Tag: pubmed

JCO Glob Oncol. 2023 Jun;9:e2200263. doi: 10.1200/GO.22.00263.

ABSTRACT

PURPOSE: Over 400,000 children are diagnosed with cancer around the world each year, with over 80% of these children residing in low- and middle-income countries. This study aims to summarize the epidemiology and care patterns of newly diagnosed childhood cancer patients in Northern Tanzania.

METHODS: Data from all children and adolescents (age 0-19 years) with newly diagnosed cancers were collected from the Kilimanjaro Cancer Registry located at the Kilimanjaro Christian Medical Centre. Descriptive and inferential analyses were used to compare the demographic and clinical characteristics of the participants over time, stage, and status at last contact. Statistical significance was set at P < .05. Secondary descriptive analysis was conducted on a subset sample with available staging data.

RESULTS: A total of 417 patients were diagnosed with cancer between 2016 and 2021. There was an increase in the rate of patients with newly diagnosed pediatric cancer each year, particularly among children under age 5 years and 10 years. Leukemias and lymphomas were the leading diagnoses and accounted for 183 (43.8%) of all patients. Over 75% of patients were diagnosed at stage III or above. From a subset analysis of patients with available staging data (n = 101), chemotherapy was the most common treatment (87.1%), compared with radiotherapy and surgery.

CONCLUSION: There is a significant burden of children with cancer in Tanzania. Our study fills crucial gaps in the literature related to the large burden of disease and survival for children with cancer in the Kilimanjaro region. Furthermore, our results can be used to understand the regional needs and guide research and strategic interventions to improve childhood cancer survival in Northern Tanzania.

PMID:37384861 | DOI:10.1200/GO.22.00263

JCO Glob Oncol. 2023 Jun;9:e2300074. doi: 10.1200/GO.23.00074.

ABSTRACT

PURPOSE: International twinning programs have been well-established between institutions in childhood cancer and have led to pediatric cancer units in low- and middle-income countries (LMICs) adopting multidisciplinary forms of care. To advance nutritional care in LMICs, the International Initiative for Pediatrics and Nutrition (IIPAN) provided the structural framework and personnel for the delivery of nutritional care. We describe the impact of a newly established nutrition program on the delivery of nutritional care and nutrition-related clinical outcomes in children and adolescents undergoing treatment for cancer in Nicaragua and Honduras.

METHODS: A prospective cohort (N = 126) collected clinical data over a 2-year period. Collection of IIPAN’s nutritional services received during treatment and clinical data were abstracted from medical charts and registered in Research Electronic Data Capture (REDCap) database. Chi-square, ANOVA, and generalized linear mixed models were used; P < .05 was considered statistically significant.

RESULTS: Nutritional assessments led to a higher number of patients receiving recommended standard of care. Children classified as underweight during treatment presented higher number of infections and toxicities, length of hospital stay, and days of treatment delays during treatment. Overall, from the start to end of treatment, 32.5% of patients improved nutritional status, 35.7% maintained it, and 17.5% worsened. On the basis of metrics, the cost per consultation was less than 4.80 US dollars (USD; Honduras) and 1.60 USD (Nicaragua).

CONCLUSION: Integration and equitable access of the nutritional care process for all patients needs to be recognized as a component of the basic management in pediatric oncology care. IIPAN’s nutritional program demonstrates that nutritional care is economical and feasible in a limited resource setting.

PMID:37384860 | DOI:10.1200/GO.23.00074

JCO Glob Oncol. 2023 Jun;9:e2200372. doi: 10.1200/GO.22.00372.

ABSTRACT

PURPOSE: Mexico and Central America have the highest childhood cancer incidence in the West. Pediatric-specific oncology knowledge contributes to the disparity. We sought to (1) determine the self-identified treatment patterns and needs of Mexican pediatric radiation oncologists and (2) pilot a workshop to improve contouring accuracy.

MATERIALS AND METHODS: Partnering with local experts and the Sociedad Mexicana de Radioterapeutas (SOMERA), a 35-question survey was designed to ascertain pediatric radiotherapy capacity and distributed through the SOMERA listserv. The most challenging malignancies were selected for workshop. Participants received precontouring and postcontouring homework to assess improvement per the Dice metric. The Wilcoxon sign-rank test was used for comparative statistics.

RESULTS: Ninety-four radiation oncologists attempted and 79 completed the survey. Forty-four (76%) felt comfortable treating a pediatric patient, and 36 (62%) were familiar with national protocols for pediatric treatment. Most had access to nutrition, rehabilitation, endocrinology, and anesthesia; 14% had access to fertility services and 27% to neurocognitive support; 11% noted no support, and only one respondent had child-life support. The postsurvey contouring workshop was conducted for high-grade glioma, medulloblastoma, and Hodgkin lymphoma. Significant improvements were seen in all target volumes.

CONCLUSION: We present the first national survey of Mexico’s pediatric radiotherapy capacity and Latin American e-contouring educational intervention with preworkshop and postworkshop Dice metrics, noting statistically significant improvement in all target volumes. Participation improved compared with prior experience through SOMERA partnership and Continuing Medical Education incentivization.

PMID:37384858 | DOI:10.1200/GO.22.00372

Acta Medica (Hradec Kralove). 2023;66(1):24-27. doi: 10.14712/18059694.2023.11.

ABSTRACT

AIMS: The sex ratio at birth approximates 0.515 (male : total, M/T), with 515 boys per 485 girls. Many factors have been shown to influence M/T including acute and chronic stress. Increasing maternal age is associated with a decline in M/T. In Aotearoa New Zealand, circa 15% of the population identify as of Māori heritage. This populationis generally considered to be socioeconomically disadvantaged. This study analysed M/T for Māori and non-Māori M/T births in Aotearoa New Zealand and relates these to mean maternal age at delivery.

METHODS: Live births by sex and maternal age at delivery were available from the website of Tatauranga Aotearoa Stats NZ for 1997-2021.

RESULTS: This study analysed 1,474,905 births (28.4% Māori) Pooled data shows that Māori M/T is significantly higher than non-Māori M/T (chi = 6.8, p = 0.009). Mean maternal age at delivery was less for Māori mothers but this was not statistically significant.

CONCLUSIONS: Several studies have shown that M/T is decreased in socioeconomically deprived populations, and for this reason Māori M/T is expected to be lower and not higher than non-Māori M/T. A lower mean maternal age at delivery might have explained the M/T differences noted in this analysis but this was not a statistically significant difference.

PMID:37384806 | DOI:10.14712/18059694.2023.11

J Infect Dis. 2023 Jun 29:jiad244. doi: 10.1093/infdis/jiad244. Online ahead of print.

ABSTRACT

BACKGROUND: Varicella causes a major health burden in many low- to middle-income countries located in tropical regions. Because of the lack of surveillance data, however, the epidemiology of varicella in these regions remains uncharacterized. Here, based on an extensive dataset of weekly varicella incidence in children ≤10 during 2011-2014 in 25 municipalities, we aimed to delineate the seasonality of varicella across the diverse tropical climates of Colombia.

METHODS: We used generalized additive models to estimate varicella seasonality, and clustering and matrix correlation methods to assess its correlation with climate. Furthermore, we developed a mathematical model to examine whether including the effect of climate on varicella transmission could reproduce the observed spatiotemporal patterns.

RESULTS: Varicella seasonality was markedly bimodal, with latitudinal changes in the peaks’ timing and amplitude. This spatial gradient strongly correlated with specific humidity (Mantel-statistic = 0.412, p-value = 0.001), but not temperature (Mantel-statistic = 0.077, p-value = 0.225). The mathematical model reproduced the spatial patterns observed not only in Colombia, but also México, and predicted a latitudinal gradient in Central American countries.

CONCLUSIONS: These results demonstrate large variability in varicella seasonality across Colombia. They further suggest that spatiotemporal humidity fluctuations can explain the calendar of varicella epidemics in Colombia, México, and potentially other countries in Central America.

PMID:37384795 | DOI:10.1093/infdis/jiad244

PLoS One. 2023 Jun 29;18(6):e0286735. doi: 10.1371/journal.pone.0286735. eCollection 2023.

ABSTRACT

BACKGROUND: 3 billion people lack proper home hand hygiene facilities globally. Of these, 1.4 billion (18%) lack soap or water, while 1.6 billion (22%) have neither. This analysis explores the link between living conditions and the use of essential agents in sub-Saharan Africa. This secondary data analysis examines potential associations between the domiciliary environment and the use of essential agents in sub-Saharan Africa.

METHODS: Eighteen demographic and health surveys were used to analyze the association between household environmental factors and handwashing with essential agents. STATA version 16 was used to analyze data from 203,311 households across weighted samples. Using a multivariable multilevel mixed effect logistic regression analysis, it was possible to determine how each independent factor affected the outcome while taking the data clustering into account. The adjusted odds ratio and its associated 95% confidence interval were used to assess the independent factors’ statistical significance.

RESULT: Only one in three households 34.84%, practiced handwashing with essential agents, with the highest prevalence in Angola (70.2%) and the lowest in Malawi (6.5%). Educational status [aOR = 1.77; 95%(CI = 1.68-1.86)], female headship[aOR = 1.09; 95%(CI = 1.06-1.2)], household wealth[aOR = 4.08; 95%(CI = 3.84-4.33)], not sharing toilets with other homes[aOR = 1.13; 95%(CI = 1.10-1.17)], having a fixed place for hand washing[aOR = 1.49; 95%(CI = 1.45-1.54)], not having regular access to water [aOR = 0.09; 95%(CI = 0.095-0.10)]and being a rural resident [aOR = 0.85; 95%(CI = 0.82-0.88)] were associated with handwashing.

CONCLUSION: sub-Saharan nations are failing to demonstrate advancements in handwashing practices. There are still a lot of homes without access to basic infrastructure for handwashing and household water sources. For essential agent adoption programs to be successful in an environment with limited resources, Water, Sanitation, and Hygiene measures must be implemented. Furthermore, it is critical to include contextual factors from the current study as well as socio-cultural and psychological characteristics that dissuade people from using essential agents in intervention strategies.

PMID:37384738 | DOI:10.1371/journal.pone.0286735

PLoS One. 2023 Jun 29;18(6):e0287911. doi: 10.1371/journal.pone.0287911. eCollection 2023.

ABSTRACT

This article reports a preregistered study in which we attempted to replicate the results of an influential study on the ego-depletion effect reported by Job, Dweck, and Walton in 2010. The original Job et al. study (Study 1, N = 60) provided evidence that the ego-depletion effect-a performance decrease on a self-control task after performing another self-control task-occurs only for individuals who hold a belief that their willpower is limited. This moderation of the ego-depletion effect by one’s willpower mindset (limited vs. nonlimited) has been interpreted as evidence against a prevalent limited-resource account of self-control. Although this alternative account of the ego-depletion effect has become well-known, the statistical evidence of the original study was on shaky ground. We therefore conducted a preregistered replication of the original study with some methodological improvements. As in the original study, participants (N = 187) performed a self-control task (Stroop color-word interference task) after performing the control or depletion version of a letter cancelation task. Despite extensive analyses, we failed to replicate the original results: There was neither a significant main effect of ego depletion nor a significant moderation of this ego-depletion effect by individual differences in willpower mindset. Together with other recent failures to replicate the original moderation effect, our results cast doubts on the claim that an individual’s view of whether willpower is limited or not affects one’s susceptibility to the ego-depletion effect.

PMID:37384732 | DOI:10.1371/journal.pone.0287911

PLoS One. 2023 Jun 29;18(6):e0287235. doi: 10.1371/journal.pone.0287235. eCollection 2023.

ABSTRACT

AIMS: To study the probability of seeking/undergoing aesthetic dental treatment (ADT) and compare self-perception of orofacial appearance (OA) based on sex, age, and monthly income; and to estimate the impact of OA on life satisfaction (LS) among Finnish and Brazilian adults, considering the indirect effect of receiving ADT and the moderating effects of those sociodemographic variables.

METHODS: This was an online cross-sectional study. Orofacial Esthetic Scale (OES), Psychosocial Impact of Dental Aesthetics Questionnaire (PIDAQ) and Satisfaction with Life Scale (SWLS) were used. Probability of seeking/receiving ADT was calculated using logistic regression and odds ratio (OR). OA scores were compared according to sociodemographic characteristics (ANOVA, α = 5%). Structural equations models estimated the impact of OA on LS.

RESULTS: 3,614 Finns [75.1% female, 32.0 (SD = 11.6) years] and 3,979 Brazilians [69.9% female, 33.0 (SD = 11.3) years] participated in the study. Women were more likely to receive ADT than men in both countries (OR>1.3). However, no statistically or practical significant differences were observed in OA between sexes (p>0.05 or p<0.05, ηp2 = 0.00-0.02). In Finland, demand for ADT (OR = 0.9-1.0) and OA scores (p>0.05) were the same among different ages and monthly income. In Brazil, younger individuals (OR>1.6) and those with higher monthly income (OR>2.7) were more likely to receive ADT, while those with lower income had a greater psychosocial impact of OA (p<0.05; ηp2>0.07). Individuals who were more satisfied with their own OA and had less psychosocial impact from OA had higher levels of LS (β = 0.31-0.34; p<0.01; explained variance: 9.8-13.1%).

CONCLUSION: Demand for ADT is influenced by sociodemographic and cultural factors. Greater societal pressure on physical appearance is observed among women in Western countries. In countries with high socioeconomic inequalities, consumerism and social prestige are involved in this demand. Self-perception of orofacial appearance plays a significant role in individuals’ subjective well-being. Therefore, the planning of aesthetic treatments in the orofacial region should consider the patient’s perceptions and social context.

PMID:37384731 | DOI:10.1371/journal.pone.0287235

PLoS One. 2023 Jun 29;18(6):e0286537. doi: 10.1371/journal.pone.0286537. eCollection 2023.

ABSTRACT

OBJECTIVES: Assess the Saudi pharmacists’ perceptions of their responsibilities toward deaf and hard-of-hearing (DHH) patients, their current practices, and their need for communication skills training.

STUDY DESIGN: A prospective cross-sectional study.

METHODS: Pharmacist and deaf communication questionnaire (PDCQ), a newly structured, validated, pilot-tested, and self-administered online questionnaire, was used to collect data. A total of 303 pharmacists working in the Saudi community and outpatient pharmacies participated in the study. Data were analyzed using SPSS and descriptive statistics were used to describe the study findings. These included Mean ± standard deviation (SD), frequency, and Chi-square tests.

RESULTS: Most pharmacists perceived that DHH patients had difficulty correctly understanding their medication instructions. Writing was the most common method used for communication, whereas the unavailability of interpreters and the low reading levels of these patients were the highest barriers to communication. Moreover, most pharmacists believed that they should be skilled at communicating with DHH patients. However, many pharmacists felt that they are not well prepared to communicate with these patients.

CONCLUSION: This research highlights the poor skills, low confidence and low knowledge Saudi pharmacists have about their legal obligations towards DHH patients. In addition, there is paucity of sufficient resources to help pharmacists improve their communication with such patients.

PMID:37384716 | DOI:10.1371/journal.pone.0286537

PLoS One. 2023 Jun 29;18(6):e0279610. doi: 10.1371/journal.pone.0279610. eCollection 2023.

ABSTRACT

BACKGROUND: Sub-Saharan Africa faces prolonged COVID-19 related impacts on economic activity, livelihoods and nutrition, with recovery slowed down by lagging vaccination progress.

OBJECTIVE: This study investigated the economic impacts of COVID-19 on food prices, consumption and dietary quality in Burkina Faso, Ethiopia, Ghana, Nigeria, and Tanzania.

METHODS: We conducted a repeated cross-sectional study using a mobile platform to collect data from July-December, 2021 (round 2). We assessed participants’ dietary intake of 20 food groups over the previous seven days and computed the primary outcome, the Prime Diet Quality Score (PDQS), and Dietary Diversity Score (DDS), with higher scores indicating better quality diets. We used generalized estimating equation (GEE) linear regression models to assess factors associated with diet quality during COVID-19.

RESULTS: Most of the respondents were male and the mean age was 42.4 (±12.5) years. Mean PDQS (±SD) was low at 19.4(±3.8), out of a maximum score of 40 in this study. Respondents (80%) reported higher than expected prices for all food groups. Secondary education or higher (estimate: 0.73, 95% CI: 0.32, 1.15), medium wealth status (estimate: 0.48, 95% CI: 0.14, 0.81), and older age were associated with higher PDQS. Farmers and casual laborers (estimate: -0.60, 95% CI: -1.11, -0.09), lower crop production (estimate: -0.87, 95% CI: -1.28, -0.46) and not engaged in farming (estimate: -1.38, 95% CI: -1.74, -1.02) were associated with lower PDQS.

CONCLUSION: Higher food prices and lower diet quality persisted during the COVID-19 pandemic. Economic and social vulnerability and reliance on markets (and lower agriculture production) were negatively associated with diet quality. Although recovery was evident, consumption of healthy diets remained low. Systematic efforts to address the underlying causes of poor diet quality through transforming food system value chains, and mitigation measures, including social protection programs and national policies are critical.

PMID:37384715 | DOI:10.1371/journal.pone.0279610