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Nevin Manimala Statistics

Hematological Incidies May Predict Oxidative Stress in Patients with ST-segment Elevation Myocardial Infarction

Turk Kardiyol Dern Ars. 2023 Apr;51(3):196-201. doi: 10.5543/tkda.2022.37011.

ABSTRACT

OBJECTIVE: Oxidative stress is closely related to the development of atherosclerosis and acute coronary syndromes. In this study, we aimed to examine the relationship between hemogram indices and oxidative stress parameters in patients with ST-segment elevation myocardial infarction.

METHODS: A single-centered, prospective, and cross-sectional study was performed in 61 patients with ST-segment elevation myocardial infarction. Before coronary angiography, in the blood samples taken from the peripheral vein, hemogram indices and oxidative stress parameters such as total oxidative status, total antioxidant status, and oxidative stress index were examined. We examined a total of 15 hemogram indices.

RESULTS: Most of the study patients were male (78%), and the mean age was 59.3 �� 12.2 years. Mean corpuscular volume value was found to be negatively and moderately signi���cantly correlated with total oxidative status and oxidative stress index values (r = ���0.438, r = ���0.490, P <��0.001). A negative and moderate signi���cant correlation was found between mean corpuscular hemoglobin and total oxidative status and oxidative stress index values (r = ���0.487, r = ���0.433, P < 0.001). Red cell distribution width value was found to be positively and moderately correlated with total oxidative status (r = 0.537, P < 0.001). Red cell distribution width was also found to be moderately and statistically signi���cantly correlated with oxidative stress index value (r = 0.410, P = 0.001). In receiver operating characteristic analysis, mean corpuscular volume, mean corpuscular hemoglobin, and red cell distribution width levels have been successful in predicting total oxidative status and oxidative stress index.

CONCLUSIONS: We conclude that mean corpuscular volume, mean corpuscular hemoglobin, and red cell distribution width levels predict oxidative stress in patients with ST-segment elevation myocardial infarction.

PMID:36999329 | DOI:10.5543/tkda.2022.37011

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A cross-sectional study on alcohol and contraception use among sexually active women of childbearing age: Implications for preventing alcohol-exposed pregnancies

Womens Health (Lond). 2023 Jan-Dec;19:17455057231161479. doi: 10.1177/17455057231161479.

ABSTRACT

BACKGROUND: A high proportion of unwanted or unplanned pregnancies may be alcohol-exposed due to contraception failure or non-use. Nevertheless, data on contraception and alcohol use in the context of the risk of alcohol-exposed pregnancies are sparse.

OBJECTIVES: To describe contraception use and alcohol consumption in sexually active non-pregnant women and investigate the factors associated with less effective contraception methods.

STUDY DESIGN: A cross-sectional national survey of women aged 18-35 years.

METHODS: Data from non-pregnant women who were sexually active (n = 517) were analysed. Descriptive statistics were used to report demographics, consumption, and contraception measures. Logistic regression was used to investigate the factors associated with less effective contraception among drinkers.

RESULTS: The majority of participants were younger (46%), of NZ European ethnicity (78%), not in a permanent relationship (54%), with some or completed tertiary education (79%), employed (81%) and not users of the community services card (82%). Twenty-five percent of women were smokers, 94% consumed alcohol, and 72% binged at least ‘monthly or less’. Most women used the pill (56%), and 20% of drinking women were using a contraception method with a 10% or more annual failure rate after 1 year of use. Women who binged ‘weekly or more often’ had similar odds of using less effective contraception as women who ‘never’ binged (p > 0.05). Younger Māori or Pacific women (odds ratio = 5.99; 95% confidence interval of odds 1.1531.2; p = 0.033) and women who had no tertiary education (odds ratio = 1.75; 95% confidence interval of odds 0.003.06; p = 0.052) had higher odds of using less effective contraception.

CONCLUSION: With 20% of women at risk of an alcohol-exposed pregnancy, public health measures to address alcohol consumption and the effective use of contraception are critical to reducing the risk for alcohol-exposed pregnancies in NZ.

PMID:36999316 | DOI:10.1177/17455057231161479

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Identification of high-risk symptom cluster burden group among midlife peri-menopausal and post-menopausal women with metabolic syndrome using latent class growth analysis

Womens Health (Lond). 2023 Jan-Dec;19:17455057231160955. doi: 10.1177/17455057231160955.

ABSTRACT

BACKGROUND: Midlife peri-menopausal and post-menopausal women with metabolic syndrome experience multiple co-occurring symptoms or symptom clusters, which often result in significant symptom cluster burden. While they are a high-risk symptom burden group, there are no studies that have focused on identifying symptom cluster trajectories in midlife peri-menopausal and post-menopausal women with metabolic syndrome.

OBJECTIVES: The objectives were to identify meaningful subgroups of midlife peri-menopausal and post-menopausal women with metabolic syndrome based on their distinct symptom cluster burden trajectories, and to describe the demographic, social, and clinical characteristics of different symptom cluster burden subgroups.

DESIGN: This is a secondary data analysis using the longitudinal data from Study of Women’s Health Across the Nation.

METHODS: Multi-trajectory analysis using latent class growth analysis was conducted to join the different developmental trajectories of symptom clusters to identify meaningful subgroups and high-risk subgroup for greater symptom cluster burden over time. Then, descriptive statistics were used to explain the demographic characteristics of each symptom cluster trajectory subgroup, and bivariate analysis to examine the association between each symptom cluster trajectory subgroup and demographic characteristics.

RESULTS: A total of four classes were identified: Class 1 (low symptom cluster burden), Classes 2 and 3 (moderate symptom cluster burden), and Class 4 (high symptom cluster burden). Social support was a significant predictor of high symptom cluster burden subgroup and highlights the need to provide routine assessment.

CONCLUSION: An understanding and appreciation for the different symptom cluster trajectory subgroups and their dynamic nature will assist clinicians to offer targeted and routine symptom cluster assessment and management in clinical settings.

PMID:36999312 | DOI:10.1177/17455057231160955

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Social prescribing in combating loneliness and supporting physical activity

Ugeskr Laeger. 2023 Mar 13;185(11):V09220545.

ABSTRACT

High-prevalence rates and increased morbidity suggest that loneliness is a major public health concern warranting novel health-care strategies and interventions promoting social connectedness. Social prescribing (SP) constitutes such strategy and is, despite scarce evidence, increasingly promoted. Focusing primarily on building and maintaining social support, SP appears especially relevant in connection to community-based physical activity. In this review, we introduce and discuss the adaptation of SP in the context of the Danish healthcare system and provide examples of current research initiatives.

PMID:36999284

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DISCLOSING A HISTORY OF CHILDHOOD CANCER TO ROMANTIC PARTNERS

Psychooncology. 2023 Mar 30. doi: 10.1002/pon.6130. Online ahead of print.

ABSTRACT

OBJECTIVE: To describe young adult childhood cancer survivors’ disclosure of their cancer history (i.e., disclosure behavior, difficulty, and timing), perceived partner responses, and associations with relationship status satisfaction.

METHODS: German long-term survivors of childhood cancer (N=509; response rate: 31.3%, age 21-26, 59.7% female) completed a registry-based nationwide survey (embedded mixed methods design, including closed and open-ended questions) on measures about disclosure history (behavior, difficulty, and timing), partner responses, and relationship status satisfaction. Statistical (χ2 -, t-, or F-tests) and qualitative analyses were conducted.

RESULTS: Half of all survivors always disclosed their cancer history to romantic partners. Thereby, three themes for considering (non-)disclosure were identified: Survivors’ attitudes, having integrated cancer as part of their identity, and anticipated effects on romantic relationships. About 40% indicated having no difficulties with disclosing their cancer history. The timing of disclosure varied, with most survivors disclosing after a few dates. Facilitators of disclosure were the visibility of their former illness (e.g., scars), having trust in a (potential) partner, getting older/mature, and previous positive experiences with disclosure. Few survivors (13.8%) had ever experienced negative responses from dating partners. Yet, those who had negative experiences, found it more difficult to disclose their cancer history. Survivors were overall rather satisfied with their relationship status, with partnered survivors reporting greater satisfaction than singles (Hedge’s g=1.68); and particularly partnered survivors with past positive responses being most satisfied.

CONCLUSIONS: Young adult childhood cancer survivors appear rather open in disclosing their cancer history to (potential) romantic partners, and few experienced negative responses. Psycho-educational programs may emphasize such findings in helping to prevent fear of disclosure or avoidance of dating and disclosure among survivors. This article is protected by copyright. All rights reserved.

PMID:36998113 | DOI:10.1002/pon.6130

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The relationship between obstructive sleep apnea and asthma severity and vice versa: a systematic review and meta-analysis

Eur J Med Res. 2023 Mar 30;28(1):139. doi: 10.1186/s40001-023-01097-4.

ABSTRACT

BACKGROUND: There is a great association between the prevalence of obstructive sleep apnea (OSA) and asthma. Nonetheless, whether OSA impacts lung function, symptoms, and control in asthma and whether asthma increases the respiratory events in OSA are unknown. This meta-analysis aimed to examine the relationship between obstructive sleep apnea and asthma severity and vice versa.

METHODS: We carried out a systematic search of PubMed, EMBASE, and Scopus from inception to September 2022. Primary outcomes were lung function, parameters of polysomnography, the risk of OSA in more severe or difficult-to-control asthmatic patients, and the risk of asthma in patients with more severe OSA. Heterogeneity was examined with the Q test and I2 statistics. We also performed subgroup analysis, Meta-regression, and Egger’s test for bias analysis.

RESULTS: 34 studies with 27,912 subjects were totally included. The results showed that the comorbidity of OSA aggravated lung function in asthmatic patients with a consequent decreased forced expiratory volume in one second %predicted (%FEV1) and the effect was particularly evident in children. %FEV1 tended to decrease in adult asthma patients complicated with OSA, but did not reach statistical significance. Interestingly, the risk of asthma seemed to be slightly lower in patients with more severe OSA (OR = 0.87, 95%CI 0.763-0.998). Asthma had no significant effect on polysomnography, but increased daytime sleepiness assessed by the Epworth Sleepiness Scale in OSA patients (WMD = 0.60, 95%CI 0.16-1.04). More severe asthma or difficult-to-control asthma was independently associated with OSA (odds ratio (OR) = 4.36, 95%CI 2.49-7.64).

CONCLUSION: OSA was associated with more severe or difficult-to-control asthma with decreased %FEV1 in children. The effect of OSA on lung function in adult patients should be further confirmed. Asthma increased daytime sleepiness in OSA patients. More studies are warranted to investigate the effect of asthma on OSA severity and the impact of different OSA severity on the prevalence of asthma. It is strongly recommended that people with moderate-to-severe or difficult-to-control asthma screen for OSA and get the appropriate treatment.

PMID:36998095 | DOI:10.1186/s40001-023-01097-4

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Tick-borne pathogens and body condition of cattle in smallholder rural livestock production systems in East and West Africa

Parasit Vectors. 2023 Mar 30;16(1):117. doi: 10.1186/s13071-023-05709-0.

ABSTRACT

BACKGROUND: The majority of the African population lives in rural areas where they heavily depend on crop and livestock production for their livelihoods. Given their socio-economic importance, we initiated a standardized multi-country (Benin, Burkina Faso, Ghana, Nigeria, Ethiopia Tanzania and Uganda) surveillance study to assess the current status of important tick-borne haemoparasites (TBHPs) of cattle.

METHODS: We assessed pathogen prevalences (Anaplasma marginale, Anaplasma centrale, Babesia bigemina, Babesia bovis, Ehrlichia ruminantium, and Theileria parva) in the blood of 6447 animals spread over fourteen districts (two districts per country). In addition, we screened for intrinsic (sex, weight, body condition) and extrinsic (husbandry, tick exposure) risk factors as predictors of infections with TBHPs.

RESULTS: There was a large macro-geographic variation observed in A. marginale, B. bigemina, B. bovis and E. ruminantium prevalences. Most correlated with the co-occurrence of their specific sets of vector-competent ticks. Highest numbers of infected cattle were found in Ghana and Benin, and lowest in Burkina Faso. While T. parva was seldomly found (Uganda only: 3.0%), A. marginale was found in each country with a prevalence of at least 40%. Babesia bovis infected individuals had lower body condition scores. Age (as estimated via body weight) was higher in A. marginale infected cattle, but was negatively correlated with B. bigemina and E. ruminantium prevalences. Ehrlichia ruminantium infection was more often found in males, and A. marginale more often in transhumance farming. High levels of co-infection, especially the combination A. marginale × B. bigemina, were observed in all countries, except for Uganda and Burkina Faso. Babesia bigemina was more or less often observed than expected by chance, when cattle were also co-infected with E. ruminantium or A. marginale, respectively.

CONCLUSIONS: Tick-borne pathogens of cattle are ubiquitous in African’s smallholder cattle production systems. Our standardized study will help a wide range of stakeholders to provide recommendations for TBHP surveillance and prevention in cattle, especially for B. bovis which heavily impacts production and continues its spread over the African continent via the invasive Rhipicephalus microplus tick.

PMID:36998091 | DOI:10.1186/s13071-023-05709-0

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Development of models to predict 10-30-year cardiovascular disease risk using the Da Qing IGT and diabetes study

Diabetol Metab Syndr. 2023 Mar 30;15(1):62. doi: 10.1186/s13098-023-01039-4.

ABSTRACT

BACKGROUND: This study aimed to develop cardiovascular disease (CVD) risk equations for Chinese patients with newly diagnosed type 2 diabetes (T2D) to predict 10-, 20-, and 30-year of risk.

METHODS: Risk equations for forecasting the occurrence of CVD were developed using data from 601 patients with newly diagnosed T2D from the Da Qing IGT and Diabetes Study with a 30-year follow-up. The data were randomly assigned to a training and test data set. In the training data set, Cox proportional hazard regression was used to develop risk equations to predict CVD. Calibration was assessed by the slope and intercept of the line between predicted and observed probabilities of outcomes by quintile of risk, and discrimination was examined using Harrell’s C statistic in the test data set. Using the Sankey flow diagram to describe the change of CVD risk over time.

RESULTS: Over the 30-year follow-up, corresponding to a 10,395 person-year follow-up time, 355 of 601 (59%) patients developed incident CVD; the incidence of CVD in the participants was 34.2 per 1,000 person-years. Age, sex, smoking status, 2-h plasma glucose level of oral glucose tolerance test, and systolic blood pressure were independent predictors. The C statistics of discrimination for the risk equations were 0.748 (95%CI, 0.710-0.782), 0.696 (95%CI, 0.655-0.704), and 0.687 (95%CI, 0.651-0.694) for 10-, 20-, and 30- year CVDs, respectively. The calibration statistics for the CVD risk equations of slope were 0.88 (P = 0.002), 0.89 (P = 0.027), and 0.94 (P = 0.039) for 10-, 20-, and 30-year CVDs, respectively.

CONCLUSIONS: The risk equations forecast the long-term risk of CVD in patients with newly diagnosed T2D using variables readily available in routine clinical practice. By identifying patients at high risk for long-term CVD, clinicians were able to take the required primary prevention measures.

PMID:36998090 | DOI:10.1186/s13098-023-01039-4

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Menstrual health and hygiene among Juang women: a particularly vulnerable tribal group in Odisha, India

Reprod Health. 2023 Mar 30;20(1):55. doi: 10.1186/s12978-023-01603-1.

ABSTRACT

BACKGROUND: Menstruation is a normal biological process that all women go through, yet it is shrouded in secrecy, taboos, and even stigma in many societies. Studies have shown that women from socially disadvantaged groups are more likely to have preventable reproductive health issues and have less understanding of hygienic menstrual practices. Therefore, this study aimed to provide an insight into the most sensitive issue of menstruation and menstrual hygiene practices among the women of the Juang tribe, recognized as one of the particularly vulnerable tribal groups (PVTG) in India.

METHODS: A cross-sectional study using a mixed-method approach was carried out among Juang women in Keonjhar district of Odisha, India. Quantitative data was gathered from 360 currently married women to assess practices associated with menstruation and its management. In addition, 15 focus group discussions and 15 in-depth interviews were conducted to explore the views of Juang women on menstrual hygiene practices, cultural beliefs, menstrual problems, and treatment-seeking behaviour. Inductive content analysis was used to analyse the qualitative data, while descriptive statistics and chi-squared tests were used to analyse quantitative data.

RESULTS: Most Juang women (85%) used old clothes as absorbents during menstruation. Distance from the market (36%), lack of awareness (31%), and high cost (15%) were cited as the contributing factors to the low level of sanitary napkin usage. Around 85% of women were restricted from participating in religious activities, and 94% avoided social gatherings. Seventy-one percent of the Juang women experienced menstrual problems, while only one-third of them sought treatment for their problems.

CONCLUSION: Hygienic practices during menstruation are far from satisfactory among Juang women in Odisha, India. Menstrual problems are common, and the treatment sought is insufficient. There is a need for awareness generation on menstrual hygiene, the adverse effects of menstrual problems, and the provision of low-cost sanitary napkins among this disadvantaged, vulnerable tribal group.

PMID:36998075 | DOI:10.1186/s12978-023-01603-1

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Medical students’ reflective capacity and its role in their critical thinking disposition

BMC Med Educ. 2023 Mar 30;23(1):198. doi: 10.1186/s12909-023-04163-x.

ABSTRACT

BACKGROUND: Developing reflective capacity and critical thinking is one of the prerequisites of education in health professions, especially medicine. This study aimed to determine the reflective capacity of medical students and its role in their critical thinking disposition.

METHODS: In this cross-sectional descriptive research, conducted in 2022, a total of 240 medical intern students were selected using the convenient sampling method. Data were collected using a reflective capacity questionnaire and critical thinking disposition questionnaire and analyzed with descriptive and inferential statistics using SPSS20.

RESULTS: The mean reflective capacity was 4.53 ± 0.50, and mean critical thinking disposition was 127.52 ± 10.85. Among the dimensions of reflection, “active self-appraisal (SA)” and “reflective with others (RO)” had the highest and lowest means, respectively. The dimensions of critical thinking disposition with the highest and lowest means were related to innovation and intellectual maturity, respectively. Reflective capacity and its dimensions were found to have a direct and statistically significant relationship with critical thinking disposition and its dimensions. Regression analysis results showed that reflective capacity accounts for 28% of students’ critical thinking disposition.

CONCLUSION: The relationship between students’ reflective capacity and their critical thinking disposition has rendered reflection as one of the necessary components of medical education. Thus, determining the learning activities by considering the reflection process and models will be very effective in creating and strengthening critical thinking disposition.

PMID:36998069 | DOI:10.1186/s12909-023-04163-x