Robust implementation of school food policy is needed to improve nutritional outcomes of children in European and Western Pacific countries: A systematic review

OBJECTIVE

The present systematic review explored compliance status with school food policies in Europe and the Western Pacific regions, challenges and facilitators of policy compliance, and its impact on children's diets and nutrient intakes.

RESEARCH METHODS

An electronic search for full-text research articles published between January 2009 and July 2023 was conducted in Science Direct and PubMed scientific databases.

RESULTS

A total of 659 titles and abstracts were screened, and final data was extracted from 34 included studies. Results showed low compliance with the school food policy in Europe and the Western Pacific regions. The European schools chad better compliance than the Western Pacific, and supportive interventions improved policy adherence. Impact assessment studies reported that the implementation of the school food policy increased fruit and vegetable consumption, thus increasing nutrient intakes (vitamin A, vitamin D, iron, calcium, folate, and dietary fibers). However, its impact on the availability and consumption of foods high in fat, sugar, and salt (HFSS) was less conclusive. The effects of the policy on the school food environment indicated no significant improvement.

CONCLUSION

Results highlighted the need for additional support and surveillance at the school level to ensure adequate policy compliance.

Impact of fellowship training for specialists on thyroidectomy outcomes of patients with thyroid cancer

We aimed to evaluate the impact of fellowship training (FT) for thyroid specialists on the outcomes of patients with thyroid cancer. We reviewed surgeries performed for thyroid cancer before (non-FT group) and after (FT group) fellowship training and compared several variables, including length of stay of patients, tumor diameter, surgical method, lymph node dissection, parathyroid implantation, surgical duration, intraoperative blood loss, and postoperative complications. Compared with the non-FT group, the FT group had a shorter hospital stay, more adequate fine needle aspiration biopsy of the thyroid, less intraoperative blood loss, higher rate of parathyroid implantation, higher lymph node dissection rate, and lower nerve injury and hypoparathyroidism rates. When the surgical duration was < 200 min and/or only central lymph node dissection was performed, the FT group had a lower incidence of postoperative complications than the non-FT group. When, the incidence of postoperative complications, including postoperative nerve injury and hypoparathyroidism. In conclusion, FT for thyroid specialists is beneficial for patients with thyroid cancer and may allow a shorter hospital stay and reduced incidence of postoperative complication. Accordingly, FT may facilitate a more appropriate surgical approach with a preoperative pathological diagnosis.

Degradation of microplastic in water by advanced oxidation processes

Plastic products have gained global popularity due to their lightweight, excellent ductility, high durability, and portability. However, out of the 8.3 billion tons of plastic waste generated by human activities, 80% of plastic waste is discarded due to improper disposal, and then transformed into microplastic pollution under the combined influence of environmental factors and microorganisms. In this comprehensive study, we present a thorough review of recent advancements in research on the source, distribution, and effect of microplastics. More importantly, we conducted deep research on the catalytic degradation technologies of microplastics in water, including advanced oxidation and photocatalytic technologies, and elaborated on the mechanisms of microplastics degradation in water. Besides, various strategies for mitigating microplastic pollution in aquatic ecosystems are discussed, ranging from policy interventions, the initiative for plastic recycling, the development of efficient catalytic materials, and the integration of multiple technological approaches. This review serves as a valuable resource for addressing the challenge of removing microplastic contaminants from water bodies, offering insights into effective and sustainable solutions.

Impact of pneumococcal conjugate vaccination on pneumococcal nasopharyngeal carriage in the Gambia: Population-based cross-sectional surveys

BACKGROUND

The introduction of pneumococcal conjugate vaccines (PCV) has reduced carriage of vaccine-type (VT) pneumococci in many settings. We determined the impact of The Gambia's national PCV programme on carriage of VT pneumococci in the population.

METHODS

Seven-valent PCV (PCV7) was introduced in August 2009 without catch-up and with doses scheduled at 2, 3, 4 months of age; it was replaced by PCV13 in May 2011. We did cross-sectional carriage surveys in 2009, 2015, and 2017 in age-stratified, population-based samples. Nasopharyngeal specimens were collected and processed according to WHO guidelines. We calculated observed and adjusted prevalence ratios (PR) of VT carriage before and after PCV introduction.

FINDINGS

We enrolled 2988, 3162, and 2709 participants in 2009, 2015, and 2017 respectively. The baseline (2009) prevalence of VT pneumococcal carriage among children aged 0-4 years was 42.6 %, which declined to 14.9 % and 17.5 % in 2015 and 2017 respectively (adjPR 0.32 [95 % CI 0.27, 0.38] and 0.38 [0.31, 0.46] respectively). VT prevalence among children aged 5-14 years was 16.6 %, 15.1 %, and 15.8 % in the three surveys (2017 vs 2009, adjPR 0.70 [0.58, 0.83]). VT prevalence among 15-44 year-olds was 6.4 %, 5.7 %, and 7.1 % in the three surveys (2017 vs 2009, adjPR 0.59 [0.46, 0.75]), while in those aged ≥ 45 years it was 4.5 %, 6.5 %, and 4.5 % respectively. Non-VT carriage increased in all age-groups. Prevalent residual serotypes were 34 and 15B (age 0-4 years), 3 and 34 (age 5-14 years), and 3 and 16F (age ≥ 15 years).

CONCLUSIONS

Introduction of PCV was associated with reduced VT pneumococcal carriage in young, and older children, although with substantial residual prevalence. Persisting VT, and non-VT, carriage indicate significant, persistent transmission of pneumococci in the population.

The impact of health insurance on maternal and reproductive health service utilization and financial protection in low- and lower middle-income countries: a systematic review of the evidence

BACKGROUND

Low- and middle-income countries have committed to achieving universal health coverage (UHC) as a means to enhance access to services and improve financial protection. One of the key health financing reforms to achieve UHC is the introduction or expansion of health insurance to enhance access to basic health services, including maternal and reproductive health care. However, there is a paucity of evidence of the extent to which these reforms have had impact on the main policy objectives of enhancing service utilization and financial protection. The aim of this systematic review is to assess the existing evidence on the causal impact of health insurance on maternal and reproductive health service utilization and financial protection in low- and lower middle-income countries.

METHODS

The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search included six databases: Medline, Embase, Web of Science, Cochrane, CINAHL, and Scopus as of 23rd May 2023. The keywords included health insurance, impact, utilisation, financial protection, and maternal and reproductive health. The search was followed by independent title and abstract screening and full text review by two reviewers using the Covidence software. Studies published in English since 2010, which reported on the impact of health insurance on maternal and reproductive health utilisation and or financial protection were included in the review. The ROBINS-I tool was used to assess the quality of the included studies.

RESULTS

A total of 17 studies fulfilled the inclusion criteria. The majority of the studies (82.4%, n = 14) were nationally representative. Most studies found that health insurance had a significant positive impact on having at least four antenatal care (ANC) visits, delivery at a health facility and having a delivery assisted by a skilled attendant with average treatment effects ranging from 0.02 to 0.11, 0.03 to 0.34 and 0.03 to 0.23 respectively. There was no evidence that health insurance had increased postnatal care, access to contraception and financial protection for maternal and reproductive health services. Various maternal and reproductive health indicators were reported in studies. ANC had the greatest number of reported indicators (n = 10), followed by financial protection (n = 6), postnatal care (n = 5), and delivery care (n = 4). The overall quality of the evidence was moderate based on the risk of bias assessment.

CONCLUSION

The introduction or expansion of various types of health insurance can be a useful intervention to improve ANC (receiving at least four ANC visits) and delivery care (delivery at health facility and delivery assisted by skilled birth attendant) service utilization in low- and lower-middle-income countries. Implementation of health insurance could enable countries' progress towards UHC and reduce maternal mortality. However, more research using rigorous impact evaluation methods is needed to investigate the causal impact of health insurance coverage on postnatal care utilization, contraceptive use and financial protection both in the general population and by socioeconomic status.

TRIAL REGISTRATION

This study was registered with Prospero (CRD42021285776).

The impact of breast density notification on psychosocial outcomes in racial and ethnic minorities: A systematic review

BACKGROUND

High breast density is an independent risk factor for breast cancer and decreases the sensitivity of mammography. This systematic review synthesizes the evidence on the impact of breast density (BD) information and/or notification on women's psychosocial outcomes among women from racial and ethnic minority groups.

METHODS

A systematic search was performed in March 2023, and the articles were identified using CINHAL, Embase, Medline, and PsychInfo databases. The search strategy combined the terms "breast", "density", "notification" and synonyms. The authors specifically kept the search terms broad and did not include terms related to race and ethnicity. Full-text articles were reviewed for analysis by race, ethnicity and primary language of participants. Two authors evaluated the eligibility of studies with verification from the study team, extracted and crosschecked data, and assessed the risk of bias.

RESULTS

Of 1784 articles, 32 articles published from 2003 to 2023 were included. Thirty-one studies were conducted in the United States and one in Australia, with 28 quantitative and four qualitative methodologies. The overall results in terms of breast density awareness, knowledge, communication with healthcare professionals, screening intentions and supplemental screening practice were heterogenous across studies. Barriers to understanding BD notifications and intentions/access to supplemental screening among racial and ethnic minorities included socioeconomic factors, language, health literacy and medical mistrust.

CONCLUSIONS

A one-size approach to inform women about their BD may further disadvantage racial and ethnic minority women. BD notification and accompanying information should be tailored and translated to ensure readability and understandability by all women.

Impact analysis of primary and secondary research in radiology journals

INTRODUCTION

Primary and secondary studies are considered the two major research categories. In this study, we examined the scientific and social media impact of primary and secondary publication types in papers published radiological journals during 2010-2020.

MATERIALS AND METHODS

PubMed publication type tags were used to filter original articles and systematic review and meta-analysis (SR/MA) articles. Clarivate Web of Science was utilized to obtain a list of all radiology journals from the category "Radiology, Nuclear Medicine and Imaging" in Science Citation Index Expanded (SCIE). Automated approach was developed for programmatic extraction of bibliometric and Altmetric yearly citations of each included article using Dimensions API and Altmetric API with Python. Statistical analysis was performed to compare the citation rates between primary and secondary research articles.

RESULTS

A total of 96,684 published articles from 2010 to 2020 were identified and their meta-data collected. The mean 2-year citation count following publication year was 5.8 for primary research and 10.2 for SR/MA articles (p < 0.001). Between 2010 and 2020, the mean number of citations per SR/MA article was 51.3 compared to 30.5 per primary research article (p < 0.001). Mean Altmetric score was 8.2 in SR/MA compared to 3.7 for primary research articles (p < 0.001).

CONCLUSION

Secondary research studies have been increasing in impact in both academia and social media compared to primary research. Our results highlight the importance and impact of systematic reviews and meta-analysis articles as a scientifically influential study type in radiology.

Microplastics and nanoplastics: Source, behavior, remediation, and multi-level environmental impact

Plastics introduced into the natural environment persist, degrade, and fragment into smaller particles due to various environmental factors. Microplastics (MPs) (ranging from 1 μm to 5 mm) and nanoplastics (NPs) (less than 1 μm) have emerged as pollutants posing a significant threat to all life forms on Earth. Easily ingested by living organisms, they lead to ongoing bioaccumulation and biomagnification. This review summarizes existing studies on the sources of MPs and NPs in various environments, highlighting their widespread presence in air, water, and soil. It primarily focuses on the sources, fate, degradation, fragmentation, transport, and ecotoxicity of MPs and NPs. The aim is to elucidate their harmful effects on marine organisms, soil biota, plants, mammals, and humans, thereby enhancing the understanding of the complex impacts of plastic particles on the environment. Additionally, this review highlights remediation technologies and global legislative and institutional measures for managing waste associated with MPs and NPs. It also shows that effectively combating plastic pollution requires the synergization of diverse management, monitoring strategies, and regulatory measures into a comprehensive policy framework.

Sleep Problems in Autism Spectrum Disorder

Sleep problems are common in children with autism spectrum disorder (ASD), with 40% to 80% prevalence. Common disorders include insomnia, parasomnias, and circadian rhythm sleep-wake disorders. These problems have a multifactorial etiology and can both exacerbate and be exacerbated by core ASD symptoms. Sleep problems also impact the health and quality of life of both patients and their caregivers. All children with autism should be regularly screened for sleep problems and evaluated for co-occurring medical contributors. Behavioral interventions with caregiver training remain first-line treatment for sleep disorders in both neurotypical and neurodiverse youth.

The IMPACT survey: a mixed methods study to understand the experience of children, adolescents and adults with osteogenesis imperfecta and their caregivers

BACKGROUND

Osteogenesis imperfecta (OI) is a rare, heritable connective tissue disorder associated with a variety of symptoms, that affect individuals' quality of life (QoL) and can be associated with increased healthcare resource use. While some aspects of OI are well studied, others remain poorly understood. Therefore, the IMPACT survey aimed to elucidate the humanistic, clinical and economic burden of OI on individuals with OI, their families, caregivers and wider society.

METHODS

We developed an international mixed methods online survey in eight languages (fielded July-September 2021), aimed at adults (aged ≥ 18 years) or adolescents (aged ≥ 12-17 years) with OI, caregivers (with or without OI) of individuals with OI and other close relatives. All respondents provided data on themselves; caregivers additionally provided data on individuals in their care by proxy. Data were cleaned, coded, and analysed using the pandas Python software package and Excel.

RESULTS

IMPACT collected 2208 eligible questionnaires (covering 2988 individuals of whom 2312 had OI) including 1290 non-caregiver adults with OI, 92 adolescents with OI, 150 caregiver adults with OI, 560 caregivers for individuals with OI, 116 close relatives and 780 proxy care-recipients with OI. Most individuals with OI (direct or proxy) described their OI as moderate (41-52% across populations) and reported OI type 1 (33-38%). Pain (72-82%) was the most reported clinical condition experienced in the past 12 months and was also most frequently rated as severely or moderately impactful. Further, among adults, 67% reported fatigue, 47% scoliosis, and 46% sleep disturbance; in adolescents, fatigue affected 65%, scoliosis and other bone problems 60%, and mental health problems 46%; in children, fractures were common in 67%, fatigue in 47%, and dental problems in 46%.

CONCLUSION

IMPACT has generated an extensive dataset on the experience of individuals with OI, their caregivers and relatives. We found that, irrespective of age, individuals with OI experience numerous and evolving symptoms that affect their QoL; however, pain and fatigue are consistently present. Upcoming analyses will provide further insights into the economic impact, healthcare journey and caregiver wellbeing, aiming to contribute to improved treatment and care for the OI community.

Yoga for Migraine Prevention: An Ancient Practice with Evidence for Current Use

PURPOSE OF REVIEW

The objective of this study is to review the recent literature on yoga for migraine prevention either as adjuvant or standalone therapy. Yoga is one of the most widely used complementary and integrative medicine (CIM) therapies; clinicians should be familiar with yoga practice so that they can best advise interested patients. It is also important to assess study design and types of yoga offered. Using PubMed and Litmaps, research published from 2018 to 2023 addressing yoga and migraine was assessed.

RECENT FINDINGS

Two systematic reviews and six studies have recently been published on yoga as adjunctive migraine preventive treatment. There is class III evidence and a grade B recommendation for yoga as an adjunct migraine preventive treatment. Yoga has been shown to reduce headache frequency, disability, and likely also pain intensity and self-efficacy. Two studies (one in children and one in adults) suggested that yoga as standalone migraine preventive treatment reduces pain intensity, disability, and perceived stress. More research is needed on the long-term efficacy (including change in monthly migraine days specifically in addition to headache frequency) and adherence to yoga practice for the prevention of migraine. In addition, to our knowledge, there is no study evaluating yoga practice in the prodromal or headache phase of migraine as acute treatment.

Development and validation of the HDSIM™ assessment system: a measure of hemorrhoid disease symptom impact

BACKGROUND

Hemorrhoid disease (HD) affects 10 million people in the US at any given time, and 50% of the US population will develop symptomatic hemorrhoids during their lifetime. Approximately 60% of people with hemorrhoids experience symptoms. Despite its prevalence and impact on quality of life, the existing patient-reported outcome measures of HD have not been validated using standard psychometric methods. The present study thus aimed to develop the Hemorrhoid Disease Symptom Impact Measure™ (HDSIM™) assessment system, a patient-reported measure of HD symptoms and impact for use in HD clinical research.

METHODS

On the basis of results from qualitative cognitive interviews, we generated the conceptual model and item pool. A cross-sectional web-based survey (n = 1066) was done, including a randomly selected retest subsample (n = 100) 1-2 weeks later. The survey sample was selected to be evenly distributed across mild, moderate, and severe levels of disease and to be nationally representative of the general United States population in terms of race, gender, and region. Existing disease-specific measures of symptoms and generic measures of quality of life and well-being were compared to the new tool for construct validation.

RESULTS

The HDSIM system includes 38 items representing six conceptual-model-driven subscales, aligning with the conceptual model: Symptoms at Worst, Symptoms at Best, Bowel Health Impact, Life Impact, Mental Health Impact, and Manageability. Psychometric analyses documented that the subscales had excellent internal consistency reliability, cross-sectional construct validity (i.e., convergent and divergent validity, known groups validity), test-retest stability, and longitudinal construct validity (i.e., responsiveness).

CONCLUSION

The HDSIM system is fit for purpose in hemorrhoid disease clinical trials research. Since measures are validated in an iterative manner over many studies and over time, the present study results should be considered preliminary.

A population-based, province-wide, record-linkage interrupted time series analysis of impact of the universal seasonal influenza vaccination policy on seasonal influenza vaccine uptake among 5-64-year-olds in the province of Manitoba, Canada

INTRODUCTION

Universal seasonal influenza vaccination policy (USIVP) was introduced in Manitoba, Canada in 2010. Its impact on seasonal influenza vaccine (SIV) uptake remains underexplored.

METHODS

We used population-wide data from Manitoba to assess the impact of the USIVP on SIV uptake. The study covered twenty influenza seasons (2000/01-2019/20). We summarized SIV uptake for influenza seasons before and after the USIVP. Utilizing a single-group interrupted time series analysis and appropriately accounting for autocorrelation, we estimated absolute change and annual trend in SIV uptake percentages among 5-17-, 18-44-, and 45-64-year-olds across strata of certain population socioeconomic and health-related characteristics following the USIVP.

RESULTS

Average SIV uptake percentage in all age groups was significantly higher after compared with before the USIVP. Following the USIVP, there was no significant absolute change in SIV uptake percentage among 18-44- and 45-64-year-olds overall; however, a significant decrease was observed among 18-44-year-old males in the higher income quintiles, across healthcare utilization, and in some regions of residence. A significant increase was observed among 5-17-year-olds in the lowest income quintiles, in Northern Manitoba, and among those with less healthcare utilization, and no chronic disease. Overall, there was mostly no significant annual trend in SIV uptake percentage among 18-44-year-olds, and while a significant upward and downward trend was observed among 5-17-year-olds and 45-64-year-olds, respectively, a significant downward trend was observed across all strata of population characteristics within all age groups in Northern Manitoba.

CONCLUSIONS

The USIVP in Manitoba was followed by an absolute increase in SIV uptake percentage only in some socioeconomically disadvantaged subpopulations among 5-17-year-olds. While there was mostly an upward annual trend in SIV uptake percentage among 5-17-year-olds, a downward trend was observed among 45-64-year-olds and across all age groups and subpopulations in socioeconomically disadvantaged Northern Manitoba. These findings are novel for Manitoba and require investigation and public health attention.

Penetration performance of protective materials from crossbow attack: a preliminary study

Crossbow-related injuries resulting in serious and mortal consequences have increased in recent years, and although significant research exists for both injury and fatality on the human body, limited data exists on the lethality of the bolt and the failure modes of protective materials. This paper concerns itself with the experimental validation of four differing crossbow bolt geometries, their effects on material failure and potentially lethality. During this study, four different types of crossbow bolt geometries were tested against two protection mechanisms that differed in mechanical properties, geometry, mass and size. The results show that at 67 ms-1, ogive, field and combo tips do not provide lethal effect at 10-m range, whilst a broadhead tip will perforate both the para-aramid and a reinforced area of polycarbonate material consisting of two 3-mm plates at 63-66 ms-1. Although perforation was apparent with a more honed tip geometry, the chain mail layering within the para-aramid protection and friction caused by polycarbonate petalling on the arrow body reduced the velocity enough to demonstrate the materials under test are effective at withstanding crossbow attack. Subsequent calculation of the maximum velocity that arrows could achieve if fired from the crossbow within this study shows results close to the overmatch value of each material and therefore a requirement to advance the knowledge in this field to influence the development of more effective armour protection mechanisms.

Validation of the brain injury associated visual impairment - impact questionnaire (BIVI-IQ)

PURPOSE

The Brain Injury associated Visual Impairment - Impact Questionnaire (BIVI-IQ) was developed to assess the impact of post-stroke visual impairment. The development of the questionnaire used robust methods involving stroke survivors and clinicians. The aim of this study was to assess the validity of the BIVI-IQ in a stroke population.

METHODS

Stroke survivors with visual impairment were recruited from stroke units, outpatient clinics and non-healthcare settings. Participants were asked to complete questionnaire sets on three separate occasions; the BIVI-IQ at each visit with additional questionnaires at baseline and visit 2. Vision assessment and anchor questions from participants and clinicians were collected. The analysis included assessment of missing data, acceptability, Rasch model analysis, test-retest reliability, construct validity (NEI VFQ-25, EQ-5D-5L) and responsiveness to change.

RESULTS

316 stroke survivors completed at least one questionnaire of the 326 recruited. Mean age was 67 years and 64% were male. Adequate fit statistics to the Rasch model were reached (χ2 = 73.12, p = 0.02) with two items removed and thresholds of two adjusted, indicating validity and unidimensionality. Excellent test-retest reliability was demonstrated (ICC = 0.905) with a 3-month interval. Construct validity was demonstrated with a strong significant correlation to the NEI VFQ-25 (r = 0.837, p < 0.01). The BIVI-IQ also demonstrated responsiveness to change with significant differences identified between groups based on participant and clinician anchor questions (X2 = 23.29, p < 0.001; X2 = 24.56, p < 0.001).

CONCLUSION

The BIVI-IQ has been shown to be valid and practical for 'everyday' use by clinicians and researchers to monitor vision-related quality of life in stroke survivors with visual impairment.

Enabling food system innovation: accelerators for change

It is widely accepted that current food systems are not on a trajectory for achieving the Sustainable Development Goals by the end of the decade. Technological innovation will have a considerable role to play in different parts of the food system; many promising options exist or are in the pipeline, some of which may be highly disruptive to existing value chains. Scaling up the innovations required, at the same time as protecting those who may lose out in the short term, will require a strong enabling environment. Here we apply an existing framework of eight change accelerators to six case studies of historical agricultural innovation. We estimated the degree to which each accelerator had been addressed at some stage in the innovation process, as a measure of the gap between what was needed and what was achieved. For the innovations that are being taken to scale and widely utilized, these accelerator gaps are small. Uptake of other innovations is stalled, and for these we found large gaps for one or more of the eight accelerators. Impactful innovation processes address all eight change accelerators at some point, with different phasing of the accelerators depending on the nature of the technology and on the impact pathway being pursued. This simple framework, when used in combination with narratives of uptake based on theories of change and impact pathways, may provide an effective means of screening future innovation processes to help prioritize and guide investment that can lead to more resilient, sustainable and equitable food systems.

Insights into the management of food waste in developing countries: with special reference to India

Up to one third of the food that is purposely grown for human sustenance is wasted and never consumed, with adverse consequences for the environment and socio-economic aspects. In India, managing food waste is a significant environmental concern. Food waste output is increasing in Indian cities and towns as a result of the country's urban expansion, modernization, and population growth. Poor management of food waste can have negative consequences for the environment and pose a risk to the public's health issues. This review focuses on the current challenges, management strategies, and future perspectives of food waste management in India. The efficient management of food waste involves a comprehensive study regarding the characterization of food waste and improved waste management methods. In addition, the government policies and rules for managing food waste that is in effect in India are covered in this review.

Analyzing gender gap in agricultural productivity: Evidence from Ethiopia

Women make up more than 50% of the agricultural labor force but contribute less than 30% to agricultural productivity. Agriculture is the main source of livelihood in Ethiopia but by contributes more than 35% to GDP, 90% to forex earnings, and 70% to employment sources. So Improving economic well-being ensuring sustainable development, and reducing poverty is impossible by ignoring the role of women. Consequently, the main objective of the study is to investigate the gender gap in agricultural productivity using national Panel data of 3474 households which were collected in 2017 and 2019 by the Policy Studies Institute for AGP II baseline study and midline evaluation. Among these, 69% (2404) were male-headed and 31% (1070) were female-headed households. The panel data were combined with DID, Oaxaca Decomposition, and the Random effect Tobit model to investigate the gender gap. The result from the DID Method of Impact Evaluation shows that female-headed households were less productive by 3.7% and 2.05 quintals per hectare when measured in terms of value in birr and quintals per hectare compared to male-headed households. In contrast, male-headed households were more productive by 4% and 2.05 quintals compared to female-headed households. Additionally, the results from the pooled and random effect Tobit model showed that soil fertility, sex of the household head, slope of the land, total livestock holding in TLU, extension contact, use of inorganic fertilizer, credit use, machinery use, and plantation method are among the determinants of the gender gap in agricultural productivity. Furthermore, results from the Oaxaca decomposition show that a gender productivity difference between male and female-headed households was roughly 11.2% when measured by value and 5% when measured by an area-weighted formula. The main finding of the study is that endowment effects were less likely to have a significant impact on the productivity gap than structural effects did. Differences in the unexplained characteristics of men and women may also contribute to the considerable productivity gap between male-headed and female-headed households. Therefore, working on women's empowerment to improve their structural disadvantages through various training programs that favor women or gender-mainstreamed extension training programs for lowering gender productivity differentials is a possible policy option.

The impact of approachable nurses: An exploratory study, the voice of hospitalized children with cancer

PURPOSE

The right of children to be heard was acclaimed at the 1989 Convention on the Rights of the Child, with subsequent research conducted in various settings, but with few in hospitals. This study explores the perceptions of children hospitalized with cancer and the impact of approachable nurses.

DESIGN & METHODS

The impact of approachable nurses was explored using a qualitative, descriptive research design, including semi-structured interviews with seven school age children in a pediatric oncology service. Audio recorded interviews were content analyzed using immersion/crystallization and editing organizational styles.

RESULTS

Children felt a sense of genuine concern when the nurses took time to talk and listen to them and the positive impact of fun and laughter in the midst of difficult and challenging circumstances. They had a lasting feeling of gratitude for creative ways nurses cared for them. Individualized attire created an immediate openness and avenue to conversation. Children were less worried about a rehospitalization because approachable nurses made them feel at home while in the hospital.

IMPLICATIONS

Nursing administration and managers are urged to provide training and regularly evaluate communication competencies. Nurses need to be accountable for the impact of their presence and actions on children both inpatient and following hospitalization. The need to promote an environment of comfort and trust supports positive impact for present and future hospitalization experiences.

The impact of blood lactic acid levels on retinopathy of prematurity morbidity

BACKGROUND

Retinopathy of prematurity (ROP) is a common disease in premature infants. In recent years, most researchers have used lactic acid as poor prognosis marker in premature infants. This study aims to explore investigate the impact of blood lactic acid levels on ROP.

METHODS

A retrospective case-control study was conducted, and infants with severe ROP born with birth weight (BW) ≤ 1500 g and gestational age (GA) ≤ 32 weeks were enrolled from November 2016 to November 2021. Infants without any stage ROP were included as controls and were matched with ROP infants (1:2) by GA and BW. All selected preterm infants were tested for heel terminal trace blood gas analysis within two weeks of life. Changes in blood lactic acid levels in the two groups were compared and analyzed by using multivariate logistic regression analysis. Sensitivity and specificity were analyzed by receiver operating characteristic (ROC) curve.

RESULTS

There were 79 infants in ROP group, and 158 infants in control group. The levels of blood lactic acid were significantly higher in the ROP group on days 1, 3, 5, and 7 compared with control group (all p < 0.05). The blood lactic acid levels on day 5 was an independent risk factor for ROP (p = 0.017). The area under the curve (AUC), sensitivity and specificity were highest on day 5 (AUC 0.716, sensitivity 77.2% and specificity 62.0%, respectively, p < 0.001), and higher on days 1, 3, and 7.

CONCLUSION

A high blood lactic acid level in the first seven days of life may be associated with increases ROP occurrence in very preterm infants, and suggest blood lactic acid level may impact the occurrence of ROP.

The New Zealand perspective of an ecosystem biology response to grapevine leafroll disease

Grapevine leafroll-associated virus 3 (GLRaV-3) is a major pathogen of grapevines worldwide resulting in grapevine leafroll disease (GLD), reduced fruit yield, berry quality and vineyard profitability. Being graft transmissible, GLRaV-3 is also transmitted between grapevines by multiple hemipteran insects (mealybugs and soft scale insects). Over the past 20 years, New Zealand has developed and utilized integrated pest management (IPM) solutions that have slowly transitioned to an ecosystem-based biological response to GLD. These IPM solutions and combinations are based on a wealth of research within the temperate climates of New Zealand's nation-wide grape production. To provide context, the grapevine viruses present in the national vineyard estate and how these have been identified are described; the most pathogenic and destructive of these is GLRaV-3. We provide an overview of research on GLRaV-3 genotypes and biology within grapevines and describe the progressive development of GLRaV-3/GLD diagnostics based on molecular, serological, visual, and sensor-based technologies. Research on the ecology and control of the mealybugs Pseudococcus calceolariae and P. longispinus, the main insect vectors of GLRaV-3 in New Zealand, is described together with the implications of mealybug biological control agents and prospects to enhance their abundance and/or fitness in the vineyard. Virus transmission by mealybugs is described, with emphasis on understanding the interactions between GLRaV-3, vectors, and plants (grapevines, alternative hosts, or non-hosts of the virus). Disease management through grapevine removal and the economic influence of different removal strategies is detailed. Overall, the review summarizes research by an interdisciplinary team working in close association with the national industry body, New Zealand Winegrowers. Teamwork and communication across the whole industry has enabled implementation of research for the management of GLD.

Impact of climate change on agriculture and adaptation strategies in Ethiopia: A meta-analysis

Ethiopia is a rainfall-based agricultural country that is susceptible to the impacts of climate change and risk. Floods and droughts, which happen more frequently and intensely, significantly and negatively influence agricultural production. The objective of the meta-analysis is to identify impacts on various sectors, adaptation strategies, and the challenges of climate change in the Ethiopian context. Twenty-three peer-reviewed articles were identified from ScienceDirect and Web of Science, followed by PRISMA guidelines, and analyzed using Stata version 13. The results reveal that climate change negatively impacts agriculture (by changing crop suitability, phenology, and productivity), the environment, and society, resulting from shifting temperature and rainfall patterns. Temperature variations, patterns of precipitation, and severe weather conditions have profound implications for agricultural productivity, water resources, ecosystems, and human well-being, which are multifaceted and interlinked. In addition, the reviewed articles informed us that farmers have used different coping strategies in response to climate change, such as soil and water conservation, agroforestry practices, integrated soil fertility management, small-scale irrigation, the application of improved crop varieties, the use of improved livestock, mixed cropping, early and late planting, and the practice of income-generating activities. The random effects meta-regression result shows that effective implementation of the above-mentioned practices reduces the risk of climate change in different sectors. The assessment also points out many challenges to the realization of these approaches, such as the lack of financing, institutional support, insufficient stakeholder involvement, ecological and sociocultural factors, and limited access to weather information. The meta-analysis concludes that addressing challenges requires holistic and integrated approaches that encompass adaptation strategies, sustainable land and water management, and social resilience-building to help the resilience of Ethiopian communities and ecosystems in the face of a changing climate.

Psychometric evaluation of the respiratory syncytial virus infection, intensity and impact questionnaire (RSV-iiiQ) in adults

BACKGROUND

Despite a number of respiratory syncytial virus (RSV) vaccine candidates being tested in clinical trials, disease-specific, self-reported instruments assessing symptom severity of RSV infection from the perspective of adult patients are still needed. The RSV Infection, Intensity and Impact Questionnaire (RSV-iiiQ) was adapted from the Influenza Intensity and Impact Questionnaire (FluiiQ™). This study evaluated some measurement properties of the RSV-iiiQ.

METHODS

Data were collected in a web-based survey over two consecutive days. Participants completed the RSV-iiiQ, the Patient Global Impression of Severity, Sheehan Disability Scale, Patient Global Impression of Change, EQ-5D-5L, and a demographic questionnaire. Test-retest reliability, internal consistency, construct validity, and responsiveness of the RSV-iiiQ scales were assessed.

RESULTS

111 adults with RSV were enrolled and self-reported a variety of symptoms across the range of disease severity via a web-based platform. The RSV-iiiQ scales demonstrated satisfactory test-retest reliability, construct validity, and discriminating ability. One-factor confirmatory factor analyses confirmed that each of the four scales was sufficiently unidimensional, and internal consistencies indicated that the computation of RSV-iiiQ scale scores was plausible. Correlation-based analyses provided support for the construct validity of the RSV-iiiQ scores, and known groups analyses supported discriminating ability. Estimates of responsiveness of the scale scores were also satisfactory.

CONCLUSIONS

RSV infection is highly symptomatic and causes significant disease burden, and self-report instruments assessing symptom severity and impact are important for evaluation of new treatments. This study describes the preliminary psychometric properties of the RSV-iiiQ and indicates this tool may be useful for the assessment of the severity of symptoms and impact of acute RSV infection in adults. The findings also indicated two items, Runny nose and Ear pain, may be unnecessary and should be revisited using item response theory analysis with a larger sample size.

A review of health education activities targeting schoolchildren for the control of soil-transmitted helminthiasis in Southeast Asia, with emphasis upon the Magic Glasses approach

Soil-transmitted helminths continue to be a serious problem causing disease and morbidity globally. Children, mostly school-aged, are more at risk of these infections. The main strategy for control remains to be the mass drug administration (MDA) of antihelminthic drugs. With the limitation of MDA to prevent re-infection, the need for additional approaches such as hygiene education and improvements in water, sanitation and hygiene (WASH) infrastructure are required. Although the importance of health education as a crucial component of an integrated approaches to STH control is highlighted, this component has often been disregarded because the other more complex solutions have been the focus of most studies and programmes. We performed literature searches from four bibliographic databases - Scopus, PubMed, Web of Science and Cochrane Library - to determine availability of studies on the impact of health education interventions targeting STH infections on schoolchildren in Southeast Asia. Our review found only three studies that evaluated health education interventions targeting children. The current lack of evidence in this area suggests the need for more studies assessing the impact of health education intervention for STH control. A successful health education programme for STH called "The Magic Glasses" has been developed targeting schoolchildren in China and the Philippines. This public health intervention displayed significant impact in terms of improving knowledge, attitude and practices, reducing prevalence of STH infections in schoolchildren and encouraging compliance to MDA. This article details the successes and benefits of the Magic Glasses programme as a promising control tool for STH in the Southeast Asian region.

Social work collective leadership in a large urban hospital during an era of unprecedented transformational change

This Department of Social Work Services (the Department) is one of the largest hospital social work departments in the country, with almost 600 staff, in the largest of eight hospitals and one medical school of a major health system. The Department's senior directors (three current and one former) share its innovative and effective collective leadership model that was initially developed in response to a confluence of unprecedented complex events stemming from the Covid-19 pandemic. The experiences of these co-leaders, an evaluation of the model, future internal considerations as its applicability to other health care settings will be discussed.

The impact of severe perinatal events on maternity care providers: a scoping review

BACKGROUND

Severe events during the perinatal period can be experienced as traumatic by pregnant women, their partners or others who are closely involved. This includes maternity care providers who can be affected by being involved in or observing these events. This may have an impact on their personal well-being and professional practice, influencing quality of care. The aim of this study is to map research investigating the impact of severe events during the perinatal period on maternity care providers, and how these experiences affect their well-being and professional practice.

METHOD

A scoping review following the manual of the Joanna Briggs Institute was undertaken. The electronic bibliographic databases included PubMed/MEDLINE, CINAHL, PsycINFO, PsycARTICLES, SocINDEX, Cochrane, Scopus, Web of Science and databases for grey literature. Records passing the two-stage screening process were assessed, and their reference lists hand searched. We included primary research papers that presented data from maternity care professionals on the impact of severe perinatal traumatic events. A descriptive content analysis and synthesis was undertaken.

RESULTS

Following a detailed systematic search and screening of 1,611 records, 57 papers were included in the scoping review. Results of the analysis identified four categories, which highlighted the impact of traumatic perinatal events on maternity care providers, mainly midwives, obstetricians and nurses: Traumatic events, Impact of traumatic events on care providers, Changes in care providers' practice and Support for care providers; each including several subcategories.

CONCLUSION

The impact of traumatic perinatal events on maternity care providers ranged from severe negative responses where care providers moved position or resigned from their employment in maternity care, to responses where they felt they became a better clinician. However, a substantial number appeared to be negatively affected by traumatic events without getting adequate support. Given the shortage of maternity staff and the importance of a sustainable workforce for effective maternity care, the impact of traumatic perinatal events requires serious consideration in maintaining their wellbeing and positive engagement when conducting their profession. Future research should explore which maternity care providers are mostly at risk for the impact of traumatic events and which interventions can contribute to prevention.

Impact of urbanization on the welfare of farm households: Evidence from Adama Rural District in Oromia regional state, Ethiopia

Urbanization is a widespread phenomenon with varying causes, patterns, and effects across countries. However, existing studies have overlooked the specific impact of urbanization on households near urban areas by failing to compare them with households in more distant regions. This study examines the impact of urbanization on rural household welfare in the Adama Rural District of the Oromia Region, Ethiopia. A multi-stage sampling technique was employed, selecting a sample of 397 households from two distinct categories. Of these households, 148 were located near the urban center, while 249 were far away. The study utilized descriptive and inferential data analysis methods and employed the propensity score matching technique to investigate the impact on farm households. Data was collected through questionnaires to gather cross-sectional information, supplemented by qualitative insights from Key Informant Interviews. The findings revealed that households near urban areas had a significantly lower mean annual consumer expenditure of 5207 ETB compared to 8092 ETB spent by families in distant areas. The results from propensity score matching further indicated that households near urban centers experienced lower annual consumption expenditures than those located further away. These results highlight the influence of urbanization on the welfare of rural farming households near urban areas. To address the negative effects of urbanization on these households, city administrations, and regional governments need to prioritize the development and implementation of alternative livelihood support strategies. Additionally, the study emphasizes the necessity of implementing policies that mitigate farmland loss while considering the socioeconomic factors impacting farmers in the region.

Assessing and detection of multiple bruises in peaches based on structured hyperspectral imaging

This study aimed to detect various types of postharvest damages in peaches based on structured hyperspectral imaging (S-HSI), including impact, falling, and compression damage, which can lead to bruising. The research involved three different spatial frequencies (60, 100, and 150 m-1) and used a 2π/3 phase shift interval to capture S-HSI images. These images were then processed using a mathematical demodulated model to create high-resolution image cubes that included both image and spectral information from the S-HSI data. Artificial neural network and principal component analysis were applied to develop bruise detection models using S-HSI spectra, which showed better discriminating effects compared with the ordinary hyperspectral spectra. The best performing discriminating models for healthy and three kinds of bruised samples were developed using the spectra of spatial frequency with 100 + 150 m-1, respectively. This study demonstrated the potential of S-HSI as an effective optical technique for bruise detection of peach.

Impact of health system strengthening interventions on child survival in sub-Saharan Africa: a systematic review protocol

BACKGROUND

Strengthening healthcare systems is a practical approach to enhance healthcare delivery and services. Although there has been a rise in the number of health systems strengthening (HSS) interventions in sub-Saharan Africa (SSA), there is limited evidence on the causal effect of these activities on child survival. Furthermore, the findings reported so far have been varied, and how they relate to each other remains unclear. This systematic review study aims to assess all available evidence to understand the impact of HSS activities on child survival in SSA.

METHODS

We developed a search strategy to retrieve all relevant studies from electronic databases such as PubMed/MEDLINE, Web of Science, and African Journals Online. We will use a combination of search terms such as "under-five mortality," "child mortality," "infant mortality," "neonatal mortality," "child survival," and "health systems strengthening." The review will include studies that establish a causal relationship between HSS interventions and child survival. This will include studies with designs such as randomized controlled trials and quasi-experimental and methods like difference-in-difference. Two reviewers will independently screen all citations, abstracts, and full-text data and a third reviewer will act as a tiebreaker in case of disagreements. The primary outcome of interest is the impact of HSS activities on under-five survival. We will evaluate the quality of each study using the Bradford Hill criteria for causation.

DISCUSSION

Our systematic review will identify and evaluate all relevant evidence that establishes a causal relationship between HSS activities and the survival of children under five years in SSA. The review's findings regarding the impact of HSS activities on child survival could be of significant interest to the donor community and policy actors in the region. We also anticipate that the review's conclusions could serve as a valuable guide for the development of future health system interventions and strategies in SSA.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022333913.

The Global Landscape of Domestic Violence against Women during the COVID-19 Pandemic: A Narrative Review

The coronavirus disease (COVID-19) pandemic has led to an alarming increase in domestic violence against women owing to lockdown measures and limited access to support services. This article provides insights into the global prevalence of domestic violence, barriers to seeking help, its impact on women and children, and the best practices implemented worldwide. Domestic violence encompasses various forms of abuse; many young women experience partner violence. Barriers to seeking help include fear, financial constraints, lack of awareness of available services, and distrust among stakeholders. The consequences of domestic violence affect the mental health of both mothers and children. Countries have increased shelter funding and developed innovative protocols to reach survivors and address this issue. However, the healthcare sector's involvement in addressing domestic violence has been limited. This review advocates collaboration among healthcare institutions and government bodies. Key recommendations include utilizing telehealth services, implementing comprehensive training programs, establishing effective referral systems, enhancing health education, developing a domestic violence registry, improving the responses of law enforcement and justice systems through healthcare integration, promoting data sharing, and conducting further research. Healthcare systems should recognize domestic violence as a public health concern and detect, prevent, and intervene in cases to support survivors.

Burden of Hidradenitis Suppurativa: A Systematic Literature Review of Patient Reported Outcomes

INTRODUCTION

Hidradenitis suppurativa (HS) has a profound negative impact on patients' health-related quality of life (HRQoL). Here we summarize the evidence on HRQoL and Patient Reported Outcomes (PROs) in patients with HS in real-world settings by conducting a systematic literature review (SLR) of observational studies.

METHODS

Data sources included MEDLINE, Embase & PsycINFO between January 1, 2010 and August 29, 2021, and conference proceedings between 2019 and 2021. Identified abstracts were reviewed and screened independently by two reviewers. Eligibility criteria included patients with HS of any severity, sample size ≥ 100, reporting PROs including HRQoL measures. Included studies were critically appraised.

RESULTS

Fifty-eight observational studies matched inclusion criteria. Dermatology Life Quality Index (DLQI) was the most commonly utilized instrument: 57% of included studies reported mean baseline DLQI scores, ranging between 8.4 and 16.9, indicating a very large impact on the patients' HRQoL. Higher scores were reported with increasing disease severity and among female patients. Pain was assessed mostly by an 11-point (0-10) numeric rating scale (NRS) with a mean baseline score ranging from 3.6 to 7.7 indicating moderate to high pain levels. There was a negative impact of HS on patients' psychological well-being, based on PRO scores related to depression and anxiety. A high proportion of sexual dysfunction was reported, with a larger impact on women than men. Work productivity and leisure activity were consistently found to be impaired in patients with HS.

CONCLUSIONS

All included studies reported a negative impact of HS on patients' lives. A diverse set of disease- and non-disease-specific PRO instruments were utilized highlighting the need for more consistent use of HS-specific validated PRO instruments to assess the impact of HS on the different aspects of patients' HRQoL to allow for data to be more meaningfully interpreted and compared in real-world settings. Patients with HS need better disease management approaches that address the observed low quality of life.

[Impact of the 2020 lockdown on prehospital psychiatric emergencies in a large city]

BACKGROUND

The coronavirus disease 2019 (COVID-19) pandemic represented a serious challenge for healthcare systems worldwide. Special psychiatric patients represent a vulnerable group and are particularly affected by lockdown interventions. Knowledge on the possible effects for this group of patients in an emergency physician setting is low.

OBJECTIVE

The aim of this paper is to investigate the impact of the first lockdown during the COVID-19 pandemic in 2020 on emergency ambulance services for psychiatric patients in a large German city.

MATERIAL AND METHODS

A retrospective analysis was conducted on all prehospital psychiatric emergencies in a large German city during the first pandemic-related lockdown from 22 March 2020 to 4 May 2020, with the same period in 2019 serving as a reference.

RESULTS

During the first lockdown there was a significant increase in the number of emergency missions with respect to psychiatric cases. A substantial rise in substance-associated deployments was observed. Moreover, there was an increase in the proportion of psychiatric patients who did not meet emergency criteria. Suicidal tendencies and agitation status played a minor role during the lockdown.

CONCLUSION

The lockdown had a notable impact on the frequency and profile of emergency physician calls in the metropolitan area studied. The substantial increase in substance-associated callouts can be interpreted as both a deterioration in access to the healthcare system and an expression of the increased stress faced by the general population and vulnerable groups in particular.

Perception of Robotics and Navigation by Spine Fellows and Early Attendings: The Impact of These Technologies on Their Training and Practice

BACKGROUND

There is scant data on the role that robotics and navigation play in spine surgery training and practice of early attendings. This study aimed to assess the impact of navigation and robotics on spine surgery training and practice.

METHODS

A survey gathering information on utilization of navigation and robotics in training and practice was administered to trainees and early attendings.

RESULTS

A total of 51 surveys were returned completed: 71% were attendings (average practice years: 2), 29% were trainees. During training, 22% were exposed to only fluoroscopy, 75% were exposed to navigation, 51% were exposed to robotics, and 40% were exposed to both navigation and robotics. In our sample, 87% and 61% of respondents who had exposure to navigation and robotics, respectively, felt that it had a positive impact on their training. In practice, 28% utilized only fluoroscopy, 69% utilized navigation, 30% utilized robotics, and 28% utilized both navigation and robotics. The top 3 reasons behind positive impact on training and practice were: 1) increased screw accuracy, 2) exposure to upcoming technology, and 3) less radiation exposure. The top 3 reasons behind negative impact were: 1) compromises training to independently place screws, 2) time and personnel requirements, and 3) concerns about availing it in practice. In sum, 76% of attendings felt that they will be utilizing more navigation and robotics in 5 years' time.

CONCLUSIONS

Navigation and robotics have a perceivably positive impact on training and are increasingly being incorporated into practice. However, associated concerns demand spine surgeons to be thoughtful about how they integrate these technologies moving forward.

Longitudinal Assessment of Empathy and Burnout Across a Single Pharmacy Class Cohort

OBJECTIVE

This is a final analysis of longitudinal evaluation of burnout and empathy among a cohort of Doctor of Pharmacy students throughout their 4-year enrollment.

METHODS

The class of 2021 received sequential Qualtrics (Qualtrics, Provo, UT) surveys containing 2 validated survey instruments, the Jefferson Scale of Empathy and the Maslach Burnout Inventory. Surveys were disseminated at the start of the program (PY1start) and the end of each academic year (PY1end, PY2, PY3, PY4). Linear mixed models accounting for repeated measures, Generalized Estimating Equation, and Cochran's Q statistic were used to evaluate longitudinal change in the Jefferson Scale of Empathy and Maslach Burnout Inventory survey scores, categorized subscales, and burnout.

RESULTS

Matched survey responses were included for 91 students (85.8% response rate). Across all years, a decrease in empathy and professional efficacy and an increase in exhaustion and cynicism was seen. High categorical levels of exhaustion and cynicism indicated evidence of burnout throughout the program. Year-to-year analysis indicated statistically significant increases in exhaustion and cynicism between PY1start and all subsequent assessments, a decrease in professional efficacy from PY1start to PY1end and PY2, and a decrease in empathy for PY1start to PY1end.

CONCLUSION

Students reported trends of decreasing empathy and professional efficacy, with a simultaneous increase in exhaustion and cynicism. Further evaluation of the impact of COVID-19 on these results, as well as additional methods to support overall student wellness, is needed.

The Impact of Morbidities Following Pediatric Cardiac Surgery on Family Functioning and Parent Quality of Life

We previously selected and defined nine important post-operative morbidities linked to paediatric cardiac surgery, and prospectively measured their incidence following 3090 consecutive operations. Our aim was to study the impact of these morbidities on family functioning and parental quality of life over 6 months in a subset of cases. As part of a prospective case matched study in five of the ten children's cardiac centers in the UK, we compared outcomes for parents of children who had a 'single morbidity', 'multiple morbidities', 'extracorporeal life support (ECLS)' or 'no morbidity'. Outcomes were evaluated using the PedsQL Family impact module (FIM) at 6 weeks and 6 months post-surgery. Outcomes were modelled using mixed effects regression, with adjustment for case mix and clustering within centers. We recruited 340 patients with morbidity (60% of eligible patients) and 326 with no morbidity over 21 months. In comparison to the reference group of 'no morbidity', after adjustment for case mix, at 6 weeks parent health-related quality of life (HRQoL) and total FIM sores were lower (worse) only for ECLS (p < 0.005), although a higher proportion of parents in both the ECLS and multi-morbidity groups had low/very low scores (p < .05). At 6 months, parent outcomes had improved for all groups but parent HRQoL and total score for ECLS remained lower than the 'no morbidity' group (p < .05) and a higher proportion of families had low or very low scores in the ECLS (70%) group (p < .01). Post-operative morbidities impact parent HRQoL and aspects of family functioning early after surgery, with this impact lessening by 6 months. Families of children who experience post-operative morbidities should be offered timely psychological support.

HIV Testing Disruptions and Service Adaptations During the COVID-19 Pandemic: A Systematic Literature Review

Access to treatment and care in safe clinical settings improves people's lives with HIV. The COVID-19 pandemic disrupted vital HIV programs and services, increasing the risk of adverse health outcomes for people with HIV and HIV transmission rates in the community. This systematic literature review provides a meta-analysis of HIV testing disruptions and a synthesis of HIV/AIDS services adapted during COVID-19. We searched scholarly databases from 01 January 2020 to 30 June 2022 using key terms on HIV testing rates and services during the COVID-19 pandemic. The process of how the included articles were identified, selected, appraised, and synthesised was reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We included 17 articles that reported changes in HIV testing during the COVID-19 pandemic and 22 that reported adaptations in HIV/AIDS services. We found that HIV testing decreased by 37% during the search period because of the COVID-19 pandemic. Service providers adopted novel strategies to support remote service delivery by expanding community antiretroviral therapy dispensing, setting up primary care outreach points, and instituting multi-month dispensing services to sustain client care. Therefore, service providers and policymakers should explore alternative strategies to increase HIV testing rates impacted by COVID-19 and leverage funding to continue providing the identified adapted services.

Assessment of climate impact on grape productivity: A new application for bioclimatic indices in Italy

Italy is a world leader for viticulture and wine business with an export valued 7 billion of euros in 2021, and wine being the second most exported product within the national agri-food sector. However, these figures might be threatened by climate change and winegrowers call for more reliable local information on future impacts of climate change on viticulture. The study aims to understand the impact of climate on wine production in Italy using grape productivity data and bioclimatic indices. Using temperature and precipitation observations from the E-OBS gridded dataset, a set of bioclimatic indices recommended by the International Organisation of Vine and Wine guidelines is calculated and correlated with grape productivity data at the regional scale (Nomenclature of territorial units for statistics, NUTS, level 2) over the last 39 years (1980-2019). The study investigates how both long-term change and natural variability of the bioclimatic indices impacted on grape productivity. Both single and multi-regression approaches are applied to assess the portion of grape productivity variability explained by the selected indices. When the single-regression approach is applied, the correlations between bioclimatic indices and grape productivity explain up to the 45 % of total production variability, however they are statistically significant only in few regions. Conversely, the multi-regression approach improves the proportion of variance explained and gives statistically significative results in region where the single regression is not statically significant. The multi-regressive approach shows the added value of considering the interplay of different bioclimatic indices in explaining the overall variability of productivity. The possibility of using bioclimatic indicators as a proxy for grape productivity provides a simple tool that grape growers, wine consortia and policy makers can use to adapt to future climate.

The first outbreak of African swine fever in Sweden: a survey of pig farmers' perceptions of information received, risks, biosecurity measures and future prospects

BACKGROUND

African swine fever (ASF), a viral hemorrhagic disease in domestic pigs and wild boar with up to 100% case fatality, was confirmed in Swedish wild boar in September 2023. The responsible authorities launched a control programme to eradicate the infection. The aim of the current study was to understand (i) how Swedish pig farmers have perceived the information issued by authorities and other stakeholders since the discovery of ASF in wild boar, (ii) which risks they see for introducing the infection to their farm, (iii) what biosecurity measures they have taken on their farms, and (iv) their outlook on the future. Such information is important for evaluating the effectiveness of the early stages of ASF control in Sweden. A questionnaire was designed and distributed to members of the Swedish pig producers' organisation.

RESULTS

A total of 155 farmers responded to the survey (response rate 36%). Almost all respondents had received general information about ASF (91%, n = 138), and 72% (n = 109) had received information about how they can protect their farm from ASF introduction. A majority (87%, n = 118) thought the information was easy to understand, 90% (n = 137) that is was relevant, and 77% (n = 117) that they currently did not lack any information. If given the resources necessary, 58% (n = 84) of the farmers would like to take additional measures such as fencing, and heavily reduce or eradicate the wild boar population. Wild boars were considered the greatest risk for introduction of ASF into their herd (39%, n = 57), followed by people (30%, n = 44), and transports (16%, n = 23). Many farmers (66%, n = 88) had a positive outlook on the future, and 89% (n = 127) have not changed their plans for the future since the ASF outbreak.

CONCLUSIONS

The responding farmers were in general satisfied with the information received in the beginning of the ASF outbreak. The majority have a positive outlook on the future and the outbreak has not caused them to change their plans. Actions that were highlighted as important to safeguard Sweden's pig production included measures to control the wild boar population.

Syndemic effect of COVID-19 outbreak on HIV care delivery around the globe: A systematic review using narrative synthesis

Background

The burden of the COVID-19 pandemic on healthcare systems worldwide has been compromising the progress made in the fight against HIV. This paper aims to determine how the COVID-19 pandemic has impacted HIV comprehensive care service delivery globally as well as to consolidate the evidence and recommendations that may be useful in averting future crisis.

Methods

This review adheres to PRISMA guidelines. PubMed, DOAJ, Science Direct and other sources like Google Scholar and citations from included studies were searched methodically to locate studies evaluating the effects of COVID on services for HIV care. The NIH and JBI quality assessment tools were used for the quality assessment of individual studies.

Results

In the present review 31 eligible studies were included and the impact on HIV care cascade were summarised under six themes: Lab services, Treatment and allied services, Counselling services, Outreach services, Psycho-social impact and Implementation of sustainable strategies. The studies also presented many innovative alternatives which were lucidly highlighted in the present article.

Conclusion

Current evidence depicts multiple factors are responsible for the interruption of HIV care service delivery during the pandemic, especially in low resources settings. The prospective, alternative solutions that have been used to circumvent the threat have also been addressed in this review, in addition to the negative aspects that have been observed. Transition with new innovative, sustainable care paradigms may prove to be the building blocks in removing HIV-AIDS as a public health threat.

Registration

Open Science Framework (DOI: 10.17605/OSF.IO/74GHM).

The relationship between speculation and translation in Bioethics: methods and methodologies

There are increasing pressures for bioethics to emphasise 'translation'. Against this backdrop, we defend 'speculative bioethics'. We explore speculation as an important tool and line of bioethical inquiry. Further, we examine the relationship between speculation and translational bioethics and posit that speculation can support translational work. First, speculative research might be conducted as ethical analysis of contemporary issues through a new lens, in which case it supports translational work. Second, speculation might be a first step prior to translational work on a topic. Finally, speculative bioethics might constitute different content altogether, without translational objectives. For each conception of speculative bioethics, important methodological aspects determine whether it constitutes good bioethics research. We conclude that whether speculative bioethics is compatible with translational bioethics-and to what extent-depends on whether it is being employed as tool or content. Applying standards of impact uniformly across bioethics may inappropriately limit speculative bioethics.

Does Anisakis spp. infestation affect the proximate composition, fatty acids, and minerals contents of its host Merluccius merlucccius?

Fish play an important role in human nutrition. They are not only a great source of protein and healthy fats, but also a unique source of essential nutrients such as omega-3 fatty acids. Moreover, most fish are parasitized, and some of these parasites are able to influence the reallocation of resources in their favor and thus reduce the nutritional quality of the fish. The present study was conducted to investigate the impact of the third stage larvae (L3) of Anisakis spp. on the proximate composition, macro-minerals (potassium, calcium, and sodium), and fatty acids of European hake (Merluccius merluccius Linnaeus, 1758). In parasitized female group, our results revealed a decrease (p< 0.005) in the amount of carbohydrate by 6.5%, of calcium by 17%, and of 2 polyunsaturated fatty acids (arachidonic acid (C20: 4w-6), and eicosapentaenoic acid (C20: 5w-3) with 33% and 15% respectively. Simultaneously, an increase by 25% in the level of a single saturated fatty acid C10:0 was noticed. According to the principal component analysis, the parasitized female was wealthy of saturated fatty acids and monounsaturated fatty acids and contains less of polyunsaturated fatty acids, omega-3 fatty acids, and omega-6 fatty acids than the unparasitized female and male. No significant changes were observed in the biochemical composition of male hake, probably due to the low mean intensity of L3 larvae of Anisakis spp. in this group.

Effect of emotion-based nutrition messages on consumption of calcium-rich foods among early adolescents in Ogbomoso, Nigeria

Introduction

Calcium is a vital micronutrient for several physiological processes, yet it remains one of the significant shortfall nutrients among Nigerian adolescents.

Objective

This study was designed to assess the effect of emotion-based nutrition messages on the consumption of calcium-rich foods among early adolescents in Ogbomoso, Nigeria.

Methodology

The quasi-experimental study involved 220 adolescents (experimental: 110 and control: 110) selected using a three-stage sampling procedure. A semi-structured, interviewer-administered questionnaire was used to collect socio-demographic characteristics, dietary practice, calcium-rich foods consumption pattern, calcium intake, and anthropometric parameters. Second, calcium-rich foods consumption pattern was assessed using a food frequency questionnaire, and intake was evaluated using the multi-pass 24-hour dietary recall to define adequacy at intake level ≥1,300 mg per day. Third, the experimental group had five weeks of nutrition education using emotion-based nutrition messages. Data were analyzed using descriptive statistics and the Chi-square test at p < 0.05.

Results

The age of respondents (years) in experimental (12.88±1.41) and control (13.4±1.03) groups was similar. Primary dietary calcium sources were meat, chicken, egg, white beans, cheese, soy milk, oranges, and locust beans at baseline. At post-intervention, intake of other calcium-rich foods such as milk, yogurt, ice cream, okra, sardine, and unripe plantain increased, however, calcium intake remains similar in both control (238.41±92.4 mg; 235.40±92.92 mg) and experimental groups (239.76±51 mg; 241.46±100.89 mg) at baseline and post-intervention, respectively. The overall calcium intake of the adolescents remains below the recommended intake level of 1,300 mg.

Conclusion

Emotion-based nutritional messages did not significantly increase the total calcium intake among early adolescents.

From Bench to Bytes: Utility of Social Media Platforms by Pathology Residents

Background

The rise of virtual media has expanded to various fields and the medical profession has not been immune to its influence. The purpose of our study was to analyse and evaluate the impact of virtual social networks, on the professional growth and career progression of Pathology residents.

Materials and Methods

A cross-sectional survey was undertaken at the section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi. An online, questionnaire based on google forms was sent via WhatsApp application to the Pathology residents (n = 30) from July to August 2023. The anonymity of the participants was maintained. The statistical analysis was performed using Microsoft Excel 2019.

Results

A total of 25 (83%) Pathology residents participated in the survey. 72% of the participants were females and 28% were males. Chemical Pathology residents constituted the largest proportion at 44%, followed by 24% from Hematology, 24% from Microbiology and 8% from Histopathology. 60% of the trainees acknowledged using social media platforms routinely for professional development. The most used social media platforms were YouTube (48%), Twitter (36%), Facebook (12%) and Instagram (4%). Social media network was perceived the most useful in increasing understanding regarding the profession (60%), strengthening the proficiency in problem-solving (56%) and enhancing critical thinking abilities (52%) whereas it was regarded as somewhat useful in enhancing clinical/professional decision-making skills (52%) and clinical expertise (60%).

Conclusion

Social media is gaining popularity in the realm of medicine and this survey reveals the perspective of Pathology residents on the social media networks and its growing impact on their professional growth.

Feasibility of introducing effective alcohol harms reduction strategies in a low regulation region: A qualitative study from Hong Kong

To counter the harms of excessive alcohol use, the World Health Organization (WHO) outlined a series of alcohol policy recommendations, including the most cost-effective "Best Buys". This study aims to obtain key stakeholder views on feasibility of implementing various publicly endorsed alcohol policies in Hong Kong, a relatively low alcohol consumption region with few extant alcohol regulations. Between 2019 and 2021, we conducted semi-structured interviews with stakeholders involved in alcohol policy adoption and implementation. Interviewees included hospitality/alcohol sales workers (n = 13) and government officers (n = 4). The stakeholders noted that although WHO advocacy facilitated local policy considerations, the adoption of stringent measures was challenged by low political priority due to the low visibility of harms. For implementing strategies, the stakeholders cited alignment with social norms as a major facilitator, whereas law enforcement difficulties and resistance from industry/business sectors were viewed as major obstacles. There was a general belief that population-level alcohol policies would be effective for certain groups of drinkers but would also harm the local economy and detract from Hong Kong's image as a "world city". Hong Kong may not be ready to adopt a wide range of highly restrictive population-level alcohol policies. Local governments should carefully consider contextual factors when following international recommendations.

Effects of microfinance and small loans centre on poverty reduction in Wa West District, Ghana

Poverty, a pervasive and consequential global issue, has garnered significant attention due to its wide-reaching prevalence and profound implications. Various strategies, including microfinance, have been implemented to tackle this pressing concern. One such strategy is the Microfinance and Small Loans Centre (MASLOC) in Ghana, which aims to reduce poverty. However, despite its potential, MASLOC's role in poverty reduction has yet to be thoroughly examined, leading to inconclusive findings, and necessitating this study. A single case study design addressed this research gap and provided valuable insights. A comprehensive dataset was compiled through interviews and observations involving 40 MASLOC beneficiaries and officials. Thematic analysis was utilized to dissect the collected data, revealing noteworthy patterns and trends. The study's outcomes shed light on MASLOC's effectiveness in mitigating poverty. Specifically, it was found that MASLOC played a pivotal role in poverty reduction by bolstering income levels, amplifying consumption patterns, facilitating access to fundamental necessities, and enabling the accumulation of valuable assets. Nevertheless, the analysis also highlighted specific challenges. Issues related to loan repayment and staffing emerged as constraints within the MASLOC framework. In essence, the study established that MASLOC contributes to the overarching goal of poverty reduction. The findings are helpful because fostering a positive attitude towards loan repayment is crucial, and this endeavour should be complemented by the strategic recruitment of competent staff members who can effectively navigate the intricacies of the scheme to ensure the sustainability of MASLOC. What sets this study apart is its innovative exploration of the impact of MASLOC on poverty-a primarily overlooked facet. By delving into this uncharted territory, the study enriches the ongoing discourse surrounding government microfinance schemes' influence on its beneficiaries. This research contributes not only to the academic realm but also to the practical realm, as it offers actionable insights for policymakers in poverty reduction.

Impact of COVID-19 on selected essential public health services - lessons learned from a retrospective record review in the Free State, South Africa

BACKGROUND

In an attempt to discern lessons to improve future pandemic responses, this study measured the effects of the COVID-19 pandemic on essential public health services (EPHSs) related to primary health care (PHC) and outpatient department (OPD) utilisation, antiretroviral treatment (ART) commencement, drug-susceptible tuberculosis (DS-TB) confirmation and treatment commencement, and Bacillus Calmette-Guérin (BCG) coverage, in the Free State province of South Africa during January 2019 to March 2021.

METHODS

A pre-post study design comparing EPHS performance between 2019 and 2020/21 was employed. Routinely collected data were analysed. An interrupted time series analysis was used to measure changes in service use and outcomes from January 2019 to March 2021. Median changes were compared using Wilcoxon rank-sum tests. A 5% statistical significance level was considered.

RESULTS

Over the study period, the median values for the annual number of PHC visits was 1.80, 55.30% for non-referred OPD visits, 69.40% for ART commencement, 95.10% and 18.70% for DS-TB confirmation and treatment commencement respectively, and 93.70% for BCG coverage. While BCG coverage increased by 5.85% (p = 0.010), significant declines were observed in PHC utilisation (10.53%; p = 0.001), non-referred OPD visits (12.05%; p < 0.001), and ART commencement (9.53%; p = 0.017) rates. Given the importance of PHC in addressing a new pandemic, along with the existing HIV and TB epidemics - as well as the entire quadruple burden of disease - in South Africa, the finding that the PHC utilisation rate statistically significantly decreased in the Free State post-COVID-19 commencement is particularly concerning.

CONCLUSIONS

The lessons learned from this retrospective review attest to a measure of resilience in EPHS delivery in the Free State in as far as a significant hike in BCG vaccination over the study period, 2019-2020/21 was observed. As evidenced by a decline in PHC service utilisation and the decreased numbers of new patients commencing ART, we also learned that EPHS delivery in the province was fragile.

Impact of vaccination against severe COVID-19 in the French population aged 50 years and above: a retrospective population-based study

BACKGROUND

Given the widespread implementation of COVID-19 vaccination to mitigate the pandemic from the end of 2020, it is important to retrospectively evaluate its impact, in particular by quantifying the number of severe outcomes prevented through vaccination.

METHODS

We estimated the number of hospitalizations, intensive care unit (ICU) admissions and deaths directly averted by vaccination in France, in people aged ≥ 50 years, from December 2020 to March 2022, based on (1) the number of observed events, (2) vaccination coverage, and (3) vaccine effectiveness. We accounted for the effect of primary vaccination and the first booster dose, the circulating variants, the age groups, and the waning of vaccine-induced protection over time.

RESULTS

An estimated 480,150 (95% CI: 260,072-582,516) hospitalizations, 132,156 (50,409-157,767) ICU admissions and 125,376 (53,792-152,037) deaths were directly averted by vaccination in people aged ≥ 50 years, which corresponds to a reduction of 63.2% (48.2-67.6), 68.7% (45.6-72.4) and 62.7% (41.9-67.1) respectively, compared to what would have been expected without vaccination over the study period. An estimated 5852 (2285-6853) deaths were directly averted among the 50-59 years old, 16,837 (6568-19,473) among the 60-69 years old, 32,136 (13,651-36,758) among the 70-79 years old and 70,551 (31,288-88,953) among the ≥ 80 years old.

CONCLUSIONS

The vaccination campaign in France considerably reduced COVID-19 morbidity and mortality, as well as stress on the healthcare system.

Prevalence, Correlates, and Impact of Psychiatric Disorders and Treatment Utilization Among Muslims in the United States: Results from the National Epidemiological Survey of Alcohol and Related Conditions

There is a paucity of research on the true prevalence of psychiatric disorders in Muslim Americans. This research aims to explore the prevalence, correlates and impact of mood disorders, anxiety disorders, and posttraumatic stress disorders (PTSD) in Muslims as compared with a non-Muslim sample. We used propensity scores to match 372 individuals who self-identified as Muslims from The National Epidemiologic Survey on Alcohol and Related Conditions III with a control group (n = 744) from the same dataset. The prevalence of psychiatric disorders was similar in Muslim Americans and non-Muslims. Help-seeking was generally low, but Muslims with a lifetime history of PTSD were less likely than non-Muslims with PTSD to seek help through self-help groups (2.2% vs. 21.1%, p < 0.05). Moreover, Muslims with mood disorders experienced lower mental health scores compared to non-Muslims with mood disorders. Efforts need to be made to identify psychiatric disorders in this faith group and engage in treatment.

The impact of participatory action research and endogenous integrated soil fertility management on farm-gate dietary outputs in northern Tanzania

In most developing countries, although agricultural extension and research devolved since 1980s to promote relevance, cost-effectiveness, ownership, and sustainability, participatory action research (PAR) have been run, albeit with limited empirical evidence on their impacts on farmers livelihoods. The study use a three-stage extended regression model (ERM) to estimate the effect PAR and the promoted agronomic practices on crop produce dietary outputs considering potential endogenous engagement, omitted variable bias, reverse causality, endogenous covariates, and factor simultaneity. Using a sample of 607 small family farms with varying levels of research engagement in the Northern Highlands of Tanzania, the study found that PAR was associated with increased farm-gate dietary outcomes: per-capita calories, proteins, and minerals produced by 139, 216, and 143 %, respectively, and consumption of farm-produced minerals by 74-200 %. The organic manure application was associated with increased the dietary outputs by 62-113 % while the application of inorganic fertilizer with increased protein and mineral outputs by 68 and 105 %, respectively. The crop diversification was associated with increased dietary outputs by 11-25 % while pest and diseases control with increased dietary outputs by 12-17 % but with reduced consumption by 13-14 %. Soil and water conservation measures including terracing were associated with decreased dietary outputs. These findings indicate that PAR contributes to nutritional outcomes of smallholder farmers contingent on the promotion of low-cost input sources and crop diversification which can be leveraged to inform upscaling of participatory policies, strategies, and technologies.