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World Journal of Surgical Oncology Jun 2024To evaluate sanitary techniques for radical thyroid cancer surgery via the transaxillary approach without inflation single-port endoscopic surgery (TAWISES) and the... (Comparative Study)
Comparative Study
A controlled study of the hygienic technical evaluation of the transaxillary approach for inflation-free single-port lumpectomy versus conventional transcervical anterior open surgery in radical thyroid cancer resection.
OBJECTIVE
To evaluate sanitary techniques for radical thyroid cancer surgery via the transaxillary approach without inflation single-port endoscopic surgery (TAWISES) and the conventional open anterior cervical approach (COACAS) in a controlled manner.
METHODS
This work was a retrospective analysis of the clinical data of 60 patients admitted to our hospital for unilateral radical thyroid cancer surgery between 01/2021 and 12/2022. The control group underwent COACAS (30 patients), and the experimental group underwent TAWISES (30 patients). The patients' operative time, intraoperative bleeding volume, 24-h postoperative pain index, drainage tube carrying time, hospitalization duration and complication rate were compared and analyzed. The patients were followed up for 3, 6 and 12 months postoperatively and evaluated based on numbness, muscular tightness, pain and other discomfort in the neck, as well as satisfaction with social adaptation and cosmetic incisions. The recurrence status was assessed for 1 year in both groups of patients. A questionnaire survey was conducted to assess patient acceptance of the two surgical approaches. The economic characteristics (cost-effectiveness and cost-utility) of the different approaches in our region were evaluated comprehensively.
RESULTS
The length of the incision, drainage tube carrying time and hospitalization duration were greater in the experimental group than in the control group (P < 0.05). The differences in complication rate, intraoperative bleeding volume, 24-h postoperative pain index and recurrence rate were not statistically significant between the two groups (P > 0.05). Neck discomfort was greater in the control group, and the difference was statistically significant at the 3-month postoperative follow-up (P < 0.05). The differences at the 6- and 12-month postoperative follow-ups were not statistically significant (P > 0.05). However, mild discomfort was significantly more common in the experimental group (63.33% > 36.67%, 80% > 53.33%, P < 0.05). The experimental group had better social adaptability, greater total medical costs, and better overall patient medical satisfaction than did the control group (P < 0.05). The acceptance of TAWISL was greater than that of COACAS (P < 0.05).
CONCLUSION
Compared with COACLAS, TAWISES is safe and effective and better meets the cosmetic, psychological and social adaptation needs of patients. TAWISES is also more cost effective and can be better utilized for the population in our region, filling the gap in surgical modalities for thyroid cancer in in our region.
Topics: Humans; Female; Thyroid Neoplasms; Male; Retrospective Studies; Middle Aged; Follow-Up Studies; Adult; Thyroidectomy; Mastectomy, Segmental; Postoperative Complications; Prognosis; Axilla; Case-Control Studies; Length of Stay; Operative Time; Endoscopy; Cost-Benefit Analysis; Pain, Postoperative
PubMed: 38937770
DOI: 10.1186/s12957-024-03445-y -
Harm Reduction Journal Jun 2024Good Samaritan Laws are a harm reduction policy intended to facilitate a reduction in fatal opioid overdoses by enabling bystanders, first responders, and health care...
Using qualitative system dynamics modeling to understand overdose bystander behavior in the context of Connecticut's Good Samaritan Laws and identify effective policy options.
BACKGROUND
Good Samaritan Laws are a harm reduction policy intended to facilitate a reduction in fatal opioid overdoses by enabling bystanders, first responders, and health care providers to assist individuals experiencing an overdose without facing civil or criminal liability. However, Good Samaritan Laws may not be reaching their full impact in many communities due to a lack of knowledge of protections under these laws, distrust in law enforcement, and fear of legal consequences among potential bystanders. The purpose of this study was to develop a systems-level understanding of the factors influencing bystander responses to opioid overdose in the context of Connecticut's Good Samaritan Laws and identify high-leverage policies for improving opioid-related outcomes and implementation of these laws in Connecticut (CT).
METHODS
We conducted six group model building (GMB) workshops that engaged a diverse set of participants with medical and community expertise and lived bystander experience. Through an iterative, stakeholder-engaged process, we developed, refined, and validated a qualitative system dynamics (SD) model in the form of a causal loop diagram (CLD).
RESULTS
Our resulting qualitative SD model captures our GMB participants' collective understanding of the dynamics driving bystander behavior and other factors influencing the effectiveness of Good Samaritan Laws in the state of CT. In this model, we identified seven balancing (B) and eight reinforcing (R) feedback loops within four narrative domains: Narrative 1 - Overdose, Calling 911, and First Responder Burnout; Narrative 2 - Naloxone Use, Acceptability, and Linking Patients to Services; Narrative 3 - Drug Arrests, Belief in Good Samaritan Laws, and Community Trust in Police; and Narrative 4 - Bystander Naloxone Use, Community Participation in Harm Reduction, and Cultural Change Towards Carrying Naloxone.
CONCLUSIONS
Our qualitative SD model brings a nuanced systems perspective to the literature on bystander behavior in the context of Good Samaritan Laws. Our model, grounded in local knowledge and experience, shows how the hypothesized non-linear interdependencies of the social, structural, and policy determinants of bystander behavior collectively form endogenous feedback loops that can be leveraged to design policies to advance and sustain systems change.
Topics: Humans; Harm Reduction; Connecticut; Opiate Overdose; Narcotic Antagonists; Naloxone; Drug Overdose; Health Policy; Law Enforcement
PubMed: 38937759
DOI: 10.1186/s12954-024-00990-3 -
BMC Endocrine Disorders Jun 2024The purpose of this study is to investigate the impact of social media-based microlearning (SMBM) on enhancing the knowledge, self-care, and self-efficacy behaviors of... (Randomized Controlled Trial)
Randomized Controlled Trial
The effectiveness of social media-based microlearning in improving knowledge, self-efficacy, and self-care behaviors among adult patients with type 2 diabetes: an educational intervention.
BACKGROUND
The purpose of this study is to investigate the impact of social media-based microlearning (SMBM) on enhancing the knowledge, self-care, and self-efficacy behaviors of patients with type 2 diabetes (T2D) receiving care at a hospital-based diabetes clinic in Zahedan, Iran.
METHODS
This intervention study was conducted from September 2021 to the end of 2022, with an intervention group (SMBM) and a control group (conventional-based training) consisting of patients with T2D. A total of 80 eligible patients were selected using a convenience sampling method and randomly assigned to either the intervention group (n = 40) or the control group (n = 40). The knowledge level, self-care, and self-efficacy of the samples were assessed before and two weeks after the educational intervention. Data analysis was conducted using SPSS version 24, and independent and paired T-tests were used for analysis.
RESULTS
The results of the study revealed that after the intervention, the levels of knowledge, self-care, and self-efficacy in the intervention group were significantly higher than those in the control group (p-value < 0.001).
CONCLUSION
In conclusion, the SMBM appears to be an effective tool for improving self-efficacy, self-care, and knowledge among patients with type 2 diabetes.
Topics: Humans; Diabetes Mellitus, Type 2; Self Efficacy; Male; Female; Middle Aged; Self Care; Social Media; Health Knowledge, Attitudes, Practice; Patient Education as Topic; Iran; Adult; Aged; Follow-Up Studies
PubMed: 38937738
DOI: 10.1186/s12902-024-01626-0 -
BMC Public Health Jun 2024Adolescence is a pivotal stage in human development that presents unique challenges, especially for girls navigating the complexities of menstruation. Despite the...
"If I use pad, I feel comfortable and safe": a mixed-method analysis of knowledge, attitude, and practice of menstrual hygiene management among in-school adolescent girls in a Nigerian city.
BACKGROUND
Adolescence is a pivotal stage in human development that presents unique challenges, especially for girls navigating the complexities of menstruation. Despite the importance of menstrual hygiene management for adolescent girls' well-being, this vital aspect of personal health is often overlooked, particularly in regions where cultural stigma prevails. This study examines knowledge, attitude, and practice of menstrual hygiene management among in-school adolescent girls in Abuja, Nigeria.
METHODS
The study employed a cross-sectional mixed-method design, integrating quantitative surveys with focus group discussions. A survey was conducted among 420 adolescent girls across four government junior secondary schools through a multistage sampling technique. Also, Focus Group Discussions were conducted among 80 respondents in groups of 10 discussants. The quantitative data set was subjected to descriptive and inferential statistical analysis, while the qualitative data were analysed using content analysis.
RESULTS
Findings revealed that the majority (53.45%) of the respondents had good knowledge of menstruation and menstrual hygiene management. Junior Secondary School (JSS) 3 students [OR = 2,09; 95% CI = 1.24-3.52] and those who started menstruation at age 15 years and above [OR = 7.52; 95% CI = 1.43-39.49] were associated with increased odds of having good knowledge of menstrual hygiene management. The attitude of most respondents (70.08%) towards menstrual hygiene management was good. Those in the JSS 3 class [OR = 6.47; 95% CI = 3.34-12.54], respondents who are Muslim [OR = 2.29; 95% CI = 1.63-5.48], and those whose parents had tertiary education [OR = 3.58; 95% CI = 1.25-10.25] were more likely to demonstrate more positive attitudes compared to their counterparts whose parents do not have tertiary education. In relation to practice, about 3 in 5 (57.80%) reportedly practise good menstrual hygiene management. Respondents who practice traditional religion [OR = 0.33; 95% CI = 0.02-4.56] were less likely to practise good menstrual hygiene management, while respondents who are the third child of their parents [OR = 2.09; 95% CI = 1.04-4.23] were more likely to practise menstrual hygiene compared to respondents with other birth orders. Qualitative results showed that participants had good knowledge of menstruation and menstrual hygiene management, and mothers were the main source of menstruation-related information. Participants had mixed feelings and reactions during their first menstruation, with 3 in 5 participants reporting experiencing menstruation-related stigma restrictions when menstruating.
CONCLUSIONS
In-school adolescent girls in Abuja, Nigeria, have good menstruation-related knowledge and positive attitudes, as well as practise menstrual hygiene management. Students' class and age at first menstruation were major factors associated with good knowledge of menstruation and menstrual hygiene management; respondents' class, religion and parents' educational qualification were associated with a positive attitude, while respondents' religion and parity line were associated with menstrual hygiene practice. Future interventions should focus on conducting school and community-level awareness programs to increase knowledge and dispel myths and misconceptions about menstruation and menstrual hygiene management.
Topics: Humans; Female; Health Knowledge, Attitudes, Practice; Adolescent; Nigeria; Cross-Sectional Studies; Menstruation; Hygiene; Menstrual Hygiene Products; Focus Groups; Surveys and Questionnaires; Students
PubMed: 38937735
DOI: 10.1186/s12889-024-19256-5 -
BMC Women's Health Jun 2024Despite the importance of health literacy and the self-care skills in improving individual and social health and health costs reduction, scientific evidence indicates... (Randomized Controlled Trial)
Randomized Controlled Trial
The effect of counseling based on health promotion awareness on self-care needs and reproductive and sexual health literacy of newly married women: a randomized controlled clinical trial study.
BACKGROUND
Despite the importance of health literacy and the self-care skills in improving individual and social health and health costs reduction, scientific evidence indicates women's poor awareness of self-care needs and low health literacy concerning reproductive and sexual health in most societies. The present study was conducted to specify the effect of health awareness promotion on self-care needs and reproductive and sexual health literacy of newly married women.
METHODS
This randomized controlled clinical trial was conducted on 64 newly married women aged 15-45 in Tehran, Iran from August 2021 to the end of December 2021. The participants were randomly assigned into the intervention (n = 32) and control (n = 32) groups. The intervention group received four individual health awareness-promotion education sessions. The reproductive and sexual self-care needs, and sexual health literacy questionnaires, were completed before and 4-week after the intervention through interview. The data were analyzed using SPSS26 software. The independent t-tests and ANCOVA were used to comparison the mean scores and a significance level of P < 0.05 was considered.
RESULTS
The results of this study indicated that after counseling, the average overall score of perceived reproductive and sexual self-care needs significantly decreased in the intervention group [Mean (standard deviation(SD)): 125.70 (24.70)] compared to the control group [Mean (SD): 87.1 (23.42)][P = 0.001]. Also, the mean score of sexual and reproductive health literacy significantly increased in the intervention group [Mean (SD): 125.50 (14.09)] compared to the control group [Mean (SD): 97.15 (14.90)] after intervention [P = 0.01].
CONCLUSIONS
The results indicated the positive effect of health promotion awareness educations on reproductive and sexual self-care needs and health literacy among newly married women. Therefore, health promotion interventions should be incorporated in health services provision programs for newly married women in comprehensive health centers to improve the health of women and families.
TRIAL REGISTRATION
Iranian Registry of Clinical Trials (IRCT): IRCT20171007036615N7 Date of registration: 2021-09-21. URL: https://fa.irct.ir/trial/58597 .
Topics: Humans; Female; Adult; Iran; Sexual Health; Reproductive Health; Health Literacy; Health Promotion; Young Adult; Self Care; Counseling; Middle Aged; Adolescent; Health Knowledge, Attitudes, Practice; Surveys and Questionnaires; Marriage
PubMed: 38937728
DOI: 10.1186/s12905-024-03214-9 -
BMC Public Health Jun 2024Primary healthcare facilities are central to the implementation of voluntary medical male circumcision (VMMC) as points of access to integrated health services in line... (Randomized Controlled Trial)
Randomized Controlled Trial
Primary healthcare facilities are central to the implementation of voluntary medical male circumcision (VMMC) as points of access to integrated health services in line with the Kenya AIDS Strategic Framework II (2020/21-2024/25). Knowledge of factors that explain men's uptake of VMMC and sexual health services at these facilities and preferences of where to get the services remain poorly understood. Using qualitative methodologies, we examined factors that determined facility choice for VMMC services and reasons for preferring the facility among men aged 25-39 years who previously underwent VMMC. The current study draws from focus group discussion interviews with circumcised men and their partners conducted as part of a randomized controlled trial to assess impact of two demand creation interventions in western Kenya. This involved 12 focus group discussions (FGD) with 6-10 participants each. Six FGDs were conducted with circumcised men, and 6 with their sex partners. Thematic issues relevant to a predetermined framework were identified. The themes were organized as follows: service availability, accessibility, affordability, appropriateness and, acceptability. Facility location, physical layout, organization of patient flow, infrastructure, and service provider skills were the outstanding factors affecting the choice of VMMC service outlets by men aged 25-39 years. Additionally, preferences were influenced by individual's disposition, attitudes, knowledge of VMMC services and tacit balance between their own recognized health needs versus desire to conform to social-cultural norms. Facility choice and individual preference are intricate issues, simultaneously involving multiple but largely intra-personal and facility-level factors. The intrapersonal dimensions elicited may also reflect differential responses to strategic communications and demand creation messages with promotion and prevention frames.
Topics: Humans; Male; Circumcision, Male; Kenya; Adult; Focus Groups; Qualitative Research; Patient Preference; Patient Acceptance of Health Care; Health Services Accessibility
PubMed: 38937707
DOI: 10.1186/s12889-024-19234-x -
Scientific Reports Jun 2024Men with writing proficiency enjoyed a privileged position in ancient Egyptian society in the third millennium BC. Research focusing on these officials of elevated...
Men with writing proficiency enjoyed a privileged position in ancient Egyptian society in the third millennium BC. Research focusing on these officials of elevated social status ("scribes") usually concentrates on their titles, scribal statues, iconography, etc., but the individuals themselves, and their skeletal remains, have been neglected. The aim of this study is to reveal whether repetitive tasks and maintained postures related to scribal activity can manifest in skeletal changes and identify possible occupational risk factors. A total of 1767 items including entheseal changes, non-metric traits, and degenerative changes were recorded from the human remains of 69 adult males of well-defined social status categories from the necropolis at Abusir (2700-2180 BC). Statistically significant differences between the scribes and the reference group attested a higher incidence of changes in scribes and manifested themselves especially in the occurrence of osteoarthritis of the joints. Our research reveals that remaining in a cross-legged sitting or kneeling position for extended periods, and the repetitive tasks related to writing and the adjusting of the rush pens during scribal activity, caused the extreme overloading of the jaw, neck and shoulder regions.
Topics: Humans; Male; Egypt, Ancient; History, Ancient; Risk Factors; Adult; Writing; Posture; Bone and Bones
PubMed: 38937484
DOI: 10.1038/s41598-024-63549-z -
Nature Communications Jun 2024Waste leakage has become a major global concern owing to the negative impacts on aquatic ecosystems and human health. We combine spatial analysis with the Shared...
Waste leakage has become a major global concern owing to the negative impacts on aquatic ecosystems and human health. We combine spatial analysis with the Shared Socioeconomic Pathways to project future waste leakage under current conditions and develop mitigation strategies up to 2040. Here we show that the majority (70%) of potential leakage of municipal solid waste into aquatic environments occurs in China, South Asia, Africa, and India. We show the need for the adoption of active mitigation strategies, in particular circular waste management systems, that could stop waste from entering the aquatic ecosystems in the first place. However, even in a scenario representing a sustainable world in which technical, social, and financial barriers are overcome and public awareness and participation to rapidly increase waste collection rates, reduce, reuse and recycling waste exist, it would be impossible to entirely eliminate waste leakage before 2030, failing to meet the waste-related Sustainable Development Goals.
PubMed: 38937482
DOI: 10.1038/s41467-024-49555-9 -
Eating and Weight Disorders : EWD Jun 2024Female fashion models are more at risk for developing eating disorders than non-models due to the intense occupational pressure they face. The present study focuses on...
PURPOSE
Female fashion models are more at risk for developing eating disorders than non-models due to the intense occupational pressure they face. The present study focuses on assessing whether female models are more prone to report orthorexia nervosa signs and symptoms than non-models.
METHODS
Female fashion models (n = 179, mean age: 25.9 SD = 4.40 years) and an age adjusted control group (n = 261, mean age: 25.0 SD = 4.97 years) were selected by snowball sampling. Participants filled out an online survey containing anthropometric questions and the 18-item Eating Habits Questionnaire.
RESULTS
According to BMI, fashion models were underweight (mean BMI = 18.1 SD = 1.68) while control participants' BMI was in the normal range (mean = 22.1 SD = 4.23, p < 0.001). On all three of Eating Habits Questionnaire subscales fashion models showed significantly higher average value (Knowledge subscale: M = 2.42 among models versus M = 2.08 in the control group, p < 0.01, Cohen's d = 0.52; Problems subscale: M = 1.93 among models versus M = 2.61 in the control group, p < 0.01, Cohen's d = 0.49; Feelings subscale: M = 3.20 among models versus M = 2.96 in the control group, p < 0.01, Cohen's d = 0.38). Orthorexic tendencies were reported by 35.1% of the models versus 20.2% of controls.
CONCLUSION
Fashion models are at risk for the development of eating disorders. Even though not yet included in the DSM-5, the assessment of orthorexia nervosa among fashion models seems to be important. It is suggested to take appropriate measures to prevent the spread of disordered eating habits among models as they can lead to the development of anorexia nervosa or bulimia nervosa.
LEVEL OF EVIDENCE
Level III, well-designed cohort study.
Topics: Humans; Female; Feeding and Eating Disorders; Feeding Behavior; Adult; Young Adult; Surveys and Questionnaires; Health Behavior; Body Mass Index; Body Image; Adolescent
PubMed: 38937320
DOI: 10.1007/s40519-024-01674-4 -
Archives of Gerontology and Geriatrics Jun 2024This systematic review aimed to identify barriers and facilitators to the implementation of physical activity programs for residents with dementia in aged care homes. (Review)
Review
OBJECTIVES
This systematic review aimed to identify barriers and facilitators to the implementation of physical activity programs for residents with dementia in aged care homes.
METHODS
A search was conducted using the databases Medline, PubMed, PsycINFO, CINAHL, Embase, and ProQuest, and captured articles were assessed for inclusion in the review. Included studies were appraised using the Mixed Methods Appraisal Tool (MMAT). Data extraction was performed for study characteristics, identified barriers and facilitators to physical activity implementation, and synthesised narratively.
RESULTS
Following full-text screening, 13 articles were included in the review. Reporting quality was high in the majority of studies (69 %). Overall, barriers to implementation of physical activity programs were linked to factors related to the resident or the aged care facility, rather than inherently with the physical activity itself. The most identified barriers were understaffing (62 %), resident fatigue or lack of motivation (46 %), distrust of staff (31 %), and fear of injury (31 %). The most identified facilitators were having a structured physical activity protocol (46 %), opportunities for social interaction (38 %), instructor-led sessions (38 %) and offering an individually tailored program (31 %).
CONCLUSIONS
Addressing barriers of understaffing and resident fatigue whilst simultaneously offering structured, personalised group physical activity programs led by instructors may help optimise implementation. Future research should focus on developing tailored implementation plans, evaluating their effectiveness and cost-effectiveness, and identifying best practices to support the delivery of physical activity interventions in residential aged care settings.
PROSPERO REGISTRATION NUMBER
CRD42022372308.
PubMed: 38936317
DOI: 10.1016/j.archger.2024.105535