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Open Research Europe 2021: In sub-Saharan Africa, the burden of non-communicable diseases is steadily rising amidst a high prevalence of communicable diseases stretching the healthcare system....
: In sub-Saharan Africa, the burden of non-communicable diseases is steadily rising amidst a high prevalence of communicable diseases stretching the healthcare system. This study explored hypertension and diabetes patients' perspective of challenges and their coping mechanisms in Mukono and Buikwe districts in Uganda. : This descriptive qualitative study involved four focus group discussions with 26 patients at four selected health facilities. All interviews were audio recorded, transcribed verbatim and data analysed following the thematic content analysis guided by the semantic approach with the aid of Atlas ti 6.0.15 software. : Five themes were identified regarding challenges and coping mechanisms of patients in managing their conditions. 1) Inadequate opportunities for diagnosis, with community screening supporting identification of patients. 2) Accessing care came amidst transport challenges, absence of health workers and the lack of essential supplies for monitoring conditions. Patients borrowed transport funds or trekked to health facilities and some formed groups to contribute resources to buy equipment and supplies. 3) Access to medications was affected by frequent drug stockouts at public health facilities which pushed patients to purchase own drugs or obtain these through friends and networks. However, other patients resorted to cheaper herbal remedies. 4) Monitoring and managing conditions was affected by insufficient knowledge and opportunities for self-monitoring. Information from health workers and experiences from peers bridged the knowledge gap while private facilities or community health workers supported self-monitoring. 5) Adopting changes in behaviour was challenging but patients fitted these within their usual routines and mobilised family members to also adopt lifestyle changes while ignoring those they deemed unrealistic. : The coping mechanisms patients adopted to manage their chronic conditions reflects self-care initiatives at the individual and community levels which could be reinforced and supplemented to better support and empower patients as steps are taken to address existing challenges.
PubMed: 38304422
DOI: 10.12688/openreseurope.13286.2 -
JMIR MHealth and UHealth Nov 2023Many adults use e-cigarettes to help them quit cigarette smoking. However, the impact of self-selected use of e-cigarettes on cigarette smoking cessation, particularly... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Many adults use e-cigarettes to help them quit cigarette smoking. However, the impact of self-selected use of e-cigarettes on cigarette smoking cessation, particularly when concurrently receiving app-based behavioral interventions, remains unexplored.
OBJECTIVE
This study used data from a randomized trial of 2 smartphone apps to compare 12-month cigarette smoking cessation rates between participants who used e-cigarettes on their own (ie, adopters: n=465) versus those who did not (ie, nonadopters: n=1097).
METHODS
The study population included all participants who did not use e-cigarettes at baseline. "Adopters" were those who self-reported the use of e-cigarettes at either 3- or 6-month follow-ups. "Nonadopters" were those who self-reported no use of e-cigarettes at either follow-up time point. The primary cessation outcome was self-reported, complete-case, 30-day point prevalence abstinence from cigarette smoking at 12 months. Secondary outcomes were missing-as-smoking and multiple imputation analyses of the primary outcome, prolonged abstinence, and cessation of all nicotine and tobacco products at 12 months. In logistic regression models, we first examined the potential interaction between e-cigarette use and treatment arm (iCanQuit vs QuitGuide) on the primary cessation outcome. Subsequently, we compared 12-month cigarette smoking cessation rates between adopters and nonadopters separately for each app.
RESULTS
There was suggestive evidence for an interaction between e-cigarette use and treatment arm on cessation (P=.05). In the iCanQuit arm, 12-month cigarette smoking cessation rates were significantly lower among e-cigarette adopters compared with nonadopters (41/193, 21.2% vs 184/527, 34.9%; P=.003; odds ratio 0.55, 95% CI 0.37-0.81). In contrast, in the QuitGuide arm, 12-month cigarette smoking cessation rates did not differ between adopters and nonadopters (46/246, 18.7% vs 104/522, 19.9%; P=.64; odds ratio 0.91, 95% CI 0.62-1.35).
CONCLUSIONS
The use of e-cigarettes while concurrently receiving an app-based smoking cessation intervention was associated with either a lower or an unimproved likelihood of quitting cigarette smoking compared to no use. Future behavioral treatments for cigarette smoking cessation should consider including information on the potential consequences of e-cigarette use.
TRIAL REGISTRATION
ClinicalTrials.gov NCT02724462; https://clinicaltrials.gov/study/NCT02724462.
Topics: Adult; Humans; Electronic Nicotine Delivery Systems; Smoking Cessation; Behavior Therapy; Logistic Models; Tobacco Products
PubMed: 37943594
DOI: 10.2196/48896 -
Current Opinion in Structural Biology Aug 2023Recently, prediction of structural/functional motifs in protein sequences takes advantage of powerful machine learning based approaches. Protein encoding adopts protein... (Review)
Review
Recently, prediction of structural/functional motifs in protein sequences takes advantage of powerful machine learning based approaches. Protein encoding adopts protein language models overpassing standard procedures. Different combinations of machine learning and encoding schemas are available for predicting different structural/functional motifs. Particularly interesting is the adoption of protein language models to encode proteins in addition to evolution information and physicochemical parameters. A thorough analysis of recent predictors developed for annotating transmembrane regions, sorting signals, lipidation and phosphorylation sites allows to investigate the state-of-the-art focusing on the relevance of protein language models for the different tasks. This highlights that more experimental data are necessary to exploit available powerful machine learning methods.
Topics: Deep Learning; Amino Acid Sequence; Proteins; Machine Learning
PubMed: 37385080
DOI: 10.1016/j.sbi.2023.102641 -
Frontiers in Health Services 2023The importance of advance care planning (ACP) has been highlighted by the advent of life-threatening COVID-19. Anecdotal evidence suggests changes in implementation of... (Review)
Review
BACKGROUND
The importance of advance care planning (ACP) has been highlighted by the advent of life-threatening COVID-19. Anecdotal evidence suggests changes in implementation of policies and procedures is needed to support uptake of ACPs. We investigated the barriers and enablers of ACP in the COVID-19 context and identify recommendations to facilitate ACP, to inform future policy and practice.
METHODS
We adopted the WHO recommendation of using rapid reviews for the production of actionable evidence for this study. We searched PUBMED from January 2020 to April 2021. All study designs including commentaries were included that focused on ACPs during COVID-19. Preprints/unpublished papers and Non-English language articles were excluded. Titles and abstracts were screened, full-texts were reviewed, and discrepancies resolved by discussion until consensus.
RESULTS
From amongst 343 papers screened, 123 underwent full-text review. In total, 74 papers were included, comprising commentaries (39) and primary research studies covering cohorts, reviews, case studies, and cross-sectional designs (35). The various study types and settings such as hospitals, outpatient services, aged care and community indicated widespread interest in accelerating ACP documentation to facilitate management decisions and care which is unwanted/not aligned with goals. Enablers of ACP included targeted public awareness, availability of telehealth, easy access to online tools and adopting person-centered approach, respectful of patient autonomy and values. The emerging barriers were uncertainty regarding clinical outcomes, cultural and communication difficulties, barriers associated with legal and ethical considerations, infection control restrictions, lack of time, and limited resources and support systems.
CONCLUSION
The pandemic has provided opportunities for rapid implementation of ACP in creative ways to circumvent social distancing restrictions and high demand for health services. This review suggests the pandemic has provided some impetus to drive adaptable ACP conversations at individual, local, and international levels, affording an opportunity for longer term improvements in ACP practice and patient care. The enablers of ACP and the accelerated adoption evident here will hopefully continue to be part of everyday practice, with or without the pandemic.
PubMed: 37780404
DOI: 10.3389/frhs.2023.1242413 -
BMJ Open Nov 2023The objective of this study is to characterise the self-reported first contact with the health system and the reasons stated for each choice, testing associations with...
OBJECTIVE
The objective of this study is to characterise the self-reported first contact with the health system and the reasons stated for each choice, testing associations with population characteristics.
DESIGN
Cross-sectional survey.
SETTING
Primary care department of a local health unit in northern Portugal.
PARTICIPANTS
Random sample of 4286 persons, retrieved from all registered adults.
OUTCOMES
Participants who stated they usually see the same doctor when a health problem arises were considered to adopt first-contact care and were asked to identify their regular doctor. Participants were asked why they adopt first-contact care or why they choose to do otherwise. Associations between personal characteristics and the adoption of first-contact care were tested using logistic regression.
RESULTS
There were 808 valid questionnaires received (19% response rate). The mean age of respondents was 53 years, 58% were women and 60% had a high school or higher degree. Most (71%) stated always seeing the same doctor when facing a health problem. This was a general practitioner (GP) in 84%. The main reasons were previous knowledge and trust in the doctor. When this doctor was not a GP, the main reason was the need to obtain an appointment quickly. Participants who chose first-contact care were less likely to have university degrees than those who did not (OR 0.31; 95% CI 0.13 to 0.76). Being registered with the same GP for over 1 year increased the odds of adopting first-contact care: twice as likely for those registered for 1-4 years with the same GP (2.07; 95% CI 1.04 to 4.11), and three times more likely for those registered for over 10 years (3.21; 95% CI 1.70 to 6.08).
CONCLUSIONS
The high adoption of first-contact care and the reasons given for this suggest a strong belief in primary care in this population. The longer patients experience continuity, the more they adopt first-contact care. The preferences of higher-educated patients regarding first-contact care deserve reflection.
Topics: Adult; Humans; Female; Middle Aged; Male; Cross-Sectional Studies; Portugal; Surveys and Questionnaires; General Practitioners; Self Report
PubMed: 37945304
DOI: 10.1136/bmjopen-2023-076849 -
Journal of Telemedicine and Telecare Oct 2023This study investigates factors related to long-term and short-term adoption of video consultations (VCs) and reasons for discontinuing use among primary care patients.
INTRODUCTION
This study investigates factors related to long-term and short-term adoption of video consultations (VCs) and reasons for discontinuing use among primary care patients.
METHODS
A sample of primary care patients using VCs with healthcare providers were invited to take a survey in a cross-sectional study. Participants were asked about their intention to continue to have video consultations in the future, and those indicating no intention to use VCs in the future (short-term adopters) were asked about their reasons for this. Prevalence and statistical differences between long-term and short-term adopters were investigated.
RESULTS
There were several statistically significant differences between long-term and short-term adopters (76% vs. 24%). Long-term adopters consisted of more middle-aged individuals (35-54 years) and the majority worked full-time (56%). They had more positive opinions of VCs and used VCs and video meetings for other purposes to a larger extent. They chose VCs because of the lack of time to go to the healthcare centre and because their provider offered them. The most common reason for discontinuing use was a preference for face-to-face consultations, with the youngest age group (16-34 years) reporting this to a larger extent.
DISCUSSION
Younger and older age groups may be less likely to continue the use of VCs, potentially preserving the digital divide. Additionally, disparities in using similar technologies might contribute to the digital divide. Moreover, convenience, positive opinions of VCs, and experience with VCs were related to long-term adoption. Further studies are needed to explore non-use, age's influence, and address usability issues.
PubMed: 37787186
DOI: 10.1177/1357633X231203267 -
Journal of Infection and Public Health Aug 2023The Hong Kong government distributed rapid antigen test (RAT) kits to households across the city and called for a universal voluntary testing exercise for three...
BACKGROUND
The Hong Kong government distributed rapid antigen test (RAT) kits to households across the city and called for a universal voluntary testing exercise for three consecutive days during the Omicron wave to identify infected persons early for quarantine and disrupt transmission chains in the community. We conducted a survey to evaluate the participation rates and explore the determinants of voluntary RAT adoption and hesitancy.
METHODS
This cross-sectional survey was conducted through computer-assisted telephone interviews from 19 May to 16 June 2022 using an overlapping dual-frame telephone number sampling design. Information on willingness to adopt voluntary RAT, four themes of personal qualities, attitudes toward the government's health policies, incentives to motivate RAT adoption, and personal sociodemographic factors were collected. Logistic regression analysis was used to examine the factors associated with RAT adoption.
RESULTS
Of the 1010 participants, 490 successfully responded to the fixed-line and 520 to the mobile phone survey, with response rates of 1.42% and 1.63% and screen hesitancy rates of 36.1% and 39.3%, respectively. Participants of adoption RAT were those aged 30-49 years, with high perceived COVID-19 infection severity, ≥ 3 doses of COVID-19 vaccination, and more agreement with the health policies on material resources and quarantine orders. Individuals who were less risk seeking and more altruistic reported a higher adoption of voluntary RAT.
CONCLUSIONS
Understanding the willingness to participate in a voluntary universal testing programme might shed light on effective ways to minimise screening hesitancy in future public health strategies and campaigns.
Topics: Humans; COVID-19; COVID-19 Vaccines; Cross-Sectional Studies; Hong Kong; Cell Phone; Vaccination
PubMed: 37336128
DOI: 10.1016/j.jiph.2023.06.006 -
Journal of Agriculture and Food Research Dec 2023Improved agricultural technologies are promoted as cost-effective and sustainable ways of improving rural households' food security and reducing poverty in developing...
Improved agricultural technologies are promoted as cost-effective and sustainable ways of improving rural households' food security and reducing poverty in developing countries. This study evaluates the relationship between improved groundnut varieties (IGVs) and household food security using detailed household and plot level data from a sample of over 1300 farm households in Northern Nigeria. Endogenous switching regression models are employed to control for potential endogeneity biases. Results show that about 30 % of groundnut plots are planted with improved varieties, and the adoption of IGVs significantly increases the likelihood of household per capita groundnut consumption by about 13 % and reduces the probability of households' vulnerability to food (access) insecurity by 22 %. Counterfactual analyses show that non-adopting households could have enjoyed comparable benefits had they adopted IGVs. These results suggest that development interventions aimed at improving the diffusion and impacts of IGVs in Nigeria need to target farmers' access to information about the technologies while developing groundnut seed systems to make quality seeds readily available to smallholder farmers at affordable prices.
PubMed: 38156042
DOI: 10.1016/j.jafr.2023.100817 -
Polyethylene glycol-based isolation of urinary extracellular vesicles, an easily adoptable protocol.MethodsX Dec 2023Urine is a highly advantageous biological specimen for biomarker research and is a non-invasive source. Most of the urinary biomarkers are non-specific, volatile and...
Urine is a highly advantageous biological specimen for biomarker research and is a non-invasive source. Most of the urinary biomarkers are non-specific, volatile and need extensive validation before clinical adoption. Extracellular vesicles are secreted by almost all cells and are involved in homoeostasis, intercellular communication, and cellular processes in healthy and pathophysiological states. Urinary extracellular vesicles (UEVs) are released from the urogenital system and mirror the molecular processes of physiological and pathological states of their source cells. Therefore, UEVs serve as a valuable source of biomarkers for the non-invasive diagnosis of various pathologies. They hold a promising source of multiplex biomarkers suitable for prognosis, diagnosis, and therapy monitoring. UEVs are easily accessible, non-invasive, and suited for longitudinal sampling. Although various techniques are available for isolating UEVs, there is yet to be a consensus on a standard and ideal protocol. We have optimized an efficient, reliable, and easily adoptable polyethylene glycol (PEG) based UEV isolation technique following MISEV guidelines. The method is suitable for various downstream applications of UEVs. This could be a cost-effective, consistent, and accessible procedure for many clinical labs and is most suited for longitudinal analysis. Adopting the protocol will pave the way for establishing UEVs as the ideal biomarker source. •Urine can be collected non-invasively and repeatedly, hence a very useful specimen for biomarker discovery. Urinary EVs (UEVs), derived from urine, offer a stable diagnostic tool, but standardised isolation and analysis approaches are warranted.•To have enough UEVs for any study, large volumes of urine sample are necessary, which limits different isolation methods by cost, yield, and time.•The protocol developed could help researchers by offering a cost-effective and dependable UEV isolation method and may lay the foundation for UEVs adoption in clinical space.
PubMed: 37608961
DOI: 10.1016/j.mex.2023.102310 -
Sensors (Basel, Switzerland) Oct 2023Point-of-care testing (POCT) platforms utilizing immunoassay-based microfluidic chips offer a robust and specific method for detecting target antibodies, demonstrating a...
Point-of-care testing (POCT) platforms utilizing immunoassay-based microfluidic chips offer a robust and specific method for detecting target antibodies, demonstrating a wide range of applications in various medical and research settings. Despite their versatility and specificity, the adoption of these immunoassay chips in POCT has been limited by their short shelf-life in liquid environments, attributed to the degradation of immobilized antibodies. This technical limitation presents a barrier, particularly for resource-limited settings where long-term storage and functionality are critical. To address this challenge, we introduce a novel freeze-dry sublimation process aimed at extending the shelf-life of these microfluidic chips without compromising their functional integrity. This study elaborates on the mechanisms by which freeze-drying preserves the bioactivity of the immobilized antibodies, thereby maintaining the chip's performance over an extended period. Our findings reveal significant shelf-life extension, making it possible for these POCT platforms to be more widely adopted and practically applied, especially in settings with limited resources. This research paves the way for more accessible, long-lasting, and effective POCT solutions, breaking down previous barriers to adoption and application.
Topics: Microfluidics; Antibodies, Immobilized; Immunoassay; Freeze Drying
PubMed: 37896617
DOI: 10.3390/s23208524