Tag: nevin manimala

Expert Rev Pharmacoecon Outcomes Res. 2022 Apr 30. doi: 10.1080/14737167.2022.2073222. Online ahead of print.

ABSTRACT

BACKGROUND: Numerous studies have provided evidence to the literature on the demand side of the determinants of health care expenditure by employing the Grossman model. However, understanding the supply side of the determinants of health care expenditure will be of crucial importance in improving health outcomes.

METHODS: This study has used the panel data of 15 Middle – East region countries for the time period of 2000 – 2016 periods. Initially, Grossman’s model of the demand for care is estimated. Furthermore, a Parallel model of the supply of care is estimated for contradistinction analysis. Finally, an integrated partial least square structural equation model is being developed.

RESULTS: Results show that the relative wage rate and ageing variables are the only indicators that are statistically significant with theoretically consistent signs as postulated by Grossman’s theoretical model. The opposite is true with schooling and the proxy of the medical care relative prices. However, in the parallel model, all the four drivers of the demand for care are statistically significant determinants of health care spending.

CONCLUSIONS: Therefore, expansion of health insurance coverage particularly for the elderly cohort of the population could be a promising mechanism to boost the demand for care and eventually improve health outcomes.

PMID:35491846 | DOI:10.1080/14737167.2022.2073222

Ann Parasitol. 2022;68(1):93-101. doi: 10.17420/ap6801.413.

ABSTRACT

The purpose of this research was to describe the malaria situation in Bushehr province from 2011 to 2018. The current study is a descriptive cross-sectional study based on available data. Between 2011 and 2018, 715 malaria patients were registered in the Bushehr province. The data were analyzed using IBM SPSS Statistics version 22. Male patients made up 92.7% of the total, while female patients made up 7.3%. The age group of 20-29 years had the highest frequency of malaria patients (42.3%), while the age group of over 50 years had the lowest frequency patients (2.5%). Regarding nationality, (96.9%) of malaria patients were Afghans, (2.2%) were Pakistanis, (0.8%) were Iranians, and (0.1%) were Indians. The disease was reported to be the most prevalent in 2017 and the least common in 2013 (29.6% and 2.6%). During this time, malaria prevalence has risen and fallen. Bushehr county had the greatest malaria prevalence (42%) and was followed by Kangan county (20.1%) and Asaluyeh county (12.9%). In terms of parasites, Plasmodium vivax was responsible for (94%) of the cases, P. falciparum for (2.4%), and mixed infection (P. vivax and P. falciparum) for (3.6%). Regarding disease transmission, (93.6%) was imported, (1%) was relapse, (0.4%) was indigenous, and (1.3%) was relapse and imported. Bushehr province is at risk of transmitting malaria due to suitable climatic conditions for the reproduction of vector mosquitoes. As well, it confronts the threat of imported malaria, which has caused concern in recent years as a result of the increase of job-seeking migrants. Strategies of malaria control, basic measures in the field of timely diagnosis and rapid and complete treatment of patients, especially in foreign nationals, vectors control, and preventive approaches are required to eliminate malaria in this province.

PMID:35491835 | DOI:10.17420/ap6801.413

Int J Risk Saf Med. 2022 Apr 21. doi: 10.3233/JRS-210054. Online ahead of print.

ABSTRACT

BACKGROUND: Antimuscarinics are the backbone of the pharmacological management of overactive bladder. Still, concerns have been raised over the nervous system (NS) adverse drug events (AEs) due to their dissimilarities to muscarinic receptor-subtype affinities.

OBJECTIVE: This study aimed to identify the nervous system and gastrointestinal adverse drug events (ADEs) associated with solifenacin use in older adults (≥65 years).

METHODS: A case/non-case analysis was performed on the reports submitted to the FDA Adverse Event Reporting System (FAERS) between 01/01/2004 and 30/06/2020. Cases were reports for solifenacin with ≥1 ADEs as preferred terms included in the Medical Dictionary of Regulatory Activities (MedDRA) system organ classes ‘nervous system’ or ‘gastrointestinal’ disorders. Non-cases were all other remaining reports for solifenacin. The case/non-cases was compared between solifenacin and other bladder antimuscarinics. Frequentist approaches, including the proportional reporting ratio (PRR) and reporting odds ratio (ROR), were used to measure disproportionality. The empirical Bayesian Geometric Mean (EBGM) score and information component (IC) value were calculated using a Bayesian approach. A signal was defined as the lower limit of 95% confidence intervals of ROR ≥ 2, PRR ≥ 2, IC > 0, EBGM > 1, for ADEs with ≥4 reports.

RESULTS: 107 MedDRA preferred terms (PTs) comprising 970 ADE reports were retrieved for nervous system disorders associated with solifenacin. For gastrointestinal disorders, 129 MedDRA PTs comprising 1817 ADE reports were retrieved. Statistically significant results were found for ‘altered state of consciousness’: ROR = 9.71 (2.13-44.35), PRR = 9.69 (2.12-44.2) and IC = 1.29 (0.93-1.66).

CONCLUSIONS: The disproportionality reporting of ‘altered state of consciousness’, a previously unidentified ADE, was unexpected. Further monitoring of this ADE is needed to ensure patient safety, as this could be linked to poor balance and falls in older adults.

PMID:35491805 | DOI:10.3233/JRS-210054

Int J Risk Saf Med. 2022 Apr 26. doi: 10.3233/JRS-210024. Online ahead of print.

ABSTRACT

BACKGROUND: As Twitter has gained significant popularity, tweets can serve as large pool of readily available data to estimate the adverse events (AEs) of medications.

OBJECTIVE: This study evaluated whether tweets were an early indicator for potential safety warnings. Additionally, the trend of AEs posted on Twitter was compared with AEs from the Yellow Card system in the United Kingdom.

METHODS: English Tweets for 35 drug-event pairs for the period 2017-2019, two years prior to the date of EMA Pharmacovigilance Risk Assessment Committee (PRAC) meeting, were collected. Both signal and non-signal AEs were manually identified and encoded using the MedDRA dictionary. AEs from Yellow Card were also gathered for the same period. Descriptive and inferential statistical analysis was conducted using Fisher’s exact test to assess the distribution and proportion of AEs from the two data sources.

RESULTS: Of the total 61,661 English tweets, 1,411 had negative or neutral sentiment and mention of at least one AE. Tweets for 15 out of the 35 drugs (42.9%) contained AEs associated with the signals. On pooling data from Twitter and Yellow Card, 24 out of 35 drug-event pairs (68.6%) were identified prior to the respective PRAC meetings. Both data sources showed similar distribution of AEs based on seriousness, however, the distribution based on labelling was divergent.

CONCLUSION: Twitter cannot be used in isolation for signal detection in current pharmacovigilance (PV) systems. However, it can be used in combination with traditional PV systems for early signal detection, as it can provide a holistic drug safety profile.

PMID:35491804 | DOI:10.3233/JRS-210024

J Parkinsons Dis. 2022 Apr 27. doi: 10.3233/JPD-223207. Online ahead of print.

ABSTRACT

BACKGROUND: Depressive disorders are recognized as a common neuropsychiatric disorder of Parkinson’s disease (PD). Reported frequencies vary widely among studies and depend on the diagnostic criteria, the methods of ascertainment used, and the population sampled.

OBJECTIVE: We aimed to evaluate the frequency of depressive disorders in PD and to investigate the relationship with PD clinical variables.

METHODS: A systematic review and meta-analysis of observational studies (community-based, prospective and retrospective cohort, case-control, community-based, and cross-sectional studies) reporting the frequency of depressive disorders in PD patients.

RESULTS: Electronic database search wielded 3,536 articles; an additional 91 were identified through citation chaining. 163 full-text articles were assessed for eligibility. Of these, 49 met the inclusion criteria for our analysis. The pooled frequency of depressive disorders was 30.7% (95% confidence interval [CI] 25.6 to 36.2; I2 = 95% ; 49 studies; combined n = 10,039). The pooled frequency of major depressive disorder was 14.0% (95% CI 10.5 to 18.5; I2 = 88% ; 23 studies; combined n = 5,218). Subgroup/meta-regression analyses were conducted to investigate the relationship between frequency and study inclusion criteria, methodology used for diagnosis, and study design. We found a statistically significant correlation between study design and depressive disorders frequency (ranging from 8% in the community-based study to 44% in the retrospective studies) and a statistically significant positive correlation between mean baseline PD duration and major depressive disorder frequency.

CONCLUSION: The current meta-analysis found a global frequency of depressive disorders of 30.7% and major depressive disorder of 14.0% . Study design influenced the frequency of depressive disorders in PD. Mean baseline PD duration and major depressive disorder frequency were positively correlated.

PMID:35491801 | DOI:10.3233/JPD-223207

J Alzheimers Dis. 2022 Apr 27. doi: 10.3233/JAD-215654. Online ahead of print.

ABSTRACT

BACKGROUND: Alzheimer’s disease (AD) is a severe health problem. Challenges still remain in early diagnosis.

OBJECTIVE: The objective of this study was to build a Stacking framework for multi-classification of AD by a combination of neuroimaging and clinical features to improve the performance.

METHODS: The data we used were from the Alzheimer’s Disease Neuroimaging Initiative database with a total of 493 subjects, including 125 normal control (NC), 121 early mild cognitive impairment, 109 late mild cognitive impairment (LMCI), and 138 AD. We selected structural magnetic resonance imaging (sMRI) features by voting strategy. The imaging features, demographic information, Mini-Mental State Examination, and Alzheimer’s Disease Assessment Scale-Cognitive Subscale were combined together as classification features. We proposed a two-layer Stacking ensemble framework to classify four types of people. The first layer represented support vector machine, random forests, adaptive boosting, and gradient boosting decision tree; the second layer was a logistic regression classifier. Additionally, we analyzed performance of only sMRI feature and combined features and compared the proposed model with four base classifiers.

RESULTS: The Stacking model combined with sMRI and non-imaging features outshined four base classifiers with an average accuracy of 86.96% . Compared with using sMRI data alone, sMRI combined with non-imaging features significantly improved diagnostic accuracy, especially in NC versus LMCI and LMCI versus AD by 14.08% .

CONCLUSION: The Stacking framework we used can improve performance in diagnosis of AD using combined features.

PMID:35491782 | DOI:10.3233/JAD-215654

J Alzheimers Dis. 2022 Apr 25. doi: 10.3233/JAD-220166. Online ahead of print.

ABSTRACT

Features of linguistic impairment in Alzheimer’s disease (AD) are primarily derived from English-speaking patients. Little is known regarding such deficits in linguistically diverse speakers with AD. We aimed to detail linguistic profiles (speech rate, dysfluencies, syntactic, lexical, morphological, semantics) from two connected speech tasks-Frog Story and picture description-in Bengali-speaking AD patients. The Frog Story detected group differences on all six linguistic levels, compared to only three with picture description. Critically, Frog Story captured the language-specific differences between the groups. Careful consideration should be given to the choice of connected speech tasks for dementia diagnosis in linguistically diverse populations.

PMID:35491794 | DOI:10.3233/JAD-220166

J Alzheimers Dis. 2022 Apr 25. doi: 10.3233/JAD-215537. Online ahead of print.

ABSTRACT

BACKGROUND: Best approaches for retaining research participants in Alzheimer’s disease cohort studies are understudied.

OBJECTIVE: Using data from the National Alzheimer’s Coordinating Center Uniform Data Set, we evaluated the associations of unique strategies with participant retention across Alzheimer’s Disease Research Centers and explored potential effect modification by race/ethnicity and diagnostic group.

METHODS: We examined retention at the first follow-up visit among participants enrolled during 2015-2017. Structured surveys ascertained 95 retention tactics among 12 strategies. Strategy-specific summary scores were created based on the number of implemented tactics for each strategy and grouped into tertiles. Generalized estimating equations were constructed to evaluate associations of strategy scores and the odds of retention, controlling for age, sex, education, race and ethnicity, study partner type, marital status, visit length, battery length, and diagnostic group. Separate models were stratified by race/ethnicity and diagnostic group. Effect modification was formally tested with interaction terms.

RESULTS: Among 5,715 total participants enrolled, 4,515 were Non-Hispanic White (79%), 335 were Hispanic/Latino (6%), 651 were Non-Hispanic Black (11%), and 214 were Non-Hispanic Asian (4%). Compared to the lowest tertile of scores, the highest tertile of scores involving improvement in study personnel and communication of study requirements and details were associated with 61% higher odds of retention in fully adjusted models (adjusted Odds Ratios [aOR] = 1.61, 95% Confidence Interval [CI] = 1.05-2.47 and aOR = 1.55, 95% CI = 1.03-2.35, respectively). We did not find evidence for effect modification.

CONCLUSION: In the setting of limited resources, specific retention strategies may be more valuable than others.

PMID:35491778 | DOI:10.3233/JAD-215537

J Osteopath Med. 2022 May 3. doi: 10.1515/jom-2022-0011. Online ahead of print.

ABSTRACT

CONTEXT: The most common skeletal disease, osteoporosis, causes bone fragility due to decreased bone mass and bone microarchitecture destruction. The health belief model is often applied to asymptomatic, prevention-related diseases such as osteoporosis. Steps to mitigate the insidious nature of osteoporosis, including education, motivation, and monitoring of bone mineral density, must begin at an earlier age.

OBJECTIVES: This study evaluates the knowledge and health beliefs surrounding osteoporosis in a population of males and females 35-50 years old to determine sex-based differences in osteoporosis knowledge and beliefs and to assess the correlation between perceptions and health motivation.

METHODS: Participants (81 males, 92 females) completed two questionnaires: the Osteoporosis Knowledge Test and the Osteoporosis Health Belief Scale. Descriptive statistics were performed along with Pearson product-moment correlation analysis to determine the relationships between the variables. Sex-based differences were calculated utilizing independent t-tests.

RESULTS: We discovered a statistically significant negative correlation between the barriers to exercise and health motivation (-0.434, p < 0.001) and a statistically significant positive correlation between the benefits of exercise and health motivation (0.385, p < 0.001). However, there was not a statistically significant correlation between health motivation with the following: the benefits of calcium, susceptibility, and the seriousness of osteoporosis. Between males and females, there was a statistically significant difference in exercise and calcium knowledge, susceptibility, and the benefits of both exercise and calcium (p < 0.05).

CONCLUSIONS: Males and females 35-50 years old perceive themselves to have a low susceptibility to osteoporosis. They do not consider osteoporosis a serious disease and have little motivation to mitigate its inception or progression. Their perceptions show that barriers to exercise impact health motivation more than the perceived benefits of exercise.

PMID:35491729 | DOI:10.1515/jom-2022-0011

Sci Prog. 2022 Apr-Jun;105(2):368504221096539. doi: 10.1177/00368504221096539.

ABSTRACT

Background: Thiamine, also known as vitamin B1, is an essential water-soluble micronutrient. Although thiamine has minimal safety concerns, parenteral administration has been associated with rare cases of anaphylactic shock, cardiac arrest, and injection site reaction. The objective of this analysis is to evaluate the incidence of anaphylaxis and injection site reactions associated with the administration of thiamine 500 mg as an intravenous (IV) push in adult patients. Method: This single-center, retrospective analysis was performed at Brigham and Women’s Hospital in Boston, Massachusetts. Electronic health records were used to identify all adult patients who were ordered for thiamine 500 mg IV push between July 1, 2020, and December 31, 2020. For the major and minor endpoints, anaphylaxis and injection site reactions were assessed, respectively. Descriptive statistics were used as appropriate. Results: A total of 463 doses of thiamine in 69 patients were evaluated. Thiamine was administered peripherally for 392 (84.7%) doses and centrally for 68 (14.7) doses. No anaphylactic reactions were observed. A total of 4 injection site reactions (0.86%) were noted with 4 unique doses. All reactions were classified as low-grade based on our institutional grading system. All injection site reactions were classified as “possible” (Naranjo score of 1-4). Conclusion: Administration of IV push 500 mg thiamine was not associated with anaphylactic events and was associated with a low rate of injection site reactions.

PMID:35491726 | DOI:10.1177/00368504221096539