This study aimed to assess the coutilisation of oral rehydration solution (ORS) and zinc for treating diarrhoea and its associated factors among under-5 children in East Africa.
Cross-sectional study design. Multilevel Poisson regression analysis with robust variance was fitted to identify predictors of zinc and ORS coutilisation. An adjusted prevalence ratio (aPR) with a 95% CI was reported to declare the statistical significance.
Twelve East African countries.
16 850 under-5 children who had diarrhoea were included in the study.
In East African nations, the coutilisation of ORS and zinc for the treatment of diarrhoea in children under 5 was 53.27% with a 95% CI (52.54% to 54.01%). Children of mothers with primary education (aPR 1.15, 95% CI 1.09 to 1.20), secondary education (aPR 1.08, 95% CI 1.02 to 1.14), higer education (aPR 1.19, 95% CI 1.10 to 1.29), those from maternal age category of 20–24 (aPR 1.14, 95% CI 1.07 to 1.21), age category of 25–29 (aPR 1.13, 95% CI 1.06 to 1.21), age category of 30–34 (aPR 1.09, 95% CI 1.02 to 1.16), those from wealthy households (aPR 1.04, 95% CI 1.01 to 1.09) and those who have a media exposure (aPR 1.04, 95% CI 1.01 to 1.08) were more likely to receive combination.
Only half of the under-5 children with diarrhoea in East Africa were treated with a combination of ORS and zinc. To increase the use of the suggested combination therapy of ORS with zinc, it is important to empower women through education and prevent teen pregnancy.
by Akira Obana, Kibo Ote, Yuko Gohto, Hidenao Yamada, Fumio Hashimoto, Shigetoshi Okazaki, Ryo Asaoka
PurposeMeasurements of macular pigment optical density (MPOD) using the autofluorescence spectroscopy yield underestimations of actual values in eyes with cataracts. Previously, we proposed a correction method for this error using deep learning (DL); however, the correction performance was validated through internal cross-validation. This cross-sectional study aimed to validate this approach using an external validation dataset.
MethodsMPODs at 0.25°, 0.5°, 1°, and 2° eccentricities and macular pigment optical volume (MPOV) within 9° eccentricity were measured using SPECTRALIS (Heidelberg Engineering, Heidelberg, Germany) in 197 (training dataset inherited from our previous study) and 157 eyes (validating dataset) before and after cataract surgery. A DL model was trained to predict the corrected value from the pre-operative value using the training dataset, and we measured the discrepancy between the corrected value and the actual postoperative value. Subsequently, the prediction performance was validated using a validation dataset.
ResultsUsing the validation dataset, the mean absolute values of errors for MPOD and MPOV corrected using DL ranged from 8.2 to 12.4%, which were lower than values with no correction (P Conclusion
The usefulness of the DL correction method was validated. Deep learning reduced the error for a relatively good autofluorescence image quality. Poor-quality images were not corrected.
This is a study assessing the effectiveness of staples versus sutures for closing incisions after total hip arthroplasty (THA). We searched all relevant literature up to July 2023, and after reading through the full text, we finally included 5 for analysis, with a total of 1084 cases who underwent total hip arthroplasty, of which 548 were closed with staples and 536 with sutures, and evaluated the risk of bias with the Cochrane Risk of Bias Assessment Tool, using the ratio of ratios (OR) and 95% confidence intervals (CI) to compare the effectiveness of staples and sutures in wound closure in total hip arthroplasty. The study found that the suture group was superior to the staple group in terms of superficial infection and incisional exudate; superficial infection (OR = 3.04, 95% CI: 1.14–8.07; p = 0.03, I 2 = 0%), incisional exudate (OR = 3.22, 95% CI: 1.84–5.65; p < 0.001, I 2 = 0%) and suture staples were superior to suture group in terms of closure time (WMD = −231.8 95% CI: −429.55 to −34.05; p = 0.02, I 2 = 100%). There was no remarkable distinction between the two groups in terms of deep infection, postoperative hospital, HWES score and patient's satisfaction, deep infection (OR = 1.24, 95% CI: 0.35–4.35; p = 0.74, I 2 = 0%), postoperative hospital (WMD = 2.50 95% CI: −2.25 to 7.25; p = 0.30, I 2 = 100%), HWES score (WMD = −0.38 95% CI: −0.52 to −0.24; p < 0.01, I 2 = 72%) and patient's satisfaction (WMD = −0.23 95% CI: −1.43 to 0.96; p = 0.70, I 2 = 94%); however, due to the small sample sizes of several studies included in this study, caution must be exercised when addressing their value.
A non-contrast CT head scan (NCCTH) is the most common cross-sectional imaging investigation requested in the emergency department. Advances in computer vision have led to development of several artificial intelligence (AI) tools to detect abnormalities on NCCTH. These tools are intended to provide clinical decision support for clinicians, rather than stand-alone diagnostic devices. However, validation studies mostly compare AI performance against radiologists, and there is relative paucity of evidence on the impact of AI assistance on other healthcare staff who review NCCTH in their daily clinical practice.
A retrospective data set of 150 NCCTH will be compiled, to include 60 control cases and 90 cases with intracranial haemorrhage, hypodensities suggestive of infarct, midline shift, mass effect or skull fracture. The intracranial haemorrhage cases will be subclassified into extradural, subdural, subarachnoid, intraparenchymal and intraventricular. 30 readers will be recruited across four National Health Service (NHS) trusts including 10 general radiologists, 15 emergency medicine clinicians and 5 CT radiographers of varying experience. Readers will interpret each scan first without, then with, the assistance of the qER EU 2.0 AI tool, with an intervening 2-week washout period. Using a panel of neuroradiologists as ground truth, the stand-alone performance of qER will be assessed, and its impact on the readers’ performance will be analysed as change in accuracy (area under the curve), median review time per scan and self-reported diagnostic confidence. Subgroup analyses will be performed by reader professional group, reader seniority, pathological finding, and neuroradiologist-rated difficulty.
The study has been approved by the UK Healthcare Research Authority (IRAS 310995, approved 13 December 2022). The use of anonymised retrospective NCCTH has been authorised by Oxford University Hospitals. The results will be presented at relevant conferences and published in a peer-reviewed journal.
by Ting-Li Chen, Elizabeth P. Chou, Min-Yi Chen, Fushing Hsieh
We investigate the dynamic characteristics of Covid-19 daily infection rates in Taiwan during its initial surge period, focusing on 79 districts within the seven largest cities. By employing computational techniques, we extract 18 features from each district-specific curve, transforming unstructured data into structured data. Our analysis reveals distinct patterns of asymmetric growth and decline among the curves. Utilizing theoretical information measurements such as conditional entropy and mutual information, we identify major factors of order-1 and order-2 that influence the peak value and curvature at the peak of the curves, crucial features characterizing the infection rates. Additionally, we examine the impact of geographic and socioeconomic factors on the curves by encoding each of the 79 districts with two binary characteristics: North-vs-South and Urban-vs-Suburban. Furthermore, leveraging this data-driven understanding at the district level, we explore the fine-scale behavioral effects on disease spread by examining the similarity among 96 age-group-specific curves within urban districts of Taipei and suburban districts of New Taipei City, which collectively represent a substantial portion of the nation’s population. Our findings highlight the implicit influence of human behaviors related to living, traveling, and working on the dynamics of Covid-19 transmission in Taiwan.by Md. Abu Raihan, Md. Saiful Islam, Shariful Islam, A. F. M. Mahmudul Islam, Khandaker Tanveer Ahmed, Tania Ahmed, Md. Nahidul Islam, Shamsunnahar Ahmed, Mysha Samiha Chowdhury, Dipto Kumar Sarker, Anika Bushra Lamisa
BackgroundEscalating antibiotic resistance presents a notable worldwide dilemma, pointing a large involvement of general population. The objective of this study was to assess knowledge, attitudes, and practices regarding the utilization of antibiotics among Bangladeshi residents.
MethodsA cross-sectional study, conducted from January 01 to April 25, 2022, included 1,947 Bangladeshi adults with a history of antibiotic use, via online surveys and face-to-face interviews using a pretested semi-structured questionnaire. Descriptive statistics, Chi-square tests, and multivariate linear regression models were employed.
ResultsMean scores for knowledge, attitudes, and practices were 6.59±1.20, 8.34±1.19, and 12.74±2.59, with correct rates of 73.22%, 92.67%, and 57.91%. Positive predictors for knowledge included being unmarried (β = 0.10, p = 0.001), higher education (College: β = 0.09, p = 0.025; Bachelor: β = 0.22, p Conclusions
Participants exhibited adequate knowledge and positive attitudes but lagged behind in proper practice of antibiotic use. Proper initiatives should be tailored to enhance prudent antibiotic use and mitigate the risk of antimicrobial resistance.
Globally, malnutrition among women of reproductive age is on the rise and significantly contributing to non-communicable disease, deaths and disability. Even though the double burden of malnutrition (DBM) is a common problem among women in sub-Saharan Africa (SSA), there are limited studies examining the factors contributing to underweight, overweight, and obesity at the SSA level.
To determine the factors associated with the DBM, and their relative magnitude, among women of reproductive age in SSA.
Cross-sectional study design.
33 SSA countries.
240 414 women of reproductive age.
A multilevel multinomial logistic regression model was applied to identify factors associated with malnutrition. The adjusted relative risk ratio with 95% CI was used to declare the statistical significance of the association.
The pooled prevalence of underweight, overweight and obesity among women in SSA were 8.87%, 16.47% and 6.10%, respectively. Women who are from rural residence and smoke cigarettes were more likely to be underweight. Conversely, women between the age of 24–34 and 35–49, who have higher education, belong to a middle and rich household, are ever married, have high parity, use contraceptives, have media exposure and smoke cigarettes were more likely to be overweight and/or obese.
The findings of our study suggest that certain factors such as residence, education status, wealth, marital status, occupation, cigarette smoking, and contraceptive use have a significant assocation with malnutrition among women. Therefore, it is important for public health programs aimed at preventing the double burden of malnutrition to focus on these factors through comprehensive public awareness and cost-effective operational health interventions.
Examining fear of cancer recurrence (FCR) among breast cancer survivors and their spouses, and the protective effect of family resilience on FCR among couples affected by breast cancer.
Cross-sectional survey design.
Ten general grade IIIa (>500 beds) hospitals in southwest China.
Overall, 392 early breast cancer survivors and their spousal caregivers (N=392) were recruited from cancer centres in hospitals.
Spouses’ and survivors’ FCR were the primary outcome measures. Family resilience and perceived stress were the secondary outcome measures. Using a convenience sampling method, we collected data on-site using paper questionnaires. The Chinese version of the Family Resilience Assessment Scale, Perceived Stress Scale, Fear of Progression Questionnaire Short Form and Fear of Progression Questionnaire-Short Form for spouses were used to evaluate the outcomes.
The model accounted for 66.3% and 53.6% of the variance in spouses’ FCR and survivors’ FCR, respectively. Family resilience directly negatively affected perceived stress and spouses’ and survivors’ FCR (β=–0.22; β=–0.13; β=–0.19). Perceived stress was a partial mediator of the association between family resilience and survivors’ FCR (β=–0.070; 95% CI :–0.151 to –0.022). Spouses’ FCR partially mediated the association between family resilience and survivors’ FCR (β=–0.048; 95% CI= –0.092 to –0.015). Perceived stress and spouses’ FCR played a significant chain-mediated role between family resilience and survivors’ FCR (β=–0.061; 95% CI: –0.119 to –0.022).
Family-centred approaches to reducing survivors’ perceived stress can improve the psychological well-being of couples affected by breast cancer and ultimately reduce FCR. Medical staff should consider the psychological feelings of survivors and their spousal caregivers when devising the intervention plan, which should address the families’ potential and mobilise family and community resources for increasing family resilience.
This study aimed to examine the association between home meal preparer and salt intake among haemodialysis patients, including daily dietary status. We hypothesised that salt intake is higher among individuals who rely on meal preparation from others than those who prepare meals by themselves.
Cross-sectional study.
Two medical facilities in Fukushima Prefecture, Japan.
237 haemodialysis outpatients who visited one of the medical facilities between February 2020 and August 2021 and were diagnosed with anuria, defined as urination of
Salt intake amount was calculated from the results of predialysis and postdialysis blood draws, using Watson’s formula based on predialysis weight, predialysis serum sodium level, postdialysis weight and serum sodium level at the end of dialysis.
Salt intake was significantly higher in participants who relied on meal preparation from others (‘relying on others’) than those who prepared meals by themselves (‘self-prepared’) (B=1.359; 95% CI: 0.495 to 2.222). No statistical difference was found between individuals who ate out or ate takeout (‘outsourcing’) and those who prepared their own meals (‘self-prepared’). These results were robust after adjustment for confounding factors.
The present study revealed an association between self-preparation of meals at home and reduced salt intake among dialysis patients. Our findings suggest that whoever is the home meal preparer is possibly a social determinant of salt intake. To improve the prognosis of haemodialysis patients, actively reaching out to the family and assessing their social environment, such as identifying the home meal preparer and, if the patient relies on others for meal preparation, conducting nutritional/dietary guidance for that person, are effective in enhancing salt reduction.
The worldwide prevalence of myopia is high and continues to increase. In this study, a school screening programme for myopia will be implemented using the whole-process information method. The purpose of this study is to investigate the prevalence of myopia in urban and rural areas of Northeast China and to determine the factors related to myopia.
This is a school-based cross-sectional study. Our study population will include 6000 school-aged children from 2 urban and 2 rural schools in Jinzhou, China. The study will be conducted using our self-developed internet-based intelligent data collection, transmission, storage and analysis system. Examination parameters include uncorrected distance visual acuity, presenting distance visual acuity, non-cycloplegic autorefraction, height, weight, waist circumference, hip circumference, spinal curvature and dental caries. The examination report will be automatically sent to parents, who will complete the questionnaire, and appropriate statistical analysis will be performed. The main outcome is the prevalence of myopia, defined as an equivalent spherical degree ≤–0.5 D.
Ethical approval was obtained from the Third Affiliated Hospital of Jinzhou Medical University (number: JYDSY-KXYJ-IEC-2023-018). Findings will be published in a peer-reviewed journal. Subjects and their parents (or other authorised agents) give informed consent prior to study participation.
ChiCTR2300072893.
To evaluate the association between urinary 8-hydroxy-2'-deoxyguanosine (U8-OHdG) level—a marker of oxidative stress—and the incidence of preterm births (PTBs).
Prospective cohort study.
The Japan Environment and Children’s Study (JECS).
Data from 92 715 women with singleton pregnancies at and after 22 weeks of gestation who were enrolled in the JECS, a nationwide birth cohort study, between 2011 and 2014 were analysed. U8-OHdG levels were assessed once in the second/third trimester using liquid chromatography–tandem mass spectrometry. Participants were categorised into the following three or five groups: low (
Adjusted OR (aOR) for PTB before 37 and 34 weeks of gestation were calculated using a multivariable logistic regression model while adjusting for confounding factors; the moderate or lowest U8-OHdG group was used as the reference, respectively.
The aORs for PTB before 37 weeks of gestation in the high U8-OHdG group were 1.13 (95% CI 1.05 to 1.22) and 1.13 (95% CI 1.04 to 1.23) after stratification. The aOR for PTB before 37 weeks in the fourth group was 0.90 (95% CI 0.81 to 0.99). After stratification, the aORs for PTB before 37 and 34 weeks in the fifth group were 1.15 (95% CI 1.03 to 1.29) and 1.46 (95% CI 1.08 to 1.97), respectively.
High U8-OHdG levels were associated with increased PTB incidence, especially in participants without representative causes for artificial PTB. Our results can help identify the mechanisms leading to PTB, considering the variable aetiologies of this condition; further validation is needed to clarify clinical impacts.
Air pollution is a global issue that poses a significant threat to public health. Children, due to their developing physiology, are particularly susceptible to the inhalation of environmental pollutants. Exposure can trigger immune modulation and organ damage, increasing susceptibility to respiratory diseases. Therefore, we aim to examine the association between heavy metal and particulate matter exposure with tuberculosis in children.
As a case–control study, we will include children diagnosed with pulmonary tuberculosis (n=60) and matched healthy controls (n=80) recruited from the same communities in Dhaka, Bangladesh. Exposure data for both cases and controls will be collected by a trained field team conducting home visits. They will administer an exposure questionnaire, measure child anthropometry, collect blood and household dust samples and instal 48-hour air quality monitors. The blood samples will be analysed by inductively coupled plasma mass spectrometry for serum heavy metal concentrations (lead, cadmium, arsenic, mercury and chromium), as a representative marker of exposure, and the presence of inflammatory biomarkers. Descriptive and inferential statistics, including independent samples t-tests, analysis of variance and conditional regression analysis, will be used to quantify heavy metal and particulate matter exposure status in tuberculosis cases compared with healthy controls, while accounting for potential confounders. Dust samples and air quality results will be analysed to understand household sources of heavy metal and particulate matter exposure. To test the study hypothesis, there is a positive association between exposure and tuberculosis diseases, we will also measure the accumulated effect of simultaneous exposures using Bayesian statistical modelling.
This study has been approved by International Centre for Diarrhoeal Disease Research, Bangladesh’s Institutional Review Board (PR-22030). The study findings will be disseminated at conferences and published in peer-reviewed journals.
It is of utmost importance to comprehend the impact that psychological factors have on physical rehabilitation, specifically in regards to wound healing following ligation of oesophageal varices in patients with liver cirrhosis. The present study investigated the correlation between wound recovery rates and psychological well-being, stress and mental health. From January 2022 to September 2023, 148 patients from were evaluated as part of this cross-sectional observational study. The psychological well-being of participants was evaluated utilizing the Hospital Anxiety and Depression Scale (HADS), Perceived Stress Scale (PSS) and Psychological General Well-Being Index (PGWBI). The rates of wound recovery were assessed following ligation. The mean duration for wound recovery was 28.37 ± 9.65 days. The mean wounds healing time of patients who obtained higher PSS scores (18.55) was marginally longer. On the contrary, there was a moderate reduction in healing time associated with higher HADS scores (mean 14.10). On average (68.88), PGWBI scores indicated a negligible effect on wound healing. The variance in healing durations between Child-Pugh classifications A, B and C (mean values of 28.65, 26.90 and 29.57 days respectively) suggested that the severity of liver disease has an impact. As a result of ligation of oesophageal varices, the study demonstrated that psychological factors and wound recovery in patients with liver cirrhosis are intricately intertwined. There seems to be the substantial and intricate relationship between stress, mental health and wound recovery. The results of this study supported the notion that psychological evaluation and support should be incorporated into the management of patients with liver cirrhosis.
by Hong Duo, Mengying Jin, Yanwei Yang, Rewaan Baheti, Yujia Feng, Zirui Fu, Yuyue Jiang, Lanzhuoying Zheng, Jing Wan, Huaqin Pan
BackgroundCoronavirus disease 2019 (COVID-19) may predispose patients to thrombotic disease in the venous and arterial circulations.
MethodsBased on the current debate on antiplatelet therapy in COVID-19 patients, we performed a systematic review and meta-analysis to investigate the effect of antiplatelet treatments. We searched PubMed, EMBASE, Cochrane Central Register of Controlled Trials, and Web of Science on February 1, 2023, and only included Randomized clinical trials. The study followed PRISMA guidelines and used Random-effects models to estimate the pooled percentage and its 95% CI.
ResultsFive unique eligible studies were included, covering 17,950 patients with COVID-19. The result showed no statistically significant difference in the relative risk of all-cause death in antiplatelet therapy versus non-antiplatelet therapy (RR 0.94, 95% CI, 0.83–1.05, P = 0.26, I2 = 32%). Compared to no antiplatelet therapy, patients who received antiplatelet therapy had a significantly increased relative risk of major bleeding (RR 1.81, 95%CI 1.09–3.00, P = 0.02, I2 = 16%). The sequential analysis suggests that more RCTs are needed to draw more accurate conclusions. This systematic review and meta-analysis revealed that the use of antiplatelet agents exhibited no significant benefit on all-cause death, and the upper bound of the confidence interval on all-cause death (RR 95% CI, 0.83–1.05) suggested that it was unlikely to be a substantiated harm risk associated with this treatment. However, evidence from all RCTs suggested a high risk of major bleeding in antiplatelet agent treatments.
ConclusionAccording to the results of our sequential analysis, there is not enough evidence available to support or negate the use of antiplatelet agents in COVID-19 cases. The results of ongoing and future well-designed, large, randomized clinical trials are needed.
To compare fluidized positioners and gel pads for skin protection in neurosurgery patients placed in lateral and prone positions. It is one of the major challenges that operating room nurses face in protecting the skin during the long duration of neurosurgery. Currently, there are increasing tools available to protect the skin under pressure, and various tools practice well in the clinic. Fluidized positioners are newly emerging protective pads that have been clinically effective in protecting the skin, but no studies have compared them to previous pads. This is a retrospective cohort study. Data from 706 patients who underwent neurosurgery between January 2018 and December 2021 were systemically reviewed. Patients undergoing long-term neurosurgery in the neurosurgical lateral and prone positions were divided into two groups: fluidized positioners or gel pads. Propensity score matching (PSM) was performed for group balance (1:1 ratio) using the following baseline characteristics: age, gender, ASA (American Society of Anesthesiologists) classification, duration of surgery, surgical position and underlying disease. The incidence of decubitus, and length of stay (LOS) in the hospital were compared between the two groups. The results were obtained for 394 patients in the fluidized positioner group with a 3.8% incidence of pressure ulcers and 312 patients in the gel pad group with an 8% incidence of pressure ulcers, which were unbalanced in terms of gender, ASA, hypertension and diabetes data. After a PSM, patients were compared in terms of pressure ulcer incidence (3.7% vs. 7.8%, p = 0.034) and LOS (22.35 vs. 25.65 days, p < 0.001). Fluidized positioners can effectively reduce the incidence of pressure injury in lateral and prone positions of neurosurgery. The results of this study may contribute to the development of policies to prevent the development of pressure ulcers during neurosurgical procedures.
To explore the actual experience of psychological distress of adult women of reproductive age at different stages after breast cancer diagnosis.
Qualitative.
Eighty-one patients with breast cancer-related distress thermometer scores >4 were selected using a purposive sampling method. Patients were divided into newly diagnosed and 1-, 3-, 6-, 9- and 12-month groups according to time since diagnosis and then interviewed. A phenomenological approach was adopted to analyse interview content, and different themes were extracted.
Women exhibited different levels of psychological distress depending on the time since diagnosis, with newly diagnosed patients showing the highest distress. Within 1 year post-diagnosis, different events caused patients distress. Themes extracted at new diagnosis and 1-, 3-, 6-, 9- and 12 months post-diagnosis included sadness and disbelief, loss of control, optimistic but concerned, physical and mental exhaustion, difficulties returning to society and limited sexual intimacy, respectively; all groups expressed reproductive concerns.
Clinical nurses should focus on different psychologically distressing events to provide targeted interventions at distinct phases. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and reproductive concerns.
During the year after a breast cancer diagnosis, patients of childbearing age experience events that cause psychological distress that differ depending on time since diagnosis. Nurses should focus on core stressful events and perform specific nursing interventions.
To provide holistic care, nurses should consider the psychological and emotional changes patients may undergo. For women of childbearing age, clinical nurses should pay particular attention to patients' marriage and fertility concerns, and be able to provide evidence-based professional guidance on reproductive preservation techniques.
The study was reported using the consolidated criteria for reporting qualitative research guidelines.
Patients contributed to data collection through interviews.
This study was conducted to examine the possible aetiology of nocturia in patients with long-term COVID-19.
Physical and neuropsychiatric symptoms, an increase in overactive bladder symptoms, especially from urinary system complaints, has been reported in patients with COVID-19, 10–14 weeks after the illness.
A descriptive design.
The study consisted of 70 patients who had experienced COVID-19, had nocturia, and were followed in the State Hospital between April and July 2022. Data were collected using a patient information form, the ‘TANGO’ nocturia screening tool, and the Visual Analog Scale. This study was created in accordance with the STROBE Statement Checklist.
When the nocturia effects of long-term COVID-19 were examined it was determined that the urinary tract was the ‘priority’ aetiological condition. It was observed that there was a significant difference between the aetiological factor groups in terms of the mean age of the patients and the number of nocturia (p < .05). According to post-hoc analysis, the mean age of patients with a dominant cardio-metabolic factor was found to be significantly younger (p < .05). In addition, when comparing the number of nocturia according to the aetiological factors of the patients, it was observed that the number of nocturia was significantly frequent in the patients with a dominant sleep factor (p < .05).
It was found that the urinary tract aetiological factor was dominant in patients with long-term COVID-19 and nocturia, patients with a dominant cardiovascular aetiological factor were younger, and that the number of nocturia was higher in patients with a dominant sleep factor.
Identification of the early signs and symptoms and underlying causes of nocturia in individuals with post-COVID-19 syndrome will enable nurses and health professionals to guide the early identification of different underlying problems, as well as the implementation of approaches to treat and eliminate nocturia.
The patients contributed to the study by agreeing to participate in the evaluation of nocturia complaints after COVID-19 infection.
To evaluate midwives' level of stress and burnout during the COVID-19 Omicron phase in Italy. Secondary aims were to explore the impact of the pandemic on midwives' personal dimensions and professional activities and potential supporting strategies.
A mixed-methods study was undertaken from July to December 2022.
Data were collected using a national online observational survey. Descriptive and inferential analyses were performed to evaluate stress, burnout and the impact of the pandemic on personal and professional dimensions. A deductive qualitative approach was used to analyse open-ended responses, that were merged with quantitative data following a convergent mixed-methods approach.
A total of 1944 midwives participated in the survey. The stress summary score mean was 10.34, and 562 midwives (28.91%) experienced burnout. The intention to reduce working hours was reported by 202 midwives (10.39%), with 60.40% (n = 122) of them experiencing burnout. The intention to leave clinical practice within the following 2 years was reported by 239 (12.29%), with 68.20% (n = 163) of them experiencing burnout. All the personal dimensions and professional activities considered were defined by more than half of midwives as being impacted ‘Moderately’ or ‘To a great extent’ by pandemic. Stress and burnout frequencies increased when the midwives' perception of the pandemic effects was higher. Potential supporting strategies described by midwives as the most important in increasing their ability to cope with the pandemic were ‘Women's awareness of the midwives' role’ (n = 1072; 55.14%) and ‘Family and friends' emotional support’ (n = 746; 38.38%).
Our findings suggested strategies to support a positive and safe working environment for midwives during a pandemic emergency, with potential transferability to similar contexts when human resources are lacking. It is recommended that maternity services provide the necessary resources for a safe and supportive working environment to prevent high stress levels and chronic burnout.
Studies conducted during the first COVID-19 pandemic wave showed an increased level of stress, anxiety, burnout, post-traumatic stress disorder and depression experienced by healthcare professionals; moreover, midwives experienced drastic changes in care pathways and policies with struggles identified when providing high-quality woman-centred care following pandemic restrictions. Although it is recommended, there is lack of knowledge about long-term psychological effects of COVID-19 for midwives. Our study highlights that during the Omicron wave midwives experienced a high level of stress and burnout with an impact on individual dimensions and professional activities. Their stress and burnout were influenced by several factors, including restrictions in place, lack of organizational acknowledgement, work overload and need for extra childcare cover. Maternity services should provide the necessary resources for a safe and supportive working environment to prevent high stress levels and chronic burnout. Recommendations on how to facilitate this are suggested.
During the writing process, we referred to ‘The Strengthening the Reporting of Observational Studies Epidemiology Statement’, the guidelines for reporting observational studies from the Equator network.
No patient or public contribution.
Work overload conditions negatively impacted on the quality of maternity services. Improving organizational aspects, reducing working hours, promoting family and friends' emotional support and improving women's awareness of midwife's role were the main strategies reported by midwives. These suggestions for ensuring a positive and safe working environment for midwives during a pandemic emergency could potentially be applied to similar situations where human resources are lacking.
by Jaecy K. Banther-McConnell, Thanchira Suriyamongkol, Samuel M. Goodfellow, Robert A. Nofchissey, Steven B. Bradfute, Ivana Mali
Orthohantaviruses are diverse zoonotic RNA viruses. Small mammals, such as mice and rats are common chronic, asymptomatic hosts that transmit the virus through their feces and urine. In North America, hantavirus infection primarily causes hantavirus cardiopulmonary syndrome (HCPS), which has a mortality rate of nearly 36%. In the United States of America, New Mexico (NM) is leading the nation in the number of HCPS-reported cases (N = 129). However, no reported cases of HCPS have occurred within eastern NM. In this study, we assessed the prevalence of Sin Nombre virus (SNV) in rodent assemblages across eastern NM, using RT-qPCR. We screened for potential rodent hosts in the region, as well as identified areas that may pose significant infection risk to humans. We captured and collected blood and lung tissues from 738 rodents belonging to 23 species. 167 individuals from 16 different species were positive for SNV RNA by RT-qPCR, including 6 species unreported in the literature: Onychomys leucogaster (Northern grasshopper mouse), Dipodomys merriami (Merriam’s kangaroo rat), Dipodomys ordii (Ord’s kangaroo rat), Dipodomys spectabilis (Banner-tailed kangaroo rat), Perognathus flavus (Silky pocket mouse), and Chaetodipus hispidus (Hispid pocket mouse). The infection rates did not differ between sexes or rodent families (i.e., Cricetidae vs. Heteromyidae). Generalized linear model showed that disturbed habitat types positively influenced the prevalence of SNV at sites of survey. Overall, the results of this study indicate that many rodent species in east New Mexico have the potential to maintain SNV in the environment, but further research is needed to assess species specific infectivity mechanisms and potential risk to humans.by Nazma Shaheen, Abira Nowar, Saiful Islam, Md. Hafizul Islam, Md. Ruhul Amin
Nutrient profiling is a method that classifies foods based on their nutrient content and identifies foods that are high in micronutrients both across and within food groups. This study aimed to identify foods that are rich sources of the seven micronutrients (iron, zinc, calcium, thiamine, riboflavin, vitamin A, and vitamin B12) of public health concern for the Bangladeshi population.. This study developed a metric termed “naturally nutrient-rich score 7 (NNR7)” specifically for third-trimester pregnant women to identify nutrient-dense foods. Further, it computed the nutrient adequacy score (NAS) of the top NNR7-scored foods for seven micronutrients to assess the extent (percent) to which foods can meet pregnant women’s recommended dietary allowances (RDA). A linear programming technique was then used to construct a nutrient-adequate model diet for third-trimester pregnant women using the top ten NNR7-scored foods. According to the NNR7, food groups such as leafy vegetables, fish, meat, poultry and eggs, and vegetables are the richest sources of the problem micronutrients. Mutton liver (916.7%), soybean (39.3%), lamb liver (2160%) and duck liver (50.0%) were found to fulfill the highest percentage of the RDA of vitamin A, zinc, vitamin B12, and iron, respectively. In the formulated nutrient-adequate diets for pregnant women, rice, potato, brown wheat flour, and soya oil were universal to all three diets and Bengal gram, orange, Ganges River sprat, and duck liver were the most common ones. The study findings highlight the need for the consumption of foods such as leafy vegetables, fish, meat, poultry, eggs, pulses and vegetables to increase the intake of problematic micronutrients. Planning a nutrient-adequate diet for pregnant women using linear programming can be an alternative approach to optimize and shape food choices to meet their nutritional requirements.