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Antibody development after three mRNA SARS-CoV-2 vaccinations in patients with systemic autoimmune rheumatic disease with and without treatment: an observational cohort study

Por: Simader · E. · Kartnig · F. · Tobudic · S. · Mrak · D. · Deimel · T. · Karonitsch · T. · Haslacher · H. · Perkmann · T. · Mitter · G. · Winkler · S. · Aletaha · D. · Blueml · S. · Mandl · P.
Objectives and design

To further elucidate the effects of rare systemic autoimmune rheumatic diseases (SARD) and their treatment on antibody development after vaccination against SARS-CoV-2, we compared patients with and without immunosuppressive therapy to healthy controls in an observational cohort study.

Participants and setting

We enrolled 52 patients with SARD and 72 healthy subjects in a prospective, observational study at the Medical University of Vienna and measured the humoral response 6 months after two mRNA vaccinations and 2–6 weeks after a third dose.

Results

Patients with vasculitis showed significantly (p=0.02) lower antibody titres 6 months after vaccination (median 247 BAU/mL, IQR [185–437]), as compared with healthy controls (median 514 BAU/mL, [185–437], IQR 323; 928, vasculitis patients: 247, IQR [185; 437], p

Conclusions

Patients with SARD displayed lower antibody development after booster vaccination, even if antibody levels after two immunisations were comparable to healthy controls. Our data may be limited due to sample size, but it provides pointers for a more individualised, antibody-titre-oriented approach and earlier booster vaccination in patients with SARD.

Exploring tools and measures for evaluating the quality of paid disability support for adults: a scoping review protocol

Por: Topping · M. · Douglas · J. · Winkler · D.
Introduction

The quality of paid disability support services has significant implications for the autonomy, well-being and community participation of adults with disability. However, variability in service provision and evaluation persists. Despite the growing public investment and focus on improving support quality, there appears to remain a lack of comprehensive tools and measures to evaluate the quality of paid disability support. This scoping review aims to systematically identify and map the existing tools and measures used to evaluate the quality of paid disability support for adults with disability.

Methods and analysis

This scoping review will be conducted following the methodology outlined by Arksey and O’Malley, enhancements proposed by Levac et al and the Joanna Briggs Institute along with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis: Extension for Scoping Reviews guidelines. The research question guiding the review is: ‘What existing tools and measures are available to evaluate the quality of paid disability support services?’ Comprehensive searches will be conducted in MEDLINE, PsycINFO, Embase, CINAHL and Scopus to identify peer-reviewed articles published in English since 2014. Supplementary grey literature searches will also be conducted, alongside an online survey to obtain stakeholder input. Articles or grey literature sources that report on tools or measures for evaluating paid disability support for adults (aged 18–65 years) with disability will be included. Data extraction will focus on study characteristics, participant demographics and the characteristics of the quality of support measurement tools. A narrative synthesis will be used to present the findings.

Ethics and dissemination

Ethical approval will be obtained for the online stakeholder survey component of the review. No ethical approval is required for the scoping review of the literature. The results will be disseminated through peer-reviewed publications, conference presentations and accessible formats to ensure a wide audience is reached, including researchers, policymakers and disability service providers.

Wearable device monitoring of HIV health in the face of climate change and weather exposures: protocol for a mixed-methods study

Por: Kassem · N. · Boutros · P. · Kwaro · D. · Muma · J. · Obor · D. · Munga · S. · Maggioni · M. A. · Bärnighausen · T. · Winkler · V. F. · Barteit · S.
Introduction

Climate change and HIV are interconnected epidemics that increase vulnerability in people living with HIV (PLWH), particularly in sub-Saharan Africa. Despite their public health significance, research on the synergistic effects of these epidemics on the health of PLWH is limited. The advancement of non-invasive wearable technology offers an opportunity to leverage objective health data for large-scale research, addressing this knowledge gap. This study will examine the impact of weather events on distinct health variables of PLWH within the Siaya Health and Demographic Surveillance System (HDSS) in rural Kenya.

Methods and analysis

Over a period of 6 months, we continuously monitored health parameters of a total of 200 participants including heart rate, activity and sleep, using consumer-grade wearable devices. We will correlate these health data with real-time weather parameters (ambient temperature, wet bulb globe temperature, precipitation level) from five weather stations within the HDSS area and compare between HIV-positive participants and an HIV-negative control group. Additionally, a convergent mixed-methods approach will explore participants’ perceptions of the impact of weather events on their health and personal experiences. The study aims to inform future research on the complex relationship between HIV and weather events, which are projected to increase in frequency in this region due to climate change and provide valuable insights for policymakers to develop effective measures to protect this vulnerable population amid the growing climate crisis.

Ethics and dissemination

This study has been approved by the Research Ethics Committees at Kenya Medical Research Institute, Nairobi (approved on 23 October 2023; SERU 4826) and Heidelberg University Hospital, Germany (approved on 14 February 2023; S-824/2022). Written informed consent was obtained from all participants prior to enrolment, with data anonymised and handled according to Kenyan and German data protection regulations. Research findings will be disseminated through peer-reviewed publications and presented at scientific conferences.

Understanding stakeholders perceptions of the impact of extractive industries on adolescent health and well-being in Mozambique: a qualitative study

Por: Cambaco · O. · Galvao · C. · Brugger · C. · Munguambe · K. R. · Utzinger · J. · Knoblauch · A. M. · Winkler · M. S.
Objectives

Adolescent health is critical for achieving Sustainable Development Goal 3, ‘health for all at all ages’. In sub-Saharan Africa (SSA), mining projects hold promise for social and economic development. Yet, the extent to which the health and well-being of adolescents are impacted by industrial mining is poorly understood. In this paper, we aim to investigate how adolescent health and well-being is perceived by key informants and caregivers in communities that have been affected by industrial mining projects in Mozambique.

Design and settings

A qualitative study was implemented from May–July 2022 in two rural districts in Mozambique’s northern and central regions. Both districts have large industrial mining projects: a coal mine in Moatize district and a mineral sands mine in Moma district.

Participants

A total of 21 key informant interviews (KIIs) were conducted with a range of stakeholders, including health professionals and civil society and private sector representatives. In addition, four focus group discussions (FGDs) were conducted with adolescents’ caregivers.

Results

Through the combined results from the KIIs and FGDs, four main health concerns affecting adolescents in mining areas were identified: sexually transmitted infections, respiratory tract infections, diarrhoeal diseases and malaria. Mining activities were perceived to exacerbate negative health effects and contribute to poor health outcomes among adolescents. Although mining companies invested in public infrastructure, most participants did not perceive this investment as a positive contribution to the health and well-being of adolescents.

Conclusion

Our study sheds light on the multifaceted challenges perceived by stakeholders that adolescents residing in mining communities in Mozambique face. Insufficient priority is given to effective interventions that specifically target adolescent health in the two study mining areas. In order to leave no one behind, as stipulated by the sustainable development agenda, more emphasis should be placed on the role and responsibility of mining companies in adequately addressing adolescents’ unique health needs in mining settings in SSA.

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