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Jarnecke AM, Saraiya TC. Identifying best practices for substance-related intimate partner violence screening and referral: a narrative review. Front Psychiatry 2024; 15:1380102. [PMID: 38957738 PMCID: PMC11217329 DOI: 10.3389/fpsyt.2024.1380102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 05/29/2024] [Indexed: 07/04/2024] Open
Abstract
Introduction Substance use is strongly associated with intimate partner violence (IPV) and is a modifiable risk factor for IPV. However, lack of comprehensive screening and referral for co-occurring IPV and substance use, along with their psychiatric sequalae, limits the identification and implementation of effective interventions for substance-related IPV. This narrative review (1) investigates the literature on screening and referral practices for IPV, and if these include screening for substance use or other psychiatric comorbidities, (2) provides recommendations for current best practices, and (3) suggests future directions for research and practice aimed at identifying and reducing substance-related IPV. Methods A narrative literature review examined studies investigating IPV screening and referral programs in clinics. Selected studies were reviewed for: (1) effectiveness, (2) barriers to implementation and sustainability, and (3) responsivity to psychiatric comorbidity, including substance use and substance use disorders (SUD). Results Findings suggest that effective IPV screening and referral programs have been developed, but disparities in IPV screening exist and many programs only screen for IPV victimization. Barriers to the implementation and sustainability of IPV screening programs include lack of ongoing provider training, funding or institutional support, and direct connection to referral services. Further, many IPV screening programs lack assessment of and referral for comorbid psychiatric conditions, including substance use, and tend not to be routinely implemented in SUD clinics. Discussion Additional systematic work is needed to develop universal and comprehensive screening and referral programs for substance-related IPV and address issues of long-term sustainability, particularly within SUD treatment settings.
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Affiliation(s)
- Amber M. Jarnecke
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
| | - Tanya C. Saraiya
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, SC, United States
- Center of Alcohol & Substance Use Studies, Rutgers University-New Brunswick, Piscataway, NJ, United States
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202
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Bakhsh H. Retrospective Analysis of Effective Management Strategies for Primary Amenorrhea of Reproductive Age in Saudi Arabia. Life (Basel) 2024; 14:772. [PMID: 38929754 PMCID: PMC11204569 DOI: 10.3390/life14060772] [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: 05/10/2024] [Revised: 06/08/2024] [Accepted: 06/13/2024] [Indexed: 06/28/2024] Open
Abstract
Primary amenorrhea, the absence of menstruation by age 15, can have significant implications for reproductive health and overall well-being. This retrospective study aimed to evaluate the effectiveness of various management strategies for primary amenorrhea among women of reproductive age in Saudi Arabia. Medical records of 63 eligible patients from 2018 to 2023 were analyzed, assessing diagnostic methods, treatment modalities, and associated outcomes. The findings revealed that hormonal therapy was the most commonly employed management strategy (50.0%) and demonstrated the highest rate of achieving menstrual regularity (62.5%). Surgical interventions were utilized in 28.1% of cases, with a 50.0% rate of symptom resolution. Lifestyle modifications were less frequent (21.9%) but showed a moderate rate of symptom resolution (35.7%). Logistic regression analysis identified age, underlying etiology, and management strategy as significant predictors of treatment success. Subgroup analyses highlighted the efficacy of hormonal therapy and lifestyle modifications for genetic etiologies, while surgical interventions were more effective for anatomical causes. The study underscores the importance of a comprehensive diagnostic approach and personalized treatment plans tailored to individual patient characteristics. Despite limitations, the findings contribute to the understanding of optimal management strategies for primary amenorrhea and emphasize the need for multidisciplinary collaboration in addressing this complex condition.
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Affiliation(s)
- Hanadi Bakhsh
- Obstetrics and Gynecology Department, College of Medicine, Princess Nourah bint Abdulrahman University, Riyadh 11564, Saudi Arabia;
- Department of Obstetrics and Gynecology, King Abdullah Bin Abdulaziz University Hospital, Princess Nourah bint Abdulrahman University, Riyadh 11671, Saudi Arabia
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203
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Kittelson T, Kittelson-Aldred A, Justad JM, Hoffman LA, Coombs NC. The Montana Postural Care Project: A pilot study implementing posture care management in a rural, low-resource region. Heliyon 2024; 10:e31752. [PMID: 38841462 PMCID: PMC11152931 DOI: 10.1016/j.heliyon.2024.e31752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/07/2024] Open
Abstract
Background Mobility impairment limits control of posture and body alignment. This leads to altered body shapes, co-occurring problems with pain and sleep, cardiopulmonary concerns, digestive health issues, and emergent health outcomes, which further complicate functions of daily living. 24-hour posture care management was developed to remedy these challenges by restoring body symmetry. Objective To determine the feasibility of introducing posture care management to a rural-based, medically complex patient population, evaluate response of body symmetry, and examine its impact on pain and sleep quality. Methods This pilot study employed a longitudinal, quasi-experimental study design from March 2016 to September 2018. The posture care management intervention introduced positioning support for use when lying down, a personalized training workshop for caregiver teams, and in-home initial and follow-up assessments to provide materials and collaboratively develop a personalized care plan. Participants were followed pre-post for 6-9 months. Results A total of 73 participants enrolled in the study; 55 (75 %) completed. The majority were male (55 %) with a median age of 11. Most caregivers were immediate family members, and most participants had 1+ diagnosis characterized as a neurodevelopmental disorder. A majority of participants improved body symmetry (56-76 %), and 53 % with comparable information saw improvement in body symmetry with no worsening of pain or sleep quality. Conclusion This study established the feasibility of administering posture care management in North America. These findings provide preliminary evidence of improvements in body symmetry and address concerns that posture care management can interfere with pain and sleep. Future research should consider levels of caregiver engagement and explore remote-monitored options of a posture care management intervention.
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Affiliation(s)
- Tamara Kittelson
- Posture 24/7, Minneapolis, MN, USA
- Specialty Occupational Therapy, LLC, Minneapolis, MN, USA
| | | | - Jean M. Justad
- Montana Developmental Disability Program, Department of Public Health and Human Services, Helena, MT, USA
| | | | - Nicholas C. Coombs
- School of Public & Community Health Sciences, University of Montana, Missoula, MT, USA
- Piedmont Research Strategies, Greensboro, NC, USA
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204
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Gao P, Zhou C, Ruan Z, Zhang Z, Fang X. Association between caregiver-child interaction and autistic-like behaviors at around three years of age. J Affect Disord 2024; 355:326-332. [PMID: 38556097 DOI: 10.1016/j.jad.2024.03.078] [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: 08/21/2023] [Revised: 02/29/2024] [Accepted: 03/12/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND The prevalence of autistic-like behaviors is increasing worldwide, both in developed and developing countries. With a high disease burden and complex developmental causes, there has been much interest in the etiology of the disease, and there is a lack of evidence on the relationship between caregiver-child interaction and autistic-like behaviors. AIM/OBJECTIVE This study investigated the association between caregiver-child interaction and children's autistic-like behaviors during early childhood. METHOD The subjects of this study were 171 kindergartens selected from the Longhua Child Cohort Study (LCCS), and a total of 40,237 children around the age of three were included. Sociodemographic characteristics, family income, and frequency of interaction between caregivers and children were all filled in by the child's primary caregiver, and the adapted Chinese Autism Behavior Checklist was used to assess children's autism-like behaviors. Tobit Regression and ancovariance analysis (ANCOVA) were used to measure the relationship between caregiver-child interactions (family and social activities) and autism-like behaviors, with a two-tailed p value of <0.05 being significant. RESULTS Tobit regression analyses found that in the 0-1 year age group, different frequencies of singing activities by caregivers with children (<3 times per week, 3-6 times per week, 6 times or more per week) were significantly negatively associated with autistic-like behaviors in a dose-response manner (B values of -0.323, -0.381, -0.544, all p < 0.0001); in the 1-3 year age group, different frequencies of reading interactions by caregivers with children (<3 times per week, 3-6 times per week, 6 times or more per week) were also significantly negatively associated with autistic-like behaviors in a dose-response manner (B values of -0.388, -0.632, -0.956, all p < 0.0001), and similar associations were found in singing and chatting interactions. CONCLUSIONS Our findings suggest that higher frequencies of early caregiver-child interactions are associated with lower levers of autistic-like behaviors in children around the age of three years.
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Affiliation(s)
- Peng Gao
- Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Cheng Zhou
- Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Zhaohui Ruan
- Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Zixing Zhang
- Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China
| | - Xinyu Fang
- Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
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205
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Casella Jean-Baptiste M, Vital Julmiste TM, Ball E. Health Information System Strengthening During Antenatal Care in Haiti: Continuous Quality Improvement Study. JMIR Form Res 2024; 8:e55000. [PMID: 38875702 PMCID: PMC11214024 DOI: 10.2196/55000] [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: 11/29/2023] [Revised: 04/02/2024] [Accepted: 05/03/2024] [Indexed: 06/16/2024] Open
Abstract
BACKGROUND Journey to 9 Plus (J9) is an integrated reproductive, maternal, neonatal, and child health approach to care that has at its core the goal of decreasing the rate of maternal and neonatal morbidity and mortality in rural Haiti. For the maximum effectiveness of this program, it is necessary that the data system be of the highest quality. OpenMRS, an electronic medical record (EMR) system, has been in place since 2013 throughout a tertiary referral hospital, the Hôpital Universitaire de Mirebalais, in Haiti and has been expanded for J9 data collection and reporting. The J9 program monthly reports showed that staff had limited time and capacity to perform double charting, which contributed to incomplete and inconsistent reports. Initial evaluation of the quality of EMR data entry showed that only 18% (58/325) of the J9 antenatal visits were being documented electronically at the start of this quality improvement project. OBJECTIVE This study aimed to improve the electronic documentation of outpatient antenatal care from 18% (58/325) to 85% in the EMR by J9 staff from November 2020 to September 2021. The experiences that this quality improvement project team encountered could help others improve electronic data collection as well as the transition from paper to electronic documentation within a burgeoning health care system. METHODS A continuous quality improvement strategy was undertaken as the best approach to improve the EMR data collection at Hôpital Universitaire de Mirebalais. The team used several continuous quality improvement tools to conduct this project: (1) a root cause analysis using Ishikawa and Pareto diagrams, (2) baseline evaluation measurements, and (3) Plan-Do-Study-Act improvement cycles to document incremental changes and the results of each change. RESULTS At the beginning of the quality improvement project in November 2020, the baseline data entry for antenatal visits was 18% (58/325). Ten months of improvement strategies resulted in an average of 89% (272/304) of antenatal visits documented in the EMR at point of care every month. CONCLUSIONS The experiences that this quality improvement project team encountered can contribute to the transition from paper to electronic documentation within burgeoning health care systems. Essential to success was having a strong and dedicated nursing leadership to transition from paper to electronic data and motivated nursing staff to perform data collection to improve the quality of data and thus, the reports on patient outcomes. Engaging the nursing team closely in the design and implementation of EMR and quality improvement processes ensures long-term success while centering nurses as key change agents in patient care systems.
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Affiliation(s)
| | | | - Ellen Ball
- Partners In Health, Boston, MA, United States
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206
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Soares GH, Haag D, Bastos JL, Mejia G, Jamieson L. Triple Jeopardy in Oral Health: Additive Effects of Immigrant Status, Education, and Neighborhood. JDR Clin Trans Res 2024:23800844241253518. [PMID: 38877725 DOI: 10.1177/23800844241253518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2024] Open
Abstract
PURPOSE To estimate the additive effects of parent's nativity status/language spoken at country of birth, education, and area-level socioeconomic status (SES) on untreated dental caries among children aged 5 to 9 y in Australia. METHODS Cross-sectional population-based data were obtained from the 2014 National Child Oral Health Study (N = 12,140). Indicators of social position used to explore additive effects on dental caries included nativity status, language, university degree, and neighborhood socioeconomic level. Multiple-way interactions were examined, and departure from additivity resulting from 2- and 3-way interactions were estimated as relative excess risk due to interaction (RERI). RESULTS Children marginalized across multiple layers of disadvantage had substantially higher frequencies of dental caries compared with children in the most advantaged category. RERI for the 3-way interaction between immigrant status, education, and neighborhood SES was negative (RERI3: -0.14; 95% confidence interval [CI]: -1.68, 1.40). When operationalizing language, education, and neighborhood SES, the joint effect of the 3 marginalized positions was additive (RERI3: 0.43; 95% CI: -2.08, 2.95). CONCLUSION Children marginalized across multiple intersecting axes of disadvantage bear the greatest burden of dental caries, with frequencies surpassing the cumulative effect of each social position alone. Findings emphasize the need to account for intersecting inequities and their oral health effects among children with immigrant backgrounds. KNOWLEDGE TRANSFER STATEMENT Our analysis underscores the necessity for policies and public health strategies targeting dental caries-related inequities to comprehensively account for various indicators of social disadvantage, particularly encompassing language proficiency, educational attainment, and neighborhood socioeconomic status. Within the intricate interplay of these factors, we identify a vulnerable subgroup comprising children with the highest prevalence of dental decay. Therefore, prioritizing this specific demographic should be the focal point of policies and public health initiatives aimed at fostering equitable oral health outcomes.
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Affiliation(s)
- G H Soares
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - D Haag
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - J L Bastos
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - G Mejia
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
| | - L Jamieson
- Australian Research Centre for Population Oral Health, Adelaide Dental School, The University of Adelaide, Adelaide, SA, Australia
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207
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Ren J, Ren Y, Mu Y, Zhang L, Chen B, Li S, Fang Q, Zhang Z, Zhang K, Li S, Liu W, Cui Y, Li X. Microbial imbalance in Chinese children with diarrhea or constipation. Sci Rep 2024; 14:13516. [PMID: 38866797 PMCID: PMC11169388 DOI: 10.1038/s41598-024-60683-6] [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: 12/15/2023] [Accepted: 04/26/2024] [Indexed: 06/14/2024] Open
Abstract
Diarrhea and constipation are common health concerns in children. Numerous studies have identified strong association between gut microbiota and digestive-related diseases. But little is known about the gut microbiota that simultaneously affects both diarrhea and constipation or their potential regulatory mechanisms. Stool samples from 618 children (66 diarrhea, 138 constipation, 414 healthy controls) aged 0-3 years were collected to investigate gut microbiota changes using 16S rRNA sequencing. Compared with healthy, children with diarrhea exhibited a significant decrease in microbial diversity, while those with constipation showed a marked increase (p < 0.05). Significantly, our results firstly Ruminococcus increased in constipation (p = 0.03) and decreased in diarrhea (p < 0.01) compared to healthy controls. Pathway analysis revealed that Ruminococcus highly involved in the regulation of five common pathways (membrane transport, nervous system, energy metabolism, signal transduction and endocrine system pathways) between diarrhea and constipation, suggesting a potential shared regulatory mechanism. Our finding firstly reveals one core microorganisms that may affect the steady balance of the gut in children with diarrhea or constipation, providing an important reference for potential diagnosis and treatment of constipation and diarrhea.
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Affiliation(s)
- Jing Ren
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Yi Ren
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Yu Mu
- Dr. Cuiyutao Healthcare Co., Ltd., Beijing, China
| | - Lanying Zhang
- Coyote Diagnostics Lab (Beijing) Co., Ltd., Beijing, China
| | - Binghan Chen
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Sisi Li
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Qinyi Fang
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Zhiming Zhang
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Kejian Zhang
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Sabrina Li
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China
| | - Wei Liu
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.
| | - Yutao Cui
- Dr. Cuiyutao Healthcare Co., Ltd., Beijing, China.
| | - Xu Li
- Coyote Bioscience (Beijing) Co., Ltd., Beijing, China.
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208
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Kayali Akyol A, Ataus A, Gülhan B, Kanik Yüksek S. Pancreatitis as a Complication of Crimean-Congo Hemorrhagic Fever in a Child. Pediatr Infect Dis J 2024:00006454-990000000-00893. [PMID: 38865579 DOI: 10.1097/inf.0000000000004420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/14/2024]
Affiliation(s)
- Aylin Kayali Akyol
- Department of Pediatrics, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Aybars Ataus
- Department of Pediatrics, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Belgin Gülhan
- Department of Pediatric Infectious Diseases, University of Health Science, Ankara City Hospital, Ankara, Turkey
| | - Saliha Kanik Yüksek
- Department of Pediatric Infectious Diseases, University of Health Science, Ankara City Hospital, Ankara, Turkey
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209
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Athan AM. A critical need for the concept of matrescence in perinatal psychiatry. Front Psychiatry 2024; 15:1364845. [PMID: 38962063 PMCID: PMC11220490 DOI: 10.3389/fpsyt.2024.1364845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 05/06/2024] [Indexed: 07/05/2024] Open
Abstract
The concept of matrescence, akin to adolescence but for mothers, has gained increasing attention in perinatal psychiatry, marking a paradigm shift towards understanding the holistic development of mothers. Matrescence encompasses the myriad psychological, social, cultural, and existential changes which occur as women transition into motherhood. Despite advances in maternal mental health, a bias towards pathologizing maternal experiences persists in research and practice. This commentary advocates for the integration of matrescence into perinatal psychiatry, drawing from the work of Dana Raphael and contemporary scholarship. Matrescence offers a strengths-based framework that acknowledges both the challenges and opportunities of motherhood, emphasizing the normative aspects of a mother's self-development. By adopting matrescence terminology and nosology, clinicians and researchers can enhance traditional psychiatric classifications. Additionally, matrescence underscores the importance of considering ecological systems and historical factors in maternal well-being, highlighting the need for comprehensive and compassionate healthcare services. Embracing matrescence as a fundamental concept in perinatal psychiatry holds promise for improving maternal mental health outcomes and promoting the flourishing of mothers worldwide.
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Affiliation(s)
- Aurelie M. Athan
- Teachers College, Columbia University, New York City, NY, United States
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210
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Pittiruti M, Crocoli A, Zanaboni C, Annetta MG, Bevilacqua M, Biasucci DG, Celentano D, Cesaro S, Chiaretti A, Disma N, Mancino A, Martucci C, Muscheri L, Pini Prato A, Raffaele A, Reali S, Rossetti F, Scoppettuolo G, Sidro L, Zito Marinosci G, Pepe G. The pediatric DAV-expert algorithm: A GAVeCeLT/GAVePed consensus for the choice of the most appropriate venous access device in children. J Vasc Access 2024:11297298241256999. [PMID: 38856094 DOI: 10.1177/11297298241256999] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2024] Open
Abstract
In pediatric patients, the choice of the venous access device currently relies upon the operator's experience and preference and on the local availability of specific resources and technologies. Though, considering the limited options for venous access in children if compared to adults, such clinical choice has a great critical relevance and should preferably be based on the best available evidence. Though some algorithms have been published over the last 5 years, none of them seems fully satisfactory and useful in clinical practice. Thus, the GAVePed-which is the pediatric interest group of the most important Italian group on venous access, GAVeCeLT-has developed a national consensus about the choice of the venous access device in children. After a systematic review of the available evidence, the panel of the consensus (which included Italian experts with documented competence in this area) has provided structured recommendations answering 10 key questions regarding the choice of venous access both in emergency and in elective situations, both in the hospitalized and in the non-hospitalized child. Only statements reaching a complete agreement were included in the final recommendations. All recommendations were also structured as a simple visual algorithm, so as to be easily translated into clinical practice.
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Affiliation(s)
- Mauro Pittiruti
- Department of Surgery, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Alessandro Crocoli
- Surgical Oncology Unit, Bambino Gesù Children Hospital IRCCS, Rome Italy
| | - Clelia Zanaboni
- Department of Anesthesia and Intensive Care, University Hospital, Parma, Italy
| | - Maria Giuseppina Annetta
- Department of Anesthesia and Intensive Care, Catholic University Hospital "A.Gemelli," Rome, Italy
| | | | - Daniele G Biasucci
- Department of Clinical Science and Translational Medicine, "Tor Vergata" University, Rome, Italy
| | - Davide Celentano
- Department of Oncology, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Simone Cesaro
- Department of Pediatric Oncology and Hematology, University Hospital, Verona, Italy
| | - Antonio Chiaretti
- Department of Pediatrics, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Nicola Disma
- Unit for Research in Anaesthesia, Gaslini Children Hospital IRCCS, Genova, Italy
| | - Aldo Mancino
- Pediatric Intensive Care Unit, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Cristina Martucci
- Surgical Oncology Unit, Bambino Gesù Children Hospital IRCCS, Rome Italy
| | - Lidia Muscheri
- Pediatric Intensive Care Unit, Catholic University Hospital "A.Gemelli," Rome, Italy
| | - Alessio Pini Prato
- Pediatric Surgery Unit, Umberto Bosio Center for Digestive Diseases, Children Hospital, Alessandria, Italy
| | - Alessandro Raffaele
- Pediatric Surgery Unit, Department of Maternal and Child Health, San Matteo Hospital IRCCS, Pavia, Italy
| | - Simone Reali
- Surgical Oncology Unit, Bambino Gesù Children Hospital IRCCS, Rome Italy
| | - Francesca Rossetti
- Department of Anesthesia and Intensive Care, Meyer Children Hospital IRCCS, Firenze, Italy
| | | | - Luca Sidro
- Department of Anesthesia and Intensive Care, Santobono-Pausilipon Children Hospital, Napoli, Italy
| | - Geremia Zito Marinosci
- Department of Anesthesia and Intensive Care, Santobono-Pausilipon Children Hospital, Napoli, Italy
| | - Gilda Pepe
- Department of Surgery, Catholic University Hospital "A.Gemelli," Rome, Italy
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Li H, Li J, Wang X, Zhang Z. A systematic review and meta-analysis of acupuncture in aspiration caused by post-stroke dysphagia. Front Neurol 2024; 15:1305056. [PMID: 38915795 PMCID: PMC11194430 DOI: 10.3389/fneur.2024.1305056] [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: 10/03/2023] [Accepted: 05/29/2024] [Indexed: 06/26/2024] Open
Abstract
Objective This systematic review and meta-analysis aims to systematically evaluate the effectiveness and safety of acupuncture in the treatment of aspiration caused by post-stroke dysphagia. Methods A computer search was conducted in nine databases, including the China National Knowledge Infrastructure (CNKI), China Science and Technology Journal (VIP), Wan-fang Database, China Biomedical Literature Database (CBM), PubMed, Web of Science, Cochrane Library, Embase, and Chinese Clinical Trial Registry (ChiCTR), from their inception until April 2024. Clinical randomized controlled trials comparing acupuncture combined therapy or single therapy with control interventions for the treatment of aspiration caused by post-stroke dysphagia were included. The primary outcome measure was the Penetration Aspiration Scale (PAS), and secondary outcome measures included the overall effective rate, video fluoroscopic swallowing study (VFSS), and hyoid bone displacement. The statistical analysis was performed using RevMan 5.3 and Stata 16.0. Results A total of 16 articles involving 1,284 patients were included. The meta-analysis results showed that acupuncture combined therapy or single therapy was more effective in improving PAS scores compared to conventional rehabilitation therapy or balloon dilation of the catheter [WMD = -1.05, 95% CI (-1.30, -0.80), Z = 0.82, p = 0.00 < 0.05]. It was also more effective in improving VFSS scores [WMD = 1.32, 95% CI (0.08, 2.55), Z = 2.09, p = 0.04 < 0.05] and hyoid bone displacement [WMD = 2.02, 95% CI (0.86, 3.18), Z = 3.41, p = 0.00 < 0.05]. Additionally, acupuncture had a higher overall effective rate [WMD = 1.21, 95% CI (1.14, 1.29), Z = 5.76, p = 0.00 < 0.05] and a lower incidence of adverse events. Sensitivity analysis indicated that the literature had minimal impact on the results, and bias tests showed no publication bias. Conclusion Acupuncture combined therapy and acupuncture single therapy can effectively improve aspiration caused by post-stroke dysphagia with a low incidence of adverse events. However, due to the low quality of the included literature, more high-quality randomized controlled trials are still needed to confirm the effectiveness and safety of acupuncture in the treatment of aspiration caused by post-stroke dysphagia. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023462707, identifier CRD42023462707.
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Affiliation(s)
- Hongwei Li
- Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Jie Li
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Xu Wang
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
| | - Zhilong Zhang
- Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
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212
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Zalewska A, Gałczyk M. Fatigue, Internet Addiction and Symptoms of Long COVID-A Cross-Sectional Study of Polish Students. J Clin Med 2024; 13:3383. [PMID: 38929912 PMCID: PMC11205095 DOI: 10.3390/jcm13123383] [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: 04/28/2024] [Revised: 06/04/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Introduction: Fatigue is the most persistent symptom in patients with long COVID. Moreover, Internet addiction itself has become a pandemic long-term effect. The aim of this study was to investigate the degree of fatigue and Internet addiction in a group of students with COVID-19 and to determine the relationship between fatigue and addiction in students with and without long COVID symptoms. Material and methods: A cross-sectional study was conducted among 402 Polish students aged 19-26. The 183 students who had COVID-19 signaled the presence of long COVID symptoms, which corresponded to 45.5% of the surveyed group. The Modified Fatigue Impact Scale was used to assess the level of fatigue, and the Kimberly Young questionnaire was used to assess the level of Internet addiction. Results: 19.7% (95% c.i.: 15.9-23.9%) of the students surveyed had a moderate level of Internet dependence (Internet addiction measure value of 50 points or more). Most of them did not complain of high levels of fatigue. Higher levels of dependence and fatigue were observed in subjects with long COVID symptoms (MFIS mean value was 26.5 in this group vs. 17.7 in the others; p = 0.0000 ***). The higher the respondents' level of dependence, the more they tended to feel tired (correlations were stronger in those with long COVID symptoms: rS = 0.23; p = 0.0017 **). Conclusions: In view of the results obtained, the study presented here has the potential to contribute to the international debate on the long-term health consequences of the COVID-19 pandemic and strategies to address them. The study provides data that may be useful in the development of educational and health policies that target the psychophysical well-being of patients with long COVID symptoms. This process should be considered as a long-term endeavor.
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Affiliation(s)
- Anna Zalewska
- Faculty of Health Sciences, University of Lomza, 14 Akademicka St., 18-400 Lomza, Poland;
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213
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Nohara N, Hiraide M, Horie T, Takakura S, Hata T, Sudo N, Yoshiuchi K. The optimal cut-off score of the Eating Attitude Test-26 for screening eating disorders in Japan. Eat Weight Disord 2024; 29:42. [PMID: 38850379 PMCID: PMC11162384 DOI: 10.1007/s40519-024-01669-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 05/26/2024] [Indexed: 06/10/2024] Open
Abstract
PURPOSE The Eating Attitude Test-26 (EAT-26) is a screening tool for eating disorders (EDs) in clinical and non-clinical samples. The cut-off score was suggested to be varied according to target population. However, no studies have examined the appropriateness of the originally proposed score of 20 for screening DSM-5 eating disorders in Japan. This study aimed to identify an appropriate cut-off score to better differentiate clinical and non-clinical samples in Japan for EDs. METHODS The participants consisted of 54 patients with anorexia nervosa restricting type, 58 patients with anorexia nervosa binge-eating/purging type, 37 patients with bulimia nervosa diagnosed according to DSM-5 criteria, and 190 healthy controls (HCs). Welch's t test was used to assess differences in age, body mass index (BMI), and total EAT-26 scores between HCs and patients with EDs. Receiver operating characteristic (ROC) analysis was conducted to identify the optimal cut-off score. RESULTS The HCs had significantly higher BMI and lower total EAT-26 mean scores than patients with EDs. The area under the ROC curve was 0.925, indicating that EAT-26 had excellent performance in discriminating patients with EDs from HCs. An optimal cut-off score of 17 was identified, with sensitivity and specificity values of 0.866 and 0.868, respectively. CONCLUSIONS The result supports the suggestions that optimal cut-off score should be different according to target populations. The newly identified cut-off score of 17 would enable the identification of patients with EDs who have been previously classified as non-clinical samples in the EAT-26 test. LEVEL OF EVIDENCE III: evidence obtained from case-control analytic study.
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Affiliation(s)
- Nobuhiro Nohara
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Maiko Hiraide
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Takeshi Horie
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan
| | - Shu Takakura
- Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Tomokazu Hata
- Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
| | - Nobuyuki Sudo
- Department of Psychosomatic Medicine, Kyushu University Hospital, 3-1-1 Maidashi, Higashi-Ku, Fukuoka, 812-8582, Japan
- Department of Psychosomatic Medicine, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka, 812-8582, Japan
| | - Kazuhiro Yoshiuchi
- Department of Stress Sciences and Psychosomatic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-Ku, Tokyo, 113-8655, Japan.
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214
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Burke AE, Sklansky DJ, Haftel HM, Mitchell A, Mann KJ. Competency-based medical education and the education continuum: Establishing a framework for lifelong learning. Curr Probl Pediatr Adolesc Health Care 2024:101642. [PMID: 38851971 DOI: 10.1016/j.cppeds.2024.101642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Affiliation(s)
- Ann E Burke
- Wright State University Boonshoft School of Medicine and Dayton Children's Hospital.
| | - Daniel J Sklansky
- University of Wisconsin School of Medicine and Public Health and American Family Children's Hospital
| | - Hilary M Haftel
- American Academy of Pediatrics, Senior Vice President, Education
| | - Andrew Mitchell
- Wright State University Boonshoft School of Medicine and Dayton Children's Hospital
| | - Keith J Mann
- American Board of Pediatrics, Vice President for Continuing Certification
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215
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Nevin SM, Le Marne FA, Beavis E, Macintosh R, Palmer EE, Sachdev R, Nunn K, Bye A. Psychosocial experiences of clinicians providing care for children with severe neurological impairment. Dev Med Child Neurol 2024. [PMID: 38837791 DOI: 10.1111/dmcn.15987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
AIM To investigate clinicians' psychosocial experiences navigating interdisciplinary care for children with severe neurological impairment (SNI), for example children with a developmental epileptic encephalopathy; secondarily, to identify preferences for future interventions to support clinicians caring for children with SNI. METHOD We conducted a qualitative descriptive study with interdisciplinary clinicians by using a purposeful sampling recruitment strategy. Twenty-four participants with expertise caring for children with SNI completed in-depth, semi-structured interviews. We transcribed the interviews, de-identified them, and performed inductive thematic analysis. RESULTS Thematic analysis elicited interrelated themes. Clinicians experienced immense professional barriers providing patient-centred care across fragmented healthcare contexts. Physical, emotional, and psychological impacts were attributed to inadequate reflective practice training and a paucity of integrated resources to support clinicians over time. Multipronged strategies were prioritized by clinicians, incorporating psychoeducation, interdisciplinary peer mentorship, and psychological resources to build reflective practice skills for clinicians providing complex care in an advancing era of medicine. INTERPRETATION This study provides novel and in-depth insight into clinicians' experiences navigating care for children with SNI. The results will be used to inform future integrated and multipronged co-developed resources tailored for clinicians, on the basis of their recommendations.
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Affiliation(s)
- Suzanne M Nevin
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Behavioral Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Fleur A Le Marne
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Erin Beavis
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rebecca Macintosh
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Elizabeth E Palmer
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Rani Sachdev
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Centre for Clinical Genetics, Sydney Children's Hospital Network, Randwick, NSW, Australia
| | - Kenneth Nunn
- Department of Psychological Medicine Sydney, Children's Hospital Network, Sydney, NSW, Australia
| | - Ann Bye
- School of Clinical Medicine, UNSW Medicine & Health, Randwick Clinical Campus, Sydney, NSW, Australia
- Department of Neurology, Sydney Children's Hospital Network, Randwick, NSW, Australia
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216
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Hajdu T, Kertesi G, Szabó B. Poor housing quality and the health of newborns and young children. Sci Rep 2024; 14:12890. [PMID: 38839887 PMCID: PMC11153610 DOI: 10.1038/s41598-024-63789-z] [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: 11/28/2023] [Accepted: 06/03/2024] [Indexed: 06/07/2024] Open
Abstract
This study uses linked administrative data on live births, hospital stays, and census records for children born in Hungary between 2006 and 2011 to examine the relationship between poor housing quality and the health of newborns and children aged 1-2 years. We show that poor housing quality, defined as lack of access to basic sanitation and exposure to polluting heating, is not a negligible problem even in a high-income EU country like Hungary. This is particularly the case for disadvantaged children, 20-25% of whom live in extremely poor-quality homes. Next, we provide evidence that poor housing quality is strongly associated with lower health at birth and a higher number of days spent in inpatient care at the age of 1-2 years. These results indicate that lack of access to basic sanitation, hygiene, and non-polluting heating and their health impacts cannot be considered as the exclusive problem for low- and middle-income countries. In high-income countries, there is also a need for public policy programs that identify those affected by poor housing quality and offer them potential solutions to reduce the adverse effects on their health.
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Affiliation(s)
- Tamás Hajdu
- Institute of Economics, HUN-REN Centre for Economic and Regional Studies, Budapest, Hungary.
| | - Gábor Kertesi
- Institute of Economics, HUN-REN Centre for Economic and Regional Studies, Budapest, Hungary
| | - Bence Szabó
- Institute of Economics, HUN-REN Centre for Economic and Regional Studies, Budapest, Hungary
- Corvinus University of Budapest, Budapest, Hungary
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217
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Cossa IA, Santos PS, Vitali FC, Santana CM, Bolan M, Cardoso M. Are sleep disorders associated with traumatic dental injuries in school children? A cross-sectional study. Aust Dent J 2024. [PMID: 38838027 DOI: 10.1111/adj.13023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND To evaluate whether the prevalence of traumatic dental injuries (TDIs) in permanent anterior teeth among school children is associated with sleep behaviours and disorders. METHODS A cross-sectional study was carried out with a representative sample of schoolchildren aged 8 to 10 years (n = 1402) from Florianopolis, Brazil. Clinical examinations for TDIs were performed according to the classification proposed by Andreasen. Parents/caregivers completed a questionnaire addressing sociodemographic characteristics and sleep behaviours/disorders (sleep duration, insomnia, sleep rhythmic movement, snoring, and signs of sleep apnoea). Descriptive analysis and Poisson regression were performed. RESULTS The prevalence of TDIs was 10.9%. Insomnia was observed in 3.0% of the children, snoring in 42.8%, sleep rhythmic movement in 27.9%, and signs of obstructive sleep apnoea in 33.6% of the schoolchildren. Most children (75.2%) slept less than eight hours a day. The prevalence of TDIs was higher among schoolchildren with an increased overjet (PR: 1.65; 95% CI: 1.15-2.35; P < 0.01), after adjusting for monthly family income, caregiver's schooling, and sleep behaviours. The prevalence of TDIs was not associated with sleep behaviours/disorders. CONCLUSIONS Parent-reported sleep disorders such as insomnia, sleep rhythmic movement, snoring and signs of sleep apnoea were not associated with the prevalence of TDIs in schoolchildren. © 2024 Australian Dental Association.
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Affiliation(s)
- I A Cossa
- Postgraduate Program of Dentistry, Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - P S Santos
- Postgraduate Program of Dentistry, Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - F C Vitali
- Postgraduate Program of Dentistry, Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - C M Santana
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - M Bolan
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - M Cardoso
- Department of Dentistry, Universidade Federal de Santa Catarina, Florianopolis, Santa Catarina, Brazil
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218
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Mohd Nippah NF, Abu N, Ab Mutalib NS, Alias H. Advances in next-generation sequencing for relapsed pediatric acute lymphoblastic leukemia: current insights and future directions. Front Genet 2024; 15:1394523. [PMID: 38894724 PMCID: PMC11183504 DOI: 10.3389/fgene.2024.1394523] [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: 03/01/2024] [Accepted: 05/17/2024] [Indexed: 06/21/2024] Open
Abstract
Leukemia is one of the most common cancers in children; and its genetic diversity in the landscape of acute lymphoblastic leukemia (ALL) is important for diagnosis, risk assessment, and therapeutic approaches. Relapsed ALL remains the leading cause of cancer deaths among children. Almost 20% of children who are treated for ALL and achieve complete remission experience disease recurrence. Relapsed ALL has a poor prognosis, and relapses are more likely to have mutations that affect signaling pathways, chromatin patterning, tumor suppression, and nucleoside metabolism. The identification of ALL subtypes has been based on genomic alterations for several decades, using the molecular landscape at relapse and its clinical significance. Next-generation sequencing (NGS), also known as massive parallel sequencing, is a high-throughput, quick, accurate, and sensitive method to examine the molecular landscape of cancer. This has undoubtedly transformed the study of relapsed ALL. The implementation of NGS has improved ALL genomic analysis, resulting in the recent identification of various novel molecular entities and a deeper understanding of existing ones. Thus, this review aimed to consolidate and critically evaluate the most current information on relapsed pediatric ALL provided by NGS technology. In this phase of targeted therapy and personalized medicine, identifying the capabilities, benefits, and drawbacks of NGS will be essential for healthcare professionals and researchers offering genome-driven care. This would contribute to precision medicine to treat these patients and help improve their overall survival and quality of life.
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Affiliation(s)
- Nur Farhana Mohd Nippah
- Department of Pediatrics, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nadiah Abu
- UKM Medical Molecular Biology Institute (UMBI), National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Syakima Ab Mutalib
- UKM Medical Molecular Biology Institute (UMBI), National University of Malaysia, Kuala Lumpur, Malaysia
| | - Hamidah Alias
- Department of Pediatrics, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
- UKM Medical Molecular Biology Institute (UMBI), National University of Malaysia, Kuala Lumpur, Malaysia
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219
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Hafiz N, Hyun K, Tu Q, Knight A, Hespe C, Chow CK, Briffa T, Gallagher R, Reid CM, Hare DL, Zwar N, Woodward M, Jan S, Atkins ER, Laba TL, Halcomb E, Johnson T, Manandi D, Usherwood T, Redfern J. Process evaluation of a data-driven quality improvement program within a cluster randomised controlled trial to improve coronary heart disease management in Australian primary care. PLoS One 2024; 19:e0298777. [PMID: 38833486 PMCID: PMC11149853 DOI: 10.1371/journal.pone.0298777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 01/30/2024] [Indexed: 06/06/2024] Open
Abstract
BACKGROUND This study evaluates primary care practices' engagement with various features of a quality improvement (QI) intervention for patients with coronary heart disease (CHD) in four Australian states. METHODS Twenty-seven practices participated in the QI intervention from November 2019 -November 2020. A combination of surveys, semi-structured interviews and other materials within the QUality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with heart disease (QUEL) study were used in the process evaluation. Data were summarised using descriptive statistical and thematic analyses for 26 practices. RESULTS Sixty-four practice team members and Primary Health Networks staff provided feedback, and nine of the 63 participants participated in the interviews. Seventy-eight percent (40/54) were either general practitioners or practice managers. Although 69% of the practices self-reported improvement in their management of heart disease, engagement with the intervention varied. Forty-two percent (11/26) of the practices attended five or more learning workshops, 69% (18/26) used Plan-Do-Study-Act cycles, and the median (Interquartile intervals) visits per practice to the online SharePoint site were 170 (146-252) visits. Qualitative data identified learning workshops and monthly feedback reports as the key features of the intervention. CONCLUSION Practice engagement in a multi-featured data-driven QI intervention was common, with learning workshops and monthly feedback reports identified as the most useful features. A better understanding of these features will help influence future implementation of similar interventions. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry (ANZCTR) number ACTRN12619001790134.
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Affiliation(s)
- Nashid Hafiz
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Karice Hyun
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- Department of Cardiology, Concord Hospital, ANZAC Research Institute, Sydney, Australia
| | - Qiang Tu
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Andrew Knight
- Primary and Integrated Care Unit, Southwestern Sydney Local Health District, Sydney, Australia
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Charlotte Hespe
- The University of Notre Dame, School of Medicine, Sydney, Australia
| | - Clara K. Chow
- Western Sydney Local Health District, Sydney, Australia
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Westmead, Australia
| | - Tom Briffa
- School of Population and Global Health, The University of Western Australia, Perth, Australia
| | - Robyn Gallagher
- Sydney Nursing School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Christopher M. Reid
- School of Population Health, Curtin University, Perth, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - David L. Hare
- University of Melbourne and Austin Health, Melbourne, Australia
| | - Nicholas Zwar
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| | - Mark Woodward
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
- The George Institute for Global Health, School of Public Health, Imperial College London, United Kingdom
| | - Stephen Jan
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Emily R. Atkins
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Westmead, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Tracey-Lea Laba
- Clinical and Health Sciences, University of South Australia, Adelaide, Australia
| | | | | | - Deborah Manandi
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Tim Usherwood
- Westmead Applied Research Centre, Faculty of Medicine and Health, University of Sydney, Sydney, Westmead, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Julie Redfern
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
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Marks H. Invalidated and 'salty': an auto/biographical and theoretical review of the lived experiences of individuals with PoTS. FRONTIERS IN SOCIOLOGY 2024; 9:1283695. [PMID: 38912309 PMCID: PMC11191735 DOI: 10.3389/fsoc.2024.1283695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 05/08/2024] [Indexed: 06/25/2024]
Abstract
Postural orthostatic Tachycardia Syndrome (PoTS), sometimes also written as 'POTS', is a form of dysautonomia (dysfunction of the autonomic nervous system) and orthostatic intolerance (which causes symptoms to be worsened when standing). This paper explores the extant literature on the lived experiences of those living with PoTS in relation to interactions between patients and healthcare providers as well as interactions at the level of the individual between PoTSies and those around them. My title contains the word 'salty' because it can be used to describe the feeling of being frustrated, while also reflecting a specific dietary change recommended to many (but not all) PoTS patients when they are told to consume additional sodium to minimise symptoms. COVID-19 is thought to have led to an increased prevalence of PoTS so this topic is particularly relevant to contemporary discussions and debates. In this sociological article, I refer not only to existing research on the lived experiences of having PoTS but also that of other chronic illnesses when relevant. The following themes are explored through auto/biographical and theoretical analysis: Undiagnosed and Invalidated; (In)Visible; Impacts of Diagnosis; Recovery and Expectations; Community. Reflecting auto/biographically, I have included analysis of interactions related to my lived experiences of presyncope, COVID-19 and dysautonomia, as I have been diagnosed with PoTS myself, which is thought to have been significantly exacerbated by the COVID-19 virus. This research is sociological, rather than medical or psychological, and conclusions are drawn about what is known so far about the lived experiences of living with PoTS, as well as discussion about what remains unknown, as there is currently a paucity of research on the lived experiences of individuals with PoTS and its comorbidities.
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Affiliation(s)
- Harriet Marks
- School of Society and Culture (Faculty of Arts, Humanities and Business), University of Plymouth, Plymouth, United Kingdom
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221
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Yang K, Song Y, Su Y, Li C, Ding N. Establishment and Validation of an Early Predictive Model for Severe Acute Pancreatitis. J Inflamm Res 2024; 17:3551-3561. [PMID: 38855164 PMCID: PMC11162219 DOI: 10.2147/jir.s457199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Accepted: 05/14/2024] [Indexed: 06/11/2024] Open
Abstract
Objective The purpose of this study is to establishment and validation of an early predictive model for severe acute pancreatitis (SAP). Methods From January 2015 to August 2022, 2986 AP patients admitted to Changsha Central Hospital were enrolled in this study. They were randomly divided into a modeling group (n = 2112) and a validation group (n = 874). In the modeling group, identify risk factors through logistic regression models and draw column charts. Use internal validation method to verify the accuracy of column chart prediction. Apply calibration curves to evaluate the consistency between nomograms and ideal observations. Draw a DCA curve to evaluate the net benefits of the prediction model. Results Nine variables including respiratory rate, heart rate, WBC, PDW, PT, SCR, AMY, CK, and TG are the risk factors for SAP. The column chart risk prediction model which was constructed based on these 9 independent factors has high prediction accuracy (modeling group AUC = 0.788, validation group AUC = 7.789). The calibration curve analysis shows that the prediction probabilities of the modeling and validation groups are consistent with the observation probabilities. By drawing a DCA curve, it shows that the model has a wide threshold range (0.01-0.88). Conclusion The study developed an intuitive nomogram containing readily available laboratory parameters to predict the incidence rate of SAP.
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Affiliation(s)
- Kongzhi Yang
- Department of Emergency Medicine, the Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People’s Republic of China
| | - Yaqin Song
- Department of Emergency Medicine, the Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People’s Republic of China
| | - Yingjie Su
- Department of Emergency Medicine, the Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People’s Republic of China
| | - Changluo Li
- Department of Emergency Medicine, the Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People’s Republic of China
| | - Ning Ding
- Department of Emergency Medicine, the Affiliated Changsha Central Hospital, Hengyang Medical School, University of South China, Changsha, Hunan, People’s Republic of China
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Alessie RJM, Angelini V, van den Berg GJ, Mierau JO, Niccodemi G. Using data on biomarkers and siblings to study early-life economic determinants of type-2 diabetes. HEALTH ECONOMICS 2024; 33:1266-1283. [PMID: 38402587 DOI: 10.1002/hec.4815] [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: 03/23/2023] [Revised: 01/09/2024] [Accepted: 02/06/2024] [Indexed: 02/27/2024]
Abstract
We study the effect of economic conditions early in life on the occurrence of type-2 diabetes in adulthood using contextual economic indicators and within-sibling pair variation. We use data from Lifelines: a longitudinal cohort study and biobank including 51,270 siblings born in the Netherlands from 1950 onward. Sibling fixed-effects account for selective fertility. To identify type-2 diabetes we use biomarkers on the hemoglobin A1c concentration and fasting glucose in the blood. We find that adverse economic conditions around birth increase the probability of type-2 diabetes later in life both in males and in females. Inference based on self-reported diabetes leads to biased results, incorrectly suggesting the absence of an effect. The same applies to inference that does not account for selective fertility.
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Affiliation(s)
- Rob J M Alessie
- University of Groningen, Groningen, The Netherlands
- Netspar, Tilburg, The Netherlands
| | - Viola Angelini
- University of Groningen, Groningen, The Netherlands
- Netspar, Tilburg, The Netherlands
| | - Gerard J van den Berg
- University of Groningen, Groningen, The Netherlands
- University Medical Centre Groningen, Groningen, The Netherlands
- IZA, Bonn, Germany
- ZEW, Mannheim, Germany
| | - Jochen O Mierau
- University of Groningen, Groningen, The Netherlands
- University Medical Centre Groningen, Groningen, The Netherlands
- Lifelines, Roden, The Netherlands
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Gollapudi M, Thomas A, Yogarajah A, Ospina D, Daher JC, Rahman A, Santistevan L, Patel RV, Abraham J, Oommen SG, Siddiqui HF. Understanding the Interplay Between Premenstrual Dysphoric Disorder (PMDD) and Female Sexual Dysfunction (FSD). Cureus 2024; 16:e62788. [PMID: 39036127 PMCID: PMC11260262 DOI: 10.7759/cureus.62788] [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: 06/20/2024] [Indexed: 07/23/2024] Open
Abstract
Premenstrual dysphoric disorder (PMDD) is a severe variant of premenstrual syndrome (PMS), categorized as a mood disorder due to marked symptoms of depression and anxiety, compounded with severe physical symptoms. Female sexual dysfunction (FSD) can manifest as low libido, difficulty achieving sexual pleasure, and dyspareunia, causing functional and psychological distress. PMDD and FSD are globally prevalent conditions with postulated biological, psychological, and social associations between them. Nevertheless, sexual dysfunction in PMDD is an important aspect of women's health that has been understudied and has notable methodological limitations. In this narrative review, we summarize the existing literature on sexual function in women with PMDD and PMS, specify the distinctions between PMDD and other general symptoms of PMS, highlight the significance of understanding sexual dysfunction in the female population, and outline some available therapeutic options. Studies show that women frequently experience debilitating sexual distress during the premenstrual phase; however, there is an essential need to formulate standardized tools for definite diagnosis. Selective serotonin re-uptake inhibitors (SSRIs) and combined oral contraceptive pills (COCPs) are approved medications for PMDD, while flibanserin and bremelanotide are effective in treating FSD. However, the potential effects of these treatment modalities on the two comorbid conditions render them inconclusive. Awareness of PMDD and FSD among clinicians and society can allow the implementation of targeted interventions to alleviate the suffering of women and enhance their quality of life.
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Affiliation(s)
- Mahati Gollapudi
- Department of Medicine, Saba University School of Medicine, Caribbean, NLD
| | - Angelica Thomas
- Department of Internal Medicine, Anhui Medical University, Hefei, CHN
| | - Angelina Yogarajah
- Department of Family Medicine, Medical University of the Americas, Devens, USA
| | - David Ospina
- Department of Internal Medicine, Universidad de los Andes, Bogotá, COL
| | - Jean C Daher
- Department of Medicine, Lakeland Regional Health, Lakeland, USA
- Department of Medicine, Universidad de Ciencias Médicas Andrés Vesalio Guzman, San José, CRI
| | - Aaliya Rahman
- Department of Internal Medicine, Dr. D. Y. Patil Medical College, Hospital and Research Centre, Pune, IND
| | - Lucia Santistevan
- Department of Medicine, University of San Martín de Porres, Lima, PER
| | - Ruby V Patel
- Department of Surgery, Hemchandracharya North Gujarat University, Ahmedabad, IND
| | - Jeby Abraham
- Department of General Medicine, Yenepoya Medical College, Mangalore, IND
| | - Sheethal G Oommen
- Department of Psychiatry, University of Medicine and Pharmacy "Gr. T. Popa", Iași, ROU
| | - Humza F Siddiqui
- Department of Internal Medicine, Jinnah Sindh Medical University, Karachi, PAK
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Turchi RM, Kuo DZ, Rusher JW, Seltzer RR, Lehmann CU, Grout RW. Considerations for Alternative Decision-Making When Transitioning to Adulthood for Youth With Intellectual and Developmental Disabilities: Policy Statement. Pediatrics 2024; 153:e2024066841. [PMID: 38804066 DOI: 10.1542/peds.2024-066841] [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] [Received: 03/27/2024] [Revised: 03/27/2024] [Accepted: 03/28/2024] [Indexed: 05/29/2024] Open
Abstract
With advances in medical care, more youth with intellectual and/or developmental disabilities (IDD) are transitioning into adulthood. Patient- and family-centered, integrated care is warranted around this time of transition. Support teams (including the youth, caregivers, teachers, and pediatricians) should engage in transition planning, ideally starting between 12 and 14 years of age, to identify and develop resources to support the maturing youth's capacity for independent decision-making. Care teams should consider the varied levels of alternative decision-making support, which may include supported decision-making, medical proxy decision-making, power of attorney, and/or establishment of legal guardianship arrangements, to support the youth's health and well-being optimally. Ultimately, if independent decision-making is not appropriate, the goal for youth with IDD should be the least restrictive alternative, while preserving human rights and human dignity and promoting their autonomy. These considerations review alternative decision-making support, concepts, and legal requirements available for youth with IDD and their care teams. Pediatricians can support youth with IDD and their families in the transition process and decision-making autonomy by actively engaging the youth in care decisions, supporting needs for augmentative communication, fostering their expression of preferences and understanding of care decisions, and linking them to resources such as the medical-legal partnership model.
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Affiliation(s)
- Renee M Turchi
- Department of Pediatrics, Drexel University College of Medicine & St. Christopher's Hospital for Children, Philadelphia, Pennsylvania
| | - Dennis Z Kuo
- Department of Pediatrics, University of Rochester, Rochester, New York
| | - John W Rusher
- Department of Pediatrics, University of North Carolina School of Medicine in Chapel Hill, Chapel Hill, North Carolina
| | - Rebecca R Seltzer
- Division of General Pediatrics, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Randall W Grout
- Division of Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Regenstrief Institute, and Eskenazi Health, Indianapolis, Indiana
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225
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Chae HH, Ahmed A, Bone JN, Abdulhussein FS, Amed S, Patel T, Blydt-Hansen TD. Adrenal insufficiency in pediatric kidney transplantation recipients. Pediatr Transplant 2024; 28:e14768. [PMID: 38770694 DOI: 10.1111/petr.14768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 04/05/2024] [Accepted: 04/08/2024] [Indexed: 05/22/2024]
Abstract
BACKGROUND Immunosuppression of pediatric kidney transplant (PKT) recipients often includes corticosteroids. Prolonged corticosteroid exposure has been associated with secondary adrenal insufficiency (AI); however, little is known about its impact on PKT recipients. METHODS This was a retrospective cohort review of PKT recipients to evaluate AI prevalence, risk factors, and adverse effects. AI risk was assessed using morning cortisol (MC) and diagnosis confirmed by an ACTH stimulation test. Potential risk factors and adverse effects were tested for associations with MC levels and AI diagnosis. RESULTS Fifty-one patients (60.8% male, age 7.4 (IQR 3.8, 13.1) years; 1 patient counted twice for repeat transplant) were included. Patients at risk for AI (MC < 240 nmol/L) underwent definitive ACTH stimulation testing, confirming AI in 13/51 (25.5%) patients. Identified risk factors for AI included current prednisone dosage (p = .001), 6-month prednisone exposure (p = .02), daily prednisone administration (p = .002), and rejection episodes since transplant (p = .001). MC level (2.5 years (IQR 1.1, 5.1) post-transplant) was associated with current prednisone dosage (p < .001), 6-month prednisone exposure (p = .001), daily prednisone administration (p = .006), rejection episodes since transplant (p = .003), greater number of medications (β = -16.3, p < .001), 6-month hospitalization days (β = -3.3, p = .013), creatinine variability (β = -2.4, p = .025), and occurrence of acute kidney injury (β = -70.6, p = .01). CONCLUSION Greater corticosteroid exposure was associated with a lower MC level and confirmatory diagnosis of AI noted with an ACTH stimulation test. Adverse clinical findings with AI included greater medical complexity and kidney function lability. These data support systematic clinical surveillance for AI in PKT recipients treated with corticosteroids.
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Affiliation(s)
- Hyunwoong Harry Chae
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Azim Ahmed
- Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jeffrey N Bone
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
| | - Fatema S Abdulhussein
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Division of Endocrinology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Shazhan Amed
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Division of Endocrinology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Trisha Patel
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Division of Endocrinology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
| | - Tom D Blydt-Hansen
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada
- Division of Nephrology, Department of Pediatrics, BC Children's Hospital, University of British Columbia, Vancouver, British Columbia, Canada
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Liu Z, Gong Y, Nagamoto H, Okunuki T, Yamaguchi R, Kobayashi Y, Li Y, Maemichi T, Kumai T. Low Body Fat Percentage and Menstrual Cycle Disorders in Female Elite Adolescent Dancers. J Dance Med Sci 2024; 28:109-116. [PMID: 38284148 DOI: 10.1177/1089313x241227282] [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: 01/30/2024]
Abstract
Introduction: The menstrual cycle is an important indicator of health in female athletes. Female elite adolescent dancers are expected to control their weight while also training intensely, which can lead to menstrual disorders. This study aimed to investigate the relationship between body composition and menstrual status in female elite adolescent dancers. Methods: In total, 131 female elite adolescent dancers (age: 15.9 ± 1.5 years) were enrolled in this study. We measured the height, weight, and body fat percentage (BFP) for each participant and calculated their body mass index (BMI). We gathered information on individual menstruation patterns and the participants' menstrual cycles over the previous year using recall methods. We then compared the differences between dancers with menstrual cycle disorders and those without. Primary amenorrhea was defined as menarche occurring after the age of 15, while secondary amenorrhe was defined as experiencing fewer than 5 or no menstrual periods for at least 3 of the previous 12 months. We conducted a reliability test using the same questionnaire 2 weeks later. Statistical significance was defined as P < .05, and we calculated the effect sizes (d) and 95% confidence intervals (95% CI). Results: The average BMI and BFP were 22.6 ± 3.0% and 19.4 ± 2.2 kg/m2, respectively. Low BFP and low BMI were observed in 51 (38.6%) and 47 (35.6%) participants, respectively. Primary amenorrhea in 3 participants (2.3%) and 29 (22.1%) reported experiencing secondary amenorrhea; they had lower BFP than the dancers who did not experience amenorrhea (P = .041, 95% CI, -2.51 to -0.05). Conclusion: Female elite adolescent dancers in China may have lower BFP and menstrual problems. Given that lower BFP may contribute to the occurrence of menstruation disorders, it is essential to pay an attention to both BFP and the menstruation status in female elite adolescent dancers.
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Affiliation(s)
- Zijian Liu
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Yining Gong
- Graduate School of Economics, Osaka University of Economics and Law, Yao, Osaka, Japan
| | - Hideaki Nagamoto
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Takumi Okunuki
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Ryusei Yamaguchi
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
| | - Yusuke Kobayashi
- Graduate School of Sport Sciences, Waseda University, Saitama, Japan
- Sport & Arthroscopy Center, Hanna Central Hospital, Nara, Japan
| | - Yanshu Li
- Graduate School of Human Sciences, Waseda University, Saitama, Japan
| | | | - Tsukasa Kumai
- Faculty of Sport Sciences, Waseda University, Saitama, Japan
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Gerritsen A, Hulst RY, van Rijssen IM, Obeid J, Pillen S, Gorter JW, Verschuren O. The temporal and bi-directional relationship between physical activity and sleep in ambulatory children with cerebral palsy. Disabil Rehabil 2024; 46:2821-2827. [PMID: 37424307 DOI: 10.1080/09638288.2023.2232720] [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: 03/24/2022] [Accepted: 06/30/2023] [Indexed: 07/11/2023]
Abstract
PURPOSE Exploring the temporal and bi-directional relationship between device-based measures of physical activity and sleep in ambulatory children with cerebral palsy (CP). MATERIALS AND METHODS 24-hour activity data were collected from children with CP (n = 51, 43% girls, mean age (range); 6.8 (3-12) years; Gross Motor Function Classification System levels I to III). Nocturnal sleep parameters and daily physical activity were measured for seven consecutive days and nights using ActiGraph GT3X accelerometers. Linear mixed models were constructed to explore the relationships between sleep and activity. RESULTS Light and moderate-to-vigorous activity were negatively associated with sleep efficiency (SE) (resp. p = 0.04, p = 0.010) and total sleep time (TST) (resp. p = 0.007, p = 0.016) the following night. Sedentary time was positively associated with SE and TST the following night (resp. p = 0.014, p = 0.004). SE and TST were positively associated with sedentary time (resp. p = 0.011, p = 0.001) and negatively with moderate-to-vigorous physical activity (resp. p < 0.001, p = 0.002) the following day. Total bedtime and TST were negatively associated with light physical activity (resp. p = 0.046, p = 0.004) the following day. CONCLUSIONS The findings from this study suggest that ambulatory children with CP may not sleep better after physical activity, and vice versa, indicating that the relationship is complex and needs further investigation.
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Affiliation(s)
- Anke Gerritsen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- Faculty of Health and Physical Activity, Saxion University of Applied Sciences, Enschede, the Netherlands
| | - Raquel Y Hulst
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Ilse M van Rijssen
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Joyce Obeid
- CanChild, Department of Pediatrics, McMaster University, Hamilton, Canada
| | - Sigrid Pillen
- Kinderslaapexpert BV (Pediatric Sleep Expert LTd), Mook, The Netherlands
- Department of Electrical Engineering, Technical University Eindhoven, Eindhoven, The Netherlands
| | - Jan Willem Gorter
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
- CanChild, Department of Pediatrics, McMaster University, Hamilton, Canada
- Department of Rehabilitation, Physical Therapy Science and Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Olaf Verschuren
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
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Męczekalski B, Niwczyk O, Battipaglia C, Troia L, Kostrzak A, Bala G, Maciejewska-Jeske M, Genazzani AD, Luisi S. Neuroendocrine disturbances in women with functional hypothalamic amenorrhea: an update and future directions. Endocrine 2024; 84:769-785. [PMID: 38062345 PMCID: PMC11208264 DOI: 10.1007/s12020-023-03619-w] [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: 08/09/2023] [Accepted: 11/17/2023] [Indexed: 01/31/2024]
Abstract
Functional hypothalamic amenorrhea (FHA) is one of the most common causes of both primary and secondary amenorrhea in women of reproductive age. It is characterized by chronic anovulation and the absence of menses that appear as a result of stressors such as eating disorders, excessive exercise, or psychological distress. FHA is presumed to be a functional disruption in the pulsatile secretion of hypothalamic gonadotropin-releasing hormone, which in turn impairs the release of gonadotropin. Hypoestrogenism is observed due to the absence of ovarian follicle recruitment. Numerous neurotransmitters have been identified which play an important role in the regulation of the hypothalamic-pituitary-ovarian axis and of which the impairment would contribute to developing FHA. In this review we summarize the most recent advances in the identification of contributing neuroendocrine disturbances and relevant contributors to the development of FHA.
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Affiliation(s)
- Błażej Męczekalski
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland.
| | - Olga Niwczyk
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Christian Battipaglia
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy
| | - Libera Troia
- Department of Gynecology and Obstetrics, Maggiore della Carità Hospital, University of Eastern Piedmont, Novara, Italy
| | - Anna Kostrzak
- Department of Gynecological Endocrinology, Poznan University of Medical Sciences, Poznan, Poland
| | - Gregory Bala
- UCD School of Medicine University College Dublin, D04 V1W8, Dublin, Ireland
| | | | - Alessandro D Genazzani
- Gynecological Endocrinology Center, Department of Obstetrics and Gynecology, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Luisi
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
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Cogen JD, Perkins A, Mockler B, Barton KS, Schwartz A, Boos M, Radhakrishnan A, Rai P, Tandon P, Philipsborn R, Grow HM. Pediatric Resident and Program Director Views on Climate Change and Health Curricula: A Multi-Institution Study. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:654-662. [PMID: 38232072 DOI: 10.1097/acm.0000000000005633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
PURPOSE The American Academy of Pediatrics emphasized in a 2007 policy statement the importance of educating trainees on the impacts of climate change on children's health, yet few studies have evaluated trainee knowledge and attitudes about climate change-related health effects in children. This multi-institution study assessed pediatric resident and program director (1) knowledge/attitudes on climate change and health, (2) perspectives on the importance of incorporating climate and health content into pediatric graduate medical education, and (3) preferred topics/activities to include in climate and health curricula. METHOD This mixed-methods study employed an anonymous cross-sectional survey of pediatric residents and residency program directors from Association of Pediatric Program Directors (APPD) Longitudinal Educational Assessment Research Network (LEARN)-affiliated programs. Multivariable regression models and factor analyses were used to examine associations among resident demographics and resident knowledge, attitudes, and interest in a climate change curriculum. A conventional content analysis was conducted for the open-ended responses. RESULTS Eighteen programs participated in the study with all program directors (100% response rate) and 663 residents (average response rate per program, 53%; overall response rate, 42%) completing respective surveys. Of the program directors, only 3 (17%) felt very or moderately knowledgeable about the association between climate change and health impacts. The majority of residents (n=423, 64%) agreed/strongly agreed that physicians should discuss global warming/climate change and its health effects with patients/families, while only 138 residents (21%) agreed/strongly agreed that they were comfortable talking with patients and families about these issues. Most residents (n=498, 76%) and program directors (n=15, 83%) agreed/strongly agreed that a climate change curriculum should be incorporated into their pediatrics training program. CONCLUSIONS Pediatric residents and program directors support curricula that prepare future pediatricians to address the impact of climate change on children's health; however, few programs currently offer specific training, despite identified needs.
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Adiguzel E, Bozkurt NM, Unal G. Independent and combined effects of astaxanthin and omega-3 on behavioral deficits and molecular changes in a prenatal valproic acid model of autism in rats. Nutr Neurosci 2024; 27:590-606. [PMID: 37534957 DOI: 10.1080/1028415x.2023.2239575] [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: 08/04/2023]
Abstract
Objectives: Autism is a devastating neurodevelopmental disorder and recent studies showed that omega-3 or astaxanthin might reduce autistic symptoms due to their anti-inflammatory properties. Therefore, we investigated the effects of omega-3 and astaxanthin on the VPA-induced autism model of rats.Material and Methods: Female Wistar albino pups (n = 40) were grouped as control, autistic, astaxanthin (2 mg/kg), omega-3 (200 mg/kg), and astaxanthin (2 mg/kg)+omega-3 (200 mg/kg). All groups except the control were prenatally exposed to VPA. Astaxanthin and omega-3 were orally administered from the postnatal day 41 to 68 and behavioral tests were performed between day 69 and 73. The rats were decapitated 24 h after the behavioral tests and hippocampal and prefrontal cytokines and 5-HT levels were analyzed by ELISA.Results: VPA rats have increased grooming behavior while decreased sociability (SI), social preference index (SPI), discrimination index (DI), and prepulse inhibition (PPI) compared to control. Additionally, IL-1β, IL-6, TNF-α, and IFN-γ levels increased while IL-10 and 5-HT levels decreased in both brain regions. Astaxanthin treatment raised SI, SPI, DI, PPI, and prefrontal IL-10 levels. It also raised 5-HT levels and decreased IL-6 levels in both brain regions. Omega-3 and astaxanthin + omega-3 increased the SI, SPI, DI, and PPI and decreased grooming behavior. Moreover, they increased IL-10 and 5-HT levels whereas decreased IL-1β, IL-6, TNF-α, IFN-γ levels in both brain regions.Conclusions: Our results showed that VPA administration mimicked the behavioral and molecular changes of autism in rats. Single and combined administration of astaxanthin and omega-3 improved the autistic-like behavioral and molecular changes in the VPA model of rats.
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Affiliation(s)
- Emre Adiguzel
- Faculty of Health Sciences, Department of Nutrition and Dietetics, Karamanoğlu Mehmetbey University, Karaman, Türkiye
| | - Nuh Mehmet Bozkurt
- Faculty of Pharmacy, Department of Pharmacology, Erciyes University, Kayseri, Türkiye
- Experimental Research and Application Center (DEKAM), Brain Research Unit, Erciyes University, Kayseri, Türkiye
- e-Neuro Lab, Drug Application and Research Center (ERFARMA), Erciyes University, Kayseri, Türkiye
| | - Gokhan Unal
- Faculty of Pharmacy, Department of Pharmacology, Erciyes University, Kayseri, Türkiye
- Experimental Research and Application Center (DEKAM), Brain Research Unit, Erciyes University, Kayseri, Türkiye
- e-Neuro Lab, Drug Application and Research Center (ERFARMA), Erciyes University, Kayseri, Türkiye
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231
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Shah S, Azhar A, Azhar S, Khan M. Changing Cancer Trends in District Dir, Pakistan: Epidemiological Insights From a 10-Year Hospital-Based Study. Cureus 2024; 16:e62944. [PMID: 39044883 PMCID: PMC11265256 DOI: 10.7759/cureus.62944] [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: 06/22/2024] [Indexed: 07/25/2024] Open
Abstract
Background More alarming than the rise of cancer globally is its discreet changing profiles over the years. According to our knowledge, no new studies on cancer have taken place in Dir since 2004. Hence, we aimed to provide and analyze the cancer trends in district Dir, Malakand division, Khyber Pakhtunkhwa (KPK), regarding its prevalence and incidence, and compare it nationally and internationally. Methods A retrospective study was conducted by collecting data from 2647 clinically diagnosed cancer patients of all ages in district Dir, between the years 2008 and 2017, from the Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar. Statistical analysis was performed using SPSS version 20 and presented using different tables and figures. Results Out of the total patients, 52.7% were male and 47.3% were female. The most common types of cancers in both genders combined were breast (9.0%), acute lymphocytic leukemia (ALL) (6.0%), skin (5.7%), non-Hodgkin Lymphoma (NHL) (5.6%), and brain tumor (5.2%). The age-standardized incidence rate (ASIR) in males in 2017 was peaking in the age group 60-69 (2707.2) with the most prevalent cancer being NHL (7.7%). In females, ASIR was highest in the age group 30-39 (2500.8) with the majority having breast cancer (18.1%), and in children, ALL (30.9%) was most prevalent. Incidence was highest in 2014 with a staggering 15 cases/100,000 population. Cancer prevalence in females aged 50 and below was significantly higher (p<0.001) compared to males. Conclusion Our study highlights that cancer profiles in Dir in the past two decades have changed with certain results non-conforming to global and regional trends. A follow-up research should be carried out to further ascertain and analyze these diverging results in hopes of drawing a more concrete conclusion from these findings.
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Affiliation(s)
- Sunnia Shah
- Community Medicine, Khyber Medical College, Peshawar, PAK
| | - Anusha Azhar
- Community Medicine, Khyber Medical College, Peshawar, PAK
| | - Saud Azhar
- General Medicine, Hayatabad Medical Complex Peshawar, Peshawar, PAK
| | - Maaz Khan
- Oncology, Khyber Medical College, Peshawar, PAK
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Conway AE, Rupprecht C, Bansal P, Yuan I, Wang Z, Shaker MS, Verdi M, Bradley J. Leveraging learning systems to improve quality and patient safety in allergen immunotherapy. Ann Allergy Asthma Immunol 2024; 132:694-702. [PMID: 38484839 DOI: 10.1016/j.anai.2024.03.003] [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: 01/26/2024] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 06/07/2024]
Abstract
Adverse events occur in all fields of medicine, including allergy-immunology, in which allergen immunotherapy medical errors can cause significant harm. Although difficult to experience, such errors constitute opportunities for improvement. Identifying system vulnerabilities can allow resolution of latent errors before they become active problems. We review key aspects and frameworks of the medical error response, acknowledging the fundamental responsibility of clinical teams to learn from harm. Adverse event response comprises 4 major phases: (1) event recognition and reporting, (2) investigation (for which root cause analysis can be helpful), (3) improvement (inclusive of the plan-do-study-act cycle), and (4) communication and resolution. Throughout the process, clinician wellness must be maintained. Adverse event prevention should be prioritized, and a human factors engineering approach can be useful. Quality improvement tools and approaches complement one another and together offer a meaningful avenue for error recovery and prevention.
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Affiliation(s)
| | - Chase Rupprecht
- Department of Internal Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
| | - Priya Bansal
- Asthma and Allergy Wellness Center, St Charles, Illinois; Northwestern Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Irene Yuan
- Section of Allergy and Clinical Immunology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ziwei Wang
- Section of Allergy and Immunology, University of California Los Angeles David Geffen School of Medicine, Los Angeles, California
| | - Marcus S Shaker
- Departments of Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Section of Allergy and Immunology, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
| | - Marylee Verdi
- Dartmouth College Student Health, Hanover, New Hampshire
| | - Joel Bradley
- Departments of Medicine and Pediatrics, Geisel School of Medicine at Dartmouth, Hanover, New Hampshire; Department of Pediatrics, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire
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Nakamura Y, Kobayashi S, Cho K, Itoh S, Miyashita C, Yamaguchi T, Iwata H, Tamura N, Saijo Y, Ito Y, Seto Y, Honjo R, Ando A, Furuse Y, Manabe A, Kishi R. Prenatal metal concentrations and physical abnormalities in the Japan Environment and Children's Study. Pediatr Res 2024; 95:1875-1882. [PMID: 37857850 DOI: 10.1038/s41390-023-02851-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 08/22/2023] [Accepted: 09/27/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND The association between prenatal metal exposure and congenital anomalies is unclear. We aimed to examine the association between exposure to cadmium, lead, mercury, selenium, and manganese and physical abnormalities. METHODS Data from 89,887 pregnant women with singleton pregnancies who participated in the Japan Environment and Children's Study (JECS) were used. The correlation between maternal blood metal concentrations and physical abnormalities during the second or third trimester was investigated using logistic regression models. Physical anomalies included those observed at birth or at 1 month, primarily from ICD-10 Chapter 17, particularly congenital anomalies associated with environmental factors (e.g., hypospadias, cryptorchidism, cleft lip and palate, digestive tract atresia, congenital heart disease, and chromosomal abnormalities) and minor abnormalities. RESULTS After adjusting for covariates, the OR (95% CIs) of physical abnormalities for a one-unit rise in Mn concentrations in all individuals were 1.26 (1.08, 1.48). The OR (95% CIs) of physical abnormalities in the 4th quartile (≥18.7 ng/g) were 1.06 (1.01, 1.13) (p-value for the trend = 0.034) compared with those in the 1st quartile (≤12.5 ng/g). CONCLUSION In Japan, maternal blood Mn concentrations above threshold during pregnancy may slightly increase the incidence of physical abnormalities. IMPACT Physical abnormalities (including minor anomalies and congenital anomalies) are associated with prenatal manganese concentrations. They are not associated with cadmium, lead, mercury, and selenium concentrations.
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Affiliation(s)
- Yuichi Nakamura
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Sumitaka Kobayashi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan.
| | - Kazutoshi Cho
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Sachiko Itoh
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Chihiro Miyashita
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Takeshi Yamaguchi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Hiroyoshi Iwata
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Naomi Tamura
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
| | - Yasuaki Saijo
- Department of Social Medicine, Asahikawa Medical University, Asahikawa, Japan
| | - Yoshiya Ito
- Division of Clinical Medicine, Japanese Red Cross Hokkaido College of Nursing, Kitami, Japan
| | - Yoshitaka Seto
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Ryota Honjo
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Akiko Ando
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Yuta Furuse
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Atsushi Manabe
- Department of Pediatrics, Hokkaido University Graduate School of Medicine, Sapporo, Japan
- Maternity and Perinatal Care Center, Hokkaido University Hospital, Sapporo, Japan
| | - Reiko Kishi
- Center for Environmental and Health Sciences, Hokkaido University, Sapporo, Japan
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Cooper J, Ryder O, Barry S. Undergraduate perspectives of the awareness, diagnosis and management of patients with eating disorders. Br Dent J 2024; 236:894-899. [PMID: 38877260 DOI: 10.1038/s41415-024-7459-8] [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: 10/27/2023] [Revised: 12/22/2023] [Accepted: 01/07/2024] [Indexed: 06/16/2024]
Abstract
Introduction Patients with eating disorders (EDs) may present with potentially life-threatening complications due to missed and late diagnoses. Dentists can play a fundamental role in the early identification and signposting of patients with suspected EDs.Aims To investigate the awareness of final-year dental students of the aetiology, diagnosis and management of EDs.Methods An anonymous electronic questionnaire was distributed to final-year dental students at the University of Manchester. Respondents reported their knowledge, confidence and education related to the management of patients with EDs.Results Over 50% of students felt they had an above average awareness of the clinical signs and oral manifestations of EDs. The majority of students lacked confidence in discussing a suspected ED diagnosis with patients (75%) and referring them to appropriate services (71%). Additionally, 58% were not confident in planning treatment for and treating a patient with an ED. In total, 100% of students reported that they would benefit from further teaching related to the management of patients with EDs.Conclusion Participants highlighted the need for further teaching related to the diagnosis and management of patients with EDs. This study supports the development of an educational resource of undergraduate dental students.
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Affiliation(s)
- Jessica Cooper
- University Dental Hospital of Manchester, Manchester, UK; University of Manchester, Manchester, UK.
| | | | - Siobhan Barry
- University Dental Hospital of Manchester, Manchester, UK; University of Manchester, Manchester, UK
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235
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Sanders JS, Mabry M, Scarbro S, Filley CM. New Frontier: The First Year of an Adult Neurodevelopmental Disabilities Clinic. Cogn Behav Neurol 2024; 37:73-81. [PMID: 38063505 DOI: 10.1097/wnn.0000000000000362] [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: 11/02/2022] [Accepted: 07/20/2023] [Indexed: 06/04/2024]
Abstract
BACKGROUND As patients with neurodevelopmental disorders (NDDs) transition from pediatric to adult health care systems, they often have difficulty finding physicians to address their NDD-related needs. In response to this care gap, we established a new consultation clinic within a behavioral neurology clinic in an adult neurology department to address the neurodevelopmental concerns of these adult patients. OBJECTIVE To characterize the population of adult patients with NDDs seen in the adult NDD clinic in its first year. METHOD Data were obtained by a retrospective chart review of all patients with NDDs seen in the adult NDD clinic from September 2020 through December 2021. RESULTS Of the 86 patients who were seen in the adult NDD clinic, the average age was 34 years (SD = 15, range = 18-74 years). Developmental diagnoses included intellectual disability (63%), autism spectrum disorder (47%), Down syndrome (15%), cerebral palsy (9%), and other genetic disorders (26%). Comorbidities addressed included behavioral concerns (34%), anxiety (29%), seizure disorders (22%), and depression (15%). Behavioral and/or mental health concerns prompted 65% of the initial clinic visits. The most common recommendation made was to begin or increase exercise (59%), followed by facilitating connection to community, social, and employment resources. CONCLUSION Adults with NDDs have diagnoses, comorbidities, and concerns that are similar to, but also distinct from, those addressed in other adult neurology clinics. This study addresses the need for, and feasibility of, caring for the diverse population of adults with NDDs in an adult neurology setting.
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Affiliation(s)
- Jessica S Sanders
- Department of Neurology, Section of Behavioral Neurology, University of Colorado School of Medicine, Aurora, Colorado
| | - Moriah Mabry
- Department of Neurology, Section of Behavioral Neurology, University of Colorado School of Medicine, Aurora, Colorado
| | - Sharon Scarbro
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, University of Colorado School of Medicine, Aurora, Colorado
| | - Christopher M Filley
- Department of Neurology, Section of Behavioral Neurology, University of Colorado School of Medicine, Aurora, Colorado
- Department of Psychiatry, Section of Behavioral Neurology, University of Colorado School of Medicine, Aurora, Colorado
- Marcus Institute for Brain Health, Aurora, Colorado
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236
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Jalali A. Informing evidence-based medicine for opioid use disorder using pharmacoeconomic studies. Expert Rev Pharmacoecon Outcomes Res 2024; 24:599-611. [PMID: 38696161 DOI: 10.1080/14737167.2024.2350561] [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: 01/11/2024] [Accepted: 04/29/2024] [Indexed: 05/08/2024]
Abstract
INTRODUCTION The health and economic consequences of inadequately treated opioid use disorder (OUD) are substantial. Healthcare systems in the United States (US) and other countries are facing a growing healthcare crisis due to opioids. Although effective medications for OUD exist, relying solely on clinical information is insufficient for addressing the opioid crisis. AREAS COVERED In this review, the role of pharmacoeconomic studies in informing evidence-based medication treatment for OUD is discussed, with a particular emphasis on the US healthcare system, where the economic burden is significantly higher than the global average. The scope/objective of pharmacoeconomics as a distinct scientific research program is briefly defined, followed by a discussion of existing evidence informed by data from systematic reviews, in addition to a convenience sample of recently published pharmacoeconomic studies and protocols. The review also explores the need for methodological advancements in the field. EXPERT OPINION Despite the potential of pharmacoeconomic research in shaping evidence-based medicine for OUD, significant challenges limiting its real-world application remain. How to address these challenges are explored, including how to combine cost-effectiveness and budget impact analyses to address the needs of the healthcare system as a whole and specific stakeholders interested in adopting new OUD treatment strategies.
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Affiliation(s)
- Ali Jalali
- Department of Population Health Sciences, Division of Comparative Effectiveness & Outcomes Research, Joan and Sanford I. Weill Medical College of Cornell University, New York, NY, USA
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237
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Wang N, Yang S, Mu GQ, Qian F, Zhu XM. Exploring lipid digestion discrepancies between preterm formula and human milk: Insights from in vitro gastrointestinal digestion and the impact of added milk fat. Food Res Int 2024; 186:114317. [PMID: 38729709 DOI: 10.1016/j.foodres.2024.114317] [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: 02/24/2024] [Revised: 03/23/2024] [Accepted: 04/16/2024] [Indexed: 05/12/2024]
Abstract
Lipids play a pivotal role in the nutrition of preterm infants, acting as a primary energy source. Due to their underdeveloped gastrointestinal systems, lipid malabsorption is common, leading to insufficient energy intake and slowed growth. Therefore, it is critical to explore the reasons behind the low lipid absorption rate in formulas for preterm infants. This study utilized a simulated in intro gastrointestinal digestion model to assess the differences in lipid digestion between preterm human milk and various infant formulas. Results showed that the fatty acid release rates for formulas IF3, IF5, and IF7 were 58.90 %, 56.58 %, and 66.71 %, respectively, lower than human milk's 72.31 %. The primary free fatty acids (FFA) and 2-monoacylglycerol (2-MAG) released during digestion were C14:0, C16:0, C18:0, C18:1n-9, and C18:2n-6, in both human milk and formulas. Notably, the higher release of C16:0 in formulas may disrupt fatty acid balance, impacting lipid absorption. Further investigations are necessary to elucidate lipid absorption differences, which will inform the optimization of lipid content in preterm infant formulas.
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Affiliation(s)
- Ning Wang
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China
| | - Sen Yang
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China
| | - Guang-Qing Mu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China
| | - Fang Qian
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China
| | - Xue-Mei Zhu
- School of Food Science and Technology, Dalian Polytechnic University, Dalian 116034, PR China.
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238
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McClafferty H. Workforce Concerns: Professional Self Care, Personal Readiness, Impact of the Pandemic, and Other Factors that Impact the Workforce. Pediatr Clin North Am 2024; 71:413-429. [PMID: 38754933 DOI: 10.1016/j.pcl.2024.03.001] [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: 05/18/2024]
Abstract
Physician burnout is pervasive and takes a heavy toll on individuals and the healthcare system. Post-coronavirus disease 2019 the negative impact of organizational culture on physician burnout has been highlighted. Substantial research has accrued identifying steps organizations can take to pivot and develop leaders committed to physician well-being. Physicians can also proactively explore research in sleep, nutrition, physical activity, stress management, and social connections. Positive mindset has a powerful protective effect in medicine, especially in the emerging areas of self-valuation, self-compassion, and positive psychology. Physician coaching can accelerate positive behavior change. Committed physician leaders are needed for sustained culture change to occur.
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239
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Saba ES, Fink D, Schloegel L, Bseikri M. The impact of adenotonsillectomy on healthcare utilization in children with obstructive sleep apnea: Experience of an integrated medical model. Int J Pediatr Otorhinolaryngol 2024; 181:111987. [PMID: 38838474 DOI: 10.1016/j.ijporl.2024.111987] [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: 03/17/2024] [Revised: 05/08/2024] [Accepted: 05/17/2024] [Indexed: 06/07/2024]
Abstract
BACKGROUND AND OBJECTIVES Studies suggest that children with obstructive sleep apnea (OSA) have increased healthcare utilization patterns in comparison to matched controls. However, the effect of adenotonsillectomy (AT) on utilization patterns in these children is poorly understood. Additionally, no previous studies have compared the effect of AT on healthcare utilization patterns across different OSA severity groups. The aim of this retrospective cohort study is to assess the effects of surgical treatment on the level of healthcare utilization among children with OSA at a large integrated multicenter healthcare system. METHODS Retrospective analysis was performed of children aged 3-12 diagnosed with OSA via an attended polysomnogram (PSG) between December 2016 and February 2019. Demographic variables including age (at time of PSG), body mass index (BMI), race, and ethnicity were obtained. Variables for healthcare utilization were assessed for 12 months prior to PSG, and for 12 months after PSG (or after AT, delayed for the first 30 days after surgery to account for surgery-related visits). Healthcare utilization variables assessed included the total number of outpatient visits, inpatient, and emergency department (ED) visits, visits involving diagnostic codes associated with upper respiratory infection (URI), otitis media (OM), and allergic rhinitis (AR), prescription data involving intranasal steroids or leukotriene receptor antagonists (LTRA), and communication data such as secure message load and specialty referrals. Repeated measure linear difference-in-difference (D-I-D) models were used to assess the causal impact of AT on healthcare utilization outcomes. Sensitivity analyses were performed using modeling with a Poisson distribution and as an unadjusted model, with statistical significance set to p < 0.05. RESULTS Analysis elicited 577 children identified with OSA. Of these, 336 (58.2 %) underwent observation while 241 (41.8 %) underwent AT. The mean age was 6.4 years, with a slight male predominance (60.5 %). Analysis of baseline healthcare utilization patterns revealed that the treatment group had a significantly higher number of baseline inpatient/ED visits and OM visits in comparison to the observation group, but no differences in regards to baseline outpatient visits, or in visits involving URI or AR. Analysis of the entire OSA cohort via D-I-D modelling showed a significantly larger reduction in outpatient visits, secure messages, specialty referrals, and the use of intranasal steroid and LTRA in the treatment group compared to the observation group. Stratification of children based on OSA severity showed that the significant differences in healthcare utilization attributed to surgical treatment were primarily driven by the severe OSA group. Children with severe OSA who underwent AT showed significant reductions in most variables including outpatient visits, inpatient/ED visits, and OM visits. Alternatively, the only significant reductions in healthcare utilization among children with mild OSA treated with AT were in AR visits, intranasal steroid use, and LTRA use. Pattern changes among children with moderate OSA compared similarly to those with mild OSA. CONCLUSION To the authors' knowledge this study represents the largest available study assessing the impact of AT on healthcare utilization in children with OSA that also considers the effect of OSA severity on utilization patterns. AT appears to decrease healthcare utilization patterns, particularly in children with severe OSA. Alternatively, children with mild or moderate OSA treated with AT had only modest reductions in healthcare utilization patterns.
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Affiliation(s)
- Elias S Saba
- Kaiser Permanente, Department of Head and Neck Surgery, Oakland, CA, USA.
| | - Deanna Fink
- Kaiser Permanente, Division of Research, Oakland, CA, USA
| | - Luke Schloegel
- Kaiser Permanente, Department of Head and Neck Surgery, Oakland, CA, USA
| | - Mustafa Bseikri
- Kaiser Permanente, Pediatric Pulmonology and Sleep Medicine, Santa Clara, CA, USA
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Dentz A, Soelch CM, Fahim C, Torsello A, Parent V, Ponsioen A, Guay MC, Bioulac-Rogier S, Clément C, Bader M, Romo L. Non-pharmacological treatment of Attention Deficit Disorder with or without Hyperactivity (ADHD). Overview and report of the first international symposium on the non-pharmacological management of ADHD. L'ENCEPHALE 2024; 50:309-328. [PMID: 38326137 DOI: 10.1016/j.encep.2023.04.010] [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: 04/04/2023] [Accepted: 04/24/2023] [Indexed: 02/09/2024]
Abstract
Attention Deficit Disorder with or without Hyperactivity (ADHD is a neurodevelopmental disorder which affects the day-to-day functioning of children and adults with this condition. Pharmacological treatment can reduce the symptoms associated with ADHD, but it has some limitations. The objective of this symposium is to determine the effects of non-pharmacological approaches on ADHD symptoms. Results indicate that the following intervention are promising approaches: cognitive behavioral therapy (CBT), mindfulness-based interventions (MBI), yoga, cognitive and metacognitive intervention, neurofeedback and parental training programs. Current research advocates multimodal approaches in conjunction with school or work accommodations integrating innovative technologies.
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Affiliation(s)
- Amélie Dentz
- Université de Fribourg, Département de Psychologie, rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland.
| | - Chantal Martin Soelch
- Université de Fribourg, Département de Psychologie, rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland
| | - Cherine Fahim
- Université de Fribourg, Département de Psychologie, rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland
| | - Alexandra Torsello
- Université de Fribourg, Département de Psychologie, rue P.A. de Faucigny 2, 1700 Fribourg, Switzerland
| | | | | | | | | | - Céline Clément
- Laboratoire Interuniversitaire des Sciences de l'Education et de la Communication (EA 2310), Université de Strasbourg, Strasbourg, France
| | - Michel Bader
- Unité de Recherche, Service de Psychiatrie de l'Enfant et de l'adolescent (SUPEA - DP CHUV), Lausanne, Switzerland
| | - Lucia Romo
- EA4430 CLIPSYD, UFR SPSE, Paris Nanterre Université, Nanterre, France
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241
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Georgiou R, Voniati L, Papaleontiou A, Gryparis A, Ziavra N, Tafiadis D. Exploring the diagnostic accuracy and applicability of the Gugging Swallowing Screen in children with feeding and/or swallowing disorders. Neurogastroenterol Motil 2024; 36:e14790. [PMID: 38545701 DOI: 10.1111/nmo.14790] [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: 10/02/2023] [Revised: 03/06/2024] [Accepted: 03/17/2024] [Indexed: 06/04/2024]
Abstract
BACKGROUND The Gugging Swallowing Screen (GUSS) is a bedside dysphagia screening tool that has been designed to determine the risk of aspiration in acute stroke patients. There is no evidence in the literature for the GUSS for the pediatric population. The present study aimed to determine the diagnostic accuracy of GUSS as a screening tool in the Greek language for children with dysphagia. METHODS Eighty-Greek-Cypriot children aged 3-12 years who had dysphagia participated in this retrospective study. The translated into Greek GUSS was administered twice (pre- and post-therapy) to each patient throughout 24 sessions of dysphagia therapy. KEY RESULTS The GUSS showed a high internal consistency (Cronbach's α = 0.826), good test-retest reliability (rs = 0.767), convergent validity compared to the Greek Pediatric Eating Assessment tool-10 (PEDI-EAT-10) total score (rs = -0.365), and inter-rater reliability (κ = 0.863). A total cutoff points equal to 13.00 was also calculated. Aspiration was identified by the GUSS with low sensitivity and high specificity (PPV 100%, NPV 57%, LR+ NA, LR- 0.79); dysphagia/penetration was identified with high sensitivity and low specificity (PPV 33%, NPV 100%, LR+ 0.102, LR- NA). CONCLUSIONS & INFERENCES The pediatric version of GUSS has been found to be a valuable tool in identifying the risk of aspiration as that of adults. It proved to be used as a good screening guide for selecting and confirming the existence of dysphagia from instrumental assessments. This is the first study of the pediatric version of GUSS, and future studies on this topic are needed.
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Affiliation(s)
- Rafaella Georgiou
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
- Department of Health Sciences, Speech and Language Therapy, European University, Nicosia, Cyprus
| | - Louiza Voniati
- Department of Health Sciences, Speech and Language Therapy, European University, Nicosia, Cyprus
| | - Andri Papaleontiou
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Alexandros Gryparis
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Nafsika Ziavra
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
| | - Dionysios Tafiadis
- Department of Speech & Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, Greece
- Department of Health Sciences, Speech and Language Therapy, European University, Nicosia, Cyprus
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Lin M, Chen B, Xiao L, Zhang L. Publication Trends of Research on Adverse Event and Patient Safety in Nursing Research: A 8-Year Bibliometric Analysis. J Patient Saf 2024; 20:288-298. [PMID: 38314796 DOI: 10.1097/pts.0000000000001207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
BACKGROUND Adverse events (AEs), which are associated with medical system instability, poor clinical outcomes, and increasing socioeconomic burden, represent a negative outcome of the healthcare system and profoundly influence patient safety. However, research into AEs remains at a developmental stage according to the existing literature, and no previous studies have systematically reviewed the current state of research in the field of AEs. Therefore, the aims of this study were to interpret the results of published research in the field of AEs through bibliometric analysis and to analyze the trends and patterns in the data, which will be important for subsequent innovations in the field. METHODS A statistical and retrospective visualization bibliometric analysis was performed on July 28, 2022. The research data were extracted from the Web of Science Core Collection, and bibliometric citation analysis was performed using Microsoft Excel, VOSviewer 1.6.18, CiteSpace 6.1.R2, and the Online Analysis Platform of Literature Metrology ( http://bibliometric.com/ ). RESULTS A total of 1035 publications on AEs were included in the analysis. The number of articles increased annually from 2014 to 2022. Among them, the United States (n = 318) made the largest contribution, and Chung-Ang University (n = 20) was the affiliation with the greatest influence in this field. Despite notable international cooperation, a regional concentration of research literature production was observed in economically more developed countries. In terms of authors, Stone ND (n = 9) was the most productive author in the research of AEs. Most of the publications concerning AEs were cited from internationally influential nursing journals, and the Journal of Nursing Management (n = 62) was the most highly published journal. Regarding referencing, the article titled "Medical error-the third leading cause of death in the US" received the greatest attention on this topic (51 citations). CONCLUSIONS After systematically reviewed the current state of research in the field of AEs through bibliometric analysis, and AEs highlighted medication errors, patient safety, according reporting, and quality improvement as essential developments and research hotspots in this field. Furthermore, thematic analysis identified 2 new directions in research, concerned with psychological safety, nurse burnout, and with important research value and broad application prospects in the future.
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Affiliation(s)
| | - Bei Chen
- From the Department of Orthopaedic Surgery, The Affiliated Hospital of Zunyi Medical University
| | - Leyao Xiao
- School of Nursing, ZunyiMedical University
| | - Li Zhang
- The Affiliated Hospital of Zunyi Medical University, Zunyi
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Azumah R, Hummitzsch K, Anderson RA, Rodgers RJ. Expression of transforming growth factor β signalling molecules and their correlations with genes in loci linked to polycystic ovary syndrome in human foetal and adult tissues. Reprod Fertil Dev 2024; 36:RD23174. [PMID: 38894494 DOI: 10.1071/rd23174] [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: 09/19/2023] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Context Altered signalling of androgens, anti-Müllerian hormone or transforming growth factor beta (TGFβ) during foetal development have been implicated in the predisposition to polycystic ovary syndrome (PCOS) in later life, aside from its genetic predisposition. In foetal ovarian fibroblasts, TGFβ1 has been shown to regulate androgen signalling and seven genes located in loci associated with PCOS. Since PCOS exhibits a myriad of symptoms, it likely involves many different organs. Aims To identify the relationships between TGFβ signalling molecules and PCOS candidate genes in different tissues associated with PCOS. Methods Using RNA sequencing data, we examined the expression patterns of TGFβ signalling molecules in the human ovary, testis, heart, liver, kidney, brain tissue, and cerebellum from 4 to 20weeks of gestation and postnatally. We also examined the correlations between gene expression of TGFβ signalling molecules and PCOS candidate genes. Key results TGFβ signalling molecules were dynamically expressed in most tissues prenatally and/or postnatally. FBN3 , a PCOS candidate gene involved in TGFβ signalling, was expressed during foetal development in all tissues. The PCOS candidate genes HMGA2, YAP1 , and RAD50 correlated significantly (P TGFBR1 in six out of the seven tissues examined. Conclusions This study suggests that possible crosstalk occurs between genes in loci associated with PCOS and TGFβ signalling molecules in multiple tissues, particularly during foetal development. Implications Thus, alteration in TGFβ signalling during foetal development could affect many tissues contributing to the multiple phenotypes of PCOS in later life.
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Affiliation(s)
- Rafiatu Azumah
- Robinson Research Institute, School of Biomedicine, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Katja Hummitzsch
- Robinson Research Institute, School of Biomedicine, The University of Adelaide, Adelaide, SA 5005, Australia
| | - Richard A Anderson
- Medical Research Council Centre for Reproductive Health, Queen's Medical Research Institute, University of Edinburgh, Edinburgh EH16 4TJ, UK
| | - Raymond J Rodgers
- Robinson Research Institute, School of Biomedicine, The University of Adelaide, Adelaide, SA 5005, Australia
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Mercera G, Noteboom F, Timmermans C, Leijdesdorff S, Heynen E, van Amelsvoort T. Sexual exploitation of young men: Background characteristics and needs from a life-course perspective. CHILD ABUSE & NEGLECT 2024; 152:106794. [PMID: 38636156 DOI: 10.1016/j.chiabu.2024.106794] [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: 09/15/2023] [Revised: 03/22/2024] [Accepted: 04/05/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Sexually exploited young men are prevalent, yet underrepresented in clinical practice, policy and research. There are multiple barriers that often prevent young men to disclose and to seek or receive support, such as gender norms, limited awareness of victimization and feelings of guilt and shame. OBJECTIVE By gaining more insight into the background characteristics of young men who experienced sexual exploitation and their needs, this study aims to raise awareness and to better inform policymakers, care- and educational professionals on adequate prevention and intervention efforts. METHODS Twenty-six young men (age 14-32) who experienced sexual exploitation or other forms of sexual violence in their youth or were at high-risk, participated in this qualitative study that was conducted in The Netherlands. By means of semi-structured interviews and case-file analyses, data was collected to identify risk and protective factors in their life-course and support needs. RESULTS Several vulnerabilities (e.g. previous experiences of abuse and neglect, household dysfunction, social rejection, running away, substance use) and a lack of positive and supportive relationships led young men into high-risk situations. Among these were involvement in pay dates, criminality and having to survive from day to day, which contributed to victimization. Prevailing gender norms and experiences of stigmatization were often a barrier to express vulnerabilities and to disclose victimization. There was a wide variety in support needs, including peer-to-peer support, therapy, support with day-to-day practices and anonymous support. CONCLUSIONS These results will contribute to adequate prevention and trauma-informed intervention strategies that meet the unique needs of young men at risk for, or victim of sexual exploitation.
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Affiliation(s)
- Gabriëlle Mercera
- Department of Psychiatry and Neuropsychology, Maastricht University, Vijverdalseweg 1, 6226 NB Maastricht, the Netherlands; Koraal, Poststraat 1, 6135 KR Sittard, the Netherlands.
| | - Frank Noteboom
- Stichting Fier, Holstmeerweg 1, 8936 AS Leeuwarden, the Netherlands.
| | | | - Sophie Leijdesdorff
- Department of Psychiatry and Neuropsychology, Maastricht University, Vijverdalseweg 1, 6226 NB Maastricht, the Netherlands.
| | - Evelyn Heynen
- Department of Clinical Psychology, Open University, Valkenburgerweg 177, 6419 AT Heerlen, the Netherlands.
| | - Thérèse van Amelsvoort
- Department of Psychiatry and Neuropsychology, Maastricht University, Vijverdalseweg 1, 6226 NB Maastricht, the Netherlands; Koraal, Poststraat 1, 6135 KR Sittard, the Netherlands.
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Sullivan CB, Stevenson E, Yalcinkaya T, Coates C. Improved Screening for Depression in Patients Initiating Fertility Treatment. Nurs Womens Health 2024; 28:205-212. [PMID: 38518809 DOI: 10.1016/j.nwh.2023.11.008] [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: 08/01/2023] [Revised: 11/04/2023] [Accepted: 02/20/2024] [Indexed: 03/24/2024]
Abstract
OBJECTIVE To improve screening for depression in patients who are initiating fertility treatment at a reproductive endocrinology and infertility (REI) center by screening all patients at their initial visit using the Patient Health Questionnaire-9 (PHQ-9). DESIGN This quality improvement project was conducted using a plan-do-study-act cycle implemented with a postintervention study design. SETTING/LOCAL PROBLEM A medium-size REI center in a mid-Atlantic U.S. metropolitan area where screening for mental health status in patients initiating fertility treatments was not occurring. PARTICIPANTS Patients who were scheduled in person with REI providers for a new patient consult regarding fertility were declared eligible. INTERVENTION/MEASUREMENTS The PHQ-9 was administered by providers at initial consults for patients seeking fertility treatments from October 2022 to February 2023. Three cycles of the plan-do-study-act model were used to execute change. For all patients who scored 5 to 9 (mild depression), conversations regarding counseling referrals occurred. For all patients who scored ≥10 (moderate to severe depression), a referral for counseling and medication management was generated. Data were analyzed via descriptive statistics. RESULTS A total of 115 participants were included. A screening rate of 84.3% (n = 97) was achieved for patients initiating treatment. Of the 97 screened, 21 patients had a score of ≥5; 19 were given a referral for counseling. However, none of the patients attended a counseling session or started medication prescribed by their primary care provider during the 2-month follow-up period. Barriers identified included costs, personal preferences, and access to services. CONCLUSION The PHQ-9 screening tool was implemented at an REI clinic to improve the frequency of mental health screenings and provide necessary referrals. However, additional follow-up is needed to ensure patients are receiving appropriate mental health care.
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246
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Pascoe JM. Foreword: Update on advances in cystic fibrosis towards a cure and implications for primary care clinicians. Curr Probl Pediatr Adolesc Health Care 2024; 54:101635. [PMID: 38839515 DOI: 10.1016/j.cppeds.2024.101635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
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Vatanparast H, Henry C, Rostami M, Finch S, Cammer A, Johnson E, Longworth Z, Wang C. Linking Immigrants with Nutrition Knowledge (Project LINK): An Innovative Approach to Improve Cultural Competence in Dietetic Education. CAN J DIET PRACT RES 2024; 85:95-100. [PMID: 38501902 DOI: 10.3148/cjdpr-2023-025] [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: 03/20/2024]
Abstract
Linking Immigrants with Nutrition Knowledge (Project LINK) was a service-learning cultural competence training programme completed by undergraduate dietetic students enrolled in the University of Saskatchewan's (USASK) nutrition and dietetic programme.This paper evaluates the impact of participation in the programme on students' cultural competence. We conducted a cross-sectional survey and qualitative analysis of reflective essays of 107 participants of Project LINK from 2011 to 2014. Cumulative logistic regression models assessed the impact of the intervention on students' cultural competencies. The Akaike information criterion compared models and Spearman correlation coefficient identified possible correlation among pre- and post-intervention data points. Student reflective essays were analyzed by inductive thematic analysis.All cultural competencies improved comparing pre- and post-participation in Project LINK. Odds of increasing one level of student knowledge were 110 times of that prior to Project LINK. Comparing student competencies before and after Project LINK, the odds of increasing one level of students' skills were six times greater, five times greater for increasing one level of students' ability to interact or encounter, and 2.8 times greater for increasing one level of students' attitude.The results of this study indicate Project LINK has successfully increased cultural competence and underscores the importance of combining opportunities for practical experience in addition to classroom-based training on cultural competence.
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Affiliation(s)
- Hassan Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
- School of Public Health, University of Saskatchewan, Saskatoon, SK
| | - Carol Henry
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | - Mehdi Rostami
- Dalla Lana School of Public Health, University of Toronto, ON
| | - Sarah Finch
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
- Department of Applied Human Sciences, University of Prince Edward Island, PEI
| | - Allison Cammer
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | - Emily Johnson
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | - Zoe Longworth
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK
| | - Cindy Wang
- School of Public Health, University of Saskatchewan, Saskatoon, SK
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Santiago J, Chaudry G. Venous Anomalies in Overgrowth Syndromes. Tech Vasc Interv Radiol 2024; 27:100962. [PMID: 39168551 DOI: 10.1016/j.tvir.2024.100962] [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: 08/23/2024]
Abstract
Overgrowth syndromes, particularly within the PIK3CA-related overgrowth syndrome (PROS) spectrum, are commonly associated with venous anomalies. The anomalies include spongiform venous malformations and persistent embryonic veins, such as the lateral marginal vein (of Servelle). The anomalous veins pose a significant risk of thromboembolic disease and should be occluded, preferably earlier in life. A thorough understanding of the conditions, anatomy, and interdisciplinary treatment of these complex anomalies is essential for optimal management. This review explores the clinical and imaging diagnosis of overgrowth syndromes and techniques for assessing and treating associated venous anomalies, particularly the endovenous closure of anomalous veins.
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Affiliation(s)
- Jose Santiago
- Division of Interventional Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115
| | - Gulraiz Chaudry
- Division of Interventional Radiology, Boston Children's Hospital and Harvard Medical School, 300 Longwood Avenue, Boston, MA 02115.
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Massare BA, Irvin CN, Hicks SD. Increased Sleep Latency and Decreased Sleep Duration are Associated With Elevated Risk of Bed Sharing Among Mother-Infant Dyads. Clin Pediatr (Phila) 2024; 63:708-713. [PMID: 37488931 PMCID: PMC11070114 DOI: 10.1177/00099228231188211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/26/2023]
Abstract
Bed sharing increases risk of sleep-related infant deaths. We hypothesized that infant sleep difficulties increase bed sharing, independent of social determinants of health (SDOH). In total, 191 mother-infant dyads in a prospective, longitudinal cohort study completed the Brief Infant Sleep Questionnaire at 1, 4, 6, and 12 months. Sleep characteristics at 1 month (latency, duration, night awakenings) were compared between dyads with/without bed sharing in the first 12 months. Infants who participated in bed sharing slept fewer hours at night (7.1 ± 1.7 hours vs 8.3 ± 1.5 hours, P = .001, d = -0.79), and took longer to fall asleep (0.7 ± 0.6 hours vs 0.5 ± 0.5 hours, P = .021, d = 0.43), even when controlling for SDOH variables that influence bed sharing. Maternal perception of sleep problems did not differ between groups (P = .12). Our findings suggest that infants with quantifiable sleep difficulties at 1 month are more likely to bed share.
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Affiliation(s)
- Brittany A. Massare
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Christine N. Irvin
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Steven D. Hicks
- Department of Pediatrics, Penn State College of Medicine, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA
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Bayrak AC, Fadiloglu E, Kayikci U, Kir EA, Cagan M, Deren O. Comparison of Apgar scores and cord blood gas parameters in fetuses with isolated congenital heart disease and healthy controls. Birth Defects Res 2024; 116:e2371. [PMID: 38877674 DOI: 10.1002/bdr2.2371] [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: 12/21/2023] [Revised: 04/22/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE This retrospective study aimed to investigate how congenital heart disease (CHD) affects early neonatal outcomes by comparing Apgar scores and umbilical cord blood gas parameters between fetuses with structural cardiac anomalies and healthy controls. Additionally, within the CHD group, the study explored the relationship between these parameters and mortality within six months. METHODS Data from 68 cases of prenatally diagnosed CHD were collected from electronic medical records, excluding cases with missing data or additional comorbidities. Only patients delivered by elective cesarean section, without any attempt at labor, were analyzed to avoid potential confounding factors. A control group of 147 healthy newborns was matched for delivery route, maternal age, and gestational week. Apgar scores at 1, 5, and 10 minutes, as well as umbilical cord blood pH, base deficit, and lactate levels, were recorded. RESULTS Maternal age, gestational week at delivery, and birth weight were similar between the CHD and control groups. While Apgar score distribution was significantly lower at 1st, 5th, and 10th minutes in the CHD group, umbilical cord blood gas parameters did not show significant differences between groups. Within the CHD group, lower umbilical cord blood pH and larger base deficit were associated with mortality within six months. CONCLUSION Newborns with CHD exhibit lower Apgar scores compared to healthy controls, suggesting potential early neonatal challenges. Furthermore, umbilical cord blood pH and base deficit may serve as predictors of mortality within six months in CHD cases. Prospective studies are warranted to validate these findings and integrate them into clinical practice, acknowledging the study's retrospective design and limitations.
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Affiliation(s)
- Ayse Cigdem Bayrak
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Erdem Fadiloglu
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Umutcan Kayikci
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Edip Alptug Kir
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Murat Cagan
- Department of Obstetrics and Gynecology, Iskenderun State Hospital, Hatay, Turkey
| | - Ozgur Deren
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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