Conectar
The rising burden of non-communicable diseases (NCDs), including mental health disorders (MHDs) such as anxiety and depression, poses a significant public health challenge globally. Evidence suggests that both diabetes and hypertension, the two most prevalent NCDs, are linked to a higher prevalence of MHDs. However, there is a lack of evidence on prevalence of generalised anxiety disorder (GAD) and depression among adults living with both diabetes and hypertension in Bangladesh. We aimed to assess the prevalence of GAD and depression and explore the associated factors among adults living with diabetes and hypertension comorbidity in rural Bangladesh.
We implemented a cross-sectional study.
The study was conducted in Chirirbandar, a sub-district of Dinajpur, Bangladesh.
We interviewed a total of 387 adults living with diabetes and hypertension comorbidity.
We had two primary outcome measures: GAD and depression. Individuals scoring ≥10 on the General Anxiety Disorder-7 scale were considered as having GAD and individuals scoring ≥10 on the Patient Health Questionnaire-9 scale were considered as having depression. The outcome variables were dichotomised based on these scores.
The prevalence of GAD was 7.24% (95% CI 5.04 to 10.29). Education level (grades 5–9) (adjusted OR (AOR): 3.40, 95% CI 1.26 to 9.19) and household wealth status (highest wealth tertile) (AOR: 0.12, 95% CI 0.02 to 0.62) were associated with GAD. The prevalence of depression was 17.83% (95% CI 14.32 to 21.98). Socioeconomic factors associated with depression included unemployment (AOR: 3.26, 95% CI 1.05 to 10.10) and household wealth status (highest wealth tertile) (AOR: 0.45, 95% CI 0.21 to 0.98). Higher odds of depression were also observed among participants with controlled hypertension (AOR: 3.88, 95% CI 1.81 to 8.35). Other factors, such as tobacco use, dietary diversity and physical activity, were not associated with GAD or depression.
A high prevalence of GAD and depression was observed among adults living with diabetes and hypertension comorbidity. The findings from the study emphasise the need for integration of mental health services into the existing non-communicable disease care. The identified factors associated with GAD or depression should be considered to develop targeted interventions for people with hypertension and diabetes comorbidity in Bangladesh.
SARS-CoV-2 is now endemic and expected to remain a health threat, with new variants continuing to emerge and the potential for vaccines to become less effective. While effective vaccines and natural immunity have significantly reduced hospitalisations and the need for critical care, outpatient treatment options remain limited, and real-world evidence on their clinical and cost-effectiveness is lacking. In this paper, we present the design of the Canadian Adaptive Platform Trial of Treatments for COVID in Community Settings (CanTreatCOVID). By evaluating multiple treatment options in a pragmatic adaptive platform trial, this study will generate high-quality, generalisable evidence to inform clinical guidelines and healthcare decision-making.
CanTreatCOVID is an open-label, individually randomised, multicentre, national adaptive platform trial designed to evaluate the clinical and cost-effectiveness of therapeutics for non-hospitalised SARS-CoV-2 patients across Canada. Eligible participants must present with symptomatic SARS-CoV-2 infection, confirmed by PCR or rapid antigen testing (RAT), within 5 days of symptom onset. The trial targets two groups that are expected to be at higher risk of more severe disease: (1) individuals aged 50 years and older and (2) those aged 18–49 years with one or more comorbidities. CanTreatCOVID uses numerous approaches to recruit participants to the study, including a multifaceted public communication strategy and outreach through primary care, outpatient clinics and emergency departments. Participants are randomised to receive either usual care, including supportive and symptom-based management, or an investigational therapeutic selected by the Canadian COVID-19 Outpatient Therapeutics Committee. The first therapeutic arm evaluates nirmatrelvir/ritonavir (Paxlovid), administered two times per day for 5 days. The second therapeutic arm investigates a combination antioxidant therapy (selenium 300 µg, zinc 40 mg, lycopene 45 mg and vitamin C 1.5 g), administered for 10 days. The primary outcome is all-cause hospitalisation or death within 28 days of randomisation.
The CanTreatCOVID master protocol and subprotocols have been approved by Health Canada and local research ethics boards in the participating provinces across Canada. The results of the study will be disseminated to policy-makers, presented at conferences and published in peer-reviewed journals to ensure that findings are accessible to the broader scientific and medical communities. This study was approved by the Unity Health Toronto Research Ethics Board (#22-179) and Clinical Trials Ontario (Project ID 4133).
The prevalence of women with primary dysmenorrhoea is high and negatively impacts physical and mental health. The intense cyclic episodes of pain generate central nervous system dysfunctional processing. In this sense, strategies focused on the central nervous system are important to re-establish normal functioning. Home-based self-administered transcranial direct current stimulation (tDCS) emerges as a strategy to modulate dysfunctional brain areas and improve the symptoms. This protocol aims to evaluate the effects of home-based self-administered tDCS for pain, premenstrual symptoms, physical performance, quality of life, electroencephalography and patient global impression in women affected by primary dysmenorrhoea.
This is a single-centre, parallel, randomised, double-blinded clinical trial protocol. 40 women affected by primary dysmenorrhoea will be randomised into two groups (active-tDCS or sham-tDCS). Then, 20 consecutive sessions of home-based self-administered tDCS will be performed. The assessments will occur at five time points: baseline, after the 20th sessions, at the first, second and third cycles after tDCS interventions (follow-ups). Primary outcome will be pain according to visual analogue scale. Quality of life, premenstrual symptoms screening, depression, anxiety, physical performance, electroencephalography and participants’ satisfaction will be the secondary outcomes. A mixed analysis of variance will calculate the effect of stimulation.
The study was approved by the ethics committee of the Federal University of Rio Grande do Norte (No. 6.037.756) and registered in the Brazilian Clinical Trials Registry (n° RBR-747k8vb). Participants may withdraw at any time without penalty. Free support will be available from the lead researcher if needed. All procedures will follow Good Clinical Practice and international ethical standards.
Knee osteoarthritis (OA) is a serious public health problem since it is linked to loss of muscular function and independence, especially in older adults. In this study, the researchers have proposed a randomised controlled trial with a three-arm study strategy to explore the effectiveness of an oral nutritional supplementation containing hydroxymethylbutyrate and undenatured type-II collagen combined with exercise training (ET) on the OA-related symptoms and biomarkers among adults with knee OA.
Adults with knee OA aged between 50 years and 75 years will be invited to participate in the study and thereafter will be randomly assigned to either one of three groups: oral nutrition supplementation+ET, ET or usual care. The primary outcomes include changes in OA-related symptoms and biomarkers. The secondary outcomes include changes in body composition, blood profiles, physical fitness, quality of life, dietary intake, disability, psychology status and morphological changes of the knee.
Ethics approval was granted by the Medical Research Ethics Committee of the National University of Malaysia (reference number JEP-2024–264). Findings of this study will be disseminated via peer-reviewed presentations at scientific conferences as well as open access publications.
Commentary on: Feo R, Young JA, Urry K, Lawless M, Hunter SC, Kitson A, Conroy T. ‘I wasn’t made to feel like a nut case after all’: A qualitative story completion study exploring healthcare recipient and carer perceptions of good professional caregiving relationships. Health Expect. 2023 Oct 19;27(1):e13871. doi: 10.1111/hex.13871. Epub ahead of print.
Healthcare providers can foster effective patient–provider relationships by addressing concerns early on and adopting key behaviours, such as showing interest in understanding the patient’s issues, validating their concerns and respecting their choices. Future research should focus on identifying strategies to help healthcare providers develop effective patient–provider relationships. This requires a thorough understanding of these relationships from the perspectives of all involved parties, including healthcare providers, patients and their informal caregivers.
The patient–provider relationship is at the core of effective disease management.
Commentary on: Kristiansen D, Boyle EH, Svec J. The impact of local supply of popular contraceptives on women’s use of family planning: findings from performance-monitoring-for-action in seven sub-Saharan African countries. Reprod Health. 2023 Nov 21;20(1):171.
Implications for practice and research The concept of ‘demand’ and ‘supply’, from the perspective of individual preferences shaped by cultural and societal norms, can be incorporated by health practitioners and policymakers when addressing the root causes of unmet health needs. Understanding women’s empowerment and agency in family planning requires a rights-based community-engaged research approach. Community-level data can illuminate the underlying mechanisms of healthcare utilisation preferences.
The issue of unmet contraceptive needs remains a gap in global healthcare, despite various contraceptive options available now more than ever.
Commentary on: Lo Faro V, Johansson T, Johansson Å. The risk of venous thromboembolism in oral contraceptive users: the role of genetic factors—a prospective cohort study of 2 40 000 women in the UK Biobank. Am J Obstet Gynecol. 2024;230:360.e1-13
Implications for practice and research Currently, venous thromboembolism (VTE) risk assessment for contraceptive counselling is based on clinical characteristics and family history. Incorporating genetic risk assessment into current practice can significantly enhance the screening of oral contraceptive users at high risk for VTE. Further research is needed to develop a comprehensive model, explore the cost-effectiveness and implementation of genetic risk assessment in contraceptive counselling, address challenges in communicating genetic information and evaluate its applicability across diverse populations.
Venous thromboembolism (VTE) is a complex disorder influenced by both acquired and inherited factors. Oral contraceptive use, an acquired factor, has been linked to an increased risk of...
To examine how empowerment, strength use, and their interactions with nursing skill level are related to nurse-perceived time pressure.
Nurse-perceived time pressure increases the chance of missed patient care and turnover intention. Time pressure may be reduced by nurses' placement in jobs that make use of their particular strengths (professional abilities, skills and expertise), rather than in jobs that fail to take advantage of these strengths. Empowerment (access to resources, information, support, and opportunities) may also contribute to a reduction time pressure. However, it is not known how strength use and empowerment impact time pressure and how such an impact differs among nurses, indicating a research gap.
This was a cross-sectional study.
The 501 nurse participants were approached at a medical center located in northern Taiwan. Complete survey responses were collected in November and December 2023. The sampling method was proportionate random sampling, which can help ensure sample representativeness. This study used scales of empowerment, strength use and time pressure.
Strength use is negatively related to time pressure. Nursing skill level strengthens the negative relationship between strength use and time pressure, while reducing the negative relationship between empowerment and time pressure.
This study uniquely highlights the pivotal role of nursing skill level in moderating the effects of empowerment and strength use.
This study impacts nurse managers by informing them how to devise policies regarding empowerment and task allocation to best utilise nurses' strengths.
It is suggested that nurse managers offer flexibility in their application of nurses' empowerment and strength use, as they may exert varied effects on different nurses.
STROBE statement was chosen as the EQUATOR checklist.
No patient or public contribution.
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