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Curran D, Bitetti J, Catterall I, Wincott S. Herpes zoster in older adults: Impact on carbon footprint in the United States. Hum Vaccin Immunother 2024; 20:2335722. [PMID: 38698759 PMCID: PMC11073404 DOI: 10.1080/21645515.2024.2335722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 03/23/2024] [Indexed: 05/05/2024] Open
Abstract
We provide estimates for (I) annual herpes zoster (HZ) cases, (II) carbon costs related to healthcare utilization, and (III) annual carbon emissions due to HZ among ≥50 years of age (YOA) United States (US) population. We estimated the annual number of HZ cases in the US based on available incidence data and demographic data of individuals ≥50 YOA. Both the healthcare resource utilization (HCRU) associated with HZ cases and the unit carbon dioxide equivalent (i.e. CO2e) costs associated with each type of HCRU in the US were estimated based on literature and studies available online. The carbon footprint associated with HZ annually among US adults ≥50 YOA was estimated by multiplying the unit carbon estimates by the HCRU. In the US population aged ≥50 YOA in 2020 (i.e. approximately 118 million), approximately 1.1 million cases of HZ occur annually assuming no vaccination. Based on 2 sources of HCRU the average kgCO2e per HZ patient ranged from 61.0 to 97.6 kgCO2e, with values by age group ranging from 40.9 kgCO2e in patients aged 50-59 to 195.9 kgCO2e in patients ≥80 YOA. The total annual HZ associated carbon ranged between 67,000 and 107,000 tons of CO2e in the US population aged ≥50 YOA. The impact of HZ on carbon footprint in the US results in considerable greenhouse gas (GHG)emissions. Assuming no vaccination, the burden of HZ is projected to rise over the coming years with the aging populations consequently worsening its impact on GHG emissions. (Figure 1).
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Affiliation(s)
| | | | - Imogen Catterall
- Medical Affairs, GSK, Zug, Switzerland
- Corporate Sustainability, The Carbon Trust, London, UK
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Freitas CND, Castelo PM, Noritomi PY, Scudine KGDO, Rontani RMP, Miziara T, Machado LMR. Mechanical stress distribution over the palate by different pacifiers assessed by finite element analysis and clinical data. Clin Anat 2024; 37:620-627. [PMID: 37991219 DOI: 10.1002/ca.24126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 10/11/2023] [Accepted: 11/12/2023] [Indexed: 11/23/2023]
Abstract
The mechanical behavior of each type of pacifier on rigid structures and their various impacts on orofacial growth have yet to be discovered. The study aimed to evaluate the stress distribution over a child's palate by three types of pacifiers using finite element analysis and clinical and laboratory data. Modulus of elasticity was obtained from 30 specimens comprising 10 of each conventional (A), orthodontic (B), and breast-shaped (C) pacifiers. Tongue strength was assessed in eight 3-year-old children (kPa). A hemi-maxilla model was obtained from 2- to 3-year-old skull tomography, and the images of pacifiers A, B, and C were captured using 3D scanning. The Hypermesh® program generated a mesh of 6-node tetrahedral elements for applying forces in the X, Y, and Z directions to enable a nonlinear analysis. Pacifier B exhibited the highest values for distributed stress on the palate, followed by pacifier A. Pacifier B stimulated the maxilla forward and sideways. In contrast, pacifier A promoted a forward and upward load, favoring a more atresic palate. Pacifiers A and B tended to rotate in the sagittal plane, generating tensions in the anterior incisors and favoring the open bite. Pacifier C exhibited lateral expansion by stress induction over the mid-palatal suture with less influence on incisor inclination. Pacifiers showed different detrimental stress distributions on the palate. This information can be helpful for improving recommendations given to parents.
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Affiliation(s)
| | - Paula Midori Castelo
- Department of Pharmaceutical Sciences, Universidade Federal de São Paulo (UNIFESP), Diadema, Brazil
| | - Pedro Yoshito Noritomi
- Three-Dimensional Technologies Division, Renato Archer Information Technology Center (CTI), Campinas, Brazil
| | | | | | - Thanus Miziara
- Three-Dimensional Technologies Division, Renato Archer Information Technology Center (CTI), Campinas, Brazil
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Mohammed Selim S, Senanayake S, McPhail SM, Carter HE, Naicker S, Kularatna S. Consumer Preferences for a Healthcare Appointment Reminder in Australia: A Discrete Choice Experiment. THE PATIENT 2024; 17:537-550. [PMID: 38605246 PMCID: PMC11343896 DOI: 10.1007/s40271-024-00692-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/18/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND It is essential to consider the evidence of consumer preferences and their specific needs when determining which strategies to use to improve patient attendance at scheduled healthcare appointments. OBJECTIVES This study aimed to identify key attributes and elicit healthcare consumer preferences for a healthcare appointment reminder system. METHODS A discrete choice experiment was conducted in a general Australian population sample. The respondents were asked to choose between three options: their preferred reminder (A or B) or a 'neither' option. Attributes were developed through a literature review and an expert panel discussion. Reminder options were defined by four attributes: modality, timing, content and interactivity. Multinomial logit and mixed multinomial logit models were estimated to approximate individual preferences for these attributes. A scenario analysis was performed to estimate the likelihood of choosing different reminder systems. RESULTS Respondents (n = 361) indicated a significant preference for an appointment reminder to be delivered via a text message (β = 2.42, p < 0.001) less than 3 days before the appointment (β = 0.99, p < 0.001), with basic details including the appointment cost (β = 0.13, p < 0.10), and where there is the ability to cancel or modify the appointment (β = 1.36, p < 0.001). A scenario analysis showed that the likelihood of choosing an appointment reminder system with these characteristics would be 97%. CONCLUSIONS Our findings provide evidence on how healthcare consumers trade-off between different characteristics of reminder systems, which may be valuable to inform current or future systems. Future studies may focus on exploring the effectiveness of using patient-preferred reminders alongside other mitigation strategies used by providers.
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Affiliation(s)
- Shayma Mohammed Selim
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4159, Australia.
| | - Sameera Senanayake
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4159, Australia
- Duke-NUS Medical School, Health Services and Systems Research, Singapore, Singapore
| | - Steven M McPhail
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4159, Australia
- Digital Health and Informatics Directorate, Metro South Health, Woolloongabba, Brisbane, QLD, Australia
| | - Hannah E Carter
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4159, Australia
| | - Sundresan Naicker
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4159, Australia
| | - Sanjeewa Kularatna
- Australian Centre for Health Services Innovation and Centre for Healthcare Transformation, School of Public Health and Social Work, Queensland University of Technology, 60 Musk Avenue, Kelvin Grove, Brisbane, QLD, 4159, Australia
- Duke-NUS Medical School, Health Services and Systems Research, Singapore, Singapore
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Nada A, Jhamb A, Maingard J. Case report of right supernumerary kidneyin a 38 year old male. Radiol Case Rep 2024; 19:3975-3978. [PMID: 39050641 PMCID: PMC11267992 DOI: 10.1016/j.radcr.2024.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 07/27/2024] Open
Abstract
Supernumerary kidney is a highly uncommon congenital anomaly characterized by the presence of at least 1 or more extra kidneys in variable positions and morphology. Due to the scarcity in the medical literature, not much is known about this condition. The additional kidney typically has its own collecting system, vascular supply, and distinct encapsulated parenchyma. In this case, we present a 38-year-old male with a right supernumerary kidney who was initially investigated for a renal artery aneurysm. In the case of our patient, the discovery of a supernumerary kidney influenced the course of management and prevented unnecessary intervention and procedure. This emphasizes the importance of thorough imaging and diagnostic techniques in patients to accurately identify and characterize such anomalies.
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Affiliation(s)
- Ahmed Nada
- St Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy VIC 3065, Australia
| | - Ash Jhamb
- St Vincent's Hospital Melbourne, Interventional Radiology Department, 41 Victoria Parade, Fitzroy VIC 3065, Australia
| | - Julian Maingard
- St Vincent's Hospital Melbourne, Interventional Radiology Department, 41 Victoria Parade, Fitzroy VIC 3065, Australia
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Deane AS, Byers KT. A review of the ethical considerations for the use of 3D printed materials in medical and allied health education and a proposed collective path forward. ANATOMICAL SCIENCES EDUCATION 2024; 17:1164-1173. [PMID: 39001638 DOI: 10.1002/ase.2483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 06/11/2024] [Accepted: 06/13/2024] [Indexed: 08/30/2024]
Abstract
3D scanning and printing technologies are quickly evolving and offer great potential for use in gross anatomical education. The use of human body donors to create digital scans and 3D printed models raises ethical concerns about donor informed consent, potential commodification, and access to and storage of potentially identifiable anatomical reproductions. This paper reviews available literature describing ethical implications for the application of these emerging technologies, existing published best practices for managing and sharing 2D imaging, and current adherence to these best practices by academic body donation programs. We conclude that informed consent is paramount for all uses of human donor and human donor-derived materials and that currently there is considerable diversity in adherence to established best practices for the management and sharing of 3D digital content derived from human donors. We propose a new and simplified framework for categorizing donor-derived teaching materials and the corresponding level of consent required for digital sharing. This framework proposes an equivalent minimum level of specific consent for human donor and human donor-derived materials relative to generalized, nonidentical teaching materials (i.e., artificial plastic models). Likewise, we propose that the collective path forward should involve the creation of a centralized, secure repository for digital human donor 3D content as a mechanism for accumulating, regulating, and controlling the distribution of properly consented human donor-derived 3D digital content that will also increase the availability of ethically created human-derived teaching materials while discouraging commodification.
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Affiliation(s)
- Andrew S Deane
- Department of Anatomy, Cell Biology & Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Anthropology, Indiana University, Indianapolis, Indiana, USA
- Centre for the Exploration of the Deep Human Journey, University of Witwatersrand, Johannesburg, South Africa
| | - Kelsey T Byers
- University of California, Office of the President Anatomical Donation Program, Oakland, CA, USA
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Zhang MY, Wei TT, Han C, Tan CY, Xie TH, Cai J, Yao Y, Zhu L. YAP O-GlcNAcylation contributes to corneal epithelial cell ferroptosis under cigarette smoke exposure. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 360:124764. [PMID: 39154884 DOI: 10.1016/j.envpol.2024.124764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2024] [Revised: 08/06/2024] [Accepted: 08/16/2024] [Indexed: 08/20/2024]
Abstract
Cigarette smoke (CS) is an important indoor air pollutant associated with an increased risk of ocular surface disease. As the eye's outermost layer, the cornea is highly sensitive to air pollutants like CS. However, the specific mechanisms linking CS exposure to corneal dysfunction have not been fully elucidated. In the present study, we found that CS exposure damages corneal epithelial cells, accompanied by increased iron (Fe2+) levels and lipid peroxidation, both hallmarks of ferroptosis. Ferroptosis inhibitors, including Ferrostatin-1 (Fer-1) and Deferoxamine mesylate (DFO), protect against CS-induced cell damage. To understand the underlying mechanisms, we investigated how CS affects iron and lipid metabolism. Our results showed that CS could upregulate intracellular iron levels by increasing TFRC expression and promote lipid peroxidation by increasing ACSL4 expression. Silencing ACSL4 or TFRC expression prevented CS-induced ferroptosis. Furthermore, we found that the upregulation of TFRC and ACSL4 was driven by increased YAP transcription. Pharmacological or genetic inhibition of YAP effectively prevented corneal epithelial cell ferroptosis under CS stimulation. Additionally, our results suggest that CS exposure could increase O-GlcNAc transferase activity, leading to YAP O-GlcNAcylation. This glycosylation of YAP interfered with its K48-linked ubiquitination, resulting in YAP stabilization. Collectively, we found that CS exposure induces corneal epithelial cell ferroptosis via the YAP O-GlcNAcylation, and provide evidence that CS exposure is a strong risk factor for ocular surface disease.
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Affiliation(s)
- Meng-Yuan Zhang
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Ting-Ting Wei
- Center of Clinical Research, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Cheng Han
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Cheng-Ye Tan
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Tian-Hua Xie
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Jiping Cai
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China
| | - Yong Yao
- Department of Ophthalmology, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
| | - Lingpeng Zhu
- Center of Clinical Research, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi People's Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China.
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Guo S, Liu D, Bi X, Feng Y, Zhang K, Jiang J, Wang Y. Barriers and facilitators to self-management among women with gestational diabetes: A systematic review using the COM-B model. Midwifery 2024; 138:104141. [PMID: 39178483 DOI: 10.1016/j.midw.2024.104141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 07/24/2024] [Accepted: 08/07/2024] [Indexed: 08/25/2024]
Abstract
BACKGROUND Gestational diabetes mellitus is a common complication during pregnancy, and its prevalence rates have increased dramatically in recent years. Treatment of gestational diabetes requires the active self-management, however, this can be challenging. Understanding the barriers and facilitators of adherence to self-management recommendations is essential for designing effective interventions. AIM To identify and synthesize barriers and facilitators to self-management of gestational diabetes reported by pregnant women. METHODS This was a mixed-methods systematic review, including qualitative, quantitative, and mixed-methods studies. A literature search was conducted in four databases (PubMed, Embase, CINAHL, and the Web of Science). Eligible studies explored the barriers and/or facilitators, experiences and/or perceptions to engage in self-management in women with gestational diabetes. The Capability, Opportunity, Motivation, Behaviour model was used to classify barriers and facilitators affecting self-management. RESULTS Thirty-six studies (23 qualitative, 11 quantitative, and 2 mixed-methods) met the inclusion criteria. We identified barriers and facilitators relating to capability (e.g., physical discomforts and constraints; lack of knowledge of GDM and self-management behaviours; forgetfulness), opportunity (e.g., limited education and resources; social support from family, friends, and peer groups; conflict with existing lifestyles or cultural norms), and motivation (e.g., perceived negative consequence of self-management behaviours or not perceived benefits; negative emotion; concern the health of the baby). CONCLUSION In this study, we identified the barriers and facilitators of self-management in women with gestational diabetes, which were explained by relevant theoretical models. Interventions should be developed with full consideration of these findings to ensure that pregnant women have the correct knowledge and confidence to self-manage their complications.
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Affiliation(s)
- Shujie Guo
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China; Department of Clinical Nursing, School of Nursing, Air Force Medical University, Xi'an, China
| | - Dongmei Liu
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoxuan Bi
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Yuxuan Feng
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Ke Zhang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Jingjing Jiang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China
| | - Yanhong Wang
- School of Nursing, Lanzhou University, Lanzhou, Gansu, China.
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Powers RA, Burckley J, Centelles V. The Legality of Labor and Perceptions of Deservingness of Rights and Services for Sex Workers. ARCHIVES OF SEXUAL BEHAVIOR 2024:10.1007/s10508-024-02951-0. [PMID: 39138694 DOI: 10.1007/s10508-024-02951-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 08/15/2024]
Abstract
Access to social services like healthcare, education, housing, and welfare are integral to creating an equitable society. While many populations inherently benefit from these services, sex workers are often denied these rights and services because of the nature of their work. The purpose of this study was to examine perceptions of deservingness of sex workers for a wide range of rights and services. This study distinguished those attitudes across legal and illegal forms of sex work, identified attitudinal and demographic correlates associated with those perceptions, and examined potential interactions between respondents' gender and age. Participants included a nationwide sample of adults from the USA (n = 549). Results indicated that participants perceived legal sex work as more deserving of rights and services compared to illegal sex work. Perceptions of deservingness were associated with attitudes toward abortion, LGBTQ+ rights, and perceptions of government legitimacy. Overall, older individuals were less willing to extend rights and services to sex workers and women were more likely to perceive sex workers as deserving of rights and services. There was an interaction between gender and age. For illegal sex work, gender differences in perceptions converged as participants aged, whereas for legal sex work, gender differences were exacerbated with age, with men reporting particularly restrictive perceptions of deservingness.
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Affiliation(s)
- Ráchael A Powers
- School of Criminal Justice, University of Cincinnati, Cincinnati, OH, 45221, USA.
| | | | - Vanessa Centelles
- Department of Sociology, Colorado State University, Fort Collins, CO, USA
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Almorish MAW, Al-Sayaghi KM, Alshoabi SA, Elneblawi NH, Machaly ER, Sobeh DES, Elkhalifa AME, Elderdery AY, Elhadi FELM, Bazie EA. Knowledge and Attitudes Regarding Crimean-Congo Hemorrhagic Fever Among Slaughterhouse Workers in Sana'a and Dhamar Cities-Yemen: A Cross-Sectional Study. J Multidiscip Healthc 2024; 17:3875-3886. [PMID: 39155975 PMCID: PMC11328860 DOI: 10.2147/jmdh.s470446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2024] [Accepted: 08/02/2024] [Indexed: 08/20/2024] Open
Abstract
Background Crimean-Congo Hemorrhagic Fever (CCHF) is a viral infection spread through tick bites or contact with secretions from infected animals or humans, posing a risk to slaughterhouse workers. This study aimed to evaluate the knowledge and attitudes of slaughterhouse workers in Yemen towards CCHF. Methods A cross-sectional study conducted on 173 adults working at slaughterhouses in Sana'a and Dhamar cities, Yemen using a multi-stage sampling. The questionnaire used in the study was a reliable survey instrument (with a Cronbach's alpha coefficient of 0.71) employed for the purpose of data collection. The questionnaire encompassed three distinct sections: 1)- demographic inquiries pertaining to age, gender, marital status, level of education, and occupation; 2)- knowledge-based inquiries consisting of 27 items;3)- the attitude section consisted of 11 questions. After completing the questionnaire, the data were analyzed by SPSS version 24, using percentages, chi-square test, and Spearman correlation coefficient. Results The mean age of the participants was 30.6 years with a SD of 11.2 years, with 84.4% male and 15.6% female. Most slaughterhouse workers were butchers (78.6%) and some were shepherds (21.4%). The participants had poor knowledge (86.7%) and attitude (72.3%) towards CCHF. There exists a noteworthy association between the knowledge scores and the gender, education level, and occupation (P=0.035, P=0.039, P=0.001). A significant positive correlation was identified between knowledge and attitude scores (r = 0.715, P<0.001). Conclusion The majority of respondents had poor knowledge of CCHF. Educational programs are essential for increasing community awareness, with involvement of technical experts crucial for disseminating information on preventing and managing CCHF.
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Affiliation(s)
- Mohammed A W Almorish
- Department of Hematology, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | - Khaled Mohammed Al-Sayaghi
- Department of Medical Surgical Nursing, College of Nursing, Taibah University, Al-Madina, Saudi Arabia
- Nursing Division, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
| | - Sultan Abdulwadoud Alshoabi
- Department of Diagnostic Radiology, College of Applied Medical Sciences, Taibah University, Al-Madina, Saudi Arabia
| | - Nora Helmi Elneblawi
- Department of Medical Surgical Nursing, College of Nursing, Taibah University, Al-Madina, Saudi Arabia
| | - Eslam Reda Machaly
- Department of Nursing, College of Applied Medical Sciences, Jouf University, Al-Jouf, Saudi Arabia
| | - Dena Eltabey Sobh Sobeh
- Department of Nursing, Faculty of Nursing, Prince Sattam Bin Abdulaziz University, Al-Kharj, Saudi Arabia
| | - Ahmed M E Elkhalifa
- Department of Public Health, College of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia
| | - Abozer Y Elderdery
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Al-Jouf, Saudi Arabia
| | | | - Elsharif A Bazie
- Pediatric Department, Faculty of Medicine, University of El Imam El Mahdi, Kosti, 1158, Sudan
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Endalamaw A, Zewdie A, Wolka E, Assefa Y. Care models for individuals with chronic multimorbidity: lessons for low- and middle-income countries. BMC Health Serv Res 2024; 24:895. [PMID: 39103802 DOI: 10.1186/s12913-024-11351-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2024] [Accepted: 07/23/2024] [Indexed: 08/07/2024] Open
Abstract
BACKGROUND Patients with multiple long-term conditions requires understanding the existing care models to address their complex and multifaceted health needs. However, current literature lacks a comprehensive overview of the essential components, impacts, challenges, and facilitators of these care models, prompting this scoping review. METHODS A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-analysis Extension for Scoping Reviews guideline. Our search encompassed articles from PubMed, Web of Science, EMBASE, SCOPUS, and Google Scholar. The World Health Organization's health system framework was utilized to synthesis the findings. This framework comprises six building blocks (service delivery, health workforce, health information systems, access to essential medicines, financing, and leadership/governance) and eight key characteristics of good service delivery models (access, coverage, quality, safety, improved health, responsiveness, social and financial risk protection, and improved efficiency). Findings were synthesized qualitatively to identify components, impacts, barriers, and facilitators of care models. RESULTS A care model represents various collective interventions in the healthcare delivery aimed at achieving desired outcomes. The names of these care models are derived from core activities or major responsibilities, involved healthcare teams, diseases conditions, eligible clients, purposes, and care settings. Notable care models include the Integrated, Collaborative, Integrated-Collaborative, Guided, Nurse-led, Geriatric, and Chronic care models, as well as All-inclusive Care Model for the Elderly, IMPACT clinic, and Geriatric Patient-Aligned Care Teams (GeriPACT). Other care models (include Care Management Plus, Value Stream Mapping, Preventive Home Visits, Transition Care, Self-Management, and Care Coordination) have supplemented the main ones. Care models improved quality of care (such as access, patient-centeredness, timeliness, safety, efficiency), cost of care, and quality of life for patients that were facilitated by presence of shared mission, system and function integration, availability of resources, and supportive tools. CONCLUSIONS Care models were implemented for the purpose of enhancing quality of care, health outcomes, cost efficiency, and patient satisfaction by considering careful recruitment of eligible clients, appropriate selection of service delivery settings, and robust organizational arrangements involving leadership roles, healthcare teams, financial support, and health information systems. The distinct team compositions and their roles in service provision processes differentiate care models.
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Affiliation(s)
- Aklilu Endalamaw
- School of Public Health, The University of Queensland, Brisbane, Australia.
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
| | - Anteneh Zewdie
- International Institute for Primary Health Care in Ethiopia, Addis Ababa, Ethiopia
| | - Eskinder Wolka
- International Institute for Primary Health Care in Ethiopia, Addis Ababa, Ethiopia
| | - Yibeltal Assefa
- School of Public Health, The University of Queensland, Brisbane, Australia
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Mohammed M, Kumar N, Zawiah M, Al-Ashwal FY, Bala AA, Lawal BK, Wada AS, Halboup A, Muhammad S, Ahmad R, Sha'aban A. Psychometric Properties and Assessment of Knowledge, Attitude, and Practice Towards ChatGPT in Pharmacy Practice and Education: a Study Protocol. J Racial Ethn Health Disparities 2024; 11:2284-2293. [PMID: 37428357 DOI: 10.1007/s40615-023-01696-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 06/17/2023] [Accepted: 06/21/2023] [Indexed: 07/11/2023]
Abstract
ChatGPT represents an advanced conversational artificial intelligence (AI), providing a powerful tool for generating human-like responses that could change pharmacy prospects. This protocol aims to describe the development, validation, and utilization of a tool to assess the knowledge, attitude, and practice towards ChatGPT (KAP-C) in pharmacy practice and education. The development and validation process of the KAP-C tool will include a comprehensive literature search to identify relevant constructs, content validation by a panel of experts for items relevancy using content validity index (CVI) and face validation by sample participants for items clarity using face validity index (FVI), readability and difficulty index using the Flesch-Kincaid Readability Test, Gunning Fog Index, or Simple Measure of Gobbledygook (SMOG), assessment of reliability using internal consistency (Cronbach's alpha), and exploratory factor analysis (EFA) to determine the underlying factor structures (eigenvalues, scree plot analysis, factor loadings, and varimax). The second phase will utilize the validated KAP-C tool to conduct KAP surveys among pharmacists and pharmacy students in selected low- and middle-income countries (LMICs) (Nigeria, Pakistan, and Yemen). The final data will be analyzed descriptively using frequencies, percentages, mean (standard deviation) or median (interquartile range), and inferential statistics like Chi-square or regression analyses using IBM SPSS version 28. A p<0.05 will be considered statistically significant. ChatGPT holds the potential to revolutionize pharmacy practice and education. This study will highlight the psychometric properties of the KAP-C tool that assesses the knowledge, attitude, and practice towards ChatGPT in pharmacy practice and education. The findings will contribute to the potential ethical integration of ChatGPT into pharmacy practice and education in LMICs, serve as a reference to other economies, and provide valuable evidence for leveraging AI advancements in pharmacy.
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Affiliation(s)
- Mustapha Mohammed
- Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Kaduna, Nigeria.
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia.
- Vice President for Medical and Health Science Office, QU Health, Qatar University, Doha, Qatar.
| | - Narendar Kumar
- Department of Pharmacy Practice, Faculty of Pharmacy, University of Sindh Jamshoro, Sindh, Pakistan
| | - Mohammed Zawiah
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
- Department of Pharmacy Practice, Faculty of Clinical Pharmacy, Hodeidah University, Al Hodeidah, Yemen
| | - Fahmi Y Al-Ashwal
- Department of Pharmacy, Al-Maarif University College, Anbar, 31001, Iraq
| | - Auwal Adam Bala
- Department of Pharmacology, College of Medicine and Health Sciences, Federal University Dutse, Dutse, Jigawa, Nigeria
| | - Basira Kankia Lawal
- Department of Clinical Pharmacy and Pharmacy Management, Kaduna State University, Kaduna, Nigeria
| | - Abubakar Sadiq Wada
- Department of Pharmacology and Therapeutics, Bayero University, Kano, Nigeria
| | - Abdulsalam Halboup
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
- Department of Clinical Pharmacy and Pharmacy Practice, University of Science and Technology, Sana'a, Yemen
| | | | - Rabbiya Ahmad
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Gelugor, Pulau Pinang, Malaysia
| | - Abubakar Sha'aban
- Division of Population Medicine, School of Medicine, Cardiff University, Heath Park, Cardiff, CF14 4YS, Wales, UK
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12
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Francis NS, Lim YM, Mat S, Loganathan A. Effectiveness of herbs taken concurrently with antihypertensive drugs in managing hypertension and lipid outcomes. A systematic review and meta-analysis. Complement Ther Med 2024; 83:103058. [PMID: 38830450 DOI: 10.1016/j.ctim.2024.103058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 05/15/2024] [Accepted: 05/28/2024] [Indexed: 06/05/2024] Open
Abstract
PURPOSE Hypertension is the primary cause of mortality. Hence globally, there is a growing interest in complementing antihypertensive drugs with herbs to alleviate blood pressure among hypertensive patients. Thus, this review aimed to evaluate the effectiveness of complementing drugs with herbs on blood pressure and lipid profile outcomes, the associated factors and the types of complementary herbs alongside their consumption regimes. METHODS This review is registered in PROSPERO on the National Institute of Health Database with an ID: CRD42021270481. Using the PICOS (population, intervention, comparison, outcome, study type) mnemonic formula and search strategy, we searched (January 2010 to February 2024) five electronic databases including Pubmed, Scopus, Web of Science, CINAHL (Cumulative Index for Nursing and Allied Health Literature) and Psychology & Behavioral Sciences Collection (PBSC). The inclusion criteria of the review were that all included papers had to be randomised control trials in English among hypertensive adults who complemented antihypertensive drugs with herbs. A Cochrane risk of bias assessment as well as a meta-analysis and narrative synthesis were conducted to answer the objectives. RESULTS Twenty-five randomised controlled trials involving 1996 participants from 14 countries were included. The risk of bias among included articles was assessed and presented using the Cochrane risk of bias tool and the graphs were generated. The effects of complementing antihypertensive drugs with different herb regimes on blood pressure and lipid profile outcomes were compared to those solely on antihypertensive drugs and placebo via a random model effects meta-analysis using the Revman manager. Systolic blood pressure (SBP) and triglycerides gave a significant reduction in favour of the intervention group which complemented herbs. The overall pooled systolic blood pressure showed a reduction of (SMD=0.81, 95 % CI 0.14-1.47, p < 0.02, p for heterogeneity=0.00001, I2 =97 %) while triglycerides were (SMD=0.73, 95 % CI 0.17-1.28, p < 0.01, p for heterogeneity=0.00001, I2 =85 %). However, diastolic blood pressure, total cholesterol, HDL and LDL did not exert significant outcomes. CONCLUSION The complemented herbs with antihypertensive drugs did show improvement in overall blood pressure management in the majority of the studies compared to the placebo group. Blood pressure and lipid profiles are the health outcomes that enable access to complementing herbs in controlling high blood pressure. Some limitations of this review are attributed to performance, detection and attrition bias in a few included articles alongside the presence of a high heterogeneity overall.
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Affiliation(s)
- Natalia Shania Francis
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar, Malaysia
| | - Yang Mooi Lim
- Department of Pre-Clinical Sciences, M. Kandiah Faculty of Medicine and Health Sciences, Universiti Tunku Abdul Rahman, Bandar Sungai Long, 43000 Kajang, Selangor, Malaysia
| | - Sumaiyah Mat
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, 50300 Kuala Lumpur, Malaysia
| | - Annaletchumy Loganathan
- Department of Allied Health Sciences, Faculty of Science, Universiti Tunku Abdul Rahman, Kampar, Malaysia.
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13
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Chen PC, Chen CI. Exploring factors impacting patient decisions in hemorrhoid surgery: A questionnaire survey in Taiwan. Surg Open Sci 2024; 20:214-221. [PMID: 39156488 PMCID: PMC11327606 DOI: 10.1016/j.sopen.2024.07.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Revised: 07/05/2024] [Accepted: 07/19/2024] [Indexed: 08/20/2024] Open
Abstract
Background Minimally invasive hemorrhoid surgeries like Doppler-Guided Hemorrhoidal Artery Ligation (DGHAL) and Stapled Hemorrhoidopexy (PPH) offer benefits over traditional methods. This study investigated public perceptions and attitudes towards these surgeries, exploring awareness, preferences, and influencing factors. Methods A detailed questionnaire was disseminated to 2011 participants from various regions of Taiwan in December 2023, gathering data on demographics, understanding of minimally invasive surgery, and attitudes towards hemorrhoid surgery. Chi-square tests were used for analysis (p < 0.05). Results Hemorrhoid prevalence was similar across sexes and age groups. About 70 % preferred medical centers or district hospitals for surgery. Postoperative complications were a primary concern, with significant sex differences. Approximately 70 % preferred minimally invasive surgery if costs were below NT$50,000. Medical personnel showed higher awareness of minimally invasive surgery benefits. Most participants relied on personal networks and medical social media for information. Conclusions The study revealed generally positive perceptions of minimally invasive hemorrhoid surgery, with cost being a significant factor. Knowledge gaps exist, particularly among non-medical personnel. Future initiatives should aim to enhance public awareness of minimally invasive surgery benefits, and policy considerations should address financial aspects of healthcare decisions.
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Affiliation(s)
- Pin-Chun Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
| | - Chih-I Chen
- Division of Colon and Rectal Surgery, Department of Surgery, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan
- Executive Master of Business Administration, National Sun Yat-sen University, Kaohsiung, Taiwan
- Division of General Surgery Medicine, Department of Surgery, E-Da hospital, I-Shou University, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung, Taiwan
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14
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Jin Y, Lu Y, Jiang X, Wang M, Yuan Y, Zeng Y, Guo L, Li W. Accelerated infected wound healing by probiotic-based living microneedles with long-acting antibacterial effect. Bioact Mater 2024; 38:292-304. [PMID: 38745591 PMCID: PMC11091528 DOI: 10.1016/j.bioactmat.2024.05.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 05/03/2024] [Accepted: 05/03/2024] [Indexed: 05/16/2024] Open
Abstract
Delays in infected wound healing are usually a result of bacterial infection and local inflammation, which imposes a significant and often underappreciated burden on patients and society. Current therapies for chronic wound infection generally suffer from limited drug permeability and frequent drug administration, owing to the existence of a wound biofilm that acts as a barrier restricting the entry of various antibacterial drugs. Here, we report the design of a biocompatible probiotic-based microneedle (MN) patch that can rapidly deliver beneficial bacteria to wound tissues with improved delivery efficiency. The probiotic is capable of continuously producing antimicrobial substances by metabolizing introduced glycerol, thereby facilitating infected wound healing through long-acting antibacterial and anti-inflammatory effects. Additionally, the beneficial bacteria can remain highly viable (>80 %) inside MNs for as long as 60 days at 4 °C. In a mouse model of Staphylococcus aureus-infected wounds, a single administration of the MN patch exhibited superior antimicrobial efficiency and wound healing performance in comparison with the control groups, indicating great potential for accelerating infected wound closure. Further development of live probiotic-based MN patches may enable patients to better manage chronically infected wounds.
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Affiliation(s)
- Yinli Jin
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China
| | - Yun Lu
- Department of Pharmacy, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xue Jiang
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China
| | - Min Wang
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Yaqi Yuan
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China
| | - Yongnian Zeng
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China
| | - Liang Guo
- Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Wei Li
- Department of Thyroid and Breast Surgery, Zhongnan Hospital of Wuhan University, School of Pharmaceutical Sciences, Wuhan University, Wuhan, 430071, China
- TaiKang Center for Life and Medical Sciences, Wuhan University, Wuhan, China
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15
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Banafshe E, Javadifar N, Abbaspoor Z, Karandish M, Ghanbari S. Factors Influencing Weight Management in Pregnant Women with Overweight or Obesity: A Meta-Synthesis of Qualitative Studies. J Acad Nutr Diet 2024; 124:964-994.e1. [PMID: 38648889 DOI: 10.1016/j.jand.2024.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 04/10/2024] [Accepted: 04/16/2024] [Indexed: 04/25/2024]
Abstract
BACKGROUND Overweight and obesity have multiple negative consequences for the health of both the mother and the child. Interventions to prevent excessive weight gain during pregnancy have had varying success, and the proportion of pregnant women who exceed national guidelines for weight gain continues to increase. OBJECTIVE To investigate the influence of factors on weight management among pregnant women with overweight or obesity. METHODS This meta-synthesis of qualitative studies involved searching databases PubMed, Embase, Cochrane, Scopus, and Web of Science. The databases were searched on October 4, 2022, and the search was updated on April 21, 2023. The screening of titles, abstracts, and full texts was conducted utilizing Covidence software. The quality assessment of the articles was performed using the Critical Appraisal Skills Programme checklist. The Enhancing Transparency in Reporting the Synthesis of Qualitative Research statement was used to enhance transparency in reporting. A meta-aggregation approach was used to guide the data extraction and synthesis. RESULTS A total of 46 studies with appropriate Critical Appraisal Skills Programme scores were included for qualitative synthesis. Findings were extracted and integrated into 4 themes: psychological factors (personally driven negative emotions and society-driven negative emotions), social factors (societal attitudes and beliefs and social support resources), factors related to education and counseling (information provision and communication), and factors associated with effective care (provided care components and the method of providing effective care). CONCLUSIONS To improve weight management during pregnancy, health care providers should provide tailored and individualized recommendations that take into consideration the factors influencing these women.
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Affiliation(s)
- Elahe Banafshe
- Midwifery Department, Nursing & Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nahid Javadifar
- Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Zahra Abbaspoor
- Department of Midwifery, Reproductive Health Promotion Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Majid Karandish
- Nutrition and Metabolic Diseases Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeed Ghanbari
- Department of Biostatistics and Epidemiology, School of Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Tzikas A, Koulierakis G, Athanasakis K, Merakou K. Nudging Interventions on Stair Use: A Scoping Review. JOURNAL OF PREVENTION (2022) 2024; 45:685-722. [PMID: 38877174 DOI: 10.1007/s10935-024-00790-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 06/01/2024] [Indexed: 06/16/2024]
Abstract
Stair use is a physical activity that can be incorporated into the daily lifestyle of a majority of the population, resulting in several health benefits. Nudges are increasingly used in public health interventions to encourage healthy behaviours such as physical activity in a cost-effective manner. This scoping review aimed to investigate the effect and the characteristics of nudges used on interventions to promote stair use. We reviewed the relevant literature published in PubMed, Cochrane Library, Mendeley and Google Scholar, from January 2009 to May 2022. Eligibility criteria included original studies of any type of design, written in English, targeting healthy adults, reporting nudging interventions, using elevator or escalator as comparators and defining a baseline for comparisons. Initially, 118 publications were identified, and after applying exclusion criteria, 27 articles were included in the analysis. Results showed that most of the nudging interventions had significant positive effect on stair use in several settings. The evidence from this review suggests that incorporating nudges into public health interventions can effectively promote physical activity through increased stair usage. Emphasizing prevention measures in public health interventions may contribute to better health outcomes.
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Affiliation(s)
- Alexandros Tzikas
- Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece.
| | - George Koulierakis
- Laboratory of Epidemiology, Health Determinants and Well-Being, Division of Epidemiology, Prevention and Quality of Life, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Konstantinos Athanasakis
- Laboratory for Health Technology Assessment, Division of Health Systems and Policy, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
| | - Kyriakoula Merakou
- Laboratory of Epidemiology, Health Determinants and Well-Being, Division of Epidemiology, Prevention and Quality of Life, Department of Public Health Policy, School of Public Health, University of West Attica, Athens, Greece
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17
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Kohansal B, fathollahzadeh S, Ghezeljeh AB, Najafi S, Saeidi N. A Systematic Review on Hearing and Balance in Patients with Chronic Kidney Disease with and Without Hemodialysis. Indian J Otolaryngol Head Neck Surg 2024; 76:2939-2947. [PMID: 39130234 PMCID: PMC11306716 DOI: 10.1007/s12070-024-04586-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2024] [Accepted: 02/28/2024] [Indexed: 08/13/2024] Open
Abstract
Objective Exploring the auditory and vestibular manifestations associated with chronic kidney disease (CKD) has been growing in recent years. Understanding these complaints in CKD patients is crucial for comprehensive patient care. This review aimed to investigate the audiological findings and profiles across various stages of CKD and guide for informed decision-making in their management. Methods Relevant articles from PubMed, ScienceDirect, EBSCO Medline, SCOPUS, Google Scholar, and Clinical Key were identified for review. The selected articles were published from 2008 to 2023 and written in English language. A total of 41 articles on auditory and vestibular assessments in CKD were eligible for review. Results Pure tone audiometry (PTA), immittance audiometry (IA) and otoacoustic emissions (OAEs) were the most commonly employed hearing tests respectively, with a higher frequency of utilization in hemodialysis cases compared to non-hemodialysis ones. Also, vestibular evoked myogenic potentials (VEMPs) emerged as the most popular vestibular test among hemodialysis patients while questionnaires were frequently employed in CKD patients. Moreover, our analysis suggests a potential association between the duration of hemodialysis and the development of tinnitus and vertigo. Abnormalities were also observed in auditory brainstem response (ABR), speech audiometry, central auditory processing tests and videonystagmography (VNG) assessment in hemodialysis and non-hemodialysis patients. Conclusion CKD patients, particularly those undergoing hemodialysis, face a higher risk of hearing loss, tinnitus, and vestibular complaints. Performing otoacoustic emissions and vestibular-evoked myogenic potentials along with PTA on CKD patients, regardless of the disease stage is recommended to more effective management of audiovestibular complaints in these population.
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Affiliation(s)
- Behieh Kohansal
- Department of Audiology, School of Rehabilitation, Arak University of Medical Sciences, Golestan Blvd., Ghods Town, Arak, Iran
| | - Saba fathollahzadeh
- Department of Audiology, School of Rehabilitation, Arak University of Medical Sciences, Golestan Blvd., Ghods Town, Arak, Iran
| | | | - Sirvan Najafi
- Department of Audiology, School of Rehabilitation, Arak University of Medical Sciences, Golestan Blvd., Ghods Town, Arak, Iran
| | - Nasser Saeidi
- Department of Internal Medicine, School of Medicine, Arak University of Medical Sciences, Arak, Iran
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Norton P, Trus P, Wang F, Thornton MJ, Chang C. Understanding and treating diabetic foot ulcers: Insights into the role of cutaneous microbiota and innovative therapies. SKIN HEALTH AND DISEASE 2024; 4:e399. [PMID: 39104636 PMCID: PMC11297444 DOI: 10.1002/ski2.399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/22/2024] [Accepted: 05/18/2024] [Indexed: 08/07/2024]
Abstract
Background Notoriously known as the silent pandemic, chronic, non-healing diabetic foot ulcers (DFUs), pose a significant rate of incidence for amputation and are a major cause of morbidity. Alarmingly, the treatment and management strategies of chronic wounds represent a significant economic and health burden as well as a momentous drain on resources with billions per annum being spent in the US and UK alone. Defective wound healing is a major pathophysiological condition which propagates an acute wound to a chronic wound, further propelled by underlying conditions such as diabetes and vascular complications which are more prevalent amongst the elderly. Chronic wounds are prone to infection, which can exacerbate the condition, occasionally resulting in amputation for the patient, despite the intervention of modern therapies. However, amputation can only yield a 5-year survival rate for 50% of patients, highlighting the need for new treatments for chronic wounds. Findings The dynamic cutaneous microbiota is comprised of diverse microorganisms that often aid wound healing. Conversely, the chronic wound microbiome consists of a combination of common skin commensals such as Staphylococcus aureus and Staphylococcus epidermidis, as well as the opportunistic pathogen Pseudomonas aeruginosa. These bacteria have been identified as the most prevalent bacterial pathogens isolated from chronic wounds and contribute to prolific biofilm formation decreasing the efficiency of antimicrobials and further perpetuating a hyper-inflammatory state. Discussion and Conclusion Here, we review recent advances and provide a new perspective on alternative treatments including phage and microbiome transplant therapies and how the definitive role of the cutaneous microbiota impacts the aetiology of DFUs.
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Affiliation(s)
- Paul Norton
- School of Dental SciencesFaculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
- Biosciences InstituteFaculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
- Centre for Skin SciencesFaculty of Life SciencesUniversity of BradfordBradfordUK
| | - Pavlos Trus
- School of Dental SciencesFaculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
- Biosciences InstituteFaculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
| | - Fengyi Wang
- School of Dental SciencesFaculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
- Biosciences InstituteFaculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
| | - M. Julie Thornton
- Centre for Skin SciencesFaculty of Life SciencesUniversity of BradfordBradfordUK
| | - Chien‐Yi Chang
- School of Dental SciencesFaculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
- Biosciences InstituteFaculty of Medical SciencesNewcastle UniversityNewcastle Upon TyneUK
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Patera E, Adwan MM. Perspectives of a non-medically and a medically qualified early career anatomy academic on facilitating case-based learning sessions for undergraduate medical students. ANATOMICAL SCIENCES EDUCATION 2024. [PMID: 39090772 DOI: 10.1002/ase.2493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 06/11/2024] [Accepted: 07/13/2024] [Indexed: 08/04/2024]
Abstract
Case-based learning (CBL) is a student-centered pedagogy where medical students are given a real-world clinical problem. At St George's University of London (SGUL), anatomy academics can volunteer to facilitate CBL sessions for pre-clinical undergraduate medical students. The major benefits of facilitating CBL sessions from the perspective of a non-medically qualified early career anatomy academic (ECAA) include exposure to clinical cases that help the academic develop an understanding over key clinical cases at the context of clinical anatomy and other disciplines including physiology, pathology, and pharmacology. Furthermore, facilitating CBL sessions assists in the acquisition of basic knowledge over history taking, the conduction of clinical examinations, the investigations performed for the diagnosis of a condition as well as how it is managed. The major benefits of facilitating CBL sessions from the perspective of a medically qualified ECAA include staying in touch with the clinical aspect of medicine and becoming familiar with the country's healthcare system and its professional standards. Perceived benefits shared by both the non-medically and medically qualified ECAA include the opportunity to become familiar with the structure and key elements of the pre-clinical medical curriculum as well as gain experience in facilitating small group teaching sessions. Overall, facilitating CBL sessions can help non-medically and medically qualified ECAAs in different contexts that may help them with their individual career goals, can encourage collaborative discussions between clinical and non-clinical anatomy academics as well as help bridge the gap between the anatomy teaching approaches employed by non-medically qualified and medically qualified anatomy academics.
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Affiliation(s)
- Eleni Patera
- Section of Anatomy, St George's University of London, London, UK
- Human Anatomy Resource Centre, University of Liverpool, Liverpool, United Kingdom
| | - Mustafa Mohammedyiya Adwan
- Section of Anatomy, St George's University of London, London, UK
- Brunel Medical School, College of Health, Medicine and Life Sciences, Brunel University London, London, United Kingdom
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20
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Veeramani A, Johnson AR, Lee BT, Dowlatshahi AS. Readability, Understandability, Usability, and Cultural Sensitivity of Online Patient Educational Materials (PEMs) for Lower Extremity Reconstruction: A Cross-Sectional Study. Plast Surg (Oakv) 2024; 32:452-459. [PMID: 39104934 PMCID: PMC11298135 DOI: 10.1177/22925503221120548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 05/10/2022] [Accepted: 05/16/2022] [Indexed: 08/07/2024] Open
Abstract
Background: Lower extremity reconstructive surgery is an evolving field wherein patients rely on accessible online materials to engage with their perioperative care. This study furthers existing research in this area by evaluating the readability, understandability, actionability, and cultural sensitivity of online health materials for lower extremity reconstruction. Methods: We identified the 10 first-appearing, educational sites found by searching the phrases "leg saving surgery", "limb salvage surgery," and "leg reconstruction surgery". Readability analysis was conducted with validated tools, including Simple Measure of Gobbledygook (SMOG). Understandability and actionability were assessed with Patient Education and Materials Assessment Tool (PEMAT), while cultural sensitivity was measured with Cultural Sensitivity Assessment Tool (CSAT). A Cohen's κ value was calculated (PEMAT and CSAT analyses) for inter-rater agreement. Results: The mean SMOG reading level for websites was 13.12 (college-freshman reading level). The mean PEMAT understandability score was 61.8% and actionability score was 26.0% (κ = 0.8022), both below the 70% acceptability threshold. The mean CSAT score was 2.6 (κ = 0.73), exceeding the 2.5 threshold for cultural appropriateness. Conclusion: Online PEM for lower extremity reconstruction continue to fall below standards of readability, understandability, and actionability; however, they meet standards of cultural appropriateness. As patients rely on these materials, creators can use validated tools and positive examples from existing PEM for greater patient accessibility.
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Affiliation(s)
- Anamika Veeramani
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Anna Rose Johnson
- Mary Culver Department of Surgery, Division of Plastic and Reconstructive Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Bernard T. Lee
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Arriyan S. Dowlatshahi
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Beks H, Walsh SM, Wood S, Clayden S, Alston L, Coffee NT, Versace VL. Application of the Australian Bureau of Statistics Socio-Economic Indexes for Areas in cardiovascular disease research: a scoping review identifying implications for research. AUST HEALTH REV 2024; 48:414-454. [PMID: 38616107 DOI: 10.1071/ah23239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 03/08/2024] [Indexed: 04/16/2024]
Abstract
Objective To scope how the Australian Bureau of Statistics Socio-Economic Indexes for Areas (SEIFA) has been applied to measure socio-economic status (SES) in peer-reviewed cardiovascular disease (CVD) research. Methods The Joanna Briggs Institute's scoping review methodology was used. Results The search retrieved 2788 unique citations, and 49 studies were included. Studies were heterogeneous in their approach to analysis using SEIFA. Not all studies provided information as to what version was used and how SEIFA was applied in analysis. Spatial unit of analysis varied between studies, with participant postcode most frequently applied. Study quality varied. Conclusions The use of SEIFA in Australian CVD peer-reviewed research is widespread, with variations in the application of SEIFA to measure SES as an exposure. There is a need to improve the reporting of how SEIFA is applied in the methods sections of research papers for greater transparency and to ensure accurate interpretation of CVD research.
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Affiliation(s)
- Hannah Beks
- Deakin Rural Health, Deakin University, PO Box 423, Warrnambool, Vic. 3280, Australia
| | - Sandra M Walsh
- Department of Rural Health, University of South Australia, Whyalla, SA, Australia
| | - Sarah Wood
- Deakin Rural Health, Deakin University, PO Box 423, Warrnambool, Vic. 3280, Australia
| | - Suzanne Clayden
- Specialist Physicians Clinic, Southwest Healthcare, Warrnambool, Vic., Australia
| | | | - Neil T Coffee
- Deakin Rural Health, Deakin University, PO Box 423, Warrnambool, Vic. 3280, Australia
| | - Vincent L Versace
- Deakin Rural Health, Deakin University, PO Box 423, Warrnambool, Vic. 3280, Australia
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Liew YM, Ooi JH, Azman RR, Ganesan D, Zakaria MI, Mohd Khairuddin AS, Tan LK. Innovations in detecting skull fractures: A review of computer-aided techniques in CT imaging. Phys Med 2024; 124:103400. [PMID: 38996627 DOI: 10.1016/j.ejmp.2024.103400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/25/2024] [Accepted: 06/05/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND/INTRODUCTION Traumatic brain injury (TBI) remains a leading cause of disability and mortality, with skull fractures being a frequent and serious consequence. Accurate and rapid diagnosis of these fractures is crucial, yet current manual methods via cranial CT scans are time-consuming and prone to error. METHODS This review paper focuses on the evolution of computer-aided diagnosis (CAD) systems for detecting skull fractures in TBI patients. It critically assesses advancements from feature-based algorithms to modern machine learning and deep learning techniques. We examine current approaches to data acquisition, the use of public datasets, algorithmic strategies, and performance metrics RESULTS: The review highlights the potential of CAD systems to provide quick and reliable diagnostics, particularly outside regular clinical hours and in under-resourced settings. Our discussion encapsulates the challenges inherent in automated skull fracture assessment and suggests directions for future research to enhance diagnostic accuracy and patient care. CONCLUSION With CAD systems, we stand on the cusp of significantly improving TBI management, underscoring the need for continued innovation in this field.
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Affiliation(s)
- Yih Miin Liew
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia.
| | - Jia Hui Ooi
- Department of Biomedical Engineering, Faculty of Engineering, Universiti Malaya, Kuala Lumpur, Malaysia; Graduate School of Biomedical Engineering, UNSW Sydney, New South Wales, Australia
| | - Raja Rizal Azman
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Dharmendra Ganesan
- Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Universiti Malaya, 50603 Kuala Lumpur, Malaysia
| | - Mohd Idzwan Zakaria
- Academic Unit Emergency Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | - Li Kuo Tan
- Department of Biomedical Imaging, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
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Hussein A, Gareeballah A, Elzaki M, Abouraida RA, Ali S, Hamd ZY, Ahmed EAM. A triple kidney: Coexistence of normal left kidney and mal-rotated horseshoe anomaly: A rare case report. Radiol Case Rep 2024; 19:3316-3320. [PMID: 38817638 PMCID: PMC11137351 DOI: 10.1016/j.radcr.2024.04.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/21/2024] [Accepted: 04/23/2024] [Indexed: 06/01/2024] Open
Abstract
The occurrence of triple kidneys, involving a normal kidney and a malrotation horseshoe kidney, is an extremely infrequent condition. This case report demonstrates a triple, mal-rotated horseshoe kidneys coexist with an upper junction stone, alongside a normal left kidney showing normal Doppler vascularity, as observed in an ultrasound examination for 18-year-old male complaints of diffuse periumbilical pain and burning micturition. Laboratory investigation revealed normal creatinine level, and presence of urinary tract infection. Management option for this case are antibiotic therapy and surgical intervention for horseshoe kidney stone. Regular monitoring of kidney function, other radiographic imaging studies, and follow-up to assess the efficacy of the treatment, and detect any further complications are essential.
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Affiliation(s)
- Abdulaziz Hussein
- University of Medical Science and Technology, Graduate College, Khartoum, Sudan
| | - Awadia Gareeballah
- Department of Diagnostic Radiologic Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarrah, Saudi Arabia
- Faculty of Radiology Science and Medical Imaging, Alzaiem Alazhari University, Khartoum, Sudan
| | - Maisa Elzaki
- Department of Diagnostic Radiologic Technology, College of Applied Medical Sciences, Taibah University, Al-Madinah Al-Munawwarrah, Saudi Arabia
- Faculty of Radiology Science and Medical Imaging, Alzaiem Alazhari University, Khartoum, Sudan
| | - Raga Ahmed Abouraida
- Department of Radiological Sciences, College of Applied Medical Sciences, King Khalid University, Abha, Saudi Arabia
| | - Sara Ali
- Department of Diagnostic Radiography Technology, Faculty of Nursing and Health Sciences, Jazan University, Jazan, Saudi Arabia
| | - Zuhal Y. Hamd
- Department of Radiological Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
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Cornwall J, Champney TH, de la Cova C, Hall D, Hildebrandt S, Mussell JC, Winkelmann A, DeLeon VB. American Association for Anatomy recommendations for the management of legacy anatomical collections. Anat Rec (Hoboken) 2024; 307:2787-2815. [PMID: 38497461 DOI: 10.1002/ar.25410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 01/31/2024] [Accepted: 02/01/2024] [Indexed: 03/19/2024]
Abstract
Collections of human remains in scientific and private institutions have a long tradition, though throughout history there has often been variable regard for the respect and dignity that these tissues demand. Recent public scandals around the use of human remains, coupled with an increasing community awareness around accountability in such instances, forces scholars to confront the ethical and moral concerns associated with these collections. This includes specific focus on the acquisition, storage, use, and disposition of these remains, which were often collected with no consent and with little knowledge, or concern, about the individual or their respective culture and practices surrounding death and postmortem treatment. As a response, the American Association for Anatomy convened a Legacy Anatomical Collections Task Force to consider these issues and to develop recommendations to assist those working with these tissues in education, research, and museum collections. This has culminated with the development of Recommendations for the Management of Legacy Anatomical Collections. The recommendations provide both an ethical foundation and practical considerations for the use, storage, and disposition of legacy collections of human tissues, and deliver guidance for establishing appropriate management and oversight, investigating provenance, and engaging with communities of care. While these Recommendations are considered a living document which will change over time as ethical principles concerning human tissue evolve, they currently represent 'best practice' recommendations that can guide researchers, teachers, and museum associates as they consider the future of legacy anatomical collections in their care.
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Affiliation(s)
- Jon Cornwall
- Centre for Early Learning in Medicine, Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Thomas H Champney
- Department of Cell Biology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Carlina de la Cova
- Department of Anthropology, University of South Carolina, Columbia, South Carolina, USA
| | - Dominic Hall
- Manager, Curation and Stewardship, Anatomy and Artifact Collections, Center for the History of Medicine at the Francis A. Countway Library of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Sabine Hildebrandt
- Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Jason C Mussell
- Department of Cell Biology & Anatomy, Louisiana State University Health Sciences Center, New Orleans, Louisiana, USA
| | - Andreas Winkelmann
- Institute of Anatomy, Medical School Brandenburg Theodor Fontane, Neuruppin, Germany
| | - Valerie B DeLeon
- Department of Anthropology, University of Florida, Gainesville, Florida, USA
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Driscoll AM, Suresh R, Popa G, Berglund L, Azer A, Hed H, Duan Y, Chu A, McGrath A. Do educational interventions reduce the gender gap in communication skills?- a systematic review. BMC MEDICAL EDUCATION 2024; 24:827. [PMID: 39085838 PMCID: PMC11293108 DOI: 10.1186/s12909-024-05773-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Efficient doctor-patient communication is essential for improving patient care. The impact of educational interventions on the communication skills of male and female students has not been systematically reviewed. The aim of this review is to identify interventions used to improve communication skills in medical curricula and investigate their effectiveness in improving the communication skills of male and female medical students. METHODS A systematic review of the literature was conducted using the PRISMA guidelines. Inclusion criteria were as follows: used intervention strategies aiming to improve communication skills, participants were medical students, and studies were primary research studies, systematic reviews, or meta-analyses. RESULTS 2913 articles were identified based on search terms. After title, abstract, and full-text review, 58 studies were included with interventions consisting of Training or Drama Courses, Curriculum-Integrated, Patient Learning Courses, and Community-Based Learning Courses. 69% of articles reported improved communication skills for both genders equally, 28% for women more than men, and 3% for men more than women. 16 of the 58 articles reported numerical data regarding communication skills pre-and post-intervention. Analysis revealed that post-intervention scores are significantly greater than pre-intervention scores for both male (p < 0.001) and female students (p < 0.001). While the post-test scores of male students were significantly lower than that of female students (p = 0.01), there is no significant difference between genders for the benefits, or difference between post-intervention and pre-intervention scores (p = 0.15), suggesting that both genders benefited equally. CONCLUSION Implementation of communication training into medical education leads to improvement in communication skills of medical students, irrespective of gender. No specific interventions benefitting male students have been identified from published literature, suggesting need of further studies to explore the phenomenon of gender gap in communication skills and how to minimize the differences between male and female students.
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Affiliation(s)
- Alexis M Driscoll
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Rohan Suresh
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - George Popa
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Leif Berglund
- Department of Clinical Sciences, Umeå university, Umeå, Sweden
| | - Amanda Azer
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Helen Hed
- Umeå University Library, Umeå, Sweden
| | - Yajie Duan
- Department of Statistics, Rutgers University, New Brunswick, NJ, 08901, USA
| | - Alice Chu
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Aleksandra McGrath
- Department of Clinical Sciences, Umeå university, Umeå, Sweden.
- Department of Surgical and Perioperative Sciences, Umeå university, Umeå, Sweden.
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Yehuala TZ, Derseh NM, Tewelgne MF, Wubante SM. Exploring Machine Learning Algorithms to Predict Diarrhea Disease and Identify its Determinants among Under-Five Years Children in East Africa. J Epidemiol Glob Health 2024:10.1007/s44197-024-00259-9. [PMID: 39073532 DOI: 10.1007/s44197-024-00259-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Accepted: 06/01/2024] [Indexed: 07/30/2024] Open
Abstract
BACKGROUND The second most common cause of death for children under five is diarrhea. Early Predicting diarrhea disease and identify its determinants (factors) using an advanced machine learning model is the most effective way to save the lives of children. Hence, this study aimed to predict diarrheal diseases, identify their determinants, and generate some rules using machine learning models. METHODS The study used secondary data from the 12 east African countries for DHS dataset analysis using Python. Machine learning techniques such as Random Forest, Decision Tree (DT), K-Nearest Neighbor, Logistic Regression (LR), wrapper feature selection and SHAP values are used for identify determinants. RESULT The final experimentation results indicated the random forest model performed the best to predict diarrhea disease with an accuracy of 86.5%, precision of 89%, F-measure of 86%, AUC curve of 92%, and recall of 82%. Important predictors' identified age, countries, wealth status, mother's educational status, mother's age, source of drinking water, number of under-five children immunization status, media exposure, timing of breast feeding, mother's working status, types of toilet, and twin status were associated with a higher predicted probability of diarrhea disease. CONCLUSION According to this study, child caregivers are fully aware of sanitation and feeding their children, and moms are educated, which can reduce child mortality by diarrhea in children in east Africa. This leads to a recommendation for policy direction to reduce infant mortality in East Africa.
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Affiliation(s)
- Tirualem Zeleke Yehuala
- Department Health informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
| | - Nebiyu Mekonnen Derseh
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Makda Fekadie Tewelgne
- Department Health informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Sisay Maru Wubante
- Department Health informatics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Shah R, Alam J, Minallah S, Shabbir M, Abbasi MS, Aslam K, Ahmed N, Heboyan A. Prescription writing pattern among the dental practitioners of a tertiary care hospital in Karachi. BMC PRIMARY CARE 2024; 25:273. [PMID: 39068392 DOI: 10.1186/s12875-024-02532-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 07/19/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVE To identify the frequency and types of prescription errors, assess adherence to WHO prescribing indicators, and highlight the gaps in current prescribing practices of Junior dental practitioners in a tertiary care hospital in Karachi, Pakistan. METHODS This cross-sectional study was conducted from January 2021 to March 2021. The study included the prescriptions by house surgeons and junior postgraduate medical trainees for walk-in patients visiting the dental outpatient department. A total of 466 prescriptions were evaluated for WHO core drug prescribing indicators. The prescription error parameters were prepared by studying the WHO practical manual on guide to good prescribing and previous studies. Prescription errors, including errors of omission related to the physician and the patients, along with errors of omission related to the drug, were also noted. The statistical analysis was performed with SPSS version 25. Descriptive analysis was performed for qualitative variables in the study. RESULTS The average number of drugs per encounter was found to be 3.378 drugs per prescription. The percentage of encounters with antibiotics was 96.99%. Strikingly, only 16.95% of the drugs were prescribed by generic names and 23.55% of drugs belonged to the essential drug list. The majority lacked valuable information related to the prescriber, patient, and drugs. Such as contact details 419 (89.9%), date 261 (56%), medical license number 466 (100%), diagnosis 409 (87.8%), age and address of patient 453 (97.2%), form and route of drug 14 (3%), missing drug strength 69 (14.8%), missing frequency 126 (27%) and duration of treatment 72 (15.4%). Moreover, the wrong drug dosage was prescribed by 89 (19%) prescribers followed by the wrong drug in 52 (11.1%), wrong strength in 43 (9.2%) and wrong form in 9 (1.9%). Out of 1575 medicines prescribed in 466 prescriptions, 426 (27.04%) drug interactions were found and 299 (64%) had illegible handwriting. CONCLUSION The study revealed that the prescription writing practices among junior dental practitioners are below optimum standards. The average number of drugs per encounter was high, with a significant percentage of encounters involving antibiotics. However, a low percentage of drugs were prescribed by generic name and from the essential drug list. Numerous prescription errors, both omissions and commissions, were identified, highlighting the need for improved training and adherence to WHO guidelines on good prescribing practices. Implementing targeted educational programs and stricter regulatory measures could enhance the quality of prescriptions and overall patient safety.
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Affiliation(s)
- Ruqaya Shah
- Department of Oral & Maxillofacial Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
| | - Jehan Alam
- Department of Oral & Maxillofacial Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
| | - Sheheryar Minallah
- Department of Oral & Maxillofacial Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan
| | - Maria Shabbir
- Department of Oral & Maxillofacial Surgery, Shaheed Mohtarma Benazir Bhutto institute of Trauma, Karachi, Pakistan
| | - Maria Shakoor Abbasi
- Department of Prosthodontics, School of Dentistry, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad, Pakistan
| | - Kashif Aslam
- Department of Prosthodontics, Dow Dental College, Dow University of Health Sciences, Karachi, Pakistan
| | - Naseer Ahmed
- Department of Prosthodontics, Altamash Institute of Dental Medicine, Karachi, 75500, Pakistan.
| | - Artak Heboyan
- Department of Research Analytics, Saveetha Institute of Medical and Technical Sciences, Saveetha Dental College and Hospitals, Saveetha University, Chennai, 600 077, India.
- Department of Prosthodontics, Faculty of Stomatology, Yerevan State Medical University after Mkhitar Heratsi, Str. Koryun 2, Yerevan, 0025, Armenia.
- Department of Prosthodontics, School of Dentistry, Tehran University of Medical Sciences, North Karegar St, Tehran, Iran.
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Hayashi S, Moriyama T, Ito Y, Harada Y, Dodo H, Kumahara K, Yogi T, Ohashi N, Higashi R, Mori A. Proton-Pump Inhibitors and Risk of Bloodstream Infection without an Identifiable Source: a Hospital-Based Case-Control Study. Jpn J Infect Dis 2024; 77:205-212. [PMID: 38296545 DOI: 10.7883/yoken.jjid.2023.253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/26/2024]
Abstract
The association between proton-pump inhibitor (PPI) use and systemic infections caused by bacterial translocation is unclear. This study aimed to investigate whether patients receiving PPI therapy have a higher risk of bloodstream infections (BSI) without an identifiable source of infection. We conducted a hospital-based case-control study which enrolled all patients aged 20 years and older who were hospitalized in Ichinomiya Nishi Hospital with BSI confirmed by two sets of positive blood cultures in 2019. Patient data were collected from medical records, and the bacterial translocation-type (BT-type) BSI group was defined as patients with BSI without an identifiable source of infection, whereas those with a BSI from an identifiable source were assigned to the control group based on the diagnostic criteria for each infectious disease. Data from 309 patients, including 66 cases and 243 controls, were analyzed. Compared with PPI non-users, PPI users had a 2.4-fold higher risk of developing BT-type BSI after controlling for potential confounders (adjusted odds ratio: 2.41, 95% confidence interval: 1.29-4.51, P = 0.006). In conclusion, PPI use is associated with a higher risk of BSI without an identifiable source; therefore, PPI use might increase the risk of BSI secondary to bacterial translocation.
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Affiliation(s)
- Shintaro Hayashi
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
| | | | - Yuichiro Ito
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
| | - Yuta Harada
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
| | - Hiroki Dodo
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
| | - Kana Kumahara
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
| | - Tatsuji Yogi
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
| | - Noritsugu Ohashi
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
| | - Reiji Higashi
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
| | - Akihiro Mori
- Department of Gastroenterology, Ichinomiya Nishi Hospital, Japan
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Bulcha G, Gutema H, Amenu D, Birhanu Z. Maternal health service utilization in the Jimma Zone, Ethiopia: results from a baseline study for mobile phone messaging interventions. BMC Pregnancy Childbirth 2024; 24:485. [PMID: 39020278 PMCID: PMC11256581 DOI: 10.1186/s12884-024-06683-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2024] [Accepted: 07/08/2024] [Indexed: 07/19/2024] Open
Abstract
BACKGROUND Over the last 20 years, global healthcare has placed a major focus on improving the survival rates of mothers and children, recognizing the potential to prevent a significant number of deaths resulting from pregnancy and childbirth. Nevertheless, there remains an ongoing obstacle to the insufficient utilization of critical obstetric services to achieve optimal health outcomes for pregnant women. This study aimed to assess the magnitude and determinants of maternal healthcare use in the Jimma Zone, Ethiopia. METHODS Data were obtained from a household survey as part of the baseline assessment of a cluster randomized controlled trial. The study participants comprised 588 women in early pregnancy, specifically those with a gestational age of less than 20 weeks. Logistic regression analysis was employed to identify factors associated with the use of maternal health services. Adjusted odds ratios (AORs) were used to assess the strength of the associations, with significance level set at a p-value ≤ 0.05. RESULTS The overall prevalence of maternal health service utilization was 87.9% (CI: 85.1, 90.4) for antenatal care, 74.7% (CI: 73.2, 79.9) for health facility delivery, and 60.4% (CI: 56.4, 64.3) for postnatal care. Multivariable logistic analysis revealed that maternal health service use was significantly influenced by access to health facilities (AOR: 6.6; 95% CI: 2.39, 18.16), financial hardship (AOR: 3; 95% CI: 1.97, 4.61), perceived respectful care (AOR: 2.3; 95% CI: 1.07, 5.11), perceived privacy of service provisions (AOR: 2.4; 95% CI: 1.47, 4.06), and attitudes toward maternal service use (AOR: 2.2; 95% CI: 1.48, 3.24). CONCLUSIONS The study revealed slightly higher rates of antenatal care, facility delivery, and postpartum care utilization. However, there was a low proportion of early antenatal care initiation, and high rates of antenatal care dropout. Mobile phone-based messaging intervention may enhance maternal health service use by addressing factors such as lack of access, economic challenges, disrespectful care, no privacy of procedures, and unfavorable attitudes.
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Affiliation(s)
- Gebeyehu Bulcha
- Department of Health, Behavior, and Society, Faculty of Public Health, Institutes of Health, Jimma University, Jimma, Ethiopia.
- Department of Maternal, Newborn and Child Health, Oromia Regional State Health Bureau, Jimma Zone Health Office, Jimma, Ethiopia.
| | - Hordofa Gutema
- Department of Health, Behavior, and Society, Faculty of Public Health, Institutes of Health, Jimma University, Jimma, Ethiopia
| | - Demisew Amenu
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, Institutes of Health, Jimma University, Jimma, Ethiopia
| | - Zewdie Birhanu
- Department of Health, Behavior, and Society, Faculty of Public Health, Institutes of Health, Jimma University, Jimma, Ethiopia
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Craven BC, Kaiser A, Blencowe LA, Jervis-Rademeyer H, Boag L, Murphy W, Miyatani M. Bone health education in individuals with spinal cord injury or disease-the Bare Bones Podcast Series: plan it, produce it, post it! FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1340881. [PMID: 39082051 PMCID: PMC11286568 DOI: 10.3389/fresc.2024.1340881] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 05/23/2024] [Indexed: 08/02/2024]
Abstract
Introduction The Consortium for Spinal Cord Medicine's inaugural Clinical Practice Guideline for Bone Health and Osteoporosis Management for Individuals with Spinal Cord Injury or Disease (CSCM-CPG) was published in 2022 for a clinician audience. The aim of this project was to develop a podcast series to ensure people with lived experience with Spinal Cord Injury or Disease (PLEX) understand the CSCM-CPG content and know how to act to reduce their fracture risk. Methods The "Bare Bones Podcast Series" consists of nine episodes; one related to each CSCM-CPG chapter. The podcast content and the questions asked in each podcast were co-developed by PLEX partners (PLEX-P) and the project team. Two PLEX-P acted as co-hosts for the series. The invited speaker(s) were CSCM-CPG expert panel members who participated in an informal dialogue with the hosts. Each podcast closes with a specific action a listener can do to advance their bone health. The related Educational Action Planning Tool (EAT) handouts contain text and infographic information specific to each podcast episode and include key concepts and a specific actionable take-home message. Local PLEX reviewers (PLEX-R) were invited to review podcast episodes and EATs and provide their feedback through focus group participation or one-on-one (1:1) interviews. The project team revised the podcast episodes and the EATs based on feedback from the PLEX-R prior to releasing them online. Results Nine podcast episodes and related EATs were designed and created collaboratively with 3 PLEX-P, 22 PLEX-R, 11 CSCM-CPG expert panel members, and the project team. The episodes were titled: "Introduction to the Bare Bones of Bone Health"; "Fracture 101"; "Blood Tests-a Window into You"; "I See Your Skeleton"; "Vitamin D for all, Calcium for Some"; "Get Moving and Loading"; "Pills or Poisons & Atomic Habits"; "Snap and Crack"; and "Directions for Research". The Bare Bones Podcast Series was shared through the project website. Conclusions The podcasts will aid PLEX and their family caregivers to advocate for ongoing bone health assessments and to promote an ongoing dialogue with care team members regarding how to prevent fractures and fracture-related morbidity and mortality.
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Affiliation(s)
- B. Catharine Craven
- KITE Research Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Brain and Spinal Cord Rehabilitation Program, Toronto Rehabilitation Institute, University Health Network, Toronto, ON, Canada
| | - Anita Kaiser
- KITE Research Institute, University Health Network, Toronto, ON, Canada
- Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Canadian Spinal Research Organization, Richmond Hill, ON, Canada
| | - Lindsie A. Blencowe
- KITE Research Institute, University Health Network, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | | | - Lynn Boag
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Wendy Murphy
- KITE Research Institute, University Health Network, Toronto, ON, Canada
| | - Masae Miyatani
- KITE Research Institute, University Health Network, Toronto, ON, Canada
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Wabe N, Urwin R, Seaman K, Westbrook JI. Longitudinal cohort study of discrepancies between prescribed and administered polypharmacy rates: implications for National Aged Care Quality Indicator Programs. BMJ Qual Saf 2024:bmjqs-2023-017042. [PMID: 39013597 DOI: 10.1136/bmjqs-2023-017042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/28/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Polypharmacy is frequently used as a quality indicator for older adults in Residential Aged Care Facilities (RACFs) and is measured using a range of definitions. The impact of data source choice on polypharmacy rates and the implications for monitoring and benchmarking remain unclear. We aimed to determine polypharmacy rates (≥9 concurrent medicines) by using prescribed and administered data under various scenarios, leveraging electronic data from 30 RACFs. METHOD A longitudinal cohort study of 5662 residents in New South Wales, Australia. Both prescribed and administered polypharmacy rates were calculated biweekly from January 2019 to September 2022, providing 156 assessment times. 12 different polypharmacy rates were computed separately using prescribing and administration data and incorporating different combinations of items: medicines and non-medicinal products, any medicines and regular medicines across four scenarios: no, 1-week, 2-week and 4-week look-back periods. Generalised estimating equation models were employed to identify predictors of discrepancies between prescribed and administered polypharmacy. RESULTS Polypharmacy rates among residents ranged from 33.9% using data on administered regular medicines with no look-back period to 63.5% using prescribed medicines and non-medicinal products with a 4-week look-back period. At each assessment time, the differences between prescribed and administered polypharmacy rates were consistently more than 10.0%, 4.5%, 3.5% and 3.0%, respectively, with no, 1-week, 2-week and 4-week look-back periods. Diabetic residents faced over two times the likelihood of polypharmacy discrepancies compared with counterparts, while dementia residents consistently showed reduced likelihood across all analyses. CONCLUSION We found notable discrepancies between polypharmacy rates for prescribed and administered medicines. We recommend a review of the guidance for calculating and interpreting polypharmacy for national quality indicator programmes to ensure consistent measurement and meaningful reporting.
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Affiliation(s)
- Nasir Wabe
- Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Rachel Urwin
- Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Karla Seaman
- Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
| | - Johanna I Westbrook
- Australian Institute of Health Innovation, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, Australia
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Zhai J, Min J, Gong M. Induction of ferroptosis by brucine suppresses gastric cancer progression through the p53-mediated SLCA711/ALOX12 axis. Heliyon 2024; 10:e33674. [PMID: 39050447 PMCID: PMC11267018 DOI: 10.1016/j.heliyon.2024.e33674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 06/24/2024] [Accepted: 06/25/2024] [Indexed: 07/27/2024] Open
Abstract
Increasing evidence indicates important antiproliferative and anti-inflammatory roles of brucine in various diseases. However, the mechanism through which brucine causes the cell death of gastric cancer (GC) remains unclear. In the current research, we looked into whether brucine inhibits GC progression. GC cell migration and proliferation were assessed in response to brucine using Transwell, scratch, and the Cell Counting Kit-8 (CCK-8) assays. To assess the expression of proteins linked to ferroptosis, western blotting was used. An in vivo experiment was conducted to investigate if brucine decreases tumor growth. The CCK-8 experiment demonstrated that brucine reduced AGS and MKN45 cell viability in a way that was dose- and time-dependent. Brucine dramatically promoted cell death in AGS and MKN45 cells according to flow cytometry. In addition, brucine reduced AGS and MKN45 cells' ability to migrate. According to Western blot investigations, brucine elevated p53 and ALOX12 expression, while suppressing the expression of SLC7A11 in AGS and MKN45 cells. Notably, silencing p53 reversed brucine-induced ferroptotic cell death. Additionally, brucine was shown to decrease tumor weight and volume in in vivo experiments. Moreover, malondialdehyde (MDA) and Fe2+ levels decreased in response to brucine treatment. Furthermore, in tumors treated with brucine, p53 and ALOX12 expression increased, whereas SLCA711 expression decreased. In summary, we demonstrated that brucine regulates the p53/SLCA711/ALOX12 axis to cause ferroptosis in GC cells. The results of this study lend support to the idea of treating GC with brucine.
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Affiliation(s)
- Jincheng Zhai
- Department of Critical Care Medicine, Fengxin County People Hospital, Yichun, 330700, Jiangxi, PR China
| | - Jiaxing Min
- Department of Critical Care Medicine, Fengxin County People Hospital, Yichun, 330700, Jiangxi, PR China
| | - Mingqiang Gong
- Department of Critical Care Medicine, Fengxin County People Hospital, Yichun, 330700, Jiangxi, PR China
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Withanage NN, Botfield JR, Black K, Mazza D. Preconception health risk factors documented in general practice electronic medical records. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:165-171. [PMID: 38336467 PMCID: PMC11287648 DOI: 10.1136/bmjsrh-2023-202038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 01/17/2024] [Indexed: 02/12/2024]
Abstract
BACKGROUND Documenting medical and lifestyle preconception health risk factors in electronic medical records (EMRs) could assist general practitioners (GPs) to identify those reproductive-aged women who could most benefit from preconception care (PCC). However, it is unclear to what extent PCC risk factors are identifiable in general practice records. This study aimed to determine the extent to which medical and lifestyle preconception health risk factors are documented in general practice EMRs. METHODS We conducted an audit of the documentation of medical and lifestyle preconception risk factors in 10 general practice EMRs in Melbourne, Australia. We retrospectively analysed the EMRs of 100 consecutive women aged 18-44 years who visited each practice between January and September 2022. Using a template informed by PCC guidelines, we extracted data from structured fields in the EMR and conducted a descriptive analysis. RESULTS Among the data extracted, the more commonly documented medical and lifestyle preconception health risk factors in the EMRs included smoking (79%), blood pressure (74%), alcohol consumption (63%) and body mass index (57%). Among the women audited, 14% were smokers, 24% were obese, 7% had high blood pressure, 5% had diabetes, 28% had a mental health condition, 13% had asthma, 6% had thyroid disease and 17% had been prescribed and could be using a potentially teratogenic medication. CONCLUSIONS Better documentation of medical and lifestyle preconception health risk factors in structured fields in EMRs may potentially assist primary care providers including GPs in identifying and providing PCC to women who could most benefit from it.
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Affiliation(s)
- Nishadi Nethmini Withanage
- SPHERE, NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Melbourne, Victoria, Australia
| | - Jessica R Botfield
- SPHERE, NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Melbourne, Victoria, Australia
| | - Kirsten Black
- SPHERE, NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Melbourne, Victoria, Australia
- Department of Obstetrics and Gynaecology, University of Sydney, Camperdown, New South Wales, Australia
| | - Danielle Mazza
- SPHERE, NHMRC Centre of Research Excellence, Department of General Practice, Monash University, Melbourne, Victoria, Australia
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Frommelt M, Hagner M, Gross TJ. Colourful complication of chronic minocycline use. BMJ Case Rep 2024; 17:e260634. [PMID: 38991577 DOI: 10.1136/bcr-2024-260634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/13/2024] Open
Affiliation(s)
- Mark Frommelt
- Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Miles Hagner
- Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
| | - Thomas J Gross
- Pulmonary, Critical Care and Occupational Medicine, University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
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Rey-Otero G, Diniz-Freitas M, Rivas-Mundiña B, Varela-Aneiros I, Sande-López L, Limeres-Posse J, García-Mato E. How trustworthy is online dental information for individuals with Down syndrome from Ibero-American countries? SPECIAL CARE IN DENTISTRY 2024. [PMID: 38984423 DOI: 10.1111/scd.13037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2024] [Accepted: 06/26/2024] [Indexed: 07/11/2024]
Abstract
BACKGROUND Internet has become an indispensable source of health-related information. However, several studies have shown there to be a lack of quality control for webpages related to disability. Specifically, available content concerning Down syndrome (DS) and dentistry is limited and of dubious quality. OBJECTIVE The aim of the present study was to assess the quality of online content in Spanish and Portuguese on dental care for individuals with DS. METHODS A simultaneous search in Google and Bing using the terms "Down syndrome" and "odontology/dentist/dental treatment" in Spanish and Portuguese was conducted in seven Ibero-American countries (Argentina, Brazil, Chile, Colombia, Spain, Mexico, and Portugal). The first 100 consecutive pages of results from the three combinations of terms in each of the search engines were accessed and selected by applying conventional exclusion criteria. The selected pages were classified according to their authorship, specificity and dissemination potential. The quality of the online content was assessed using the DISCERN questionnaire and the Questionnaire to Evaluate Health Web Sites According to European Criteria (QEEC). The presence of the Health On Net (HON) and Accredited Medical Website (AMW) seals was also assessed. RESULTS The mean DISCERN score was 2.51 ± 0.85 and 2.57 ± 0.86 for the Spanish and Portuguese webpages, respectively. The mean readability score was 3.43 ± 1.26 and 3.25 ± 1.08 for the Spanish and Portuguese webpages, respectively. None of the selected webpages presented the HONcode or AMW trust seals. CONCLUSIONS The content available online in Spanish and Portuguese regarding Down syndrome and dentistry is scarce and of highly questionable quality.
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Affiliation(s)
- G Rey-Otero
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (Spain), Santiago de Compostela, Spain
| | - M Diniz-Freitas
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (Spain), Santiago de Compostela, Spain
| | - B Rivas-Mundiña
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (Spain), Santiago de Compostela, Spain
| | - I Varela-Aneiros
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (Spain), Santiago de Compostela, Spain
| | - L Sande-López
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (Spain), Santiago de Compostela, Spain
| | - J Limeres-Posse
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (Spain), Santiago de Compostela, Spain
| | - E García-Mato
- Medical-Surgical Dentistry Research Group (OMEQUI), Health Research Institute of Santiago de Compostela (IDIS), University of Santiago de Compostela (Spain), Santiago de Compostela, Spain
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Hosapatna M, Kunder K, Bhat NP, Shetty A, Sanyal S, Prabhath S, Sumalatha S. Falx cerebelli and its associated occipital venous sinus: an anatomical study. Surg Radiol Anat 2024:10.1007/s00276-024-03416-8. [PMID: 38977460 DOI: 10.1007/s00276-024-03416-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 06/12/2024] [Indexed: 07/10/2024]
Abstract
PURPOSE This study presents the morphological variation of falx cerebelli, which helps to identify the possible variations in the presence of the occipital sinus in the posterior margin of the fold whose damage during midline incision of posterior cranial fossa surgeries may lead to internal hemorrhage. METHOD The study was conducted on 48 cranial cavities exploring the falx cerebelli. Variations in the number of folds, its proximal and distal attachments, and the drainage pattern of the occipital sinus were evaluated by histological processing of the upper 1/3rd section of the falx fold. RESULTS The variation in the number of folds recorded are single folds in 87.5%, double folded in 8.3%, and multiple folds (five and seven folded) in 4.2% of the cases. The variation in the proximal and distal attachments in single falx folds showed three combinations: Ramified triangular in 66.7%, both ramified type in 12.5%, and both triangular type in 8.3% of the cases. Double and multiple folds showed ramified and triangular types of variation in their attachments. Histological findings showed the presence of occipital venous sinuses in most of the single falx fold. Two aberrant venous sinuses were seen in a double and five-folded falx cerebelli. CONCLUSIONS This study records the variations in the morphology of falx cerebelli. The histological data of this study sheds light on the drainage pattern of venous sinuses in the area whose negligence during midline incisions of brain surgeries may increase the possibility of hemorrhage.
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Affiliation(s)
- Mamatha Hosapatna
- Department of Anatomy, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Kushi Kunder
- Department of Anatomy, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Nandini Prashanth Bhat
- Department of Anatomy, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
| | - Ashwija Shetty
- Department of Anatomy, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Sanjoy Sanyal
- Department of Anatomy, Department Chair of Anatomical Sciences, Richmond Gabriel University College of Medicine, Kingstown, West Indies, VC0282, Saint Vincent And The Grenadines
| | - Sushma Prabhath
- Department of Anatomy, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India
| | - Suhani Sumalatha
- Department of Anatomy, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India.
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ElBshari S, Afrooz I, Beck RH, Watad R, Al-Qahtani N, Deeb A. Dental caries in children and adolescents with poorly-controlled diabetes: a case-control study. FRONTIERS IN ORAL HEALTH 2024; 5:1401485. [PMID: 39035710 PMCID: PMC11258009 DOI: 10.3389/froh.2024.1401485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 06/14/2024] [Indexed: 07/23/2024] Open
Abstract
The relationship between diabetes and dental caries remains uncertain. The main objective of this study was to quantify dental caries in children and adolescents with and without poorly-controlled diabetes to examine whether poorly-controlled diabetes influences caries prevalence and severity. This was a case-control study of children and adolescents with poorly-controlled diabetes and age-matched controls attending paediatric clinics at Sheikh Shakhbout Medical City, Abu Dhabi, UAE in August 2022. Dental caries was diagnosed by visual examination and dental probing to derive total number of decayed, missing, and filled tooth or surface (DMFT/DMFS) indices. Differences in caries metrics between subjects with diabetes and controls were assessed using chi-squared or Mann Whitney U-tests. Fifty-seven children and adolescents without diabetes and 42 with poorly-controlled (HbA1c ≥ 7.5) diabetes were recruited. The median (interquartile range, IQR) DMFT index was 4 (5) and the DMFS index was 4 (11). There were no significant differences in DMFT % [14.0 (21.5) vs.13.0 (20.0); p = 0.602], DMFT index [4 (5) vs. 3 (6); p = 0.749], nor DMFS index [5 (12) vs. 4 (11); p = 0.484] between patients and controls. Diabetes either has no effect on caries risk or its effect is so small that it is masked by dominant risk factors such as diet and obesity that require addressing through robust public health measures. While poor glycaemic control does not appear to influence caries risk, diet and obesity remain serious and addressable risk factors affecting oral health.
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Affiliation(s)
- Shahd ElBshari
- Dental School, Ajman University, Ajaman, United Arab Emirates
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Imrana Afrooz
- Clinical Trial Unit, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Rasha Hassan Beck
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
- Medical School, Gulf University, Ajaman, United Arab Emirates
| | - Rama Watad
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Nabras Al-Qahtani
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
| | - Asma Deeb
- Paediatric Endocrine Division, Sheikh Shakhbout Medical City, Abu Dhabi, United Arab Emirates
- College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
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Kegne T, Alemu YM, Wassie GT. Timely initiation of complementary feeding and associated factors among mothers having children aged 6 to 24 months in North-West Ethiopia: a comparative cross-sectional study. BMC Pediatr 2024; 24:428. [PMID: 38961360 PMCID: PMC11223442 DOI: 10.1186/s12887-024-04906-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/23/2024] [Indexed: 07/05/2024] Open
Abstract
BACKGROUND The timely introduction of complementary foods during infancy is necessary for nutritional reasons, and to enable the transition from milk feeding to family foods. In the past years, despite efforts that have been put to increase the utilization of timely initiation of complementary feeding practice in Ethiopia, improvements are not satisfactory. OBJECTIVE To compare the prevalence of timely initiation of complementary feeding and its associated factors among mothers who have Children 6-24 months in Debre Tabor town and rural Farta district, North-west Ethiopia, 2021. METHODS A community-based comparative cross-sectional study was employed from December 1/2020 to 30/ 2020 among 1100 mothers. Data were collected using a structured questioner and analyzed using Statistical Product and Service Solutions. Logistic regression analysis with a 95% confidence interval carried out to determine the association between explanatory and the outcome variables. A P-value of < 0.05 was considered statistically significant. RESULTS The prevalence of timely initiation of complementary feeding among urban and rural mothers was 69.8% with (95% CI: 66%, 74%) and 51.9% with (95% CI: 48- 56%) respectively. Urban residence [AOR = 1.39, 95% CI: (1.02-1.94)], had antenatal care visits [AOR = 0.24 (95%CI: (0.13, 0.44)], had post natal care checkups [AOR = 0.44, 95%CI: (0. 27- 0.72)] and being a governmental employee [AOR = 2.82; 95% CI: (1.91-6.1)] were factors associated with timely initiation of complementary feeding among urban mothers. Whereas in rural settings: institutional delivery [(AOR = 2.21, CI: 1.35-3.65)], post natal care checkups [(AOR = 0.53, CI: (0.36-0.77)] being daily laborer [AOR = 3.47; 95% CI: (1.78-6.75)] were associated with timely initiation of complementary feeding. CONCLUSION The prevalence of timely introduction of complementary feeding in children aged 6-24 months is still low in the study areas. There was also disparity between urban and rural mothers in which urban mothers practiced better.
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Affiliation(s)
- Tilahun Kegne
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Yihun Mulugeta Alemu
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Gizachew Tadesse Wassie
- Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia.
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Spruijtenburg B, Rezusta A, Houbraken J, Hagen F, de Groot T, Meis JF, Meijer EFJ. Susceptibility Testing of Environmental and Clinical Aspergillus sydowii Demonstrates Potent Activity of Various Antifungals. Mycopathologia 2024; 189:61. [PMID: 38958798 PMCID: PMC11222195 DOI: 10.1007/s11046-024-00869-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 06/13/2024] [Indexed: 07/04/2024]
Abstract
The genus Aspergillus consists of a vast number of medically and environmentally relevant species. Aspergillus species classified in series Versicolores are ubiquitous in the environment and include the opportunistic pathogen Aspergillus sydowii, which is associated with onychomycosis and superficial skin infections. Despite frequent clinical reports of A. sydowii and related series Versicolores species, antifungal susceptibility data are scarce, hampering optimal treatment choices and subsequent patient outcomes. Here, we employed antifungal susceptibility testing (AFST) based on microbroth dilution on a set of 155 series Versicolores strains using the common antifungals amphotericin B, itraconazole, voriconazole, posaconazole, isavuconazole and micafungin with the addition of luliconazole and olorofim. All strains were identified using partial calmodulin gene sequencing, with 145 being A. sydowii, seven A. creber and three A. versicolor, using the latest taxonomic insights. Overall, tested antifungals were potent against the entire strain collection. In comparison to A. fumigatus, azole and amphotericin B MICs were slightly elevated for some strains. AFST with luliconazole and olorofim, here reported for the first time, displayed the highest in vitro activity, making these antifungals interesting alternative drugs but clinical studies are warranted for future therapeutic use.
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Affiliation(s)
- Bram Spruijtenburg
- Radboudumc-CWZ Center of Expertise for Mycology, Weg Door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands
- Canisius-Wilhelmina Hospital (CWZ)/Dicoon, 6532 SZ, Nijmegen, The Netherlands
| | - Antonio Rezusta
- Servicio de Microbiología, Hospital Universitario Miguel Servet, IIS Aragon, Saragossa, Spain
| | - Jos Houbraken
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
| | - Ferry Hagen
- Westerdijk Fungal Biodiversity Institute, Uppsalalaan 8, 3584 CT, Utrecht, The Netherlands
- Institute for Biodiversity and Ecosystems Dynamics, University of Amsterdam, Amsterdam, The Netherlands
- Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Theun de Groot
- Radboudumc-CWZ Center of Expertise for Mycology, Weg Door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands
- Canisius-Wilhelmina Hospital (CWZ)/Dicoon, 6532 SZ, Nijmegen, The Netherlands
| | - Jacques F Meis
- Radboudumc-CWZ Center of Expertise for Mycology, Weg Door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands
- Institute of Translational Research, Cologne Excellence Cluster On Cellular Stress Responses in Aging-Associated Diseases (CECAD) and Excellence Center for Medical Mycology, University of Cologne, Cologne, Germany
| | - Eelco F J Meijer
- Radboudumc-CWZ Center of Expertise for Mycology, Weg Door Jonkerbos 100, 6532 SZ, Nijmegen, The Netherlands.
- Canisius-Wilhelmina Hospital (CWZ)/Dicoon, 6532 SZ, Nijmegen, The Netherlands.
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Bhalla H, Huang G, Seaman K, Silva SSM, Wu B, Wabe N, Westbrook JI, Nguyen AD. Diabetes in residential aged care: Pharmacological management and concordance with clinical guidelines. Australas J Ageing 2024. [PMID: 38961713 DOI: 10.1111/ajag.13351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Revised: 05/20/2024] [Accepted: 05/23/2024] [Indexed: 07/05/2024]
Abstract
OBJECTIVE Existing studies have highlighted suboptimal diabetes management in residential aged care facilities (RACFs). However, understanding of diabetes management in Australian metropolitan RACFs has been limited. This retrospective cohort study aimed to explore the pharmacological management of diabetes in 25 RACFs in Sydney Australia and assess concordance with clinical practice guidelines (CPGs). METHODS Data from 231 permanent RACF residents aged ≥65 years and over with type 2 diabetes mellitus over the period from 1 July 2016 to 31 December 2019 were used. Concordance was measured by assessing the medications and medical history data for each individual resident for concordance with evidence-based CPGs. Multivariable logistic regression was used to estimate the effect of resident characteristics on concordance with CPGs. RESULTS Of the 231 residents with diabetes, 87 (38%) were not taking any antidiabetic medication. Pharmacological management inconsistent with CPG recommendations was observed for 73 (32%) residents, with the most common reason for non-concordance being the use of medications with significant adverse effects in older adults (47, 2%). Residents with hypertension or other heart diseases in addition to their diabetes had greater odds of their diabetes management being non-concordant with CPGs (OR = 2.84 95% CI = 1.54, 5.3 and OR = 2.64, 95% CI = 1.07, 6.41, respectively). CONCLUSIONS Pharmacological diabetes management in metropolitan Australian RACFs is suboptimal, with a high prevalence of inconsistency with CPGs (32%) observed. Additionally, having hypertension or heart diseases significantly increased the possibility of non-concordance among diabetic RACF residents. Further investigation into the underlying relationships with comorbidities is required to develop better strategies.
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Affiliation(s)
- Hargun Bhalla
- Faculty of Medicine, Health, and Human Sciences (FMHHS), Macquarie University, Sydney, New South Wales, Australia
| | - Guogui Huang
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Karla Seaman
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - S Sandun Malpriya Silva
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Bosco Wu
- Faculty of Medicine, Health, and Human Sciences (FMHHS), Macquarie University, Sydney, New South Wales, Australia
| | - Nasir Wabe
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Johanna I Westbrook
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
| | - Amy D Nguyen
- Centre for Health Systems and Safety Research, Australian Institute of Health Innovation, Macquarie University, Sydney, New South Wales, Australia
- St Vincent's Clinical School, UNSW Medicine, UNSW Sydney, Sydney, New South Wales, Australia
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Peters J, Chen M, Huang K, Siero M, Elliot J, Bleakney A, Hsiao-Wecksler E, McDonagh D. A user-inspired mobility experience of the future: a qualitative investigation. Disabil Rehabil Assist Technol 2024:1-10. [PMID: 38958198 DOI: 10.1080/17483107.2024.2373303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 06/22/2024] [Indexed: 07/04/2024]
Abstract
Wheelchair users (WCUs) face additional challenges than non-WCU to multi-tasking (i.e. open doors, cook, use a cell-phone) while navigating their environments. While assistive devices have attempted to provide WCUs with mobility solutions that enable multi-tasking capabilities, current devices have been developed without the input of end-users and have proven to be non-usable. More balanced approaches that integrate the end-users' voices may improve current assistive technology usability trends. This study sought to empathically understand the lived experience of WCUs, their needs towards a mobility device, and their perceptions towards hands-free mobility. Full-time WCUs and care providers participated in semi-structured interviews examining wheelchair use and perceptions towards current and future mobility devices. Thematic analysis was used to analyze interview data. 9 WCUs (aged 32.1 ± 7.0 years; wheelchair experience 17.9 ± 11.6 years) and five care providers (years caring for WCU 3.75 ± 0.96 years) participated in the study. The most common disability type was spinal cord injury (WCUs: n = 3; care providers: n = 3). Qualitative analysis revealed four key themes: (1) Current wheelchair usage, (2) WCU and care provider perspectives, (3) Future wheelchair, and (4) Hands-free wheelchair. Accordingly, participants desire bespoke, light-weight mobility devices that can through tight spaces, access uneven terrain, and free the hands during navigation. This study provides meaningful insight into the needs of WCUs and care providers that assistive technology innovators can use to develop more usable assistive technologies. Amongst study participants, the concept of a hands-free mobility device appears to be usable and desirable.
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Affiliation(s)
- Joseph Peters
- Kansas City University College of Osteopathic Medicine, Kansas City University of Medicine and Bioscience, Kansas, MO, USA
| | - Michael Chen
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Kathryn Huang
- Disability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Marissa Siero
- Technology Entrepreneur Center, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Jeannette Elliot
- Disability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Adam Bleakney
- Disability Resources and Educational Services, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Elizabeth Hsiao-Wecksler
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Department of Mechanical Science and Engineering, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - Deana McDonagh
- Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, IL, USA
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, USA
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Berezin AE, Berezina TA, Hoppe UC, Lichtenauer M, Berezin AA. An overview of circulating and urinary biomarkers capable of predicting the transition of acute kidney injury to chronic kidney disease. Expert Rev Mol Diagn 2024; 24:627-647. [PMID: 39007888 DOI: 10.1080/14737159.2024.2379355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 07/09/2024] [Indexed: 07/16/2024]
Abstract
INTRODUCTION Acute kidney injury (AKI) defined by a substantial decrease in kidney function within hours to days and is often irreversible with higher risk to chronic kidney disease (CKD) transition. AREAS COVERED The authors discuss the diagnostic and predictive utilities of serum and urinary biomarkers on AKI and on the risk of AKI-to-CKD progression. The authors focus on the relevant literature covering evidence of circulating and urinary biomarkers' capability to predict the transition of AKI to CKD. EXPERT OPINION Based on the different modalities of serum and urinary biomarkers, multiple biomarker panel seems to be potentially useful to distinguish between various types of AKI, to detect the severity and the risk of AKI progression, to predict the clinical outcome and evaluate response to the therapy. Serum/urinary neutrophil gelatinase-associated lipocalin (NGAL), serum/urinary uromodulin, serum extracellular high mobility group box-1 (HMGB-1), serum cystatin C and urinary liver-type fatty acid-binding protein (L-FABP) were the most effective in the prediction of AKI-to-CKD transition regardless of etiology and the presence of critical state in patients. The current clinical evidence on the risk assessments of AKI progression is mainly based on the utility of combination of functional, injury and stress biomarkers, mainly NGAL, L-FABP, HMGB-1 and cystatin C.
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Affiliation(s)
- Alexander E Berezin
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Tetiana A Berezina
- Department of Internal Medicine & Nephrology, VitaCenter, Zaporozhye, Ukraine
| | - Uta C Hoppe
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
| | - Michael Lichtenauer
- Department of Internal Medicine II, Division of Cardiology, Paracelsus Medical University, Salzburg, Austria
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Mehta A, Gupta RK, Mahajan A, Kapoor A, Singh D. Knowledge and Perceptions of Self-Medication Among Bachelor of Medicine and Bachelor of Surgery (MBBS) Students: A Cross-Sectional, Questionnaire-Based Study. Cureus 2024; 16:e65269. [PMID: 39184611 PMCID: PMC11342907 DOI: 10.7759/cureus.65269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2024] [Indexed: 08/27/2024] Open
Abstract
INTRODUCTION Self-medication (SM) is a common practice worldwide, and the irrational use of drugs is a cause of concern. Self-medication has various forms, including taking medications without a physician's prescription, using a previous prescription for a similar condition, or using drugs obtainable at home without getting a physician's advice. The youth are highly influenced by the media and the internet, which promote SM behavior. AIMS AND OBJECTIVES To determine the knowledge and perceptions of SM in Bachelor of Medicine and Bachelor of Surgery (MBBS) students in all professional years, including interns in Acharya Shri Chander College of Medical Sciences (ASCOMS) and Hospital, Jammu. MATERIAL AND METHODS The present study was conducted at ASCOMS Hospital, Jammu. A total of 200 students of MBBS were included in the study. A self-structured questionnaire was used to assess the knowledge and awareness level. The collected data were recorded in a Microsoft Excel sheet (Microsoft Corp., Redmond, WA) and analyzed with the help of IBM SPSS Statistics software for Windows, version 21.0 (IBM Corp., Armonk, NY). RESULT The present study reveals that 60% of the subjects were males and 65% of the students practiced SM, which indicates that SM is highly prevalent amongst MBBS students. It was observed that minor illness and quick relief were the major reasons for SM. Further, headache, cold/cough, and fever were the major indications for SM, whereas antipyretics and analgesics were the most commonly used drugs for SM. Conclusion: The present study concluded that there was a high prevalence of SM practice among medical students, especially among females. However, the knowledge and perceptions of SM were not insufficient.
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Affiliation(s)
- Abhijay Mehta
- Paediatrics, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, IND
| | - Ravinder K Gupta
- Paediatrics, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, IND
| | - Anirudh Mahajan
- Paediatrics, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, IND
| | - Anisha Kapoor
- Paediatrics, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, IND
| | - Damanpreet Singh
- Paediatrics, Acharya Shri Chander College of Medical Sciences and Hospital, Jammu, IND
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Wang H, Alanis N, Haygood L, Swoboda TK, Hoot N, Phillips D, Knowles H, Stinson SA, Mehta P, Sambamoorthi U. Using natural language processing in emergency medicine health service research: A systematic review and meta-analysis. Acad Emerg Med 2024; 31:696-706. [PMID: 38757352 PMCID: PMC11246236 DOI: 10.1111/acem.14937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 04/15/2024] [Accepted: 04/17/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES Natural language processing (NLP) represents one of the adjunct technologies within artificial intelligence and machine learning, creating structure out of unstructured data. This study aims to assess the performance of employing NLP to identify and categorize unstructured data within the emergency medicine (EM) setting. METHODS We systematically searched publications related to EM research and NLP across databases including MEDLINE, Embase, Scopus, CENTRAL, and ProQuest Dissertations & Theses Global. Independent reviewers screened, reviewed, and evaluated article quality and bias. NLP usage was categorized into syndromic surveillance, radiologic interpretation, and identification of specific diseases/events/syndromes, with respective sensitivity analysis reported. Performance metrics for NLP usage were calculated and the overall area under the summary of receiver operating characteristic curve (SROC) was determined. RESULTS A total of 27 studies underwent meta-analysis. Findings indicated an overall mean sensitivity (recall) of 82%-87%, specificity of 95%, with the area under the SROC at 0.96 (95% CI 0.94-0.98). Optimal performance using NLP was observed in radiologic interpretation, demonstrating an overall mean sensitivity of 93% and specificity of 96%. CONCLUSIONS Our analysis revealed a generally favorable performance accuracy in using NLP within EM research, particularly in the realm of radiologic interpretation. Consequently, we advocate for the adoption of NLP-based research to augment EM health care management.
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Affiliation(s)
- Hao Wang
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104
| | - Naomi Alanis
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104
| | - Laura Haygood
- Health Sciences Librarian for Public Health, Brown University, 69 Brown St., Providence, RI 02912
| | - Thomas K. Swoboda
- Department of Emergency Medicine, The Valley Health System, Touro University Nevada School of Osteopathic Medicine, 657 N. Town Center Drive, Las Vegas, NV 89144
| | - Nathan Hoot
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104
| | - Daniel Phillips
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104
| | - Heidi Knowles
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104
| | - Sara Ann Stinson
- Mary Couts Burnett Library, Burnett School of Medicine at Texas Christian University, 2800 S. University Dr., Fort Worth, TX 76109
| | - Prachi Mehta
- Department of Emergency Medicine, JPS Health Network, 1500 S. Main St., Fort Worth, TX 76104
| | - Usha Sambamoorthi
- College of Pharmacy, University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107
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Shepard S, Sajjadi NB, Checketts JX, Hughes G, Ottwell R, Chalkin B, Hartwell M, Vassar M. Examining the Public's Most Frequently Asked Questions About Carpal Tunnel Syndrome and Appraising Online Information About Treatment. Hand (N Y) 2024; 19:768-775. [PMID: 36564990 PMCID: PMC11284989 DOI: 10.1177/15589447221142895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Carpal tunnel syndrome (CTS) is the most common entrapment neuropathy. Patients often search online for health information regarding common musculoskeletal complaints. Thus, the purpose of this study was to use language processing information from Google to assess the content of CTS frequently asked questions (FAQs) searched online and the transparency and quality of online CTS information. METHODS On March 11, 2021, we searched Google for 3 terms "carpal tunnel syndrome treatment," "carpal tunnel syndrome surgical treatment," and "carpal tunnel syndrome non-surgical treatment" until a minimum of 100 FAQs and their answer links were extracted from each search. We used Rothwell classification to categorize the FAQs. The Journal of the American Medical Association's benchmark criteria were used to assess information transparency. Information quality was assessed using the Brief DISCERN tool. RESULTS Our Google search returned 124 unique FAQs. Fifty-six (45.2%) were value based and most were related to the evaluation of treatment options (45/56, 80.4%). The most common source type was medical practices (26.6%). Nearly half of the answer sources (45.9%) were found to be lacking in transparency. One-way analysis of variance revealed a significant difference in mean Brief DISCERN scores among the 5 source types, F(4, 119) = 5.93, P = .0002, with medical practices averaging the worst score (13.73/30). CONCLUSIONS Patients are most commonly searching Google to gain information regarding CTS treatment options. Online sources such as medical practices should use widely accepted rubrics for ensuring transparency and quality prior to publishing CTS information.
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Affiliation(s)
- Samuel Shepard
- Oklahoma State University Center for Health Sciences, Tulsa, USA
| | | | | | - Griffin Hughes
- Oklahoma State University Center for Health Sciences, Tulsa, USA
| | | | - Brian Chalkin
- Oklahoma State University Medical Center, Tulsa, USA
| | - Micah Hartwell
- Oklahoma State University Center for Health Sciences, Tulsa, USA
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Tulsa, USA
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Singh SK, Chauhan A, Alderman H, Avula R, Dwivedi LK, Kapoor R, Meher T, Menon P, Nguyen PH, Pedgaonker S, Puri P, Chakrabarti S. Utilization of Integrated Child Development Services (ICDS) and its linkages with undernutrition in India. MATERNAL & CHILD NUTRITION 2024; 20:e13644. [PMID: 38586943 PMCID: PMC11168363 DOI: 10.1111/mcn.13644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/29/2024] [Accepted: 03/04/2024] [Indexed: 04/09/2024]
Abstract
The Integrated Child Development Services (ICDS) programme has been the central focus of the POSHAN Abhiyaan to combat maternal and child malnutrition under the national nutrition mission in India. This paper examined the linkages between utilization of ICDS and underweight among children aged 6-59 months. The study utilized data from two recent rounds of the National Family Health Survey (NFHS-4 [2015-2016] and NFHS-5 [2019-2021]). Descriptive analyses were used to assess the change in utilization of ICDS and the prevalence of underweight at the national and state levels. Multivariable logistic regressions were performed to examine factors associated with the utilization of ICDS and underweight. Linkages between utilization of ICDS and underweight were examined using the difference-in-differences (DID) approach. Utilization of ICDS increased from 58% in 2015-2016 to 71% in 2019-2021. The prevalence of underweight decreased from 37% to 32% in the same period. Changes in ICDS utilization and underweight prevalence varied considerably across states, socioeconomic and demographic characteristics. Results from decomposition of DID models suggest that improvements in ICDS explained 9%-12% of the observed reduction in underweight children between 2016 and 2021, suggesting that ICDS made a modest but meaningful contribution in addressing undernutrition among children aged 6-59 months in this period.
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Affiliation(s)
- Shri K. Singh
- International Institute for Population SciencesMumbaiIndia
| | - Alka Chauhan
- The International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | - Harold Alderman
- The International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | - Rasmi Avula
- The International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | | | - Rati Kapoor
- The International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | - Trupti Meher
- International Institute for Population SciencesMumbaiIndia
| | - Purnima Menon
- The International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | - Phuong H. Nguyen
- The International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
| | | | - Parul Puri
- International Institute for Population SciencesMumbaiIndia
| | - Suman Chakrabarti
- The International Food Policy Research InstituteWashingtonDistrict of ColumbiaUSA
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Michaels BS, Ayers T, Brooks-McLaughlin J, McLaughlin RJ, Sandoval-Warren K, Schlenker C, Ronaldson L, Ardagh S. Potential for Glove Risk Amplification via Direct Physical, Chemical, and Microbiological Contamination. J Food Prot 2024; 87:100283. [PMID: 38679200 DOI: 10.1016/j.jfp.2024.100283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
This review focuses on the potential direct physical, chemical, and microbiological contamination from disposable gloves when utilized in food environments, inclusive of the risks posed to food products as well as worker safety. Unrecognized problems endemic to glove manufacturing were magnified during the COVID-19 pandemic due to high demand, increased focus on PPE performance, availability, supply chain instability, and labor shortages. Multiple evidence-based reports of contamination, toxicity, illness, deaths, and related regulatory action linked to contaminated gloves in food and healthcare have highlighted problems indicative of systemic glove industry shortcomings. The glove manufacturing process was diagramed with sources and pathways of contamination identified, indicating weak points with documented occurrences detailed. Numerous unsafe ingredients can introduce chemical contaminants, potentially posing risks to food and to glove users. Microbial hazards present significant challenges to overall glove safety as contaminants appear to be introduced via polluted water sources or flawed glove manufacturing processes, resulting in increased risks within food and healthcare environments. Frank and opportunistic pathogens along with food spoilage organisms can be introduced to foods and wearers. When the sources and pathways of glove-borne contamination were explored, it was found that physical failures play a pivotal role in the release of sweat build-up, liquefaction of chemical residues, and incubation of microbial contaminants from hands and gloves. Thus, with glove physical integrity issues, including punctures in new, unused gloves that can develop into significant rips and tears, not only can direct physical food contamination occur but also chemical and microbiological contamination can find their way into food. Enhanced regulatory requirements for Acceptable Quality Limits of food-grade gloves, and the establishment of appropriate bioburden standards would enhance safety in food applications. Based on the information provided, together with a false sense of security associated with glove use, the unconditional belief in glove chemical and microbiological purity may be unfounded.
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Affiliation(s)
- Barry S Michaels
- B. Michaels Group Inc., 487 West River Road, Palatka, FL 32177, USA.
| | - Troy Ayers
- Eurofins Microbiology Laboratories Inc., Des Moines, IA 50321, USA
| | | | | | | | | | - Lynda Ronaldson
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
| | - Steve Ardagh
- Eagle Protect PBC, South Lake Tahoe, CA 96150, USA; Eagle Protect Ltd. Christchurch 8011, New Zealand
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Wagnew F, Alene KA, Kelly M, Gray D. Undernutrition increases the risk of unsuccessful treatment outcomes of patients with tuberculosis in Ethiopia: A multicenter retrospective cohort study. J Infect 2024; 89:106175. [PMID: 38729526 DOI: 10.1016/j.jinf.2024.106175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 04/26/2024] [Accepted: 05/01/2024] [Indexed: 05/12/2024]
Abstract
BACKGROUND While undernutrition has been identified as a common risk factor for tuberculosis (TB), its impact on treatment outcomes has yet to be investigated in high TB burden and low-income countries such as Ethiopia. Therefore, this study aimed to investigate the effect of undernutrition on treatment outcomes among patients with TB in northwest Ethiopia. METHODS A retrospective cohort study was conducted using data from different hospitals in northwest Ethiopia, for the period from July 2017 to August 2023. A Cox proportional hazard model was performed to determine the effect of undernutrition on TB treatment outcomes, which were defined as a composite of death, treatment failure, or loss to follow-up. RESULTS A total of 602 patients with TB were included in the analysis. Of these, 367 (60.9%) were male, and 344 (57.1%) were undernourished. Upon completion of the follow-up period, 65 (10.8%) adults with TB had unsuccessful treatment outcomes. After adjusting for potential confounders, patients with undernutrition had a two times higher risk of experiencing unsuccessful treatment outcomes compared to well-nourished patients (AHR: 2.0, 95% CI: 1.2, 3.6). In addition, patients residing in rural areas (AHR: 3.1, 95% CI: 1.7, 5.4), having a history of prior TB treatment (AHR: 2.2, 95%CI: 1.1, 4.1), and the presence of diabetes comorbidity (AHR: 2.4, 95% CI: 1.1, 5.2) were at higher risk of unsuccessful treatment outcomes. CONCLUSIONS Undernutrition increases the risk of unsuccessful treatment outcomes in Ethiopia. This finding suggests that nutritional support during TB treatment can improve successful treatment outcomes in high TB burden and low-income countries such as Ethiopia.
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Affiliation(s)
- Fasil Wagnew
- National Centre for Epidemiology and Population Health (NCEPH), College of Health and Medicine, The Australian National University, Canberra, Australia; College of Health Sciences, Debre Markos University, Debre Markos, Ethiopia; Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Nedlands, Western Australia, Australia.
| | - Kefyalew Addis Alene
- Geospatial and Tuberculosis Research Team, Telethon Kids Institute, Nedlands, Western Australia, Australia; School of Population Health, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
| | - Matthew Kelly
- National Centre for Epidemiology and Population Health (NCEPH), College of Health and Medicine, The Australian National University, Canberra, Australia
| | - Darren Gray
- Population Health Program, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
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Cheetham A, Grist E, Nielsen S. Pharmacist-prescriber collaborative models of care for opioid use disorder: an overview of recent research. Curr Opin Psychiatry 2024; 37:251-257. [PMID: 38726819 DOI: 10.1097/yco.0000000000000943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/01/2024]
Abstract
PURPOSE OF REVIEW Collaborative models of care where pharmacists work alongside physicians have been developed for a range of physical health conditions, with benefits including improved patient outcomes and increased access to ongoing care. Opioid agonist treatment (methadone and buprenorphine) is a clinically effective and cost-effective treatment for opioid use disorder that is under-utilized in many countries due to a shortage of prescribers. In recent years, there has been increased interest in the development of collaborative models that utilize pharmacists to overcome barriers to treatment. In this article, we present a narrative review to synthesise recent work in this rapidly developing area. RECENT FINDINGS Two key aspects of opioid agonist treatment were identified: Collaborative models have utilized pharmacists to facilitate buprenorphine induction, and collaborative models provide increased capacity for delivering ongoing care in a variety of settings and patient groups where prescriber access is limited. Pharmacists have undertaken direct patient care responsibilities with varying degrees of autonomy, with benefits including a reduction in prescriber workload, and improvements in treatment retention and continuity of care. SUMMARY Collaborative models in which pharmacists are responsible for buprenorphine induction and ongoing management with methadone and buprenorphine have been shown to reduce demands on prescribers while improving or maintaining patient outcomes, and appear feasible and acceptable in a wide range of outpatient settings.
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Affiliation(s)
- Ali Cheetham
- Monash Addiction Research Centre, Eastern Health Clinical School, Monash University Peninsula Campus, Frankston, Victoria, Australia
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Liang J, Li Z, Dong H, Xu C, Yin C. A Randomized Controlled Clinical Trial Investigating the Weaning Process From Mechanical Ventilation in Elderly Patients With Dementia. THE CLINICAL RESPIRATORY JOURNAL 2024; 18:e13808. [PMID: 39012086 PMCID: PMC11250139 DOI: 10.1111/crj.13808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/11/2024] [Accepted: 06/29/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND Limited data is available regarding the weaning techniques employed for mechanical ventilation (MV) in elderly patients with dementia in China. OBJECTIVE The primary objective of this study is to investigate diverse weaning methods in relation to the prognostic outcomes of elderly patients with dementia undergoing MV in the intensive care unit (ICU). Specifically, we seek to compare the prognosis, likelihood of successful withdrawal from MV, and the length of stay (LOS) in the ICU. METHODS The study was conducted as a randomized controlled trial, encompassing a group of 169 elderly patients aged ≥ 65 years with dementia who underwent MV. Three distinct weaning methods were used for MV cessation, namely, the tapering parameter, spontaneous breathing trial (SBT), and SmartCare (Dräger, Germany). RESULTS In the tapering parameter group, the LOS in the ICU was notably prolonged compared to both the SBT and SmartCare groups. However, no statistically significant differences were observed among the groups with respect to demographic characteristics, such as age and sex, as well as factors including the rationale for ICU admission, cause of MV, MV mode, oxygenation index, hemoglobin levels, albumin levels, ejection fraction, sedation and analgesia practices, tracheotomy, duration of MV, successful extubation, successful weaning, incidences of ventilator-associated pneumonia, and overall prognosis. CONCLUSIONS Both the SBT and SmartCare withdrawal methods demonstrated a reduction in the duration of MV and LOS in the ICU when compared to the tapering parameter method. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR1900028449.
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Affiliation(s)
- Jian‐Feng Liang
- Department of Intensive Care UnitBeijing Geriatric HospitalBeijingChina
| | - Zhi‐Yong Li
- Department of Intensive Care UnitBeijing Geriatric HospitalBeijingChina
| | - Hai‐Shan Dong
- Department of Intensive Care UnitBeijing Geriatric HospitalBeijingChina
| | - Chang Xu
- Department of Intensive Care UnitBeijing Geriatric HospitalBeijingChina
| | - Chao‐Qun Yin
- Department of Intensive Care UnitBeijing Geriatric HospitalBeijingChina
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