bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between obesity status and successful aging among older people in China: evidence from CHARLS
Authors: Luo Huiqiang , Ren Xiaohui , Li Jijie , Wu Kan , Wang Yixi , Chen Qing , Li Ningxiu
Published: May 2020

Background

The paper aimed to examine the association between obesity status and successful aging among elderly adults in China and further find gender differences in the effect of components of successful aging on obesity status.

Methods

The data came from the follow-up survey(2015) of China Health and Retirement Longitudinal Study (CHARLS) and 4019 dwellers age 60 and over are included. Obesity status were defined by the body mass index (BMI) according to Chinese criteria. Successful aging was defined following Rowe and Kahn’s multidimensional model. Multivariable logistic regression was used to estimate the relationship between obesity status and successful aging.

Results

The rate of successful aging in men and women was 18.87 and 9.48% respectively. For BMI, the proportion of population with underweight, overweight and obesity in men was 10.29, 23.04 and 29.63% respectively and that in women was 1.40, 11.69 and 9.47%. Men with obesity (OR = 1.587 95% CI 1.087 ~ 2.316) has an positive relationship with successful aging than normal weight men; Women with underweight (OR = 0.197 95% CI 0.058 ~ 0.824) has an negative relationship with successful aging than normal weight women; Meanwhile, no matter men and women, the relationship between obesity status and successful aging were not significant among oldest adults(≥75 years).

Conclusion

Obesity status was significantly association with successful aging in young older adults (60-74 years), and the components of successful aging differently were related with the obesity status of male and female.
Identification of transmission foci of Schistosoma mansoni: narrowing the intervention target from district to transmission focus in Ethiopia
Authors: Tiruneh Abebaw , Kahase Daniel , Zemene Endalew , Tekalign Eyob , Solomon Absra , Mekonnen Zeleke
Published: May 2020

Background

Schistosoma mansoni (S. mansoni) infection is a significant public health problem in Ethiopia, and has wide distribution in the country. The impact of the disease is particularly high on school-age children. Nationwide 385 endemic districts were identified, whereby control and elimination interventions are underway using school-based annual mass drug administration (MDA) with praziquantel. The national elimination program targets endemic districts as a whole. The aim of this study was to identify the transmission foci of Schistosoma mansoni and determine prevalence of soil-transmitted helminths (STHs) in Abeshge district.

Methods

The study was conducted from April to May, 2019 among school-age children randomly selected from public elementary schools in Abeshge district, South-central Ethiopia. Demographic information and data on risk factors of S. mansoni infection were gathered using pre-tested questionnaire. Moreover, a stool sample was collected from each child and examined using Kato-Katz thick smear technique. The data were analyzed using STATA_MP version 12.

Results

A total of 389 school-age children from five public elementary schools were included in the study. The overall prevalence of S. mansoni and STHs was 19.3% (75/389) and 35% (136/389), respectively. The prevalence of S. mansoni was 60.6% in Kulit Elementary school, while it was zero in Geraba. The prevalence of S. mansoni was significantly higher among males (AOR = 2.6, 95% CI 1.3–5.1), those with habit of swimming and/or bathing in rivers (AOR = 2.9, 95%CI 1.3–5.1) and involved in irrigation activities (AOR = 2.9, 95% CI 1.0–8.3). Overall, the prevalence of S. mansoni was significantly higher among school children attending Kulit Elementary School compared to those attending the remaining schools (AOR = 12.5, 95%CI 6.2–25.1).

Conclusion

A wide variation of S. mansoni prevalence was observed among the school children in the different schools. Control interventions better identify and target foci of S. mansoni transmission, instead of targeting the district homogenously.
Rural chronic disease research patterns in the United Kingdom, United States, Canada, Australia and New Zealand: a systematic integrative review
Authors: Disler R. , Glenister K. , Wright J.
Published: May 2020

Background

People living in rural and remote communities commonly experience significant health disadvantages. Geographical barriers and reduced specialist and generalist services impact access to care when compared with metropolitan context. Innovative models of care have been developed for people living with chronic diseases in rural areas with the goal of overcoming these inequities. The aim of this paper was to describe the characteristics and outcomes of studies investigating innovative models of care for people living with chronic disease in rural areas of developed countries where a metropolitan comparator was included.

Methods

An integrative systematic review was undertaken. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used to understand the empirical and theoretical data on clinical outcomes for people living with chronic disease in rural compared with metropolitan contexts and their models of care in Australia, New Zealand, United States, Canada and the United Kingdom.

Results

Literature searching revealed 620 articles published in English between 1st January 2000 and 31st March 2019. One hundred sixty were included in the review including 68 from the United States, 59 from Australia and New Zealand (5), 21 from Canada and 11 from the United Kingdom and Ireland. 53% (84) focused on cardiovascular disease; 27% (43) diabetes mellitus; 8% (12) chronic obstructive pulmonary disease; and 13% (27) chronic kidney disease. Mortality was only reported in 10% (16) of studies and only 18% (29) reported data on Indigenous populations.

Conclusions

This integrated review reveals that the published literature on common chronic health issues pertaining to rural and remote populations is largely descriptive. Only a small number of publications focus on mortality and comparative health outcomes from health care models in both urban and non-urban populations. Innovative service models and telehealth are together well represented in the published literature but data on health outcomes is relatively sparse. There is significant scope for further directly comparative studies detailing the effect of service delivery models on the health outcomes of urban and rural populations. We believe that such data would further knowledge in this field and help to break the deadly synergy between increased rurality and poorer outcomes for people with chronic disease.
The levels and trends of contraceptive use before first birth in India (2015–16): a cross-sectional analysis
Authors: Singh Pragya , Singh Kaushalendra Kumar , Singh Anjali , Pandey Anjali
Published: May 2020

Background

Indian women are more prone to first birth at a relatively younger age after marriage. Also, we do not have sufficient literature available that focuses on contraceptive use before first birth. The analysis of the present study was done using data from the fourth round of National Family Health Survey (2015–16), India. The objectives of the present study were to measure the levels and trends of contraceptive use before first birth among Indian ever married women, aged 15–34 years.

Methods

The study includes 279,896 ever married women aged 15–34 years at the time of the NFHS-4 survey. To identify the socio-demographic determinants governing the pioneering study behavior, multivariable techniques have been used in the analysis. The statistical significance of the relationship between socio-demographic factors and contraceptive use prior to first birth was tested using a chi-squared test for association. Hosmer Lemeshow statistics and Nagelkerke R square have been used to check how well the logistic regression model fits the data. Map of India showing different zonal classification is made using the ArcGIS software version 10.3.

Result

The trends of contraceptive usage show a decline in use before first birth and the various socio-demographic factors affecting the use of contraceptive before first birth are religion, caste, education, wealth index, media exposure, age at marriage and the zonal classifications.

Conclusion

The noticeable result in this study is the comparative decline in contraceptive use by women in India before first birth in NFHS-4 with respect to previous NFHS done in India. The likelihood of using contraception before first birth is significantly affected by factors like place of residence, religion, caste, current age of women, age at marriage, education level of women, wealth index, media exposure and zonal classification.
Associations of socio-demographic factors with adiposity among immigrants in Norway: a secondary data analysis
Authors: Qureshi Samera Azeem , Straiton Melanie , Gele Abdi A.
Published: May 2020

Background

Obesity is becoming an important public health challenge, especially among immigrants coming from low and middle income to high-income countries. In this study we examined the relationship between overweight/obesity and various socio-demographic indicators among different immigrant groups in Norway.

Methods

We used data from the Living Conditions Survey among Immigrants 2016, conducted by Statistics Norway. Our study sample included 4194 immigrants from 12 different countries. Participants were asked about a number of topics including health, weight, height, demographic factors, length of residence and employment. We ran logistic regression analysis to determine the odds ratio (OR) of the associations between socio-demographic factors with adiposity among immigrants.

Results

Approximately 53% of the sample was overweight/obese. There was a significant difference in overweight/obesity by gender, age, country of origin and marital status. Overall immigrant men were almost 52% more likely to be overweight/obese than women. Women from Somalia had the highest odds (13.1; CI: 7.4–23.1) of being overweight/obese, followed by Iraq (8.6; CI: 4.9–14.9), Pakistan (7.5; CI: 4.2–13.4), Kosovo (7.0; CI: 4.1–12.1), and Turkey (6.8; CI: 4.0–11.6) as compared to the women from Vietnam (reference). Whereas men from Turkey had the highest odds (5.2; CI: (3.2–8.3)) of being overweight/obese, followed by Poland (4.2; CI: 2.7–6.1), Bosnia (4.1; CI: (2.6–6.5) and Kosovo (3.9; CI: 2.5–6.1). The odds for obesity increased with age and odds were highest in the eldest group 45–66 years (4.3; CI: 3.2–5.8) as compared to reference group16–24 years. The odds of being overweight/obese was higher among married (1.6; CI: 1.3–1.9) and divorced/separated/widowed (1.5; CI: 1.1–2.0) as compared to singles. Education, employment status, physical activity and length of residence were not associated with the odds of being overweight/obese.

Conclusion

The findings of this study call attention to the importance of a greater understanding of the processes leading to obesity among certain immigrant groups in Norway. Moreover, there is a need for culturally adapted prevention strategies targeting immigrant men and women with high rates of overweight/obesity.
Factors associated with musculoskeletal symptoms and heart rate variability among cleaners – cross-sectional study
Authors: Sotrate Gonçalves Josiane , de Oliveira Sato Tatiana
Published: May 2020

Background

The professionals who perform cleaning activity constitute a major economic sector in Brazil. Cleaners may develop health problems related to the musculoskeletal and cardiovascular systems. It is necessary to understand the working and health conditions of cleaners in Brazil. Thus, the aim of this study was to identify factors associated with musculoskeletal symptoms and heart rate variability (HRV) among cleaners.

Methods

A cross-sectional study conducted at a public higher education institution with 45 outsourced cleaners following approval from the institutional ethics committee. The participants answered a questionnaire addressing sociodemographic, occupational and health data, the Nordic Musculoskeletal Questionnaire, the Physical Activity Questionnaire (work and leisure) and the short version of the Copenhagen Psychosocial Questionnaire. Clinical data (height, body mass, waist-to-hip ratio and blood pressure) and heart rate variability (HRV) were also collected. Logistic and linear regression models were created to identify factors associated with symptoms and HRV.

Results

The sample consisted of women (100%) predominantly older than 50 years of age (44%), without a conjugal life (64%), with three or more children (59%), low educational level (58%) and who worked less than 12 months at the company (87%). Systemic arterial hypertension (23%) was the most reported health problem. The highest frequency of musculoskeletal symptoms was identified in the lower limbs (ankles/feet: 31% in the previous 12 months and 24% in the previous 7 days; knees: 31% in the previous 12 months and 20% in the previous 7 days). Moreover, the workers reported not practicing physical activity during leisure time (84%). Psychosocial aspects indicated health risks for the dimensions “influence at work” (74%), “burnout” (59%) and “stress” (52%). Associations were found between ankle/foot symptoms and body mass index, shoulder symptoms and predictability, and knee symptoms and self-rated health and burnout. HRV indices were associated with age.

Conclusions

This study outlined the profile of female cleaners and identified risk factors. The workers exhibited musculoskeletal symptoms, which were associated with the body mass index and some psychosocial factors. HRV indices were associated with age. Thus, health promotion and prevention measures should be taken to benefit this population of workers.
Individual and community level factors associated with anemia among lactating mothers in Ethiopia using data from Ethiopian demographic and health survey, 2016; a multilevel analysis
Authors: Liyew Alemneh Mekuriaw , Teshale Achamyeleh Birhanu
Published: May 2020

Background

Maternal anemia is a worldwide public health problem especially in developing countries including Ethiopia. The anemia burden among lactating mothers was higher in Africa particularly in Ethiopia, and scant attention was paid. To date, there is limited evidence on community level determinants of anemia among lactating mothers in Ethiopia. This study, therefore, aimed to assess the prevalence and factors associated with anemia among lactating mothers in Ethiopia.

Methods

Secondary data analysis was employed using the 2016 Ethiopian Demographic and Health Survey. A total weighted sample of 4658 lactating women was included. A multilevel logistic regression model was used to identify individual and community level determinants of anemia during lactation. Finally, the adjusted odds ratio with a 95% confidence interval was reported.

Results

The overall prevalence of anemia was 28.3% (95% CI; 26.7, 30.0) with the higher regional prevalence in Somali (68.3%) and Afar (47.2%) regions. Current modern contraceptive use [AOR = 0.71; 95% CI: 0.58, 0.87], Poorer [AOR = 0.77; 95% CI: 0.61, 0.98], middle [AOR = 0.74; 95% CI: 0.56, 0.97], rich [AOR = 0.64; 95% CI: 0.46, 0.85], and richest [AOR = 0.66; 95% CI: 0.43, 0.98] wealth index, being working within the 12 months preceding the survey [AOR = 0.77; 95% CI: 0.64, 0.92], and taking iron during pregnancy [AOR = 0.82; 95% CI: 0.68, 0.98] were associated with lower odds of anemia. Whereas, being female household head [AOR = 1.22; 95% CI: 1.01, 1.49], having two births [AOR = 1.27; 95% CI: 1.04, 1.55] and three to four births [AOR = 1.53; 95% CI: 1.14, 2.06] within 5 years, and higher community illiteracy level [AOR = 1.06; 95% CI: 1.06, 1.70] were associated with the increased odds of anemia during lactation.

Conclusion

In this study the prevalence of anemia among lactating mothers was high. It was affected by both individual and community level factors. Therefore, focusing on family planning services especially on modern contraceptive methods, iron supplementation during pregnancy, child spacing, and improving community literacy could decrease anemia during lactation.
The association between physical fitness and mental health in Norwegian adolescents
Authors: Åvitsland Andreas , Leibinger Eva , Haugen Tommy , Lerum Øystein , Solberg Runar B. , Kolle Elin , Dyrstad Sindre M.
Published: May 2020

Background

Studies indicate that health-related components of physical fitness are associated with mental health outcomes. However, research is scarce concerning this relationship in young adolescents in general and non-existent in Norwegian populations specifically. The aim of the study was to examine whether body composition, muscular strength and cardiorespiratory fitness were associated with self-reported mental health in Norwegian adolescents.

Methods

Adolescents from four regions of Norway (n = 1486; mean age = 13.9; girls = 50.6%) participated. Self-reported mental health (psychological difficulties) was measured by completing the Strengths and Difficulties Questionnaire. Cardiorespiratory fitness was assessed with an intermittent running test; muscular strength was assessed by measuring handgrip strength, standing broad jump and sit-ups; and body composition was assessed by calculating body mass index from weight and height. Linear mixed effects models were conducted to assess the associations between the health-related components of physical fitness and psychological difficulties. School clusters were included as random effects and all models were controlled for sex, socioeconomic status and birthplace (domestic or foreign).

Results

Body composition was not associated with psychological difficulties. Muscular strength was independently associated with psychological difficulties, but when all independent variables were entered in the fully adjusted model, only cardiorespiratory fitness was associated with psychological difficulties.

Conclusions

There was a small but significant inverse association between cardiorespiratory fitness and levels of psychological difficulties in Norwegian adolescents. The results suggest that muscular strength is not associated with psychological difficulties in adolescents, when controlling for cardiorespiratory fitness. Future research should focus on the prospective association between physical fitness components and mental health outcomes in adolescents.

Trial registration

The study is registered in ClinicalTrials.gov ID nr: NCT03817047. Retrospectively registered January 25, 2019.
Full vaccination coverage among children aged 12–23 months in Ethiopia: a systematic review and meta-analysis
Authors: Ketema Daniel Bekele , Assemie Moges Agazhe , Alamneh Alehegn Aderaw , Alene Muluneh , Chane Kassahun Yawukal , Alamneh Yoseph Merkebe , Birhanu Molla Yigzaw , Alebel Animut
Published: May 2020

Background

Vaccination is one of the most cost-effective means of public health interventions to prevent childhood deaths from infectious diseases. Although several fragmented studies have been conducted concerning full vaccination coverage among children aged 12–23 months in Ethiopia, the pooled estimate has not been determined so far. Therefore, this systematic review and meta-analysis aims to estimate the pooled prevalence of full vaccination coverage among children aged 12–23 months in Ethiopian.

Methods

To find potentially relevant studies, we systematically searched five major databases (i.e., PubMed/MEDLINE, CINAHL, EMBASE, Google Scholar, and Science Direct). This review included community based cross-sectional studies reported in English language; had good quality, and published from the 1st of January 2000 to the 20th of November 2019. Data were analyzed using Stata™ Version 14.1 software. The pooled estimates with 95% confidence intervals (CIs) were presented using forest plots. Higgins and Egger’s tests were used to assess heterogeneity and publication bias, respectively. Primary estimates were pooled using a random effects meta-analysis model.

Results

Of the total of 851 identified articles 21 studies involving 12,094 children met the inclusion criteria and were included in this meta-analysis. The included studies sample size ranged from 173 to 923. The lowest proportion of full vaccination coverage was reported from Afar Region [21% (95% CI: 18, 24%)], whereas the highest proportion of full vaccination coverage was reported from Amhara Region [73% (95% CI: 67, 79%)]. The overall prevalence of full vaccination coverage among children in Ethiopia was 60% (95% CI: 51, 69%).

Conclusions

Our finding suggested that six in every 10 children in Ethiopia were fully vaccinated. However, this finding is much lower than the World Health Organization recommended rate. Moreover, high regional variations in terms of full vaccination coverage across the country was observed. Therefore, a special attention should be given to improve the overall childhood vaccination coverage.
Peptic ulcer perforation after cesarean section; case series and literature review
Authors: Shirazi Mahboobeh , Zaban Mehnoosh Tork , Gummadi Sriharsha , Ghaemi Marjan
Published: May 2020

Background

Peptic ulcer perforation in the early post-cesarean period is rare but may result in maternal mortality.

Case presentation

Four cases of post-cesarean peptic ulcer perforation are presented. In all four patients, presentations include peritoneal signs such as acute abdominal pain and progressive distention, hemodynamic instability and intraperitoneal free fluid by ultrasound. Laparotomy and repair were done in all 4 cases. There were 2 maternal deaths. We also have reviewed English literature for the similar cases reported from 1940 to March 2019.

Conclusion

New onset tachycardia, abdominal pain and progressive distension after cesarean section without congruent changes in hemoglobin should raise concerns for intra-abdominal emergencies including perforated peptic ulcer. Early use of ultrasound should be considered to assist in diagnosis. Coordinated care by an obstetrician and a general surgeon is necessary in presence of any unusual postoperative abdominal pain. Early recognition of the disease is imperative to limit the surgical delay and to improve the outcomes.
The effect of laparoscopy on mast cell degranulation and mesothelium thickness in rats
Authors: Poerwosusanta Hery , Gunadi  , Noor Zairin , Oktaviyanti Ika Kustiyah , Mintaroem Karyono , Pardjianto Bambang , Widodo Moch Aris , Widjajanto Edi
Published: May 2020

Background

Laparoscopy induces adhesion due to ischemia-reperfusion injury. However, the detail pathomechanism is poorly understood. This study aimed to investigate the impact of laparoscopy on mast cell and mesothelium morphological changes in the rat.

Methods

Forty-nine males of Sprague-DawleyRattus norvegicuswere divided into four groups: a) control and b) intervention groups P1, P2, and P3 that underwent 60 min laparoscopic using carbon dioxide (CO2) insufflation at 8, 10, and 12 mmHg groups, respectively. Serum hydrogen peroxide (H2O2), catalase (CAT), superoxide dismutase (SOD), malondialdehyde (MDA), and oxidative stress index (OSI) levels were determined 24 h after laparoscopy. Histopathological analyses of mast cell infiltration and degranulation and mesothelium thickness in the liver, greater omentum, mesenterium, small intestine, and peritoneum were performed 7 days after the procedure.

Results

H2O2, MDA, and OSI levels were significantly increased in the intervention groups compared with the control (p<0.05), while the SOD and CAT levels were decreased in the intervention groups compared with the control (p<0.05). Mast cell infiltration and degranulation were higher in the intervention groups than in control (p<0.05), while the mesothelium thickness was significantly lower in the laparoscopic groups than in control (p<0.05). Interestingly, the decrease in mesothelium thickness was strongly associated with the increase in mast cell infiltration and degranulation (p<0.01).

Conclusions

Our study shows that laparoscopy in rats increases mast cell infiltration and degranulation, which also results in and correlates with a decrease in mesothelial thickness.
Effect of silver diammine fluoride on micro-ecology of plaque from extensive caries of deciduous teeth - in vitro study
Authors: Liu Bao ying , Liu Jin , Zhang Di , Yang Zhi lei , Feng Ya ping , Wang Meng
Published: May 2020

Background

The mechanism of action of silver diammine fluoride (SDF) on plaque micro-ecology is seldom studied. This study investigated micro-ecological changes in dental plaque on extensive caries of deciduous teeth after topical SDF treatment.

Methods

Deciduous teeth with extensive caries freshly removed from school children were collected in clinic. Unstimulated saliva collection and initial plaque sampling were done before tooth extraction, then each caries was topically treated with 38% SDF in vitro. After intervention, each tooth was stored respectively in artificial saliva at 37 °C. Repeated plaque collections were done at 24 h and 1 week post-intervention. Post-intervention micro-ecological changes including microbial diversity, microbial metabolism function as well as species correlations were analyzed and compared after pyrosequencing of the DNA from the plaque sample using Illumina MiSeq platform.

Results

After SDF application, microbial diversity decreased (P > 0.05), although not statistically significant. Microbial community composition post-intervention was noticeably different from that of supragingival and pre-intervention plaque as well as saliva. At 1 week post-intervention, the relative content of Pseudomonas, Fusobacterium and Pseudoramibacter were higher than before, while most of the other bacteria were reduced, although the changes were not statistically significant (P > 0.05). The inter-microbial associations became more complex, much more positive associations among survived bacteria were observed than negative ones. COG function classification diagram showed carbohydrate transportation and metabolic functions in the plaque were significantly reduced at 24 h and 1 week post-intervention.

Conclusions

SDF has extensive antimicrobial effect on dental plaque, which may reduce carbohydrate metabolism in dental plaque and help promote new balance of the plaque flora.
The role of social media for persons affected by infertility
Authors: Sormunen Taina , Karlgren Klas , Aanesen Arthur , Fossum Bjöörn , Westerbotn Margareta
Published: May 2020

Background

Infertility remains a common universal disorder and a whole range of assisted reproductive technologies has been established. Society may fail to recognize the grief caused by infertility, which may lead to those struggling with it hiding their feelings. Previous research points out that infertile persons experience shortcomings in fertility care regarding continuity of care and social support. Social media may provide social and psychological support for infertile persons. Finding others who are going through similar experiences can help in the realization that the person is not alone and that her/his feelings are reasonable. The aim was to explore the roles of social media for persons affected by infertility.

Methods

A cross-sectional, computer-assisted, self-administered online questionnaire, containing both open and closed questions, was used to collect data. The questionnaire was linked to the bulletin board of six closed infertility social forums. Both quantitative and qualitative analysis methods were used. A total of 132 participants completed the questionnaire containing questions about their use of social media dealing with infertility.

Results

Most of the questionnaires were answered by females (97.7%) through Facebook (87%). Over 60% of the respondents had taken part in discussions about infertility in social media, between one and three years and 39% participated more than once a day. Half of the participants devoted one to three hours weekly to the forums and wrote 1–5 postings per week. The forums offered participants information, solidarity, and the opportunity to receive and give support. However, an adverse aspect that was described concerned advice that were not evidence-based. Infertility was experienced as being alienated from social life and being fragmented as a person.

Conclusion

Participating in infertility forums offers persons information about fertility treatments and social support in the process of coping with infertility.
“Kunika women are always sick”: views from community focus groups on short birth interval (kunika) in Bauchi state, northern Nigeria
Authors: Ansari Umaira , Pimentel Juan , Omer Khalid , Gidado Yagana , Baba Muhd Chadi , Andersson Neil , Cockcroft Anne
Published: May 2020

Background

In Northern Nigeria, short birth interval is common. The word kunika in the Hausa language describes a woman becoming pregnant before weaning her last child. A sizeable literature confirms an association between short birth interval and adverse perinatal and maternal health outcomes. Yet there are few reported studies about how people view short birth interval and its consequences. In support of culturally safe child spacing in Bauchi State, in North East Nigeria, we explored local perspectives about kunika and its consequences.

Methods

A qualitative descriptive study included 12 gender-segregated focus groups facilitated by local men and women in six communities from the Toro Local Government Area in Bauchi State. Facilitators conducted the groups in the Hausa language and translated the reports of the discussions into English. After an inductive thematic analysis, the local research team reviewed and agreed the themes in a member-checking exercise.

Results

Some 49 women and 48 men participated in the 12 focus groups, with an average of eight people in each group. All participants were married with ages ranging from 15 to 45 years. They explained their understanding of kunika, often in terms of pregnancy while breastfeeding. They described many disadvantages of kunika, including health complications for the mother and children, economic consequences, and adverse impact on men’s health and family dynamics. The groups concluded that some people still practise kunika, either intentionally (for example, in order to increase family size or because of competition between co-wives) or unintentionally (for example, because of frequent unprotected sex), and explained the roles of men and women in this.

Conclusion

Men and women in our study had a clear understanding of the concept of kunika. They recognized many adverse consequences of kunika beyond the narrow health concerns reported in quantitative studies. Their highlighted impacts of kunika on men’s wellbeing can inform initiatives promoting the role of men in addressing kunika.
Shufeng Jiedu capsules for treating acute exacerbations of chronic obstructive pulmonary disease: a systematic review and meta-analysis
Authors: Xia Ru-yu , Hu Xiao-yang , Fei Yu-tong , Willcox Merlin , Wen Ling-zi , Yu Ming-kun , Zhang Li-shan , Dai Meng-yuan , Fei Guang-he , Thomas Mike , Francis Nick , Wilkinson Tom , Moore Michael , Liu Jian-ping
Published: May 2020

Background

Chinese herbal medicine is widely used in combination with usual care for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) in China. Chinese patent medicine Shufeng Jiedu (SFJD) capsules is widely used for respiratory infectious diseases. This review aims to evaluate effectiveness and safety of SFJD for AECOPD.

Methods

A systematic review of randomised controlled trials (RCTs) in patients with AECOPD, who received SFJD as a single intervention or as add-on treatment to usual care. PubMed, the Cochrane Library, EMBASE, Scopus, Web of Science and four Chinese databases were searched from inception to April 2019. Two authors screened trials, extracted data, and assessed risk of bias, independently. Meta-analysis was performed using RevMan 5.3 software. We performed subgroup analyses and sensitivity analyses according to the predefined protocol. Quality of evidence was assessed using GRADE.

Results

Thirteen RCTs (1036 patients, with 936 inpatients) were included, all compared SFJD in combination with usual care (including antibiotics) to usual care alone. The mean age of participants ranged from 52 to 67 years, with approximately 60% male. Due to lack of blinding and other factors, all trials were of high risk of bias. SFJD was associated with a significant reduction in treatment failure, from 20.1 to 8.3% (11 trials; 815 patients; relative risk 0.43, 95% confidence interval [CI] 0.30 to 0.62), and duration of hospital stay (2 trials; 79 patients; mean difference − 4.32 days, 95% CI − 5.89 to − 2.75 days). No significant difference in adverse events was found between SFJD and control groups.

Conclusion

Low certainty evidence suggests SFJD may bring additional benefit in reducing treatment failure, shorten hospital stay, and improving symptoms. Further large, high quality RCTs are needed to confirm its benefit and safety.

Trial registration

PROSPERO CRD42019133682.
Therapeutic effect of Arthrocnemum machrostachyum methanolic extract on Ehrlich solid tumor in mice
Authors: Sharawi Zeina W.
Published: May 2020

Background

The anti-cancer effect of the halophyte Arthrocnemum indicum, a member of Arthrocnemum family of salt-tolerant plants, was evaluated against colorectal cancer cell, CaCo2. However, the anti-cancer effect of another halophyte Arthrocnemum machrostachyum was not investigated yet. Herein, the anticancer effect of A. machrostachyum methanolic extract (AME) was evaluated against Ehrlich solid tumor (EST) in mice and the potential mechanism of action was also studied.

Methods

Male Swiss albino mice (n = 28) were randomly divided into 4 groups (n = 7/group). Group 1 (negative control group); group 2 (EST) injected intramuscularly by 0.2 mL Ehrlich ascitic carcinoma (2 × 106 cells); and groups 3 and 4 injected intratumorally with AME (180 and 360 mg/kg body weight, respectively) at D12 trice weekly for 2 weeks. Gene expression, protein expression, DNA damage, and TNFa level in tumors were determined by real-time PCR, western blot, comet assay, and Elisa, respectively.

Results

Treatment with AME induced anti-tumor effects against EST as indicated by 1) notable reduction in tumor size; 2) elevation in tissue necrosis and apoptosis, as confirmed histologically; 3) increased DNA fragmentation; 4) decreased expression of the apoptotic genes (p53, Bax and caspase 3), and increased expression of the anti-apoptotic marker Bcl2; 5) significantly upregulated cell cycle regulatory genes Cdc2 and connexin26, and; 6) decreased TNFa levels in tumor tissues. Interestingly, a high dose of AME exhibited a more potent anti-tumor effect against EST.

Conclusion

These findings indicate that AME has a potent antitumor effect against EST and could be used as an adjuvant to anticancer drugs to combat tumor, but after application of further confirmatory clinical trials.
Native and exotic plants with edible fleshy fruits utilized in Patagonia and their role as sources of local functional foods
Authors: Chamorro Melina Fernanda , Ladio Ana
Published: May 2020

Background

Traditionally part of the human diet, plants with edible fleshy fruits (PEFF) contain bioactive components that may exert physiological effects beyond nutrition, promoting human health and well-being. Focusing on their food-medicine functionality, different ways of using PEFF were studied in a cross-sectional way using two approaches: a bibliographical survey and an ethnobotanical case study in a rural community of Patagonia, Argentina.

Methods

A total of 42 studies were selected for the bibliographical review. The case study was carried out with 80% of the families inhabiting the rural community of Cuyín Manzano, using free listing, interviews, and participant observation. In both cases we analyzed species richness and use patterns through the edible consensus and functional consensus indices. Local foods, ailments, medicines and drug plants were also registered.

Results

The review identified 73 PEFF, the majority of which (78%) were native species, some with the highest use consensus. PEFF were used in 162 different local foods, but mainly as fresh fruit. Of the total, 42% were used in a functional way, in 54 different medicines. The principal functional native species identified in the review wereAristotelia chilensisandBerberis microphylla.In the case study 20 PEFF were in current use (50% were native), and consensus values were similar for native and exotic species. These were used in 44 different local foods, mainly as fresh fruit. Only 30% were recognized for their functional value by inhabitants (mainly as gastrointestinal and respiratory treatments). The species with the highest functional consensus were the exoticSambucus nigraandRosa rubiginosa, followed by the nativeA. chilensis, Ribes magellanicumandB. microphylla. Infusions also constituted important local functional foods.

Conclusions

This survey highlights the importance of studying the different local functional foods to depict the biocultural diversity of a human society. The preparation of different beverages and herbal medicines was relevant, and would be a promising subject to investigate in the future. The living heritage of PEFF appears to have undergone hybridization processes, such that exotic species play an increasingly significant role.
Antimicrobial effects of mustard oil-containing plants against oral pathogens: an in vitro study
Authors: Eichel Vanessa , Schüller Anne , Biehler Klaus , Al-Ahmad Ali , Frank Uwe
Published: May 2020

Background

The present study examines the antimicrobial activity of nasturtium herb (Tropaeoli maji herba) and horseradish root (Armoraciae rusticanae radix) against clinically important oral bacterial pathogens involved in periodontitis, gingivitis, pulpitis, implantitis and other infectious diseases.

Methods

A total of 15 oral pathogens, including members of the genera Campylobacter, Fusobacterium, Prevotella, Parvimonas, Porphyromonas, Tanerella, Veillonella, and HACEK organisms, were exposed to [1] a combination of herbal nasturtium and horseradish using a standardized gas test and [2] a mixture of synthetic Isothiocyantes (ITCs) using an agardilution test. Headspace gas chromatography mass spectrometry was employed to quantify the amount of allyl-, benzyl-, and 2- phenyl- ethyl-ITC.

Results

With exception of Veillonella parvula, all tested species were highly susceptible to herbal nasturtium and horseradish in the gas test with minimal inhibitory concentrations (MICs) between 50/20 mg and 200/80 mg and to synthetic ITCs in the agardilution with MICs between 0.0025 and 0.08 mg ITC/mL, respectively. Minimal bactericidal concentrations extended from 0.005 mg ITC/mL to 0.34 mg ITC/mL.

Conclusions

ITCs may be considered an interesting alternative to antibiotics for prevention and treatment of oropharyngeal infections, periodontitis and related diseases. Furthermore, the suitability of ITCs for endocarditis prophylaxis in dental procedures might be worth further investigation.
The state of ethics education at medical schools in Turkey: taking stock and looking forward
Authors: Kavas Mustafa Volkan , Ulman Yesim Isil , Demir Figen , Artvinli Fatih , Şahiner Melike , Demirören Meral , Şenyürek Gamze , Pakiş Işıl , Bakırcı Nadi
Published: May 2020

Background

Ethics teaching is globally considered an essential part of medical education fostering professionalism. It does not only provide knowledge for good clinical conduct, but also trains medical students as virtuous practitioners. Although Turkey has had a considerable experience in ethics education of healthcare professionals, the general state of ethics curricula at medical schools in Turkey is unknown.

Methods

The purpose of this study was to collect comprehensive data about the ethics education programs at medical schools in Turkey. To this aim, we designed a cross-sectional descriptive questionnaire survey which focuses on the content, teaching years, teaching, assessment and evaluation methodologies, workforce and infrastructure. We delivered the questionnaire to all medical schools in Turkey. Seventy-nine medical schools participated in this study (response rate: 78%).

Results

Although most institutions had an undergraduate ethics curriculum (91.1%), the findings suggest deficiency of teaching personnel (34.2% had no instructors). Furthermore, the distribution and composition of the workforce was imbalanced. The content varies largely among institutions. Medical schools with an ethics department were more likely to diversify teaching topics. However, ethics education was largely based on the four-principle approach. The content was usually conveyed to students theoretically. Around 90% of schools had classroom lectures. It is the only method used at one-third of them. Clinical ethics education was mostly lacking. Multiple-choice tests were widely used to assess and evaluate student attainments (86.1%).

Conclusions

Staff qualified to teach ethics and ethics education integrated into the six-year medical curriculum given by a multidisciplinary team are urgent necessities. Considering teaching, assessment and evaluation methodologies used, most medical schools seem to fall short of fostering students to develop ethical attitudes. Endeavors aiming for modern topics should be encouraged. As the organization ethics education change continuously, we think that a platform for monitoring ethics education at medical schools in Turkey should be established. Such a body would help ethics instructors to network and find solutions to current problems and build shared wisdom.
Identification of capacity development indicators for faculty development programs: A nominal group technique study
Authors: Salajegheh Mahla , Gandomkar Roghayeh , Mirzazadeh Azim , Sandars John
Published: May 2020

Background

Although there have been many research studies of the effectiveness of faculty development in health profession education, the contribution of these programs to organizational development through capacity development has not been studied. Further understanding of capacity development requires appropriate indicators and no previous indicators for faculty development of health profession educators were identified. The aim of the study was to identify indicators of capacity development in the context of faculty development programs at Tehran University of medical sciences (TUMS).

Methods

A nominal group technique session was conducted with key informants from faculty development program providers to generate and prioritize a list of capacity development indicators.

Results

A list of 26 indicators was generated and five categories were identified: Development and innovation in teaching and learning process, Development and innovation in communication and collaboration at different levels, Development and sustaining faculty development programs, Development of educational leadership and management, Development in scholarship.

Conclusions

Capacity development for faculty development interventions of health profession educators is a process of engagement within a wider system, including individual and collective action, and involves the socialization of the teachers into suitable roles through professional identity development and participation within the wider system.
Hybrid simulation of pediatric gynecologic examination: a mix-methods study of learners’ attitudes and factors affecting learning
Authors: Torres Anna , Horodeńska Magdalena , Witkowski Grzegorz , Torres Kamil
Published: May 2020

Background

Children and adolescents with reproductive health issues may require immediate or emergency care, however in many countries availability of the pediatric and adolescent gynecology (PAG) service is low.That being said, teaching PAG examination to OBGYN, pediatrics and emergency medicine residents seems reasonable, and cannot be underestimated. In order to provide residents with opportunity to learn PAG examination, a high-fidelity hybrid simulation workshop was implemented in our institution.

Methods

The study aimed to investigate learners’ attitudes towards the high-fidelity simulation (HFS) hybrid model as compared with task trainer-SP (simulated patient)-voice model in the HFS environment and the factors connected to learners’ attitudes towards the hybrid model that could influence learning in high-fidelity simulation (HFS).

The concept of attitude was used as the theoretical framework and the mixed method approach to study design was utilized with simultaneous collection of quantitative (original questionnaires) and qualitative data (semi-structured interviews).

Results

Residents valued the HFS hybrid model higher over task trainer-SP-voice model in regards to all three attitude components: cognitive (95%), affective (87.5%) and behavioral (83.7%). Analysis of qualitative data revealed six themes important to learners and informing learning of PAG examination in HFS. Further analysis of the themes allowed to develop a conceptual model, in which six factors connected to attitude components influenced learning. These factors were: task difficulty, attention, emotional realism of the simulation, patient’s emotions, physical realism of the simulation, and technical issues.

Conclusions

Participants of our study appreciated learning experience with the HFS hybrid model more, based on attitude questionnaire. Moreover, findings revealed that multiple, various factors connected to attitude may influence learning of PAG examination in HFS with hybrid model, and we propose a conceptual model illustrating relationships between those factors.
Measuring and assessing the competencies of preceptors in health professions: a systematic scoping review
Authors: Bartlett Andrew D. , Um Irene S. , Luca Edward J. , Krass Ines , Schneider Carl R.
Published: May 2020

Background

In healthcare, preceptors act as a role model and supervisor, thereby facilitating the socialisation and development of the preceptee into a professional fit to practice. To ensure a consistent approach to every preceptorship experience, preceptor competencies should be measured or assessed to ensure that the desired outcomes are achieved. Defining these would ensure quality management and could inform development of an preceptor competency framework.

This review aimed to evaluate the evidence for preceptor competencies and assessment in health professions.

Methods

This study followed the PRISMA ScR scoping review guidelines. A database search was conducted in Embase, Medline, CINAHL and IPA in 2019. Articles were included if they defined criteria for competency, measured or assessed competency, or described performance indicators of preceptors. A modified GRADE CERQual approach and CASP quality assessment were used to appraise identified competencies, performance indicators and confidence in evidence.

Results

Forty one studies identified 17 evidence-based competencies, of which 11 had an associated performance indicator. The competency of preceptors was most commonly measured using a preceptee completed survey (moderate to high confidence as per CERQual), followed by preceptor self-assessment, and peer-assessment. Preceptee outcomes as a measure of preceptor performance had good but limited evidence.

Conclusions

Competencies with defined performance indicators allow for effective measurement and may be modifiable with training. To measure preceptor competency, the preceptor perspective, as well as peer and preceptee assessment is recommended. These findings can provide the basis for a common preceptor competency framework in health professions.