Tag: pubmed

BMC Complement Med Ther. 2024 Dec 21;24(1):422. doi: 10.1186/s12906-024-04722-9.

ABSTRACT

BACKGROUND: As the primary cause of various preventable illnesses, smoking results in approximately five million premature deaths each year in the US and a multitude of adults living with serious illness. The majority of smokers know the health risks associated with smoking and intend to quit. However, quitting is very difficult partly because of insomnia and stress associated with it. Current tobacco cessation medications are not designed to address these problems, which may have contributed to their limited success in enabling cessation. Novel interventions are thus urgently needed to enhance success rates in tobacco cessation. Based on its historical usage and our preliminary data, kava is such a candidate. Kava, customarily enjoyed by South Pacific Islanders, is known for its relaxing effects, stress-relieving properties, and ability to enhance sleep. In the US, it is marketed and distributed as a dietary supplement due to its recognized calming properties. A pilot trial was performed among active smokers with a one-week ingestion of a kava supplement. The results for the first-time revealed kava’s potential in enabling tobacco cessation with effects on a panel of biological signatures. The primary goal of this trial is to replicate kava’s effects on the biological signatures of tobacco use, stress, and sleep in addition to its compliance and safety among those who smoke.

METHODS: A double-blind randomized placebo controlled two-arm trial will enroll 76 smokers with intention to quit, who will consume AB-free kava at a dietary supplement dose or placebo, 3 times per day for 4 weeks with two follow-ups.

DISCUSSION: The study will (1) monitor the adherence to and safety of AB-free kava consumption among smokers and evaluate changes in smoking habits, and (2) quantify a panel of non-invasive translatable biomarkers to objectively evaluate AB-free kava’s holistic effects on biological signatures associated with tobacco use, stress, and sleep. We hypothesize that AB-free kava is a novel and promising intervention to facilitate tobacco cessation via its holistic effects associated with managing stress and insomnia during abstinence. If the results from this study support our hypothesis, kava could emerge as an affordable and accessible dietary supplement candidate for tobacco cessation.

TRIAL REGISTRATION: registered on 04/14/2023 in ClinicalTrials.gov with the identifier NCT05814055.

PMID:39709468 | DOI:10.1186/s12906-024-04722-9

AIDS Res Ther. 2024 Dec 21;21(1):96. doi: 10.1186/s12981-024-00681-w.

ABSTRACT

BACKGROUND: Real-world data on treatment patterns and clinical outcomes for newer drugs, including integrase strand transfer inhibitors, among older people with human immunodeficiency virus (PWH) are limited.

METHODS: This cohort study included PWH enrolled in the Veterans Aging Cohort Study (VACS) who were prescribed a standard 3-drug antiretroviral therapy (ART) regimen containing dolutegravir (DTG), bictegravir (BIC), cobicistat boosted elvitegravir (EVG), raltegravir (RAL), or darunavir/ritonavir (DRV) plus 2 nucleoside reverse transcriptase inhibitors between January 1, 2014, and March 31, 2020, and who were ≥50 years at regimen initiation. The association between regimen and virologic effectiveness or discontinuation was assessed using logistic regression models with inverse probability of treatment weights. Pairwise comparisons were made between DTG-based regimen and each of the other 3-drug regimens, stratified by ART experience.

RESULTS: Among 15,702 PWH (across treatment groups, median age 58-62 years; 94-98% male; 5-11% Hispanic; 44-60% Black; 29-42% White), 5,800 received DTG-based regimens, 2,081 BIC-based regimens, 4,159 EVG-based regimens, 1,607 RAL-based regimens, and 2,055 received DRV-based regimens. Among ART-naïve PWH, there were no statistical differences in the odds of virologic suppression, and 6- and 12-month discontinuations were higher in those on DRV. Among ART-experienced PWH, compared to DTG, those on RAL and DRV were less likely to be suppressed at 6 months (RAL vs DTG: aOR 0.64, 95% CI 0.51-0.81; DRV vs DTG: aOR 0.63, 95% CI 0.51-0.76) and those on EVG and DRV were less likely suppressed at 12 months (EVG vs DTG: aOR 0.82, 95% CI 0.68-0.99; DRV vs DTG: aOR 0.64, 95% CI 0.52-0.80). Those on DRV were more likely to have virologic failure within 12 months (aOR 1.96, 95% CI 1.30-2.97). Six- and 12-month discontinuations were higher in those on RAL and DRV, but less likely for BIC-based regimens.

CONCLUSIONS: DTG-based regimens demonstrated higher levels of effectiveness and durability compared to DRV- or RAL-based regimens and had similar treatment responses as BIC- and EVG-based regimens among ART-experienced older PWH.

PMID:39709467 | DOI:10.1186/s12981-024-00681-w

Cancer Imaging. 2024 Dec 21;24(1):171. doi: 10.1186/s40644-024-00811-7.

ABSTRACT

PURPOSE: Staging of non-small cell lung cancer (NSCLC) is commonly based on [¹⁸F]FDG PET/CT, in particular to exclude distant metastases and guide local therapy approaches like resection and radiotherapy. Although it is hoped that PET/CT will increase the value of primary staging compared to conventional imaging, it is generally limited to the characterization of TNM. The first aim of this study was to evaluate the PET parameter metabolic tumor volume (MTV) above liver background uptake as a prognostic marker in lung cancer. The second aim was to investigate the possibility of incorporating MTV into the TNM classification system for disease prognosis in locally advanced NSCLC treated with chemoradiotherapy.

METHODS: Retrospective evaluation of 235 patients with histologically proven, locally advanced NSCLC from the multi-centre randomized clinical PETPLAN trial and a clinical cohort from a hospital registry. The PET parameters SUVmax, SULpeak, MTV and TLG above liver background uptake were determined. Kaplan-Meier curves and stratified Cox proportional hazard regression models were used to investigate the prognostic value of PET parameters and TNM along with clinical variables. Subgroup analyses were performed to compare hazard ratios according to TNM, MTV, and the two variables combined.

RESULTS: In the multivariable Cox regression analysis, MTV was associated with significantly worse overall survival independent of stage and other prognostic variables. In locally advanced disease stages treated with chemoradiotherapy, higher MTV was significantly associated with worse survival (median 17 vs. 32 months). Using simple cut-off values (45 ml for stage IIIa, 48 ml for stage IIIb, and 105 ml for stage IIIc), MTV was able to further predict differences in survival for stages IIIa-c. The combination of TNM and MTV staging system showed better discrimination for overall survival in locally advanced disease stages, compared to TNM alone.

CONCLUSION: Higher metabolic tumor volume is significantly associated with worse overall survival and combined with TNM staging, it provides more precise information about the disease prognosis in locally advanced NSCLC treated with chemoradiotherapy compared to TNM alone. As a PET parameter with volumetric information, MTV represents a useful addition to TNM.

PMID:39709461 | DOI:10.1186/s40644-024-00811-7

BMC Res Notes. 2024 Dec 21;17(1):376. doi: 10.1186/s13104-024-07046-6.

ABSTRACT

OBJECTIVE: Dengue fever is a rapidly spreading viral disease transmitted by mosquitoes, and it is becoming a global concern. This study aimed to assess the awareness, attitude, and performance of the people in Hormozgan province in carrying out preventive behaviors and dengue fever control methods.

METHOD: This descriptive-analytical study was conducted in 1401 in Bandar Abbas, Iran. A total of 642 men and women participated in the study, and a researcher-made questionnaire was used to collect data on demographic information, awareness, attitude, and performance. The data were analyzed using descriptive statistics.

FINDINGS: The study included 642 citizens of Bandar Abbas, with the majority being male. The average scores for awareness, attitude, and performance were relatively low, indicating insufficient knowledge and weak preventive behaviors regarding dengue fever.

CONCLUSION: The findings suggest a need for educational programs to increase awareness and preventive behaviors among the citizens, especially in essential areas such as protected coverage against mosquito bites and inspection of water accumulation sites in homes. It is also important for health centers and mass media to provide more information and education about dengue fever and its prevention.

PMID:39709455 | DOI:10.1186/s13104-024-07046-6

BMC Health Serv Res. 2024 Dec 21;24(1):1636. doi: 10.1186/s12913-024-12038-0.

ABSTRACT

BACKGROUND: Maternal and child health remains a global priority, with antenatal care (ANC) recognized as essential for ensuring positive pregnancy outcomes. Despite significant improvements, in low- and middle-income countries, ANC service utilization remains low in Sub-Saharan Africa. This paper contributes to the understanding of the evolution and determinants of ANC service utilization among women of reproductive age in Rwanda.

METHODS: This review focused on studies published between 2010 and 2024 and examined the factors associated with ANC utilization in Rwanda. Two reviewers independently performed screening of the abstracts and full texts and conducted data extraction and synthesis. The aggregated odds ratios for various factors associated with ANC service utilization were presented in forest plots, created using GraphPad Prism version 10.

RESULTS: The review included 11 studies and 1 report on ANC service utilization in Rwanda. By 2019-2020, 47% of women had received ANC in the first trimester, and 59% had four or more visits. Higher education levels, better wealth status, health insurance coverage, and small household size are associated with adequate ANC service utilization. Conversely, a significant distance from health facilities and unwanted pregnancies were associated with lower odds of adequate ANC utilization. Delayed ANC was more likely among women with higher parity, those who lacked social support, and those with no or only primary education.

CONCLUSION: Rwanda has made considerable strides in improving ANC services. Addressing barriers such as distance to healthcare facilities, education, and economic disparities is crucial for enhancing maternal and child health outcomes. This review underscores the need for targeted interventions to achieve the World Health Organization recommendations of 8 antenatal care visits and sustainable development goals related to maternal and child health in Rwanda.

PMID:39709445 | DOI:10.1186/s12913-024-12038-0

J Ethnobiol Ethnomed. 2024 Dec 21;20(1):107. doi: 10.1186/s13002-024-00748-y.

ABSTRACT

BACKGROUND: Ethiopia is recognized as a significant center of origin for a wide variety of plant species, particularly those with medicinal properties. A substantial segment of the population across the nation depends on these therapeutic plants for their primary healthcare needs. Many communities, both rural and urban, engage in traditional medicine practices, passing down their knowledge orally from one generation to the next. Consequently, this study was undertaken to record the traditional medicinal plants and the related indigenous knowledge in the Yeki district of Southwest Ethiopia.

METHODS: Between March 2024 and August 2024, semi-structured interviews, in-person meetings, group discussions, and escorted field trips were used to gather quantitative ethnobotanical data. A total of 132 informants 100 men and 32 women were interviewed in order to gather ethnobotanical data. The informant consensus factor (ICF), fidelity level (FL), plant part value, preference ranking, and direct matrix ranking were among the quantitative techniques that were employed. Furthermore, the study used a variety of statistical tests, such as independent t-tests, one-way ANOVA, correlation, and regression with R software version 4.3.2, to compare the ethnobotanical knowledge of various informant groups.

RESULT: A total of 98 species of traditional medicinal plants from 81 genera and 45 plant families were identified in the current study. The Asteraceae (11 species) were the largest family used by local peoples, followed by Solanaceae (8 species). The most commonly used plant parts were leaves and roots, and the primary technique for making remedies was crushing. The respiratory systems disease categories had the second highest consensus score (ICF: 0.90), after the dermal disease category (ICF: 0.91). The number of medicinal plants reported by respondents across gender, age groups, educational level, and informant’s type varied significantly (P < 0.05). Various medicinal species can be found in the area’s vegetation, but they are threatened by deforestation, agricultural extension, firewood, modernization, IAS, charcoal production, and material culture.

CONCLUSION: The results highlight the extensive variety of medicinal plants and the accompanying traditional knowledge present in the Guraferda district. The elevated ethnobotanical indices justify the need for additional phytochemical and pharmacological research. It is advisable to implement integrated conservation strategies to tackle the challenges confronting these precious plant resources.

PMID:39709441 | DOI:10.1186/s13002-024-00748-y

BMC Womens Health. 2024 Dec 21;24(1):660. doi: 10.1186/s12905-024-03507-z.

ABSTRACT

BACKGROUND: Central obesity and breast cancer (BC) have been identified as relevant by empirical research. The weight-adjusted-waist index (WWI) is a novel methodology for quantifying central obesity. Inspection of the association between WWI and BC in American adult women was the primary goal of the current investigation.

METHODS: Cross-sectional assessments were conducted on information gathered from 10,193 National Health and Nutrition Examination Survey (NHANES) participants from 2011 to 2018. The waist circumference was divided by the square root of the body’s mass to compute WWI. Data were assessed via descriptive statistics to present data distributions according to BC grouping and WWI grouping, receiver operating characteristic curves (ROCs) to evaluate the obesity indicators’ applied value, logistic regression to reflect associations between WWI and BC prevalence, and restricted cubic splines (RCSs) and subgroup analysis forest plots to visualise and complement the relationships.

RESULTS: This study enrolled 10,193 participants whose WWI ranged from 8.38 to 14.41, 259 of whom were diagnosed with BC, and the results revealed significant differences in baseline characteristics between the groups. With an area under the curve (AUC) value (95% confidence interval) (CI)of 0.611 (0.577-0.644), WWI was a promising indicator of BC with good application value rather than waist circumference (WC), body mass index (BMI), or waist-height ratio (WHtR). WWI and BC laid out a substantial relationship, yielding an odds ratio (OR) of 1.54 and a 95% CI of (1.34, 1.79), which remained at 1.19 (1.00, 1.42) after considerable adjustments were made, according to the logistic regression analysis. Compared with the lowest quartile of WWI, the highest quartile had a 62% greater in the probability of suffering from BC. With the RCS’s inverted U-shape highlighting the importance of considering the nonlinear nature of the relationship and subgroup analyses reflecting variations among populations, all the results demonstrated that WWI was a well-suggestive indicator of BC hazard.

CONCLUSION: The current investigation revealed a meaningful association between the prevalence of BC and WWI, which was superior to other obesity indicators, albeit one that was more complex than the positive relationship initially derived. There existed a turning point for BC prevalence at WWI of approximately 12 cm/√kg. Nevertheless, maintaining WWI in the lower range is critical for preventing and administering BC and minimizing disease risk.

PMID:39709439 | DOI:10.1186/s12905-024-03507-z

BMC Nurs. 2024 Dec 21;23(1):943. doi: 10.1186/s12912-024-02618-0.

ABSTRACT

BACKGROUND: While efforts to improve the educational preparedness of nurses to care for lesbian, gay, bisexual, transgender, and queer (LGBTQ +) people have increased, the influence of role-modeled behaviors by healthcare professionals working with nursing students and recent graduates is not well understood. The purpose of this study is to describe the role-modeled behaviors of healthcare professionals observed by nursing students and recent graduates caring for LGBTQ + patients in clinical settings.

METHODS: A cross-sectional, online survey was conducted. Recruitment of nursing students who had completed one or more clinical rotations or were recent graduates (≤ 2 years) was performed through university emails and social media. Items included measurement of stigmatizing attitudes, observed stigmatizing behaviors, and ability to provide inclusive/affirming care for LGBTQ + patients. Open-text items prompted participants to describe observed behaviors. Data were analyzed using descriptive statistics and Wilcoxon signed rank sum tests to evaluate differences between LGB (lesbian, gay, bisexual) and T + (transgender and gender diverse) subscales. Open-text responses were analyzed using thematic analysis to identify relevant themes.

RESULTS: Participants (N = 73) had a low level of stigmatizing attitudes toward LGBTQ + people (M = 1.8, SD = 0.4), although higher stigmatizing attitudes toward T + people were reported (M = 3.0, SD = 0.2; Z = -7.254, p < .001). Half of the participants reported that they observed LGBTQ + stigmatizing behaviors role-modeled by two + healthcare professional roles; approximately one-third of participants personally engaged in one + LGBTQ + stigmatizing behaviors, most commonly toward T + people. Themes from participants’ examples of observed stigmatizing behaviors included: cis-heteronormative bias, non-affirmation of chosen name/pronouns, outing patients, and rejected competency.

CONCLUSIONS: The majority of participants described observing stigmatizing behaviors toward LGBTQ + people in clinical settings. Poorer attitudes and a higher frequency of stigmatizing behaviors observed towards T + people point to deficits in healthcare provided to T + people in particular. Efforts to address LGBTQ + stigma in healthcare should be expanded to include clinical settings to address role-modeled behaviors and socialization of nurses.

PMID:39709436 | DOI:10.1186/s12912-024-02618-0

BMC Palliat Care. 2024 Dec 21;23(1):297. doi: 10.1186/s12904-024-01629-7.

ABSTRACT

BACKGROUND: Global demand for care during the last year of life (end-of-life) is rising and with shortfalls in community healthcare services, paramedics are increasingly called on to deliver this. Despite this growing demand on the paramedic workforce, little large-scale or detailed empirical research has evaluated current practice and paramedic experiences of attending this patient group. Therefore, as part of a wider study evaluating paramedic delivery of end-of-life care, a large-scale survey in England describing paramedics’ current practice and experiences providing end-of-life care was undertaken.

METHODS: A cross-sectional online survey design. Quantitative data were analysed using descriptive statistics and qualitative free text responses using Framework Analysis. The survey link was distributed to registered paramedics employed by all 11 NHS Trusts employing paramedics in England, United Kingdom.

RESULTS: Nine hundred and twenty responses were received. They reported shortfalls in availability of healthcare professionals for advice and/or referral. Respondents often, always or sometimes: lacked patient medical history (91%, 839), access to existing advance care planning documentation (98%, 900) and specific medicines needed (80%, 737); encountered conflicting views (89%, 819); and reported lack of pre-registration training (81%, 743) or continuing professional development (77%, 708) influenced their ability to meet patient needs.

CONCLUSIONS: This first national survey of paramedic practice and experiences in delivering end-of-life care provides new evidence and insight into the challenges faced by paramedics and the potential impact of these challenges on their perceived levels of competence and confidence. Respondents reported multiple challenges, which potentially impact their ability to provide good quality end-of-life care and increase the risk of hospital conveyance. Paramedic practice at end-of-life must be supported via improved access to: patient records; anticipatory medicines and authority to administer; 24/7 palliative care advice (for shared decision-making); and paramedic specific palliative and end-of-life care training and education (including via integrative ways of working between palliative care and ambulance services). Action is required to integrate paramedicine within the wider healthcare professional team, with robust education and training to support care delivery.

PMID:39709434 | DOI:10.1186/s12904-024-01629-7

BMC Nurs. 2024 Dec 21;23(1):944. doi: 10.1186/s12912-024-02634-0.

ABSTRACT

AIM: This study aimed to translate and evaluate the psychometric properties of the Persian version of the Innovative Behavior Inventory-20 (IBI-20) among clinical nurses in northwest Iran.

METHODS: A descriptive survey with psychometric analysis was conducted involving 321 nurses from Ardabil medical training centers. The study employed a stratified proportional sampling method. Data were collected using standard questionnaires, including a demographic profile form and the innovative behavior questionnaire. Descriptive statistics, such as mean, standard deviation, frequency, and percentage, were calculated using IBM SPSS Statistics for Windows, version 26.0. Reliability was assessed through Cronbach’s alpha, McDonald’s omega, and Coefficient H. Confirmatory factor analysis (CFA) and structural equation modeling (SEM) was performed using IBM SPSS version 26.0 and AMOS version 24.0, with a significance level set at p < 0.05.

RESULTS: The findings indicate that the IBI-20 possesses good face validity, content validity, construct validity, convergent and discriminant validity, and reliability. CFA confirmed the accuracy of the tool’s six-factor structure, with all factors exhibiting factor loadings greater than 0.3. Internal consistency was excellent, as demonstrated by a high Cronbach’s alpha, McDonald’s omega, and Coefficient H. The test-retest reliability of the IBI was also robust, with an intraclass correlation coefficient (ICC) of 0.942.

CONCLUSION: Our study validated the Persian version of the Innovative Behavior Inventory-20 (IBI-20) for assessing innovative behaviors among Iranian nurses. The IBI-20 is a vital tool for addressing healthcare challenges. The validation process, including face validity, content validity, and confirmatory factor analysis, demonstrated excellent validity, establishing it as a reliable instrument for evaluating innovative behaviors among nurses. These findings significantly impact nursing practice and research, ultimately enhancing patient outcomes.

PMID:39709430 | DOI:10.1186/s12912-024-02634-0