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BMC Public Health Jun 2024
PubMed: 38951837
DOI: 10.1186/s12889-024-19124-2 -
BMC Public Health Jun 2024Hysterectomy is a gynaecological surgical procedure in which the uterus is removed as a treatment for both malignant and benign gynaecological diseases. A hysterectomy...
BACKGROUND
Hysterectomy is a gynaecological surgical procedure in which the uterus is removed as a treatment for both malignant and benign gynaecological diseases. A hysterectomy is also performed to minimise risks in women with problems related to the uterus. This study aimed to estimate the prevalence of reported hysterectomy and associated risk factors in Brazilian women aged 50 and older.
METHODS
A cross-sectional study using data from the Brazilian Longitudinal Study of Ageing (ELSI-Brazil) was conducted. A total of 5,293 women aged 50 and over who participated in the ELSI-Brazil study in 2015 and 2016 were included. The prevalence rate of hysterectomy was estimated and the main reasons for performing the surgery were identified. The bivariate analyses utilised the chi-square test, while multivariate analyses employed Poisson regression with a robust estimator.
RESULTS
The reported prevalence of hysterectomy was 17.8%. The most prevalent reason for the surgery was the presence of uterine myoma. Significant and independent associations were observed in women aged 63 and older, married, having undergone preventive exams, hormonal treatment, had up to three deliveries and having a private health plan.
CONCLUSION
The main objective of the study was achieved. The prevalence of hysterectomy in Brazilian women aged 50 and older was 17.8%. Significant associations were observed with participants' sociodemographic and clinical characteristics reinforcing the importance of considering the reproductive characteristics of women as indicators of health status.
Topics: Humans; Female; Hysterectomy; Brazil; Middle Aged; Longitudinal Studies; Cross-Sectional Studies; Aged; Prevalence; Risk Factors
PubMed: 38951794
DOI: 10.1186/s12889-024-19231-0 -
BMC Pregnancy and Childbirth Jun 2024Hypertensive disorders of pregnancy (HDP) are a significant cause of maternal mortality worldwide. The classification and treatment of hypertension in pregnancy remain...
Does the implementation of revised American College of Cardiology and American Heart Association (ACC/AHA) guidelines improve the identification of stillbirths and preterm births in hypertensive pregnancies: a population-based cohort study from South Asia and sub-Saharan Africa.
BACKGROUND
Hypertensive disorders of pregnancy (HDP) are a significant cause of maternal mortality worldwide. The classification and treatment of hypertension in pregnancy remain debated. We aim to compare the effectiveness of the revised 2017 ACC/AHA blood pressure threshold in predicting adverse pregnancy outcomes.
METHODS
We conducted a secondary data analysis of the Alliance for Maternal and Newborn Health Improvement (AMANHI) biorepository study, including 10,001 pregnant women from Bangladesh, Pakistan, and Tanzania. Blood pressure was measured using validated devices at different antenatal care visits. The blood pressure readings were categorized as: normal blood pressure (systolic blood pressure (sBP) < 120 mm Hg and diastolic blood pressure (dBP) < 80 mm Hg), elevated blood pressure (sBP 120-129 and dBP < 80), stage 1 hypertension (sBP 130-139 or dBP 80-89, or both), and stage 2 hypertension (sBP ≥ 140 or dBP ≥ 90, or both). We estimated risk ratios for stillbirths and preterm births, as well as diagnostic test properties of both the pre-existing JNC7 (≥ 140/90) and revised ACC/AHA (≥ 130/80) thresholds using normal blood pressure as reference group.
RESULTS
From May 2014 to June 2018, blood pressure readings were available for 9,448 women (2,894 in Bangladesh, 2,303 in Pakistan, and 4,251 in Tanzania). We observed normal blood pressure in 70%, elevated blood pressure in 12.4%, stage 1 hypertension in 15.2%, and stage 2 hypertension in 2.5% of the pregnant women respectively. Out of these, 310 stillbirths and 9,109 live births were recorded, with 887 preterm births. Using the ACC/AHA criteria, the stage 1 hypertension cut-off revealed 15.3% additional hypertension diagnoses as compared to JNC7 criteria. ACC/AHA defined hypertension was significantly associated with stillbirths (RR 1.8, 95% CI 1.4, 2.3). The JNC 7 hypertension cut-off of ≥ 140/90 was significantly associated with a higher risk of preterm births (RR 1.6, 95% CI 1.2, 2.2) and stillbirths (RR 3.6, 95% CI 2.5, 5.3). Both criteria demonstrated low sensitivities (8.4 for JNC-7 and 28.1 for ACC/AHA) and positive predictive values (11.0 for JNC7 and 5.2 for ACC/AHA) in predicting adverse outcomes.
CONCLUSION
The ACC/AHA criteria (≥ 130/80) identified additional cases of hypertension but had limited predictive accuracy for stillbirths and preterm births, highlighting the ongoing need for improved criteria in managing pregnancy-related hypertension.
Topics: Humans; Female; Pregnancy; Premature Birth; Stillbirth; Adult; Hypertension, Pregnancy-Induced; Practice Guidelines as Topic; United States; Pakistan; Cohort Studies; American Heart Association; Bangladesh; Tanzania; Young Adult; Blood Pressure; Infant, Newborn; Asia, Southern
PubMed: 38951766
DOI: 10.1186/s12884-024-06637-2 -
BMC Ecology and Evolution Jul 2024Parent-offspring conflict represents the sensitive balance of resource allocation between self-maintenance and reproduction. Two strategies have been proposed to better...
BACKGROUND
Parent-offspring conflict represents the sensitive balance of resource allocation between self-maintenance and reproduction. Two strategies have been proposed to better understand how species manage this conflict. In fixed-level feeding behavior, parents feed offspring consistent quantities of food; while flexible feeding shows plasticity in parental allocation based on offspring need. Life-history theory predicts that parents of long-lived species prioritize their survival and may favor the fixed-level hypothesis to maximize lifetime reproductive success. In this study, we highlight the natural variation of parent-offspring allocation strategies within a unique population of Leach's storm-petrels (Hydrobates leucorhous), and through month-long food supplementation and restriction manipulations, we investigate how chick condition affects parental provisioning during the chick-rearing period of reproduction.
RESULTS
We show that the parents upregulated chick feeding frequency of nutritionally deprived chicks, resulting in a larger total amount of food delivered during the study period. Additionally, the proportion of nights when both parents fed was highest in restricted chicks, and the proportion of nights when neither parents fed was lowest in restricted chicks, suggesting that storm-petrel parents shorten their foraging bouts to deliver food more often when their chicks are in relatively poor condition.
CONCLUSIONS
Our results support that Leach's storm-petrels use a flexible-level feeding strategy, suggesting that parents can assess offspring condition, and respond by feeding chicks at higher frequencies. These data provide insight on how a long-lived seabird balances its own energetic demands with that of their offspring during the reproductive period.
Topics: Animals; Feeding Behavior; Birds; Female; Male; Reproduction; Longevity
PubMed: 38951762
DOI: 10.1186/s12862-024-02273-8 -
BMC Geriatrics Jun 2024Anaemia is a disease of public health importance with multi-causal pathways. Previous literature suggests the role of indoor air pollution (IAP) on haemoglobin levels,...
INTRODUCTION
Anaemia is a disease of public health importance with multi-causal pathways. Previous literature suggests the role of indoor air pollution (IAP) on haemoglobin levels, but this has been studied less due to logistic constraints. A high proportion of the population in developing countries, including India, still depends on unclean fuel, which exacerbates IAP. The objective was to study the association between anaemia and IAP among the older Indian adult population (≥ 45 years) as per gender.
METHODS
Our study analysed the nationally representative dataset of the Longitudinal Ageing Study in India (LASI 2017-18, Wave-1). We have documented the association of anaemia (outcome variable) with IAP (explanatory variable). To reduce the confounding effects of demographic and socioeconomic; health related and behavioural covariates; propensity score matching (PSM) was conducted. Nested multilevel regression modelling was conducted. States and union territories were categorised cross tabulated as low, middle and high as per anaemia and IAP exposure. P value < 0.05 was considered statistically significant. SATA version 17 was used for analysis.
RESULTS
More than half (52.52%) of the participants were exposed to IAP (male (53.55%) > female (51.63%)). The odds of having anaemia was significantly 1.19 times higher (AOR 1.19 (1.09-1.31)) among participants using unclean/ solid fuel. The adjusted odds were significantly higher among participants exposed to pollution-generating sources (AOR 1.30; 1.18-1.43), and household indoor smoking (AOR 1.17 (1.07-1.29). The odds of having anaemia were significantly higher (AOR 1.26; 1.15-1.38) among participants exposed to IAP, which was higher in males (AOR 1.36; 1.15-1.61) than females (AOR 1.21; 1.08-1.35). Empowered Action Group (EAG) states like Uttar Pradesh, Chhattisgarh, Madhya Pradesh, Bihar had both high anaemia and IAP exposure.
CONCLUSION
This study established the positive association of anaemia with indoor air pollution among older Indian adults through a nationally representative large dataset. The association was higher among men. Further research is recommended to understand detailed causation and to establish temporality. It is a high time to implement positive intervention nationally to decrease solid/ unclean fuel usage, vulnerable ventilation, indoor smoking, IAP and health hazards associated with these with more focused actions towards EAG states.
Topics: Humans; India; Male; Female; Air Pollution, Indoor; Anemia; Aged; Middle Aged; Cross-Sectional Studies; Longitudinal Studies; Multilevel Analysis; Aged, 80 and over
PubMed: 38951755
DOI: 10.1186/s12877-024-05171-2 -
EMBO Reports Jul 2024
PubMed: 38951712
DOI: 10.1038/s44319-024-00192-9 -
Scientific Reports Jul 2024Overly restrictive clinical trial eligibility criteria can reduce generalizability, slow enrollment, and disproportionately exclude historically underrepresented...
Overly restrictive clinical trial eligibility criteria can reduce generalizability, slow enrollment, and disproportionately exclude historically underrepresented populations. The eligibility criteria for 196 Alzheimer's Disease and Related Dementias (AD/ADRD) trials funded by the National Institute on Aging were analyzed to identify common criteria and their potential to disproportionately exclude participants by race/ethnicity. The trials were categorized by type (48 Phase I/II pharmacological, 7 Phase III/IV pharmacological, 128 non-pharmacological, 7 diagnostic, and 6 neuropsychiatric) and target population (51 AD/ADRD, 58 Mild Cognitive Impairment, 25 at-risk, and 62 cognitively normal). Eligibility criteria were coded into the following categories: Medical, Neurologic, Psychiatric, and Procedural. A literature search was conducted to describe the prevalence of disparities for eligibility criteria for African Americans/Black (AA/B), Hispanic/Latino (H/L), American Indian/Alaska Native (AI/AN) and Native Hawaiian/Pacific Islander (NH/PI) populations. The trials had a median of 15 criteria. The most frequent criterion were age cutoffs (87% of trials), specified neurologic (65%), and psychiatric disorders (61%). Underrepresented groups could be disproportionately excluded by 16 eligibility categories; 42% of trials specified English-speakers only in their criteria. Most trials (82%) contain poorly operationalized criteria (i.e., criteria not well defined that can have multiple interpretations/means of implementation) and criteria that may reduce racial/ethnic enrollment diversity.
Topics: Humans; Alzheimer Disease; Clinical Trials as Topic; Cognitive Dysfunction; Dementia; Eligibility Determination; Ethnicity; National Institute on Aging (U.S.); Patient Selection; United States; Black or African American; Hispanic or Latino; American Indian or Alaska Native; Native Hawaiian or Other Pacific Islander
PubMed: 38951633
DOI: 10.1038/s41598-024-65767-x -
Scientific Reports Jul 2024Pink bollworm (PBW) Pectinophora gossypiella is an important pest cotton worldwide. There are multiple factors which determines the occurrence and distribution of P....
Pink bollworm (PBW) Pectinophora gossypiella is an important pest cotton worldwide. There are multiple factors which determines the occurrence and distribution of P. gossypiella across different cotton growing regions of the world, and one such key factor is 'temperature'. The aim was to analyze the life history traits of PBW across varying temperature conditions. We systematically explored the biological and demographic parameters of P. gossypiella at five distinct temperatures; 20, 25, 30, 35 and 40 ± 1 °C maintaining a photoperiod of LD 16:8 h. The results revealed that the total developmental period of PBW shortens with rising temperatures, and the highest larval survival rates were observed between 30 °C and 35 °C, reaching 86.66% and 80.67%, respectively. Moreover, significant impacts were observed as the pupal weight, percent mating success, and fecundity exhibited higher values at 30 °C and 35 °C. Conversely, percent egg hatching, larval survival, and adult emergence were notably lower at 20 °C and 40 °C, respectively. Adult longevity decreased with rising temperatures, with females outliving males across all treatments. Notably, thermal stress had a persistent effect on the F1 generation, significantly affecting immature stages (egg and larvae), while its impact on reproductive potential was minimal. These findings offer valuable insights for predicting the population dynamics of P. gossypiella at the field level and developing climate-resilient management strategies in cotton.
Topics: Animals; Temperature; Larva; Female; Male; Gossypium; Lepidoptera; Fertility; Moths; Longevity; Pupa
PubMed: 38951576
DOI: 10.1038/s41598-024-65241-8 -
BMJ Open Jul 2024The objective of this study was to investigate how kinesiophobia and self-efficacy explain the relationship between fatigue and physical activity (PA) in post-coronary...
Fatigue and physical activity in post-CABG patients: the parallel mediation model of kinesiophobia and self-efficacy : a prospective multicentre and cross-sectional study in China.
OBJECTIVES
The objective of this study was to investigate how kinesiophobia and self-efficacy explain the relationship between fatigue and physical activity (PA) in post-coronary artery bypass grafting (post-CABG) patients over the age of 45.
DESIGN
A prospective multicentre and cross-sectional study.
SETTING
The study was conducted in four public tertiary hospitals in China.
PARTICIPANTS
A total of 1278 patients who underwent CABG surgery were selected from the case pool, with their surgeries occurring between 3 and 19 months prior to selection. Out of 1038 patients who met the inclusion criteria and were invited to participate in the study, 759 patients agreed to participate and complete the questionnaire. Ultimately, 376 questionnaires were deemed eligible and included in the analysis.
PRIMARY AND SECONDARY OUTCOME MEASURES
The questionnaire included the following scales: the Chinese version of the Multidimensional Fatigue Inventory (MFI-20), the Tampa Scale for Kinesiophobia Heart (TSK-SV Heart), the Cardiac Exercise Self-Efficacy Instrument (CESEI) and the International Physical Activity Questionnaire-Long (IPAQ-L). A serial mediation model was used to test whether the association between fatigue and PA was mediated by kinesiophobia and self-efficacy, in the overall sample and subsamples defined by age.
RESULTS
The results confirmed that fatigue was directly (95% CI (-5.73 to -3.02)) associated with PA. Higher kinesiophobia (95% CI (-0.16 to -0.05)) or lower PA self-efficacy (95% CI (-0.11 to -0.02)) were parallel pathways through which higher fatigue impediment reduced PA levels. In both subgroups, the street pathways of kinesiophobia and self-efficacy were altered. In the age, 45-60 years group, kinesiophobia (Boot 95% CI (-0.19 to-0.05)) was a mediator of fatigue on PA levels, while in the 61-75 years age group, self-efficacy (Boot 95% CI (-0.17 to -0.04)) was a mediator of fatigue on PA levels.
CONCLUSIONS
A clear relationship between fatigue and PA was mediated by both kinesiophobia and self-efficacy. Furthermore, our findings highlight the importance of adapting the intervention according to the age of the patients, mainly by reducing patients' kinesiophobia in patients aged 45-60 years and increasing patients' self-efficacy in patients aged 61-75 years. It may be possible to improve PA levels in post-CABG patients over 45 years of age by eliminating kinesiophobia and increasing self-efficacy.
Topics: Humans; Self Efficacy; Cross-Sectional Studies; Male; Prospective Studies; Female; Middle Aged; China; Exercise; Fatigue; Aged; Coronary Artery Bypass; Phobic Disorders; Surveys and Questionnaires; Kinesiophobia
PubMed: 38951011
DOI: 10.1136/bmjopen-2023-082576 -
BMJ Open Jul 2024Persistent symptoms after mild traumatic brain injury (mTBI) negatively affect daily functioning and quality of life. Fear avoidance behaviour, a coping style in which...
INTRODUCTION
Persistent symptoms after mild traumatic brain injury (mTBI) negatively affect daily functioning and quality of life. Fear avoidance behaviour, a coping style in which people avoid or escape from activities or situations that they expect will exacerbate their symptoms, maybe a particularly potent and modifiable risk factor for chronic disability after mTBI. This study will evaluate the efficacy of graded exposure therapy (GET) for reducing persistent symptoms following mTBI, with two primary aims: (1) To determine whether GET is more effective than usual care; (2) to identify for whom GET is the most effective treatment option, by evaluating whether baseline fear avoidance moderates differences between GET and an active comparator (prescribed aerobic exercise). Our findings will guide evidence-based care after mTBI and enable better matching of mTBI patients to treatments.
METHODS AND ANALYSIS
We will conduct a multisite randomised controlled trial with three arms. Participants (n=220) will be recruited from concussion clinics and emergency departments in three Canadian provinces and randomly assigned (1:2:2 ratio) to receive enhanced usual care, GET or prescribed aerobic exercise. The outcome assessment will occur remotely 14-18 weeks following baseline assessment, after completing the 12-week treatment phase. The primary outcome will be symptom severity (Rivermead Post-concussion Symptoms Questionnaire).
ETHICS AND DISSEMINATION
Informed consent will be obtained from all participants. All study procedures were approved by the local research ethics boards (University of British Columbia Clinical Research Ethics Board, University of Calgary Conjoint Health Research Ethics Board, University Health Network Research Ethics Board-Panel D). Operational approvals were obtained for Vancouver Coastal Health Research Institute and Provincial Health Services Authority. If GET proves effective, we will disseminate the GET treatment manual and present instructional workshops for clinicians.
TRIAL REGISTRATION NUMBER
ClinicalTrials.gov #NCT05365776.
Topics: Humans; Brain Concussion; Fear; Canada; Implosive Therapy; Avoidance Learning; Quality of Life; Randomized Controlled Trials as Topic; Post-Concussion Syndrome; Male; Multicenter Studies as Topic; Adult; Female
PubMed: 38950993
DOI: 10.1136/bmjopen-2024-086602