Tag: pubmed

Niger Postgrad Med J. 2022 Apr-Jun;29(2):89-95. doi: 10.4103/npmj.npmj_11_22.

ABSTRACT

CONTEXT: Coronavirus disease (COVID-19) has led to over 2,589,638 deaths globally as of March 2021 and speedy discovery of vaccines. Nigeria started the phase one COVID-19 vaccination in March 2021 using the Oxford AstraZeneca vaccine. Reports of severe adverse events with the Oxford AstraZeneca vaccine resulted in its suspension in some countries necessitating the need to determine its safety.

AIMS: To assess the prevalence, types and severity of the adverse events following COVID-19 vaccination in Rivers State, Nigeria.

SETTINGS AND DESIGN: A cross-sectional study design was adopted.

SUBJECTS AND METHODS: Simple random sampling method was used to select a total of 428 adults from recipients of the first dose of COVID-19 vaccine within 28 days of vaccination. A questionnaire adapted from World Health Organisation was interviewer-administered through phone calls; responses were recorded on Kobo Toolbox.

STATISTICAL ANALYSIS USED: Descriptive analysis of variables was done and the association between adverse events and age, allergy and medical history were determined. The level of statistical significance was predetermined at a P < 0.05.

RESULTS: In this study, 50.5% of respondents reported post-vaccination adverse events out of which 10 (4.6%) were severe (30% of the severe cases were life-threatening, 60% were hospitalised and 10% were placed on bed rest). The most common side effects were fever (73.0%), pain at the injection site (41.2%), fatigue (33.3%), body ache (17.5%) and headache (13.8%). No significant association was observed between the incidence of severe adverse events and participants with allergies or medical history.

CONCLUSIONS: The adverse events associated with the COVID-19 vaccine were largely mild and resolved within a few days. Further research is required to classify adverse events into categories.

PMID:35488575 | DOI:10.4103/npmj.npmj_11_22

Niger Postgrad Med J. 2022 Apr-Jun;29(2):123-130. doi: 10.4103/npmj.npmj_739_21.

ABSTRACT

BACKGROUND: The clinical uses of ultrasonography have varied and increased over time, especially the ability of ultrasonographic measured parameters to predict the outcomes of labour. The proper understanding of the association between these ultrasonographic parameters, mode of delivery, adverse maternal and foetal outcomes will further improve patient counselling as well as the planning of intrapartum care.

AIM: The study explored the ultrasonographic measurement of foetal head circumference (HC) and cheek-to-cheek diameter (CCD) at term as predictors of labour outcomes.

METHODOLOGY: Eligible pregnant women at term were recruited from the antenatal clinic and had obstetric ultrasound scans done with HC and CCD measured. Maternal and foetal outcomes were measured and included progress in labour, obstetric lacerations, mode of delivery and suspected foetal distress. Data analysis was performed using the Statistical Package for the Social Sciences (SPSS) version 20.

RESULTS: One hundred and thirty-two patients were recruited into the study. Foetal HC measurements ≥35 cm were closely associated with caesarean delivery odds ratio – 2.40 (95% confidence interval – 1.02-5.66. P = 0.046). Neither CCD nor CCD/HC ratio was predictive of the modes of delivery. The occurrence of perineal lacerations and poor progress of labour were observed more frequently with increasing HC and CCD.

CONCLUSIONS: HC performed well in predicting caesarean delivery as well as perinatal outcomes among parturients. The ultrasonographic measured HC (≥35 cm) is associated with a higher incidence of both obstetric interventions for poor progress of labour and adverse perinatal outcomes in comparison to CCD. The association between HC and labour dystocia was found to be linear. The CCD did not perform well as a predictor of the mode of delivery.

PMID:35488580 | DOI:10.4103/npmj.npmj_739_21

Niger Postgrad Med J. 2022 Apr-Jun;29(2):82-88. doi: 10.4103/npmj.npmj_777_21.

ABSTRACT

CONTEXT: Indonesia has a large population with a large number of motorised vehicles, so it cannot be separated from traffic accidents.

AIMS: This study aimed to determine and analyse the advanced level risk factors for road traffic accidents (RTA) in rural and urban areas based on data from the Basic Health Research 2018 (Riskesdas).

METHODS: This study used Riskesdas data sourced from the National Institute of Health Research and Development, Ministry of Health, Indonesia, which was collected from 34 provinces in Indonesia using a cross-sectional method. The statistical data consisted of 59,423 respondents aged over 15 years old, who had experienced a road traffic injury and lived in rural or urban areas. The data variables analysis was socio-demographic, lifestyle, smoking status, alcohol consumption, mental disorders, nutritional status and use of helmets on motorcycle riders and passengers.

STATISTICAL ANALYSIS: Multivariate logistic regression was used to analyse the most dominant risk factors related to RTA in rural and urban areas.

RESULTS: The prevalence of RTA in urban areas was 34.1%, while in rural areas was 28.2%. The factors related to traffic accidents in respondents from urban areas (P < 0.005) were sex (1.342 [1.217-1.480]), age (1.111 [1.067-1.156]) and use of helmets on motorcycle riders and passengers (0.662 [0.566-0.771]). Meanwhile, risk factors for respondents from rural areas (P < 0.005) were mental disorders (0.842 [0.743-0.955]), age (1.095 [1.040-1.154]) and use of helmets on motorcycle riders and passengers (0.682 [0.585-0.796]).

CONCLUSIONS: We found that the prevalence of RTA in urban areas was higher than in rural areas. The dominant risk factors related to RTA in Indonesia were age, sex, mental disorders and the use of helmets on motorcycle riders and passengers. This finding supports the importance of road safety education and the prevention of RTA needs to be done both in urban and rural areas.

PMID:35488574 | DOI:10.4103/npmj.npmj_777_21

Midwifery. 2022 Apr 11;110:103339. doi: 10.1016/j.midw.2022.103339. Online ahead of print.

ABSTRACT

PURPOSE: The aim of this study was to determine maternal attachment and mental health status in mothers of babies with infantile colic.

DESIGN: Cross-sectional online survey.

SETTING: The study was conducted on messaging and social media platforms, and groups related to mothers and babies.

PARTICIPANTS: 380 mothers, 107 of whom had babies with infantile colic and 273 of whom had healthy babies, participated in the study.

MEASUREMENT TOOLS AND FINDINGS: A Personal Information Form, the Maternal Attachment Inventory, and the Depression, Anxiety and Stress Scale were used to collect data. No statistically significant relationship was found between infantile colic status and maternal attachment. The depression, anxiety and stress scores of the mothers who had babies with infantile colic were significantly higher compared to the mothers with healthy babies (p<0.05). Additionally, as the depression scores of the mothers increased, their maternal attachment levels decreased (p <0.05).

KEY CONCLUSIONS: Maternal depression, anxiety and stress make it difficult for mothers to provide care for their babies. Therefore, health professionals should screen mothers who have babies with infantile colic in the postpartum period in terms of mental health. Besides, the mothers should be provided with support to assist them in coping with their Babies’ colic.

IMPLICATIONS FOR PRACTICE: Health professionals should be aware that infantile colic negatively affects the mental health of mothers and increases the frequency of follow-ups of these mothers in the postpartum period. More research is needed to examine the effects of infantile colic on maternal attachment.

PMID:35486961 | DOI:10.1016/j.midw.2022.103339

Menopause. 2022 May 1;29(5):545-552. doi: 10.1097/GME.0000000000001941.

ABSTRACT

OBJECTIVE: Menopausal syndrome generally includes psychological problems. Listening to music has been used to cope with changes during this period. This study was conducted to determine the effect of listening to music on the symptoms of menopause and depression levels.

METHODS: This randomized-controlled study was carried out between July 2019 and December 2020. The study sample consisted of 48 postmenopausal women (21 in the music group and 27 in the control group). Music was played by the researcher to the postmenopausal women in the intervention group in a total of 18 sessions for six weeks. The data were collected using an introductory information form, Beck depression inventory (BDI), and menopause rating scale (MRS).

RESULTS: The posttest MRS scores of the women in the control group were higher than those in the music group, without a statistically significant difference between the groups (P > 0.05). Comparison of the post-test BDI scores of the participants in the music and control groups revealed a significant decrease in the depression scores among the women in the music group (P = 0.036). Comparison of the pretest and posttest MRS and BDI differences between the participants showed a statistically significant decrease in the MRS total and sub-scale scores among the women in the music group after the intervention.

CONCLUSIONS: There was a significant decrease of posttest BDI scores of the women in the music group but not in the control group. Listening to music can help reduce depression levels and symptoms of menopause in postmenopausal women. Music could be used as a nonpharmacological therapeutic option in nursing care.

PMID:35486946 | DOI:10.1097/GME.0000000000001941

Menopause. 2022 May 1;29(5):580-589. doi: 10.1097/GME.0000000000001944.

ABSTRACT

OBJECTIVE: To compare the impact of micronized progesterone (MP) or medroxyprogesterone acetate (MPA) in combination with transdermal estradiol (t-E2) on traditional coagulation factors and thrombin generation parameters in postmenopausal women diagnosed with premature ovarian insufficiency or early menopause.

METHOD: Randomized prospective trial conducted in women diagnosed with premature ovarian insufficiency or early menopause and an intact uterus, recruited over 28 months. All participants were prescribed t-E2 and randomized to either cyclical MP or MPA using a web-based computer randomization software, Graph Pad. Thrombin generation parameters were measured at baseline and repeated after 3-months. Traditional hemostatic biomarkers were measured at baseline and repeated after 3, 6, and 12-months. Seventy-one participants were screened for the study, of whom 66 met the inclusion criteria. In total, 57 participants were randomized: 44 completed the thrombin generation assessment arm of the study, whilst 32 completed 12-months of the traditional coagulation factor screening component of the trial.

RESULTS: Thrombin generation parameters did not significantly change from baseline after 3-months duration for either progestogen component when combined with t-E2, unlike the traditional coagulation factors. Protein C activity, free Protein S, and Antithrombin III levels decreased with time in both treatment arms.

CONCLUSION: Fluctuations in traditional hemostatic biomarkers were not reproduced by parallel changes in thrombin generation parameters that remained neutral in both groups compared with baseline. The absence of statistically significant changes in thrombin generation for the first 3-months of hormone therapy use is reassuring and would suggest a neutral effect of both progestogens on the global coagulation assay.

PMID:35486948 | DOI:10.1097/GME.0000000000001944

Nicotine Tob Res. 2022 Apr 29:ntac115. doi: 10.1093/ntr/ntac115. Online ahead of print.

ABSTRACT

INTRODUCTION: We calculate the U.S. adult smoking cessation rate for 2014-2019, compare it to the historical trend, and estimate the implication for future smoking prevalence.

METHODS: We repeated an earlier analysis, which examined the cessation rate from 1990-2014, extending the period to 2019. Employing National Health Interview Survey (NHIS) and National Survey on Drug Use and Health (NSDUH) data, we estimated the adult cessation rate in six-year intervals, using weighted non-linear least squares. We then employed a meta-regression model to test whether the cessation rate has increased beyond expectation. We used cessation rate estimates and smoking initiation rate estimates to project smoking prevalence in 2030 and eventual steady-state prevalence.

RESULTS: The annual cessation rate increased 29% using NHIS data (from 4.2% in 2008-2013 to 5.4% in 2014-2019) and 33% with NSDUH data (4.2% to 5.6%). The cessation rate increase accounts for 60% of a smoking prevalence decline in the most recent period exceeding the 1990-2013 predicted trend. The remaining 40% owes to declining smoking initiation. With current initiation and cessation rates, smoking prevalence should fall to 8.3% in 2030 and eventually reach a steady state of 3.53%.

CONCLUSIONS: The smoking cessation rate continued to increase during 2014-2019. NHIS and NSDUH results are practically identical. The larger share (60%) of the smoking prevalence decrease, beyond expectation, attributable to the increased cessation rate is encouraging since the positive health effects of cessation occur much sooner than those derived from declining initiation.

IMPLICATIONS: The smoking cessation rate in the U.S. continues to increase, accelerating the decline in smoking prevalence. This increase suggests that the Healthy People 2030 goal of 5% adult smoking prevalence, while ambitious, is attainable. Our findings can be used in simulation and statistical models that aim to predict future prevalence and population health effects due to smoking under various scenarios.

PMID:35486922 | DOI:10.1093/ntr/ntac115

J Hosp Palliat Nurs. 2022 Jun 1;24(3):167-174. doi: 10.1097/NJH.0000000000000845. Epub 2022 Feb 11.

ABSTRACT

The need for hospice care is increasing in the United States, but insufficient lengths of stay and disparity in access to care continue. Few studies have examined the relationship between the presence of symptoms and hospice referral. The study measured the association between hospice referral and demographic characteristics and the presence of pain and depression in a cohort of people hospitalized with metastatic cancer in New Jersey in 2018. This study was secondary analysis of the 2018 New Jersey State Inpatient Database. The sample was limited to adult patients with metastatic cancer. Descriptive statistics evaluated the composition of the sample. Generalized linear modeling estimated the effect of pain and depression on incidence of hospice referral in a racially and economically diverse population. Absence of pain resulted in lower odds of receiving a referral to hospice upon discharge (adjusted odds ratio [AOR], 0.44; 95% confidence interval [CI], 0.40-0.49; P = .00). Likewise, an absence of depression also resulted in decreased odds of a hospice referral (AOR, 0.85; 95% CI, 0.76-0.96; P = .008). Compared with Whites, Blacks (AOR, 0.86; 95% CI, 0.76-0.97; P = .00) and Hispanics had significantly lower odds of receiving a hospice referral (AOR, 0.84; 95% CI, 0.72-0.96; P = .01). Patients with a primary language other than English, there were significantly lower odds of receiving a hospice referral (AOR, 0.85; 95% CI, 0.73-0.99; P = .03). Patients with pain and depression had increased hospice referrals. Disparities persist in hospice referral, particularly in Black and Hispanic cases and those without a primary language of English.

PMID:35486912 | DOI:10.1097/NJH.0000000000000845

JMIR Perioper Med. 2022 Apr 29. doi: 10.2196/29045. Online ahead of print.

ABSTRACT

BACKGROUND: At the height of COVID 19 pandemic, the hepato-pancreato-biliary (HPB) unit had to reorganize surgical case volume due to rationing of healthcare resources. We report local audit evaluating the impact of COVID-19 on the HPB unit and its impact on HPB surgical oncology practice.

OBJECTIVE: The primary measure of the study was to review the impact of the COVID 19 pandemic on the HPB unit’s elective and emergency surgical cases. Secondary measures were to investigate the impact on HPB surgical oncology operative case volume.

METHODS: We performed a comparative audit of the HPB unit surgical case volume for January-June 2019 (baseline) and 2020 (COVID-19). Elective and emergency cases performed under general anesthesia were audited. Elective cases included hernia, gallbladder surgeries, liver and pancreatic resections. Emergency cases included cholecystectomies and laparotomies performed for general surgical indications. We excluded endoscopy and procedures done under local anaesthesia. The retrospective data collected in the two time periods were compared. The study was registered with the Chinese Clinical Trial Registry (ChiCTR2000040265).

RESULTS: Elective surgical case volume decreased by 41.8% (n=351 (2019) vs. 204 (2020)) during the COVID-19 pandemic. Hernia surgery decreased by 63.9% (n=155 (2019) vs. 56 (2020), P=<.001) and cholecystectomy by 40.1% (n=157 (2019) vs. 94 (2020), P=.826). Liver and pancreatic resection volume increased by 16.7% (n=30 (2019) vs. 35 (2020), P=.004) and 111.1% (n=9 (2019) vs. 19 (2020), P=.001). The emergency surgical workload reduced by 40.9% (n=193 (2019) vs. 114 (2020)). The most significant reduction in emergency workload was observed in March, 41 to 23 cases (43.9%, P=.94), April 35 to 8 cases (77.1%, P =.01), and May 32 to 14 cases (56.3%, P=.39), however only April month showed statistically significant reduction in workload (P=.01).

CONCLUSIONS: Reallocation of resources due to the COVID-19 pandemic did not adversely impact elective HPB oncology work. With prudent measures in place, essential surgical services can be maintained during a pandemic.

CLINICALTRIAL: Chinese Clinical Trial Registry (ChiCTR2000040265).

PMID:35486909 | DOI:10.2196/29045

JMIR Diabetes. 2022 Apr 20. doi: 10.2196/36181. Online ahead of print.

ABSTRACT

BACKGROUND: Lockdown restrictions reduce COVID-19 community transmission; however, they may pose challenges for non-communicable disease management. A 112-day hard lockdown in Victoria, Australia (commencing March 23, 2020), coincided with an intervention trial of reducing and breaking up sitting time in desk workers with type 2 diabetes who were using a provided consumer grade activity tracker (Fitbit).

OBJECTIVE: To compare continuously recorded activity levels preceding and during COVID-19 lockdown restrictions among working adults with type 2 diabetes participating in a sitting less and moving more intervention.

METHODS: Eleven participants (8/11 male; mean [SD] age 52.8 [5.0] years) in Melbourne, Australia had Fitbit activity tracked before (mean [SD]: 122.7 [47.9] days) and during (99.7 [62.5] days) city-wide COVID-19 lockdown restrictions. Regression models compared device (Fitbit Inspire HR)-derived activity (steps; METs [metabolic equivalents], mean time in sedentary, lightly, fairly, and very active minutes, and usual bout durations) during restrictions, to pre-restriction. Changes in activity were statistically significant when estimates (Δ%) did not intercept zero.

RESULTS: Overall, there was a decrease in mean: steps (-1,584 steps/day; Δ% : 9%; 95%CI: -11, -7); METs (-83 METs/day; Δ% : -5%; 95%CI: -6, -5); and, lightly active (Δ% : -4%; 95%CI: -8, -1), fairly active (Δ% : -8%; 95%CI: -21, -15), and very active (Δ% : -8%; 95%CI: -11, -5) intensity minutes per day, and increases in mean sedentary minutes per day (+51 mins/day; Δ% : +3%; 95%CI: 1, 6). Only very active (+5.1 mins) and sedentary (+4.3 mins) bout durations changed significantly.

CONCLUSIONS: In a convenience sample of adults with type 2 diabetes, COVID-19 lockdown restrictions were associated with decreases in overall activity levels and increases in very active and sedentary bout durations. A Fitbit monitor provided meaningful continuous long-term data in this context.

CLINICALTRIAL: Australian New Zealand Clinical Trials Registry ANZCTRN12618001159246.

PMID:35486904 | DOI:10.2196/36181