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Metabolism Open Jun 2024'Vision 2020, the Right to Sight', jointly coordinated by the World Health Organization's program for the prevention of blindness and deafness and the international...
INTRODUCTION
'Vision 2020, the Right to Sight', jointly coordinated by the World Health Organization's program for the prevention of blindness and deafness and the international agency for the prevention of blindness, was launched in 1999, however, the initiative faces many challenges to hitting its target. One of the challenges for this is, the absence of comprehensive data regarding eye care service utilization among diabetes mellitus patients in Africa. Therefore, this study was aimed at assessing the prevalence of eye care service utilization and associated factors among adult diabetes mellitus patients in Africa.
METHODS
This systematic review and meta-analysis was conducted as per the international preferred reporting items for systematic review and meta-analysis protocols (PRISMA) guidelines. Published articles were searched using reputable databases (PubMed, Cochrane Library) and Web searches (Science Direct, African Journals Online, and Google Scholar). Quality appraisal was assessed based on the Joanna Briggs Institute's (JBI) critical appraisal checklist. The extracted data was exported to STATA version 11 (STATA Corp., LLC) for further analysis. Heterogeneity between the results of primary studies was assessed using Cochran's Q chi-square test and quantified with the I statistics. Publication bias was assessed by visual inspection of the funnel plot and Egger's regression tests.
RESULTS
The database search found 26,966 articles. The pooled prevalence of eye care service utilization among diabetic patients in Africa is found to be 40.92 % (95 % CI: 27.14-54.70, P < 0.001). Good knowledge (POR = 3.57, 95 % CI: 2.67-4.76), good attitude (POR = 5.68, 95 % CI: 4.20-7.68), age greater than 65 years old (POR = 7.11, 95 % CI: 3.86-13.10), urban residence (POR = 5.03, 95 % CI: 2.12-11.96), and disease duration greater than 6 years (POR = 3.81, 95 % CI: 2.25-6.45) were factors associated with eye care service utilization.
CONCLUSION
This meta-analysis revealed that a high proportion of people with diabetes failed to use eye care services. Older age, good knowledge, urban residence and longer duration of illness were found to be the contributing factors for the utilization of eye care services in diabetes mellitus patients. Therefore, by considering the negative impact of low eye care service utilization, it is important to improve the habit of regular screening of the eye into routine assessment of diabetes mellitus follow up targeting patients with older age and longer duration of illness to reduce the magnitude of the problem.
PubMed: 38957624
DOI: 10.1016/j.metop.2024.100293 -
Frontiers in Medicine 2024In 1978, the World Health Organization (WHO) adopted primary health care (PHC) as the most effective strategy to meet the healthcare needs of communities. This raises...
What are the experiences of medical students and their trainers regarding undergraduate training in primary health care at four South African medical schools? A qualitative study.
BACKGROUND
In 1978, the World Health Organization (WHO) adopted primary health care (PHC) as the most effective strategy to meet the healthcare needs of communities. This raises the question as to the extent and nature of the training that undergraduate (UG) medical students receive in medical schools regarding PHC, following this statement.
AIM
The study aim was to explore the experiences of UG medical students and their trainers regarding training in PHC in their institutions.
METHODS
A qualitative study was conducted among UG medical students (MBChB 4-6) and their trainers at four conveniently selected South African medical schools. A total of 16 focus group discussions (FGDs) and 27 in-depth interviews were conducted among students and their trainers, respectively. The MAXQDA 2020 (Analytics Pro) software program was used to arrange the data, resulting in 2,179 data segments, from which categories, sub-themes and themes were derived.
RESULTS
Both the UG medical students and their trainers regarded PHC as mainly an approach to health rather than a level of care. Students were trained by specialists and generalists, received training in the undifferentiated patient, coordinated, comprehensive and continuity of care. The training in tertiary centers, conducted mainly by specialists, the implicitness of the training and the inadequacy of trainers at the PHC settings presented challenges.
CONCLUSION
Students and their trainers experienced UG student training in PHC in line with the internationally recognized principles on the subject. The view by students and their trainers that PHC is an approach rather than a level of care enhanced its training across disciplines. The implicitness of the training and the tertiary learning platforms were the main challenges experienced. For optimum PHC training, more time should be dedicated to distributed training platforms with supportive specialist outreach programs in the South African medical schools.
PubMed: 38957301
DOI: 10.3389/fmed.2024.1337140 -
Cureus Jun 2024The prevalence of overweight and obesity among adolescents in Saudi Arabia has been progressively increasing. Obesity is associated with an increased risk of various...
BACKGROUND
The prevalence of overweight and obesity among adolescents in Saudi Arabia has been progressively increasing. Obesity is associated with an increased risk of various morbidities and mortality. Identifying the factors that contribute to obesity in this age group is crucial for implementing targeted prevention measures.
AIM
The aim of this study was to identify risk factors for overweight and obesity among adolescents aged nine to 17 years residing in Tabuk City, Saudi Arabia.
METHODS
A case-control study was conducted during the 2021-2022 academic year at Alabnaa Schools in Tabuk City, Saudi Arabia. The study included overweight/obese individuals (cases, n = 125) and normal-weight individuals (controls, n = 201) who were selected based on their body mass index and classified according to the World Health Organization's reference for defining overweight and obesity in individuals aged five to 19 years. Data were collected from both groups using a self-administered questionnaire.
RESULTS
The study analyzed 125 overweight/obese students and 201 normal-weight students who were matched for sex and age (p > 0.05). Logistic regression analysis identified several risk factors for overweight or obesity among adolescents. A family history of obesity was found to be associated with a 5.735 times increased likelihood of obesity (95% CI: 3.318-9.912, p < 0.001). Another significant contributing risk factor for obesity was frequent consumption of four or more meals per day (adjusted odds ratio: 3.091, 95% CI: 1.094-8.736, p = 0.033). Students who used electronic devices for more than five hours were 2.422 times more likely to exhibit obesity (p = 0.006).
CONCLUSIONS
Certain factors may increase the risk of overweight or obesity in adolescents aged nine to 17 years. These factors include frequent eating, prolonged use of electronic devices, family history of obesity, and the misconception that obesity is not an illness. Tailored school health programs are needed to improve students' healthy lifestyles and eating behaviors, minimize sedentary entertainment and use of electronic devices, and engage children in physical activity.
PubMed: 38957243
DOI: 10.7759/cureus.61533 -
Japan Journal of Nursing Science : JJNS Jul 2024A summary of studies focusing on the mental health of midwives during the COVID-19 pandemic has not yet been conducted. This review aims to comprehensively understand... (Review)
Review
AIM
A summary of studies focusing on the mental health of midwives during the COVID-19 pandemic has not yet been conducted. This review aims to comprehensively understand the current state of midwives' mental health in the context of the COVID-19 pandemic and to provide valuable insights to guide future research.
METHODS
This study was based on a framework for conducting scoping reviews. The protocol was registered before conducting this review and procedures were carried out according to that protocol. Article searches were conducted in four databases from December 2019 to December 2023. From 921 articles selected according to pre-registered protocol criteria, the analysis finally included 14 studies.
RESULTS
A total of 13 studies were cross-sectional and one was longitudinal, with pre-pandemic data. More than 80% of the studies began data collection within approximately 1 year after the pandemic was declared by the World Health Organization (by February 2021). Half of the studies were conducted in Asia. Burnout and turnover intentions were investigated in several studies but used different measures. Only two studies were aimed at positive aspects such as job satisfaction and well-being.
CONCLUSIONS
Most research on midwives' mental health during the COVID-19 pandemic has focused on negative aspects such as burnout and turnover intentions. However, most results were cross-sectional, with studies in the early stages of the pandemic, so continued follow-up is needed.
PubMed: 38957121
DOI: 10.1111/jjns.12612 -
Korean Circulation Journal Jun 2024The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical...
BACKGROUND AND OBJECTIVES
The recent developments in chronic thromboembolic pulmonary hypertension (CTEPH) are emphasizing the multidisciplinary team. We report on the changes in clinical practice following the development of a multidisciplinary team, based on our 7 years of experience.
METHODS
Multidisciplinary team was established in 2015 offering both balloon pulmonary angioplasty (BPA) and pulmonary endarterectomy (PEA) with technical upgrades by internal and external expertise. For operable cases, PEA was recommended as the primary treatment modality, followed by pulmonary angiography and right heart catheterization after 6 months to evaluate treatment effect and identify patients requiring further BPA. For patients with inoperable anatomy or high surgical risk, BPA was recommended as the initial treatment modality. Patient data and clinical outcomes were closely monitored.
RESULTS
The number of CTEPH treatments rapidly increased and postoperative survival improved after team development. Before the team, 38 patients were treated by PEA for 18 years; however, 125 patients were treated by PEA or BPA after the team for 7 years. The number of PEA performed was 64 and that of BPA 342 sessions. World Health Organization functional class I or II was achieved in 93% of patients. The patients treated with PEA was younger, male dominant, higher pulmonary artery pressure, and smaller cardiac index, than BPA-only patients. In-hospital death after PEA was only 1 case and none after BPA.
CONCLUSIONS
The balanced development of BPA and PEA through a multidisciplinary team approach proved synergistic in increasing the number of actively treated CTEPH patients and improving clinical outcomes.
PubMed: 38956937
DOI: 10.4070/kcj.2024.0021 -
Human Resources For Health Jul 2024Public health emergencies of international concern (PHEICs) as the COVID-19 pandemic and others that have occurred since the early 2000s put enormous pressure on health... (Review)
Review
BACKGROUND
Public health emergencies of international concern (PHEICs) as the COVID-19 pandemic and others that have occurred since the early 2000s put enormous pressure on health and care systems. This is being a context for protests by health and care workers (HCWs) because of additional workload, working conditions and effects on mental and physical health. In this paper, we intended to analyze the demands of HCWs associated with industrial actions, protests, strikes and lockouts (IAPSLs) which occurred during COVID-19 pandemic and other PHEICs; to identify the impact of these grievances; and describe the relevant interventions to address these IAPSLs.
METHODS
We included studies published between January 2000 and March 2022 in PubMed, Embase, Scopus, BVS/LILACS, WHO's COVID-19 Research Database, ILO, OECD, HSRM, and Google Scholar for grey literature. Eligibility criteria were HCWs as participants, IAPSLs as phenomenon of interest occurring in the context of COVID-19 and other PHEICs. GRADE CERQual was used to assess risk of bias and confidence of evidence.
RESULTS
1656 records were retrieved, and 91 were selected for full-text screening. We included 18 publications. A system-wide approach, rather than a limited approach to institutions on strike, makes it possible to understand the full impact of the strike on health and care services. PHEICs tend to aggravate already adverse working conditions of HCWs, acting as drivers for HCWs strikes, leading to staff shortages, and financial issues, both in the North and in the Global South, particularly evident in Asia and Africa. In addition, issues related to deficiencies in leadership and governance in heath sector and lack of medical products and technologies (e.g., lack of personal protective equipment) were the main drivers of strikes, each contributing 25% of the total drivers identified.
CONCLUSIONS
It is necessary to focus on the preparedness of health and care systems to respond adequately to PHEICs, and this includes being prepared for HCWs' IAPSLs, talked much in the context of COVID-19 pandemic. Evidence to assist policymakers in defining strategies to respond adequately to the health and care needs of the population during IAPSLs is crucial. The main impact of strikes is on the disruption of health care services' provision. Gender inequality being a major issue among HCWs, a proper understanding of the full impact of the strike on health and care services will only be possible if gender lens is combined with a systemic approach, rather than gender-undifferentiated approaches limited to the institutions on strike.
Topics: Humans; COVID-19; Health Personnel; SARS-CoV-2; Strikes, Employee; Pandemics; Workload; Public Health
PubMed: 38956631
DOI: 10.1186/s12960-024-00923-y -
Globalization and Health Jul 2024During the COVID-19 pandemic, intellectual property licensing through bilateral agreements and the Medicines Patent Pool were used to facilitate access to new COVID-19...
During the COVID-19 pandemic, intellectual property licensing through bilateral agreements and the Medicines Patent Pool were used to facilitate access to new COVID-19 therapeutics in low- and middle-income countries (LMICs). The lessons learnt from the application of the model to COVID-19 could be relevant for preparedness and response to future pandemics and other health emergencies.The speed at which affordable versions of a new product are available in LMICs is key to the realization of the potential global impact of the product. When initiated early in the research and development life cycle, licensing could facilitate rapid development of generic versions of innovative products in LMICs during a pandemic. The pre-selection of qualified manufacturers, for instance building on the existing network of generic manufacturers engaged during the COVID-19 pandemic, the sharing of know-how and the quick provision of critical inputs such as reference listed drugs (RLDs) could also result in significant time saved. It is important to find a good balance between speed and quality. Necessary quality assurance terms need to be included in licensing agreements, and the potentials of the new World Health Organization Listed Authority mechanism could be explored to promote expedited regulatory reviews and timely access to safe and quality-assured products.The number, capacity, and geographical distribution of licensed companies and the transparency of licensing agreements have implications for the sufficiency of supply, affordability, and supply security. To foster competition and support supply security, licenses should be non-exclusive. There is also a need to put modalities in place to de-risk the development of critical pandemic therapeutics, particularly where generic product development is initiated before the innovator product is proven to be effective and approved. IP licensing and technology transfer can be effective tools to improve the diversification of manufacturing and need to be explored for regional manufacturing for accelerated access at scale in in LMICs and supply security in future pandemics.
Topics: Humans; Intellectual Property; Licensure; COVID-19; Developing Countries; Pandemics; COVID-19 Drug Treatment; Antiviral Agents; Drug Industry; Pandemic Preparedness
PubMed: 38956614
DOI: 10.1186/s12992-024-01057-5 -
Trials Jul 2024Cardiovascular disease (CVD) is the leading cause of mortality worldwide, and at present, India has the highest burden of acute coronary syndrome and ST-elevation...
Improving medication adherence among persons with cardiovascular disease through m-health and community health worker-led interventions in Kerala; protocol for a type II effectiveness-implementation research-(SHRADDHA-ENDIRA).
BACKGROUND
Cardiovascular disease (CVD) is the leading cause of mortality worldwide, and at present, India has the highest burden of acute coronary syndrome and ST-elevation myocardial infarction (MI). A key reason for poor outcomes is non-adherence to medication.
METHODS
The intervention is a 2 × 2 factorial design trial applying two interventions individually and in combination with 1:1 allocation ratio: (i) ASHA-led medication adherence initiative comprising of home visits and (ii) m-health intervention using reminders and self-reporting of medication use. This design will lead to four potential experimental conditions: (i) ASHA-led intervention, (ii) m-health intervention, (iii) ASHA and m-health intervention combination, (iv) standard of care. The cluster randomized trial has been chosen as it randomizes communities instead of individuals, avoiding contamination between participants. Subcenters are a natural subset of the health system, and they will be considered as the cluster/unit. The factorial cluster randomized controlled trial (cRCT) will also incorporate a nested health economic evaluation to assess the cost-effectiveness and return on investment (ROI) of the interventions on medication adherence among patients with CVDs. The sample size has been calculated to be 393 individuals per arm with 4-5 subcenters in each arm. A process evaluation to understand the effect of the intervention in terms of acceptability, adoption (uptake), appropriateness, costs, feasibility, fidelity, penetration (integration of a practice within a specific setting), and sustainability will be done.
DISCUSSION
The effect of different types of intervention alone and in combination will be assessed using a cluster randomized design involving 18 subcenter areas. The trial will explore local knowledge and perceptions and empower people by shifting the onus onto themselves for their medication adherence. The proposal is aligned to the WHO-NCD aims of improving the availability of the affordable basic technologies and essential medicines, training the health workforce and strengthening the capacity of at the primary care level, to address the control of NCDs. The proposal also helps expand the use of digital technologies to increase health service access and efficacy for NCD treatment and may help reduce cost of treatment.
TRIAL REGISTRATION
The trial has been registered with the Clinical Trial Registry of India (CTRI), reference number CTRI/2023/10/059095.
Topics: Humans; Medication Adherence; India; Community Health Workers; Cardiovascular Diseases; Randomized Controlled Trials as Topic; Cost-Benefit Analysis; Reminder Systems; Telemedicine; House Calls; Implementation Science; Treatment Outcome; Cardiovascular Agents; Multicenter Studies as Topic
PubMed: 38956612
DOI: 10.1186/s13063-024-08244-0 -
BMC Public Health Jul 2024To study the historical global incidence and mortality trends of gastric cancer and predicted mortality of gastric cancer by 2035.
OBJECTIVE
To study the historical global incidence and mortality trends of gastric cancer and predicted mortality of gastric cancer by 2035.
METHODS
Incidence data were retrieved from the Cancer Incidence in Five Continents (CI5) volumes I-XI, and mortality data were obtained from the latest update of the World Health Organization (WHO) mortality database. We used join-point regression analysis to examine historical incidence and mortality trends and used the package NORDPRED in R to predict the number of deaths and mortality rates by 2035 by country and sex.
RESULTS
More than 1,089,000 new cases of gastric cancer and 769,000 related deaths were reported in 2020. The average annual percent change (AAPC) in the incidence of gastric cancer from 2003 to 2012 among the male population, South Korea, Japan, Malta, Canada, Cyprus, and Switzerland showed an increasing trend (P > 0.05); among the female population, Canada [AAPC, 1.2; (95%Cl, 0.5-2), P < 0.05] showed an increasing trend; and South Korea, Ecuador, Thailand, and Cyprus showed an increasing trend (P > 0.05). AAPC in the mortality of gastric cancer from 2006 to 2015 among the male population, Thailand [3.5 (95%cl, 1.6-5.4), P < 0.05] showed an increasing trend; Malta Island, New Zealand, Turkey, Switzerland, and Cyprus had an increasing trend (P > 0.05); among the male population aged 20-44, Thailand [AAPC, 3.4; (95%cl, 1.3-5.4), P < 0.05] showed an increasing trend; Norway, New Zealand, The Netherlands, Slovakia, France, Colombia, Lithuania, and the USA showed an increasing trend (P > 0.05). It is predicted that the mortality rate in Slovenia and France's female population will show an increasing trend by 2035. It is predicted that the absolute number of deaths in the Israeli male population and in Chile, France, and Canada female population will increase by 2035.
CONCLUSION
In the past decade, the incidence and mortality of gastric cancer have shown a decreasing trend; however, there are still some countries showing an increasing trend, especially among populations younger than 45 years. Although mortality in most countries is predicted to decline by 2035, the absolute number of deaths due to gastric cancer may further increase due to population growth.
Topics: Humans; Stomach Neoplasms; Male; Female; Incidence; Global Health; Mortality; Forecasting; Sex Distribution
PubMed: 38956557
DOI: 10.1186/s12889-024-19104-6 -
BMC Pediatrics Jul 2024Growth charts are an important method for evaluating a child's health, growth, and nutritional status. It is essential to monitor the growth of children and adolescents... (Comparative Study)
Comparative Study
BACKGROUND
Growth charts are an important method for evaluating a child's health, growth, and nutritional status. It is essential to monitor the growth of children and adolescents using growth charts.
OBJECTIVES
To present body mass index (BMI)-for-age references reflecting children's growth in Shanxi. We also compare our new data with growth references of other cities of China and World Health Organization (WHO) growth standards.
METHODS
A stratified cluster random sampling method was used to recruit 5461 children and adolescents aged 6-17 years. Height and weight were measured and BMI was calculated. The LMS method was used to calculate the percentile values of body mass index by sex and age. Smoothed BMI-for-age growth curves were presented for both sexes and compared with reference data from other cities of China and WHO.
RESULTS
BMI centiles increased with age but with different patterns in both boys and girls. The centile curves from the 3rd to the 50th had a slight increase, while a sharp increase was seen from 11 to 17 years in boys and from 6 to 14 years in girls in the higher centiles. In comparison with other cities of China, the values for the 50th percentile are higher than those reported for children from China 2009, Shanghai, Changsha and China 2010 in both sexes. In comparison with WHO growth references, Chinese girls and boys had higher values in all percentiles, whereas curves of girls look roughly the same. The medians for BMI in Shanxi increase linearly from 6 to 17 years in boys.
CONCLUSIONS
The BMI percentiles of children aged 6-17 years in Shanxi differed significantly from the growth reference curves of other cities of China and WHO. Recommending the provision of BMI reference curves for local children and adolescents to assess their growth and development and monitor their nutritional status. Early detection of overweight and obesity in children provides a scientific basis for the prevention and control of overweight and obesity in children.
Topics: Humans; Adolescent; Child; China; Male; Female; Body Mass Index; Growth Charts; World Health Organization; Reference Values; Body Height; Body Weight
PubMed: 38956525
DOI: 10.1186/s12887-024-04905-w