Tag: pubmed

Front Public Health. 2023 Jun 5;11:1128845. doi: 10.3389/fpubh.2023.1128845. eCollection 2023.

ABSTRACT

BACKGROUND: Patient self-referral is when patients refer themselves to upper-level health facilities without having to see anyone else first or without being told to refer themselves by another health professional. Self-referral leads to a diminished quality of healthcare services. However, globally, many women who gave birth referred themselves to hospitals without having referral sheets, including in Ethiopia and the study area. Therefore, this study aimed to assess self-referral practice and associated factors among women who gave birth in South Gondar zone primary hospitals in Northwest Ethiopia.

METHODS: A cross-sectional mixed-method study was conducted among women who gave birth in South Gondar zone primary hospitals between 1 June 2022 and 15 July 2022. Semi-structured questionnaires were used to gather quantitative data from 561 participants who were selected by a systematic random sampling technique. Interview guides were used to collect qualitative data from selected six key informants. Quantitative data were entered into Epi Data version 4.6.0.4 and then exported to the statistical software SPSS version 25 for further analysis. Thematic analysis using open code version 4.02 software was applied for qualitative data analysis. A binary logistic regression analysis was employed. In a bivariable analysis, a p < 0.25 was used to select candidate variables for multivariable analysis. P < 0.05 and a 95% confidence interval were used to determine significant variables on the outcome of interest.

RESULTS: The overall magnitude of self-referral was 45.6%, with 95% CI (41.5%, 49.9%). They had no antenatal care (ANC) follow-up (AOR = 3.02, 95% CI: 1.64-5.57) and 1-3 ANC follow-ups (AOR = 1.57, 95% CI: 1.03-2.41), poor knowledge about the referral system (AOR = 4.04, 95% CI: 2.30-7.09), and use of public transportation (AOR = 2.34, 95% CI: 1.43-3.82), which were significantly associated with self-referral practice.

CONCLUSION: This study showed that nearly half of the deliveries were self-referred. ANC follow-up, women’s knowledge of the referral system, and mode of transportation were factors significantly associated with the self-referral practice. Therefore, developing awareness-creation strategies and increasing coverage of ANC 4 and above are necessary interventions to reduce the self-referral practice.

PMID:37342276 | PMC:PMC10277469 | DOI:10.3389/fpubh.2023.1128845

Front Public Health. 2023 Jun 5;11:1138982. doi: 10.3389/fpubh.2023.1138982. eCollection 2023.

ABSTRACT

OBJECTIVE: The aim of this study was twofold: (i) to assess the health gap among young socio-economic groups generated by the economic crisis in Greece and (ii) to investigate HRQoL (Health Related Quality of Life) inequalities using the Theil index.

METHODS: The EQ-5D-5L instrument was administered to a sample of 4,177 young individuals in Greece, mean age 22.3 (±SD 4.8) and 53.8% males, and 46.2% females. The Greek version of the EQ-5D-5L instrument was used in a web-based questionnaire to collect data. Subjects were asked to assess their subjective health status during the economic crisis of 2016 using the EQ-5D-5L instrument, and to recall their health before the crisis of 2009. The health gap was assessed on a Visual Analogue Scale (EQ-VAS), the EQ-5D-5L Index, and the five dimensions of the EQ-5D-5L instrument. Regression analysis was employed to measure the effects of the economic crisis on age, sex, education, and income on the EQ-VAS and EQ-5D-5L. Theil index was used to assess HRQoL inequalities.

RESULTS: The economic crisis brought a significant deterioration in the HRQoL of young Greeks. The EQ-VAS was reduced during the crisis by -10.05% (p < 0.001) and the EQ-5D-5L index declined by -19.61% (p < 0.001). The prevalence of the health gap in each dimension of the EQ-5D-5L was also significant in terms of deterioration of Mobility [change by 66.8% (p < 0.001)], Self-care [change by 61.0% (p < 0.001)], Usual activities [change by 97.1% (p < 0.001)], Pain/discomfort [change by 65.0% (p < 0.001)], and Anxiety/depression [change by 70.5% (p < 0.001)]. Significant reductions in EQ-5D-5L indices were also associated with greater inequalities in the distribution of health among age, gender, income, and educational groups. The EQ-5D-5L health gap among the poor was much greater (0.198), in comparison to richer (0.128) classes. Similar gaps were also found in terms of educational inequalities. The EQ-5D-5L health gap among those with primary education was 0.211, whereas for those with tertiary education it was 0.16. The Theil index indicated an increase in income-related HRQoL inequalities by 222.3% for the EQ-5D-5L index and by 124.2% for the EQ-VAS. The effects of demographic and socioeconomic variables on the EQ-VAS were found statistically significant: sex (p < 0.05), age (p < 0.001), education (p < 0.001), and income (p < 0.001).

CONCLUSION: The EQ-5D-5L instrument appears to be a powerful tool in assessing the health gap and the HRQoL inequalities among young people in Greece. The findings indicate the importance of developing effective health policies to combat inequalities and mitigate the impact of austerity measures on the quality of life of the young.

PMID:37342272 | PMC:PMC10277562 | DOI:10.3389/fpubh.2023.1138982

Ther Adv Chronic Dis. 2023 Jun 17;14:20406223231173896. doi: 10.1177/20406223231173896. eCollection 2023.

ABSTRACT

BACKGROUND: Metabolic-associated fatty liver disease (MAFLD) has become an important cause of liver cancer. The current understanding of MAFLD-related liver cancer is not sufficient, however.

OBJECTIVE: The objective of this study was to investigate the clinical and metabolic characteristics of inpatients with MAFLD-related liver cancer.

DESIGN: This is a cross-sectional investigation.

METHODS: An investigation was conducted to collect the cases of hepatic malignant tumor hospitalized in Beijing Ditan Hospital, Capital Medical University from 1 January 2010 to December 31 2019. The basic information, medical history, laboratory examination results, and imaging examination results of 273 patients diagnosed with MAFLD-related liver cancer were recorded. The general information and metabolic characteristics of patients with MAFLD-related liver cancer were analyzed.

RESULTS: In total, 5958 patients were diagnosed with hepatic malignant tumor. Among them, liver cancer due to other causes accounted for 6.19% (369/5958), MAFLD-related liver cancer was diagnosed in 273 cases of them. From 2010 to 2019, MAFLD-related liver cancer showed an increasing trend. Among 273 patients with MAFLD-related liver cancer, 60.07% were male, 66.30% were ⩾60 years old, and 43.22% had cirrhosis. The 273 patients were comprised by 38 patients with evidence of fatty liver and 235 patients without evidence of fatty liver. There was no significant difference in the proportions of sex, age, overweight/obesity, type 2 diabetes, and the presence of ⩾2 metabolic-related factors between the two groups. In the group without evidence of fatty liver, 47.23% patients had cirrhosis, which was significantly higher than 18.42% in the group with evidence of fatty liver (p < 0.001).

CONCLUSION: MAFLD-related liver cancer should be considered in liver cancer patients with metabolic risk factors. Half of MAFLD-related liver cancer occurred in the absence of cirrhosis.

PMID:37342267 | PMC:PMC10278433 | DOI:10.1177/20406223231173896

J Clin Nurs. 2023 Jun 21. doi: 10.1111/jocn.16801. Online ahead of print.

ABSTRACT

AIMS: To assess the association of postoperative delirium developed in the post-anaesthetic care unit (PACU) with older patients’ ability to perform activities of daily living (ADL) during the first five postoperative days.

BACKGROUND: Previous studies have focused on the association between postoperative delirium and long-term function decline, however the association between postoperative delirium and the ability to perform ADL, particularly in the immediate postoperative period, needs further investigation.

DESIGN: A prospective cohort study.

METHODS: A total of 271 older patients who underwent elective or emergency surgery at a tertiary care hospital in Victoria, Australia, participated in the study. Data were collected between July 2021 and December 2021. Delirium was assessed using the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The Katz Index of Independence in Activities of Daily Living (KATZ ADL) scale was used to measure ADL. ADL was assessed preoperatively and daily during the first five postoperative days. The STROBE checklist was used to report this study.

RESULTS: Results showed that 44 (16.2%) patients developed new episode of delirium. Postoperative delirium was independently associated with decline in ADL (RR = 2.83, 95% CI = 2.71-2.97; p < 0.001).

CONCLUSIONS: Postoperative delirium was associated with a decline in ADL among older people during the first five postoperative days. Screening for delirium in the PACU is essential to identify delirium during the early stages of postoperative period and implement a timely comprehensive plan.

RELEVANCE TO CLINICAL PRACTICE: Delirium assessment of older patients in the PACU, and for at least the first five postoperative days, is strongly recommended. We also recommend engagement of patients in a focused physical and cognitive daily activity plan, particularly for older patients undergoing major surgery.

PATIENT OR PUBLIC CONTRIBUTION: Patients and nurses helped in data collection at a tertiary care hospital.

PMID:37341067 | DOI:10.1111/jocn.16801

Acta Bioeng Biomech. 2022;24(4):21-30.

ABSTRACT

PURPOSE: Foot pronation is not an isolated factor influencing lower limb functions. Exploring gait variability and impact loading associated with the foot posture are crucial for understanding foot pronation-related injury mechanisms. This study aimed to evaluate how foot posture affects impact loading and running variability during running.

METHODS: Twenty-five male participants were recruited into this study. Pressure under the foot arch, acceleration and marker trajectory were recorded in the right limb for each runner after 1, 4, 7 and 10 km running, respectively. Linear mixed effects models were used to analyze the statistical difference of the data.

RESULTS: FPI-6 has significantly increased after the 10 km running (p〈0.01). For the tibial acceleration, peak resultant acceleration after 10 km running was significantly increased than after 4 km running (p=0.02). At the dorsum of the foot, the short-time largest Lyapunov exponent (LyE) after 10 km running decreased 0.28 bit/s compared with LyE after 7 km running ( p = 0.03). In the tibia, LyE after 4 km and 10 km running was decreased significantly ( p 〈 0.01 and p = 0.01).

CONCLUSIONS: The foot was significantly pronated at the middle and at the end of running. Foot pronation during distance running increased the distal tibia peak impact acceleration but did not increase running instability.

PMID:37341060

Acta Bioeng Biomech. 2022;24(4):159-167.

ABSTRACT

PURPOSE: The COVID-19 pandemic has reduced physical activity and increased the time spent sitting. Combined with the lack of ergonomics at home workplaces, the risk of discomfort has increased, especially around the cervical spine and upper limbs. Evaluation of the mentioned problem is the subject of the study.

METHODS: The study used an original questionnaire based on the Nordic Musculoskeletal Questionnaire. The analysis used responses from people who reported discomfort in the form of tingling or numbness in the cervical spine, shoulder, elbow and wrist during the pandemic. Statistical analysis of the results was carried out to formulate conclusions. In addition, individual data were presented as percentages.

RESULTS: Considering the working time exceeding 8 hours a day, discomfort in the wrist joint area was most often reported among people working remotely (15.1%). Shoulder complex discomfort was the most common symptom (22%) reported by people working more than 8 hours a day, under the age of 31. In young people, the risk of discomfort in the shoulder, hand and cervical spine area increased.

CONCLUSIONS: Extended working time is conducive to the appearance of symptoms within the hands. In future studies, it will be necessary to analyze the ergonomic factors responsible for this phenomenon.

PMID:37341051

Acta Bioeng Biomech. 2022;24(4):75-83.

ABSTRACT

PURPOSE: The aim of this study was to compare the effects of scapular stabilization exercise with and without cognitive functional therapy (CFT) on disability and scapular kinematics in people suffering from chronic neck pain.

METHODS: A total of 72 patients with chronic non-specific neck pain were randomized into scapular stabilization exercise alone, n = 24, combined (scapular stabilization exercise + CFT), n = 24, and a control group, n = 24. Scapular kinematic and disability were measured at baseline and after the intervention.

RESULTS: Statistically significant differences in neck pain and disability scale (NPAD) were found when the multimodal physiotherapy group including a cognitive functional approach was compared with stabilization exercises group at 6 weeks (effect size (95%CI) = -1.63 (-2.55, -.71); P = 0.019)). Regarding the neck disability index (NDI), a significant between-group difference was observed at six-week (effect size (95%CI) = -2.69 (-3.80, -1.58); P = 0.007), with the superiority of effect in multimodal physiotherapy group. A significant between-group difference was observed in the scapular upward rotation and scapular osterior tilt at 30°, 60°, 90° and 120° of shoulder adduction.

CONCLUSIONS: A group-based multimodal rehabilitation program including scapular stabilization exercise plus cognitive functional therapy was superior to group-based stabilization exercises alone for decreasing disability and, improving scapular kinematic in patients with chronic neck pain.

PMID:37341050

Br J Psychiatry. 2023 Jun 21:1-8. doi: 10.1192/bjp.2023.74. Online ahead of print.

ABSTRACT

BACKGROUND: Common postpartum mental health (PMH) disorders such as depression and anxiety are preventable, but determining individual-level risk is difficult.

AIMS: To create and internally validate a clinical risk index for common PMH disorders.

METHOD: Using population-based health administrative data in Ontario, Canada, comprising sociodemographic, clinical and health service variables easily collectible from hospital birth records, we developed and internally validated a predictive model for common PMH disorders and converted the final model into a risk index. We developed the model in 75% of the cohort (n = 152 362), validating it in the remaining 25% (n = 75 772).

RESULTS: The 1-year prevalence of common PMH disorders was 6.0%. Independently associated variables (forming the mnemonic PMH CAREPLAN) that made up the risk index were: (P) prenatal care provider; (M) mental health diagnosis history and medications during pregnancy; (H) psychiatric hospital admissions or emergency department visits; (C) conception type and complications; (A) apprehension of newborn by child services (newborn taken into care); (R) region of maternal origin; (E) extremes of gestational age at birth; (P) primary maternal language; (L) lactation intention; (A) maternal age; (N) number of prenatal visits. In the index (scored 0-39), 1-year common PMH disorder risk ranged from 1.5 to 40.5%. Discrimination (C-statistic) was 0.69 in development and validation samples; the 95% confidence interval of expected risk encompassed observed risk for all scores in development and validation samples, indicating adequate risk index calibration.

CONCLUSIONS: Individual-level risk of developing a common postpartum mental health disorder can be estimated with data feasibly collectable from birth records. Next steps are external validation and evaluation of various cut-off scores for their utility in guiding postpartum individuals to interventions that reduce their risk of illness.

PMID:37341030 | DOI:10.1192/bjp.2023.74

Eur Psychiatry. 2023 Jun 21:1-24. doi: 10.1192/j.eurpsy.2023.2422. Online ahead of print.

NO ABSTRACT

PMID:37341028 | DOI:10.1192/j.eurpsy.2023.2422

Urol J. 2023 Jun 21. doi: 10.22037/uj.v20i.7508. Online ahead of print.

ABSTRACT

PURPOSE: To explore the safety and efficacy of bipolar plasma-kinetic transurethral resection of the prostate in patients taking low-dose aspirin.

MATERIALS AND METHODS: Benign prostatic hyperplasia (BPH) patients who underwent surgical treatment from November 2018 to May 2020 were retrospectively analyzed,divided into two groups according to whether taking 100mg aspirin daily aspirin or not. The perioperative indexes, complications and sequelae also were used to evaluate safety. The efficacy was evaluated by the functional outcomes in 3,6,12 months.

RESULTS: There were no statistical differences in the baseline characteristics or perioperative indicators and complications and sequelae, except for a longer operative time(90.49 ± 14.34 vs 84.95 ± 15.49; 95%CI: 0.26-10.83; P = .040) and a shorter hospital stay time(HST) (8.52 ± 1.55 vs 9.09 ± 1 .50; 95% CI: 0.21-1.11; P = .042) in the non-aspirin group. During the 12-months follow-up period, the functional outcomes of the two groups were significantly improved except International Index of Erectile Function (IIEF-5).

CONCLUSION: Based on our research results, PKRP a safe and effective method for patients with BPH who taking 100mg aspirin daily.

PMID:37341011 | DOI:10.22037/uj.v20i.7508