Tag: pubmed

PLoS One. 2022 Oct 7;17(10):e0274525. doi: 10.1371/journal.pone.0274525. eCollection 2022.

ABSTRACT

INTRODUCTION: Mental health is recognized as a critical component of public health Given the close relationship between mental health and life style and the importance of students as valuable human resources, the present study aimed at determining the relationship between life style and mental health among medical students in Sousse during COVID-19 pandemic.

METHODS: We conducted a cross-sectional observational study in university students from the first to the fifth grade of the Faculty of Medicine of Sousse during the academic year 2020/2021. Data were collected anonymously via an online questionnaire published on the Facebook groups of each grade, on december 2020. The online survey consisted of three sections. The first one aimed to collect sociodemographic information. The second section of the survey addressed recent lifestyle choices and the third one assessed psychological distress using the French version of 12 items of The General Health Questionnaire (GHQ-12). The significance level was considered 0.05.

RESULTS: Overall 147 were studied. Using the bimodal scoring, the total score was between 0 and 12, to evoke psychiatric disorders, we set the threshold of 4. For our sample, the median scale was 7 [4-9], and more than half of the students (68%; n = 100) had a score higher than 4. Psychiatric disorder was significantly more frequent in female students (73.3% vs 42.3%; p = 0.002). Higher GHQ-scale was found in younger students, foreigners, students who need more than 30 minutes to get to the faculty, unemployed students, and students of fifth grade. However, differences were not statistically significant. Regarding lifestyle choices, we found that physical inactivity, no smoking habits, no alcohol use, no illicit substance use, other substance use, changing in eating habits, and absence of coping methods of stress were higher in students with psychiatric disorders. However, this association was statistically significant only for physical activity (p = 0.016). The results of the regression analysis suggest female gender as an independent predictor of high GHQ-12 scores. Practicing physical activity was found as protective factor for psychiatric disorders.

CONCLUSION: Considering the vital role of medical students in providing and promoting community health, the need for more detailed planning and interventions to improve their life style and mental health is essential.

PMID:36206267 | DOI:10.1371/journal.pone.0274525

PLoS One. 2022 Oct 7;17(10):e0258632. doi: 10.1371/journal.pone.0258632. eCollection 2022.

ABSTRACT

The Baja California Pacific Islands (BCPI) is a seabird hotspot in the southern California Current System supporting 129 seabird breeding populations of 23 species and over one million birds annually. These islands had a history of environmental degradation because of invasive alien species, human disturbance, and contaminants that caused the extirpation of 27 seabird populations. Most of the invasive mammals have been eradicated and colonies have been restored with social attraction techniques. We have recorded the number of breeding pairs annually for most of the colonies since 2008. To assess population trends, we analyzed these data and show results for 19 seabird species on ten island groups. The maximum number of breeding pairs for each nesting season was used to estimate the population growth rate (λ) for each species at every island colony. We performed a moving block bootstrap analysis to assess whether seabird breeding populations are increasing or decreasing. San Benito, Natividad, and San Jerónimo are the top three islands in terms of abundance of breeding pairs. The most widespread species is Cassin’s Auklet (Ptychoramphus aleuticus) with 14 colonies. Thirty-one populations of 14 species are significantly increasing while eleven populations of seven species are decreasing. We did not find statistical significance for 19 populations, however, 15 have λ>1 which suggest they are growing. Twelve of the 18 species for which we estimated a regional population trend are significantly increasing, including seven surface-nesting species: Brandt’s Cormorant (Phalacrocorax penicillatus), Brown Pelican (Pelecanus occidentalis), Caspian Tern (Hydroprogne caspia), Double-crested Cormorant (P. auritus), Elegant Tern (Thalasseus elegans), Laysan Albatross (Phoebastria immutabilis) and Western Gull (Larus occidentalis), and five burrow-nesting species: Ainley’s (Hydrobates cheimomnestes), Ashy (H. homochroa) and Townsend’s (H. socorroensis) Storm-Petrels, and Craveri’s (Synthliboramphus craveri) and Guadalupe (S. hypoleucus) Murrelets. The BCPI support between 400,000 and 1.4 million breeding individuals annually. Our results suggest that these islands support healthy and growing populations of seabirds that have shown to be resilient to extreme environmental conditions such as the “Blob”, and that such resilience has been strengthen from conservation and restoration actions such as the eradication of invasive mammals, social attraction techniques and island biosecurity.

PMID:36206266 | DOI:10.1371/journal.pone.0258632

PLoS One. 2022 Oct 7;17(10):e0269351. doi: 10.1371/journal.pone.0269351. eCollection 2022.

ABSTRACT

BACKGROUND: Aging is the most significant risk factor for dementia. Alzheimer’s disease (AD) accounts for approximately 60-80% of all dementia cases in older adults. This study aimed to examine the relationship between finger movements and brain volume in AD patients using a voxel-based reginal analysis system for Alzheimer’s disease (VSRAD) software.

METHODS: Patients diagnosed with AD at the Center for Comprehensive Care and Research on Memory Disorders were included. The diagnostic criteria were based on the National Institute on Aging-Alzheimer’s Association. A finger-tapping device was used for all measurements. Participants performed the tasks in the following order: with their non-dominant hand, dominant hand, both hands simultaneously, and alternate hands. Movements were measured for 15 s each. The relationship between distance and output was measured. Magnetic resonance imaging measurements were performed, and VSRAD was conducted using sagittal section 3D T1-weighted images. The Z-score was used to calculate the severity of medial temporal lobe atrophy. Pearson’s product-moment correlation coefficient analyzed the relationship between the severity of medial temporal lobe atrophy and mean values of the parameters in the finger-tapping movements. The statistical significance level was set at <5%. The calculated p-values were corrected using the Bonferroni method.

RESULTS: Sixty-two patients were included in the study. Comparison between VSRAD and MoCA-J scores corrected for p-values showed a significant negative correlation with the extent of gray matter atrophy (r = -0. 52; p< 0.001). A positive correlation was observed between the severity of medial temporal lobe atrophy and standard deviation (SD) of the distance rate of velocity peak in extending movements in the non-dominant hand (r = 0. 51; p< 0.001).

CONCLUSIONS: The SD of distance rate of velocity peak in extending movements extracted from finger taps may be a useful parameter for the early detection of AD and diagnosis of its severity.

PMID:36206254 | DOI:10.1371/journal.pone.0269351

PLoS One. 2022 Oct 7;17(10):e0273808. doi: 10.1371/journal.pone.0273808. eCollection 2022.

ABSTRACT

BACKGROUND: Trachoma is a public health issue in more than 50 nations worldwide, mainly in Sub-Saharan Africa, where hundreds of millions of people are considered blind. Ethiopia is projected to have 30% of the global active trachoma burden. The frequency of Trachoma Folliculitis in children aged 1 to 9 years old is 30% in the Oromia Region. Therefore, the aim of this study was to assess the prevalence of active trachoma and associated variables among children aged 1 to 9 years old in Arsi Negele Town, West Arsi Zone, Oromia Regional State, Southern Ethiopia, December 24-26, 2019.

METHODS: A community-based cross-sectional study was conducted in the Arsi Negele town community on December 24-26, 2019. A total of 178 study volunteers were recruited using a single population proportion formula and assigned to families in the town’s three kebeles in proportion. A simple random selection procedure was used to choose study participants from the identified households. Madda Walabu University provided ethical approval, and different government structures provided letters of permission. Pre-tested structured questionnaires and binocular loupes X 2.5 were used to collect data from either mothers or fathers of eligible children for eye examination; torches with bottles of alcohol were used to gather data from either mothers or fathers of eligible children for eye examination. For analysis, data was entered into (IBM, SPSS) version 22. To assess factors associated with active trachoma, bivariate and multivariable logistic regressions were used. The crude and adjusted odds ratios with 95% confidence intervals were calculated to investigate the degree of association between the independent variables and active trachoma. Multivariate logistic regression was used to find connections between dependent and independent variables with a p≤ 0.05 confidence levels and a 95% confidence interval.

RESULT: The prevalence of active trachoma was determined to be 21.91% TF among 178 children aged 1 to 9 years. Flies on children’s faces (AOR = 3.427; 95 percent CI: 1.432-8.171), unclean children’s faces (AOR = 3.99; 95 percent CI: 1.427-11.158), face washing habits (AOR = 3.064; 95 percent CI: 1.273-7.373), and not using soap while face washing (AOR = 4.564; 95 percent CI 1.561-13.342) were found to be statistically significant associated factors with the prevalence of active trachoma.

CONCLUSION: The prevalence of active trachoma was found to be relatively high. Face washing practices and the lack of soap use while washing faces were found as associated factors requiring optimal interventions to prevent trachoma infection among children aged 1-9 years in Arsi Negele town.

PMID:36206245 | DOI:10.1371/journal.pone.0273808

Am J Physiol Heart Circ Physiol. 2022 Oct 7. doi: 10.1152/ajpheart.00454.2022. Online ahead of print.

ABSTRACT

There are numerous sex-related differences in cardiac electrophysiology and arrhythmia propensity but very little knowledge about the reasons. Difference in body size has been proposed as one reason and was tested in this study of >20 cardiac electrophysiology parameters in 319 (158 women) apparently healthy 50-64 years old subjects from a randomly enrolled population sample, the SCAPIS pilot study (Swedish CArdio-Pulmonary bioImaging Study), using Frank vectorcardiography. We studied conventional conduction intervals, parameters reflecting electrical heterogeneity (dispersion) in the ventricles, QRS- and T-vector directions, spatial QRS-T angles, and T-vector loop morphology. Body surface area (BSA; two methods) and lean body mass (LBM), both estimated from body weight and height, were used as body size parameters. According to multivariable linear regression analysis adjusted for sex, there was no association between electrophysiological parameters and body size apart from QRS duration and QRSarea. In conclusion, most electrophysiological parameters assessed completely non-invasively and showing statistically significant differences between women and men on the group level show no association with BSA or LBM. Scaling (indexing) the electrophysiological parameters for body size parameters are therefore not an option. As a consequence, the explanation for the sex-related electrophysiological differences should be sought along other lines.

PMID:36206051 | DOI:10.1152/ajpheart.00454.2022

JMIR Form Res. 2022 Oct 7;6(10):e35176. doi: 10.2196/35176.

ABSTRACT

BACKGROUND: Achieving health goals requires informed decision-making supported by transparent, reliable, and relevant health information. This helps decision makers, such as health managers, to better understand the functioning of their health system and improve their ability to respond quickly to health demands. To achieve this, the health system needs to be supported by a digitized decision-making information system. In Sub-Saharan African countries, inadequate digital infrastructure, including limited internet connectivity and insufficient access to appropriate computer software, makes it difficult to collect, process, and analyze data for health statistics. The processing of data is done manually in this case; however, this situation affects the quality of the health statistics produced and compromises the quality of health intervention choices in these countries.

OBJECTIVE: This study aimed to describe the conceptual approach of a data production and dissemination platform model proposed and implemented in Gabon. More precisely, it aimed to present the approach applied for the multidimensional analysis of the data production and dissemination process in the existing information system and present the results of an evaluation of the proposed model implemented in a real context.

METHODS: The research was carried out in 3 phases. First, a platform was designed and developed based on the examination of the various data production and indicator generation procedures. Then, the platform was implemented in chosen health facilities in Gabon. Finally, a platform evaluation was carried out with actual end users.

RESULTS: A total of 14 users with 12 years of average experience in health data management were interviewed. The results show that the use of the proposed model significantly improved the completeness, timeliness, and accuracy of data compared with the traditional system (93% vs 12%, P<.001; 96% vs 18%, P<.001; and 100% vs 18%, P<.001; respectively).

CONCLUSIONS: The proposed model contributes significantly to the improvement of health data quality in Gabon.

PMID:36206045 | DOI:10.2196/35176

JMIR Ment Health. 2022 Oct 7;9(10):e35313. doi: 10.2196/35313.

ABSTRACT

BACKGROUND: Adolescents with depression or anxiety initiate mental health treatment in low numbers. Supporting Our Valued Adolescents (SOVA) is a peer support website intervention for adolescents seen in primary care settings and their parents with the goal of increasing treatment uptake through changing negative health beliefs, enhancing knowledge, offering peer emotional support, and increasing parent-adolescent communication about mental health.

OBJECTIVE: This pilot study aimed to refine recruitment and retention strategies, refine document intervention fidelity, and explore changes in study outcomes (the primary outcome being treatment uptake).

METHODS: We conducted a 2-group, single-blind, pilot randomized controlled trial in a single adolescent medicine clinic. Participants were aged 12 to 19 years with clinician-identified symptoms of depression or anxiety for which a health care provider recommended treatment. The patient and parent, if interested, were randomized to receive the SOVA websites and enhanced usual care (EUC) compared with EUC alone. Baseline, 6-week, and 3-month measures were collected using a web-based self-report survey and blinded electronic health record review. The main pilot outcomes assessed were the feasibility of recruitment and retention strategies. Implementation outcomes, intervention fidelity, missingness, and adequacy of safety protocols were documented. Descriptive statistics were used to summarize mental health service use and target measures with 2-sample t tests to compare differences between arms.

RESULTS: Less than half of the adolescents who were offered patient education material (195/461, 42.2%) were referred by their clinician to the study. Of 146 adolescents meeting the inclusion criteria, 38 completed the baseline survey, qualifying them for randomization, and 25 (66%, 95% CI 51%-81%) completed the 6-week measures. There was limited engagement in the treatment arm, with 45% (5/11) of adolescents who completed 6-week measures reporting accessing SOVA, and most of those who did not access cited forgetting as the reason. Changes were found in target factors at 6 weeks but not in per-protocol analyses. At 12 weeks, 83% (15/18) of adolescents randomized to SOVA received mental health treatment as compared with 50% (10/20) of adolescents randomized to EUC (P=.03).

CONCLUSIONS: In this pilot trial of a peer support website intervention for adolescents with depression or anxiety, we found lower-than-expected study enrollment after recruitment. Although generalizability may be enhanced by not requiring parental permission for adolescent participation in the trials of mental health interventions, this may limit study recruitment and retention. We found that implementing education introducing the study into provider workflow was feasible and acceptable, resulting in almost 500 study referrals. Finally, although not the primary outcome, we found a signal for greater uptake of mental health treatment in the arm using the SOVA intervention than in the usual care arm.

TRIAL REGISTRATION: ClinicalTrials.gov NCT03318666; https://clinicaltrials.gov/ct2/show/NCT03318666.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): RR2-10.2196/12117.

PMID:36206044 | DOI:10.2196/35313

JMIR Med Inform. 2022 Oct 7;10(10):e36313. doi: 10.2196/36313.

ABSTRACT

BACKGROUND: Electronic health record (EHR) has emerged as a backbone health care organization that aims to integrate health care records and automate clinical workflow. With the adoption of the eHealth care system, health information communication technologies and EHRs are offering significant health care advantages in the form of error reduction, improved communication, and patient satisfaction.

OBJECTIVE: This study aimed to (1) investigate factors associated with physicians’ EHR adoption status and prevalence of EHRs in Kuwait and (2) identify factors predicting physician satisfaction with EHRs in public hospitals in Kuwait.

METHODS: This study was conducted at Kuwait’s public Al-Jahra hospital from May to September 2019, using quantitative research methods. Primary data were gathered via questionnaires distributed among 295 physicians recruited using convenience sampling. Data were analyzed in SPSS using descriptive, bivariate, and multivariate linear regression, adjusted for demographics.

RESULTS: Results of the study revealed that the controlled variable of gender (β=-.197; P=.02) along with explanatory variables, such as training quality (β=.068; P=.005), perception of barriers (β=-.107; P=.04), and effect on physician (β=.521; P<.001) have a significant statistical relationship with physicians’ EHR adoption status. Furthermore, findings also suggested that controlled variables of gender (β=-.193; P=.02), education (β=-.164; P=.03), effect on physician (β=.417; P<.001), and level of ease of use (β=.254; P<.001) are significant predictors of the degree of physician satisfaction with the EHR system.

CONCLUSIONS: The findings of this study had significant managerial and practical implications for creating an inductive environment for the acceptance of EHR systems across a broad spectrum of health care system in Kuwait.

PMID:36206039 | DOI:10.2196/36313

JAMA Health Forum. 2022 Oct 7;3(10):e223503. doi: 10.1001/jamahealthforum.2022.3503.

ABSTRACT

IMPORTANCE: Home dialysis rates for end-stage kidney disease (ESKD) treatment are substantially lower in the US than in other high-income countries, yet there is limited knowledge on how to increase these rates.

OBJECTIVE: To report results from the first year of a nationwide randomized clinical trial that provides financial incentives to ESKD facilities and managing clinicians to increase home dialysis rates.

DESIGN, SETTING, AND PARTICIPANTS: Results were analyzed from the first year of the End-Stage Renal Disease Treatment Choice (ETC) model, a multiyear, mandatory-participation randomized clinical trial designed and implemented by the US Center for Medicare & Medicaid Innovation. Data were reported on Medicare patients with ESKD 66 years or older who initiated treatment with dialysis in 2021, with data collection through December 31, 2021; the study included all eligible ESKD facilities and managing clinicians. Eligible hospital referral regions (HRRs) were randomly assigned to the ETC (91 HRRs) or a control group (211 HRRs).

INTERVENTIONS: The ESKD facilities and managing clinicians received financial incentives for home dialysis use.

MAIN OUTCOMES AND MEASURES: The primary outcome was the percentage of patients with ESKD who received any home dialysis during the first 90 days of treatment. Secondary outcomes included other measures of home dialysis and patient volume and characteristics.

RESULTS: Among the 302 HRRs eligible for randomization, 18 621 eligible patients initiated dialysis treatment during the study period (mean [SD] age, 74.8 [1.05] years; 7856 women [42.1%]; 10 765 men [57.9%]; 859 Asian [5.2%], 3280 [17.7%] Black, 730 [4.3%] Hispanic, 239 North American Native, and 12 394 managing clinicians. The mean (SD) share of patients with any home dialysis during the first 90 days was 20.6% (7.8%) in the control group and was 0.12 percentage points higher (95% CI, -1.42 to 1.65 percentage points; P = .88) in the ETC group, a statistically nonsignificant difference. None of the secondary outcomes differed significantly between groups.

CONCLUSIONS AND RELEVANCE: The trial results found that in the first year of the US Center for Medicare & Medicaid Innovation-designed ETC model, HRRs assigned to the model did not have statistically significantly different rates in home dialysis compared with control HRRs. This raises questions about the efficacy of the financial incentives provided, although further evaluation is needed, as the size of these incentives will increase in subsequent years.

TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT05005572.

PMID:36206005 | DOI:10.1001/jamahealthforum.2022.3503

JAMA Netw Open. 2022 Oct 3;5(10):e2234258. doi: 10.1001/jamanetworkopen.2022.34258.

ABSTRACT

IMPORTANCE: Hemorrhagic shock is a common cause of preventable death after injury. Vasopressor administration for patients with blunt trauma and hemorrhagic shock is often discouraged.

OBJECTIVE: To evaluate the association of early norepinephrine administration with 24-hour mortality among patients with blunt trauma and hemorrhagic shock.

DESIGN, SETTING, AND PARTICIPANTS: This retrospective, multicenter, observational cohort study used data from 3 registries in the US and France on all consecutive patients with blunt trauma from January 1, 2013, to December 31, 2018. Patients were alive on admission with hemorrhagic shock, defined by prehospital or admission systolic blood pressure less than 100 mm Hg and evidence of hemorrhage (ie, prehospital or resuscitation room transfusion of packed red blood cells, receipt of emergency treatment for hemorrhage control, transfusion of >10 units of packed red blood cells in the first 24 hours, or death from hemorrhage). Blunt trauma was defined as any exposure to nonpenetrating kinetic energy, collision, or deceleration. Statistical analysis was performed from January 15, 2021, to February 22, 2022.

EXPOSURE: Continuous administration of norepinephrine in the prehospital environment or resuscitation room prior to hemorrhage control, according to European guidelines.

MAIN OUTCOMES AND MEASURES: The primary outcome was 24-hour mortality, and the secondary outcome was in-hospital mortality. The average treatment effect (ATE) of early norepinephrine administration on 24-hour mortality was estimated according to the Rubin causal model. Inverse propensity score weighting and the doubly robust approach with 5 distinct analytical strategies were used to determine the ATE.

RESULTS: A total of 52 568 patients were screened for inclusion, and 2164 patients (1508 men [70%]; mean [SD] age, 46 [19] years; median Injury Severity Score, 29 [IQR, 17-36]) presented with acute hemorrhage and were included. A total of 1497 patients (69.1%) required emergency hemorrhage control, 128 (5.9%) received a prehospital transfusion of packed red blood cells, and 543 (25.0%) received a massive transfusion. Norepinephrine was administered to 1498 patients (69.2%). The 24-hour mortality rate was 17.8% (385 of 2164), and the in-hospital mortality rate was 35.6% (770 of 2164). None of the 5 analytical strategies suggested any statistically significant association between norepinephrine administration and 24-hour mortality, with ATEs ranging from -4.6 (95% CI, -11.9 to 2.7) to 2.1 (95% CI, -2.1 to 6.3), or between norepinephrine administration and in-hospital mortality, with ATEs ranging from -1.3 (95% CI, -9.5 to 6.9) to 5.3 (95% CI, -2.1 to 12.8).

CONCLUSIONS AND RELEVANCE: The findings of this study suggest that early norepinephrine infusion was not associated with 24-hour or in-hospital mortality among patients with blunt trauma and hemorrhagic shock. Randomized clinical trials that study the effect of early norepinephrine administration among patients with trauma and hypotension are warranted to further assess whether norepinephrine is safe for patients with hemorrhagic shock.

PMID:36205999 | DOI:10.1001/jamanetworkopen.2022.34258