bluuebunny/crossref_metadata_2025 huggingface dataset:
Sociodemographic, health-related, and social predictors of subjective well-being among Chinese oldest-old: a national community-based cohort study
Authors: Cheng Gang , Yan Yan
Published: February 2021

Background

There is still a lack of systematic investigation of comprehensive contextual factors of subjective well-being (SWB) among Chinese oldest-old. This study aimed to explore sociodemographic, health-related, and social predictors of SWB among Chinese oldest-old using a large and representative sample.

Methods

The study included 49,069 individuals aged 80 and older from the Chinese Longitudinal Healthy Longevity Survey, a prospective, nationwide, community-based study conducted from 1998 to 2014. SWB was measured by eight items covering life satisfaction, positive affect (optimism, happiness, personal control, and conscientiousness), and negative affect (anxiety, loneliness, and uselessness). Generalized estimating equation models were used to explore the predictors of SWB.

Results

We found that age, gender, ethnic group, education, primary occupation before retirement, current marital status, and place of residence were sociodemographic predictors of SWB among the Chinese oldest-old. The health-related predictors included self-rated health, visual function, hearing function, diet quality, smoking status, drinking status, and exercise status. SWB was influenced by some social factors, such as the number of biological siblings, the number of children, leisure activities, financial independence, and access to adequate medical service. In particular, self-rated health, access to adequate medical services, exercise status, and place of residence exert a stronger effect than other factors.

Conclusions

SWB in the oldest-old is influenced by a large number of complex sociodemographic, health-related, and social factors. Special attention should be paid to the mental health of centenarians, women, rural residents, widowed, physically disabled, and childless oldest-old people. Relevant agencies can improve physical activities, leisure activities, financial support, and medical services to promote the well-being of the oldest-old.
Neurologic sequelae of severe chikungunya infection in the first 6 months of life: a prospective cohort study 24-months post-infection
Authors: van Ewijk Roelof , Huibers Minke H. W. , Manshande Meindert E. , Ecury-Goossen Ginette M. , Duits Ashley J. , Calis Job C. , van Wassenaer-Leemhuis Aleid G.
Published: February 2021

Background

Perinatally chikungunya infected neonates have been reported to have high rates of post-infection neurologic sequelae, mainly cognitive problems. In older children and adults chikungunya does not appear to have sequelae, but data on postnatally infected infants are lacking.

Methods

We performed a prospective, non-controlled, observational study of infants infected before the age of 6 months with a severe chikungunya infection during the 2014–2015 epidemic in Curaçao, Dutch Antilles. Two years post-infection cognitive and motor - (BSID-III) and social emotional assessments (ITSEA) were performed.

Results

Of twenty-two infected infants, two died and two were lost to follow up. Eighteen children were seen at follow-up and included in the current study. Of these, 13 (72%) had abnormal scores on the BSID-III (cognitive/motor) or ITSEA.

Conclusion

In the first study aimed at postnatally infected infants, using an uncontrolled design, we observed a very high percentage of developmental problems. Further studies are needed to assess causality, however until these data are available preventive measure during outbreaks should also include young infants. Those that have been infected in early infancy should receive follow up.
Pseudomonas aeruginosa device associated – healthcare associated infections and its multidrug resistance at intensive care unit of University Hospital: polish, 8.5-year, prospective, single-centre study
Authors: Litwin Agnieszka , Rojek Stanislaw , Gozdzik Waldemar , Duszynska Wieslawa
Published: February 2021

Background

Pseudomonas aeruginosa has recently shown to be one of the most important strains of bacteria and alert pathogens in Europe among Intensive Care Unit patients that provide serious therapeutic problems because of its multidrug resistance.

Methods

The purpose of this microbiological study was data analysis of device associated- healthcare associated infections (DA-HAIs) in an ICU in terms of the incidents of P.aeruginosa strain infections and its susceptibility within an 8.5-year observation.

Results

Among 919 isolated strains responsible for 799 DA-HAIs (17,62 ± 1,98/1000 patient-days) in 4010 ICU patients P.aeruginosa was the pathogen in 108/799 (13.52%) cases. Incidence rate (density) of: VAP/1000 MV- days, UTI /1000 UC- days and CLA-BSI/1000 CL- days were 11,15 ± 2.5, 6.82 ± 0.81, 2.35 ± 1.54.respectivelly. P.aeruginosa was the pathogen most frequently responsible for VAP 69/108 (63.88%). Mean frequency of VAP, UTI and CLA-BSI with P.aeruginosa etiology was 69/493 (14.28%), 32/299 (11.1%) and 7/127 (5.77%) respectively. The mean density of P.aeruginosa infection amounted to 2.43/1000 patient-days. The decrease was observed in the total number of DA-HAIs caused by the P.aeruginosa from 15.75% and 3.23/1000 patient-days in 2011 to 5.0% and 1.17/1000 in 2016 (p = 0.0104, p = 0.0348). Starting from 2016 to 2019 incidence and density of P.aeruginosa DA-HAIs increased to 12.33% and 2.63/1000 (p = 0.1388, p = 0.0818). P.aeruginosa was susceptible to ceftazidime, cefepime, amikacin, meropenem, ciprofloxacin, colistin, in 55.55, 58.33, 70.37, 53.73, 50, and 100% respectively. MDR characterised it in 40% in 2011 and 66.7% in 2019, (p = 0.177).

Conclusions

The study revealed a changeable prevalence of P. aeruginosa strain infections; however their frequency was never highest in our ICU patients as it presented in the last years in Europe. The study showed a significant decrease in 2016 and increase in 2019, a nearly 3-fold increase of P.aeruginosa infections among Gram-negative strain infections, and a 2-fold increase of the P.aeruginosa DA-HAIs frequency between 2016 and 2019 as well as an increased resistance. Microbiological analysis of DA-HAIs in each hospital should be a standard method used in hospital infection control and antibiotic policy. In the case of P.aeruginosa, in order to minimize transmission, preventive infection methods should be assessed mainly in case of VAP.
A comparison of two multiplex-PCR assays for the diagnosis of traveller’s diarrhoea
Authors: Schaumburg Frieder , Froböse Neele , Köck Robin
Published: February 2021

Background

Numerous multiplex-PCR assays are now available in routine diagnostics but their clinical value is controversial if a clear association between clinical symptoms and the detection of a particular pathogen is missing. The objective of this work was to evaluate a multiplex-PCR assay for the diagnosis of traveller’s diarrhoea (TD) in a case-control study and to assess the concordance with the BioFire® FilmArray® Gastrointestinal Panel.

Methods

Stool samples from cases (n = 61) and controls (n = 30) were collected during travel and analysed by the GI-EB Screening assay (Seegene) in a case-control study. The concordance with the BioFire® FilmArray® Gastrointestinal Panel was expressed as the proportion of participants in which both tests agreed in the category “detected” and “not detected”.

Results

None of the test-target organisms (Campylobacter spp., Clostridioides difficile toxin A/B, Salmonella spp., Shigella spp./enteroinvasive Escherichia coli, E. coli O157, Shiga toxin-producing E. coli, Yersinia enterocolitica) was significantly associated with TD GI-EB Screening assay. The GI-EB Screening assay had an agreement with the BioFire® FilmArray® of 86.8–100%.

Conclusion

The selection of test-target organisms included in the GI-EB Screening assay appears inappropriate for the diagnostic work-up of TD as none of the detected pathogens was associated with TD. The GI-EB Screening assay had a good concordance with BioFire® FilmArray®.
An exploration of patient-provider dynamics and childbirth experiences in rural and urban Peru: a qualitative study
Authors: Vargas Brianna , Louzado-Feliciano Paola , Santos Nicole , Fuller Shannon , Jimsheleishvili Sopiko , Quiñones Ángela , Martin Holly H.
Published: February 2021

Background

Between 2006 and 2013, Peru implemented national programs which drastically decreased rates of maternal and neonatal mortality. However, since 2013, maternal and neonatal mortality in Peru have increased. Additionally, discrimination, abuse, and violence against women persists globally and impacts birthing experiences and mental health. This qualitative study sought to better understand the attitudes and beliefs regarding childbirth among women and providers in Southern Peru. This study also explores how these beliefs influence utilization of skilled care, patient-provider dynamics, and childbirth experiences and identifies factors that impact providers’ provision of care.

Methods

Thirty semi-structured interviews were conducted with 15 participants from rural Colca Canyon and 15 participants from urban Arequipa between April and May 2018. In each region, 10 women who had experienced recent births and five providers were interviewed. Provider participants predominantly identified as female and were mostly midwives. All interviews were conducted, transcribed, and coded in Spanish. A framework analysis was followed, and data were charted into two separate thematic frameworks using contextual and evaluative categories of conceptualization of childbirth.

Results

All recent births discussed were facility-based births. Four domains emerged: women’s current birth experiences, provision of childbirth care, beliefs about childbirth among women and providers, and future health-seeking behavior. Findings suggest that women’s feelings of helplessness and frustration were exacerbated by their unmet desire for respectful maternity care and patient advocacy or companionship. Providers attributed strain to perceived patient characteristics and insufficient support, including resources and staff.

Conclusions

Our findings suggest current childbirth experiences placed strain on the patient-provider dynamic and influenced women’s attitudes and beliefs about future experiences. Currently, the technical quality of safe childbirth is the main driver of skilled birth attendance and facility-based births for women regardless of negative experiences. However, lack of respectful maternity care has been shown to have major long-term implications for women and subsequently, their children. This is one of the first studies to describe the nuances of patient-provider relationships and women’s childbirth experiences in rural and urban Peru.
Perceived differences on the role of traditional birth attendants in rural Tanzania: a qualitative study
Authors: Shimpuku Yoko , Madeni Frida E. , Shimoda Kana , Miura Satoe , Mwilike Beatrice
Published: February 2021

Background

In many low to middle income countries, traditional birth attendants (TBAs) play various roles (e.g., provision of health education, referral to hospitals, and delivery support) that can potentially improve women’s access to healthcare. In Tanzania, however, the formal healthcare systems have not acknowleded the role of the TBAs. TBAs’ contributions are limited and are not well described in policy documents. This study aimed to examine the perspectives of both TBAs and skilled birth attendants (SBAs) to clarify the role of TBAs and issues impacting their inclusion in rural Tanzania.

Methods

We used a qualitative descriptive design with triangulation of investigators, methods, and data sources. We conducted semi-structured interviews with 15 TBAs and focus group discussions with 21 SBAs in Kiswahili language to ask about TBAs’ activities and needs. The data obtained were recorded, transcribed, and translated into English. Two researchers conducted the content analysis.

Results

Content analysis of data from both groups revealed TBAs’ three primary roles: emergency delivery assistance, health education for the community, and referrals. Both TBAs and SBAs mentioned that one strength that the TBAs had was that they supported women based on the development of a close relationship with them. TBAs mentioned that, while they do not receive substantial remuneration, they experience joy/happiness in their role. SBAs indicated that TBAs sometimes did not refer women to the hospital for their own benefit. TBAs explained that the work issues they faced were mainly due to insufficient resources and unfavorable relationships with hospitals. SBAs were concerned that TBAs’ lacked formal medical training and their actions could interfere with SBAs’ professional work. Although there were no between-group interactions at the time of this study, both groups expressed willingness to collaborate/communicate to ensure the health and lives of mothers and babies.

Conclusions

TBAs and SBAs have different perceptions of TBAs’ knowledge and skills, but agreed that TBAs need further training/inclusion. Such collaboration could help build trust, improve positive birth experiences of mothers in rural Tanzania, and promote nationwide universal access to maternal healthcare.
Beyond counting induced abortions, miscarriages and stillbirths to understanding their risk factors: analysis of the 2017 Ghana maternal health survey
Authors: Ahinkorah Bright Opoku , Seidu Abdul-Aziz , Ameyaw Edward Kwabena , Budu Eugene , Bonsu Freda , Mwamba Bupe
Published: February 2021

Background

Inasmuch as induced abortions, miscarriages and stillbirths constitute common adverse pregnancy outcomes contributing to poor maternal health, there is paucity of literature about these in Ghana. We investigated the factors associated with induced abortions, miscarriages and stillbirths in Ghana.

Methods

Data derived from the 2017 Ghana Maternal Health Survey was used in this study. Women aged 15–49 constituted the target for the study. This study examined the relationship between socio-demographic characteristics and induced abortions, stillbirths and miscarriages. Subsequently, multivariable binary logistic regression models were fitted to investigate the factors associated with induced abortions, stillbirths and miscarriages at 95 % confidence interval (CI).

Results

The prevalence of miscarriages, induced abortions and stillbirths in Ghana in 2017 were 10.8 %, 10.4 % and 2 % respectively. Induced abortions (12.9 %) and miscarriages (11.1 %) were found to be higher among urban residents whiles rural residents had more of stillbirths (2.1 %). Compared to women aged 15–24, those in all age categories had lower odds of experiencing induced abortions, with the lowest odds occurring among women aged 35–49 (AOR = 0.26, 95 % CI = 0.21-32). Conversely, women of all age categories had higher odds of experiencing miscarriages compared to those aged 15–24 with the highest odds among those aged 25–34 (AOR = 1.62, 95 % CI = 1.39–1.89). Women with at least primary education were more likely to experience miscarriages than those with no formal education, with those with higher level of education having the highest odds (AOR = 1.42, 95 % CI = 1.13–1.78). While the likelihood of induced abortions was lower among Muslims, compared to Christians (AOR = 0.65, 95 % CI = 0.52–0.82), the odds of miscarriages were higher among Muslims, compared to Christians (AOR = 1.31, 95 % CI = 1.13–1.52). Women with parity 1 or more were less likely to experience induced abortions, miscarriages and stillbirths compared to those with parity 0.

Conclusions

Our study indicates that efforts to limit induced abortions, miscarriages and stillbirths in Ghana need to focus on the disparities in socio-demographic characteristics of women. Synergy between government health institutions and the private sector cannot be left out if much success can be achieved in efforts to subside the current prevalence of induced abortions, stillbirths and miscarriages confronting the country.
Genomic profiling of Chinese patients with urothelial carcinoma
Authors: Yang Bo , Zhao Xiao , Wan Chong , Ma Xin , Niu Shaoxi , Guo Aitao , Wang Jieli , Wang Jinliang , Sun Decong , Jiao Shunchang
Published: February 2021

Backgrounds

Urothelial carcinoma (UC) is the most common genitourinary malignancy in China. In this study, we surveyed the genomic features in Chinese UC patients and investigated the concordance of genetic alterations between circulating tumor DNA (ctDNA) in plasma and matched tumor tissue.

Materials and methods

A total of 112 UC patients were enrolled, of which 31 were upper tract UC (UTUC) and 81 were UC of bladder (UCB). Genomic alterations in 92 selected genes were analyzed by targeted next-generation sequencing.

Results

In the study cohort, 94.64, 86.61 and 62.50% of patients were identified as having valid somatic, oncogenic and actionable somatic alterations, respectively. The most frequently altered genes included TP53, KMT2D, KDM6A, FAT4, FAT1, CREBBP and ARID1A. The higher prevalence of HRAS (22.0% vs 3.7%) and KMT2D (59.26% vs 34.57%) was identified in UTUC than in UCB. Comparisons of somatic alterations of UCB and UTUC between the study cohort and western cohorts revealed significant differences in mutant prevalence. Notably, 28.57, 17.86 and 47.32% of the cases harbored alterations in FGFRs, ERBBs and DNA damage repair genes, respectively. Furthermore, 75% of the patients carried non-benign germline variants, but only two (1.79%) were pathogenic. The overall concordance for genomic alterations in ctDNA and matched tumor tissue was 42.97% (0–100%). Notably, 47.25% of alterations detected in ctDNA were not detected in the matched tissue, and 54.14% of which were oncogenic mutations.

Conclusions

We found a unique genomic feature of Chinese UC patients. A reasonably good concordance of genomic features between ctDNA and tissue samples were identified.
MicroRNA-545 suppresses progression of ovarian cancer through mediating PLK1 expression by a direct binding and an indirect regulation involving KDM4B-mediated demethylation
Authors: Zhang Hailing , Zhang Ke , Xu Zhen , Chen Zhilong , Wang Qian , Wang Chenyang , Cui Jinquan
Published: February 2021

Background

Ovarian cancer (OC) is a life-threatening gynecological malignancy where dysregulation of microRNAs (miRNAs) is frequently implicated. This study focuses on the function of miR-545 on OC development and the molecules involved.

Methods

miR-545 expression in OC tissues and cell lines was determined, and its link to the survival of patients was analyzed. Altered expression of miR-545 was induced to determine its role in proliferation, apoptosis, migration and invasion of OC cells and the angiogenesis ability of human umbilical vein endothelial cells (HUVECs). The targeting mRNAs of miR-545 were predicted and validated through luciferase assays. Gain-of-function studies of KDM4B and PLK1 were performed to explore their involvements in OC development. In vivo experiments were conducted by inducing xenograft tumors in nude mice.

Results

Poor expression of miR-545 was found in OC tissues and cells compared to the normal ones and it indicated unfavorable prognosis in patients. Overexpression of miR-545 suppressed growth, migration, invasion and angiogenesis of OC cells as well as the angiogenesis ability of HUVECs. miR-545 was found to target mRNAs of KDM4B and PLK1, while KDM4B promoted the transcription of the PLK1 promoter through demethylation of H3K9me3. Either overexpression of KDM4B or PLK1 partially blocked the inhibitory effects of miR-545 mimic on OC cell growth, especially the former one. The in vitro results were reproduced in vivo.

Conclusion

This study evidenced that miR-545 suppresses progression of OC through mediating PLK1 expression by a direct binding and an indirect regulation involving KDM4B-mediated demethylation.
A phase II trial proposal of total neoadjuvant treatment with primary chemotherapy, stereotactic body radiation therapy, and intraoperative radiation therapy in borderline resectable pancreatic adenocarcinoma
Authors: Paiella Salvatore , Malleo Giuseppe , Simoni Nicola , Micera Renato , Guariglia Stefania , Cavedon Carlo , Marchegiani Giovanni , Esposito Alessandro , Landoni Luca , Casetti Luca , Tuveri Massimiliano , Milella Michele , Secchettin Erica , Manzini Gessica , Bovo Chiara , De Pastena Matteo , Fontana Martina , Salvia Roberto , Mazzarotto Renzo , Bassi Claudio
Published: February 2021

Background

The current management guidelines recommend that patients with borderline resectable pancreatic adenocarcinoma (BRPC) should initially receive neoadjuvant chemotherapy. The addition of advanced radiation therapy modalities, including stereotactic body radiation therapy (SBRT) and intraoperative radiation therapy (IORT), could result in a more effective neoadjuvant strategy, with higher rates of margin-free resections and improved survival outcomes.

Methods/design

In this single-center, single-arm, intention-to-treat, phase II trial newly diagnosed BRPC will receive a “total neoadjuvant” therapy with FOLFIRINOX (5-fluorouracil, irinotecan and oxaliplatin) and hypofractionated SBRT (5 fractions, total dose of 30 Gy with simultaneous integrated boost of 50 Gy on tumor-vessel interface). Following surgical exploration or resection, IORT will be also delivered (10 Gy). The primary endpoint is 3-year survival. Secondary endpoints include completion of neoadjuvant treatment, resection rate, acute and late toxicities, and progression-free survival. In the subset of patients undergoing resection, per-protocol analysis of disease-free and disease-specific survival will be performed. The estimated sample size is 100 patients over a 36-month period. The trial is currently recruiting.

Trial registration

NCT04090463 at clinicaltrials.gov.
Clinical characteristics and overall survival prognostic nomogram for invasive cribriform carcinoma of breast: a SEER population-based analysis
Authors: Liu Jiameng , Zheng Xiaobin , Han Zhonghua , Lin Shunguo , Han Hui , Xu Chunsen
Published: February 2021

Background

The prognositc factors in patient with invasive cribriform carcinoma (ICC) of breast is still remain controversal. The study aims to establish a nomogram to predict the survival outcomes in patients with ICC based on the Surveillance, Epidemiology and End Results (SEER) database.

Methods

We retrieved SEER database for clinical data about patients including ICC and infiltrating ductal carcinoma (IDC) from 2004 to 2015. Kaplan-Meier survival was used to compare the difference survival outcomes between ICC and IDC. ICC patients were randomly allocated to training cohort and validation cohort. A nomogram was built to predict individual patient’s 3-year and 5-year survival status for ICC. The established TMN model and the newly established nomogram was further evaluated by the concordance index (C-index) and the decision curve analysis (DCA).

Results

Comparing the baseline clinical data between IDC and ICC, a significant of smaller tumor mass, less infiltrated lymph nodes, lower metastases rate, better tumor differentiation degree, higher proportion of estrogen receptor (ER) and progesterone receptor (PR) positive and lower rate of chemotherapy and radiotherapy was found in ICC. Age at diagnosis, marriage status, tumor location, T stage, M stage, ER status, surgery were independent significant prognostic factors for the overall survival (OS). A significantly higher C-index was found in nomogram compared with established TNM model in validation cohort.

Conclusions

The prognosis of ICC patients is better than that of IDC patients. The nomogram is recommended for future patient with ICC to survival analysis.
Patient perspective of tardive dyskinesia: results from a social media listening study
Authors: Farrar Mallory , Lundt Leslie , Franey Ericha , Yonan Chuck
Published: February 2021

Background

Tardive dyskinesia (TD) is a persistent and potentially disabling movement disorder associated with prolonged exposure to dopamine receptor blocking agents such as antipsychotics. With the expanding use of antipsychotics, research is needed to better understand patient perspectives of TD, which clinical assessments may fail to capture. Social media listening (SML), which is recognized by the US FDA as a method that can advance ongoing efforts for more patient-focused drug development, has been used to understand patient experiences in other disease states. This is the first study to use SML analysis of unsolicited patient and caregiver insights to help clinicians understand how patients describe their symptoms, the emotional distress associated with TD, and the impact on caregivers.

Methods

In this pilot study, a comprehensive search was performed for publicly available, English-language, online content posted between March 2017 and November 2019 on social media platforms, blogs, and forums. An analytics platform (NetBase™) identified posts containing patient or caregiver experiences of assumed TD using predefined search terms. All posts were manually curated and reviewed to ensure quality and validity of the post and to further classify key symptoms, sentiments, and themes.

Results

A total of 261 posts from patients/caregivers (“patient insights”) were identified using predefined search terms; 107 posts were used for these analyses. Posts were primarily from forums (47%) and Twitter (33%). Analysis of the most common sentiment-related terms (e.g. “feel” [n = 31], “worse” [n = 17], “symptom” [n = 14], “better” [n = 12]) indicated that 64% were negative, 33% were neutral, and 3% were positive. Theme analysis revealed that patients often felt angry about having TD from a medication used to treat a different condition. In addition, patients felt insecure, including feeling unaccepted by society and fear of being judged by others.

Conclusion

Although this study was limited by inherent methodological constraints (e.g., small sample size, reliance on patient self-report), the perspectives generated from analyzing social media may help convey the unmet needs of patients with TD. This analysis indicated that movement-related symptoms are the most common patient concern, resulting in strong feelings of anger and insecurity.
Magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of eastern Ethiopia
Authors: Fetene Metsihet Tariku , Teji Kedir , Assefa Nega , Bayih Wubet Alebachew , Tsehaye Genet , Hailemeskel Habtamu Shimels
Published: February 2021

Background

Use of substances like alcohol, tobacco and khat during pregnancy can bring miscarriage, prematurity, neurodevelopmental problems, sudden infant death syndrome and others. There are limited studies on the magnitude and associated factors of substance use among pregnant women in Eastern Ethiopia. Therefore, the aim of this study was to assess the magnitude and associated factors of substance use among pregnant women attending antenatal care in public hospitals of Easttern Ethiopia, 2019.

Method

Hospital based cross-sectional study was employed on 510 pregnant women attending ANC at public hospitals of Eastern Ethiopia (Jigjiga, Dire Dawa and Harar towns). Data were collected from the study participants that were selected using systematic sampling method from each public hospital. The data were collected through interviewer administered structured questionnaire. Binary logistic regressions with 95% confidence interval were used to determine the degree of association between covariates and outcome variable. Multicollinearity between independent variables by using the standard error was checked. The goodness of fit was tested by Hosmer-Lemeshow statistic and Omnibus tests.

Results

Out of 526 participants, a total of 510 study participants were involved in this study thereby making a response rate of 96.9%. In this study, the magnitude of substance use among pregnant women attending ANC was 26.5% (95% CI: 22.7, 30.6%). Among the overall pregnant mothers, 100 (19.6%) chewed khat, 48 (9.4%) drank alcohol, 12 (2.4%) used tobacco products and 28(20.7%) were dual substance users. Pre pregnancy substance use (AOR = 27.25, CI: 14.107–52.66), partner substance use (AOR = 3.704 CI: 1.839–7.464), family substance use (AOR = 3.447 CI: 1.69–7.031) and the amount of monthly household income (AOR = 3.397, 95% CI: 1.316–8.766) were found to be statistically significant and positively associated with substance use during pregnancy.

Conclusion

The magnitude of antenatal substance use in the study area was 26.5%. Pre- pregnancy substance use, partner substance use, monthly house hold income and family substance use were found to be positively associated with substance use during pregnancy. Therefore, health education which is inclusive of child bearing age women with their partner and family may be helpful to decrease antenatal substance use during pregnancy.
Acceptability of tDCS in treating stress-related mental health disorders: a mixed methods study among military patients and caregivers
Authors: Smits Fenne M. , de Kort Guido J. , Geuze Elbert
Published: February 2021

Background

Noninvasive brain stimulation techniques like transcranial direct current stimulation (tDCS) offer potential new approaches to treat stress-related mental health disorders. While the acceptability of tDCS as a treatment tool plays a crucial role in its development and implementation, little is known about tDCS acceptability for users in mental healthcare, especially in the context of stress-related disorders.

Methods

Using a mixed-methods approach, we investigated tDCS acceptability among 102 active duty and post-active military patients with stress-related symptoms (posttraumatic stress disorder, anxiety and impulsive aggression) who participated in a 5-session tDCS intervention. Quantitative dropout and adverse effects data was collected for all patients involved in the sham-controlled tDCS intervention. We additionally explored perspectives on the acceptability of tDCS treatment via a theory-based semi-structured interview. A subgroup of patients as well as their caregivers were interviewed to include the views of both patients and mental healthcare professionals.

Results

Quantitative outcomes showed minimal tDCS-related adverse effects (mild itching or burning sensations on the scalp) and high tDCS treatment adherence (dropout rate: 4% for active tDCS, 0% for sham). The qualitative outcomes showed predominantly positive attitudes towards tDCS interventions for stress-related disorders, but only as complementary to psychotherapy. Remarkably, despite the perception that sufficient explanation was provided, patients and caregivers stressed that tDCS treatment comprehension was limited and should improve. Also, the travel associated with frequent on-site tDCS sessions may produce a significant barrier to care for patients with stress-related disorders and active-duty military personnel.

Conclusions

Acceptability numbers and perspectives from military patients and caregivers suggest that tDCS is an acceptable complementary tool in the treatment of stress-related disorders. Critically, however, if tDCS is to be used beyond scientific studies, adequately educating users on tDCS working mechanisms is vital to further improve its acceptability. Also, the perceived potential barrier to care due to frequent travel may favor home-based tDCS solutions.

Trial registration

The tDCS intervention was part of a sham-controlled trial registered on 05-18-2016 at the Netherlands Trial Register with ID NL5709.
Depressive, anxiety, and insomnia symptoms between population in quarantine and general population during the COVID-19 pandemic: a case-controlled study
Authors: Wang Chengmin , Song Weidong , Hu Xiaohui , Yan Shaoguang , Zhang Xing , Wang Xunqiang , Chen Wenli
Published: February 2021

Background

The COVID-19 pandemic have caused mental and psychological problems on the general population, patients, and related workers. Our study is to determine the impact of mental and psychological symptoms among population in quarantine for 2 weeks during COVID-19 pandemic.

Methods

A case-controlled study design have conducted at department of psychiatry of Shenzhen Longgang Center for Chronic Disease Control in Shenzhen, China mainland from 7th April to 15th June 2020.1674 participants (aged 18 to 65 years) in quarantine for 2 weeks and 1743 age-sex matched controls living in Shenzhen were recruited between 7th April 2020 and 15th June 2020. The assessment of depressive, anxiety, and insomnia symptoms were determined by self-reported questionnaires PHQ-9, GAD-7, and ISI, respectively.

Results

A total of 1674 participants in quarantine for 2 weeks and 1743 age-sex matched controls (32.6 ± 9.3 years vs. 32.7 ± 10.7 years, 49.8% vs. 47.8% females) were recruited. Population in quarantine had higher score on PHQ-9 (6.1 ± 5.5 vs. 3.0 ± 3.7, p < 0.001), GAD-7 (4.2 ± 4.7 vs. 1.9 ± 3.7, p < 0·001), and ISI (5.5 ± 5.8 vs. 3.1 ± 5.0%, p < 0.001) compared to general population. Population in quarantine showed significantly higher risks of depression (OR: 4.55, 95% CI: 3.82–5.41), anxiety (OR: 2.92, 95% CI: 2.43–3.51), and insomnia (OR: 2.40, 95% CI: 2.02–2.89), when compared to the general population. Younger, more education, non-married and lower household income showed higher risks of mental health problems.

Conclusions

Population in quarantine had a higher level of depressive, anxiety, and insomnia symptoms than controls. Specifically, they were at a higher risk prevalence of depression, anxiety, and insomnia, especially the severity of depression, when compared to controls. Younger, more education, non-married, and lower income population in quarantine were at higher risks of mental health problems. Mental health professionals should pay attention to the mental and psychological symptoms for population in quarantine.
Suicidal ideation among Lebanese adults: scale validation and correlates
Authors: Zakhour Maha , Haddad Chadia , Sacre Hala , Fares Kassandra , Akel Marwan , Obeid Sahar , Salameh Pascale , Hallit Souheil
Published: February 2021

Background

According to the World Health Organization (WHO) figures in 2015, the number of people attempting suicide worldwide per year exceeds 800,000 individuals. The majority of completed suicides (78%) occur in low- and middle-income countries. Therefore, this study aimed to validate the suicidal ideation subscale of the Columbia-Suicide Severity Rating Scale and evaluate risk factors (emotional intelligence, alexithymia, anxiety, depression, and stress) related to suicidal ideation among the Lebanese adult population.

Methods

A structured cross-sectional survey was carried out between November 2017 and March 2018, enrolling a proportionate random sample of 789 community-dwelling participants from all the Lebanese regions. A correlation analysis between the C-SSRS and anxiety and depression assessed the convergent validity of the scale. An exploratory and a confirmatory factor analysis validated its construct. Cronbach’s alpha was used to assess internal consistency reliability. Multiple linear regression was performed using the suicidal ideation score as the dependent variable. All variables were included in the multivariable model.

Results

The C-SSRS scale converged over a solution of one factor; the proportion of explained variance was 0.797. The Cronbach’s alpha value was good (0.797). The convergent validity was tested with depression and anxiety scales. The results showed a moderate positive correlation between the suicide ideation score and depression (rho = 0.507, p < 0.001) and anxiety (rho = 0.402, p < 0.001). The multivariable analysis showed that higher depression (Unstandardized Beta, B = 0.035, p < 0.001), higher anxiety (B = 0.015, p = 0.008), and higher alcohol dependence (B = 0.024, p < 0.001) were significantly linked to higher suicidal ideation score. However, higher self-esteem (B = -0.041, p = 0.006) was significantly associated with lower suicidal ideation scores.

Conclusion

Our findings suggest that the Arabic version of the C-SSRS subscale could serve as an appropriate assessment tool for suicidal ideation. This paper also gave insights into factors correlated with higher suicidal ideation scores, such as depression, anxiety, and alcohol dependence. Further studies are necessary to confirm our findings and implement suicide prevention programs.
Cooking for Health: a healthy food budgeting, purchasing, and cooking skills randomized controlled trial to improve diet among American Indians with type 2 diabetes
Authors: Hawley Caitlin N. , Huber Corrine M. , Best Lyle G. , Howard Barbara V. , Umans Jason , Beresford Shirley A. A. , McKnight Barbara , Hager Arlette , O’Leary Marcia , Thorndike Anne N. , Ornelas India J. , Brown Meagan C. , Fretts Amanda M.
Published: February 2021

Background

The prevalence of poor diet quality and type 2 diabetes are exceedingly high in many rural American Indian (AI) communities. Because of limited resources and infrastructure in some communities, implementation of interventions to promote a healthy diet is challenging—which may exacerbate health disparities by region (urban/rural) and ethnicity (AIs/other populations). It is critical to adapt existing evidence-based healthy food budgeting, purchasing, and cooking programs to be relevant to underserved populations with a high burden of diabetes and related complications. The Cooking for Health Study will work in partnership with an AI community in South Dakota to develop a culturally-adapted 12-month distance-learning-based healthy food budgeting, purchasing, and cooking intervention to improve diet among AI adults with type 2 diabetes.

Methods

The study will enroll 165 AIs with physician-diagnosed type 2 diabetes who reside on the reservation. Participants will be randomized to an intervention or control arm. The intervention arm will receive a 12-month distance-learning curriculum adapted from Cooking Matters® that focuses on healthy food budgeting, purchasing, and cooking skills. In-person assessments at baseline, month 6 and month 12 will include completion of the Nutrition Assessment Shared Resources Food Frequency Questionnaire and a survey to assess frequency of healthy and unhealthy food purchases. Primary outcomes of interest are: (1) change in self-reported intake of sugar-sweetened beverages (SSBs); and (2) change in the frequency of healthy and unhealthy food purchases. Secondary outcomes include: (1) change in self-reported food budgeting skills; (2) change in self-reported cooking skills; and (3) a mixed-methods process evaluation to assess intervention reach, fidelity, satisfaction, and dose delivered/received.

Discussion

Targeted and sustainable interventions are needed to promote optimal health in rural AI communities. If effective, this intervention will reduce intake of SSBs and the purchase of unhealthy foods; increase the purchase of healthy foods; and improve healthy food budgeting and cooking skills among AIs with type 2 diabetes – a population at high risk of poor health outcomes. This work will help inform future health promotion efforts in resource-limited settings.

Trial registration

This study was registered on ClinicalTrials.gov on October 9, 2018 with Identifier NCT03699709.
Experience of and factors associated with violence against sexual and gender minorities in nine African countries: a cross-sectional study
Authors:   the Southern and Eastern African Research Collective for Health (SEARCH), Müller Alex , Daskilewicz Kristen , Kabwe Mc Lean , Mmolai-Chalmers Anna , Morroni Chelsea , Muparamoto Nelson , Muula Adamson S. , Odira Vincent , Zimba Martin
Published: February 2021

Objective

The objective of this research was to assess physical and sexual violence experienced by sexual and gender minorities in nine African countries, and to examine factors associated with violence.

Methods

We conducted an exploratory multi-country cross-sectional study among self-identifying sexual and gender minorities, using a survey tool available in paper and online. Participants were sampled through venue-based and web-based convenience sampling. We analysed data using descriptive statistics and logistic regression, with Stata15.

Findings

Of 3798 participants, 23% were gender minorities, 20% were living with HIV, and 18% had been coerced into marriage. Fifty-six per cent of all participants had experienced physical or sexual violence in their lifetime, and 29% in the past year. Gender minorities had experienced significantly higher levels of violence compared to cisgender (sexual minority) participants. The variable most strongly associated with having experienced violence was being coerced into marriage (AOR, 3.02), followed by people living nearby knowing about one’s sexual orientation and/or gender identity (AOR, 1.90) and living with HIV (AOR, 1.47).

Conclusion

Sexual and gender minorities in Eastern and Southern Africa experience high levels of violence. Sexual orientation and gender identity need to be recognised as risk factors for violence in national and regional law and policy frameworks. States should follow the African Commission Resolution 275 and provide protection against violence based on real or perceived sexual orientation or gender identity.
Enhanced passive safety surveillance of the quadrivalent inactivated split-virion influenza vaccine (IIV4) in Finland during the 2019/20 influenza season
Authors: Chabanon Anne-Laure , Wague Sophie , Moureau Annick , Nissila Markku , Serradell Laurence
Published: February 2021

Background and aims

The Enhanced Passive Safety Surveillance is a requirement of the European Medicines Agency (EMA) for seasonal influenza vaccines, aiming to rapidly detect any significant change in frequency or severity of expected reactogenicity or allergic events prior to widespread use of a vaccine in any particular year. The aim of this surveillance was to assess the quadrivalent inactivated split-virion influenza vaccine (IIV4) during routine immunization in Finland, as per the national immunization program for 2019/20. The primary objective was to investigate the suspected adverse drug reactions (ADR) occurring within 7 days following vaccination.

Methods

Passive surveillance of individuals vaccinated with IIV4 was conducted within the first 4 to 6 weeks of the influenza season in Finland. Potential ADRs were reported via phone or posted adverse event forms. The vaccinee reporting rate and ADR reporting rate were calculated and compared with the known or expected safety data in order to identify any change which was clinically significant.

Results

Data were collected from 939 individuals, with 56 reports received for 163 suspected ADRs. Of these, 38 individuals reported 117 suspected ADRs within 7 days following vaccination, corresponding to an ADR reporting rate of 12.46% (95% CI: 10.41, 14.74%); vaccination-site pain, vaccination-site reaction, and pyrexia were the most frequently reported ADRs. The 18-to-65 years of age category had an ADR reporting rate of 12.56%, the over-65 years of age category had an ADR reporting rate of 16.22%, and no ADRs were reported for individuals aged 6 months to 18 years. No serious suspected ADRs were reported at any time post-vaccination, and the ADR rates were comparable to those reported for IIV4 in the 2018/19 seasonal assessment. The frequency of suspected ADRs was generally aligned with those reported in the Summary of Product Characteristics (SmPC), with the exception of asthenia, somnolence, and erythema, which were slightly higher. No reporting pattern by type, frequency, or severity was identified for the suspected ADRs.

Conclusions

No clinically significant changes in what is known or expected for IIV4 was reported for the 2019/20 season, which supports the overall safety profile.
Knowledge and experience of cancer prevention and screening among Gypsies, Roma and Travellers: a participatory qualitative study
Authors: Condon Louise , Curejova Jolana , Morgan Donna Leeanne , Miles Glenn , Fenlon Deborah
Published: February 2021

Background

The incidence of cancer is increasing worldwide, which has led to greater public health focus on primary prevention. Ethnic minorities have lower awareness of cancer risk factors and services, and are at greater risk of cancer mortality. While Gypsies, Roma and Travellers have poor health outcomes even in comparison with other ethnic minorities, little is known about how they view and enact primary prevention. This study takes a participatory approach to explore knowledge and experience of cancer prevention and screening in these communities.

Methods

Peer researchers conducted interviews (n = 37) and a focus group (n = 4) with a purposive sample of community members in Wales and South-West England. Participants self-identified as Roma (from Slovakia and Romania) or as Gypsies, Travellers or Showpeople (here described as Gypsy/Travellers). A third of the sample were Roma, and a quarter male, with ages ranging from 18 to 77 years. Data were collected from October 2018 to March 2019.

Results

Women and men knew that lifestyle factors, such as healthy diet, stopping smoking, drinking less alcohol and using sun protection, contribute to cancer risk reduction. However, there was a widespread lack of confidence in the effectiveness of these measures, particularly in relation to smoking. Traditional cultural beliefs were shared by Roma and Gypsy/Travellers, but did not necessarily affect the behaviour of individuals. Most women participated in cervical and breast screening but few Gypsy/Traveller men would engage with bowel screening, which conflicted with community ideals of stoical masculinity. Roma participants described language barriers to screening, with confusion about differences in timing and eligibility between the UK and Slovakian programmes; this led some to access screening abroad.

Conclusion

This study provides new knowledge about how Gypsies, Roma and Travellers keep healthy and prevent disease, giving insights into similarities and differences between ages, sexes and communities. These culturally distinct and high-need ethnic minorities have specific needs in relation to cancer prevention and screening, which merit targeted and acceptable health promotion to reduce health inequalities.