SAGE Open Medicine最新文献

Objective: To comprehensively analyze the factors associated with anemia among adolescent girls in Pekanbaru, with a focus on nutritional status and anthropometric factors.

Methods: A cross-sectional study was conducted among 230 adolescent girls aged 10-19 years in Pekanbaru from six State Senior High Schools. Simple random sampling technique with proportional allocation to size was used to select the participants. Anemia was defined as hemoglobin levels below the WHO cut-off point. Data on age, menstrual patterns, iron supplementation, and knowledge of anemia were collected from structured interviews, dietary intake from 24-h food recall questionnaires, anthropometric measurements from height, weight, body mass index, mid-upper arm circumference.

Results: The prevalence of anemia among adolescent girls in Pekanbaru was 19.9%. The average age of the adolescent girls was 15 years with a menarche age of 12 years. Although statistically insignificant through bivariate testing, it was found that negative attitudes toward iron supplementation, noncompliance in taking iron supplements, and low mid-upper arm circumference may increase the risk of anemia among respondents. Multivariate analysis showed that variables that significantly influenced anemia were low mid-upper arm circumference (PR = 1.951, 95% CI: 1.05-3.60), nutritional status underweight (PR = 0.506, 95% CI: 0.26-0.96), and vitamin B12 intake (PR = 0.558, 95% CI: 0.31-0.97). Adolescent girls with low mid-upper arm circumference had a 1.95 times higher risk of experiencing anemia after controlling for other variables.

Conclusion: Anemia among adolescent girls in Pekanbaru were significantly associated with low mid-upper arm circumference (<22 cm), nutritional status (underweight), and vitamin B12 intake. A comprehensive and sustained approach is recommended, including enhanced nutrition education, and dietary diversification.

Objectives: The outbreak of COVID-19 in 2020 resulted in closed universities, digital teaching and restricted social contact. The students may encounter psychological stress and worries about their careers ahead, and some may experience feelings of doubt and helplessness while studying. Little is known about this closure's impact on undergraduate nursing students writing their bachelor's theses. This study aimed to explore how undergraduate nursing students in Norway, writing their bachelor's theses, experienced coping with the impact of COVID-19 on their social and academic lives.

Methods: We used qualitative individual in-depth interviews, and 14 undergraduate nursing students participated. Data were analyzed using content analysis based on Brinkmann and Kvale.

Results: The analyses showed that the social restrictions demanded that the students had to cope with several challenges related to their social and academic lives. Two main categories and four subcategories emerged during the analysis. The main categories were (1) Practical challenges, with Physical restrictions and digitalisation and Circadian rhythm and sleep deprivation as subcategories and (2) Mental challenges, with the sub-categories' Social isolation and loneliness, and Motivational and emotional challenges.

Conclusion: When the universities closed, the students struggled with loneliness, sleep deprivation, keeping their routines, and being motivated to complete their bachelor's theses. The universities must develop strategies to ensure that the students receive satisfactory information, support and guidance.

Background: Diabetes self-management education supports healthy dietary behaviors but often lacks food skill-building education to plan, budget for, select, and prepare (cook) healthier food.

Objectives: This study examined the relationship between food skills, diabetes self-management, and stress with medically underinsured patients with type-2 diabetes mellitus within the Fresh Start Food is Medicine (FIM) program. A secondary objective was to examine the impact on diet quality and clinical outcomes.

Methods: Adults (n = 150) with type-2 diabetes mellitus participated in the 20-week Fresh Start FIM intervention, which included nine group education classes, a produce prescription, and telephone-based health coaching. Group education and skill-building centered around food skills and diabetes self-management. Measures included surveys (e.g., food skills confidence, diet quality, and stress) and clinical measures (e.g., weight, HbA1c, and blood pressure). Data analysis included paired t-tests, Wilcoxon signed-rank tests, and linear regression.

Results: Significant improvements were observed in food skills confidence (p < 0.001), diet quality (e.g., fruit p = 0.03; vegetable p < 0.001; whole grain p < 0.001 consumption), diabetes self-management (p < 0.001), and perceived stress (p = 0.01). Food skills confidence and diabetes self-management were significant predictors of perceived stress (p = 0.05 and 0.009, respectively). Blood pressure significantly declined (systolic: -6.7 mmHg, p = 0.007; diastolic, p = 0.02).

Conclusion: Integrating food skills education and individualized behavioral support within an FIM intervention improved food skills confidence, diabetes self-management, and diet quality while reducing perceived stress among medically underinsured patients with type-2 diabetes mellitus. Enhanced self-efficacy in diabetes management and food skills were key contributors to stress reduction, emphasizing the importance of skill-oriented education within diabetes self-management education. These findings underscore the critical role of food skills in building capacity to improve dietary behaviors and health with resource-limited populations.

Objectives: The tobacco epidemic represents one of the most significant public health challenges faced globally. Nicotine replacement therapy was developed to substitute for the nicotine contained in tobacco products temporarily. The objective of this study was to investigate pharmacists' knowledge, attitudes, and practices regarding the utilization of nicotine replacement therapy in Iraq.

Methods: This cross-sectional study involved 300 pharmacists across five provinces from October 1, 2023 to December 31, 2023.

Results: Indicate that 300 pharmacists participated in the analysis, with approximately two-thirds identifying as male. About two-thirds of the participants (95% confidence interval: 65.3%) expressed that they knew how to use nicotine replacement therapy. Furthermore, about half of them (95% confidence interval: 50.3%) reported their awareness of how to make dose titration, with a majority agreeing that the assessment of nicotine dependence influences the selection of nicotine replacement therapy products. Fair knowledge was associated with each degree of education, not attending training programs, and the availability of nicotine replacement therapy in their pharmacies (0.01, 0.002, 0.003, respectively).

Conclusions: There exists a critical necessity for pharmacists to augment their comprehension of the medications utilized in smoking cessation. Such enhancement is essential to improve their practices and, consequently, to attain superior outcomes in supporting individuals in their efforts to quit smoking.

Objective: This study aimed to develop an observational tool to assess the social interactive behaviors of children with special education needs during animal-assisted activity and to examine its reliability and validity.

Methods: The study comprised two phases: developing and evaluating the measurement tool. The tool was created through literature reviews and expert interviews. The pilot observational study was conducted in a special educational school in Hong Kong, China, involving 138 children with intellectual disability participating in animal-assisted activity sessions to examine the tool's reliability and validity.

Results: Initially, the measurement tool included 26 observational variables across three dimensions (inter-rater reliability of 0.74). After excluding variables with low discriminability, the final tool contained seven observational variables. The tool demonstrated strong reliability (inter-rater reliability of 0.81) and satisfactory validity, significantly discriminating among different intellectually disabled students (ps < 0.05).

Conclusions: This study developed and validated an observational tool for measuring the social behaviors of children with special education need during animal-assisted activity sessions. More extensive studies are needed to further evaluate the instrument.

Objectives: Radiation exposure has been a cause of concern in computed tomography imaging. Reducing radiation dose increases the image noise which can be compensated by using reconstruction techniques. Recently artificial intelligence-based reconstruction technique has been introduced. Therefore, the purpose of the study was to prospectively compare the image quality between Idose4 and Precise Image in normal BMI individuals.

Methods: Sixty-six consecutive patients with a normal body habitus undergoing contrast-enhanced abdomen and pelvis scan were included in the study. All scans were performed using 100 kVp and tube current modulation. The acquired images were reconstructed to iDose4 and precise imaging. Quantitatively images were analyzed by placing regions of interest in different organs to estimate the image noise, signal-to-noise ratio, and contrast-to-noise ratio. Qualitative analysis was done by two radiologists on a five-point Likert scale.

Results: Image noise was significantly reduced using Precise Image across the plain (9.11 ± 1.43 vs 8.18 ± 1.2), arterial (14.34 ± 2.1 vs 10.21 ± 1.5), and portovenous phase (14.78 ± 2.30 vs 11.97 ± 2.07) with maximum noise reduction in the arterial and portovenous phases. Signal-to-noise ratio and contrast-to-noise ratio was significantly improved in all the organs across the plain, arterial, and portovenous phases. Qualitative analysis showed no significant difference between Idose4 and Precise Image with regards to visualization of large vessels in the arterial and portovenous phases. However, precise image was graded better than Idose4 with respect to visualization/conspicuity, image noise, and artifacts.

Conclusion: Precise Image can be useful in reducing the image noise and improving the signal-to-noise ratio and contrast-to-noise ratio in low-dose computed tomography protocol among normal BMI individuals.

Background: Cytomegalovirus infection is a common complication following hematopoietic stem cell transplantation that significantly influences clinical outcomes.

Objectives: To develop and validate a predictive model for cytomegalovirus infection risk in patients with β-thalassemia major undergoing hematopoietic stem cell transplantation.

Design: Retrospective cohort study.

Methods: Clinical data from 291 β-thalassemia major patients undergoing hematopoietic stem cell transplantation were retrospectively analyzed. Independent risk factors identified via univariate and multivariate logistic regression analyses formed the basis of a predictive nomogram. The model's performance was evaluated by the concordance index (C-index), receiver operating characteristic curves, calibration plots, and decision curve analysis. Internal validation was performed using bootstrap resampling, and external validation was conducted with an independent cohort of 84 patients from another center.

Results: Three independent predictors of cytomegalovirus infection were identified: serum albumin levels, donor type, and grade III-IV acute graft-versus-host disease. A nomogram incorporating these predictors was established, demonstrating good discriminative ability (C-index: 0.745; 95% CI: 0.684-0.807). Internal and external validations yielded C-indices of 0.746 and 0.649, respectively. Receiver operating characteristic analysis showed an area under the curve of 0.745 in the training cohort and 0.649 in the validation cohort.

Conclusion: We developed and validated a reliable predictive model for assessing cytomegalovirus infection risk after hematopoietic stem cell transplantation in β-thalassemia major patients. This scoring system offers clinicians a practical tool for early risk stratification and intervention.

Objectives: Previous studies reported that many inflammatory factors have associations with osteoporosis. This study use Mendelian randomization (MR) analysis to explore the causal genetic relationship between 41 inflammatory factors and osteoporosis.

Methods: A bidirectional two-sample MR analysis was performed by employing five Mendelian randomization analysis methods including MR Egger regression, weighted median, inverse-variance weighted and weight mode methods. Summary statistics from the genome-wide association study (GWAS) of 41 inflammatory cytokines and osteoporosis were included in this study. This study examined the MR analysis results for heterogeneity and horizontal pleiotropy.

Results: Using the inverse variance weighted (IVW) method, this analysis indicated that elevated monocyte chemotactic protein-1 (MCP-1) levels were potentially linked to a 22% increased likelihood of osteoporosis (Odds Ratio (OR) = 1.22, 95% CI: 1.04-1.43, p = 0.014). Additionally, through the IVW approach, we observed that higher tumor necrosis factor-related apoptosis inducing ligand (TRAIL) levels were possibly associated with a 15% greater risk of osteoporosis (OR = 1.12, 95% CI: 1.03-1.29, p = 0.012). Other 39 inflammatory cytokines don't have casual genetic association with osteoporosis. When this study use MR to estimate the influence of osteoporosis on inflammatory factors, none of the p-values with IVW method were lower than 0.05.

Conclusion: This is the first bidirectional MR analysis to explore the causal genetic relationship between inflammatory cytokines and osteoporosis. This study found that MCP-1 and TRAIL are probably the upstream factors correlated with osteoporosis, and no inflammatory cytokine was involved in osteoporosis development downstream.

Immune checkpoint inhibitors therapy in cancer patients may induce immune-related diabetes mellitus through islet β-cell destruction, necessitating systematic glycemic management. This scoping review aims to identify and synthesize evidence on glycemic management strategies for immune-related diabetes mellitus. Guided by Arksey and O'Malley's five-stage scoping review framework, we strictly adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. A systematic search was conducted across guideline repositories, academic databases, and professional oncology/endocrinology association websites. The search period spanned from database inception to June 30, 2024. Of 5085 initially identified records, 9 studies met inclusion criteria. Evidence was synthesized into five key domains: (1) risk assessment and early detection, (2) therapeutic interventions and monitoring, (3) patient education, (4) glycemic target optimization, and (5) multidisciplinary care coordination. This review consolidates evidence-based best practices for immune-related diabetes mellitus management derived from rigorous methodology. Clinicians should tailor these strategies to individual patient profiles to optimize outcomes while mitigating treatment disruptions.

Background: Evidence-based practice in intrapartum care is critical for lowering maternal and neonatal mortality and morbidity. Evidence-based practice, according to the World Health Organization Quality of Care Framework for Maternal and Newborn Health, is an important component of intrapartum care. However, little is understood about evidence-based intrapartum care practice in Ethiopia, particularly in the study setting.

Objective: To assess evidence-based intrapartum care practice and associated factors among obstetric care professionals in Jimma Zone public hospitals in Southwest Ethiopia.

Methods: A facility-based cross-sectional study was carried out on 217 obstetric care providers in Jimma Zone public hospitals in southwest Ethiopia. The study used a census approach to include all eligible participants within the specified population. Data were collected from June 1 to 30, 2023, using semistructured self-administered questionnaires. The collected data were entered into EpiData version 4.6 and exported to Statistical Packages for Social Sciences version 25 for analysis. Multivariable logistic regression was run to see the association between evidence-based intrapartum care practice and predictor variables. Statistical significance was set at p-values less than 0.05 in the multivariable logistic regression.

Results: Overall, 41.2% (95% CI: 40.8-42.3) of obstetric care providers in Jimma Zone public hospitals used evidence-based practices for intrapartum care. Attending in-service training (AOR (95% CI): 3.5 (1.61-9.71)), accessibility of obstetric care guidelines (AOR (95% CI): 2.082 (1.222-3.547)), having regular case presentation (AOR (95% CI): 2.5 (1.234-6.743)), having knowledge (AOR (95% CI): 2.3 (1.222-3.547)), attitude of obstetric care providers (AOR (95% CI): 1.847 (1.065-3.204)), having less than 2 years of work experience (AOR (95% CI): 1.32 (1.012-3.56)), and having 2-5 years of work experience (AOR (95% CI): 3.49 (1.23-6.312)) were among factors significantly associated with evidence-based intra-partum care practice of obstetric care providers in Jimma Zone public hospitals.

Conclusions: This study indicated that the majority of obstetric care providers did not practice evidence-based intrapartum care, which requires attention from all stakeholders. It is recommended for hospitals in the Jimma Zone to make guidelines available, provide in-service trainings, and identify systematic strategies to improve the knowledge and attitude of obstetric care providers.