Tag: nevin manimala

BMC Health Serv Res. 2024 Aug 20;24(1):952. doi: 10.1186/s12913-024-11343-y.

ABSTRACT

BACKGROUND: Evaluating health workers’ knowledge and practice of adverse drug reaction (ADR) reporting is an important step in identifying gaps in quality ADR reporting during public health interventions like the seasonal malaria chemoprevention (SMC) campaign. Pharmacovigilance (PV) monitoring is vital in SMC due to the number of children exposed to malaria medicines for a period of 4 or 5 months during the campaign. In Nigeria more than 10 million children are exposed to SMC medicines every year. The scale of this intervention emphasised the need for efficient and effective safety monitoring during the campaign. Thus, the objective of this study was to evaluate healthcare workers’ (HCW) awareness, knowledge, attitude and practice (KAP) of ADR reporting in health facilities participating in SMC campaign to identify pharmacovigilance gaps which may suggest possible ways to ensure safety during the campaign.

METHODS: World Health Organization’s service availability and readiness assessment (SARA) recommendations were used to sample 2,598 out of 5,195 used as supervising health facilities (HFs) during the 2022 SMC campaign across nine states of the country. Out of the sampled HFs, 2,144 eligible and consented health facility workers (HFWs) were assessed for awareness, and KAP of ADR using the validated 45-item self-administered questionnaire. The data was analysed using descriptive statistics and correlation analysis at p < 0.05.

RESULTS: The majority of the respondents are males (n = 1,333, 62.2%). The HFWs showed good awareness (n = 2,037, 95.0%) of pharmacovigilance (PV). However, only 809 (37.7%) of them had good knowledge scores. The mean ADR reporting attitude score (85.0 ± 15.3%) was good with many of the respondents (n = 1,548, 72.2%) having a good score. However, the respondents’ ADR practice was suboptimal, only 1,356 (63.2%) of them had encounters with ADR, and a lot of negative perceived barriers to ADR reporting were identified in the study. For example, 493 (23%) believed that ADRs were not reported because they were not serious and life-threatening while 248 (11.6%) reported a fear of liability. Correlation analysis revealed female gender (r = 0.163, p < 0.001), older age (r = 0.207, p < 0.001) and years of practice (r = 0.050, p = 0.021) as factors significantly associated with ADR knowledge and attitude scores.

CONCLUSION: The study indicated that HCWs across health facilities participating in SMC campaigns have ADR reporting knowledge and practice gaps. The study suggest training alone may not be effective in addressing gaps in ADR reporting. In addition to PV training, implementers can include continuous mentoring of health care workers or other similar interventions as part of strategy to improve ADR reporting. Also, context specific strategies to improve ADR reporting among health care worker needs to be implemented to address under-reporting of ADRs during SMC campaigns and other malaria public health interventions.

PMID:39164692 | DOI:10.1186/s12913-024-11343-y

BMC Psychiatry. 2024 Aug 20;24(1):569. doi: 10.1186/s12888-024-06009-2.

ABSTRACT

BACKGROUND: Young people and adults with ADHD are at risk of a range of physical health problems. There is limited guidance on how to approach health problems in ADHD, and especially around 16-25 year olds who will be transitioning from paediatric to adult care. The aim of this scoping review was to identify psychosocial interventions that target physical health in young people and adults with ADHD.

METHODS: We constructed searches in MEDLINE, PsycInfo, EMBASE of adolescents, young people and adults. Inclusion criteria were; studies of psychosocial interventions examining a component of physical health, applicable to people aged 16-25, with clinical or research diagnoses of ADHD. Data were extracted using a data extraction tool and tabulated, including study intervention framing/aims, population, intervention, and relevant outcomes (including specific statistics where relevant).

RESULTS: Our search identified 22 unique papers covering, psychosocial interventions targeting at least one of sleep (n=7), smoking (n=3), substance/alcohol use (n=4), physical health/exercise (n=6) and general health (n=3). Studies examined psychotherapy/behaviour interventions (n=12), psychoeducation (n=4), digital (n=2) and social interventions (n=4). There was significant heterogeneity in intervention framing, outcome measures and population.

CONCLUSION: Further work on the impact of targeted physical health interventions, with explicit reference to a conceptual framework of poor health in ADHD is required. Furthermore, future work standardising reporting of physical health outcomes in ADHD is crucial for the development of an evidence base in this field.

PMID:39164688 | DOI:10.1186/s12888-024-06009-2

BMC Public Health. 2024 Aug 20;24(1):2262. doi: 10.1186/s12889-024-19800-3.

ABSTRACT

BACKGROUND: Long-term care insurance (LTCI) in China provides financial and care security for persons with disabilities and includes caregivers in the paid labour workforce. However, it is unclear how the LTCI affects health outcomes in female recipients, female caregivers, and female non-recipients and female non-caregivers.

METHODS: Using the China Health and Retirement Longitudinal Study data and staggered difference-in-differences method, we evaluated the effect of LTCI on health outcomes in women with different roles, including female recipients, female caregivers, and female non-recipients and female non-caregivers, and discussed the heterogeneity of the effect on women’s health outcomes.

RESULTS: LTCI statistically significant increased self-rated health and reduced depression in women and improved the health in women with different roles by increasing self-rated health in female recipients, reducing chronic diseases in female caregivers, and reducing depression in female non-recipients and female non-caregivers. There was a more pronounced improvement in health outcomes among women in the west and northeast and women in rural village.

CONCLUSIONS: After the implementation of LTCI, health outcomes in female recipients, female caregivers, and female non-recipients and female non-caregivers were improved. LTCI’ improvement on women’s health outcomes was heterogeneous geographically and socially. Our findings highlight the importance of delivering differentiated health interventions for women with different roles in the implementation process of LTCI and minimizing women’s health inequalities in geography and society.

PMID:39164684 | DOI:10.1186/s12889-024-19800-3

BMC Endocr Disord. 2024 Aug 20;24(1):155. doi: 10.1186/s12902-024-01689-z.

ABSTRACT

OBJECTIVE: Neutrophil-to-lymphocyte ratio (NLR) has been shown to be an independent predictor for cardiovascular diseases and metabolic diseases. The role of NLR in metabolic syndrome (MS) has also been explored albeit with conflicting results. The objective of this study was to assess the predictive role of NLR in MS.

METHODS: We conducted a meta-analysis of observational studies to evaluate the predictive role of NLR in MS. Cochrane library, PubMed, Medline, Embase, and Scopus were systematically searched from their inception to December 2023. The Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) guidelines was followed. The statistical analysis was performed using RevMan 5.3 software. A randomeffect model was used.

RESULTS: Twenty six studies enrolling 70,937 individuals were included in this meta-analysis. Compared with the individuals without MS, NLR value was significantly higher in the patients of MS (mean difference (MD) 0.40, 95% confidence intervals (CI): 0.27-0.52, P < 0.00001, I² = 97%). The derived NLR value also was significantly higher in participants with MS than those without MS (MD 0.48, 95%CI: 0.13-0.84, P = 0.007, I² = 96%). There was no statistically significant association for NLR between the patients with 4 metabolic risk factors (MRF) and those with 3 MRF, or between patients with 5 MRF and those with 4 MRF (MD 0.16, 95%CI: -0.02-0.35, P = 0.10, I² = 84%; MD 0.12, 95%CI: -0.06-0.29, P = 0.20, I² = 68%). However, MS patients with 5 MRF had a significantly higher mean NLR value than those with 3MRF (MD 0.37, 95%CI: 0.05-0.68, P = 0.02, I² = 92%). Compared with the individuals with low NLR, incidence of MS was significantly higher in those with high NLR (OR 2.23, 95%CI: 1.25-3.98, P = 0.006, I² = 97%).

CONCLUSION: The findings of our meta-analysis suggested that the value of NLR and derived NLR were higher in MS patients. MS patients with 5 MRF had a significantly higher mean NLR value. High NLR also demonstrated a significantly increased the incidence of MS. NLR may be a good predictive biomarker in MS.

PMID:39164679 | DOI:10.1186/s12902-024-01689-z

BMC Public Health. 2024 Aug 20;24(1):2260. doi: 10.1186/s12889-024-19716-y.

ABSTRACT

BACKGROUND: Diabetes is a major public health problem in Qatar and is associated with an increased risk of depression. However, no study has been conducted in Qatar on the relationship between dietary patterns and depression symptoms in adults. The aim of this study was to assess the association between dietary patterns and depression symptoms among adults with or without diabetes in Qatar.

METHODS: A total of 1000 participants from the Qatar Biobank (QBB) were included in this cross-sectional study. Food intake was assessed using a computer-administered food frequency questionnaire (FFQ), and dietary patterns were identified using factor analysis. Depression symptoms were evaluated using the Patient Health Questionnaire-9 (PHQ-9).

RESULTS: Depression symptoms were present in 13.5% of the sample. Two dietary patterns were identified: “unhealthy” (high consumption of fast food, biryani, mixed dish (chicken/meat/fish), croissant) and “prudent” (high consumption of fresh fruit, salads/raw vegetables, canned/dried fruit, and dates). After adjusting for sociodemographic, lifestyle factors (smoking and physical activity), diabetes and medication use for diabetes and hypertension, a high intake of “unhealthy” pattern was associated with an increased prevalence of depressive symptoms in individuals with diabetes (prevalence ratio, PR = 1.41; 95% CI = 1.28, 1.56; p-value < 0.001), while there was no statistically significant association between depressive symptoms and the “prudent” dietary pattern. The “prudent” pattern was inversely and significantly associated with depressive symptoms in individuals with a normal body weight (PR = 0.21; 95% CI = 0.06, 0.76; p-value = 0.018).

CONCLUSION: The “unhealthy” dietary pattern was positively associated with depression symptoms in those with diabetes, whereas the “prudent” dietary pattern was inversely associated with depression symptoms in those with a normal body weight. Promoting healthy eating habits should be considered in the prevention and management of depression.

PMID:39164668 | DOI:10.1186/s12889-024-19716-y

J Environ Manage. 2024 Aug 19;368:122167. doi: 10.1016/j.jenvman.2024.122167. Online ahead of print.

ABSTRACT

Mitigating the environmental impact of composting by the reduction of greenhouse gases (N₂O, CH₄) and ammonia (NH₃) emissions is a major challenge. To meet this challenge, the understanding of the relationships between composted substrates initial physicochemical parameters and gas emissions is essential. From a long-term perspective, it will allow to guide the recipe formulation of the initial mixture to be composted, with a view to reducing gas emissions during composting. This study gathered literature data targeting sewage sludge composting and performed statistical correlation analyses between cumulative gas emissions and the following parameters: sewage sludge, bulking agent and composted mixture initial physicochemical parameters (pH, dry matter, total carbon, total nitrogen, C/N), the dry mass ratio of sewage sludge to bulking agent and the duration of composting. The average values of cumulative emissions show a large variability: 1.37 ± 2.71 gC.kg initial mix DM^-1, 0.13 ± 0.17 gN.kg initial mix DM^-1 and 2.23 ± 2.79 gN.kg initial mix DM^-1 for CH₄, N₂O and NH₃ emissions respectively. Although the correlation analysis highlighted some significant interesting correlations between initial physicochemical parameters and gas emissions (p.value < 0.05), reliable multiparametric model could not fit the data, meaning that the actual literature data are not sufficient to explain most part of gas emissions. Among the most interesting relationships, the study showed that the dry matter of the composted mixture is negatively correlated to N₂O emissions, while the ratio of sewage sludge to bulking agent and the duration of composting are positively correlated to N₂O emissions. It was also shown that the pH of the bulking agent is positively correlated to NH₃ emissions. Considering the large part of the emission variability that is not explained and the difficulty to link the correlation with their causality, it will be interesting to improve composting gas emissions knowledge in future research by analyzing free air space, bulking agent adsorption capacity and available and biodegradable organic matter. These parameters are of particular interest in solving the main problems associated with sewage sludge composting, namely porosity and nitrogen retention. This study also highlighted the necessity to extend the duration of the composting studies over 40 days in order to measure possible N₂O late release and better identify parameters influencing N₂O emissions.

PMID:39163668 | DOI:10.1016/j.jenvman.2024.122167

Accid Anal Prev. 2024 Aug 19;207:107747. doi: 10.1016/j.aap.2024.107747. Online ahead of print.

ABSTRACT

The field of spatial analysis in traffic crash studies can often enhance predictive performance by addressing the inherent spatial dependence and heterogeneity in crash data. This research introduces the Geographical Support Vector Regression (GSVR) framework, which incorporates generated distance matrices, to assess spatial variations and evaluate the influence of a wide range of factors, including traffic, infrastructure, socio-demographic, travel demand, and land use, on the incidence of total and fatal-or-serious injury (FSI) crashes across Greater Melbourne’s zones. Utilizing data from the Melbourne Activity-Based Model (MABM), the study examines 50 indicators related to peak hour traffic and various commuting modes, offering a detailed analysis of the multifaceted factors affecting road safety. The study shows that active transportation modes such as walking and cycling emerge as significant indicators, reflecting a disparity in safety that heightens the vulnerability of these road users. In contrast, car commuting, while a consistent factor in crash risks, has a comparatively lower impact, pointing to an inherent imbalance in the road environment. This could be interpreted as an unequal distribution of risk and safety measures among different types of road users, where the infrastructure and policies may not adequately address the needs and vulnerabilities of pedestrians and cyclists compared to those of car drivers. Public transportation generally offers safer travel, yet associated risks near train stations and tram stops in city center areas cannot be overlooked. Tram stops profoundly affect total crashes in these areas, while intersection counts more significantly impact FSI crashes in the broader metropolitan area. The study also uncovers the contrasting roles of land use mix in influencing FSI versus total crashes. The proposed framework presents an approach for dynamically extracting distance matrices of varying sizes tailored to the specific dataset, providing a fresh method to incorporate spatial impacts into the development of machine learning models. Additionally, the framework extends a feature selection technique to enhance machine learning models that typically lack comprehensive feature selection capabilities.

PMID:39163666 | DOI:10.1016/j.aap.2024.107747

J Psychiatr Res. 2024 Aug 15;178:236-242. doi: 10.1016/j.jpsychires.2024.08.005. Online ahead of print.

ABSTRACT

The outbreak of the coronavirus disease 2019 (COVID-19) pandemic threatened adolescents’ mental health and livelihoods, which can worsen their non-suicidal self-injury (NSSI) behaviors. With the significant increase of total online time use, adolescents become more prone to problematic internet use (PIU). This study examined whether depression mediated the relationship between PIU and NSSI among adolescence during the COVID-19 outbreak. Constructed with a cross-sectional design during the COVID-19 outbreak in Taiwan, 1060 participants were drawn from junior high schools through stratified and cluster sampling, and completed a set of comprehensive surveys. The mediation model demonstrated a good fit to the data, GFI = .96, CFI = .97, NFI = .97, NNFI = .95, IFI = .97, and SRMR = .02. The overall fit of the mediational model was adequate. The path from PIU to depression, β = .41, p < .001, and the path from depression to NSSI, β = .40, p < .001, were both significant. Moreover, the effect of PIU to NSSI decreased from .23 (p < .001) to .05 (p = .099) when depression was incorporated into the analysis. Moreover, results in bootstrapping analysis displayed that the indirect effect (PIU on NSSI via depression) was statistically significant (p < .001) and the direct effect (PIU on NSSI) was statistically non-significant (p = .134). The full mediation model was confirmed. The findings of the structure equation modeling and bootstrap analysis showed that PIU significantly and positively predicted NSSI, and that depression fully mediated this relationship.

PMID:39163662 | DOI:10.1016/j.jpsychires.2024.08.005

Domest Anim Endocrinol. 2024 Aug 13;89:106880. doi: 10.1016/j.domaniend.2024.106880. Online ahead of print.

ABSTRACT

Porcine adrenocorticotrophic hormone (ACTH) has been considered valid for the ACTH stimulation test (ACTHST) in humans and dogs; however, its safety and efficacy for use in cats are unknown. Also, the equivalence between 5 µg/kg and 125 µg/cat dose of synthetic corticotropin (1-24 ACTH – cosyntropin/tetracosactide) is assumed for ACTHST in cats. This study evaluated the safety and effectiveness of different porcine recombinant ACTH doses for the ACTHST in healthy cats and its equivalence with tetracosactide. The study was divided into two arms. The first evaluated safety and equivalence of intravenous 1 µg/kg, 5 µg/kg, or 125 µg/cat porcine ACTH in seven healthy cats for the ACTHST evaluating basal and post-ACTH androstenedione, aldosterone, cortisol, and progesterone concentrations. In the second arm, the equivalence of the 125 µg/cat porcine ACTH dose was evaluated compared to results obtained using 125 µg/cat of tetracosactide in ten healthy cats regarding cortisol responses. In all tests, several cat-friendly strategies were adopted, and the ACTHST protocol involved basal and 60-minute post-ACTH blood sampling and intravenous ACTH injection. No adverse reactions were documented, and no tested cat showed any complications during the study. No porcine ACTH tested dose significantly increased androstenedione secretion. In contrast, all tested doses were able to increase progesterone concentration significantly (P < 0.05), and Δ-progesterone in response to 5 µg/kg or 125 µg/cat was considered equivalent (P > 0.99). The 125 µg/cat dose promoted greater responses for both cortisol and aldosterone, characterized by Δ-cortisol (P = 0.009) and Δ-aldosterone (P = 0.004). Despite equivalent Δ-cortisol results in response to 5 µg/kg or 125 µg/cat (P = 0.18); post-ACTH results of cortisol in response to 5 µg/kg only approximate statistical significance when compared with basal (P = 0.07). Porcine ACTH and tetracosactide significantly increased post-ACTH cortisol concentration (P < 0.0001) while the Δ-cortisol was slightly greater in response to the porcine ACTH (P = 0.006). These results suggest porcine ACTH could be an alternative source of corticotropin for the ACTHST in cats; however, maximum corticoadrenal stimulation seemed more reliable in response to a 125 µg/cat regarding cortisol and aldosterone.

PMID:39163657 | DOI:10.1016/j.domaniend.2024.106880

Blood Adv. 2024 Aug 20:bloodadvances.2024013748. doi: 10.1182/bloodadvances.2024013748. Online ahead of print.

ABSTRACT

Bronchiolitis obliterans syndrome (BOS) after hematopoietic cell transplantation (HCT) is associated with substantial morbidity and mortality. Quantitative CT (qCT) can help diagnose advanced BOS meeting National Institutes of Health (NIH) criteria (NIH-BOS) but has not been used to diagnose early, often asymptomatic BOS (early BOS), limiting the potential for early intervention and improved outcomes. Using Pulmonary Function Tests (PFT) to define NIH-BOS, early BOS, and mixed BOS (NIH-BOS with restrictive lung disease) in patients from two large cancer centers, we applied qCT to identify early BOS and distinguish between types of BOS. Patients with transient impairment or healthy lungs were included for comparison. PFT were done at month 0, 6, and 12. Analysis was performed with association statistics, principal component analysis, conditional inference trees (CIT), and machine learning (ML) classifier models. Our cohort included 84 allogeneic HCT recipients — 66 BOS (NIH-defined, early, or mixed) and 18 without BOS. All qCT metrics had moderate correlation with Forced Expiratory Volume in 1 second, and each qCT metric differentiated BOS from those without BOS (non-BOS) (P < 0.0001). CIT’s distinguished 94% of participants with BOS versus non-BOS, 85% early BOS versus non-BOS, 92% early BOS versus NIH-BOS. ML models diagnosed BOS with area under the curve (AUC) 0.84 (95% confidence interval [CI] 0.74-0.94) and early BOS with AUC 0.84 (95% CI 0.69 – 0.97). Quantitative CT metrics can identify individuals with early BOS, paving the way for closer monitoring and earlier treatment in this vulnerable population.

PMID:39163616 | DOI:10.1182/bloodadvances.2024013748