Tag: nevin manimala

Stud Health Technol Inform. 2023 May 18;302:458-462. doi: 10.3233/SHTI230172.

ABSTRACT

One of the major barriers to joining pulmonary rehabilitation (PR) programs is a lack of awareness about its benefits, combined with overall skepticism about regular exercise among COPD patients. Empowering COPD patients with foundational knowledge about PR may potentially facilitate their decision to join a PR program. A virtual reality (VR) app may serve as an engaging and interactive means to deliver PR education; however, the feasibility of this approach in COPD patients is unknown. The goal of this project was to assess the feasibility of VR-based PR education in COPD patients. Using mixed methods design, the feasibility of the VR app was assessed by evaluating its usability, patient acceptance, and its impact on patient knowledge about PR. The results of the usability assessment showed high user acceptance of the VR system and the ability to successfully operate the VR appliances. The use of the VR education app resulted in a statistically significant increase in patient understanding of the main concepts of pulmonary rehabilitation. Further development and evaluation of VR-based systems for patient engagement and empowerment are warranted.

PMID:37203716 | DOI:10.3233/SHTI230172

Stud Health Technol Inform. 2023 May 18;302:356-357. doi: 10.3233/SHTI230138.

ABSTRACT

Patient-Accessible Electronic Health Records (PAEHR) are particularly disputed in mental healthcare. We aim to explore if there is any association between patients having a mental health condition and someone unwanted seeing their PAEHR. A chi-square test showed a statistically significant association between group belonging and experiences of someone unwanted seeing their PAEHR.

PMID:37203682 | DOI:10.3233/SHTI230138

Stud Health Technol Inform. 2023 May 18;302:272-276. doi: 10.3233/SHTI230117.

ABSTRACT

The German Medical Informatics Initiative makes clinical routine data available for biomedical research. In total, 37 university hospitals have set up so-called data integration centers to facilitate this data reuse. A standardized set of HL7 FHIR profiles (“MII Core Data Set”) defines the common data model across all centers. Regular Projectathons ensure continuous evaluation of the implemented data sharing processes on artificial and real-world clinical use cases. In this context, FHIR continues to rise in popularity for exchanging patient care data. As reusing data from patient care in clinical research requires high trust in the data, data quality assessments are a key point of concern in the data sharing process. To support the setup of data quality assessments within data integration centers, we suggest a process for finding elements of interest from FHIR profiles. We focus on the specific data quality measures defined by Kahn et al.

PMID:37203661 | DOI:10.3233/SHTI230117

Stud Health Technol Inform. 2023 May 18;302:237-241. doi: 10.3233/SHTI230110.

ABSTRACT

Missing data is a common problem in the intensive care unit as a variety of factors contribute to incomplete data collection in this clinical setting. This missing data has a significant impact on the accuracy and validity of statistical analyses and prognostic models. Several imputation methods can be used to estimate the missing values based on the available data. Although simple imputations with mean or median generate reasonable results in terms of mean absolute error, they do not account for the currentness of the data. Furthermore, heterogeneous time span of data records adds to this complexity, especially in high-frequency intensive care unit datasets. Therefore, we present DeepTSE, a deep model that is able to cope with both, missing data and heterogeneous time spans. We achieved promising results on the MIMIC-IV dataset that can compete with and even outperform established imputation methods.

PMID:37203654 | DOI:10.3233/SHTI230110

Eur Respir J. 2023 May 18:2300291. doi: 10.1183/13993003.00291-2023. Online ahead of print.

ABSTRACT

BACKGROUND: We aimed to study whether statin use is associated with lowering the development of interstitial lung disease (ILD) or idiopathic pulmonary fibrosis (IPF).

METHODS: The study population was the National Health Insurance Service-Health Screening Cohort (NHIS-HEALS). ILD and IPF cases were identified using the diagnosis codes (J84.1 for ILD and J84.1A for special code for IPF) based on the International Classification of Diseases, 10th revision codes. The study participants were followed up from January 1, 2004 to December 31, 2015. Statins use was defined by the cumulative defined daily dose per 2-year interval and categorized into never-use, less than 182.5, 182.5 to 365.0, 365.0 to 547.5, and 547.5 or more. A Cox model was used to fit a model with a time-dependent variable of statin use.

RESULTS: Incidence rates for ILD with and without statin use were 20.0 and 44.8/100 000 person-year, respectively and those for IPF were 15.6 and 19.3/100 000 person-year, respectively. The use of statins was independently associated with a lower incidence of ILD and IPF in a dose-response fashion (p’s for trend<0.001). ILD showed adjusted hazard ratios (aHRs) 1.02 (95% confidence interval (CI) 0.87-1.20), 0.60 (0.47-0.77), 0.27 (0.16-0.45) and 0.24 (0.13-0.42) according to the increasing category of statin use compared to the never-use. IPF showed aHRs 1.29 (1.07-1.57), 0.74 (0.57-0.96), 0.40 (0.25-0.64) and 0.21 (0.11-0.41), respectively.

INTERPRETATION: A population-based cohort analysis found that statin use is independently associated with a decreased risk of ILD and IPF in a dose-response manner.

PMID:37202155 | DOI:10.1183/13993003.00291-2023

Pediatr Obes. 2023 May 18:e13042. doi: 10.1111/ijpo.13042. Online ahead of print.

ABSTRACT

Obesity and components of the metabolic syndrome (MetS) are associated with differences in brain structure and function and in general and food-related cognition in adults. Here, we review evidence for similar phenomena in children and adolescents, with a focus on the implications of extant research for possible underlying mechanisms and potential interventions for obesity and MetS in youth. Current evidence is limited by a relative reliance on small cross-sectional studies. However, we find that youth with obesity and MetS or MetS components show differences in brain structure, including alterations in grey matter volume and cortical thickness across brain regions subserving reward, cognitive control and other functions, as well as in white matter integrity and volume. Children with obesity and MetS components also show some evidence for hyperresponsivity of food reward regions and hyporesponsivity of cognitive control circuits during food-related tasks, altered brain responses to food tastes, and altered resting-state connectivity including between cognitive control and reward processing networks. Potential mechanisms for these findings include neuroinflammation, impaired vascular reactivity, and effects of diet and obesity on myelination and dopamine function. Future observational research using longitudinal measures, improved sampling strategies and study designs, and rigorous statistical methods, promises to further illuminate dynamic relationships and causal mechanisms. Intervention studies targeted at modifiable biological and behavioural factors associated with paediatric obesity and MetS can further inform mechanisms, as well as test whether brain and behaviour can be altered for beneficial outcomes.

PMID:37202148 | DOI:10.1111/ijpo.13042

BMJ Open. 2023 May 18;13(5):e072313. doi: 10.1136/bmjopen-2023-072313.

ABSTRACT

OBJECTIVES: This study aimed to assess the prevalence and associated factors of stunting and thinness among primary school-age children in the Gudeya Bila district.

METHODS AND ANALYSIS: A community-based cross-sectional study was conducted in the Gudeya Bila district which is located in the Western part of Ethiopia. Among the calculated sample size of 561 school-aged children, 551 children were randomly selected by systematic random sampling technique and participated in this study. Critical illness, physical disability and the inability of caregivers to respond were exclusion criteria. Under-nutrition was the primary outcome while factors associated were the second outcome of this study. Semi-structured interviewer-administered questionnaires were used to collect the data while interview and body measurement were used as data collection techniques. Health Extension Workers collected the data. Data were entered into Epi Data V.3.1 and transported into SPSS V.24.0 software for data cleaning and analysis. Both bivariable and multivariable logistic regressions were run to identify the associated factors of under-nutrition. Model fitness was checked by using Hosmer-Lemeshow’s test. Variables with p values <0.05 were considered statistically significant in the multivariable logistic regression.

RESULTS AND CONCLUSION: The prevalence of stunting and thinness among primary school children was 8.2% (95% CI 5.6% to 10.6%) and 7.1% (95% CI 4.5% to 8.9%), respectively. Being male caregiver (adjusted OR (AOR)=4.26;95% CI 1.256% to 14.464%), family size ≥4 (AOR=4.65; 95% CI 1.8 51% to 11.696%), separated kitchen room (AOR=0.096; 95% CI 0.019 to 0.501) and hand washing after toilet use (AOR=0.152; 95% CI 0.035% to 0.667%) were significantly associated with stunting. Moreover, drinking coffee (AOR=2.25; 95% CI 1.968% to 5.243%) and child dietary diversity score <4 (AOR=2.54; 95% CI 1.721% to 8.939%) were significantly associated with thinness. Under-nutrition in this study was high compared with the global target of eradicating under-nutrition. Community-based nutritional education programmes and implementing health extension programmes are important to reduce the problem of under-nutrition to an undetectable level and to eradicate chronic under-nutrition.

PMID:37202139 | DOI:10.1136/bmjopen-2023-072313

BMJ Open. 2023 May 18;13(5):e071381. doi: 10.1136/bmjopen-2022-071381.

ABSTRACT

INTRODUCTION: Historic disruption in health infrastructure combined with data from a recent vaccine coverage survey suggests there are likely significant immunity gaps to vaccine preventable diseases and high risk of outbreaks in Timor-Leste. Community-based serological surveillance is an important tool to augment understanding of population-level immunity achieved through vaccine coverage and/or derived from prior infection.

METHODS AND ANALYSIS: This national population-representative serosurvey will take a three-stage cluster sample and aims to include 5600 individuals above 1 year of age. Serum samples will be collected by phlebotomy and analysed for measles IgG, rubella IgG, SARS-CoV-2 antispike protein IgG, hepatitis B surface antibody and hepatitis B core antigen using commercially available chemiluminescent immunoassays or ELISA. In addition to crude prevalence estimates and to account for differences in Timor-Leste’s age structure, stratified age-standardised prevalence estimates will be calculated, using Asia in 2013 as the standard population. Additionally, this survey will derive a national asset of serum and dried blood spot samples which can be used for further investigation of infectious disease seroepidemiology and/or validation of existing and novel serological assays for infectious diseases.

ETHICS AND DISSEMINATION: Ethical approval has been obtained from the Research Ethics and Technical Committee of the Instituto Nacional da Saúde, Timor-Leste and the Human Research Ethics Committee of the Northern Territory Department of Health and Menzies School of Health Research, Australia. Co-designing this study with Timor-Leste’s Ministry-of-Health and other relevant partner organisations will allow immediate translation of findings into public health policy, which may include changes to routine immunisation service delivery and/or plans for supplementary immunisation activities.

PMID:37202138 | DOI:10.1136/bmjopen-2022-071381

BMJ Open. 2023 May 18;13(5):e067343. doi: 10.1136/bmjopen-2022-067343.

ABSTRACT

INTRODUCTION: In Liberia, emergency care is still in its early development. In 2019, two emergency care and triage education sessions were done at J. J. Dossen Hospital in Southeastern Liberia. The observational study objectives evaluated key process outcomes before and after the educational interventions.

METHODS: Emergency department paper records from 1 February 2019 to 31 December 2019 were retrospectively reviewed. Simple descriptive statistics were used to describe patient demographics and χ² analyses were used to test for significance. ORs were calculated for key predetermined process measures.

RESULTS: There were 8222 patient visits recorded that were included in our analysis. Patients in the post-intervention 1 group had higher odds of having a documented full set of vital signs compared with the baseline group (16% vs 3.5%, OR: 5.4 (95% CI: 4.3 to 6.7)). After triage implementation, patients who were triaged were 16 times more likely to have a full set of vitals compared with those who were not triaged. Similarly, compared with the baseline group, patients in the post-intervention 1 group had higher odds of having a glucose documented if they presented with altered mental status or a neurologic complaint (37% vs 30%, OR: 1.7 (95% CI: 1.3 to 2.2)), documented antibiotic administration if they had a presumed bacterial infection (87% vs 35%, OR: 12.8 (95% CI: 8.8 to 17.1)), documented malaria test if presenting with fever (76% vs 61%, OR: 2.05 (95% CI: 1.37 to 3.08)) or documented repeat set of vitals if presenting with shock (25% vs 6.6%, OR: 8.85 (95% CI: 1.67 to 14.06)). There was no significant difference in the above process outcomes between the education interventions.

CONCLUSION: This study showed improvement in most process measures between the baseline and post-intervention 1 groups, benefits that persisted post-intervention 2, thus supporting the importance of short-course education interventions to durably improve facility-based care.

PMID:37202137 | DOI:10.1136/bmjopen-2022-067343

BMJ Open. 2023 May 18;13(5):e069683. doi: 10.1136/bmjopen-2022-069683.

ABSTRACT

OBJECTIVE: To assess the magnitude of suicidal ideation, attempts and associated factors among adults living with HIV attending antiretroviral therapy follow-ups at Tirunesh Beijing General Hospital, Addis Ababa.

DESIGN: Hospital-based observational, descriptive, cross-sectional study was conducted.

SETTING: A study was conducted in Tirunesh Beijing General Hospital, Addis Ababa from 8 February 2022 to 10 July 2022.

PARTICIPANTS: Two hundred and thirty-seven HIV-positive youth were recruited for interviews, using the systematic random sampling technique. The Composite International Diagnostic Interview was used to assess suicide. Patient Health Questionnaire-9, the Oslo social support and HIV perceived stigma scale instruments were used to assess the factors. Bivariate and multivariate logistic regressions were computed to assess factors associated with suicidal ideation and attempt. Statistical significance was declared at p value <0.05.

RESULTS: The finding of the study revealed magnitude of suicide ideation and suicide attempt was 22.8% and 13.5%, respectively. Disclosure status (adjusted odd ratio (AOR)=3.60, 95% CI 1.44 to 9.01), history of using substances (AOR)=2.86, 95% CI 1.07 to 7.61), living alone (AOR=6.47, 95% CI 2.31 to 18.10) and having comorbidity or other opportunistic infection (AOR=3.74, 95% CI 1.32 to 10.52) are factors associated with suicide ideation while disclosure status (AOR=5.02, 95% CI 1.95 to 12.94), living arrangement (AOR=3.82, 95% CI 1.29 to 11.31) and depression history is a factor associated with suicide attempts (AOR=3.37, 95% CI 1.09 to 10.40).

CONCLUSION: The finding of the study indicated the magnitude of suicide ideation and attempt is high among the subjects included in this study. Disclosure status, history of using substances, living alone and having comorbidity or other opportunistic infection are factors associated with suicide ideation while disclosure status, living arrangement and depression history are factors associated with a suicide attempt.

PMID:37202134 | DOI:10.1136/bmjopen-2022-069683