-
BMC Public Health Jun 2024Many women in low- and middle-income countries, including Kenya, access antenatal care (ANC) late in pregnancy. Home pregnancy testing can enable women to detect...
BACKGROUND
Many women in low- and middle-income countries, including Kenya, access antenatal care (ANC) late in pregnancy. Home pregnancy testing can enable women to detect pregnancy early, but it is not widely available. Our study explored the acceptability and potential of home pregnancy testing delivered by community health volunteers (CHV) on antenatal care initiation in rural Kenya.
METHODS
This study was part of a public health intervention to improve uptake and quality of ANC. Between November and December 2020, we conducted 37 in-depth interviews involving women who tested positive or negative for a urine pregnancy test provided by CHVs; CHVs and their supervisors involved in the delivery of the pregnancy tests; facility healthcare workers; and key informants. Using Sekhon et al.'s framework of acceptability, the interviews explored participants' perceptions and experiences of home pregnancy testing, including acceptability, challenges, and perceived effects on early ANC uptake. Data were analysed thematically in NVivo12 software.
RESULTS
Home pregnancy testing was well-received by women who trusted test results and appreciated the convenience and autonomy it offered. Adolescents cherished the privacy, preferring home testing to facility testing which could be a stigmatising experience. Testing enabled earlier pregnancy recognition and linkage to ANC as well as reproductive decision-making for those with undesired pregnancies. Community delivery of the test enhanced the reputation and visibility of the CHVs as credible primary care providers. CHVs in turn were motivated and confident to deliver home pregnancy testing and did not find it as an unnecessary burden; instead, they perceived it as a complement to their work in providing ANC in the community. Challenges identified included test shortages, confidentiality and safeguarding risks, and difficulties accessing facility-based care post-referral. Newly identified pregnant adolescents hesitated to seek ANC due to stigma, fear of reprimand, unwanted parental notification, and perceived pressure from healthcare workers to keep the pregnancy.
CONCLUSION
Home pregnancy testing by CHVs can improve early ANC initiation in resource-poor settings. Mitigating privacy, confidentiality, and safeguarding concerns is imperative. Additional support for women transitioning from pregnancy identification to ANC is essential to ensure appropriate care. Future research should focus on integrating home pregnancy testing into routine community health services.
Topics: Humans; Female; Kenya; Pregnancy; Prenatal Care; Adult; Patient Acceptance of Health Care; Adolescent; Young Adult; Rural Population; Pregnancy Tests; Community Health Workers; Qualitative Research; Interviews as Topic; Home Care Services
PubMed: 38951787
DOI: 10.1186/s12889-024-19254-7 -
BMC Cancer Jul 2024The number of cancer survivors has increased in recent decades, and the majority of them suffer from sequelae of their disease and treatment. This study, which is part...
BACKGROUND
The number of cancer survivors has increased in recent decades, and the majority of them suffer from sequelae of their disease and treatment. This study, which is part of the larger research project OPTILATER, aims to explore different aspects of care services for long-term survivors (≥ 5 years after initial cancer diagnosis) in Germany. The study places an emphasis on the situation of people from different age groups, with different socio-demographic and cultural backgrounds, and sexually and gender diverse individuals.
METHODS
To investigate experiences related to follow-up care, focus groups (n = 2) will be conducted with members of patient advisory councils and advocacy groups, representatives of communities, healthcare workers and networks, as well as members of Associations of Statutory Health Insurance Physicians. Guided interviews will be carried out with patients and relatives (n = 40) to investigate needs, barriers and obstacles in terms of follow-up care. On this basis, additional focus groups (n = 2) will be carried out to derive possible scenarios for improving the consideration of needs. Focus groups and interviews will follow a semi-structured format and will be analysed content-analytically. Focus groups and interviews will be conducted online, recorded, transcribed, and analysed independently by two persons.
DISCUSSION
The qualitative approach is considered suitable because of the exploratory research aims. The identification of experiences and barriers can reveal disparities and optimization potential in the care of long-term cancer survivors.
Topics: Humans; Cancer Survivors; Qualitative Research; Female; Male; Focus Groups; Neoplasms; Germany; Health Services Needs and Demand; Middle Aged; Adult; Aged
PubMed: 38951760
DOI: 10.1186/s12885-024-12527-9 -
Scientific Reports Jul 2024Honey bees are important insect pollinators that provide critical pollination services to fruit and nut crops in the US. They face challenges likely due to pressures...
Honey bees are important insect pollinators that provide critical pollination services to fruit and nut crops in the US. They face challenges likely due to pressures associated with agricultural intensification related habitat loss. To better understand this, pollen preferences of foraging bees and the nutritional profile of pollen brought into hives by foraging bees in crop fields and nut orchards can provide valuable information. We trained bees to forage on bee-collected pollen from hives placed for pollination services in almond orchards, sunflower fields, or mixed species from inter-row plantings. Using bees trained to a certain kind of hive pollen, we applied a binary scoring system, to test preferences of these preconditioned foragers. We also performed metabolomic analyses of the hive pollen used for training and testing to elucidate their nutritional content. Irrespective of preconditioning, bees collected all the available choice pollen types, predominantly choosing hive-collected mixed species pollen (MSP), followed by almond orchard pollen. The hive-collected MSP was chemically diverse, richest in cholesterol, vitamins, and phytochemicals quercetin, kaempferol, coumarin, and quinine, but was not consistently high for essential amino acids and polyunsaturated fatty acids. Although diversity in chemical profiles may not directly relate to plant species diversity, our results suggest that foragers collect a variety of pollen types when available reiterating the importance of diverse floral resources.
Topics: Bees; Animals; Pollen; Pollination; Nutrients; Prunus dulcis; Feeding Behavior
PubMed: 38951538
DOI: 10.1038/s41598-024-65569-1 -
Nature Communications Jun 2024Argonaute proteins are the central effectors of RNA-guided RNA silencing pathways in eukaryotes, playing crucial roles in gene repression and defense against viruses and...
Argonaute proteins are the central effectors of RNA-guided RNA silencing pathways in eukaryotes, playing crucial roles in gene repression and defense against viruses and transposons. Eukaryotic Argonautes are subdivided into two clades: AGOs generally facilitate miRNA- or siRNA-mediated silencing, while PIWIs generally facilitate piRNA-mediated silencing. It is currently unclear when and how Argonaute-based RNA silencing mechanisms arose and diverged during the emergence and early evolution of eukaryotes. Here, we show that in Asgard archaea, the closest prokaryotic relatives of eukaryotes, an evolutionary expansion of Argonaute proteins took place. In particular, a deep-branching PIWI protein (HrAgo1) encoded by the genome of the Lokiarchaeon 'Candidatus Harpocratesius repetitus' shares a common origin with eukaryotic PIWI proteins. Contrasting known prokaryotic Argonautes that use single-stranded DNA as guides and/or targets, HrAgo1 mediates RNA-guided RNA cleavage, and facilitates gene silencing when expressed in human cells and supplied with miRNA precursors. A cryo-EM structure of HrAgo1, combined with quantitative single-molecule experiments, reveals that the protein displays structural features and target-binding modes that are a mix of those of eukaryotic AGO and PIWI proteins. Thus, this deep-branching archaeal PIWI may have retained an ancestral molecular architecture that preceded the functional and mechanistic divergence of eukaryotic AGOs and PIWIs.
Topics: Argonaute Proteins; Humans; RNA Interference; Archaea; RNA, Small Interfering; Archaeal Proteins; Cryoelectron Microscopy; MicroRNAs; Evolution, Molecular; Phylogeny
PubMed: 38951509
DOI: 10.1038/s41467-024-49452-1 -
EJNMMI Physics Jul 2024This study proposes a practical method for evaluating 2D spatial resolution with scatter on a CZT planar detector gamma camera, which is simpler and faster than the NEMA...
PURPOSE
This study proposes a practical method for evaluating 2D spatial resolution with scatter on a CZT planar detector gamma camera, which is simpler and faster than the NEMA method. It is used to characterize the influence of distance on spatial resolution FWHM on a CZT camera equipped with a WEHR collimator.
METHODS
The practical method uses linear sources tilted with respect to the detector axes. The spatial resolution full width at half maximum (FWHM) with four tilt angles was compared to the FWHM evaluated using the NEMA NU1-2018 method. Spatial resolution FWHM was also assessed with tilted sources acquired at distances of 0 to 20 cm using a single angle, with and without the post-processing image enhancement proposed by the manufacturer.
RESULTS
Estimated spatial resolution FWHM with tilted sources was close to the spatial resolution FWHM estimated at 7.63 mm by the NEMA method, with deviations ranging from - 5.62 to 4.59% at 10 cm depending on the angle considered. The study of spatial resolution FWHM dependence on distance indicates that, for distances less than 3 cm, the FWHM no longer decreases with distance. The manufacturer's post-processing reduces the FWHM by an average of 15%.
CONCLUSION
The practical method is quicker to implement and gives comparable results to the NEMA reference method for spatial resolution FWHM. Evaluation of spatial resolution with linear sources at short distances from the collimator is limited by the collimator effect and signal digitization. The tilted source method can be used to measure spatial resolution quickly and easily under clinical conditions for CZT planar cameras.
PubMed: 38951275
DOI: 10.1186/s40658-024-00656-w -
Current Microbiology Jul 2024Nukadoko, a fermented rice bran employed in traditional Japanese pickling, uses lactic acid bacteria to ferment vegetables. Here, we report the microbial and chemical...
Nukadoko, a fermented rice bran employed in traditional Japanese pickling, uses lactic acid bacteria to ferment vegetables. Here, we report the microbial and chemical data of a mixture of matured 150-year-old nukadoko and commercially available rice bran placed in two open environments over 29 days. Across the two environments, Loigolactobacillus was identified as the dominant microbial genera in the later stages of fermentation in nukadoko. The period of increase in the relative abundance of Loigolactobacillus correlated with a decrease in pH and Oxidation-Reduction Potential (ORP) values. While the two environments showed a difference in the rate of change in microbial diversity, they shared the common process through which Loigolactobacillus outcompeted adventitious bacteria in nukadoko, as indicated by the alpha and beta diversity index. Thus, the similarities in microbial and chemical data across two open environments during fermentation using starters indicate that starters contribute to the stability of fermentation in open environments.
Topics: Fermentation; Oryza; Fermented Foods; Hydrogen-Ion Concentration; Food Microbiology
PubMed: 38951184
DOI: 10.1007/s00284-024-03760-3 -
BMJ Open Jul 2024The natural and best approach to give newborns the nutrients they need for healthy growth and development is through breast feeding. Breastfeeding rates fall more...
BACKGROUND
The natural and best approach to give newborns the nutrients they need for healthy growth and development is through breast feeding. Breastfeeding rates fall more sharply with time for mothers under the age of 20 years.
AIM
This study sought to explore the challenges experienced by adolescent mothers who visit the department of obstetrics and gynaecology of Korle Bu Teaching Hospital in Ghana.
METHOD
This study employed a qualitative phenomenology design and collected data from adolescent mothers. Data were gathered with the aid of a semistructured in-depth interview guide from 13 breastfeeding adolescent mothers. Data for the study were analysed using content analysis. The study was conducted at the obstetrics and gynaecology department of Korle Bu Teaching Hospital, Ghana.
FINDINGS
Two major themes were generated from the study to be the challenges that confront adolescent breastfeeding mothers, and they are maternal factors of breastfeeding barriers and societal factors of breastfeeding barriers. Subcategories were generated for both themes during the process.
CONCLUSION AND RECOMMENDATION
Training of pregnant adolescents during antenatal care visits on how to manage the inability to lactate, breastfeeding stress, painful and sore nipple, engorged breast, stigma from society will lessen their burden. Furthermore, training close family members and friends on how to be kind and support adolescent mothers during breast feeding is important. In-service training should be organised for health workers to enhance their knowledge and practice of approaching and guiding adolescent mothers on effective breast feeding and the provision of cubicles in public places where adolescent mothers can comfortably breastfeed.
Topics: Humans; Breast Feeding; Ghana; Female; Adolescent; Hospitals, Teaching; Mothers; Qualitative Research; Young Adult; Pregnancy; Infant, Newborn; Interviews as Topic; Pregnancy in Adolescence; Health Knowledge, Attitudes, Practice
PubMed: 38950996
DOI: 10.1136/bmjopen-2023-077504 -
BMJ Open Jul 2024Hepatitis C virus (HCV) infection poses a global health challenge. By the end of 2021, the WHO estimated that less than a quarter of global HCV infections had been...
OBJECTIVES
Hepatitis C virus (HCV) infection poses a global health challenge. By the end of 2021, the WHO estimated that less than a quarter of global HCV infections had been diagnosed. There is a need for a public health tool that can facilitate the identification of people with HCV infection and link them to testing and treatment, and that can be customised for each country.
METHODS
We derived and validated a risk score to identify people with HCV in Egypt and demonstrated its utility. Using data from the 2008 and 2014 Egypt Demographic and Health Surveys, two risk scores were constructed through multivariable logistic regression analysis. A range of diagnostic metrics was then calculated to evaluate the performance of these scores.
RESULTS
The 2008 and 2014 risk scores exhibited similar dependencies on sex, age and type of place of residence. Both risk scores demonstrated high and similar areas under the curve of 0.77 (95% CI: 0.76 to 0.78) and 0.78 (95% CI: 0.77 to 0.80), respectively. For the 2008 risk score, sensitivity was 73.7% (95% CI: 71.5% to 75.9%), specificity was 68.5% (95% CI: 67.5% to 69.4%), positive predictive value (PPV) was 27.8% (95% CI: 26.4% to 29.2%) and negative predictive value (NPV) was 94.1% (95% CI: 93.5% to 94.6%). For the 2014 risk score, sensitivity was 64.0% (95% CI: 61.5% to 66.6%), specificity was 78.2% (95% CI: 77.5% to 78.9%), PPV was 22.2% (95% CI: 20.9% to 23.5%) and NPV was 95.7% (95% CI: 95.4% to 96.1%). Each score was validated by applying it to a different survey database than the one used to derive it.
CONCLUSIONS
Implementation of HCV risk scores is an effective strategy to identify carriers of HCV infection and to link them to testing and treatment at low cost to national programmes.
Topics: Humans; Egypt; Female; Male; Cross-Sectional Studies; Adult; Middle Aged; Hepatitis C; Young Adult; Risk Assessment; Adolescent; Risk Factors; Logistic Models; Aged; Sensitivity and Specificity
PubMed: 38950989
DOI: 10.1136/bmjopen-2024-085506 -
The Journal of Rheumatology Jul 2024To provide a set of living treatment recommendations that will provide contemporary guidance on the management of patients with axial spondyloarthritis (axSpA) in Canada.
OBJECTIVE
To provide a set of living treatment recommendations that will provide contemporary guidance on the management of patients with axial spondyloarthritis (axSpA) in Canada.
METHODS
The Spondyloarthritis Research Consortium of Canada (SPARCC), in conjunction with the Canadian Rheumatology Association, organized a treatment recommendations panel composed of rheumatologists, researchers, allied health professionals, and a patient advocate. A Grading of Recommendations Assessment, Development, and Evaluation (GRADE)-ADOLOPMENT approach was used in which existing guidelines were adopted or adapted to a Canadian context. Recommendations were also placed in a health equity framework.
RESULTS
56 recommendations were made for patients with active axSpA, stable axSpA, active or stable axSpA, comorbidities, and for assessment, screening, and imaging. Recommendations were also made for principles of management, disease monitoring, and ethical considerations.
CONCLUSION
These living treatment recommendations will provide up to date guidance for the management of axSpA for Canadian practice. As part of the living model, they will be updated regularly as changes occur in the treatment landscape.
PubMed: 38950949
DOI: 10.3899/jrheum.2023-1237 -
JCO Clinical Cancer Informatics Jun 2024There has been growing interest in the use of real-world data (RWD) to address clinically and policy-relevant (research) questions that cannot be answered with data from... (Review)
Review
There has been growing interest in the use of real-world data (RWD) to address clinically and policy-relevant (research) questions that cannot be answered with data from randomized controlled trials (RCTs) alone. This is, for example, the case in rare malignancies such as sarcomas as limited patient numbers pose challenges in conducting RCTs within feasible timeliness, a manageable number of collaborators, and statistical power. This narrative review explores the potential of RWD to generate real-world evidence (RWE) in sarcoma research, elucidating its application across different phases of the patient journey, from prediagnosis to the follow-up/survivorship phase. For instance, examining electronic health records (EHRs) from general practitioners (GPs) enables the exploration of consultation frequency and presenting symptoms in primary care before a sarcoma diagnosis. In addition, alternative study designs that integrate RWD with well-designed observational RCTs may offer relevant information on the effectiveness of clinical treatments. As, especially in cases of ultrarare sarcomas, it can be an extreme challenge to perform well-powered randomized prospective studies. Therefore, it is crucial to support the adaptation of novel study designs. Regarding the follow-up/survivorship phase, examining EHR from primary and secondary care can provide valuable insights into identifying the short- and long-term effects of treatment over an extended follow-up period. The utilization of RWD also comes with several challenges, including issues related to data quality and privacy, as described in this study. Notwithstanding these challenges, this study underscores the potential of RWD to bridge, at least partially, gaps between evidence and practice and holds promise in contributing to the improvement of sarcoma care.
Topics: Humans; Sarcoma; Electronic Health Records; General Practitioners; Data Collection; Clinical Trials as Topic; Prospective Studies
PubMed: 38950319
DOI: 10.1200/CCI.24.00054