bluuebunny/crossref_metadata_2025 huggingface dataset:
Practice of stress management behaviors and associated factors among undergraduate students of Mekelle University, Ethiopia: a cross-sectional study
Authors: Hailu Gebrezabher Niguse
Published: April 2020

Background

Stress is one of the top five threats to academic performance among college students globally. Consequently, students decrease in academic performance, learning ability and retention. However, no study has assessed the practice of stress management behaviors and associated factors among college students in Ethiopia. So the purpose of this study was to assess the practice of stress management behaviors and associated factors among undergraduate university students at Mekelle University, Tigray, Ethiopia, 2019.

Methods

A cross-sectional study was conducted on 633 study participants at Mekelle University from November 2018 to July 2019. Bivariate analysis was used to determine the association between the independent variable and the outcome variable at p < 0.25 significance level. Significant variables were selected for multivariate analysis.

Results

The study found that the practice of stress management behaviors among undergraduate Mekelle university students was found as 367(58%) poor and 266(42%) good. The study also indicated that sex, year of education, monthly income, self-efficacy status, and social support status were significant predictors of stress management behaviors of college students.

Conclusion

This study found that the majority of the students had poor practice of stress management behaviors.
Civic engagement and mental health system strengthening in Indonesia: a qualitative examination of the views of health professionals and national key stakeholders
Authors: Irmansyah Irman , Susanti Herni , James Karen , Lovell Karina , Idaiani Sri , Imah Soimah , Hargiana Giur , Keliat Budi-Anna , Utomo Bagus , Colucci Erminia , Brooks Helen
Published: April 2020

Background

Mental health services in Indonesia are developing rapidly in response to national and global health policy to support people living with psychosis. This presents a unique opportunity for civic engagement, the active involvement of patients, carers and communities in mental health care, to shape emergent services. In-depth explorations of the views of professionals and other key stakeholders in mental health care on the use of civic engagement in Indonesia are lacking which contributes to a limited understanding of its potential in this regard. The study aimed to explore contemporary professionals’ and other key stakeholders’ perspectives on the current use of and potential for civic engagement to strengthen mental health systems in Indonesia.

Methods

Qualitative interviews were undertaken and analysed using thematic analysis underpinned by a critical realist approach. Eighteen multi-disciplinary professionals and lay health workers involved in mental health care in Jakarta and Bogor and 10 national key stakeholders were recruited.

Results

Despite high levels of awareness of and support for civic engagement amongst mental health professionals and policy makers combined with a nascent grass roots movement, analysis revealed unstructured and insufficient mechanisms for civic engagement which resulted in ad-hoc and mostly superficial levels of involvement activity. Civic engagement was thought to require a marked shift in existing practices as well as organisational and societal cultures. Challenging stigma is a key feature of civic engagement and our analysis highlights the relevance of social contact methods which are locally and culturally contextualised in this regard. Our findings point to a need to expand current definitions of civic engagement which focus on indivdiual enablement to ones that also encompass environmental and organisational enablement to optimise the future use of civic engagement in mental health settings.

Conclusions

Key mental health stakeholders have identified that central aspects of Indonesian culture are well aligned to the ethos of civic engagement which has the potential to facilitate the enactment of recent global health policy. However, full realisation is likely to be impeded by prevailing paternalistic cultures in mental health services and high levels of stigma and discrimination towards those with mental illness in Indonesia without intervention.
Clinical and cost effectiveness of staff training in the delivery of Positive Behaviour Support (PBS) for adults with intellectual disabilities, autism spectrum disorder and challenging behaviour - randomised trial
Authors:   the PBS study group, Strydom Andre , Bosco Alessandro , Vickerstaff Victoria , Hunter Rachael , Hassiotis Angela
Published: April 2020

Background

Although Positive Behaviour Support (PBS) is a widely used intervention for ameliorating challenging behaviour (CB), evidence for its use in adults with intellectual disability (ID) and comorbid autism (ASD) is lacking. We report a planned subsidiary analysis of adults with both ASD and ID who participated in a randomised trial of PBS delivered by health professionals.

Methods

The study was a multicentre, cluster randomised trial conducted in 23 community ID services in England, participants were randomly allocated to either the delivery of PBS (n = 11 clusters) or to treatment as usual (TAU; n = 12). One-hundred and thirteen participants (46% of all participants in the trial) had a diagnosis of ID, autism spectrum disorder and CB (ASD+); (47 allocated to the intervention arm, and 66 to the control). CB (primary outcome) was measured with the Aberrant Behaviour Checklist total score (ABC-CT). Secondary outcomes included mental health status, psychotropic medication use, health and social care costs and quality adjusted life years (QALYs) over 12 months.

Results

There were no statistically significant differences in ABC-CT between ASD+ groups randomised to the two arms over 12 months (adjusted mean difference = − 2.10, 95% CI: − 11.3 7.13, p = 0.655) or other measures. The mean incremental cost of the intervention per participant was £628 (95% CI -£1004 to £2013). There was a difference of 0.039 (95% CI − 0.028 to 0.103) for QALYs and a cost per QALY gained of £16,080.

Conclusions

Results suggest lack of clinical effectiveness for PBS delivered by specialist ID clinical teams. Further evidence is needed from larger trials, and development of improved interventions.

Trial registration

ClinicalTrials.gov: NCT01680276.
Prevalence of anxiety, depression, and stress in patients with multiple sclerosis in Kermanshah-Iran: a cross-sectional study
Authors: Karimi Saba , Andayeshgar Bahare , Khatony Alireza
Published: April 2020

Background

Multiple sclerosis (MS) is a chronic disease that decreases the physical ability and affects the mental health of the patients. This descriptive-analytical study investigated the prevalence of depression, anxiety and stress in MS patients.

Methods

A total of 87 MS patients were recruited in this study through simple random sampling method using a random number table. Data were collected by Depression, Anxiety, and Stress Scale-21 (DASS-21) and analyzed by descriptive and analytical statistics.

Results

The mean age of the patients was 35.5 ± 9.2 years. Of them, 41 (47.1%) had moderate depression, 34 (39.1%) had moderate anxiety, and 39 (44.8%) had moderate stress. There was a significant relationship between depression and job, education, and economic status of the participants. There was also a significant association between the participants’ economic status and anxiety. There was no significant relationship between stress and any of the variables.

Conclusion

Given the relatively high prevalence of anxiety, depression, and stress in MS patients as well as the significant relationship between their economic status and depression and anxiety, interventional measures are required to be taken to decrease their problems and to provide a favorable ground for their employment. Periodic examinations by psychologists / psychiatrists and treatment of patients with symptoms of stress, anxiety and depression are also essential.
How do education and experience with mental illness interact with causal beliefs, eligible treatments and stigmatising attitudes towards schizophrenia? A comparison between mental health professionals, psychology students, relatives and patients
Authors: Mannarini Stefania , Rossi Alessandro , Munari Cristina
Published: April 2020

Background

The main purpose of this study was to investigate the perception of schizophrenia in different categories of persons (directly and/or indirectly) involved with it. Hypotheses were made concerning the definition of a multi-class structure where each class should identify a profile characteristic of each respondent’s specific role, (e.g.: mental health professional, relative, patient, and student) and specific indicators of schizophrenia (e.g.: causal beliefs, eligible treatments, social distance, perceived dangerousness and public avoidance).

Methods

This study involved 577 participants all in contact with schizophrenia with different roles. A Latent Class Analysis (LCA) was applied to define a latent structure of schizophrenia aspects. Such structure was expected be affected by the interaction between respondents’ roles, as external variable, and schizophrenia indicators as manifest variables.

Results

A four-latent-class structure representing the four respondents’ roles was evidenced, further each class was characterized by schizophrenia indicators representing a profile for each role. Analogies and differences of views and preferences of the respondents’ roles concerning schizophrenia emerged clearly.

Conclusions

The four groups of people involved with schizophrenia with different roles demonstrated to interact significantly with specific indicators of schizophrenia shedding new lights on the understanding of schizophrenia in its complexity.
Factors affecting the quality of life of single mothers compared to married mothers
Authors: Kim Ga Eun , Kim Eui-Jung
Published: April 2020

Background

In this study, we aimed to compare the quality of life (QOL) of single mothers with that of married mothers and to identify the sociodemographic and psychological factors affecting single mothers’ QOL. We identified the factors that were similar and different between single and married mothers.

Methods

We analyzed survey data obtained from 195 single mothers and 357 married mothers living in an urban community in South Korea. The QOL was assessed with the World Health Organization Quality of Life-abbreviated form (WHOQOL-BREF). All participants completed the following self-report questionnaires: the Global Assessment of Recent Stress, the Center for Epidemiologic Studies-Depression Scale, the Scale for Suicide Ideation, the Korean version of the Alcohol Use Disorder Identification Test, and the WHOQOL-BREF. These self-rating scales were used as continuous variables. Multiple linear regression analysis was performed to examine the association of quality of life with the sociodemographic and psychological factors for single and married mothers.

Results

Single mothers showed lower QOL than married mothers. Older age, high income and education level, and professional job status were positively correlated with the QOL of single mothers. Residential instability, higher stress levels, depressive symptoms, suicidal ideation, and alcohol-related problems were negatively associated with the QOL of single mothers. Multiple regression analysis suggested that residential instability (public rental housing: β = − 10.779, p <  0.001; Jeonse rental housing: β = − 0.324, p = 0.01) and alcohol-related problems (β = − 0.522, p <  0.001) were independent factors affecting lower QOL, whereas professional job status (β = 8.452, p = 0.037) was independently associated with higher QOL in single mothers. However, these factors were not associated with the QOL of married mothers. Higher education level was independently associated with higher QOL in both groups (β = 3.149, p <  0.033 in single mothers, β = 12.052, p <  0.001 in married mothers).

Conclusions

Higher education level was associated with higher QOL in both groups. Unlike in married mothers, type of residence and occupation (related to the economic level) had a significant impact on QOL in single mothers. Alcohol-related problems were significantly correlated to QOL in single mothers compared to married mothers.
Rapid and temporary improvement of depression and anxiety observed following niraparib administration: a case report
Authors: Jewett Benjamin E. , Miller Merry N. , Ligon Libby A. , Carter Zachary , Mohammad Ibrahim , Ordway Gregory A.
Published: April 2020

Background

Cancer patients are disproportionately affected by generalized anxiety and major depression. For many, current treatments for these conditions are ineffective. In this case report, we present a serendipitous case of anxiety and depression improvement following administration of the poly (ADP-ribose) polymerase (PARP) inhibitor niraparib.

Case presentation

A 61-year old woman with a 20-year history of mild depression developed recurrent ovarian carcinoma and was placed on niraparib for maintenance chemotherapy. With the original onset of ovarian cancer, she experienced an episode of major depression that was resolved with sertraline. After recurrence of ovarian cancer, she experienced a recurrence of major depression and a new onset of generalized anxiety that failed to completely respond to multiple medications. After beginning niraparib therapy the patient noticed a rapid resolution of the symptoms of her anxiety and depression, an effect that was limited to 10–14 days. Due to bone marrow suppression, the patient was taken off and restarted on niraparib several times. Each discontinuation of niraparib resulted in return of her depression and anxiety, while each recontinuation of niraparib resulted in an improvement in her mood and anxiety.

Conclusions

This case demonstrates rapid and temporary improvement of anxiety and depression following niraparib administration. There is ample preclinical data that PARP signaling may play a role in psychiatric illness. A small amount of indirect data from clinical trials also shows that niraparib may have psychiatric benefits. Further research on PARP inhibition and its potential psychoactive effects is sorely needed.
The social determinants of otitis media in Aboriginal children in Australia: are we addressing the primary causes? A systematic content review
Authors: DeLacy Jack , Dune Tinashe , Macdonald John J.
Published: April 2020

Background

Aboriginal and Torres Strait Islander children experience some of the highest rates of otitis media in the world. Key risk factors for otitis media in Aboriginal children in Australia are largely social and environmental factors such as overcrowded housing, poverty and limited access to services. Despite this, little is known about how to address these risk factors. A scoping content review was performed to determine the relationship between social determinants of health and otitis media in Aboriginal and Torres Strait Islander children as described by peer-reviewed and grey literature.

Method

Search terms were established for location, population and health condition. The search terms were used to conduct a literature search using six health research databases. Following the exclusion process, articles were scoped, analysed and categorised using scoping parameters and a social determinants of health framework.

Results

Housing-related issues were the most frequently reported determinants for otitis media (56%). Two articles (4%) directly investigated the impact of social determinants of health on rates of otitis media within Aboriginal and Torres Strait Islander children. The majority of the literature (68%) highlights social determinants as playing a key role in the high rates of otitis media seen in Aboriginal populations in Australia. There were no intervention studies targeting social determinants as a means to reduce otitis media rates among Aboriginal and Torres Strait Islander children.

Conclusions

This review identifies a disconnect between otitis media drivers and the focus of public health interventions within Aboriginal and Torres Strait Islander populations. Despite consensus that social determinants play a key role in the high rates of otitis media in Aboriginal and Torres Strait Islander children, the majority of intervention studies within the literature are focussed on biomedical approaches such as research on vaccines and antibiotics. This review highlights the need for otitis media intervention studies to shift away from a purely biomedical model and toward investigating the underlying social determinants of health. By shifting interventions upstream, otitis media rates may decrease within Aboriginal and Torres Strait Islander children, as focus is shifted away from a treatment-focussed model and toward a more preventative model.
Mechanisms of change and participant outcomes in a Recovery Education Centre for individuals transitioning from homelessness: a qualitative evaluation
Authors: Reid Nadine , Khan Bushra , Soklaridis Sophie , Kozloff Nicole , Brown Rebecca , Stergiopoulos Vicky
Published: April 2020

Background

Recovery Education Centres (RECs) are increasingly implemented to support the process of recovery for individuals experiencing mental health challenges. However, the evidence on key REC mechanisms and outcomes, particularly for diverse subpopulations or service delivery contexts is scant. This study identified mechanisms and outcomes of an REC focused on adults with mental health challenges transitioning from homelessness.

Methods

Qualitative methods were used to explore in-depth the experiences of homeless and unstably housed participants experiencing mental health challenges in Toronto, Canada. Twenty service users participated in semi-structured interviews between July 2017 and June 2018, six to 14 months following REC enrollment. A realist informed interview guide explored participants’ perspectives on key REC mechanisms and outcomes. Interviews were audio-recorded, transcribed verbatim and analyzed using inductive thematic analysis. Investigator triangulation and member checking processes enhanced analytical rigour.

Results

Participants perceived that program participation supported the process of recovery through several mechanisms: a judgment-free environment; supportive relationships, mutuality and role modelling; deconstruction of self-stigma; and reclaiming of one’s power. Participants described several outcomes at the personal, interpersonal and social levels, including improvements in health and well-being; self-esteem, confidence and identity; sense of empowerment, control and personal responsibility; as well as improvements in interpersonal skills, pro-social behaviours and ability to self-advocate; and increased goal development and future orientation.

Conclusions

Findings suggest RECs can support the process of recovery among people transitioning from homelessness and can successfully support subpopulations experiencing mental health challenges and social disadvantage.
A partial mediation effect of father-child attachment and self-esteem between parental marital conflict and subsequent features of internet gaming disorder in children: a 12-month follow-up study
Authors: Jeong Hyunsuk , Yim Hyeon Woo , Lee Seung-Yup , Lee Hae Kook , Potenza Marc N. , Jo Sun-Jin , Son Hye Jung
Published: April 2020

Background

This study evaluated whether parent-child attachment and self-esteem may mediate the relationship between parental marital conflict and increases in features of internet gaming disorder (IGD) in children at 1 year.

Methods

The baseline and one-year follow-up data for 268 pre-teens aged between 9 and 10 from the Internet User Cohort for Unbiased Recognition of Gaming Disorder in Early Adolescence (iCURE) study were collected. The students were children at low risk for IGD in the initial self-reported assessment, anyone living with both parents, current game user at baseline, and those who completed a 12-month follow-up assessment. The Internet Game Use-Elicited Symptom Screen (IGUESS) was used to identify increases in IGD features at 12 months. To examine a potential mediation effect, structural equation modeling was performed.

Results

The direct effect was statistically significant, and parental marital conflict at baseline significantly predicted the increases in IGD features in children at the 12-month follow-up after adjusting for gender, sex, socioeconomic status, and baseline IGUESS score (ß = 0.206, P = 0.003). The indirect effect showed that attachment to fathers through self-esteem was a significant mediating effect (ß = 0.078, P = 0.045). Parental marital conflicts were associated with increases in IGD features in children through poor father-child attachment, and in turn, the lower levels of self-esteem in the children.

Conclusions

Parents, especially fathers, should make an effort to bond with their children to reduce the risk of their children’s developing the IGD features.
Prenatal care and uptake of HIV testing among pregnant women in Gambia: a cross-sectional study
Authors: Yaya Sanni , Oladimeji Olanrewaju , Oladimeji Kelechi Elizabeth , Bishwajit Ghose
Published: April 2020

Background

Improving the coverage of antenatal care is regarded as an important strategy to reduce the risks of maternal and child mortality in low income settings like Gambia. Nonetheless, a large number of countries in Africa, including Gambia, are struggling to attain an optimum level of healthcare utilization among pregnant women. The role of socioeconomic inequalities in maternal healthcare uptake has received little attention in Gambia. To address this evidence gap, the present study analyses nationally representative data to explore the socioeconomic inequalities in the use of maternal healthcare.

Methods

Data on women aged 15–49 years (n = 5351) were extracted from the latest round of Gambia Demographic and Health Survey in 2013 for this study. The outcome measures were early and adequate antenatal visit and HIV tests during the last pregnancy. Data were analyzed using descriptive and multivariate regression methods. Socioeconomic status was assessed through the women’s education, type of employment, and household wealth quintile.

Results

From the total of 5351 participants included in the study, 38.7 and 78.8% of the women had early and adequate ANC visits respectively with a 65.4% HIV test coverage during ANC visits. The odds of early [OR = 1.30, 95% confidence interval (CI) =1.06, 1.59] and adequate [OR = 1.45, 95%CI = 1.15, 1.82] ANC visits were higher in the rural areas compared with urban. Women with secondary [OR = 1.24, 95%CI = 1.04, 1.48] and higher education [OR = 1.80, 95%CI = 1.20, 2.70] had higher odds of making early ANC visits. Women from richest wealth quintile households had significantly higher odds of having early [OR = 1.49, 95%CI = 1.14, 1.95] and adequate ANC visits [OR = 2.06, 95%CI = 1.48, 2.87], but not of having HIV tests. Having access to electronic media showed a positive association with adequate ANC visits [OR = 1.32, 95%CI = 1.08, 1.62] and with taking HIV test during ANC [OR = 1.48, 95%CI = 1.21, 1.80]. A fewer odds of having unintended child was associated with early ANC visit [OR = 0.70, 95%CI = 0.59, 0.84], but positively associated with taking HIV test [OR = 1.75, 95%CI = 1.42, 2.15].

Conclusion

A large proportion of women in Gambia were not using antenatal care and HIV tests during pregnancy. There are important sociodemographic differences in using maternal healthcare services such as HIV testing during pregnancy. This calls for strategic direction to promote the utilization of these services.
Feasibility of an HIV self-testing intervention: a formative qualitative study among individuals, community leaders, and HIV testing experts in northern Tanzania
Authors: Njau Bernard , Lisasi Esther , Damian Damian J. , Mushi Declare L. , Boulle Andrew , Mathews Catherine
Published: April 2020

Background

Achieving the 95–95-95 global targets by 2030, innovative HIV testing models, such as HIV self-testing are needed for people, who are unaware of their HIV status. We aimed to explore key informants, mountain climbing porters, and female bar workers’ attitudes, perceived norms, and personal agency related to HIV self-testing.

Methods

This was a formative qualitative study to inform the design of an HIV self-testing intervention in Northern Tanzania. Informed by the Integrated Behaviour Model, we conducted four focus group discussions, and 18 in-depth interviews with purposively selected participants. Data were analyzed using the framework method.

Results

We recruited 55 participants. Most participants had positive attitudes towards HIVST, in that they anticipated positive consequences related to the introduction and uptake of HIVST. These included privacy and convenience, avoidance of long queues at health facilities, reduced counselor workload, and reduced indirect costs (given that transport to health facilities might not be required). Participants expressed the belief that significant people in their social environment, such as parents and peers, would approve their uptake of HIVST, and that they would accept HIVST. Additionally, features of HIVST that might facilitate its uptake were that it could be performed in private and would obviate visits to health facilities. Most participants were confident in their capacity to use HIVST kits, while a few were less confident about self-testing while alone. Strategies to maximize beliefs about personal agency and facilitate uptake included supplying the self-test kits in a way that was easy to access, and advocacy. Perceived potential constraints to the uptake of HIVST were the cost of buying the self-test kits, poverty, illiteracy, poor eyesight, fear of knowing one’s HIV status, lack of policy/ guidelines for HIVST, and the absence of strategies for linkage to HIV care, treatment, and support.

Conclusions

The findings suggest that HIVST may be feasible to implement in this study setting, with the majority of participants reporting positive attitudes, supportive perceived norms, and self-efficacy. Hence, future HIVST interventions should address the negative beliefs, and perceived barriers towards HIVST to increase HIV testing among the target population in Northern Tanzania.
Determinants of diabetic retinopathy in Southwest Ethiopia: a facility-based case-control study
Authors: Garoma Dugasa , Merga Hailu , Hiko Desta
Published: April 2020

Background

Diabetic Retinopathy is one of the serious complications patients’ diabetic patients suffer from. Little is known about which risk factors are associated with this complication. The aim of this study was therefore to identify determinants of Diabetic Retinopathy in Jimma University Medical Center.

Methods

A facility-based case-control study was conducted. Cases were Diabetic patients with diabetic retinopathy and who were on follow up at the Jimma University Medical Center while controls were Diabetic patients but free of diabetic retinopathy and who were on follow up at the Jimma University Medical Center. Cases and controls were identified and 311 of them were recruited using systematic random sampling. Data were entered into the Epi-Data version 4.1 and analyzed using SPSS Version 20. Binary Logistic regression analysis was conducted to identify determinants of diabetic retinopathy.

Result

A total of 106 cases and 205 controls diabetic participated in the study. Being ≥60 years of age (AOR = 5.04,95%CI: 1.83,13.87),being illiterate (AOR = 7.17, 95% CI: 2.61,19.7), poor adherence to medication (AOR =3: 95% CI: 1.29,6.95),having high systolic blood pressure (AOR = 3.38:95% CI: 1.26,9.05), having family history of Diabetes Mellitus (AOR = 3.95: 95% CI: 1.64,9.54), having other micro vascular complications (AOR = 3.76,95% CI: 1.33,10.66), poor glycemic control (AOR = 9.08, 95%CI: 3.7,22.29), poor cholesterol control (AOR = 0.21, 95%CI: 0.08,0.51) and being anaemic (AOR = 2.8, 95%CI: 1.05,7.47) were the independent determinants of diabetic retinopathy.

Conclusion

This study found that poor adherence to medication, being at the age of 60 years and above, being illiterate patients, having high systolic blood pressure, having a family history of Diabetes Mellitus, having other micro vascular complication, poor glycemic control, poor cholesterol control and being anemic patient were the independent determinants of diabetic retinopathy. Therefore, more attention should be given to older age and illiterate patients. Giving more emphasis for patients poorly adhered to anti-diabetic medications and giving advice for diabetic patients with high systolic blood pressure to follow their blood pressure regularly are also vital. Diabetic patients should also control their Blood sugar and blood cholesterol levels to prevent diabetic retinopathy or reduce its further complications.
Depressed mood, suicidal behaviors, and health risk behaviors among youths in the Commonwealth of the Northern Mariana Islands: the 2017 CNMI Youth Risk Behavior Survey
Authors: Sakamoto Jennifer Lisa , Shibanuma Akira , Jimba Masamine
Published: April 2020

Background

The current study investigated the prevalence of depressed mood, suicide ideation, suicide plan, and suicide attempt and their associations with health risk behaviors among high school adolescents in the Commonwealth of the Northern Mariana Islands (CNMI).

Methods

This is a cross-sectional study analyzing self-reported data from the 2017 CNMI Youth Risk Behavior Survey (n = 1943). Modified Poisson regression models were used to identify the associations between 17 health risk behavior variables, including violence-related behaviors, substance use behaviors, sexual behaviors, and early risk-taking behaviors, and four variables related to depressed mood and suicidal behaviors.

Results

40.7% adolescents reported being depressed, 25.0% reported suicide ideation, 22.8% reported formulating a suicide plan, and 13.6% attempted suicide. Female adolescents were more likely to report depressed mood and all included suicidal behaviors (p < 0.001). Being in a physical fight and forced sexual intercourse were associated with depressed mood, suicide ideation, suicide plan, and suicide attempt for both female and male adolescents. Use of “soft drugs” such as current smoking was associated with depressed mood (ARR = 2.33, 95% CI = 1.56–3.45, p < 0.001), suicide ideation (ARR = 1.23, 95% CI = 1.08–1.43, p < 0.001), suicide plan (ARR = 1.19; 95% CI = 1.05–1.35; p < 0.001), and suicide attempt (ARR = 1.18; 95% CI = 1.06–1.30; p < 0.001) for females, whereas use of “hard drugs” such as heroin was associated with depressed mood (ARR = 2.27, 95% CI = 1.37–3.85, p < 0.01), suicide ideation (ARR = 1.30, 95% CI = 1.01–1.67, p < 0.05), suicide plan (ARR = 1.82; 95% CI = 1.22–2.70; p < 0.01), and suicide attempt (ARR = 2.78; 95% CI = 1.47–5.26; p < 0.01) for male adolescents.

Conclusion

The prevalence of depressed mood, suicide ideation, suicide plan, and suicide attempt among CNMI adolescents was high, especially in female adolescents. While there were gender differences, many of the health risk behaviors were associated with depressed mood and suicidal behaviors. As sociodemographic factors are difficult to change, modifiable factors should be targeted to improve the mental health of adolescents.
Knowledge, attitudes and practices regarding echinococcosis in Xizang Autonomous Region, China
Authors: Qucuo Nima , Wu Guangjian , He Ruifeng , Quzhen Danzeng , Zhuoga Ciren , Deji Suolang , Zhang Lijie , Zhao Zhigang , Du Zhongjun
Published: April 2020

Background

Echinococcosis is a neglected zoonotic parasitic disease caused echinococcus parasitizes, poseing a significant economic burden on both humans and animals. There are limited studies on echinococcosis in China, especially Xizang Autonomous Region, although the area is endemic area for echinococcosis. The study aimed to provide information for strategic prevention against this disease.

Methods

A cross-sectional survey was conducted among the residents in Xizang Autonomous Region, China to evaluate their knowledge, attitudes and practices on endemicity of echinococcosis. A face-to-face survey was conducted to collect the data using a well-designed questionnaire. The contents included basic personal information, knowledge, attitudes and practices about echinococcosis, personal hygiene and behavior habits, dog feeding and whether they had received the information on echinococcosis, and so on. We surveyed 840 persons in practice. All data analysis was performed using Epi Info 7.2.

Results

Of the total particpants, 86.8% had a primary education level or below (including primary and illiterate), and even 45.0% were illiterate. Farmers and herdsmen represent the main occupations in this study. People who know all the echinococcosis-related knowledge in the questionnaire only accounted for 8.7% of the participants. However, none of the participants was aware of routes of echinococcosis infection in human or dogs. The data showed participants with higher educational background had the high awareness rate of echinococcosis-related knowledge or attitudes (chi-square for trend, χ2 = 21.23, p<0.05 & χ2 = 48.43, p<0.05). In addition, The percentage of the participant with awareness of echinococcosis-related practices was associated with their age and principle occupation (χ2 = 52.72, p<0.05 & χ2 = 20.63, p<0.05).

Conclusions

Xizang Autonomous Region is an epidemic area of Echinococcosis. The prevalence of the disease has been largely due to the lack of knowledge, awareness, and poor hygiene practice in local residences. Therefore, effective disease prevention education and awareness campaigns in community will be significantly helpful in prevention and control of echinococcosis.
Potential value of serum Aspergillus IgG antibody detection in the diagnosis of invasive and chronic pulmonary aspergillosis in non-agranulocytic patients
Authors: Yu Qihong , He Jingdong , Xing Bin , Li Xin , Qian Hongyu , Zhang Hong , Xu Meilin , Peng Haiying
Published: April 2020

Background

At present, serum Aspergillus IgG and IgM antibody detection is mainly used in the diagnosis of chronic pulmonary aspergillosis (CPA), but its value in the diagnosis of invasive pulmonary aspergillosis (IPA) in non-agranulocytic patients is still unclear. IgM can be used as a marker of acute infection to help diagnose acute infection-related diseases. IgG is a marker of long-term infection and is used to assist in the diagnosis of pre-existing or chronic infection-related diseases. The aim of this study was to investigate and compare the value of serum Aspergillus IgG and IgM antibody detection in the diagnosis of IPA and CPA in non-agranulocytic patients.

Methods

Fifty-eight cases of pulmonary aspergillosis (37 IPA and 21 CPA cases), 15 cases of community-acquired bacterial pneumonia and 50 cases in the healthy control group were collected. The serum (1,3)-β-D-glucan test (G test) was performed with a chromogenic method, and the galactomannan test (GM test) and Aspergillus IgG and IgM antibody detection were performed by commercial enzyme-linked immunosorbent assay (ELISA) in all patients. The sensitivity and specificity, cut-off value and area under the curve (AUC) of Aspergillus IgG and IgM antibodies were further obtained by receiver operating characteristic (ROC) curves.

Results

The positive rate of the G test, Aspergillus IgG antibody detection and the GM test also showed notable differences among the IPA, CPA, community-acquired bacterial pneumonia and healthy groups (P = 0.006, P <  0.001 and P = 0.217, respectively). Only the positive rate of the GM test showed a significant difference between the IPA and CPA groups (P = 0.04). ROC curves indicated that Aspergillus IgG antibody detection had a higher specificity in the IPA group than in the CPA group (0.952). The detection of Aspergillus IgG antibody can preferably distinguish IPA from community-acquired bacterial pneumonia and healthy controls (sensitivity = 0.923, specificity = 0.459, cut-off value = 134.46, AUC = 0.727). It can also distinguish CPA from community-acquired bacterial pneumonia and healthy controls (sensitivity = 0.952, specificity = 0.692, cut-off value = 75.46, AUC = 0.873).

Conclusions

Serum Aspergillus IgG antibody detection may have certain clinical value in the diagnosis of IPA and CPA in non-agranulocytic patients.
Cough in hypereosinophilic syndrome: case report and literature review
Authors: Xie Jiaxing , Zhang Jianheng , Zhang Xiaoxian , Zhang Qingling , Chung Kian Fan , Wang Chunyan , Lai Kefang
Published: April 2020

Background

Cough and airway eosinophilic inflammation has not been highlighted in hypereosinophilic syndrome (HES).

Case presentation

We report 2 further cases and reviewed the clinical features and treatment of HES present with cough from the literature. Both cases were middle age male, presenting with chronic cough, airway eosinophilic inflammation and hyper eosinophilia who have been previous misdiagnosed as cough-variant asthma and failed anti-asthma treatment. PDGFRA fusion gene was confirmed in one case, but not in the other case. Both had evidence of myeloproliferative features. The tyrosine kinase inhibitor, imatinib, resulted in complete resolution of eosinophilia and cough. By searching PubMed, we found 8 HES cohorts of 411 cases between 1975 and 2013, where the incidence of cough was 23.11%. Sixteen case reports of HES presented with cough as predominant or sole symptom, with nine male patients with positive PDGFRA fusion gene, who responded well to imatinib. Six of seven patients, who tested negative for the PDGFRA, responded to systemic glucocorticoids.

Conclusions

Cough and airway eosinophilic inflammation is common in some HES patients. PDGFRA+ HES patients present with chronic cough respond well to imatinib. Our case reports indicate that PDGFRA negative HES patients may respond to imatinib as well.
Relevance of suspicious lymph nodes in preoperative imaging for resectability, recurrence and survival of intrahepatic cholangiocarcinoma
Authors: Bartsch Fabian , Hahn Felix , Müller Lukas , Baumgart Janine , Hoppe-Lotichius Maria , Kloeckner Roman , Lang Hauke
Published: April 2020

Background

Intrahepatic cholangiocarcinoma (ICC) is often diagnosed at an advanced stage resulting in a low resectability rate. Even after potentially curative resection the risk for tumor recurrence is high. Although the extent and value of lymphadenectomy is part of ongoing discussion, the role of preoperative imaging for assessment of suspicious lymph nodes (suspLN) has only been studied modestly. Aim of this study is to demonstrate the influence of suspicious lymph nodes in preoperative imaging on resectability, recurrence, and long-term outcome.

Methods

All patients who underwent exploration for ICC between January 2008 and June 2018 were included. Preoperative imaging (CT or MRI) was analysed with focus on suspLN at the hepatoduodenal ligament, lesser curvature, interaortocaval, and superior to the diaphragm; suspLN were classified according to the universally accepted RECIST 1.1 criteria; histopathology served as gold standard.

Results

Out of 187 patients resection was performed in 137 (73.3%), in 50 patients the procedure was terminated after exploration. Overall, suspLN were found preoperatively in 73/187 patients (39%). Comparing patients who underwent resection and exploration only, suspLN were significantly more common in the exploration group (p = 0.011). Regarding lymph node stations, significant differences could be shown regarding resectability: All tumors with suspLN superior to the diaphragm were irresectable. Preoperative imaging assessment showed a strong correlation with final histopathology, especially of suspLN of the hepatoduodenal ligament and the lesser curvature. Sensitivity of suspLN was 71.1%, specificity 90.8%. Appearance of tumor recurrence was not affected by suspLN (p = 0.289). Using a short-axis cut-off of <> 1 cm, suspLN had significant influence on recurrence-free survival (RFS, p = 0.009) with consecutive 1-, 3-, and 5-year RFS of 41, 21, and 15% versus 29, 0, and 0%, respectively. Similarly, 1-, 3- and 5-year overall survival (OS) was 75, 30, and 18% versus 59, 18, and 6%, respectively (p = 0.040).

Conclusion

Suspicious lymph nodes in preoperative imaging are predictor for unresectability and worse survival. Explorative laparoscopy should be considered, if distant suspicious lymph nodes are detected in preoperative imaging. Nevertheless, given a sensitivity of only 71.1%, detection of suspicious lymph nodes in the preoperative imaging alone is not sufficient to allow for a clear-cut decision against a surgical approach.
Hypoalbuminemia after pancreaticoduodenectomy does not predict or affect short-term postoperative prognosis
Authors: Xu Wei , Peng Xiangqun , Jiang Bo
Published: April 2020

Background

Hypoalbuminemia (HA) is a risk factor for the complications following pancreaticoduodenectomy (PD). This study aimed to explore the factors that affect HA following PD and evaluate the influence of HA on the short-term postoperative prognosis.

Methods: Total 163 patients who underwent PD and met inclusion criteria were subdivided into two groups according to the status of HA. The relationships of postoperative albumin (ALB) level and exogenous ALB infusion with postoperative responses and complications were assessed by correlation analysis.

Results

Preoperative ALB ≥35.0 g/L and postoperative complication grade were factors influencing HA after PD. Correlation analysis demonstrated significant negative correlation of postoperative ALB level with white blood cell (WBC) count and neutrophil count. Postoperative exogenous ALB infusion positively correlated with blood urea nitrogen, creatinine, complication grade, postoperative intraperitoneal hemorrhage and pancreatic fistula. No significant differences were observed between the complications and30-day mortality rates with and without postoperative HA.

Conclusions

HA after PD should not be considered as an indicator but rather a result of poor prognosis. WBCs, especially neutrophils, are involved in reducing postoperative ALB level. Infusion of exogenous ALB to maintain ALB > 30 g/L could not improve clinical outcomes.
Investigation of cardiovascular protective effect of Shenmai injection by network pharmacology and pharmacological evaluation
Authors: Li Lin , Yang Dongli , Li Jinghao , Niu Lu , Chen Ye , Zhao Xin , Oduro Patrick Kwabena , Wei Chun , Xu Zongpei , Wang Qilong , Li Yuhong
Published: April 2020

Background

Shenmai injection (SMI) has been used in the treatment of cardiovascular disease (CVD), such as heart failure, myocardial ischemia and coronary heart disease. It has been found to have efficacy on doxorubicin (DOX)-induced cardiomyopathy. The aims of this study were to explore the underlying molecular mechanisms of SMI treatment on CVD by using network pharmacology and its protective effect on DOX-induced cardiotoxicity by in vitro and in vivo experiment based on network pharmacology prediction.

Methods

Network pharmacology method was used to reveal the relationship between ingredient-target-disease and function-pathway of SMI on the treatment of CVD. Chemical ingredients of SMI were collected form TCMSP, BATMAN-TCM and HIT Database. Drugbank, DisGeNET and OMIM Database were used to obtain potential targets for CVD. Networks were visualized utilizing Cytoscape software, and the enrichment analysis was performed using IPA system. Finally, cardioprotective effects and predictive mechanism confirmation of SMI were investigated in H9c2 rat cardiomyocytes and DOX-injured C57BL/6 mice.

Results

An ingredient-target-disease & function-pathway network demonstrated that 28 ingredients derived from SMI modulated 132 common targets shared by SMI and CVD. The analysis of diseases & functions, top pathways and upstream regulators indicated that the cardioprotective effects of SMI might be associated with 28 potential ingredients, which regulated the 132 targets in cardiovascular disease through regulation of G protein-coupled receptor signaling. In DOX-injured H9c2 cardiomyocytes, SMI increased cardiomyocytes viability, prevented cell apoptosis and increased PI3K and p-Akt expression. This protective effect was markedly weakened by PI3K inhibitor LY294002. In DOX-treated mice, SMI treatment improved cardiac function, including enhancement of ejection fraction and fractional shortening.

Conclusions

Collectively, the protective effects of SMI on DOX-induced cardiotoxicity are possibly related to the activation of the PI3K/Akt pathway, as the downstream of G protein-coupled receptor signaling pathway.
Protective effect of total flavonoids from Ixeris Sonchifolia on herpes simplex virus keratitis in mice
Authors: Wang Yong-Qiang , Cai Li , Zhang Nan , Zhang Jing , Wang Hai-Hong , Zhu Wei
Published: April 2020

Background

To investigate the protective effect ofIxeris Sonchifolia(Bae.) Hance (ISH) extract on herpes simplex virus keratitis (HSK) in mice.

Methods

A mouse model of HSK was established by inoculating 60 mice (60 right eyes) with herpes simplex virus type 1 (HSV-1) by corneal scratch. The other 15 mice as blank control only received corneal scratch but without HSV-1. From the 2nd day after the successful modeling, the experimental group was fed with ISH total flavonoids (50, 100 and 200 mg/kg) orally, twice a day for 14 days. The model group and control group were given the same amount of normal saline. The pathological changes of cornea were observed once a day by slit lamp microscopy combined with fluorescein staining. The corneal histopathological examination, the survival status and the serum levels of interleukin-2 (IL-2), IL-4 and interferon-gama (INF-γ) were performed at the end of the experiment.

Results

The result showed that ISH could significantly improve the corneal lesion degree, increase mice survival rate, and markedly increase the levels of IL-2 and INF-γ, reduce the levels of IL-4 in serum of mice.

Conclusions

ISH could increase the anti-virus ability, promote the healing of corneal inflammation and alleviate the pathological damage of cornea, which suggested that ISH has a potential and valuable therapeutic effect on the HSK.
Patient perspectives of bedside teaching in an obstetrics, Gynaecology and neonatology hospital
Authors: Carty Michelle , O’Riordan Nicola , Ivers Mary , Higgins Mary F.
Published: April 2020

Background

Osler taught doctors to “have no teaching without a patient for a text, and the best teaching is that taught by the patient himself”. Bedside teaching (BST) facilitates clinical practice of skills, teaches empathy, instils confidence and builds on patient-doctor relationships. However, its use has declined dramatically due to concerns regarding privacy and autonomy. Most of the research in this area concentrates on medical student or academic opinion of BST using survey based methods. This qualitative study aimed to explore the patient’s experiences and opinions of BST.

Methods

With ethical approval a qualitative study was conducted using semi-structured interviews which were examined using Thematic Analysis. Patients who had participated in a BST tutorial were invited to participate and gave written consent after discussion with a study researcher.

Results

Twenty-two patients were interviewed (obstetrics ante-natal [n = 10], obstetrics post-natal [n = 5] and gynaecology [n = 7]) ranging from ages 24-80 yrs. Four major themes were identified, with 11 sub-themes. The major themes included (i) Professional Mannerisms (ii) Privacy and Personal Wellbeing (iii) Quality of Patient Experience of BST and (iv) Clinical Experience and Learning Importance. The reaction of patients toward teaching at the bedside was altruistic and positive, with importance placed on learning.

Conclusion

This research supports the concept of patient focused learning, and can reassure faculty that patients largely support its continuation as an integral component in education. Future research aims to extend this assessment to other patient groups with the aim of learning from and improving their experience.