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International Journal of Environmental... Jun 2024This systematic review investigated the practices that support and hinder the recovery and healing of communities and the environments within which they live, following... (Review)
Review
This systematic review investigated the practices that support and hinder the recovery and healing of communities and the environments within which they live, following climate-related environmental disasters. Although the literature focused on recovery is dominated by interventions aimed at the individual and their mental health, a thematic analysis of thirty-six studies established a range of practices that enhance collective recovery and healing. Four narratives were identified from the findings highlighting key practices: (1) collective and community-led recovery; (2) recognising the criticality of context, place, and identity; (3) adopting a holistic conception of well-being and Country-centred practices; and (4) decolonising and Indigenising the literature. This study details recommendations for research and practice. First Nations' knowledges and healing practices need to be recognised and harnessed in climate-related environmental disaster recovery. Community-led interventions harness local knowledge, networks, and expertise, which improves the dissemination of resources and enables recovery efforts to be tailored to the specific needs of communities.
Topics: Humans; Natural Disasters
PubMed: 38929041
DOI: 10.3390/ijerph21060795 -
International Journal of Environmental... Jun 2024The escalating awareness of heat-related risks and the associated imperative to enhance preparedness strategies at various levels has spurred a growing emphasis on...
The escalating awareness of heat-related risks and the associated imperative to enhance preparedness strategies at various levels has spurred a growing emphasis on disseminating knowledge about heat vulnerability. These efforts aim to equip diverse stakeholders with practical heat planning and forecasting tools. The success of these communication initiatives hinges on understanding the nuanced perceptions of risk and the priority assigned to addressing heat as a health risk. This paper delves explicitly into the unhoused population's risk perceptions and coping strategies. Acknowledged as one of the most underserved and vulnerable groups to extreme heat, unhoused individuals face prolonged exposure, a heightened frequency of mental and physical health issues, and limited coping resources during extreme heat events. Despite widespread acknowledgment of their vulnerability, little attention has been directed towards researching health behavior within this demographic about excessive heat. We developed a survey instrument using the theory of planned behavior (TPB) to bridge this gap. We collected quantitative survey data from unhoused populations in Columbia, South Carolina, an area of the United States that experiences extreme heat events and has a sizeable unhoused population. Using a series of hierarchical multiple regression models, our findings indicate that TPB variables predict the intention to avoid the heat while considering additional coping strategies common among unhoused individuals. These findings offer valuable insights for public health researchers, practitioners, and community officials engaged in direct interactions with unhoused populations, informing how this underserved group manages excessive heat exposure.
Topics: Humans; Adaptation, Psychological; Adult; Female; Male; Middle Aged; Young Adult; Hot Temperature; Aged; Adolescent; Surveys and Questionnaires; Health Knowledge, Attitudes, Practice; Perception; Risk Assessment; Coping Skills
PubMed: 38928983
DOI: 10.3390/ijerph21060737 -
International Journal of Environmental... May 2024The onset of the COVID-19 pandemic brought about global uncertainties and fears, escalating the dissemination of fake news. This study aims to analyze the impact of fake...
INTRODUCTION
The onset of the COVID-19 pandemic brought about global uncertainties and fears, escalating the dissemination of fake news. This study aims to analyze the impact of fake news on COVID-19 vaccine adherence among pregnant women, providing crucial insights for effective communication strategies during the pandemic.
METHODS
A cross-sectional, exploratory study was conducted with 113 pregnant women under care at a Women's Health Reference Center. Data analysis included relative frequency and odds ratio to assess the relationship between sociodemographic and behavioral variables regarding vaccination.
RESULTS
In the behavioral context of vaccination, internet access shows a significant association with decision-making, influencing vaccine refusal due to online information. Nuances in the odds ratios results highlight the complexity of vaccine hesitancy, emphasizing the importance of information quality. Pre-vaccination sentiments include stress (87.61%), fear (50.44%), and anxiety (40.7%), indicating the need for sensitive communication strategies.
DISCUSSION
Results revealed that pregnant women with higher education tend to adhere more to vaccination. Exposure to news about vaccine inefficacy had a subtle association with hesitancy, while finding secure sources was negatively associated with hesitancy. The behavioral complexity in the relationship between online information access and vaccination decision underscores the need for effective communication strategies.
CONCLUSIONS
In the face of this challenging scenario, proactive strategies, such as developing specific campaigns for pregnant women, are essential. These should provide clear information, debunk myths, and address doubts. A user-centered approach, understanding their needs, is crucial. Furthermore, ensuring information quality and promoting secure sources are fundamental measures to strengthen trust in vaccination and enhance long-term public health.
Topics: Humans; Female; Pregnancy; COVID-19 Vaccines; Adult; Cross-Sectional Studies; Internet; COVID-19; Pregnant Women; Young Adult; Emotions; Vaccination Hesitancy; Vaccination
PubMed: 38928965
DOI: 10.3390/ijerph21060719 -
International Journal of Environmental... May 2024Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably also in... (Review)
Review
Preschoolers with disabilities and their caregivers have been neglected in health and social service provision in most low-income countries and arguably also in low-resourced areas of more affluent nations. Yet as this rapid review of the published literature identifies, there are low-cost, evidence-based strategies to address their needs that can be implemented in communities by local people. Five key features of the necessary supports are examined. First, the leadership functions required to create and implement the support services. Second, the family-centred, home-based support provided to caregivers and the personnel undertaking this form of support. Third, providing opportunities for peer support to flourish and encouraging the formation of advocacy groups across families. Fourth, mobilizing the support of significant groups within the community: notably, traditional healers and leaders, health services and poverty alleviation initiatives. Fifth, devising ways in which preschool educational opportunities can be offered to children as a prelude to their inclusion in primary schools. The review serves a further purpose. It provides an example of how public health researchers and academics could achieve more rapid implementation of evidence-based knowledge into existing and new support services through dissemination to community practitioners.
Topics: Humans; Child, Preschool; Developmental Disabilities; Developing Countries; Social Support; Caregivers
PubMed: 38928898
DOI: 10.3390/ijerph21060651 -
Diagnostics (Basel, Switzerland) Jun 2024This study evaluates the potential of ChatGPT and Google Bard as educational tools for patients in orthopedics, focusing on sports medicine and pediatric orthopedics....
BACKGROUND
This study evaluates the potential of ChatGPT and Google Bard as educational tools for patients in orthopedics, focusing on sports medicine and pediatric orthopedics. The aim is to compare the quality of responses provided by these natural language processing (NLP) models, addressing concerns about the potential dissemination of incorrect medical information.
METHODS
Ten ACL- and flat foot-related questions from a Google search were presented to ChatGPT-3.5 and Google Bard. Expert orthopedic surgeons rated the responses using the Global Quality Score (GQS). The study minimized bias by clearing chat history before each question, maintaining respondent anonymity and employing statistical analysis to compare response quality.
RESULTS
ChatGPT-3.5 and Google Bard yielded good-quality responses, with average scores of 4.1 ± 0.7 and 4 ± 0.78, respectively, for sports medicine. For pediatric orthopedics, Google Bard scored 3.5 ± 1, while the average score for responses generated by ChatGPT was 3.8 ± 0.83. In both cases, no statistically significant difference was found between the platforms ( = 0.6787, = 0.3092). Despite ChatGPT's responses being considered more readable, both platforms showed promise for AI-driven patient education, with no reported misinformation.
CONCLUSIONS
ChatGPT and Google Bard demonstrate significant potential as supplementary patient education resources in orthopedics. However, improvements are needed for increased reliability. The study underscores the evolving role of AI in orthopedics and calls for continued research to ensure a conscientious integration of AI in healthcare education.
PubMed: 38928668
DOI: 10.3390/diagnostics14121253 -
Cancers Jun 2024Melanoma is the cancer with the highest risk of dissemination to the central nervous system (CNS), one of the leading causes of mortality from this cancer.
BACKGROUND
Melanoma is the cancer with the highest risk of dissemination to the central nervous system (CNS), one of the leading causes of mortality from this cancer.
OBJECTIVE
To identify patients at higher risk of developing CNS metastases and to evaluate associated prognostic factors.
METHODS
A cohort study (1998-2023) assessed patients who developed CNS melanoma metastases. Multivariate logistic regression was used to identify predictive factors at melanoma diagnosis for CNS metastasis. Cox regression analysis evaluated the CNS-independent metastasis-related variables impacting survival.
RESULTS
Out of 4718 patients, 380 (8.05%) developed CNS metastases. Multivariate logistic regression showed that a higher Breslow index, mitotic rate ≥ 1 mm, ulceration, and microscopic satellitosis were significant risk factors for CNS metastasis development. Higher patient age and the location of the primary tumor in the upper or lower extremities were protective factors. In survival analysis, post-CNS metastasis, symptomatic disease, prior non-CNS metastases, CNS debut with multiple metastases, elevated LDH levels, and leptomeningeal involvement correlated with poorer survival.
CONCLUSION
Predictive factors in the primary tumor independently associated with brain metastases include microscopic satellitosis, ulceration, higher Breslow index, and trunk location. Prognostic factors for lower survival in CNS disease include symptomatic disease, multiple CNS metastases, and previous metastases from different sites.
PubMed: 38927977
DOI: 10.3390/cancers16122272 -
Bioengineering (Basel, Switzerland) Jun 2024This paper presents an eye image segmentation-based computer-aided system for automatic diagnosis of ocular myasthenia gravis (OMG), called OMGMed. It provides great...
This paper presents an eye image segmentation-based computer-aided system for automatic diagnosis of ocular myasthenia gravis (OMG), called OMGMed. It provides great potential to effectively liberate the diagnostic efficiency of expert doctors (the scarce resources) and reduces the cost of healthcare treatment for diagnosed patients, making it possible to disseminate high-quality myasthenia gravis healthcare to under-developed areas. The system is composed of data pre-processing, indicator calculation, and automatic OMG scoring. Building upon this framework, an empirical study on the eye segmentation algorithm is conducted. It further optimizes the algorithm from the perspectives of "network structure" and "loss function", and experimentally verifies the effectiveness of the hybrid loss function. The results show that the combination of "nnUNet" network structure and "Cross-Entropy + Iou + Boundary" hybrid loss function can achieve the best segmentation performance, and its MIOU on the public and private myasthenia gravis datasets reaches 82.1% and 83.7%, respectively. The research has been used in expert centers. The pilot study demonstrates that our research on eye image segmentation for OMG diagnosis is very helpful in improving the healthcare quality of expert doctors. We believe that this work can serve as an important reference for the development of a similar auxiliary diagnosis system and contribute to the healthy development of proactive healthcare services.
PubMed: 38927831
DOI: 10.3390/bioengineering11060595 -
Genes Jun 2024This study analyzed ancient DNA from the remains of horses unearthed from the Shihuyao tombs. These were found to date from the Han and Tang Dynasties in Xinjiang...
This study analyzed ancient DNA from the remains of horses unearthed from the Shihuyao tombs. These were found to date from the Han and Tang Dynasties in Xinjiang (approximately 2200 to 1100 years ago). Two high-quality mitochondrial genomes were acquired and analyzed using next-generation sequencing. The genomes were split into two maternal haplogroups, B and D, according to a study that included ancient and contemporary samples from Eurasia. A close genetic affinity was observed between the horse of the Tang Dynasty and Akhal-Teke horses according to the primitive horse haplotype G1. Historical evidence suggests that the ancient Silk Road had a vital role in their dissemination. Additionally, the matrilineal history of the Akhal-Teke horse was accessed and suggested that the early domestication of the breed was for military purposes.
Topics: Animals; Horses; Genome, Mitochondrial; China; DNA, Ancient; Haplotypes; DNA, Mitochondrial; Phylogeny; History, Ancient; High-Throughput Nucleotide Sequencing; Domestication
PubMed: 38927726
DOI: 10.3390/genes15060790 -
Antibiotics (Basel, Switzerland) Jun 2024Carbapenemases, a class of enzymes specialized in the hydrolysis of carbapenems, represent a significant threat to global public health. These enzymes are classified... (Review)
Review
Carbapenemases, a class of enzymes specialized in the hydrolysis of carbapenems, represent a significant threat to global public health. These enzymes are classified into different Ambler's classes based on their active sites, categorized into classes A, D, and B. Among the most prevalent types are IMI/NMC-A, KPC, VIM, IMP, and OXA-48, commonly associated with pathogenic species such as , , and . The emergence and dissemination of carbapenemase-producing bacteria have raised substantial concerns due to their ability to infect humans and animals (both companion and food-producing) and their presence in environmental reservoirs. Adopting a holistic One Health approach, concerted efforts have been directed toward devising comprehensive strategies to mitigate the impact of antimicrobial resistance dissemination. This entails collaborative interventions, highlighting proactive measures by global organizations like the World Health Organization, the Center for Disease Control and Prevention, and the Food and Agriculture Organization. By synthesizing the evolving landscape of carbapenemase epidemiology in Portugal and tracing the trajectory from initial isolated cases to contemporary reports, this review highlights key factors driving antibiotic resistance, such as antimicrobial use and healthcare practices, and underscores the imperative for sustained vigilance, interdisciplinary collaboration, and innovative interventions to curb the escalating threat posed by antibiotic-resistant pathogens. Finally, it discusses potential alternatives and innovations aimed at tackling carbapenemase-mediated antibiotic resistance, including new therapies, enhanced surveillance, and public awareness campaigns.
PubMed: 38927223
DOI: 10.3390/antibiotics13060557 -
Antibiotics (Basel, Switzerland) Jun 2024Antimicrobial resistance (AMR) is a major public health threat linked to increased morbidity and mortality. It has the potential to return us to the pre-antibiotic era....
Antimicrobial resistance (AMR) is a major public health threat linked to increased morbidity and mortality. It has the potential to return us to the pre-antibiotic era. Antimicrobial stewardship (AMS) programs are recognized as a key intervention to improve antimicrobial use and combat AMR. However, implementation of AMS remains limited in Africa, particularly in Rwanda. This study aimed to assess prescription practices, identify areas for improvement, and promote adherence to AMS principles. Conducted at King Faisal Hospital in Rwanda, this qualitative study used semi-structured interviews with eight participants until saturation was reached. The interviews were recorded, transcribed, and thematically analyzed, revealing four emerging themes. The first theme was on AMS activities that were working well based on availability of microbiology laboratory results and prescription guidelines as factors influencing antibiotic prescription adjustments. The second theme was related to challenges during the implementation of the AMS program, including the prescription of broad-spectrum antibiotics, limited local data on AMR patterns, and stock-outs of essential antibiotics. The third theme was on the importance of adhering to AMR management guidelines at KFH. The last emerged on recommendations from participants centered on regular training for healthcare workers, widespread dissemination of AMR findings across departments, and the enforcement of antibiotic restriction policies. These actions can improve prescription behaviors, upholding the highest standards of patient care, and strengthening the nascent AMS program.
PubMed: 38927214
DOI: 10.3390/antibiotics13060548