code for postprocedural disorders of eye and adnexa (H59) was used to identify hospital admission. We used the chi-squared test to assess the difference between the hospital admission rates between 1999 and 2020.

RESULTS: Hospital admission rate decreased by 6.3% [from 4.98 (95% CI 4.79-5.17) in 1999 to 4.67 (95% CI 4.50-4.84) in 2020 per 100,000 persons, trend test, p<0.05]. The most common hospital admissions causes were other postprocedural disorders of eye and adnexa “Chorioretinal scars after surgery for detachment.” The age group 75 years and above accounted for 44.3% of the total number of admissions. Hospital admission rate among females decreased by 30.2% [from 5.90 (95% CI 5.61-6.19) in 1999 to 4.12 (95% CI 3.89-4.35) in 2020 per 100,000 persons]. Hospital admission rate among males increased by 30.2% [from 4.02 (95% CI 3.77-4.26) in 1999 to 5.23 (95% CI 4.97-5.49) in 2020 per 100,000 persons].

CONCLUSION: This study revealed that hospital admission rates for postprocedural disorders of the eye and adnexa decreased over the course of the study period. Eye and adnexa disorders accounted for the preponderance of hospital admissions among the elderly. Further research is required to identify risk factors that can be avoided.

PMID:37937276 | PMC:PMC10627053 | DOI:10.2147/OPTO.S437044

J Parasitol Res. 2023 Oct 10;2023:6687665. doi: 10.1155/2023/6687665. eCollection 2023.

ABSTRACT

Trematodes are chronic, debilitating diseases in livestock, causing significant economic losses worldwide. From mid-December 2021 to May 2022, a cross-sectional study was carried out in the Damot Sore District to estimate the prevalence of trematode infections in cattle and associated risk factors. Trematode eggs were found in 100 of the 384 faecal samples tested, with an overall prevalence of 26.04% (95% CI: 21.88-30.69%). The prevalence for Fasciola, Paramphistome, and Schistosoma species were 12.50%, 5.21%, and 0, respectively. Moreover, the infection rate with two parasites was 8.33%. The data were then examined further using univariable and multivariable logistic regression analysis. As a result, age was the only potential predictor identified to influence trematode infections in cattle among the potential predictors considered. Furthermore, old cattle were more likely to be infected with trematodiasis nearly 12 times (OR = 11.5) that of young cattle, and this difference was statistically significant (p < 0.05), whereas other risk factors considered were statistically insignificant (p > 0.05). According to the findings of this study, cattle trematodiasis is a moderately common disease in the study area. As a result, additional research on the meteorological conditions of snail infection was forwarded, along with other points to reduce the disease problem in livestock production.

PMID:37937272 | PMC:PMC10627722 | DOI:10.1155/2023/6687665

BMC Urol. 2023 Nov 7;23(1):179. doi: 10.1186/s12894-023-01355-x.

ABSTRACT

BACKGROUND: Laser lithotripsy using a thulium fiber laser (TFL) has become an effective treatment option for small renal stones with low complication rates. TFL has a higher absorption coefficient, smaller fibers, and better pulse rate capability.

METHODS: We conducted a systematic review and meta-analysis to evaluate the published evidence regarding TFL’s lithotripsy performance in retrograde intrarenal surgery (RIRS), for which we primarily assessed the outcomes of stone-free rate, operation time, and complications. We searched different databases from inception to April 2023. We assessed the methodological quality and risk of bias using the Cochrane Risk of Bias tool for randomized trials and the ROBINS-I tool for non-randomized studies. We used a random-effects model for meta-analysis and assessed heterogeneity using the I2 statistic.

RESULTS: Twelve published studies evaluated the efficacy of RIRS using a TFL for treating renal and ureteral stones. The meta-analysis revealed a predicted stone-free rate of 89.37% (95% CI: 83.93% to 93.12%), indicating that, on average, approximately 89.37% of patients achieved a stone-free state after treatment. The substantial heterogeneity among the studies was evident, as shown by a Q-value of 33.1174 and a p-value of 0.0003. The I² value of 69.80% (95% CI: 25.91% to 92.02%) highlighted the proportion of variability attributed to genuine heterogeneity across the studies. Moreover, the H² value 3.31 (95% CI: 1.35 to 12.53) indicated significant heterogeneity beyond random chance. The estimated overall effect size (logit-transformed) of 2.1289 was highly statistically significant (z = 8.7648, p < 0.0001) with a confidence interval of 1.6528 to 2.6049. The reported complications varied across studies, encompassing Clavien grade I-II complications in most cases, with a subset experiencing more severe Clavien grade III-V complications. Additionally, other studies noted a range of complications, such as haematuria, fever, transient creatinine elevation, and postoperative issues like bleeding, pain, and sepsis.

CONCLUSION: This meta-analysis suggests that RIRS using TFL is an effective and safe treatment option for renal and ureteral stones, with high stone-free and low complication rates. The included studies exhibited a low risk of bias and were of high quality. However, more extensive randomized controlled trials with extended follow-up periods are needed to investigate this technique’s efficacy and safety.

PMID:37936133 | DOI:10.1186/s12894-023-01355-x

BMC Health Serv Res. 2023 Nov 7;23(1):1218. doi: 10.1186/s12913-023-10213-3.

ABSTRACT

BACKGROUND: COVID-19 pandemic represented a shock for healthcare systems. Italy was one of the first country to deal with a huge number of patients to be diagnosed, isolated, and treated with scarce evidence-based guidelines and resources. Several organizational and structural changes were needed to face the pandemic at local level. The article aims at studying the perceived impact of the newly implemented District Operation Centres (DOCs) of Local Health Authority (LHA) Roma 1 in managing active surveillance and home care of COVID-19 patients and their close contacts in cooperation with general practitioners (GPs).

METHODS: A questionnaire, developed according to Delphi methodology, was validated by 7 experts and administered to a randomized sample of GPs and family paediatricians (FPs). All medical doctors selected received a phone interview between December 2020 and January 2021. The questionnaire investigated general characteristics of the sample, relations with DOC and its usefulness, and potential developments. A descriptive analysis was performed and inferential statistical tests were used to assess differences.

RESULTS: In April 2020 the LHA Roma 1 implemented one DOCs in each local health district. 215 medical doctors were interviewed, reaching the sample target for health districts (80% CL and 10% MOE) and the whole LHA (90% CL and 5% MOE). Several aspects in the management of COVID-19 cases and close contacts of COVID-19 cases, and of the support of DOCs to GPs/FPs were investigated. More than 55% of the GPs and FPs interviewed found the DOCs useful and more than 78% would recommend a service DOC-like to other LHAs. The medical professionals interviewed would use DOCs in the future as support in treating vulnerable patients, utilizing digital health tools, enlisting specialist doctors, establishing networks, and facilitating professional counselling by nurses.

CONCLUSIONS: This study is an attempt to evaluate an organizational change happened during COVID-19 pandemic. DOCs were created to support GPs and FPs as a link between primary healthcare and public health. Although several difficulties were disclosed, DOCs’ experience can help to overcome the fragmentation of the systems and the duality between primary care and public health and make the system more resilient.

PMID:37936132 | DOI:10.1186/s12913-023-10213-3

BMC Psychiatry. 2023 Nov 7;23(1):808. doi: 10.1186/s12888-023-05310-w.

ABSTRACT

INTRODUCTION: Patient satisfaction with mental health services has for several decades been considered an important component when evaluating service quality. It is often assessed in the context of monitoring quality of care, developing or evaluating newly implemented interventions or changes in practice. Because of this, patient satisfaction questionnaires are often added to longer questionnaire batteries, and shorter questionnaires are preferred to prevent respondent fatigue and non-compliance and to secure easy implementation. However, most studies use unvalidated patient satisfaction measures, making comparisons between studies difficult. Validation studies of short patient satisfaction measures are therefore warranted.

METHODS: The primary aim was to examine the construct validity and internal reliability of the Client Satisfaction Questionnaire-4 (CSQ-4) in a Norwegian outpatient mental health setting. A total of 467 patients were recruited from an outpatient psychiatric care clinic in Central Norway. The secondary aim was to examine an earlier proposed cutoff for classifying dissatisfied patients in this new population. A principal component analysis was conducted to evaluate factor structure, correlation analyses were conducted to test for predicted relationships, and Cronbach’s alpha was calculated to examine internal reliability.

RESULTS: The CSQ-4 showed a clear unidimensional structure with one factor explaining 80% of its variance. Its internal reliability was very high, with a Cronbach’s alpha of 0.92. As hypothesised this study found no statistically significant sex differences in satisfaction and no statistically significant association between age and satisfaction. Positive changes in symptoms during treatment and higher post-treatment functional impairment were associated with higher patient-reported treatment satisfaction scores, which indicates good construct validity.

CONCLUSION: This is the first study to evaluate the CSQ-4 in a psychiatric population. The CSQ-4 demonstrated good structural validity and internal reliability and was correlated with outcome variables in terms of symptom change and post-treatment functioning. In sum, this indicates that the CSQ-4 is a good short alternative for evaluating patient satisfaction in routine outpatient mental health care.

PMID:37936112 | DOI:10.1186/s12888-023-05310-w

BMC Public Health. 2023 Nov 7;23(1):2185. doi: 10.1186/s12889-023-17023-6.

ABSTRACT

BACKGROUND: One-fifth of the Sri Lankan population consists of adolescents, with 71% of them schooling. An extreme need exists in the country for the introduction of evidence-based interventions for the psychosocial well-being of adolescents. The present study assessed the effectiveness of an educational intervention to promote the psychosocial well-being of school-going adolescents in grade nine in Western Province, Sri Lanka.

MATERIALS AND METHODS: A quasi-experimental study was conducted among grade nine students in Western Province in 2019. Panadura Medical Officer of Health (MOH) area was selected as the interventional area (IA), and Kelaniya MOH area was identified as the control area (CA). Teachers at schools in the IA received training on psychosocial health promotion of adolescents. They delivered the activity-based educational intervention package to the grade nine students as 20-min classroom sessions for three months. Pre- and post-intervention assessments of attitudes and practices related to the psychosocial well-being of adolescents were conducted using an interviewer-administered questionnaire. Categorical data were compared using Chi-Square or Fisher’s exact test. Mann-Whitney U test was applied to determine the difference between the medians of the pre-and post-intervention scores on attitude and practices for psychosocial well-being.

RESULTS: A total of 1040 grade nine students were enrolled. There was a statistically significant increase in median score on attitudes [81.8 (IQR:75.5-85.5) to 82.3(IQR:78.6-87.2] and practices [81.7(IQR: 76.1-85.7) to 83.1(IQR: 79.1-86.9)] in the IA while there was no significant difference in the CA. The proportion of bullied adolescents in the past 30 days reduced significantly from 14.8% (n = 38) to 7.9% (n = 20) in IA(p = .03), whereas there was a slight reduction from 17.1% (n = 44) to 11.3% (n = 26) in CA (p = .17).

CONCLUSIONS: The present psychosocial intervention is effective in improving the psychosocial well-being of school adolescents, though long-term effectiveness was not assessed. It is recommended to utilise study findings in deciding to introduce the present intervention to basic and in-service teacher training packages and school curricula with necessary modifications.

PMID:37936110 | DOI:10.1186/s12889-023-17023-6

BMC Infect Dis. 2023 Nov 7;23(1):767. doi: 10.1186/s12879-023-08657-3.

ABSTRACT

BACKGROUND: Increasing life expectancy and persistently low fertility levels have led to old population age structures in most high-income countries, and population ageing is expected to continue or even accelerate in the coming decades. While older adults on average have few interactions that potentially could lead to disease transmission, their morbidity and mortality due to infectious diseases, respiratory infections in particular, remain substantial. We aim to explore how population ageing affects the future transmission dynamics and mortality burden of emerging respiratory infections.

METHODS: Using longitudinal individual-level data from population registers, we model the Belgian population with evolving age and household structures, and explicitly consider long-term care facilities (LTCFs). Three scenarios are presented for the future proportion of older adults living in LTCFs. For each demographic scenario, we simulate outbreaks of SARS-CoV-2 and a novel influenza A virus in 2020, 2030, 2040 and 2050 and distinguish between household and community transmission. We estimate attack rates by age and household size/type, as well as disease-related deaths and the associated quality-adjusted life-years (QALYs) lost.

RESULTS: As the population is ageing, small households and LTCFs become more prevalent. Additionally, families with children become smaller (i.e. low fertility, single-parent families). The overall attack rate slightly decreases as the population is ageing, but to a larger degree for influenza than for SARS-CoV-2 due to differential age-specific attack rates. Nevertheless, the number of deaths and QALY losses per 1,000 people is increasing for both infections and at a speed influenced by the share living in LTCFs.

CONCLUSION: Population ageing is associated with smaller outbreaks of COVID-19 and influenza, but at the same time it is causing a substantially larger burden of mortality, even if the proportion of LTCF residents were to decrease. These relationships are influenced by age patterns in epidemiological parameters. Not only the shift in the age distribution, but also the induced changes in the household structures are important to consider when assessing the potential impact of population ageing on the transmission and burden of emerging respiratory infections.

PMID:37936094 | DOI:10.1186/s12879-023-08657-3

BMC Med Educ. 2023 Nov 7;23(1):838. doi: 10.1186/s12909-023-04504-w.

ABSTRACT

BACKGROUND: Studies exploring influencing factors of emotional engagement among medical students are scarce. Thus, we aimed to identify influencing factors of medical students’ emotional engagement.

METHODS: We carried out a multi-center cross-sectional study among 10,901 medical students from 11 universities in China. The Chinese version of Utrecht Work Engagement Scale-Student version (UWES-S) was used to evaluate emotional engagement level of medical students. The predictors related to engagement level were determined by the logistic regression analysis. Furthermore, we constructed a nomogram to predict emotional engagement level of medical students.

RESULTS: A total of 10,576 sample were included in this study. The mean emotional engagement score was 74.61(± 16.21). In the multivariate logistic regression model, we found that males showed higher engagement level compared with females [odds ratio (OR) (95% confidence interval (CI)): 1.263 (1.147, 1.392), P < 0.001]. Medical students from the second batches of medical universities had higher engagement level and from “Project 985” universities had lower engagement level compared with 211 project universities [OR (95%CI): 1.376 (1.093, 1.733), P = 0.007; OR (95%CI): 0.682 (0.535, 0.868), P = 0.002]. Medical students in grade 4 and grade 2 presented lower engagement level compared with in grade 1 [OR (95%CI): 0.860 (0.752, 0.983), P = 0.027; OR (95%CI): 0.861 (0.757, 0.980), P = 0.023]. Medical students lived in provincial capital cities had higher engagement level compared with in country [OR (95%CI): 1.176 (1.022, 1.354), P = 0.024]. Compared with eight-year emotional duration, medical students in other emotional duration (three-year and four-year) had lower engagement level [OR (95%CI): 0.762 (0.628, 0.924), P = 0.006]. Medical students’ engagement level increased with increases of grade point average and interest in studying medicine. Medical students learned by converging style showed lower engagement level [OR (95%CI): 0.827 (0.722, 0.946), P = 0.006] compared with accommodating style. The model showed good discriminative ability (area under curve = 0.778), calibrating ability and clinical utility.

CONCLUSIONS: We identified influencing factors of medical students’ emotional engagement and developed a nomogram to predict medical students’ emotional engagement level, providing reference and convenience for educators to assess and improve emotional engagement level of medical students. It is crucial for educators to pay more attention to emotional engagement of medical students and adopt effective strategies to improve their engagement level.

PMID:37936085 | DOI:10.1186/s12909-023-04504-w

BMC Infect Dis. 2023 Nov 7;23(1):766. doi: 10.1186/s12879-023-08778-9.

ABSTRACT

BACKGROUND: In recent years, observational studies have been conducted to investigate the potential impact of vitamins on sepsis. However, many of these studies have produced inconsistent results. Our Mendelian randomization (MR) study aims to evaluate the causality between vitamins and sepsis from a genetic perspective.

METHODS: Our MR study was designed following the STROBE-MR guidelines. Genetic instrumental variables for vitamins including folate, vitamin B12, B6, A (Retinol), C, D, and K were obtained from previous genome-wide association studies (GWAS) and MR studies. Five different sepsis severity levels were included in the analysis. The genetic instrumental variables were screened for potential confounders using PhenoScanner V2. MR analysis was performed using MR-egger, inverse-variance weighted multiplicative random effects (IVW-RE), inverse-variance weighted multiplicative fixed-effects (IVW-FE), and wald ratio methods to assess the relationship between vitamins and sepsis. Sensitivity analysis was performed using the MR-egger_intercept method, and the MR-PRESSO package and Cochran’s Q test were used to evaluate the heterogeneity of the instrumental variables.

RESULTS: Our MR study found no statistically significant association between vitamins and sepsis risk, regardless of the type of vitamin (P-value > 0.05). The odds ratios (ORs) for folate, vitamin B6, vitamin B12, vitamin A, vitamin D, vitamin K, and vitamin C were 1.164 (95% CI: 0.895-1.514), 0.987 (95% CI: 0.969-1.005), 0.975 (95% CI: 0.914-1.041), 0.993 (95% CI: 0.797-1.238), 0.861 (95% CI: 0.522-1.42), 0.955 (95% CI: 0.86-1.059), and 1.049 (95% CI: 0.911-1.208), respectively. Similar results were observed in subgroups of different sepsis severity levels.

CONCLUSIONS: Our MR study found no evidence of a causal association between vitamins and sepsis risk from a genetic perspective. Further randomized controlled trials are necessary to confirm these results.

PMID:37936083 | DOI:10.1186/s12879-023-08778-9