Tag: pubmed

Child Adolesc Psychiatry Ment Health. 2024 Nov 5;18(1):140. doi: 10.1186/s13034-024-00811-2.

ABSTRACT

AIM: Our aim was to assess the burden of children and adolescents’ mental health problems on the Slovenian outpatient healthcare system before, during and after the pandemic.

METHODS: In a retrospective analysis of healthcare indicators from 2008 to 2023, we analysed data from the National Institute of Public Health. Key domains included initial visits for mental and behavioural disorders (MBDs) to primary care for the population aged 0-19; the number of referrals to an initial assessment with a child and adolescent psychiatrist (CAP) at the secondary level for the population aged 0-17 along with the corresponding waiting times; and the number of urgent referrals for the population aged 0-17 to emergency mental health centres at the tertiary level. The calculations included rates per 1000 people. Descriptive statistics and diagrams were used to compare the data. Segmented linear regression analysis (SLR) was conducted on the primary healthcare data to identify the distinct temporal point indicating an increase.

RESULTS: Comparing the average rates of the 2020-2022 period to those of the 2018-2019 period, there was a 20% increase in initial visits to primary care, a 23% increase in the referral rate to a CAP at the secondary level, and a 41% increase to the tertiary level of care. In secondary care, a four- to sevenfold increase in waiting times for the initial CAP assessment was observed between 2019 and 2023. The incidence of initial visits to primary healthcare services for MBD increased from 2008 to 2019 (average annual growth rate of 4.5%). The average annual growth rate for the 2020-2022 period tripled to 13.9%. The SLR showed that the trend of accelerating growth could have begun in 2017 for the 0-5 age group and possibly for the 15-19 age group as well.

CONCLUSIONS: After the initial decline in 2020, all levels of the Slovenian healthcare system faced an increased burden of MBD in children and adolescents from 2021 to 2022 compared to pre-pandemic levels. Nevertheless, a portion of this increase aligns with longitudinal growing trends from 2008 onwards. Tackling the crisis requires urgent national action, significant improvement in organization, and investments in mental health.

PMID:39501287 | DOI:10.1186/s13034-024-00811-2

Acta Vet Scand. 2024 Nov 5;66(1):58. doi: 10.1186/s13028-024-00781-7.

ABSTRACT

BACKGROUND: Bovine respiratory disease (BRD) is common in intensively raised cattle and is often treated with antibiotics. For practitioners, knowledge of the bacteria involved in an outbreak and their antibiotic susceptibility is warranted. To this end, samples from the upper or lower respiratory tract of calves can be submitted for bacteriological culture and susceptibility testing of relevant isolates. However, it is debated whether isolates from the upper respiratory tract are representative of bacteria causing infections in the lower respiratory tract. In this study, we used MALDI-TOF MS, multilocus sequence typing (MLST) and core-genome multilocus sequence typing (cgMLST) to compare culture results of 219 paired samples (sample pairs) of deep nasal swabs (DNS) and tracheobronchial lavage (TBL). The sample pairs came from 171 calves in 30 calf groups across 25 farms with 48 calves sampled twice.

RESULTS: The predominant bacterial pathogen was Pasteurella multocida, which was isolated from 37.4% of DNS and 22.4% of TBL. There was no statistically significant difference in isolation frequency of P. multocida between calves considered healthy and those suspected for BRD for DNS (P = 0.778) or TBL (P = 0.410). Among the 49 sample pairs where P. multocida was isolated from TBL, the same species was isolated from DNS in 29 sample pairs (59.2%). Isolates from 28 of these sample pairs were evaluated by MLST, and in 24 pairs (86.0%) P. multocida from DNS and TBL were of the same sequence type (ST). Moreover, cgMLST showed that the genetic distance between isolates within 21 of the 28 sample pairs (75.0%), was less than two alleles, and DNS and TBL isolates were considered identical. In seven sample pairs (25%), the genetic distance was greater, and DNS and TBL isolates were considered nonidentical.

CONCLUSIONS: Pasteurella multocida was readily isolated from DNS and in calves where this species was isolated also from TBL, DNS and TBL isolates were identical in 75% of the sample pairs. This suggests that during an outbreak of BRD, submission of DNS samples from 4 to 6 calves could be a convenient approach for practitioners seeking guidance on P. multocida present in the lower respiratory tract and their antibiotic susceptibility.

PMID:39501282 | DOI:10.1186/s13028-024-00781-7

BMC Med Educ. 2024 Nov 5;24(1):1262. doi: 10.1186/s12909-024-06069-8.

ABSTRACT

INTRODUCTION/BACKGROUND: Peer-led teaching sessions (PLTS) supplement conventional medical education, allowing students to share knowledge effectively. PLTS have shown significant academic benefits for student instructors. However, the impact on attendees, especially concerning NBME-style examinations, remains underexplored.

METHODS: This study analyzed de-identified data from 67 first-year medical students at Kirk Kerkorian School of Medicine, divided into PLTS attendees (study group) and non-attendees (control group) based on session participation. Data were collected before two NBME examinations, with attendees defined as those attending at least five Peer-led teaching sessions. Academic performance was measured using NBME Customized Assessment Services (CAS) exam scores. Statistical analyses, including p-tests, chi-square, and t-tests, assessed differences in performance and potential biases based on MCAT scores, first-generation status, and socioeconomic background.

RESULTS: The study group initially had 26 students, and the control group had 31 students. Post-first examination, the study group adjusted to 22 students, and the control group to 35 students. MCAT scores and demographics showed no significant differences between groups. The first examination revealed a significant higher score in PLTS attendees’ scores (4.28% increase, p = 0.036), indicating a positive impact of PLTS on basic science knowledge. The second examination on organ systems physiology showed no significant difference (p = 0.722).

DISCUSSION: PLTS effectively enhance foundational science understanding but may be less impactful for advanced topics. The diminishing effect may result from increased use of diverse study resources and adaptation to medical school. Future research should explore long-term benefits, optimal implementation strategies, and the impact of instructor quality and engagement. Therefore, the overall conclusion is that PLTS positively influence NBME-style exam performance in early medical education, but benefits decrease over time.

PMID:39501281 | DOI:10.1186/s12909-024-06069-8

BMC Womens Health. 2024 Nov 6;24(1):591. doi: 10.1186/s12905-024-03432-1.

ABSTRACT

BACKGROUND: There is no pooled evidence regarding the prevalence and potential factors associated with depression among women with urinary incontinence worldwide. Hence, a systematic review and meta-analysis were conducted to determine the overall prevalence of depression among urinary incontinent women globally and explore any heterogeneity present.

METHODS: A computerized systematic literature search was performed using the Scopus, PubMed, Embase, Google Scholar, and Snowballing databases. Each database was searched from its start date of March 20, 2023. The study conforms to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. All included articles were published in English and evaluated the prevalence and associated factors of depression among urinary incontinent female patients. Pooled estimations with a 95% confidence interval (CI) were calculated with the DerSimonian‒Laird (DL) random-effects model. Publication bias was evaluated by using funnel plots and statistical tests.

RESULTS: Our initial electronic database search with the chosen search terms identified 1120 articles in PubMed (35 4), Embase (105), Scopus (325) and Google Scholar (176). The results of the 8 studies reporting a binary outcome using the different validation scales are summarized in the overall prevalence of depression was 18% (95% CI = 11-25%). Unable to read and write (OR: 1.34, 95% CI: [1.01, 1.78], I²= 0%), caesarean delivery (OR: 1.48, 95% CI: [1.30, 1.70], I² = 0%), obesity (OR: 1.37, 95% CI: [1.19, 1.58], I² = 0%), party greater than three (OR: 1.26, 95% CI: [0.98, 1.62], I²= 0%), comorbidity (OR: 1.32, 95% CI: [1.16, 1.49], I² = 85.3%), smoking (OR: 1.58, 95% CI: [0.99, 1.92], I2 = 0%) and single, divorced and widowed (OR: 1.67, 95% CI: [1.45, 1.92], I² = 0%) were the major factors associated with depression.

CONCLUSION AND RECOMMENDATIONS: This review demonstrated the high prevalence of depression among women with urinary incontinence. Being unable to read and write, delivery via caesarean section, obesity, having more than three children, having comorbidities, smoking, being single, being divorced and being widowed were all associated factors. This study identified that there was a strong association between urinary incontinence and depression. Future studies recommend focusing on the causal association between depression and urinary incontinence.

PROSPERO: Registration numbers of CRD42023418779.

PMID:39501253 | DOI:10.1186/s12905-024-03432-1

BMC Med. 2024 Nov 5;22(1):508. doi: 10.1186/s12916-024-03733-0.

ABSTRACT

BACKGROUND: Endometriosis is a chronic, estrogen-dependent, benign condition, affecting 10-15% of women of reproductive age. It is associated with a prevalence of sexual dysfunction that is nearly twice as high as that seen in women with other benign gynecological conditions. Our study aimed to assess the effect of surgical intervention on sexual function, as measured by the FSFI (Female Sexual Function Index) score, in women with endometriosis compared to those with other benign gynecological conditions, both before and after surgery.

METHODS: A comparative analysis was conducted at the Medical University of Vienna from 2015 to 2020. The study included patients suspected of having endometriosis, fibroids, adnexal cysts, and/or infertility. Based on findings during surgery, patients were categorized into two groups: those with endometriosis (n = 64) and control patients (n = 38). All participants completed the FSFI questionnaire before surgery and again 8 to 18 weeks after the operation.

RESULTS: No significant differences were observed in the preoperative FSFI scores between the endometriosis patients and the control group. Similarly, no significant differences were found between the two groups in postoperative scores. However, in women diagnosed with endometriosis, surgical removal of endometriotic lesions significantly increased their full-scale FSFI score, and resulted in a significant improvement in the areas “desire” and “satisfaction”. Improvements were noted in all other areas as well, though they were not statistically significant.

CONCLUSIONS: Our research indicates that the surgical removal of endometriotic lesions can lead to an improvement in sexual function, as measured by the FSFI, within 8 to 18 weeks post-surgery. This improvement was not observed in the control group, which underwent surgery for other benign gynecological issues.

PMID:39501251 | DOI:10.1186/s12916-024-03733-0

BMC Public Health. 2024 Nov 5;24(1):3052. doi: 10.1186/s12889-024-20564-z.

ABSTRACT

BACKGROUND: Problem-solving interventions with workplace involvement (PSI-WPI) have been shown to reduce sick leave and increase return to work in an occupational health services context. However, many employees struggle with reduced work functioning, anxiety-, and depressive symptoms up to 12 months after a sick leave episode, and it is unclear if the intervention affects outcomes other than sick leave. The aim of this study is to investigate if a PSI-WPI added to care as usual (CAU) is superior to CAU with respect to self-reported sick leave, psychological symptoms, work ability, work performance, and health after RTW when provided in primary care.

METHODS: Employed individuals aged 18-59 years on sick leave (2 to 12 weeks) diagnosed by a physician at a primary care center with mild to moderate depression, anxiety, or adjustment disorder were enrolled in a two-armed cluster-randomised trial evaluating the effectiveness of a PSI-WPI. Multiple outcomes were recorded at baseline, six months, 12 months, and every fourth week during the study period. Outcomes were categorised into psychological symptoms, health, work ability, work performance, and self-reported sick leave. Data were analysed using MANOVA, GEE (Generalized Estimating Equations), and cox regression.

RESULTS: One hundred ninety-nine individuals responded to the invitation to participate; one participant withdrew, one was excluded as the employment ended, nine did not answer the baseline survey, and three were removed from the analysis due to missing data. The analysis included 81 subjects who received the intervention and 104 subjects who received the control. Baseline characteristics were similar across both groups. No differences between the groups were found among either variables except one. There was a significant difference between the groups in self-rated health (EQ5D) in favour of the CAU group from baseline to six-month follow-up, with a mean difference of -8.44 (-14.84, -2.04).

CONCLUSIONS: A problem-solving intervention with workplace involvement added to CAU did not result in statistically significant reductions in outcomes. Further research is needed to understand why problem-solving interventions appear to have an effect on sick leave in an occupational health services context and not in a primary care context.

TRIAL REGISTRATION: NCT3346395, registration date 2017-11-17.

PMID:39501245 | DOI:10.1186/s12889-024-20564-z

BMC Urol. 2024 Nov 6;24(1):241. doi: 10.1186/s12894-024-01639-w.

ABSTRACT

PURPOSE: Upper urinary tract stones are a common condition in urology clinics. Percutaneous nephrolithotomy (PCNL) is an effective procedure frequently used for the treatment of stones larger than 2 cm. MAP scoring is used to predict oncological outcomes and intraoperative complications after partial nephrectomy by using the thickness and adhesion of perinephric adipose tissue. We examined the relationship between MAP score and clinical and demographic findings of the patients, especially postoperative Hgb drop and postoperative complications.

MATERIAL-METHOD: Patients were divided into 2 groups: Those with MAP score < 3 and ≥ 3. The impact of the MAP score on the demographic, clinical, and surgical parameters of the groups was assessed and analyzed. The relationship between MAP score and complications based on Clavien Dindo classification was also examined. The study investigated factors affecting the development of complications, the amount of bleeding, and the influence of MAP scores on these outcomes.

RESULTS: The Hgb drop was 2.56 ± 1.00 in the group with a MAP score ≥ 3 which was statistically significantly higher than the group with a MAP score < 3 (1.43 ± 1.21) (p < 0.001). The stone-free rate was 81.7% in the group with a MAP score < 3, which was statistically significantly higher than the group with a MAP score ≥ 3 (59.6%) (p = 0.012).

CONCLUSION: As the MAP score of patients scheduled for standard PNL operation increased, there was a corresponding rise in Hgb drop, a decline in stone-free rates and an uptick in postoperative urinary complications of postoperative urinary infections.

PMID:39501243 | DOI:10.1186/s12894-024-01639-w

BMC Public Health. 2024 Nov 5;24(1):3055. doi: 10.1186/s12889-024-20545-2.

ABSTRACT

BACKGROUND: Dengue has emerged as a rapidly escalating health issue in low- and middle-income countries, with its burden and geographic spread increasing over the years. Malaysia, in particular, has witnessed a significant rise in dengue cases, accompanied by a spike in mortality rates. Several studies have identified various factors, primarily focusing on the 27 clinical aspects of severe dengue infection and the development of dengue-related fatalities. Expanding on this focus, this study aims to identify the demographic, clinical, and environmental factors contributing to dengue mortality, providing a more comprehensive understanding of the variables influencing dengue-related fatalities.

METHODS: This study utilized a 1:2 case-control design, analyzing data from the E-dengue system database and medical records from January 2015 to December 2022, involving 219 participants (73 dengue fatalities as cases and 146 recovered patients as controls). Dengue deaths were confirmed by the Penang State Mortality Review Committee, and controls were randomly selected from laboratory-confirmed dengue cases. Statistical analyses were performed using SPSS software, including descriptive statistics, chi-square tests, and multivariable logistic regression to identify predictors of dengue mortality, with variables included in the multivariable model if p < 0.05.

RESULTS: Several significant predictors of dengue-related mortality, including clinical and environmental factors were identified. Key predictors were a platelet count below 50,000/µL (OR 15.70; 95% CI: 5.65-43.53), presence of one comorbid condition (OR 2.90; 95% CI: 1.22-6.90), more than two comorbid conditions (OR 10.15; 95% CI: 3.53-29.23), bronchial asthma (OR 12.00; 95% CI: 1.08-132.13), and outbreak locality status (OR 2.3; 95% CI: 1.11-4.79). An interaction was also found between locality status and platelet levels.

CONCLUSION: The study emphasizes the need for developing risk profiles for dengue patients by integrating factors such as platelet levels, comorbidities, and locality status to improve clinical care. Nuanced protocols are needed to address the specific challenges of single-case and outbreak areas. In single-case localities, patients with low platelet counts (below 100,000/µL) should be prioritized for rapid intervention to mitigate severe outcomes. In outbreak areas, healthcare systems should bolster resources and apply comprehensive triage approaches considering platelet levels and other risk factors. Implementing predictive models that account for geographical factors can enhance resource allocation and preparedness for dengue outbreaks. These recommendations aim to empower public health personnel, healthcare providers, and communities to collectively reduce dengue-related mortality rates.

PMID:39501241 | DOI:10.1186/s12889-024-20545-2

BMC Womens Health. 2024 Nov 5;24(1):587. doi: 10.1186/s12905-024-03425-0.

ABSTRACT

BACKGROUND: Dignified care is an important priority for childbearing mothers. Threats to this deteriorate the therapeutic relationship between healthcare providers and clients, which leads to a negative effect on the quality of care. However, little evidence is identified about dignified care and associated factors in the Ethiopian context. Therefore, this study aimed to assess dignified care and associated factors among mothers who gave birth at public hospitals in Sidama Regional States, southern Ethiopia, 2023.

METHOD: An institution-based cross-sectional study was conducted among 418 mothers who gave birth at public hospitals in Sidama Regional States from July 30 to August 30, 2023. A systematic random sampling technique was employed to select study participants. An interviewer-administered structured questionnaire was used, and the data was collected by Kobotool and analyzed using SPSS Version 25. Bivariable and multivariable logistic regression analyses were conducted, and the crude and adjusted odds ratios, together with their corresponding 95% confidence, were computed. A P value < 0.05 was considered a level of statistical significance in this study.

RESULTS: In this study, the overall study participants’ magnitude of dignified care was found to be 44.1%. Secondary education (AOR: 3.91, 95% CI: 1.56, 9.82), spontaneous vaginal delivery (AOR: 2.68, 95% CI: 1.31, 5.46), the presence of a companion during labor and delivery (AOR: 12.35, 95% CI : 7.08, 21.53), and less than two days hospital stay (AOR: 3.26, 95% CI: 1.37, 7.75), and midwife attendance of labour and delivery (AOR = 4.47 (1.40-14.25) were significantly associated with dignified care.

CONCLUSIONS: The findings of this study showed that the dignified care of mothers who gave birth at public hospitals in Sidama Regional State was relatively low to the pooled prevalence of respectful maternity care in Ethiopia. In light of these results, it is recommended to prioritize midwife attendance during labor and delivery, promote the presence of companions, facilitate a shorter hospital stay, and enhance educational opportunities.

PMID:39501236 | DOI:10.1186/s12905-024-03425-0

BMC Public Health. 2024 Nov 5;24(1):3054. doi: 10.1186/s12889-024-20566-x.

ABSTRACT

BACKGROUND: This study investigated the prevalence of pain, depressive symptoms, and their co-occurrence in Norwegian adolescents. Additionally, we investigated if perceived achievement pressure and coping with pressure were associated with pain, depressive symptoms and co-occurrent pain and depressive symptoms.

METHODS: Cross-sectional data from the Norwegian Ungdata Survey (2017-2019) were analysed. Adolescents from across Norway completed an electronic questionnaire including questions on perceived achievement pressure, coping with pressure, pain, and depressive symptoms. Descriptive statistics presented prevalence rates, and multinominal regression reported in relative risk ratios (RR) was employed to estimate associations, adjusted for gender (boys/girls), school level, and socioeconomic status.

RESULTS: The analyses included 209,826 adolescents. The prevalence of pain was 33%, 3% for depressive symptoms, and 14% reported co-occurring pain and depressive symptoms. The prevalence of co-occurring symptoms was higher in girls (22%) than boys (6%). Significant associations were found between perceived achievement pressure and pain (RR 1.11, 95% CI 1.10-1.11), depressive symptoms (RR 1.27, 95% CI 1.27-1.28), and co-occurring symptoms (RR 1.34, 95% CI 1.33-1.34). Struggling to cope with pressure was associated with pain (RR 2.67 95% CI 2.53-2.81), depressive symptoms (RR 16.68, 95% CI 15.60-17.83), and co-occurring symptoms (RR 27.95, 95% CI 26.64-29.33).

CONCLUSION: The prevalence of co-occurring pain and depressive symptoms is high among Norwegian adolescents. Perceived achievement pressure and struggling to cope with pressure were associated with isolated and, more strongly, co-occurring pain and depressive symptoms. Enhancing adolescents’ ability to cope with pressure could be a crucial target in treating pain and depressive symptoms.

PMID:39501232 | DOI:10.1186/s12889-024-20566-x