Tag: nevin manimala

Health Econ Rev. 2022 Feb 12;12(1):13. doi: 10.1186/s13561-022-00357-z.

ABSTRACT

BACKGROUND: Despite the focus of the National Health Insurance Scheme (NHIS) to bridge healthcare utilisation gap among women in Ghana, recent evidence indicates that most maternal deaths still occur from rural Ghana. The objective of this study was to examine the rural-urban differences in the effects of NHIS enrolment on delivery care utilisation (place of delivery and assistance at delivery) and antenatal care services among Ghanaian women.

METHODS: A nationally representative sample of 4169 women from the 2014 Ghana Demographic and Health Survey was used. Out of this sample, 2880 women are enrolled in the NHIS with 1229 and 1651 being urban and rural dwellers, respectively. Multivariate logistic and negative binomial models were fitted as the main estimation techniques. In addition, the Propensity Score Matching technique was used to verify rural-urban differences.

RESULTS: At the national level, enrolment in NHIS was observed to increase delivery care utilisation and the number of ANC visits in Ghana. However, rural-urban differences in effects were pronounced: whereas rural women who are enrolled in the NHIS were more likely to utilise delivery care [delivery in a health facility (OR = 1.870; CI = 1.533-2.281) and assisted delivery by a medical professional (OR = 1.994; CI = 1.631-2.438)], and have a higher number of ANC visits (IRR = 1.158; CI = 1.110-1.208) than their counterparts who are not enrolled, urban women who are enrolled in the NHIS on the other hand, recorded statistically insignificant results compared to their counterparts not enrolled. The PSM results corroborated the rural-urban differences in effects.

CONCLUSION: The rural-urban differences in delivery and antenatal care utilisation are in favour of rural women enrolled in the NHIS. Given that poverty is endemic in rural Ghana, this positions the NHIS as a potential social equaliser in maternal health care utilisation especially in the context of developing countries by increasing access to delivery care services and the number of ANC visits.

PMID:35150373 | DOI:10.1186/s13561-022-00357-z

Environ Monit Assess. 2022 Feb 12;194(3):176. doi: 10.1007/s10661-022-09775-2.

ABSTRACT

Climate extremes are becoming more prevalent and hazardous as global climate change increases. The purpose of this study was to find out how often severe rainfall and temperature events occur, as well as the study area’s spatial vulnerability indexes to extremes of both indices. Thirty years of daily rainfall and temperature data from 10 national meteorological stations were used. Four rainfall and eight temperature extremes were extracted using Climpact2 software tools. These variables were calculated for standardized anomaly and vulnerability indices and mapped using ArcMap. The results showed that the spatial variation of climatic extremes in the study area was significantly varied. Avery high rainfall (R95P) and extremely high rainfall (R99P) were widely experienced in the study area’s west-south, but in the southeast, similar trends were rare. R95P had a statistically significant growing trend, but R99P did not. The warmest night temperature (TNx) event was widely observed in the east, southeast, and northwest, but the coldest night temperature (TNn) was only found in the eastern part. Extremely cold daytime temperatures (TXn) were more prevalent in the south and southeast of the study area, whereas extremely warm daytime temperatures (TXx) were more prevalent in the north. The number of dry spells (CDD), R95P, R99P, cold spells at night (TN10P), warm spells at night (TN90P), cold spells during the day (TX10P), and warm spells during the day (TX10P) frequency bell curves were skewed to the left side of the histogram. This suggests that the distribution of the variables was not symmetrical due to the fact that the negative anomaly frequencies of the variables were higher than the positive ones. The results of the spatial vulnerability study show that all provinces were vulnerable to the combined effects of climatic extremes, with scores ranging from 0.20 to 0.8, with none of them vulnerable and extremely vulnerable areas. Omo-Nada and Chora-Botor were particularly sensitive to climate change with an average score of 0.61. Only 12 of the 27 severe climate indexes were taken into account in this study, and the remaining 15 extreme indices will have to be investigated further.

PMID:35150331 | DOI:10.1007/s10661-022-09775-2

Nurs Health Sci. 2022 Feb 12. doi: 10.1111/nhs.12929. Online ahead of print.

ABSTRACT

The public debate surrounding the COVID-19 vaccine is especially intense regarding pregnant women, who are concerned with its effects on themselves and their fetus, and a vulnerable at-risk population for psychological distress. We aimed at describing differences in vaccination status between Jewish and Arab pregnant women, and understanding factors contributing to psychological distress among Arab women. Pregnant women (n = 860) aged 19-46 completed self-report questionnaires during the national vaccination program (March-April 2021). The questionnaires related to background, COVID-19-related vaccination status and intentions in this regard, COVID-19-related anxiety, and the Mental Health Inventory-Short Form. Data were analyzed using descriptive statistics, t and chi-square tests, Pearson correlations, and a hierarchical regression. Considerably fewer Jewish women had been infected and more were vaccinated than Arab women. Poorer health, lower economic status, being a mother, not being vaccinated, and higher anxiety over economic damage, a family member being infected, delivery, and raising the baby contributed to higher distress. Findings offer novel insights for nurses in their efforts to encourage vaccination, highlighting the need to understand women’s concerns during the vulnerable period of pregnancy. This article is protected by copyright. All rights reserved.

PMID:35150201 | DOI:10.1111/nhs.12929

J Cosmet Dermatol. 2022 Feb 12. doi: 10.1111/jocd.14841. Online ahead of print.

ABSTRACT

OBJECTIVE: To investigate the effects of intense pulsed light (IPL) and ablative 2.940 nm erbium-doped yttrium aluminum garnet (Er: YAG) laser on dynamic changes in collagen by quantitative analysis of type I collagen (Col I) and type III collagen (Col III), transforming growth factor (TGF) and matrix metalloproteinases (MMPs) in the dermis of rabbits.

METHODS: Backs of ten rabbits were divided into four treatment areas: IPL normal energy group, IPL high energy group, erbium laser normal energy group and erbium laser high energy group. HE staining was performed immediately after the first treatment and two weeks after the first treatment. Col I, Col III, TGF-β1 and MMP-1 were collected by real-time PCR at baseline, 2 weeks after each session and three months after the entire treatment monthly.

RESULTS: HE staining showed that collagen fibers in the superficial layer of the dermis in the four treatment groups were increased and thickened to different degrees. Real-time PCR showed that statistically differences were noted in each checkpoint before and after treatments in the four groups, whereas no significant difference in the change in the four biomarkers was found among the four treatment groups.

CONCLUSION: Both the IPL and Er:YAG laser can effectively upregulate collagens, but in this experiment, there was no significant difference in the therapeutic effect among the four irradiation groups. Moreover, the high energy level group tended to bring more serious epidermal injury.

PMID:35150199 | DOI:10.1111/jocd.14841

Ann Neurol. 2022 Feb 12. doi: 10.1002/ana.26324. Online ahead of print.

ABSTRACT

OBJECTIVE: To obtain individual clinical and neuroimaging data of patients undergoing Deep Brain Stimulation for essential tremor from five different European centers to identify predictors of outcome and to identify an optimal stimulation site.

METHODS: We analysed retrospectively baseline covariates, pre- and postoperative clinical tremor scores (12-month) as well as individual imaging data from 119 patients to obtain individual electrode positions and stimulation volumes. Individual imaging and clinical data was used to calculate a probabilistic stimulation map in normalized space using voxel-wise statistical analysis. Finally, we used this map to train a classifier to predict tremor improvement.

RESULTS: Probabilistic mapping of stimulation effects yielded a statistically significant cluster that was associated with a tremor improvement greater than 50%. This cluster of optimal stimulation extended from the posterior subthalamic area to the ventralis intermedius nucleus and coincided with a normative structural-connectivity-based cerebello-thalamic tract (CTT). The combined features “distance between the stimulation volume and the significant cluster” and “CTT activation” were used as a predictor of tremor improvement. This correctly classified a greater than 50% tremor improvement with a sensitivity of 89% and a specificity of 57%.

INTERPRETATION: Our multicentre ET probabilistic stimulation map identified an area of optimal stimulation along the course of the CTT. The results of this study are mainly descriptive until confirmed in independent datasets, ideally through prospective testing. This target will be made openly available and may be used to guide surgical planning and for computer-assisted programming of deep brain stimulation in the future. This article is protected by copyright. All rights reserved.

PMID:35150172 | DOI:10.1002/ana.26324

Dermatol Ther. 2022 Feb 12:e15376. doi: 10.1111/dth.15376. Online ahead of print.

ABSTRACT

BACKGROUND: Post acne scars following sebaceous injury and abnormal wound healing during the course of acne is a prevalent and challenging to treat condition.

AIM OF THE WORK: To evaluate microneedling by dermapen with topical vitamin C versus microneedling with topical insulin in treating atrophic post-acne scars.

PATIENTS AND METHODS: A split -face comparative study included 30 subjects with atrophic post-acne scars. Human insulin was topically applied to the left side of the face and on the right side, vitamin C serum was applied. Scars were assessed via the Acne Scar Assessment Scale (ASAS) and Scar quartile grading scale (SQGS).

RESULTS: After one month of 4 treatments, a statistically significant mean improvement in ASAS value was reported on both split sides of the face (2.13 and 1.83) compared to baseline (3.03 and 2.93) (p=0.005; p=0.001 respectively). When compared to baseline, the mean ASAS value improved significantly with a slight more improvement on the vitamin c treated side CONCLUSION: Topical insulin and vitamin c combined with microneedling, may both achieve comparable significant improvement for treating post acne scars. Insulin can be a promising novel anti-scarring therapy pending larger controlled studies to verify its efficacy. This article is protected by copyright. All rights reserved.

PMID:35150195 | DOI:10.1111/dth.15376

Clin Endocrinol (Oxf). 2022 Feb 12. doi: 10.1111/cen.14687. Online ahead of print.

ABSTRACT

OBJECTIVE: To assess the influence of longitudinal weight gain from 0 to 4 years old on dehydroepiandrosterone sulfate (DHEAS) levels at 7 years old.

METHODS: DHEAS levels were measured at 7 years old in a subsample of 587 children from the Generation XXI birth cohort. Weight trajectories (0-4 years of age) were identified using model-based clustering and categorized as “normal weight gain”, “weight gain during infancy”, “weight gain during childhood” and “persistent weight gain”. Differences in DHEAS levels at age 7 between the four weight trajectories were analyzed through ANCOVA, adjusted for birth weight (BW) and body mass index (BMI).

RESULTS: In the crude analysis, compared with the “normal weight gain” trajectory [5.53 (95% CI: 5.10-5.98) µmol/L], DHEAS levels were significantly higher in children in the “persistent weight gain” [8.75 (95% CI: 7.23-10.49) µmol/L, p<0.001] and in children in the “weight gain during infancy” trajectories [7.68 (95% CI: 6.22-9.49) µmol/L, p=0.021], and marginally significant higher in children in the “weight gain during childhood” trajectory [6.89 (95% CI: 5.98-8.00) µmol/L; p=0.052]. In BW- and BMI-adjusted model, a statistically significant difference in DHEAS levels was found between the “persistent weight gain” [7.93 (95% CI: 6.43-9.86) µmol/L] and the “normal weight gain” trajectories [5.75 (95% CI: 5.32-6.23) µmol/L; p=0.039].

CONCLUSION: Higher DHEAS levels are found in 7-year-old children following a trajectory of persistent weight gain from 0-4 years, independently of their BW or current BMI, highlighting the impact of exposure to overweight in the first years of life on prepubertal adrenal androgen production. This article is protected by copyright. All rights reserved.

PMID:35150162 | DOI:10.1111/cen.14687

J Prosthodont. 2022 Feb 12. doi: 10.1111/jopr.13495. Online ahead of print.

ABSTRACT

PURPOSE: To compare concentration and release kinetics of osteocalcin and crestal bone loss under immediate and delayed loading conditions during osseointegration.

MATERIALS AND METHODS: Forty-one patients who were indicated for rehabilitation with dental implants randomly received either implant with placement of permanent prosthesis after 3 months (delayed loading) or implant with placement of permanent prosthesis within 7 days (immediate loading). Radiographic assessment of crestal bone loss at the mesial and distal surface was done at 3, 6 and 12 months after implant placement. Peri-implant sulcular fluid was collected immediately from the buccal surface at two sites after implant insertion and also, at 7, 15, 30 and 90 days after surgery. The level of osteocalcin was evaluated using ELISA and data were compared using two sample t-test. Differences between two groups were analyzed by unpaired Student’s t test. Intragroup comparison was done by repeated measures ANOVA.

RESULTS: Mean crestal bone loss was lower in the immediate loading group compared to the delayed loading group at 3, 6 and 12 months (P < 0.001). Intragroup comparison revealed a statistically significant increase in osteocalcin levels in both group I (F = 26712.2) and group II (F = 10497.2) at the predetermined time intervals CONCLUSIONS: Lesser crestal bone loss and early release of osteocalcin was found in the immediately loaded condition than in the delayed loaded condition. The study substantiates that immediately loaded implants shows less crestal bone as well as early release of osteocalcin facilitating upregulation of bone metabolism, improving long term health of bone and prognosis of implants. Immediately loaded implants can be a better treatment protocol provided there is adequate bone and primary stability. This article is protected by copyright. All rights reserved.

PMID:35150170 | DOI:10.1111/jopr.13495

J Adv Nurs. 2022 Feb 12. doi: 10.1111/jan.15185. Online ahead of print.

ABSTRACT

AIMS: To examine the association between coping strategies and quality of life (QOL) among Thai family carers of persons living with dementia.

DESIGN: A descriptive correlational quantitative design.

METHODS: Data were collected between January 2021 and April 2021. A multi-pronged approach for recruitment was used. Participants completed measures assessing carer demographic characteristics, coping styles, QOL, perceived stress and perceived social support. Hierarchical multiple regression analysis was used to determine the association between types of coping strategies used and QOL scores, adjusting for carer characteristics and carers’ stress and social support.

RESULTS: There were 86 participants (mean age 52.84 years), and the majority were female (87.2%). After adjusting for covariates, hierarchical multiple regression revealed that only positive emotion-focused coping demonstrated a statistically significant association with total QOL scores. Problem-focused coping and negative emotion-focused coping were not significantly associated with total QOL scores of Thai family carers of persons living with dementia.

CONCLUSION: Positive emotion-focused coping was associated with improved QOL scores. This finding supports the use of positive emotion-focused coping in Thai family carers of persons living with dementia, which potentially could improve the QOL of this population.

IMPACT: It is essential to differentiate between positive and negative emotion-focused coping to generate valid estimates of the association between coping and QOL. Nurses should encourage carers to use positive emotion-focused coping strategies as these strategies were found to be helpful in enhancing carers’ QOL.

PMID:35150154 | DOI:10.1111/jan.15185