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Stuhec, M., and I. Locatelli. "Age-related pharmacotherapy of attention deficit hyperactivity disorder in Slovenia in children and adolescents: A population-based study." European Psychiatry 42 (May 2017): 129–33. http://dx.doi.org/10.1016/j.eurpsy.2017.01.002.
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AbstractBackgroundThere are no data on age-related pharmacotherapy for Attention Deficit Hyperactivity Disorder (ADHD) medication in children and adolescents in the most European countries. The main aim of this paper was to obtain that data for children and adolescents in Slovenia.MethodThe number of ADHD drug prescriptions per patient was obtained from the health claims data on prescription drugs of the Health Insurance Institute of Slovenia for the study period (2003–2015). Three age groups were analyzed: 2–5 years, 6–12 years, and 13–17 years. Only immediate-release methylphenidate (IR-MPH), methylphenidate-osmotic release oral delivery system (OROS-MPH), and atomoxetine (ATX) were available and included in this study.ResultsLess than 50% of patients in Slovenia were treated with medication. The number of patients treated with MPH in the 6–12 age group remained approximately the same between 2007 and 2015 (604–729 patients). In the 13–17 age group, however that number increased 2-fold between 2003 and 2015, from 288 to 555. The number of patients treated with ATX in the 6–12 age group age group increased from 20 to 163 between 2007 and 2015. The number was similar in the 13–17 age group, increasing from 10 to 165 in the same period. In 2015, 21% of the patients from all age groups in this study were treated with ATX.ConclusionsThe number of patients treated for ADHD increased rapidly in all age groups. Patients under the age of six are prescribed medication in Slovenia, which should be avoided.
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Khavjou, Olga A., Wayne L. Anderson, Amanda A. Honeycutt, Laurel G. Bates, NaTasha D. Hollis, Scott D. Grosse, and Hilda Razzaghi. "State-Level Health Care Expenditures Associated With Disability." Public Health Reports 136, no. 4 (March 5, 2021): 441–50. http://dx.doi.org/10.1177/0033354920979807.
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Objective Given the growth in national disability-associated health care expenditures (DAHE) and the changes in health insurance–specific DAHE distribution, updated estimates of state-level DAHE are needed. The objective of this study was to update state-level estimates of DAHE. Methods We combined data from the 2013-2015 Medical Expenditure Panel Survey, 2013-2015 Behavioral Risk Factor Surveillance System, and 2014 National Health Expenditure Accounts to calculate state-level DAHE for US adults in total, per adult, and per (adult) person with disability (PWD). We adjusted expenditures to 2017 prices and assessed changes in DAHE from 2003 to 2015. Results In 2015, DAHE were $868 billion nationally (range, $1.4 billion in Wyoming to $102.8 billion in California) accounting for 36% of total health care expenditures (range, 29%-41%). From 2003 to 2015, total DAHE increased by 65% (range, 35%-125%). In 2015, DAHE per PWD were highest in the District of Columbia ($27 839) and lowest in Alabama ($12 603). From 2003 to 2015, per-PWD DAHE increased by 13% (range, −20% to 61%) and per-capita DAHE increased by 28% (range, 7%-84%). In 2015, Medicare DAHE per PWD ranged from $10 067 in Alaska to $18 768 in New Jersey. Medicaid DAHE per PWD ranged from $9825 in Nevada to $43 365 in the District of Columbia. Nonpublic–health insurer per-PWD DAHE ranged from $7641 in Arkansas to $18 796 in Alaska. Conclusion DAHE are substantial and vary by state. The public sector largely supports the health care costs of people with disabilities. State policy makers and other stakeholders can use these results to inform the development of public health programs that support and provide ongoing health care to people with disabilities.
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Haji, Eman, Fatema Jamsheer, Ghufran Jassim, Ashwaq Sabt, Amani Abdulla AlSabagh, Lama Mahmood Nasar, Khadija Ebrahim Hassan, and Ebtisam Nuhaily. "Global School-Based Student Health Survey 2016-Bahrain: Mental health." Journal of the Bahrain Medical Society 35, no. 1 (2023): 34–41. http://dx.doi.org/10.26715/jbms.35_1_4.
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Background: The Global school-based student health survey (GSHS) was developed to help countries measure and assess students' health behaviors and protective factors. This report discusses results from the first GSHS carried out in Bahrain during 2015-2016 by the Ministry of Education in collaboration with World Health Organization (WHO) and Centers for Disease Control and Prevention (CDC). Methods: The GSHS includes students aged 13-17 years and employed a two-stage sample design involving a school and class level. 64 public and private schools were sampled out of 162 schools, and 320 classes of students in grades 7-11 were selected. Students completed a questionnaire addressing mental health, protective factors, sexual behaviors, violence, and unintentional injury. Results: 7,143 (89%) of the 8,068 sampled students completed the questionnaire. Of the students who responded, 3,685 (51.1%) were males, and 5,843 (84.5%) were between the ages of 13 to 17 years old. 27.2% of students were physically attacked, 41.4% were in a physical fight, and 28.6% were bullied one or more times during the past 12 months. 38.1% of the students never or rarely wore a seatbelt when in a car, and 30.7% never or rarely wore a helmet when riding a bicycle. 16.2% of students felt lonely most of the time or always, and 15.2% seriously considered attempting suicide during the past 12 months. Conclusion: The study reported rates of violence, physical fights, bullying, and unsafe practices among school-Age children. Raising awareness regarding mental health and emotional well-being, assessment and support among school children is vital. Keywords: Bahrain, Mental health, School, School health, WHO
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Atmiroseva, Atmiroseva, and Atik Nurwahyuni. "Inpatient Readmission Insidence of National Health Insurance Patients at Partner Hospitals of BPJS-Health in Sukabumi 2015." Journal of Indonesian Health Policy and Administration 2, no. 2 (July 1, 2017): 20. http://dx.doi.org/10.7454/ihpa.v2i2.1909.
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The INA-CBG payment system in the JKN program allegedly increasing the incidence of readmission. This study aims to map the incidence of readmission in JKN participants admitted to thirteen partner hospitals of BPJS-Health in Sukabumi. The research design is a descriptive study with the unit of analysis is patient. The study used secondary data from inpatient claims in thirteen partner hospitals BPJS-Health Sukabumi which has been verified during 2015. The study found that the number of readmission is 8.81% with the most readmission incidence occurs in the equal CMG category and at the least in the equal severity level category. The cost of inpatient readmission services is more expensive 104-113% of the initial care cost. Moreover, about 15-16% cases of severity level readmission is increasing and 12-13% of its severity level is decreased. Less than 3% cases of readmission ended not good because they died, were referred, or had to come home forcibly.
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Li, Jia, Aynur Demirel, Andres Azuero, Amie McLain, and Ceren Yarar-Fisher. "The Relationship Between Healthy Eating Index-2015 and Cardiometabolic Risk Factors in People with Long-Standing Spinal Cord Injury." Current Developments in Nutrition 4, Supplement_2 (May 29, 2020): 540. http://dx.doi.org/10.1093/cdn/nzaa046_040.
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Abstract Objectives The Healthy Eating Index (HEI)-2015 is a measure of diet quality in reference to the 2015 Dietary Guidelines for Americans. We examined the relationship between HEI-2015 and several indices of cardiometabolic risk factors among individuals with chronic spinal cord injury (SCI) (>3 years after injury). Methods Twenty-four participants without type 2 diabetes were included (45 ± 12 y, 8F/16 M, 9 Tetraplegia/15 Paraplegia, time since injury: 20 ± 13 y). All participants underwent a 2-hour oral glucose tolerance test (OGTT), a Dual-energy X-ray absorptiometry scan (DXA), and 3 24-hour multiple-pass dietary recalls. HEI-2015 was calculated using the dietary recall data. To build the regression model, firstly, principal component (PC) analysis was used to reduce the number of covariates from 3 (level of injury, gender, percentage body fat estimated from the DXA) to 2 PCs. Multiple linear regression analyses were run to predict indices of lipid metabolism and glucose homeostasis as well as C-reactive protein (CRP) from the HEI and the 2 PC scores. Results The average HEI-2015 score was lower for participants with SCI compared to the general American population (48 ± 11 vs. 59, P < 0.05). The regression models for fasting glucose (FG), Cholesterol, HDL, LDL, and CRP had moderate to large effect sizes (adjusted R2 > 13%), indicating good explanatory ability of the predictors. Small or limited effect sizes were observed for other models (glucose tolerance, fasting insulin, triaglycerides, and Matsuda index, adjusted R2 < 13% for all). Furthermore, the HEI accounted for a moderate amount of variation in FG as evidenced by partial Omega-squared of 13%. Each 10-point increase of the HEI was associated with a 3.3 mg/dL decrease in FG concentrations. However, HEI accounted for a limited amount of variations in other indices (ωP2 < 5% for all). Conclusions Our exploratory analyses suggest that HEI-2015 has limited effects on blood lipids and CRP but may be associated with lower FG concentrations in our sample group. Future larger studies are warranted to delineate the relationship between diet quality and cardiometabolic health outcomes in individuals with SCI. Funding Sources The National Institute on Disability, Independent Living, and Rehabilitation Research.
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Ioannidis, John P. A. "Meta-analyses in environmental and occupational health." Occupational and Environmental Medicine 75, no. 6 (March 24, 2018): 443–45. http://dx.doi.org/10.1136/oemed-2016-104128.
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ObjectivesMeta-analyses are considered generally as the highest level of evidence, but concerns have been voiced about their massive, low-quality production. This paper aimed to evaluate the landscape of meta-analyses in the field of occupational and environmental health and medicine.MethodsUsing relevant search terms, all meta-analyses were searched for, but those published in 2015 were assessed for their origin, whether they included randomised trials and individual-level data and whether they had authors from the industry or consultancy firms.ResultsPubMed searches (last update February 2017) identified 1251 eligible meta-analyses in this field. There was a rapid increase over time (n=16 published in 1995 vs n=163 published in 2015). Of the 163 eligible meta-analyses published in 2015, 49 were from China, followed at a distance by the USA (n=19). Only 16 considered randomised (intervention) trials and 13 included individual-level data. Only 1 of the 150 meta-analyses had industry authors and none had consultancy firm authors. As an example of conflicting findings, 12 overlapping meta-analyses addressed mobile phones and brain cancer risk and they differed substantially in number of studies included, eligibility criteria and conclusions.ConclusionsThere has been a major increase in the publication of meta-analyses in occupational and environmental health over time, with the majority of these studies focusing on observational data, while a commendable fraction used individual-level data. Authorship is still limited largely to academic and non-profit authors. With massive production of meta-analyses, redundancy needs to be anticipated and efforts should be made to safeguard quality and protect from bias.
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Morton Hamer, Melinda J., Paul L. Reed, Jane D. Greulich, Gabor D. Kelen, Nicole A. Bradstreet, and Charles W. Beadling. "The West Africa Disaster Preparedness Initiative: Strengthening National Capacities for All-Hazards Disaster Preparedness." Disaster Medicine and Public Health Preparedness 11, no. 4 (November 24, 2016): 431–38. http://dx.doi.org/10.1017/dmp.2016.155.
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AbstractObjectiveThe Ebola outbreak demonstrated the need for improved disaster response throughout West Africa. The West Africa Disaster Preparedness Initiative was a training and assessment effort led by US Africa Command and partners to strengthen capacities among 12 West African partner nations (PNs).MethodsSeries of 3-week training sessions with representatives from each PN were held from 13 July through 20 November 2015 at the Kofi Annan International Peacekeeping Training Centre in Accra, Ghana. A team conducted Disaster Management Capabilities Assessments (DMCAs) for each PN, including a review of key data, a survey for leaders, and in-person interviews of key informants.ResultsAll 12 PNs generated a national Ebola Preparedness and Response Plan and Emergency Operations Center standard operating procedures. DMCA metrics were generated for each PN. Top performers included Ghana, with a plan rated good/excellent, and Benin and Burkina Faso, which both achieved a satisfactory rating for their plans. More than 800 people from 12 nations were trained.ConclusionPNs have improved disaster management capabilities and awareness of their strengths and weaknesses. The Economic Community of West African States has increased its lead role in this and future planned initiatives. (Disaster Med Public Health Preparedness. 2017;11:431–438)
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Riatto, Sabrina Gonçalves, Javier Montero, David Ribas Pérez, Antonio Castaño-Séiquer, and Abraham Dib. "Oral Health Status of Syrian Children in the Refugee Center of Melilla, Spain." International Journal of Dentistry 2018 (2018): 1–7. http://dx.doi.org/10.1155/2018/2637508.
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Introduction. Little is known about the state of oral health among immigrants from conflict zones, such as the refugee children from the Syrian Civil War. Aim. To determine the oral health status of Syrian immigrant children refugee at the Center for Temporary Stay of Immigrants in Melilla to plan prevention and care programs. Design. Using the criteria set by the World Health Organization, an exploration of the oral cavity of all Syrian children aged 5–13 living at that center was conducted in May 2015. All subjects were clinically evaluated by a calibrated and standardized examiner, accompanied by a dentist who registered the clinical variables, and translators. The sociodemographic and clinical variables were analyzed through a descriptive and analytical study, respectively. Results. The prevalence of caries in both the permanent and deciduous dentition was 75% and 50% in 6- and 12-year-olds, respectively. The dft was 3.2 ± 2.9 in 6-year-old children. At 12 years old, the DMFT was 1.6 ± 2.6 teeth, the DMFM was 1.1 ± 1.7 teeth, the SiC was 3.2, and the IR was 5%. Eighty-six percent of the examined sextants were periodontally healthy. Conclusions. The prevalence of caries was high in the sample population studied, confirming the need for a comprehensive primary oral health care program.
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Bennion, Matthew Russell, Gillian E. Hardy, Roger K. Moore, Stephen Kellett, and Abigail Millings. "e-Therapies in England for stress, anxiety or depression: how are apps developed? A survey of NHS e-therapy developers." BMJ Health & Care Informatics 26, no. 1 (June 2019): e100027. http://dx.doi.org/10.1136/bmjhci-2019-100027.
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ObjectiveTo document the quality of web and smartphone apps used and recommended for stress, anxiety or depression by examining the manner in which they were developed.DesignThe study was conducted using a survey sent to developers of National Health Service (NHS) e-therapies.Data sourcesData were collected via a survey sent out to NHS e-therapy developers during October 2015 and review of development company websites during October 2015.Data collection/extraction methodsData were compiled from responses to the survey and development company websites of the NHS e-therapies developers.ResultsA total of 36 (76.6%) out of the 48 app developers responded. One app was excluded due to its contact details and developer website being unidentifiable. Data from the missing 10 was determined from the app developer’s website. The results were that 12 out of 13 web apps and 20 out of 34 smartphone apps had clinical involvement in their development. Nine out of 13 web apps and nine out of 34 smartphone apps indicated academic involvement in their development. Twelve out of 13 web apps and nine out of 34 smartphone apps indicated published research evidence relating to their app. Ten out of 13 web apps and 10 out of 34 smartphone apps indicated having other evidence relating to their app. Nine out of 13 web apps and 19 out of 34 smartphone apps indicated having a psychological approach or theory behind their app.ConclusionsAs an increasing number of developers are looking to produce e-therapies for the NHS it is essential they apply clinical and academic best practices to ensure the creation of safe and effective apps.
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Temple, Jeromey B., and Briony Dow. "The unmet support needs of carers of older Australians: prevalence and mental health." International Psychogeriatrics 30, no. 12 (May 25, 2018): 1849–60. http://dx.doi.org/10.1017/s104161021800042x.
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ABSTRACTBackground:Population aging places greater demands on the supply of informal carers. The aims of this study were to examine (1) the types of unmet support needs of carers of older Australians and (2) the association of unmet needs with mental health.Methods:Utilizing new data from the 2015 Australian Bureau of Statistics (ABS) Survey of Disability, Ageing and Carers, we calculated the prevalence of carers experiencing specific and multiple unmet needs for support, using single and multiple item measures. Logistic regression models were fitted to examine the association between unmet needs and psychological distress (using the Kessler psychological distress scale), once demographic and health factors were controlled for.Results:In 2015, 35% of carers of older Australians cited at least one unmet need for support. Among this group, almost two-thirds cited multiple unmet support needs (64.7%). The most prevalent types of unmet needs included financial (18%), physical (13%), and emotional support (12%), as well as additional respite care and support to improve carer health (12%). After controlling for demographic and health characteristics of the carer, having any unmet need for support increased the odds of psychological distress by twofold (OR = 2.20, 95% CI = 1.65, 2.94). With each successive unmet need for support, the odds of psychological distress increased 1.37 times (OR = 1.36, 95% CI = 1.22, 1.54). Those who had received assistance with care, but required further support were 1.95 times more likely (OR = 1.95, 95% CI = 1.17, 3.24) to be in distress and those who had not received care assistance were about 2.4 times more likely (OR = 2.38 95% OR = 1.56, 3.62) to be in distress relative to those with no unmet need.Conclusions:Addressing unmet support needs of carers is important, not only for the planning of services for carers in an aging population, but also because of the association between unmet support needs and carers mental health.
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Chen, Li-Wu, Abbey Gregg, and David Palm. "Longitudinal Evaluation of Quality Improvement and Public Health Accreditation Readiness in Nebraska Local Health Departments, 2011-2016." Public Health Reports 133, no. 3 (April 13, 2018): 250–56. http://dx.doi.org/10.1177/0033354918754542.
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Objectives: Public health accreditation is intended to improve the performance of public health departments, and quality improvement (QI) is an important component of the Public Health Accreditation Board process. The objective of this study was to evaluate the QI maturity and accreditation readiness of local health departments (LHDs) in Nebraska during a 6-year period that included several statewide initiatives to progress readiness, including funding and technical assistance. Methods: We used a mixed-methods approach that consisted of both online surveys and key informant interviews to assess QI maturity and accreditation readiness. Nineteen of Nebraska’s 21 LHDs completed the survey in 2011 and 2013, 20 of 20 LHDs completed the survey in 2015, and 19 of 20 LHDs completed the survey in 2016. We facilitated a large group discussion with staff members from 16 LHDs in 2011, and we conducted key informant interviews with staff members from 4 LHDs in 2015. Results: Both QI maturity and accreditation readiness improved from 2011 to 2016. In 2011, of 19 LHDs, only 6 LHD directors agreed that their LHD had a culture that focused on QI, but this number increased every year up to 12 in 2016. The number of LHDs that had a high capacity to engage in QI efforts improved from 3 in 2011 to 8 in 2016. The number of LHDs with a QI plan increased from 3 in 2011 to 10 in 2016. The number of LHDs that were confident in their ability to obtain Public Health Accreditation Board accreditation improved from 6 in 2011 to 13 in 2016. Although their QI maturity generally increased over time, LHDs interviewed in 2015 still faced challenges adopting a formal QI system. External financial and technical support helped LHDs build their QI maturity and accreditation readiness. Conclusion: Funding and technical assistance can improve LHDs’ QI maturity and accreditation readiness. Improvement takes time and sustained efforts by LHDs, and support from external partners (eg, state health departments) helps build LHDs’ QI maturity and accreditation readiness.
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Chen, Tiffany J., Kathleen B. Watson, Shannon L. Michael, Jessica J. Minnaert, Janet E. Fulton, and Susan A. Carlson. "A New Decade of Healthy People: Considerations for Comparing Youth Physical Activity Across 2 Surveillance Systems." Journal of Physical Activity and Health 18, S1 (August 1, 2021): S94—S101. http://dx.doi.org/10.1123/jpah.2021-0015.
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Background: Healthy People 2030 includes objectives to increase meeting the aerobic physical activity guideline for ages 6–13 years (of ages 6–17 y, monitored by National Survey of Children’s Health [NSCH]) and grades 9 to 12 (mostly aged 14–18+ y, monitored by Youth Risk Behavior Survey [YRBS]). This study compares methodologies, prevalence, and patterns of meeting the guideline, particularly for overlapping ages 14–17 years. Methods: Nationally representative surveys, 2016–2017 NSCH (adult proxy report, 6–17 y) and 2015 and 2017 YRBS (self-report, grades 9–12), assess meeting the guideline of ≥60 minutes of daily moderate to vigorous physical activity. Prevalence and odds ratios were estimated by age group and demographics. Results: For youth aged 14–17 years, 17.4% (95% confidence interval [CI], 16.1–18.7; NSCH) and 27.0% (95% CI, 25.6–28.5; YRBS) met the guideline. 25.9% (95% CI, 24.8–27.2) aged 6–13 years (NSCH) and 26.6% (95% CI, 25.3–28.0) in grades 9 to 12 (YRBS) met the guideline. Across surveys, fewer females (P < .001) and Asian youth (P < .001 except among NSCH 14–17 y) met the guideline. Conclusions: Neither methodology nor estimates for meeting the aerobic guideline are similar across surveys, so age continuity between juxtaposed estimates should not be assumed by magnitude nor age for separate Healthy People 2030 youth physical activity objectives.
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Journal, Baghdad Science. "Detection of zpx gene of Cronobacter sakazakii isolated from Clinical samples for Iraqi children under Two Years." Baghdad Science Journal 14, no. 2 (June 4, 2017): 279–88. http://dx.doi.org/10.21123/bsj.14.2.279-288.
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The study included 200 samples were collected from children under two years included (50 samples from each of Cerebrospinal fluid, Blood, Stool and Urine) from, (Central Children Hospital and Children's Protections Educational Hospital) The Iraqi Ministry of Health, the Department of Health Baghdad .the period from the first of 2015 September to the first of December 2015, Were obtained isolates bacterial subjected to the cultural, microscopic and biochemical examination and diagnosed to the species by using vitek2 system .The results showed there were contamination in 6.5% of clinical samples. The diagnosed colonies which gave pink color on the MacConkey agar, golden yellow color on the Trypton Soy agar and green color on the Birillent Enterobacter sakazakii agar and gave a probability of 99% in the vitek 2 and were identified as Cronobacter sakazakii. The identifcation revealed of thirteen isolates, (6) isolated from Cerebrospinal fluid samples and its contamination with percent 12%, (7) isolated from blood samples and its contamination with percent 14% and not isolated bacteria from stool and urine samples. Detection of zpx gene showed the presence of this gene in 13(100%)of isolates
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Kawsar, Mohanarathi, and Memory Kakowa. "P223 Impact of national chlamydia screening programme in children aged <16 years attending a sexual health clinic: 10 years later." Sexually Transmitted Infections 93, Suppl 1 (June 2017): A89.2—A89. http://dx.doi.org/10.1136/sextrans-2017-053232.265.
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IntroductionThe objectives of this study were to compare the rates of sexually transmitted infections (STIs) and the uptake of chlamydia test in a Level 3 sexual health clinic during pre and post National chlamydia screening programme (NCSP) periods. The programme has also included children aged <16 years if they are found to be Fraser competent.MethodsThe study period1stSeptember 2002 – 31stAugust 2016. Data were collected retrospectively from the Lilie Sexual Health Management System.ResultsTotal of 894 (N=894) children were studied; of whom 80% were girls. Age range was 13-15 years. Demographic details were similar in pre and post- NSCP periods.Abstract P223 Table 1STI and testing ratesOverall STI rateChlamydia rateTest UptakePre-NSCP2003&2004 (n=160)19%6%46%Introduction of NSCP locally in 2004Post- NSCP2005&2006 (n=155)23%13%59%2007&2008 (n=156)21%15%60%Level 2 young people sexual health service was introduced in 20082009&2010 (n=140), 5 years later14%7%64%2011&2012 (n=107)8%4%66%2013&2014(n=94)12%8%66%2015&2016 (n=82), 10 years later9%3%67%DiscussionThe rate of genital chlamydia infections had peaked during the immediate post- NSCP period. This is probably related to increased uptake of chlamydia test using the less invasive method. However, the overall trend has shown some reduction in both chlamydia and other STI rates in children aged 13-15 years attending our clinic for the past eight years. The reduction might have been contributed by NSCP in addition to changes in the sexual health services locally.
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Do Vale, Daniela Neves Fernandes, Luís Eduardo Maggi, and Wagner Coelho de Albuquerque Pereira. "FOLLOW-UP OF DIABETIC PATIENTS UNDER A PRIMARY CARE PROGRAM IN THE CITY OF RIO BRANCO – ACRE - BRAZIL." Multidisciplinary Sciences Reports 1, no. 1 (August 15, 2021): 1–14. http://dx.doi.org/10.54038/ms.v1i1.6.
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Aims: Analyze the monitoring of patients with Diabetes Mellitus treated in the Family Health Strategy in the city Rio Branco, Acre State, Brazil. Methods: The study is an observational, analytical, cross-sectional research with a quantitative approach. Held from January 2015 to December 2016, in 12 health units (Family Health Strategy - ESF), in the city of Rio Branco, Acre. For data collection, a simple random drawing of a Family Health Group from each Health segment was carried out. After the drawing, a Verification Form was applied, developed from the recommendations of the Ministry of Health for monitoring diabetic patients. Results: In the 306 records analyzed, there was a predominance of females (68%), with an average age of 61.6 (SD ± 13) years. As for the metabolic control variables, the most prevalent test was fasting blood glucose (85%), with an average of 211.6 mg / dl. Regarding the number of medical consultations per year, in 2015, 216 consultations were carried out, with 36.9% of patients having three or more consultations / year, this number rose to 253 in 2016, with more than 3 consultations/year (48.1%). Metformin was the most used medication (77.8%), followed by Glibenclamide (53.3%) and insulin (22%). Conclusions: FHS groups in the city of Rio Branco, Acre partially follow the guidelines of the Ministry of Health in monitoring diabetic patients. The motives for that are yet to be evaluates, nevertheless it can have an unfavorable impact on their quality of life.
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Atlin, C. R., M. McGowan, and A. Toma. "LO068: Physician adherence to Antimicrobial Guidelines for Community Acquired Pneumonia in the St. Michael’s Hospital Emergency Department." CJEM 18, S1 (May 2016): S53—S54. http://dx.doi.org/10.1017/cem.2016.105.
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Introduction: The Toronto Central Local Health Integration Network released new antimicrobial guidelines for the treatment of community acquired pneumonia (CAP) in August 2013. These deemphasized antimicrobial coverage for atypical organisms and use amoxicillin-clavulanic acid (AMC) as first-line for low risk CAP. The purpose of this study was to assess physician adherence to these guidelines in St. Michael’s Hospital (SMH) Emergency Department (ED). Methods: A retrospective chart review was conducted from April 1 to May 31 in 2013, 2014 and 2015. All adult patients who were discharged home from the ED with a diagnosis of pneumonia were included. Severity of pneumonia was graded based on the CRB-65 score as per the CAP guidelines. Primary outcome was type of antibiotic prescribed by the ED physician. Data was analyzed using simple descriptive statistics. Results: There were a total of 141 patients analyzed during the study period (N=46 in 2013, N=59 in 2014, N=36 in 2015). Demographics and relevant comorbidities were similar across the years: age (2013: median=53 years, range 20-92 years; 2014: 56, 21-83; 2015: 54, 20-81); preexisting lung disease (30%, 27%, 25% respectively); HIV positive status (9%, 7%, 17%). CRB-65 score was: low risk (0 points)=70% in 2013, 66% in 2014, 75% in 2015; intermediate risk (1-2 points)=30%, 34%, 25%; high risk (3-4 points)=0% in all years. Percentage of patients discharged home with a documented prescription was 83%, 85%, and 94% respectively. In 2013, patients received azithromycin (AZM) (n=17, 43% of antibiotic prescriptions that year); levofloxacin (LVX) (n=10, 25%); AMC (n=5, 13%); clarithromycin (CLR) (n=5, 13%); trimethoprim-sulfamethoxazole (SXT) (n=2, 5%); doxycycline (DOX) (n=1, 3%). In 2014: AMC (n=26, 51%); AZM (n=12, 24%); LVX (n=9, 18%); CLR (n=2, 4%); DOX (n=1, 2%); erythromycin (ERY) (n=1, 2%). In 2015: AMC (n=17, 47%); AZM (n=12, 33%); LVX (n=4, 11%); CLR (n=1, 3%); SXT (n=1, 3%); DOX (n=1, 3%). Number of return ED visits within 2 weeks were: n=16 (35%); n=11 (19%); and n=10 (28%) respectively. Conclusion: The results of this study show that there has been a change in antibiotic prescribing practices in the SMH ED since dissemination of the CAP guidelines, with AMC accounting for nearly half of antibiotic prescriptions. Further antimicrobial stewardship efforts will focus on evaluating factors influencing prescribing practices.
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Mazela, Jan, Teresa Jackowska, Marcin Czech, Ewa Helwich, Oliver Martyn, Pawel Aleksiejuk, Anna Smaga, Joanna Glazewska, and Jacek Wysocki. "Epidemiology of Respiratory Syncytial Virus Hospitalizations in Poland: An Analysis from 2015 to 2023 Covering the Entire Polish Population of Children Aged under Five Years." Viruses 16, no. 5 (April 29, 2024): 704. http://dx.doi.org/10.3390/v16050704.
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Background: Respiratory syncytial virus (RSV) is an important cause of childhood hospitalizations. The aim of the study was to estimate the rates of RSV-related hospitalizations in children aged less than 5 years in Poland. Methods: This retrospective observational cohort study was based on data obtained from the National Health Fund in Poland regarding all acute respiratory tract infections and RSV-coded admissions of children (age <5 years) to public hospitals between July 2015 and June 2023. Patients were stratified based on the following age groups: 0–1 month, 2–3 months, 4–6 months, 7–12 months, 13–24 months, and 25–60 months. Results: The number of RSV-related hospitalizations increased every season, both before and through the ending phase of the coronavirus disease 2019 (COVID-19) pandemic. The COVID-19 pandemic was associated with a shift in the seasonality pattern of RSV infection. Hospitalization rates per 1000 inhabitants were the highest for children aged 0–12 months, reaching 47.3 in the 2022/23 season. Within this group, the highest hospitalization rate was observed for children aged 2–3 months—94.9 in the 2022/23 season. During the ending phase of the COVID-19 pandemic, the observed increase in admission rates was 2-, 4-, and 5-fold the pre-COVID rate for children aged <12 months, 12–24 months, and 25–60 months, respectively. Conclusions: In Poland, RSV infections cause a significant burden in hospitalized children aged less than 5 years. RSV-related hospitalizations were most frequent in children aged less than 1 year. The COVID-19 pandemic was associated with a shift in the seasonality pattern of RSV infections. After the pandemic, more RSV-related hospitalizations were observed in older children (aged 13 months and older) vs. the pre-pandemic phase.
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Demissie, Zewditu, Heather B. Clayton, Alana M. Vivolo-Kantor, and Lianne F. Estefan. "Sexual Teen Dating Violence Victimization: Associations With Sexual Risk Behaviors Among U.S. High School Students." Violence and Victims 33, no. 5 (October 2018): 964–80. http://dx.doi.org/10.1891/0886-6708.vv-d-17-00124.
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Adolescent dating violence may lead to adverse health behaviors. We examined associations between sexual teen dating violence victimization (TDVV) and sexual risk behaviors among U.S. high school students using 2013 and 2015 National Youth Risk Behavior Survey data (combined n = 29,346). Sex-stratified logistic regression models were used to estimate these associations among students who had dated or gone out with someone during the past 12 months (n = 20,093). Among these students, 10.5% experienced sexual TDVV. Sexual TDVV was positively associated with sexual intercourse before age 13, four or more lifetime sexual partners, current sexual activity, alcohol or drug use before last sexual intercourse, and no pregnancy prevention during last sexual intercourse. Given significant findings among both sexes, it is valuable for dating violence prevention efforts to target both female and male students.
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Tjitrosemito, Soekisman. "Biodiversity Contribution to Sustainable Development Goals in Indonesia." BIODIVERS - BIOTROP Science Magazine 2, no. 1 (January 30, 2023): 37–44. http://dx.doi.org/10.56060/bdv.2023.2.1.1994.
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In 2015, the world leaders agreed to the 17 Sustainable Development Goals (SDGs)- a shared blueprint for peace, prosperity for people, and the planet, now and into the future. These SDGs are 1. No poverty, 2. Zero hunger, 3. Good Health and Well-being, 4. Quality Education, 5. Gender Equality, 6. Clean Water and Sanitation, 7. Affordable and Clean Energy, 8. Decent work and Economic Growth, 9. Industry, Innovation and Infrastructure, 10. Reduced inequalities, 11. Sustainable cities and communities, 12. Responsible consumption and production, 13. Climate Action, 14. Life below Water, 15. Life on Land, 16. Peace, Justice, and Strong Institutions, 17. Partnership for the Goals, 17. Sustainable Development Goals Integration. In this article, we propose and highlight the rapid loss of biodiversity and dangerously changing climate are some indicators of this crisis.
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Pisu, Maria, Gabrielle Betty Rocque, Kelly Kenzik, Bradford E. Jackson, Yufeng Li, Aras Acemgil, Richard A. Taylor, Terri Salter, and Edward E. Partridge. "Choosing Wisely: Opportunities for improving value of cancer care in the Deep South." Journal of Clinical Oncology 34, no. 7_suppl (March 1, 2016): 13. http://dx.doi.org/10.1200/jco.2016.34.7_suppl.13.
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13 Background: Under the Choosing Wisely (CW) Campaign, the American Society of Clinical Oncology (ASCO) and the American Society of Therapeutic Radiology and Oncology (ASTRO) recommend against non-evidence-based costly medications, tests, and procedures. CW recommendation adherence in the Deep South is largely unknown, and opportunities to reduce overuse and costs may exist. Methods: Analysis of administrative claims and tumor registry data from 12 cancer centers of the University of Alabama Health System Cancer Community Network, for Medicare beneficiaries ≥65 years old with cancer. Main outcome: percent of beneficiaries adhering to 9 CW recommendations. Results: 2012-2015 (Q1) adherence varied across CW recommendations and cancer centers, and increased over time for CW 2 and 7, decreased for 3, 5, and 6, and did not change for others. Conclusions: Opportunities to improve quality and value of cancer care exist in the Deep South. Research should understand how to minimize use of non-evidence based medications, tests, and procedures. [Table: see text]
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Huh, Youn, Yu Na Kim, and Young Sik Kim. "Trends and Determinants in Breastfeeding among Korean Women: A Nationwide Population-Based Study." International Journal of Environmental Research and Public Health 18, no. 24 (December 16, 2021): 13279. http://dx.doi.org/10.3390/ijerph182413279.
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Many efforts have been launched to promote breastfeeding in Korea. However, breastfeeding trends and associated factors with breastfeeding in Korea remain unknown. This study aimed to examine trends and determinants in breastfeeding using the Korea National Health and Nutrition Examination Survey (KNHANES) (2010–2018). We analyzed data from the KNHANES V (2010–2012), VI (2013–2015), and VII (2016–2018). A total of 9232 women aged 19–49 years were included in this study. We performed multivariable logistic regression analyses to investigate breastfeeding prevalence trends and associated factors with breastfeeding. Compared to 2010–2012, the odds ratio associated with breastfeeding during 2013–2015 and 2016–2018 increased to 1.30 (95% confidence interval (CI): 1.11–1.51) and 1.40 (95% CI: 1.21–1.63), respectively. The breastfeeding rate was associated with 40–49 years (OR, 95% CI: 0.47, 0.34–0.64 compared to 19–29 years), richer and poorer income (1.20, 1.03–1.39 in richer group and 1.24, 1.05–1.46 in poorer group compared to richest group), education level (0.74, 0.65–0.86 in ≤12 years of education compared to ≥13 years of education), smoking status (1.77, 1.38–2.28 in non-smoking compared to smoking), and self-rated health (1.40, 1.14–1.70 in good and 1.20, 1.00–1.44 in average compared to bad). Education programs and policies such as the Baby-Friendly Hospital Initiative (BFHI) and mother-friendly workplaces are necessary to increase the rates of breastfeeding in these groups.
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Gayatri, Rara Warih, and Desi Ariwinanti. "TINGKAT PENGETAHUAN KESEHATAN GIGI ANAK SEKOLAH DASAR NEGERI KAUMAN 2 MALANG." Preventia : The Indonesian Journal of Public Health 1, no. 2 (December 30, 2016): 186. http://dx.doi.org/10.17977/um044v1i2p186-190.
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Abstract : The problem of dental caries remains a problem globally. More than 90% of the world population have experienced dental caries. According to Gayatri (2015), the dental caries status among school-aged children in SDN Kauman 2 Malang shown the score of DMF-T index 5.75 and was considered high. The purpose of this study was to determine the level of dental health knowledge among school-aged children in SDN Kauman 2 Malang. This was a cross-sectional quantitative descriptive research. The sampling method used stratified random sampling and the measured variable was the level of dental health knowledge. Data collection technique used a questionnaire containing a set of questions to children aged 6-12 years. Data processing included editing, coding, scoring, data entry and cleaning. The data was analysed using univariate statistical method. The result of this study shown 82.9% (n = 63) 5-6 grade students of SDN Kauman 2 had a high level of dental health knowledge and 17.1% (n = 13) had a low level of dental health knowledge. In this regard, a good level of dental health knowledge is expected to support the establishment of good dental health behaviour. The recommendation from this study was the need for a further research on a relation between knowledge, attitude and behaviour of dental health in students of SDN Kauman 2 Malang.Kata kunci : Knowledge, dental health, school-aged childrenAbstrak : Karies gigi masih menjadi permasalahan dunia. Lebih dari 90% penduduk dunia mengalami karies gigi. Menurut Gayatri (2015) gambaran status karies gigi anak usia sekolah di SDN Kauman 2 Kota Malang menunjukkan nilai indeks DMF-T 5,75 yang berarti prevalensi karies gigi dianggap tinggi. Tujuan penelitian ini untuk mengetahui tingkat pengetahuan kesehatan gigi pada anak SDN Kauman 2 Malang. Penelitian ini menggunakan metode deskriptif kuantitatif dengan desain potong lintang (cross-sectional). Metode sampling yang digunakan merupakan metode stratified random sampling dengan variabel yang diukur adalah tingkat pengetahuan kesehatan gigi. Teknik pengumpulan data menggunakan kuesioner dengan memberikan seperangkat pertanyaan kepada anak usia 6-12 tahun. Pengolahan data yang dilakukan meliputi proses editing, coding, scoring, data entry dan cleaning. Analisa data dilakukan dengan analisis statistik univariat. Hasil dari penelitian ini adalah sebanyak 82,9 % (n=63) siswa kelas 5-6 SDN Kauman 2 memiliki tingkat pengetahuan kesehatan gigi tinggi dan sebanyak 17,1% (n=13) memilki tingkat pengetahuan kesehatan gigi rendah. Dalam hal ini, tingkat pengetahuan yang baik mengenai kesehatan gigi diharapkan dapat mendukung terbentuknya perilaku kesehatan gigi yang baik pula. Saran dari penelitian ini, perlu adanya penelitian lanjutan mengenai hubungan antara pengetahuan, sikap dan perilaku tentang kesehatan gigi pada anak SDN Kauman 2 Malang.Kata kunci: pengetahuan, kesehatan gigi, anak sekolah dasar
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Ladipo, Zana. "P237 Are the over 50s being let down by sexual health clinics? – an audit of sexual history taking in over 50s." Sexually Transmitted Infections 93, Suppl 1 (June 2017): A93.3—A94. http://dx.doi.org/10.1136/sextrans-2017-053232.279.
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IntroductionAgeing and Human Immunodeficiency Virus (HIV) has been very topical for a long time but not much has been said of ageing and sexually transmitted infections (STI). The Public Health England STI 2015 update indicates there has been an increase in the rate of STIs in the over 45s since 2011.Methods50 random case notes of patients over 50, seen between April 2015 and March 2016 in Sefton Sexual Health Clinic, Southport, North West England. These cases were audited against the 97% target in Sexual History taking 2013 guidelines.ResultsThere were 31 men (62%), 4 of whom were homosexual, and 19 (38%) women, all heterosexual. Patients were aged between 50 to 75 years old. 78% were symptomatic. 16% had casual partners, 38% of these used commercial sex workers. 44% were asked about previous STIs and 60% of patients were offered STI screening and off these 13% declined. 82% of patients were asked if they had ever had an HIV test and of these 44% had. Of the 56% that said they had never had a test, 100% were offered a test and 87% accepted. The commonest diagnosis was the first episode of herpes and herpes reoccurrence (both 12%), then first episode of warts (10%) and wart reoccurrence (8%). No patients tested positive for Chlamydia or Gonorrhoea.DiscussionSTI and BBV screening at any age should be guided by an accurate sexual health history and not an assumption. It is a disservice to simply assume low risk due to age.
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Arciuolo, Robert J., Julie E. Lazaroff, Jennifer B. Rosen, Sungwoo Lim, and Jane R. Zucker. "Trends in Hepatitis B Surveillance Among Pregnant Women in New York City, 1998-2015." Public Health Reports 135, no. 5 (August 14, 2020): 676–84. http://dx.doi.org/10.1177/0033354920946793.
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Objective Infants born to women with hepatitis B virus (HBV) infection are at high risk for chronic HBV infection and premature death. We examined epidemiologic trends among women with HBV infection who gave birth in New York City (NYC) to inform public health prevention activities. Methods We obtained data on HBV-infected women residing and giving birth in NYC during 1998-2015 from the NYC Perinatal HBV Prevention Program. We obtained citywide birth data from the NYC Office of Vital Statistics. We calculated the incidence of births to HBV-infected women per 100 000 live births and stratified by maternal race, birthplace, and age. We calculated annual percentage change (APC) in incidence of births to HBV-infected women by using joinpoint regression. Results Of 29 896 HBV-infected women included in the study, 28 195 (94.3%) were non–US-born, of whom 16 600 (58.9%) were born in China. Overall incidence of births to HBV-infected women per 100 000 live births increased from 1156 in 1998 to 1573 in 2006 (APC = 3.1%; P < .001) but declined to 1329 in 2015 (APC = –1.4%; P = .02). Incidence among US-born women declined from 1998 to 2015 (330 to 84; APC = –7.3%; P < .001) and among non–US-born women increased from 1998 to 2007 (1877 to 2864; APC = 3.6%; P < .001) but not thereafter. Incidence among women born in China increased from 1998 to 2006 (13 275 to 16 480; APC = 1.8%; P = .02) but decreased to 12 631 through 2015 (APC = –3.3%; P < .001). Conclusions The incidence of births to HBV-infected women in NYC declined significantly among US-born women but not among non–US-born women, highlighting the need for successful vaccination programs worldwide.
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Lin, Carol, Isabelle Casavant, Alicia Jaramillo, and Timothy Green. "Using repeated home-based HIV testing services to reach and diagnose HIV infection among persons who have never tested for HIV, Chókwè health demographic surveillance system, Chókwè district, Mozambique, 2014–2017." PLOS ONE 15, no. 11 (November 20, 2020): e0242281. http://dx.doi.org/10.1371/journal.pone.0242281.
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Background HIV prevalence in Mozambique (12.6%) is one of the highest in the world, yet ~40% of people living with HIV (PLHIV) do not know their HIV status. Strategies to increase HIV testing uptake and diagnosis among PLHIV are urgently needed. Home-based HIV testing services (HBHTS) have been evaluated primarily as a 1-time campaign strategy. Little is known about the potential of repeating HBHTS to diagnose HIV infection among persons who have never been tested (NTs), nor about factors/reasons associated with never testing in a generalized epidemic setting. Methods During 2014–2017, counselors visited all households annually in the Chókwè Health and Demographic Surveillance System (CHDSS) and offered HBHTS. Cross-sectional surveys were administered to randomly selected 10% or 20% samples of CHDSS households with participants aged 15–59 years before HBHTS were conducted during the visit. Descriptive statistics and logistic regression were used to assess the proportion of NTs, factors/reasons associated with never having been tested, HBHTS acceptance, and HIV-positive diagnosis among NTs. Results The proportion of NTs decreased from 25% (95% confidence interval [CI]:23%–26%) during 2014 to 12% (95% CI:11% –13%), 7% (95% CI:6%–8%), and 7% (95% CI:6%–8%) during 2015, 2016, and 2017, respectively. Adolescent boys and girls and adult men were more likely than adult women to be NTs. In each of the four years, the majority of NTs (87%–90%) accepted HBHTS. HIV-positive yield among NTs subsequently accepting HBHTS was highest (13%, 95% CI:10%–15%) during 2014 and gradually reduced to 11% (95% CI:8%–15%), 9% (95% CI:6%–12%), and 2% (95% CI:0%–4%) during 2015, 2016, and 2017, respectively. Conclusions Repeated HBHTS was helpful in increasing HIV testing coverage and identifying PLHIV in Chókwè. In high HIV-prevalence settings with low testing coverage, repeated HBHTS can be considered to increase HIV testing uptake and diagnosis among NTs.
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Song, SuJin, Jae Eun Shim, and Won O. Song. "Trends in total fat and fatty acid intakes and chronic health conditions in Korean adults over 2007–2015." Public Health Nutrition 22, no. 8 (February 15, 2019): 1341–50. http://dx.doi.org/10.1017/s1368980018003701.
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AbstractObjectiveTo investigate trends in total fat and fatty acid intakes and chronic health conditions among Korean adults over nine years between 2007 and 2015.DesignCross-sectional, observational study using a stratified, multistage probability sampling design at a national level. Intakes of total fat and fatty acids were estimated from 24 h dietary recalls by sex and age groups. Trends of total fat and fatty acid intakes were determined by multiple linear regression after adjusting for covariates. Trends in age-standardized prevalence of obesity, hypercholesterolaemia and hypertriacylglycerolaemia were examined by sex.SettingKorea.ParticipantsPopulation data of 47749 healthy adults (aged ≥19 years) derived from the Korea National Health and Nutrition Examination Survey between 2007 and 2015.ResultsOver the survey period, daily intakes of energy and total, saturated, monounsaturated, polyunsaturated, n-3 and n-6 fats (grams and percentage of energy (%E)) increased steadily. In all sex and age groups, significant increases were seen in SFA intake from 9·9 g (4·7 %E) to 12·0 g (5·3 %E) and in MUFA intake from 9·9 g (4·6 %E) to 13·3 g (5·8 %E). The prevalence of hypercholesterolaemia increased from 10·7 to 17·9 % over the same period.ConclusionsIn Korean adults, total fat, SFA and other fatty acids have been increasing along with the prevalence of hypercholesterolaemia. This information can help set adequate macronutrient and fatty acid distribution ranges in developing population-specific preventive strategies against diet-related illness.
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Chaouni, Bouchra, Abdellah Idrissi Azami, Soumaya Essayeh, El Houcine Arrafiqui, Abdelhakim Bailal, Sanae Raoui, Saaïd Amzazi, et al. "Moroccan Lagoon Microbiomes." Water 14, no. 11 (May 27, 2022): 1715. http://dx.doi.org/10.3390/w14111715.
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Lagoons are fragile marine ecosystems that are considerably affected by anthropogenic pollutants. We performed a spatiotemporal characterization of the microbiome of two Moroccan lagoons, Marchica and Oualidia, both classified as Ramsar sites, the former on the Mediterranean coast and the latter on the Atlantic coast. We investigated their microbial diversity and abundance using 16S rRNA amplicon- and shotgun-based metagenomics approaches during the summers of 2014 and 2015. The bacterial microbiome was composed primarily of Proteobacteria (25–53%, 29–29%), Cyanobacteria (34–12%, 11–0.53%), Bacteroidetes (24–16%, 23–43%), Actinobacteria (7–11%, 13–7%), and Verrucomicrobia (4–1%, 15–14%) in Marchica and Oualidia in 2014 and 2015, respectively. Interestingly, 48 strains were newly reported in lagoon ecosystems, while eight unknown viruses were detected in Mediterranean Marchica only. Statistical analysis showed higher microbial diversity in the Atlantic lagoon than in the Mediterranean lagoon and a robust relationship between alpha diversity and geographic sampling locations. This first-ever metagenomics study on Moroccan aquatic ecosystems enriched the national catalog of marine microorganisms. They will be investigated as candidates for bioindication properties, biomonitoring potential, biotechnology valorization, biodiversity protection, and lagoon health assessment.
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Abodunrin, Olunike Rebecca, Mobolaji Timothy Olagunju, Omolola Titilayo Alade, and Morẹ́nikẹ́ Oluwátóyìn Foláyan. "Relationships between Oral Health and the Sustainable Development Goals: A Scoping Review." BioMed 3, no. 4 (October 30, 2023): 460–70. http://dx.doi.org/10.3390/biomed3040037.
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The aim of this scoping review was to map the research that links oral health and sustainable development goals (SDGs). The question that guided this review was what is the published evidence specifically linking oral health and SDGs? The search of articles published between 2015 and June 2023 in English was conducted in June 2023 in PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Scopus. The extracted data from the 12 of the 520 publications that met the inclusion criteria were synthesized. These were publications from the African (n = 2) and European (n = 1) regions. Ten of the studies were not country specific. There were three observational studies. The referenced SDGs were SDG 1 (n = 1), SDG 3 (n = 11), SDG 4 (n = 3), SDG 5 (n = 2), and SDG 13 (n = 1). The studies linking oral health to SDG3 discussed a range of issues related to integrated oral health care, dental education on the SDGs, improved health equalities, access to universal health care, and sustainable health approaches. The small number of studies identified suggests the need to take proactive steps to generate research-based evidence that explores the interplay between oral diseases, oral health, and SDGs to address the dearth in the literature. By so doing, resources allocated to the SDGs can also be effectively uses to control oral diseases.
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Benowitz, Isaac, Joseph Perz, and Julia Marders. "Detection of Possible Medical Product-Related Infection or Pathogen Transmission—United States, 2015–2019." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s30—s31. http://dx.doi.org/10.1017/ice.2020.508.
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Background: Medications, medical devices, biological products, and other medical products can cause healthcare-associated infections related to contamination in production or transportation (intrinsic contamination) or contamination at the point of use (extrinsic contamination). Rapid identification of contaminated medical products can lead to actions to decrease further patient harm. We sought to describe events that prompted public health investigations of contaminated medical products in healthcare facilities. Methods: We reviewed records of CDC consultations with health departments and healthcare facilities from January 2015 through August 2019 to identify public health investigations in which medical products were identified as a likely source of patient infection or pathogen transmission to at least 1 patient. We collected data on products, contamination type, pathogens, route of patient exposure, healthcare setting where exposure occurred, and resulting actions. Results: There were 34 investigations involving medications (n = 15, 44%), medical devices (n = 12, 35%), biological products (n = 3, 9%), and other medical products (n = 4, 12%). Intrinsic contamination was suspected in 15 investigations (44%), with 13 (87%) based on isolation of a pathogen from unopened products and 2 (13%) based on isolation of similar pathogens from patients in contact with a medical product at multiple facilities. Extrinsic contamination was suspected in 19 investigations (56%) based on evidence of pathogen transmission at a single healthcare facility and concurrent infection control gaps at that facility supporting a mechanism of contamination. The most common pathogens prompting investigation were nontuberculous mycobacteria (n = 9, 26%), Burkholderia spp (n = 7, 21%), Klebsiella spp (n = 3, 9%), Serratia spp (n = 2, 6%), and other environmental and commensal organisms. Patients were most commonly exposed in hospitals (n = 19, 56%) and outpatient settings (n = 9, 26%). The most common patient exposures that resulted in transmission of the pathogen were infusions and injections (n = 15, 44%), diagnostic and therapeutic procedures (n = 9, 26%), and surgery (n = 5, 15%). Patient were notified and offered testing in at least 6 investigations (18%) . Interventions included product removal, healthcare provider alerts, patient notification and testing, modification of injection safety practices and other general infection control practices, correction of improper storage and handling, and changes in product design, manufacturing processes, or instructions for use. Conclusions: Public health investigations identified intrinsic and extrinsic contamination of medications, devices, and other products as a cause of healthcare-associated infections. Healthcare facilities should consider contaminated products in investigations of healthcare-associated infections, take steps to identify local infection control concerns, and alert public health authorities to events that could suggest widespread contamination.Funding: NoneDisclosures: None
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Lauria, Laura, Angela Spinelli, Marta Buoncristiano, Mauro Bucciarelli, and Enrica Pizzi. "Breastfeeding Prevalence at Time of Vaccination: Results of a Pilot Study in 6 Italian Regions." Journal of Human Lactation 35, no. 4 (January 18, 2019): 774–81. http://dx.doi.org/10.1177/0890334418823539.
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Background: In Italy, there is no widespread standardized national monitoring system for breastfeeding practices. Research aims: To estimate breastfeeding indicators according to World Health Organization recommendations and associated socioeconomic factors, highlighting the potential and limitations of vaccination centers as sources of data. Methods: A cross-sectional study was conducted in the vaccination centers of 13 Local Health Districts in Italy. Data on breastfeeding practices were collected via structured questionnaires between February and November, 2015, from 14,191 mothers recruited during vaccination appointments for the 1st, 2nd and 3rd doses against Diphtheria, Tetanus, and Pertussis, and for the 1st dose against Measles, Mumps, and Rubella. Crude breastfeeding rates and direct age standardized rates were compared. Logistic regression models were used to explore socio-demographic characteristics associated with breastfeeding indicators. Results: Overall, 14,191 mothers were recruited, with a response rate higher than 94%. Exclusive breastfeeding rates among children aged 2–3 months and 4–5 months were 44.4% and 25.8%, respectively; breastfeeding rates among children aged 11–12 and 13–15 months were 34.2% and 24.9%; 10.4% never breastfed. Strong geographical and socioeconomic differences were found. Some differences also emerged between crude and standardized rates. Conclusions We conclude that a survey system in vaccination centers is practicable and its use could produce, with standardized methodology, representative regional and national breastfeeding estimates that could monitor progress towards present and future targets.
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T., Anil Balraj, S. Srinivas, K. Ramesh Reddy, Manisha Reddy G., and Anusiri Inugala. "Malrotation presenting beyond infancy: a clinical study." International Surgery Journal 5, no. 10 (September 25, 2018): 3288. http://dx.doi.org/10.18203/2349-2902.isj20184076.
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Background: Intestinal malrotation is a congenital anomaly that results from abnormal or incomplete rotation and fixation of midgut during embryonic development. This study was done at Niloufer Hospital and Institute for Women and Child Health, Hyderabad with an aim of evaluating the clinical presentation, diagnosis, management and outcome of malrotation presenting beyond 1 year of lifeMethods: Overall 50 cases of malrotation presented to the department of pediatric surgery over a period of 2 year (April 2015 to April 2017). 12 patients of these 50 (12/50) whose age was above 1 year i.e. who were beyond infancy were studied in this studyResults: Out of the 12 patients, 6 were female and 6 were male. Age of patients ranged from 15 months to 13 years. Younger patients below 2 years commonly presented with typical symptoms of bilious vomiting and patients above 2 years of age presented with more varied and vague symptoms. 1/12 of patients presented with a poor general condition and succumbed during the course of treatmentConclusion: Small intestinal obstruction due to malrotation is relatively common in neonatal period. Malrotation beyond infancy is an uncommon diagnosis. Malrotation in grown up children usually is not suspected due to varied symptoms. High index of suspicion is needed as early intervention and treatment in the form of Ladds procedure can prevent any catastrophic events like volvulus and bowel ischemia.
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Gwomson, Dauda, Sodipo Olutomi Y., and Lar Luret A. "Lassa fever: A recurring decimal in Plateau state, Nigeria." International Journal of Biomedical Research 9, no. 5 (May 29, 2018): 197. http://dx.doi.org/10.7439/ijbr.v9i5.4769.
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Background: Since the first reported case of Lassa fever (LF) in Jos, Plateau state Nigeria in the early 70’s, the state has been plagued with increasing number of cases. This could be due to poor environmental practices, food and personal hygiene. By the end of August 2017 there were 42 reported cases with 15 confirmed cases. Sadly, over the years there have been challenges with reporting and investigation of cases. This could be due to weak health systems commonly seen in developing countries.Methods and Materials: We reviewed 2012-2016 surveillance data from the State Ministry of Health (SMoH) using Microsoft Excel. Descriptive analysis was conducted on the reported LF cases in the state.Results: Between the years 2012 – 2016 there were 109 reported LF cases, with 57 (52.3%) males and 52 (47.7%) females. The mean age of the reported cases was 27.9± 13.6 years. Out of these, 23 (21.1%) were confirmed cases: 1 (4.5%) in 2012, none in 2013, 2014 and 2015, and 21 (91.3%) in 2016.The male: female ratio was10 (43.5%): 13 (56.5%). Six (26.1%) of the confirmed cases were health workers. The case fatality rate of the confirmed cases was 52.2%. Even though there is significant association between LF and death (P-value = 0.003) the odds ratio, 0.215 (95% CI) is low. The reporting years show consistent increasing trend from 2012 to 2016, except for 2015 where there was a decline in the number of reported cases. In 2016 there were 74 (67.9%) cases, 5 (4.6%) in 2015, 15 (13.7%) in 2014, 12 (11.0%) in 2013 and 3 (2.6%) in 2012.Conclusion: Even though reported cases are increasing, there are still gaps observed in the surveillance system of the SMoH. The annual recurrence of LF outbreak in the state without reciprocal preventive efforts on ground to combating it has exposed the populace and health workers to ill-health and death.
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Twenge, Jean M., Thomas E. Joiner, Megan L. Rogers, and Gabrielle N. Martin. "Increases in Depressive Symptoms, Suicide-Related Outcomes, and Suicide Rates Among U.S. Adolescents After 2010 and Links to Increased New Media Screen Time." Clinical Psychological Science 6, no. 1 (November 14, 2017): 3–17. http://dx.doi.org/10.1177/2167702617723376.
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In two nationally representative surveys of U.S. adolescents in grades 8 through 12 ( N = 506,820) and national statistics on suicide deaths for those ages 13 to 18, adolescents’ depressive symptoms, suicide-related outcomes, and suicide rates increased between 2010 and 2015, especially among females. Adolescents who spent more time on new media (including social media and electronic devices such as smartphones) were more likely to report mental health issues, and adolescents who spent more time on nonscreen activities (in-person social interaction, sports/exercise, homework, print media, and attending religious services) were less likely. Since 2010, iGen adolescents have spent more time on new media screen activities and less time on nonscreen activities, which may account for the increases in depression and suicide. In contrast, cyclical economic factors such as unemployment and the Dow Jones Index were not linked to depressive symptoms or suicide rates when matched by year.
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Hammeken, Lianna H., Simon M. D. Baunwall, Jens F. Dahlerup, Christian L. Hvas, and Lars H. Ehlers. "Health-related quality of life in patients with recurrent Clostridioides difficile infections." Therapeutic Advances in Gastroenterology 15 (January 2022): 175628482210784. http://dx.doi.org/10.1177/17562848221078441.
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Background: The health-related quality of life (HrQoL) can be substantially affected in patients with recurrent Clostridioides difficile infection (rCDI) but the impact of effective treatment of the infection remains unclear. This study aimed to evaluate the HrQoL in patients with rCDI and estimate the gain in HrQoL associated with effective treatment of rCDI. Methods: Patients’ HrQoL was estimated based on EuroQol 5-Dimensions 3-Levels (EQ-5D-3L) questionnaires obtained from a Danish randomised controlled trial (RCT). In the RCT, 64 patients with rCDI were randomised to receive either vancomycin ( n = 16), fidaxomicin ( n = 24) or faecal microbiota transplantation (FMT) preceded by vancomycin ( n = 24). The primary outcome in the RCT was rCDI resolution. Patients were closely monitored during the RCT, and rescue FMT was offered to those who failed their primary treatment. Patients’ HrQoL was measured at baseline and at 8- and 26-weeks follow-up. Linear regression analyses conditional on the differences between baseline and follow-up measurements were used to assess statistical significance ( p < 0.05). Results: Within 26 weeks of follow-up, 13 (81%) patients treated with vancomycin, 12 (50%) patients treated with fidaxomicin, and 3 (13%) patients treated with FMT had a subsequent recurrence and received a rescue FMT. The average HrQoL for untreated patients with rCDI was 0.675. After receiving effective treatment, this value increased by 0.139 to 0.813 ( p < 0.001) at week 8 and by 0.098 to 0.773 ( p = 0.003) at week 26 of follow-up compared with baseline. Conclusion: The HrQoL was adversely affected in patients with an active episode of rCDI but increased substantially after receiving an effective treatment algorithm in which rescue FMT was provided in case of a primary treatment failure. Trial registration: The RCT was preregistered at EudraCT (j.no. 2015-003004-24, https://www.clinicaltrialsregister.eu/ctr-search/trial/2015-003004-24/results ) and at ClinicalTrials.gov (study identifier NCT02743234, https://clinicaltrials.gov/ct2/show/NCT02743234 ).
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Loo, Leong Shuen, Kathryn Cisera, Tony M. Korman, and Ian Woolley. "Management of gonorrhoea in a hospital network: are we following best practice?" Sexual Health 16, no. 5 (2019): 523. http://dx.doi.org/10.1071/sh19018.
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Background Gonorrhoea is usually managed in community sexual health or general practice, but a proportion of cases present to hospital settings. In this study, we examined how gonorrhoea was managed through a large hospital network and what the implications may be for public health management. Methods: A retrospective chart review was performed of the management of patients with Neisseria gonorrhoeae infection diagnosed at a large Australian healthcare network from January 2015 to May 2018. Documentation rates of five parameters of care were assessed: (1) the presence (or absence) of previous sexually transmissible infections (STIs); (2) recent travel; (3) discussion of HIV testing; (4) contact tracing; and (5) public health notification. Results: In all, 110 cases (48 male, 62 female) were analysed. Most cases were in the 15–39 years age group; 98 cases (89%) were symptomatic, and 12 (11%) were screening tests. The most common presenting syndromes were pelvic inflammatory disease (32%; 31/98 symptomatic cases), urethritis (26%; 25/98) and epididymo-orchitis (13%; 13/98). None of the five parameters assessed were documented in most cases. Documentation was most likely to occur in patients admitted to hospital. When HIV testing was performed, no new cases of HIV were identified. Conclusion: Infections with gonorrhoea present on a regular basis to hospital practice, but overall management is suboptimal. Automated prompts for other recommended tests, including HIV testing when testing for other sexually transmissible diseases is ordered, may improve management. Better awareness of best practice is needed, which can be facilitated with ongoing education. However, the greatest benefit is likely achieved by linking patients back to community-based services, which are best placed to provide ongoing long-term care.
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Kim, Kyoung Min, Dohyun Kim, and Un Sun Chung. "Investigation of the Trend in Adolescent Mental Health and its Related Social Factors: A Multi-Year Cross-Sectional Study For 13 Years." International Journal of Environmental Research and Public Health 17, no. 15 (July 27, 2020): 5405. http://dx.doi.org/10.3390/ijerph17155405.
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We aimed to investigate the mental health change and associated social correlates in adolescents in terms of depression, suicidal ideation, and suicidal attempt. In total, 978,079 students (12–18 years old, 7th–12th grade) participated in the survey for 13 years (2006–2018) by a multiple-year cross-sectional design (not a repeat measure for smaller group). Mental health outcome variables were assessed using self-report surveys with the independent variables of sex, age, economic status, school achievement, and parental educational level. Korean social indices of income inequality (Gini index, higher scores representing greater economic inequity with score range of 0–1), education (national proportion of tertiary education attainment), and actual suicides were investigated together as related social factors. The prevalence of depressive episodes, suicidal ideation, and suicidal attempt markedly dropped by 34.6%, 42.2%, and 48.3%, respectively. Moreover, the Gini index (from 0.314 in 2008 to 0.295 in 2015) and proportion of tertiary education (from 82.1% in 2006 to 69.7% in 2018) showed a decreasing tendency. These indices and adolescent mental health outcomes highly correlated with each other (Pearson’s r between Gini index and depressive episode = 0.789, suicidal ideation = 0.724, and suicidal attempt = 0.740; Pearson’s r between proportion of tertiary education and depressive episode = 0.930, suicidal ideation = 0.809, and suicidal attempt = 0.851). Adolescent mental health has improved in the last 13 years in Korea, and improvements in social inequality (decreased Gini index) and lessened burden of academic competition (decreased national proportion of tertiary education) were significantly associated with the improvement of adolescent’s mental health. However, the impact of parental educational level on children’s mental health was relatively minimal, compared with the impact of economic inequality and academic burden. Further studies are needed to reveal the underlying mechanism for the association between adolescent mental health and sociodemographic factors to save adolescents from psychological distress.
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Pokharel, Grishma, Madhur Basnet, Sagar Poudel, Naresh Kafle, Rahul Kumar Jaiswal, Sunil Bogati, Indira Ojha, and Dipesh Soni. "Non-psychiatric Referral among First Encounter Patients Attending the Psychiatry Out Patient Services of a Tertiary Care Hospital: A Descriptive Cross-sectional Study." Journal of Nepal Medical Association 59, no. 242 (October 23, 2021): 881–84. http://dx.doi.org/10.31729/jnma.6244.
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Introduction: Pathway of psychiatric care is defined as the sequence of contacts with individuals and organizations initiated by the distressed person’s efforts and his significant others to seek appropriate health care. This study aimed to find the prevalence of non-psychiatric referral as first encounter among patients attending the psychiatry outpatient department of a tertiary care hospital. Methods: A descriptive cross-sectional study was carried out from 29th March 2015 to 25th April 2015 in the outpatient department of the department of psychiatry of a tertiary via direct interview using the World Health Organization’s encounter form. Ethical approval was taken from undergraduate medical research protocol review board (Reference number 105/071/072). Psychiatric diagnoses were made by respective consultants using the International Classification of Diseases-10 Clinical Descriptions and Diagnostic Guidelines criteria. Data was entered in the Microsoft Excel 2007 and analyzed by Stata version 15. Point estimate at 95% Confidence Interval was calculated along with frequency and percentage for binary data. Results: Out of 50 patients, 26 (52%) (38.2-65.8 at 95% Confidence Interval) of new cases in the outpatient department had non-psychiatric referrals. Among them, 13 (26%) referred from faith healers, 7 (14%) from the general hospital and 6 (12%) from medical out patient department. Conclusions: The prevalence of non-psychiatric referral for the patients seen for the first time in the psychiatry outpatient department was similar to findings from studies done in different parts of South East Asia.
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Rose, Shyanika W., Allison M. Glasser, Yitong Zhou, Tess Boley Cruz, Amy M. Cohn, Brianna A. Lienemann, M. Justin Byron, et al. "Adolescent tobacco coupon receipt, vulnerability characteristics and subsequent tobacco use: analysis of PATH Study, Waves 1 and 2." Tobacco Control 27, e1 (February 22, 2018): e50-e56. http://dx.doi.org/10.1136/tobaccocontrol-2017-054141.
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ObjectivesWe examine adolescent receipt of tobacco coupons and subsequent tobacco use.MethodsData were from the Population Assessment of Tobacco and Health (PATH) Study (2013–2015). We identified correlates of coupon receipt at Wave 1 (youth sample age 12–17 ; n = 13 651) including demographics, additional vulnerability factors that may place youth at risk of tobacco use and correlates of coupon receipt by channel. We examined associations of Wave 1 coupon receipt with Wave 2 tobacco use using weighted multivariable models.ResultsOverall, 7.6% of US youth received tobacco coupons in the 6 months before Wave 1. Coupon recipients were more likely to be women, living outside urban areas, living with a tobacco user, current and former (vs never) tobacco users, having high internalising mental health symptoms and having a favourite tobacco advertisement. Coupons were received primarily through direct mail (56%), product packs (28%) and online (25%). Never tobacco users at Wave 1 who received coupons were more likely to be ever users at Wave 2 (adjusted OR (aOR)=1.42; 95% CI 1.06 to 1.91). Coupon recipients were more likely to use a new tobacco product between waves (aOR=1.67; 95% CI 1.18 to 2.36) and report past 30-day tobacco use at Wave 2 (aOR=1.81; 95% CI 1.31 to 2.49).ConclusionsOne in 13 US youth (7.6%) received coupons. Vulnerable youth had the greatest odds of coupon receipt. Coupon recipients had greater odds of tobacco use among never users, trying a new tobacco product and current use. Coupon bans, limits on youth coupon exposure, stronger age verification, pack inserts or restricting coupon redemption may help reduce tobacco use among adolescents, particularly for those at greatest risk.
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Becker-Dreps, Sylvia, Bryan Blette, Rafaela Briceno, Jorge Aleman, Michael G. Hudgens, Gilberto Moreno, Ana Ordonez, Julio Rocha, David J. Weber, and Erick Amaya. "Changes in Pneumonia Incidence and Infant Mortality 5 Years Following Introduction of the 13-valent Pneumococcal Conjugate Vaccine in a “3+0” Schedule in Nicaragua." Open Forum Infectious Diseases 4, suppl_1 (2017): S67—S68. http://dx.doi.org/10.1093/ofid/ofx162.161.
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Abstract Background Streptococcus pneumoniae causes an estimated 826,000 deaths of children in the world each year and many health facility visits. To reduce the burden of pneumococcal disease, many nations have added pneumococcal conjugate vaccines to their national immunization schedules. Nicaragua was the first country eligible for funding from the GAVI Alliance to introduce the 13-valent pneumococcal conjugate vaccine (PCV13), provided to infants at 2, 4, and 6 months of age. The goal of this study was to evaluate the population impact of the first five years of the program. Methods Numbers of visits for pneumonia, pneumonia-related deaths, bacterial meningitis, and infant deaths between 2008 and 2015 were collected from all 107 public health facilities in León Department. Vital statistics data provided additional counts of pneumonia-related deaths that occurred outside health facilities. Adjusted incidence rates and incidence rate ratios (IRRa) in the vaccine (2011–2015) and pre-vaccine periods (2008–2010) were estimated using official population estimates as exposure time. Results The IRRa for pneumonia hospitalizations was 0.70 (95% confidence interval [CI]: 0.66, 0.75) for infants, and 0.92 (95% CI: 0.85, 0.99) for one year olds. The IRRa for post-neonatal infant mortality was 0.56 (95% CI: 0.41, 0.77). In the population as a whole, ambulatory visits and hospitalizations for pneumonia, as well as pneumonia-related mortality and rates of bacterial meningitis were lower in the vaccine period. Conclusion Five years following program introduction, reductions were observed in health facility visits for pneumonia in immunized age groups and infant mortality, which would be hard to achieve with any other single public health intervention. Future study is warranted to understand whether the lack of a booster dose (e.g.,, at 12 months) may be responsible for the small reductions in pneumonia hospitalizations observed in one year-olds as compared with infants. Disclosures S. Becker-Dreps, Pfizer: Consultant and Grant Investigator, Consulting fee and Research grant; D. J. Weber, Pfizer: Consultant and Speaker’s Bureau, Consulting fee and Speaker honorarium
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Adade, Abigail Esinam, Kenneth Owusu Ansah, Nutifafa Eugene Yaw Dey, Francis Arthur-Holmes, Henry Ofori Duah, and Agbadi Pascal. "Exposure to substance and current substance among school-going adolescents in Timor-Leste." PLOS Global Public Health 2, no. 8 (August 4, 2022): e0000797. http://dx.doi.org/10.1371/journal.pgph.0000797.
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Few studies have examined how exposure to substance influences adolescent’s use of substance in Timor-Leste. We assessed this relationship using nationally representative data from Timor-Leste to address this gap. Data was pulled from the 2015 Timor-Leste Global school-based student health survey. Data of students aged 13-17years (N = 3700) from class 7–11 across schools in Timor-Leste were analyzed for this study. Second-hand smoking exposure (AOR = 1.57 [1.31, 1.89] and parental tobacco use, AOR = 1.94 [1.54, 2.44]) was significantly related to in-school adolescent’s current use of substance after adjusting for covariates. Current substance use was also positively associated with being male, being in class 10–12, and being food insecure and negatively associated with having at least three close friends and benefiting from parental supervision. To reduce substance use among in-school adolescents, policymakers must consider the inclusion of all models in the social learning environment of adolescents in Timor-Leste.
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Andia, A., B. Souleymane, M. Daou, M. Zara, S. Beydou, MS Aminou, and E. Adehossi. "Geriatric in Patient Profile at the Department of Internal Medicine at Niamey National Hospital, Niger." European Scientific Journal, ESJ 13, no. 27 (September 30, 2017): 279. http://dx.doi.org/10.19044/esj.2017.v13n27p279.
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Background: The ageing population in developing countries has brought a demographic and an epidemiological transition, with the impact of chronic diseases resulting from life style changes on the health status of the population. Objective: To describ a profile geriatrics patient, specifically to identify epidemiologic, clinical, etiologic and outcome of this group at the department of internal medicine to NNH Patients and method: Medical records of all geriatric patients aged ≥65 years admitted at the department of NNH Between January 2012 and December 2015 were retrieved and reviewed retrospectively. Results: A total of 6074 admissions at the internal medicine department of NNH over three years were reported and 1130 (18, 6%) were geriatrics patients, the average age was 75, 95 years and more than half were men (50,7%). 80 % of patients were in the young old group (65-74 years), 13% in the old group (75-84 years) and 7% in the oldest old group (≥85 years). High blood pressure was the frequent comorbidity (12, 3%) and the most symptoms caused hospitalization were stroke (17, 6%), fevers (16, 5%) and worst health (13, 1%). Frequent illnesses were cardiovascular diseases (38.4%), infections, (19.2%) and endocrine diseases (11%). The average length of hospital stays was 8, 7 days. The mortality rate was 18, 2% and the worst outcomes factors were female sex, frail elderly group in 75 to 84 years and high blood pressure. Conclusion: Chronic diseases were responsible of morbidity and mortality for the majority elderly’s patient.
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Airagnes, Guillaume, Joane Matta, Frédéric Limosin, Nicolas Hoertel, Marcel Goldberg, Marie Zins, and Cedric Lemogne. "Towards quantifying the reciprocal associations between frequency of cannabis use and alcohol consumption: a cross-lagged analysis from the CONSTANCES cohort." BMJ Open 12, no. 2 (February 2022): e052819. http://dx.doi.org/10.1136/bmjopen-2021-052819.
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ObjectiveDisentangle the temporal relationships between frequency of cannabis use and alcohol consumption.MethodsA cross-lagged model providing standardised coefficients (SCs)±their standard errors in 13 255 men and 13 696 women enrolled in 2015 or 2016 in the French population-based 'CONSulTANts des Centres d'Examens de Santé' (CONSTANCES) cohort. Cannabis use was categorised as follows: ‘No use during the past 12 months’, ‘Use during the past 12 months but not in the past month’ and ‘Use in the past month’ for cannabis use at baseline, and No use during the past 12 months, ‘Use less than once per month’ and ‘Use once per month or more’ for cannabis use at 1 year of follow-up. Alcohol consumption was measured at baseline and at 1 year of follow-up and three categories were determined: low risk (<28 drinks per week in men; <14 drinks per week in women), moderate risk (≥28 and<42 in men; ≥14 and<28 in women) and high risk (≥42 in men; ≥28 in women). Analyses were adjusted for age, sex, education, income, tobacco consumption, self-rated health status and depressive symptoms.ResultsBoth associations from alcohol to cannabis and from cannabis to alcohol were significant (SC=0.02±0.01 with p=0.003 and SC=0.06±0.01 with p<0.001, respectively). However, the SC of the association from cannabis to alcohol was three times higher than the opposite association (p<0.001). After stratification for sex, SCs of the association from cannabis to alcohol were more than two times higher than for the opposite association in men, and more than four times higher in women (both p<0.001).ConclusionsThe association between frequency of cannabis use and subsequent alcohol consumption was stronger than the opposite association. This finding encourages considering the risk of increased alcohol consumption among cannabis users.
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Winzer, Regina, Lene Lindberg, Karin Guldbrandsson, and Anna Sidorchuk. "Effects of mental health interventions for students in higher education are sustainable over time: a systematic review and meta-analysis of randomized controlled trials." PeerJ 6 (April 2, 2018): e4598. http://dx.doi.org/10.7717/peerj.4598.
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Background Symptoms of depression, anxiety, and distress are more common in undergraduates compared to age-matched peers. Mental ill health among students is associated with impaired academic achievement, worse occupational preparedness, and lower future occupational performance. Research on mental health promoting and mental ill health preventing interventions has shown promising short-term effects, though the sustainability of intervention benefits deserve closer attention. We aimed to identify, appraise and summarize existing data from randomized control trials (RCTs) reporting on whether the effects of mental health promoting and mental ill health preventing interventions were sustained at least three months post-intervention, and to analyze how the effects vary for different outcomes in relation to follow-up length. Further, we aimed to assess whether the effect sustainability varied by intervention type, study-level determinants and of participant characteristics. Material and Methods A systematic search in MEDLINE, PsycInfo, ERIC, and Scopus was performed for RCTs published in 1995–2015 reporting an assessment of mental ill health and positive mental health outcomes for, at least, three months of post-intervention follow-up. Random-effect modeling was utilized for quantitative synthesis of the existing evidence with standardized mean difference (Hedges’ g) used to estimate an aggregated effect size. Sustainability of the effects of interventions was analyzed separately for 3–6 months, 7–12 months, and 13–18 months of post-intervention follow-up. Results About 26 studies were eligible after reviewing 6,571 citations. The pooled effects were mainly small, but significant for several categories of outcomes. Thus, for the combined mental ill health outcomes, symptom-reduction sustained up to 7–12 months post-intervention (standardized mean difference (Hedges’ g) effect size (ES) = −0.28 (95% CI [−0.49, −0.08])). Further, sustainability of symptom-reductions were evident for depression with intervention effect lasting up to 13–18 months (ES = −0.30 (95% CI [−0.51, −0.08])), for anxiety up to 7–12 months (ES = −0.27 (95% CI [−0.54, −0.01])), and for stress up to 3–6 months (ES = −0.30 (95% CI [−0.58, −0.03])). The effects of interventions to enhance positive mental health were sustained up to 3–6 months for the combined positive mental health outcomes (ES = 0.32 (95% CI [0.05, 0.59])). For enhanced active coping, sustainability up to 3–6 months was observed with a medium and significant effect (ES = 0.75 (95% CI [0.19, 1.30])). Discussion The evidence suggests long-term effect sustainability for mental ill health preventive interventions, especially for interventions to reduce the symptoms of depression and symptoms of anxiety. Interventions to promote positive mental health offer promising, but shorter-lasting effects. Future research should focus on mental health organizational interventions to examine their potential for students in tertiary education.
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Becker, Daniel J., Daniel Lin, Steve Lee, Benjamin P. Levy, Danil V. Makarov, Heather T. Gold, and Scott Sherman. "Exploration of the ASCO and ESMO Value Frameworks for Antineoplastic Drugs." Journal of Oncology Practice 13, no. 7 (July 2017): e653-e665. http://dx.doi.org/10.1200/jop.2016.020339.
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Purpose: In 2015, both ASCO and the European Society for Medical Oncology (ESMO) proposed frameworks to quantify the benefit of antineoplastic drugs in the face of rising costs. We applied these frameworks to drugs approved by the US Food and Drug Administration over the past 12 years and examined relationships between costs and benefits. Methods: We searched FDA.gov for drugs that received initial approval for solid tumors from 2004 to 2015 and calculated the ASCO Net Health Benefit version 2016 (NHB16) and 2015 (NHB15) and the ESMO Magnitude of Clinical Benefit Scale scores for each drug. We calculated descriptive statistics and explored correlations and associations among benefit scores, cost, and independent variables. Results: We identified 55 drug approvals supported by phase II (18.2%) and III (81.8%) trials, with primary outcomes of overall survival (36.4%), progression-free survival (43.6%), or response rate (20.0%). No significant association was found between NHB16 and year of approval ( P = .81), organ system ( P = .20), or trial comparator arm ( P = .17), but trials with progression-free survival outcomes were associated with higher scores ( P = .007). Both NHB15 and Magnitude of Clinical Benefit Scale scores were approximately normally distributed, but only a moderate correlation existed between them ( r = 0.40, P = .006). No correlation between benefit score and cost (NHB16, r = 0.19; ESMO, r = −0.07) was found. Before 2010, two (15.3%) of 13 approved drugs exceeded $500/NHB point × month compared with 10 (25.0%) of 40 drugs subsequently approved. Conclusion: Our analysis of the ASCO and ESMO value frameworks illuminates the heterogeneous benefit of new medications and highlights challenges in constructing a unified concept of drug value. Drug benefit does not correlate with cost, and the number of high cost/benefit outliers has increased.
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Molitor, Fred, Celeste Doerr, John Pugliese, and Lauren Whetstone. "Three-year trends in dietary behaviours among mothers, teenagers and children from SNAP-Ed (Supplemental Nutrition Assistance Program–Education) eligible households across California." Public Health Nutrition 23, no. 1 (November 20, 2019): 3–12. http://dx.doi.org/10.1017/s1368980019003197.
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AbstractObjective:To examine trends from 2015 to 2017 in dietary behaviours and diet quality among low-income mothers, teenagers and children.Design:Cross-sectional telephone surveys using a validated 24 h dietary assessment.Setting:Randomly sampled households with incomes ≤185 % of the US federal poverty level across California.Participants:Survey participants were 13 247 mothers (≥18 years), 3293 teenagers (12–17 years) and 6043 children (5–11 years). Respondents were mostly Latino.Results:Over the 3-year study period, consumption of fruits and vegetables with and without 100 % fruit juice increased (P ≤ 0·05) by at least 0·3 cups/d for mothers, teenagers and children. Intake of water also increased (P ≤ 0·001) by more than 1 cup/d for mothers and children and 2 cups/d for teenagers. Sugar-sweetened beverage (SSB) consumption was unchanged over the 3 years. Overall diet quality, as assessed by the Healthy Eating Index-2015, improved (P ≤ 0·01) for mothers, teenagers and children. Covariates for the fifteen regression models (three age groups by five outcome variables) included race/ethnicity, age, education for mothers, and gender for teenagers and children.Conclusions:The observed increases in fruit and vegetable intake and improvements in overall diet quality during the 3-year period suggest that low-income Californians may have lowered their risk of preventable diseases. However, more intense or strategic SSB-reduction interventions are required. Regional- or state-level, population-based surveillance of dietary behaviours is useful for public health nutrition policy and programme decision making, and can be used to assess potential trends in future negative health outcomes and related costs associated with poor dietary behaviours within at-risk populations.
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Schley, Katharina, Jack C. Kowalik, Shannon M. Sullivan, Andrew Vyse, Carole Czudek, Eszter Tichy, and Jamie Findlow. "Assessing the Role of Infant and Toddler MenACWY Immunisation in the UK: Does the Adolescent MenACWY Programme Provide Sufficient Protection?" Vaccines 11, no. 5 (May 4, 2023): 940. http://dx.doi.org/10.3390/vaccines11050940.
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A combined Haemophilus influenzae type b (Hib)/meningococcal serogroup C (MenC) vaccine will soon be unavailable in the UK immunisation schedule due to discontinuation by the manufacturer. An interim statement by the Joint Committee on Vaccination and Immunisation (JCVI) advises stopping MenC immunisation at 12 months of age when this occurs. We undertook an analysis of the public health impact of various potential meningococcal vaccination strategies in the UK in the absence of the Hib/MenC vaccine. A static population-cohort model was developed evaluating the burden of IMD (using 2005–2015 epidemiological data) and related health outcomes (e.g., cases, cases with long-term sequelae, deaths), which allows for the comparison of any two meningococcal immunisation strategies. We compared potential strategies that included different combinations of infant and/or toddler MenACWY immunisations with the anticipated future situation in which a 12-month MenC vaccine is not used, but the MenACWY vaccine is routinely given in adolescents. The most effective strategy is combining MenACWY immunisation at 2, 4, and 12 months of age with the incumbent adolescent MenACWY immunisation programme, resulting in the prevention of an additional 269 IMD cases and 13 fatalities over the modelling period; of these cases, 87 would be associated with long-term sequelae. Among the different vaccination strategies, it was observed that those with multiple doses and earlier doses provided the greatest protection. Our study provides evidence suggesting that the removal of the MenC toddler immunisation from the UK schedule would potentially increase the risk of unnecessary IMD cases and have a detrimental public health impact if not replaced by an alternate infant and/or toddler programme. This analysis supports that infant and toddler MenACWY immunisation can provide maximal protection while complementing both infant/toddler MenB and adolescent MenACWY immunisation programmes in the UK.
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Amatya, Yogendra, and Samita Acharya. "Postpartum quality of life after normal vaginal delivery and caesarean section." Journal of Patan Academy of Health Sciences 2, no. 2 (December 1, 2015): 13–18. http://dx.doi.org/10.3126/jpahs.v2i2.20324.
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Introductions: Caesarean section is rising. The best method of delivery, vaginal or caesarean, for postpartum quality of life in women is a matter of controversy both from professionals’ perspectives and from women’s experience of childbirth. This study analyses quality of life after these two methods of deliveries.Methods: This was a cross-sectional comparative study in postnatal care outpatient department at Patan Hospital. Primipara women with normal delivery and elective caesarean section done in Patan Hospital were enrolled to analyse postpartum quality of life. The SF-12 questionnaire tool at 6 weeks post delivery was used to compare age, ethnicity, education, family type and employment. Data was analysed using ANOVA test for descriptive parameters.Results: There were 468 primipara, age 30-45 years, 94% in 15-30 years77.8% educated, 74.4% in joint family,73.5% housewife. Normal vaginal delivery was 360 (72.6%) and 128 (27.4%) elective caesarean. Vaginal delivery group had average SF score of Physical Health Composite Score of 68.7, Mental Health CompositeScore69.5 and total SF score 67.7. While in caesarean group, it was 64.8,64.1 and 63.4.Conclusions: Normal vaginal delivery had better quality of life resulting in both superior physical as well as mental health.Journal of Patan Academy of Health Sciences, Vol. 2, No. 2, 2015. page:13-18
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Yuriah, Siti, Shania Juniarti, and Puput Sepriani. "Midwifery care for Mrs "Y" at BPM Soraya Palembang." International journal of health sciences 7, S1 (November 18, 2023): 2966–84. http://dx.doi.org/10.53730/ijhs.v7ns1.14631.
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According to the World Health Organization (WHO) in 2015 the Maternal Mortality Rate (MMR) was recorded as many as 303,000 mothers died during pregnancy to childbirth. Based on the 2012 Indonesian Health Demographic Survey (IDHS), the MMR was recorded at 359 per 100,000 live births.While the number of MMR in Palembang City from 2013 to 2014 has decreased from 13 people/29,911 KH to 12 people/29,235 KH. The purpose of this study was to determine the provision of continuous midwifery care from pregnancy to the postpartum period for Mrs. "Y" at BPM Soraya Palembang. The method used was a midwifery management framework using SOAP at BPM Soraya Palembang on Mrs. “Y” aged 33 years and data was collected through interviews, observation, physical examination, documentation study and literature study. The results of this study after carrying out Midwifery Care during pregnancy, childbirth, postpartum, and newborns to Mrs. "Y" aged 33 years at BPM Soraya, the results of care obtained from all health education and care can be provided properly, as well as all processes can run smoothly and normally. In the study of Midwifery Care on Mrs. "Y" aged 33 years showed that overall there was no gap between theory and practice.
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Pellikaan, Karlijn, Anna Rosenberg, Charlotte Wellink, Juan Tellez Garcia, Denise van Abswoude, Laura van Zutven, Hennie Brüggenwirth, James Resnick, Aart Jan van der Lely, and Laura de Graaff. "RF17 | PMON27 Genetic Subtype Differences in Relation to Health Problems Among Adults With Prader-Willi Syndrome." Journal of the Endocrine Society 6, Supplement_1 (November 1, 2022): A463—A464. http://dx.doi.org/10.1210/jendso/bvac150.964.
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Abstract Background Prader-Willi syndrome (PWS) is a complex rare genetic disorder associated with hypothalamic dysfunction, pituitary hormone deficiencies, hyperphagia and (morbid) obesity. PWS is caused by loss of expression of paternally expressed genes on chromosome 15q11.2-q13. The most common genetic mechanisms leading to PWS are paternal deletion (DEL) and maternal uniparental disomy (mUPD). DELs can be subdivided in type 1 and (smaller) type 2 deletions (DEL-1, DEL-2). Most research has focused on behavioral, cognitive and psychological differences between patients with a DEL-1, DEL-2 or mUPD. However, little is known about the genetic subtype differences in relation to physical health problems. Methods We reviewed the medical files of all adults with genetically confirmed PWS who visited the outpatient clinic of the Center for Adults with Complex Rare Genetic Syndromes at the Erasmus University Medical Center, Rotterdam, the Netherlands, between January 2015 and June 2021. All patients underwent a systematic health screening, including a structured interview, a medical questionnaire, a complete physical examination, biochemical measurements, and a review of the medical records. Health problems, physical complaints, symptoms of disease and behavioral challenges were compared between adults with an mUPD and DEL and between adults with a DEL-1 and DEL-2. Results Twenty-eight adults had an mUPD and 65 a DEL (13 DEL-1, 27 DEL-2, 25 unspecified). Gender, age and BMI did not differ between the genetic subgroups. Although psychiatric problems (psychotic episodes) were significantly more often present in adults with an mUPD (P < 0.001) and scoliosis was more prevalent among patients with DEL (P = 0.04), there was only a slight difference in prevalence of other medical problems like hypertension, cold intolerance, edema, hyperphagia, skin picking, abdominal pain and fatigue. There were no significant differences between DEL-1 and DEL-2. However, fatigue, cold intolerance, edema and hyperphagia were slightly more prevalent among adults with a DEL-1, whereas osteopenia, constipation and skin picking were more prevalent among adults with a DEL-2. Conclusion The differences in health problems between PWS adults with DEL-1, DEL-2 and mUPD are mostly present in the psychological domain. Especially psychotic episodes were more frequent in adults with an mUPD. Apart from scoliosis, there were no significant differences in physical health outcomes between the genetic subtypes. Presentation: Sunday, June 12, 2022 1:00 p.m. - 1:05 p.m., Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.
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Rivera, Rebecca, Richard Holden, Mariah Adams, Emily Dawkins, Wanzhu Tu, and Daniel Clark. "DELIVERING FOOD RESOURCES AND KITCHEN SKILLS TO OLDER ADULTS WITH FOOD INSECURITY AND HYPERTENSION." Innovation in Aging 6, Supplement_1 (November 1, 2022): 535. http://dx.doi.org/10.1093/geroni/igac059.2036.
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Abstract Non-Hispanic Black adults experience higher rates of food insecurity, poor diet quality, and hypertension compared with their non-Hispanic White counterparts. Delivering Food Resources and Kitchen Skills (FoRKS) is an integrated intervention that concurrently addresses food insecurity, nutrition literacy, and chronic disease self-management among older patients at a Federally Qualified Health Center. Two clinical dietitians led virtual hypertension self-management, cooking skills, and nutrition education classes twice per week for 16 weeks. Participants registered for classes, ordered free meal ingredients, and received encouragement from the dietitians through the FoRKS mobile technology application. This study presents diet quality descriptive results from the FoRKS pilot intervention conducted at Eskenazi Health from September 2021 to January 2022 in Indianapolis, Indiana. Participants (n=13) with hypertension (systolic blood pressure ≥120 mm Hg) and who identified as food insecure per the 18-item US Household Food Security Survey Module completed the 2018-version of the National Cancer Institute’s Automated Self-Administered 24-hour (ASA24) Dietary Assessment Tool at baseline and post-intervention assessments. Healthy Eating Index (HEI)-2015 scores range from 0-100 and were calculated from ASA24 data. Participants were non-Hispanic Black (n=12) or non-Hispanic White (n=1) with mean age 58 years (range 53-65 years). Mean±SD HEI-2015 scores improved from 51.5±11.9 at baseline to 55.2±12.5 after the intervention. This preliminary data supports further investigation into the efficacy of integrated lifestyle interventions, i.e., FoRKS, using a randomized controlled study design. Addressing food and culinary skills can lead to improvements in diet quality that may translate to improved disease management among diverse older adults.