Circles

Sorry, no results were found.

Posts

2 mins ago


68; CI = 1.58-1.79) had higher odds of SSN, compared to those with no formal education. Women who were working had higher odds of SSN (aOR = 1.44; CI = 1.37-1.51) than those who were not working. Women in the middle (aOR = 0.93; CI = 0.87-0.99) and richer (aOR = 0.92; CI = 0.85-0.98) wealth status had lower odds of SSN, compared to those in the poorest wealth status. Women's autonomy in household decision-making is a significant predictor of SSN. Women autonomy in household decision-making programs and interventions should be intensified to achieve Sustainable Development Goals 3.7 and 5 which seek to achieve universal access to sexual and reproductive health services and ensure gender equality and empower all women and girls by 2030.
Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression.

We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study Mbekweni (N=510) and TC Newman (N=413). Data were collected from pregnant women between 28 and 32 weeks' gestation.

Associations between trauma and depressive symptoms differed by site (




χ


2



=2163.6, df=1419, p<0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p<0.01) and 0.47 in TC Newman (p<0.01). Trauma was differentially associated with SES (Mbekweni -0.10, p=0.07; TC Newman -0.05, p=0.37) and SES with depression (Mbekweni -0.18, p<0.01; TC Newman -0.02, p=0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. -0.002-0.039) in Mbekweni and 0.001 (95% C.I. -0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni.

Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.
Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.We examine the long-term relationship between childhood circumstances and cognitive aging. In particular, we differentiate the level of cognitive deficit from the rate of cognitive decline. Applying a linear mixed-effect model to three waves of China Health and Retirement Longitudinal Surveys (CHARLS 2011, 2013, 2015) and matching cognitive outcomes to CHARLS Life History Survey (2014), we find that key domains of childhood circumstances, including family socioeconomic status (SES), neighborhood cohesion, friendship, and health conditions, are significantly associated with both the level of cognitive deficit and the rate of decline. In contrast, childhood neighborhood safety only affects the level of cognitive deficit. Childhood relationship with mother only affects the rate of cognitive decline. The effects of adverse childhood circumstances are generally larger on level of cognitive deficit than on rate of cognitive decline. Moreover, education plays a more important role in mediating the relationships compared to other later-life factors. These findings suggest that exposure to disadvantaged childhood circumstances can exacerbate cognitive deficit as well as cognitive decline over time, which may be partially ameliorated by educational attainment.According to the World Health Organization, dengue is a neglected tropical disease. Latin America, specifically Colombia is in alert regarding this arbovirosis as there was a spike in the number of reported dengue cases at the beginning of 2019. Although there has been a worldwide decrease in the number of reported dengue cases, Colombia has shown a growing trend over the past few years. This study performed a Poisson multilevel analysis with mixed effects on STATA® version 16 and R to assess sociodemographic, climatic, and entomological factors that may influence the occurrence of dengue in three municipalities for the period 2010-2015. Information on dengue cases and their sociodemographic variables was collected from the National Public Health Surveillance System (SIVIGILA) records. For climatic variables (temperature, relative humidity, and precipitation), we used the information registered by the weather stations located in the study area, which are managed by the Instituto de Hidrologia, Meteorologia y Estudios Ambientales (IDEAM) or the Corporación Autónoma Regional (CAR). The entomological variables (house index, container index, and Breteau index) were provided by the Health office of the Cundinamarca department. SIVIGILA reported 1921 dengue cases and 56 severe dengue cases in the three municipalities; of them, three died. One out of four cases occurred in rural areas. The age category most affected was adulthood, and there were no statistical differences in the number of cases between sexes. The Poisson multilevel analysis with the best fit model explained the presentation of cases were temperature, relative humidity, precipitation, childhood, live in urban area and the contributory healthcare system. The temperature had the biggest influence on the presentation of dengue cases in this region between 2010 and 2015.Blunt abdominal trauma is a common cause of solid organ injury in children. Nonoperative management has been established as the standard of care for suspected liver and spleen injuries without peritonitis. Major ductal injury with resultant biloma is a rare complication of nonoperative management of blunt liver injury. https://www.selleckchem.com/products/mek162.html Endoscopic retrograde cholangiopancreatography (ERCP) and/or percutaneous drain placement are considered to be safe adjuncts in the management of these bile leaks. However, in the rare cases of persistent bile leak, further nonoperative alternatives have not been reported. In this case report we present a novel multidisciplinary approach to managing persistent bile leaks in blunt liver injury.

2 mins ago


Healthcare providers commonly experience symptoms of anxiety during public health crises and pandemics. The objective of the study was to identify the frequency of symptoms of generalized anxiety disorder (GAD) in general practitioners and to estimate the association with particular psychosocial and demographic factors. This is a cross-sectional study, where a total of 531 general practitioners completed an online form that contained sociodemographic variables, questions about fear and perceptions concerning medical work during the COVID-19 pandemic, 7-Item Generalized Anxiety Disorder Scale (GAD-7), questionnaire on psychosomatic problems and Fear of COVID-19 Scale. The presence of symptoms of GAD was defined by a GAD-7 score of 10 or more points. Voluntary and anonymous participation, acceptance of terms, and informed consent were requested. A p value of less then 0.05 was considered statistically significant. Symptoms of GAD were identified in 4 out of 10 Colombian general practitioners; the following psychosocial and demographic factors were associated with a greater presence of these symptoms female gender, social discrimination, anguish, job disappointment, nightmares, stress and other symptoms of fear regarding the pandemic. https://www.selleckchem.com/GSK-3.html Conversely, feeling protected by the state or employer, being satisfied with their job as a physician, and trusting government measures and information were associated with a lower presence of symptoms of GAD. These findings highlight the importance of timely psychotherapeutic and psychopharmacological interventions in these individuals. The authors suggest mental health providers should be deployed during times of crisis to decrease the risk of developing mental illness.
Many predictive models for incident type 2 diabetes (T2D) exist, but these models are not used frequently for public health management. Barriers to their application include (1) the problem of model choice (some models are applicable only to certain ethnic groups), (2) missing input variables, and (3) the lack of calibration. While (1) and (2) drives to missing predictions, (3) causes inaccurate incidence predictions. In this paper, a combined T2D risk model for public health management that addresses these three issues is developed.

The combined T2D risk model combines eight existing predictive models by weighted average to overcome the problem of missing incidence predictions. Moreover, the combined model implements a simple recalibration strategy in which the risk scores are rescaled based on the T2D incidence in the target population. The performance of the combined model was compared with that of the eight existing models using data from two test datasets extracted from the Multi-Ethnic Study of Athescaling and averaging was shown to provide accurate and robust incidence predictions, overcoming the problem of recalibration and missing predictions in practical application of predictive models.
Cardiovascular (CV) disease affects a high percentage of patients with type 2 diabetes mellitus (T2DM), especially in the hospital setting, impacting on mortality, complications, quality of life and use of health resources. The aim of this study was to estimate the incidence, mean length of hospital stay (LOHS) and costs attributable to hospital admissions due to CV events in patients with T2DM versus patients without diabetes mellitus (non-DM) in Spain.

Retrospective observational study based on the Spanish National Hospital Discharge Database for 2015. Hospital admissions for patients aged ≥35 years with a diagnosis of CV death, non-fatal acute myocardial infarction (AMI), non-fatal stroke, unstable angina, heart failure and revascularization were evaluated. The International Classification of Diseases, Ninth Revision (250.x0 or 250.x2) coding was used to classify records of patients with T2DM. For each CV complication, the hospital discharges of the two groups, T2DM and non-DM, were precisely matched ahese complications.
Patients with T2DM had a higher incidence and number of hospital admissions per patient due to CV events versus the non-DM population. This generates a significant clinical and economic burden given the longer admission stay and higher costs associated with some of these complications.
Roux-en-Y gastric bypass surgery (RYGB) reduces albuminuria and the long-term incidence of end-stage renal disease in patients with obesity and diabetes. Preclinical modeling in experimental diabetic kidney disease demonstrates that improvements in glomerular structure likely underpin these findings.

In adult male Zucker diabetic fatty (ZDF) rats, we profiled the effect of RYGB on weight and metabolic control as well biochemical, structural and ultrastructural indices of diabetic renal injury. Furthermore, we sequenced the renal cortical transcriptome in these rats and used bioinformatic pathway analyses to characterize the transcriptional alterations governing the renal reparative response to RYGB.

In parallel with improvements in weight and metabolic control, RYGB reduced albuminuria, glomerulomegaly, podocyte stress and podocyte foot process effacement. Pathway analysis of RYGB-induced transcriptomic changes in the renal cortex highlighted correction of disease-associated alterations in fibrosis, inflammation and biological oxidation pathways. RYGB reversed disease-associated changes in the expression of transforming growth factor (TGF)-β superfamily genes that strongly correlated with improvements in structural measures of glomerulopathy.

Improved glomerular structure in ZDF rats following RYGB is underpinned by pathway level changes, including interruption of the TGF-β-driven early profibrotic programme. Our data provide an important layer of experimental support for clinical evidence demonstrating that RYGB arrests renal damage in patients with obesity and type 2 diabetes.
Improved glomerular structure in ZDF rats following RYGB is underpinned by pathway level changes, including interruption of the TGF-β-driven early profibrotic programme. Our data provide an important layer of experimental support for clinical evidence demonstrating that RYGB arrests renal damage in patients with obesity and type 2 diabetes.

11 mins ago


357, p = .001), anger (Z = -2.214, p = .027), sleep (Z = -2.268, p = .023), help (Z = -2.184, p = .029), intrusiveness (Z = -2.469, p = .014), hyperarousal (Z = -2.717, p = .007), and total IES (Z = -2.456 , p =, 014). https://www.selleckchem.com/products/emd-1214063.html Mann Whitney test showed a significantly lower score on post-test Intrusiveness in the experimental group (U = 202, p = .038).

The Expressive Writing intervention was effective in improving organizational and emotional variables. Expressive Writing supports healthcare professionals in relieving the burden of traumatic episodes, ordering associated thoughts and emotions, and implementing a process of deep comprehension.
The Expressive Writing intervention was effective in improving organizational and emotional variables. Expressive Writing supports healthcare professionals in relieving the burden of traumatic episodes, ordering associated thoughts and emotions, and implementing a process of deep comprehension.
Many authors tried to clarify the palliative care nurses' role, overall in the home care setting, but little is known in different settings of care. We aim to present a Specialist profile of palliative care (PC) nurses in an Italian hospital-based Palliative Care Unit.

With an organizational case study approach, we conducted a literature review on PC nurse's role, and we presented the Specialist PC nurses' profile, describing competences and key related activities.

Our specialist profile highlights that clinical activities are similar to the experiences described in the literature (symptom assessment and management, communication, interprofessional work), while training and research activities are new fields of interest that it's important to explore and promote, most of all in our country.

Sustaining the flexibility of the role, being recognized by colleagues and keeping the three dimensions connected are the major challenges drawing up a specialist palliative care nurses' profile can help the team to better define the role framework in an interdisciplinary context.
Sustaining the flexibility of the role, being recognized by colleagues and keeping the three dimensions connected are the major challenges drawing up a specialist palliative care nurses' profile can help the team to better define the role framework in an interdisciplinary context.
In Burns Units, the long professional relationship with patients suffering from intense physical pain and psychological distress, which cannot be completely resolved or minimized, exposes nurses to very intense emotions and stressful experiences. Learning to care for patients with such medical conditions can arouse many emotions also in nursing students, that can be both positive and negative. The goal of this study was to describe the emotional impact experienced by nursing students in a Italian Burns Unit.

A qualitative research was implemented among 16 undergraduate nursing students, before and after clinical practice in a Burns Unit, through a semi-structured interview.

Strong and conflicting emotions from nursing students were reported in the preliminary stage of the internship. Their enthusiasm and curiosity for a new opportunity countered their fear and anxiety of not feeling able to deal with the clinical situation. The internship experience ranged from emotions of joy at the healing of patients to impotence and frustration at not being able to alleviate intense and lasting suffering. All students reported that the internship was experienced as an important opportunity for personal and professional growth.

In light of the results, we highlight that nurse trainers should support students to take full advantage of this training, helping them to express their emotions and, in the same time, to learn to manage them profitably.
In light of the results, we highlight that nurse trainers should support students to take full advantage of this training, helping them to express their emotions and, in the same time, to learn to manage them profitably.
Safety in hospitals is a structural variable on which depends not only on health, but also on physical safety of patients and employees, whom are increasingly exposed to risks as a result of which they may suffer from occupational diseases and/or develop important psycho-physical consequences. The study aimed to evaluate the association between work environment and perceived burnout levels in two hospitals of Southern Italy.

From March to August 2019 an observational study was carried out through a survey consisting of four sections sociodemographic data; the Post Occupancy Evaluation (POE) questionnaire; the perception of the environment and possible causes of stress; the burnout levels perceived through the Maslach Burnout Inventory (MBI). A convenience sample of 169 healthcare workers participated in the study. All nurses (including nursing coordinators), clinicians, support staff of the "Vito Fazzi" Hospital of Lecce (Le) and "San Giuseppe da Copertino" Hospital of Copertino (Le) with at least one yea (44.4%), a lack of visual privacy n=89 (52.6%) and acoustic n=128 (75.7%). The analysis also shows higher scores on the 'depersonalization' scale among the health care workers of San Giuseppe da Copertino" Hospital (LE) (M= 9.36; DS= 9.439) and higher levels on the 'emotional exhaustion' scale in the surgical areas (M= 22.0; DS= 11.86) and in the female gender (M= 23.10; DS=. 12.01). Conclusions. The study reveals a poor condition of environmental comfort and safety, which generate high levels of stress and burnout in healthcare workers. Such a study can encourage further multicenter studies.
Despite Allied Health Professions (AHPs) represent a substantial part of workforce within the health system and they might give a relevant contribution to research, literature on publication productivity of AHPs working in non-research/academic institutions is scarce. The aim of this investigation was to provide point prevalence of AHPs working in a non- research/academic setting who have written at least one article published in indexed journals, in order to describe their scientific productivity.

A descriptive cross-sectional study was carried out of AHPs working in large Local Health Authority in Italy, who published in journals indexed in Scopus and/or PubMed. H-index, publications and citations number, journal name, publication year, and journal Impact Factor were extracted.

Fifty-two AHP workers were identified as authors, having published 105 articles between 1993 and 2019. The number of papers increased over the years (p < .001). Published papers in journals with Impact Factor were 67.6% (n = 71) of the total, with a median Impact Factor = 2.

Videos

A message to doctors, nurses, and all other healthcare practitioners from “the original voice of vaccine research.”

Hear about Dr. Tenpenny’s battle to keep an Ohio medical license, how she became a vaccine expert + how she’s almost fully recovered from a stroke in 2023. ?

https://live.childrenshealthdefense.org/chd-tv/shows/good-morning-chd/saying-no-to-vaccines/?utm_source=telegram&utm_medium=social&utm_campaign=chdtvpromo&utm_id=20240814

Dr. T on the web ➡️ https://drtenpenny.com/

In this episode of The Cost of Everything, host Christy Ai and author Robert Mack delve into the profound impact of depression and anxiety on individuals and society. They analyze staggering statistics, such as the 280 million people globally affected by depression, including 21 million in the US alone, along with the economic consequences, like lost productivity and rising healthcare costs. The discussion navigates through the multifaceted nature of mental health challenges, touching on cultural attitudes that stigmatize mental health issues in some societies. Despite these hurdles, there’s an encouraging trend of decreasing stigma, paving the way for more open discussions and enhanced support, including tailored mental health programs in workplaces and communities.

Welcome to The Daily Wrap Up, a concise show dedicated to bringing you the most relevant independent news, as we see it, from the last 24 hours.

All Video Source Links Can Be Found Here At The Last American Vagabond: https://www.thelastamericanvagabond.com/eugenics-healthcare-graphene-oxide

Want to send a check to support TLAV, or just words of encouragement?
Use our new P.O. box:
Ryan Cristian
1113 Murfreesboro Rd. Ste 106-146
Franklin, Tn 37064

Get TLAV Apparel:
https://truthclothing.io/collections/tlav
https://tlavfreespeech.itemorder.com/shop/home/

Support TLAV through Autonomy:
Join Autonomy: 
https://www.universityofreason.com/a/29887/QZmKjVCA
Ryan Cristián’s Objectivity Course: 
https://marketplace.autonomyagora.com/objective-research
Richard Grove’s Course: 
https://www.universityofreason.com/a/2147526145/QZmKjVCA

Like What You See? Help Us Stay People Funded: 
https://tlavagabond.substack.com/
https://www.thelastamericanvagabond.com/donations/donation-form/
https://www.subscribestar.com/the-last-american-vagabond
https://cash.app/$TLAVagabond
https://www.buymeacoffee.com/tlavagabond

Bitcoin Donations: 3HybuDuvH4x5uJHemgc7EW4ms2nz3F8Gah
Ethereum Donations: 0x5e68B8984d9D8167dAf890588a7037Ae6Cc87d4b
Litecoin Donations: MX3T2kYvzfD4mNS4VNSyXFgY4abhUJC5ff
Bitcoin Cash Donations: qqsef23980qu5nlk2dj7s7ezwedl4fmy2gl2mxp9dp

Support The Last American Vagabond by Subscribing here:
http://www.feedblitz.com/f/?Sub=906867

The Last American Vagabond Links:
Sovern: https://sovren.media/u/tlavagabond/
Rumble: https://rumble.com/user/TheLastAmericanVagabond
Odysee: https://odysee.com/@TLAVagabond:5
Rokfin: https://www.rokfin.com/TLAVagabond
Minds: https://www.minds.com/TLAVagabond
Bitchute: https://www.bitchute.com/channel/24yVcta8zEjY/
Telegram: https://t.me/TLAVagabond
VK: https://vk.com/id504366611
Twitter: https://twitter.com/TLAVagabond
Instagram: https://www.instagram.com/the_last_american_vagabond/
TikTok: https://www.tiktok.com/@thelastamericanvagabond
Getter: https://gettr.com/user/tlavagabond
TruthSocial: https://truthsocial.com/@TLAVagabond
Locals: https://thelastamericanvagabond.locals.com/
Facebook: https://www.facebook.com/Vagabond-Censored-103475109010293/
Memo: https://memo.cash/profile/1Np4Z2d25RSsQi99gKhf2cd5CAwN57jk13
MeWe: https://mewe.com/profile/5bcfb5d2a5f4e5420d7d5a2f

#TLAVPirateStreams #TheDailyWrapUp #TheLastAmericanVagabond

"Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. Fair use is a use permitted by copyright statute that might otherwise be infringing. Non-profit, educational or personal use tips the balance in favor of fair use.”

Circles

Sorry, no results were found.

Videos

A message to doctors, nurses, and all other healthcare practitioners from “the original voice of vaccine research.”

Hear about Dr. Tenpenny’s battle to keep an Ohio medical license, how she became a vaccine expert + how she’s almost fully recovered from a stroke in 2023. ?

https://live.childrenshealthdefense.org/chd-tv/shows/good-morning-chd/saying-no-to-vaccines/?utm_source=telegram&utm_medium=social&utm_campaign=chdtvpromo&utm_id=20240814

Dr. T on the web ➡️ https://drtenpenny.com/

In this episode of The Cost of Everything, host Christy Ai and author Robert Mack delve into the profound impact of depression and anxiety on individuals and society. They analyze staggering statistics, such as the 280 million people globally affected by depression, including 21 million in the US alone, along with the economic consequences, like lost productivity and rising healthcare costs. The discussion navigates through the multifaceted nature of mental health challenges, touching on cultural attitudes that stigmatize mental health issues in some societies. Despite these hurdles, there’s an encouraging trend of decreasing stigma, paving the way for more open discussions and enhanced support, including tailored mental health programs in workplaces and communities.

Welcome to The Daily Wrap Up, a concise show dedicated to bringing you the most relevant independent news, as we see it, from the last 24 hours.

All Video Source Links Can Be Found Here At The Last American Vagabond: https://www.thelastamericanvagabond.com/eugenics-healthcare-graphene-oxide

Want to send a check to support TLAV, or just words of encouragement?
Use our new P.O. box:
Ryan Cristian
1113 Murfreesboro Rd. Ste 106-146
Franklin, Tn 37064

Get TLAV Apparel:
https://truthclothing.io/collections/tlav
https://tlavfreespeech.itemorder.com/shop/home/

Support TLAV through Autonomy:
Join Autonomy: 
https://www.universityofreason.com/a/29887/QZmKjVCA
Ryan Cristián’s Objectivity Course: 
https://marketplace.autonomyagora.com/objective-research
Richard Grove’s Course: 
https://www.universityofreason.com/a/2147526145/QZmKjVCA

Like What You See? Help Us Stay People Funded: 
https://tlavagabond.substack.com/
https://www.thelastamericanvagabond.com/donations/donation-form/
https://www.subscribestar.com/the-last-american-vagabond
https://cash.app/$TLAVagabond
https://www.buymeacoffee.com/tlavagabond

Bitcoin Donations: 3HybuDuvH4x5uJHemgc7EW4ms2nz3F8Gah
Ethereum Donations: 0x5e68B8984d9D8167dAf890588a7037Ae6Cc87d4b
Litecoin Donations: MX3T2kYvzfD4mNS4VNSyXFgY4abhUJC5ff
Bitcoin Cash Donations: qqsef23980qu5nlk2dj7s7ezwedl4fmy2gl2mxp9dp

Support The Last American Vagabond by Subscribing here:
http://www.feedblitz.com/f/?Sub=906867

The Last American Vagabond Links:
Sovern: https://sovren.media/u/tlavagabond/
Rumble: https://rumble.com/user/TheLastAmericanVagabond
Odysee: https://odysee.com/@TLAVagabond:5
Rokfin: https://www.rokfin.com/TLAVagabond
Minds: https://www.minds.com/TLAVagabond
Bitchute: https://www.bitchute.com/channel/24yVcta8zEjY/
Telegram: https://t.me/TLAVagabond
VK: https://vk.com/id504366611
Twitter: https://twitter.com/TLAVagabond
Instagram: https://www.instagram.com/the_last_american_vagabond/
TikTok: https://www.tiktok.com/@thelastamericanvagabond
Getter: https://gettr.com/user/tlavagabond
TruthSocial: https://truthsocial.com/@TLAVagabond
Locals: https://thelastamericanvagabond.locals.com/
Facebook: https://www.facebook.com/Vagabond-Censored-103475109010293/
Memo: https://memo.cash/profile/1Np4Z2d25RSsQi99gKhf2cd5CAwN57jk13
MeWe: https://mewe.com/profile/5bcfb5d2a5f4e5420d7d5a2f

#TLAVPirateStreams #TheDailyWrapUp #TheLastAmericanVagabond

"Copyright Disclaimer Under Section 107 of the Copyright Act 1976, allowance is made for "fair use" for purposes such as criticism, comment, news reporting, teaching, scholarship, and research. Fair use is a use permitted by copyright statute that might otherwise be infringing. Non-profit, educational or personal use tips the balance in favor of fair use.”

I go over 3 reasons why state intervention in healthcare fails.

If you want to get a sense of my principles and values in a succinct book, check out The Definitive Guide to Libertarian Voluntaryism over at:

https://amzn.to/33sDMkW

(affiliate)


Please help me continue my work over at Patreon: https://www.patreon.com/thepholosopher

and at Subscribestar: https://www.subscribestar.com/the-pholosopher

#healthcare #freemarket #libertarian #ancap #voluntaryist

I go over 3 common misconceptions about libertarians.

Please help me continue my work and take part in the next video topic poll over at Patreon: https://www.patreon.com/thepholosopher

Subscribestar: https://www.subscribestar.com/the-pholosopher

#healthcare #freemarket #libertarian #ancap #voluntaryist

Posts

2 mins ago


68; CI = 1.58-1.79) had higher odds of SSN, compared to those with no formal education. Women who were working had higher odds of SSN (aOR = 1.44; CI = 1.37-1.51) than those who were not working. Women in the middle (aOR = 0.93; CI = 0.87-0.99) and richer (aOR = 0.92; CI = 0.85-0.98) wealth status had lower odds of SSN, compared to those in the poorest wealth status. Women's autonomy in household decision-making is a significant predictor of SSN. Women autonomy in household decision-making programs and interventions should be intensified to achieve Sustainable Development Goals 3.7 and 5 which seek to achieve universal access to sexual and reproductive health services and ensure gender equality and empower all women and girls by 2030.
Maternal depression is an important cause of morbidity and mortality. Experiences of childhood trauma contribute to maternal depression, potentially causing adult socio-economic disparities in mental health. We investigate whether adult socioeconomic status (SES) mediates the relationship between childhood trauma and antenatal depression.

We analyzed data from two sociodemographically distinct peri-urban sites in the Western Cape, South Africa in a birth cohort study, the Drakenstein Child Health Study Mbekweni (N=510) and TC Newman (N=413). Data were collected from pregnant women between 28 and 32 weeks' gestation.

Associations between trauma and depressive symptoms differed by site (




χ


2



=2163.6, df=1419, p<0.01); direct effects of trauma on depression were 0.24 mean increased symptoms in Mbekweni (p<0.01) and 0.47 in TC Newman (p<0.01). Trauma was differentially associated with SES (Mbekweni -0.10, p=0.07; TC Newman -0.05, p=0.37) and SES with depression (Mbekweni -0.18, p<0.01; TC Newman -0.02, p=0.62) across both sites. Indirect effects of trauma on depression through SES were 0.018 (95% C.I. -0.002-0.039) in Mbekweni and 0.001 (95% C.I. -0.004-0.006) in TC Newman, suggesting mediation was not supported. SES was a stronger indicator of depression risk in relatively poorer Mbekweni.

Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.
Neighborhood-level effects and poverty are potentially important modifiers, and points of intervention, for maternal mental health outcomes.We examine the long-term relationship between childhood circumstances and cognitive aging. In particular, we differentiate the level of cognitive deficit from the rate of cognitive decline. Applying a linear mixed-effect model to three waves of China Health and Retirement Longitudinal Surveys (CHARLS 2011, 2013, 2015) and matching cognitive outcomes to CHARLS Life History Survey (2014), we find that key domains of childhood circumstances, including family socioeconomic status (SES), neighborhood cohesion, friendship, and health conditions, are significantly associated with both the level of cognitive deficit and the rate of decline. In contrast, childhood neighborhood safety only affects the level of cognitive deficit. Childhood relationship with mother only affects the rate of cognitive decline. The effects of adverse childhood circumstances are generally larger on level of cognitive deficit than on rate of cognitive decline. Moreover, education plays a more important role in mediating the relationships compared to other later-life factors. These findings suggest that exposure to disadvantaged childhood circumstances can exacerbate cognitive deficit as well as cognitive decline over time, which may be partially ameliorated by educational attainment.According to the World Health Organization, dengue is a neglected tropical disease. Latin America, specifically Colombia is in alert regarding this arbovirosis as there was a spike in the number of reported dengue cases at the beginning of 2019. Although there has been a worldwide decrease in the number of reported dengue cases, Colombia has shown a growing trend over the past few years. This study performed a Poisson multilevel analysis with mixed effects on STATA® version 16 and R to assess sociodemographic, climatic, and entomological factors that may influence the occurrence of dengue in three municipalities for the period 2010-2015. Information on dengue cases and their sociodemographic variables was collected from the National Public Health Surveillance System (SIVIGILA) records. For climatic variables (temperature, relative humidity, and precipitation), we used the information registered by the weather stations located in the study area, which are managed by the Instituto de Hidrologia, Meteorologia y Estudios Ambientales (IDEAM) or the Corporación Autónoma Regional (CAR). The entomological variables (house index, container index, and Breteau index) were provided by the Health office of the Cundinamarca department. SIVIGILA reported 1921 dengue cases and 56 severe dengue cases in the three municipalities; of them, three died. One out of four cases occurred in rural areas. The age category most affected was adulthood, and there were no statistical differences in the number of cases between sexes. The Poisson multilevel analysis with the best fit model explained the presentation of cases were temperature, relative humidity, precipitation, childhood, live in urban area and the contributory healthcare system. The temperature had the biggest influence on the presentation of dengue cases in this region between 2010 and 2015.Blunt abdominal trauma is a common cause of solid organ injury in children. Nonoperative management has been established as the standard of care for suspected liver and spleen injuries without peritonitis. Major ductal injury with resultant biloma is a rare complication of nonoperative management of blunt liver injury. https://www.selleckchem.com/products/mek162.html Endoscopic retrograde cholangiopancreatography (ERCP) and/or percutaneous drain placement are considered to be safe adjuncts in the management of these bile leaks. However, in the rare cases of persistent bile leak, further nonoperative alternatives have not been reported. In this case report we present a novel multidisciplinary approach to managing persistent bile leaks in blunt liver injury.

2 mins ago


Healthcare providers commonly experience symptoms of anxiety during public health crises and pandemics. The objective of the study was to identify the frequency of symptoms of generalized anxiety disorder (GAD) in general practitioners and to estimate the association with particular psychosocial and demographic factors. This is a cross-sectional study, where a total of 531 general practitioners completed an online form that contained sociodemographic variables, questions about fear and perceptions concerning medical work during the COVID-19 pandemic, 7-Item Generalized Anxiety Disorder Scale (GAD-7), questionnaire on psychosomatic problems and Fear of COVID-19 Scale. The presence of symptoms of GAD was defined by a GAD-7 score of 10 or more points. Voluntary and anonymous participation, acceptance of terms, and informed consent were requested. A p value of less then 0.05 was considered statistically significant. Symptoms of GAD were identified in 4 out of 10 Colombian general practitioners; the following psychosocial and demographic factors were associated with a greater presence of these symptoms female gender, social discrimination, anguish, job disappointment, nightmares, stress and other symptoms of fear regarding the pandemic. https://www.selleckchem.com/GSK-3.html Conversely, feeling protected by the state or employer, being satisfied with their job as a physician, and trusting government measures and information were associated with a lower presence of symptoms of GAD. These findings highlight the importance of timely psychotherapeutic and psychopharmacological interventions in these individuals. The authors suggest mental health providers should be deployed during times of crisis to decrease the risk of developing mental illness.
Many predictive models for incident type 2 diabetes (T2D) exist, but these models are not used frequently for public health management. Barriers to their application include (1) the problem of model choice (some models are applicable only to certain ethnic groups), (2) missing input variables, and (3) the lack of calibration. While (1) and (2) drives to missing predictions, (3) causes inaccurate incidence predictions. In this paper, a combined T2D risk model for public health management that addresses these three issues is developed.

The combined T2D risk model combines eight existing predictive models by weighted average to overcome the problem of missing incidence predictions. Moreover, the combined model implements a simple recalibration strategy in which the risk scores are rescaled based on the T2D incidence in the target population. The performance of the combined model was compared with that of the eight existing models using data from two test datasets extracted from the Multi-Ethnic Study of Athescaling and averaging was shown to provide accurate and robust incidence predictions, overcoming the problem of recalibration and missing predictions in practical application of predictive models.
Cardiovascular (CV) disease affects a high percentage of patients with type 2 diabetes mellitus (T2DM), especially in the hospital setting, impacting on mortality, complications, quality of life and use of health resources. The aim of this study was to estimate the incidence, mean length of hospital stay (LOHS) and costs attributable to hospital admissions due to CV events in patients with T2DM versus patients without diabetes mellitus (non-DM) in Spain.

Retrospective observational study based on the Spanish National Hospital Discharge Database for 2015. Hospital admissions for patients aged ≥35 years with a diagnosis of CV death, non-fatal acute myocardial infarction (AMI), non-fatal stroke, unstable angina, heart failure and revascularization were evaluated. The International Classification of Diseases, Ninth Revision (250.x0 or 250.x2) coding was used to classify records of patients with T2DM. For each CV complication, the hospital discharges of the two groups, T2DM and non-DM, were precisely matched ahese complications.
Patients with T2DM had a higher incidence and number of hospital admissions per patient due to CV events versus the non-DM population. This generates a significant clinical and economic burden given the longer admission stay and higher costs associated with some of these complications.
Roux-en-Y gastric bypass surgery (RYGB) reduces albuminuria and the long-term incidence of end-stage renal disease in patients with obesity and diabetes. Preclinical modeling in experimental diabetic kidney disease demonstrates that improvements in glomerular structure likely underpin these findings.

In adult male Zucker diabetic fatty (ZDF) rats, we profiled the effect of RYGB on weight and metabolic control as well biochemical, structural and ultrastructural indices of diabetic renal injury. Furthermore, we sequenced the renal cortical transcriptome in these rats and used bioinformatic pathway analyses to characterize the transcriptional alterations governing the renal reparative response to RYGB.

In parallel with improvements in weight and metabolic control, RYGB reduced albuminuria, glomerulomegaly, podocyte stress and podocyte foot process effacement. Pathway analysis of RYGB-induced transcriptomic changes in the renal cortex highlighted correction of disease-associated alterations in fibrosis, inflammation and biological oxidation pathways. RYGB reversed disease-associated changes in the expression of transforming growth factor (TGF)-β superfamily genes that strongly correlated with improvements in structural measures of glomerulopathy.

Improved glomerular structure in ZDF rats following RYGB is underpinned by pathway level changes, including interruption of the TGF-β-driven early profibrotic programme. Our data provide an important layer of experimental support for clinical evidence demonstrating that RYGB arrests renal damage in patients with obesity and type 2 diabetes.
Improved glomerular structure in ZDF rats following RYGB is underpinned by pathway level changes, including interruption of the TGF-β-driven early profibrotic programme. Our data provide an important layer of experimental support for clinical evidence demonstrating that RYGB arrests renal damage in patients with obesity and type 2 diabetes.

11 mins ago


357, p = .001), anger (Z = -2.214, p = .027), sleep (Z = -2.268, p = .023), help (Z = -2.184, p = .029), intrusiveness (Z = -2.469, p = .014), hyperarousal (Z = -2.717, p = .007), and total IES (Z = -2.456 , p =, 014). https://www.selleckchem.com/products/emd-1214063.html Mann Whitney test showed a significantly lower score on post-test Intrusiveness in the experimental group (U = 202, p = .038).

The Expressive Writing intervention was effective in improving organizational and emotional variables. Expressive Writing supports healthcare professionals in relieving the burden of traumatic episodes, ordering associated thoughts and emotions, and implementing a process of deep comprehension.
The Expressive Writing intervention was effective in improving organizational and emotional variables. Expressive Writing supports healthcare professionals in relieving the burden of traumatic episodes, ordering associated thoughts and emotions, and implementing a process of deep comprehension.
Many authors tried to clarify the palliative care nurses' role, overall in the home care setting, but little is known in different settings of care. We aim to present a Specialist profile of palliative care (PC) nurses in an Italian hospital-based Palliative Care Unit.

With an organizational case study approach, we conducted a literature review on PC nurse's role, and we presented the Specialist PC nurses' profile, describing competences and key related activities.

Our specialist profile highlights that clinical activities are similar to the experiences described in the literature (symptom assessment and management, communication, interprofessional work), while training and research activities are new fields of interest that it's important to explore and promote, most of all in our country.

Sustaining the flexibility of the role, being recognized by colleagues and keeping the three dimensions connected are the major challenges drawing up a specialist palliative care nurses' profile can help the team to better define the role framework in an interdisciplinary context.
Sustaining the flexibility of the role, being recognized by colleagues and keeping the three dimensions connected are the major challenges drawing up a specialist palliative care nurses' profile can help the team to better define the role framework in an interdisciplinary context.
In Burns Units, the long professional relationship with patients suffering from intense physical pain and psychological distress, which cannot be completely resolved or minimized, exposes nurses to very intense emotions and stressful experiences. Learning to care for patients with such medical conditions can arouse many emotions also in nursing students, that can be both positive and negative. The goal of this study was to describe the emotional impact experienced by nursing students in a Italian Burns Unit.

A qualitative research was implemented among 16 undergraduate nursing students, before and after clinical practice in a Burns Unit, through a semi-structured interview.

Strong and conflicting emotions from nursing students were reported in the preliminary stage of the internship. Their enthusiasm and curiosity for a new opportunity countered their fear and anxiety of not feeling able to deal with the clinical situation. The internship experience ranged from emotions of joy at the healing of patients to impotence and frustration at not being able to alleviate intense and lasting suffering. All students reported that the internship was experienced as an important opportunity for personal and professional growth.

In light of the results, we highlight that nurse trainers should support students to take full advantage of this training, helping them to express their emotions and, in the same time, to learn to manage them profitably.
In light of the results, we highlight that nurse trainers should support students to take full advantage of this training, helping them to express their emotions and, in the same time, to learn to manage them profitably.
Safety in hospitals is a structural variable on which depends not only on health, but also on physical safety of patients and employees, whom are increasingly exposed to risks as a result of which they may suffer from occupational diseases and/or develop important psycho-physical consequences. The study aimed to evaluate the association between work environment and perceived burnout levels in two hospitals of Southern Italy.

From March to August 2019 an observational study was carried out through a survey consisting of four sections sociodemographic data; the Post Occupancy Evaluation (POE) questionnaire; the perception of the environment and possible causes of stress; the burnout levels perceived through the Maslach Burnout Inventory (MBI). A convenience sample of 169 healthcare workers participated in the study. All nurses (including nursing coordinators), clinicians, support staff of the "Vito Fazzi" Hospital of Lecce (Le) and "San Giuseppe da Copertino" Hospital of Copertino (Le) with at least one yea (44.4%), a lack of visual privacy n=89 (52.6%) and acoustic n=128 (75.7%). The analysis also shows higher scores on the 'depersonalization' scale among the health care workers of San Giuseppe da Copertino" Hospital (LE) (M= 9.36; DS= 9.439) and higher levels on the 'emotional exhaustion' scale in the surgical areas (M= 22.0; DS= 11.86) and in the female gender (M= 23.10; DS=. 12.01). Conclusions. The study reveals a poor condition of environmental comfort and safety, which generate high levels of stress and burnout in healthcare workers. Such a study can encourage further multicenter studies.
Despite Allied Health Professions (AHPs) represent a substantial part of workforce within the health system and they might give a relevant contribution to research, literature on publication productivity of AHPs working in non-research/academic institutions is scarce. The aim of this investigation was to provide point prevalence of AHPs working in a non- research/academic setting who have written at least one article published in indexed journals, in order to describe their scientific productivity.

A descriptive cross-sectional study was carried out of AHPs working in large Local Health Authority in Italy, who published in journals indexed in Scopus and/or PubMed. H-index, publications and citations number, journal name, publication year, and journal Impact Factor were extracted.

Fifty-two AHP workers were identified as authors, having published 105 articles between 1993 and 2019. The number of papers increased over the years (p < .001). Published papers in journals with Impact Factor were 67.6% (n = 71) of the total, with a median Impact Factor = 2.

12 mins ago


The chemical structures of the isolates were elucidated by a combination of NMR spectroscopy, HRMS and [α]D analyses. All compounds were tested against MRSA and Efm, and compound 3 showed moderate antibacterial activity against MRSA (IC50 value 70 μg/mL). This is the first study that has dealt with chemical and bioactivity profiling of A.sinoxea leading to isolation and characterization of pure sponge metabolites.Curcumin, a principal bioactive substance of turmeric (Curcuma longa L.), is reported as a strong antioxidant, anti-inflammatory, antibacterial, antifungal, and antiviral agent. However, its antimicrobial properties require further detailed investigations into clinical and multidrug-resistant (MDR) isolates. In this work, we tested curcumin's efficacy against over 100 strains of pathogens belonging to 19 species. This activity was determined by the broth microdilution method and by calculating the minimum inhibitory concentration (MIC). Our findings confirmed a much greater sensitivity of Gram-positive than Gram-negative bacteria. This study exhibited a significantly larger variation in the curcumin activity than previous works and suggested that numerous clinical strains of widespread pathogens have a poor sensitivity to curcumin. Similarly, the MICs of the MDR types of Staphylococcus aureus, S. haemolyticus, Escherichia coli, and Proteus mirabilis were high (≥2000 µg/mL). However, curcumin was effective against some species and strains Streptococcus pyogenes (median MIC = 31.25 µg/mL), methicillin-sensitive S. https://www.selleckchem.com/B-Raf.html aureus (250 µg/mL), Acinetobacter lwoffii (250 µg/mL), and individual strains of Enterococcus faecalis and Pseudomonas aeruginosa (62.5 µg/mL). The sensitivity of species was not associated with its affiliation to the genus, and it could differ a lot (e.g., S. pyogenes, S. agalactiae and A. lwoffii, A. baumannii). Hence, curcumin can be considered as a promising antibacterial agent, but with a very selective activity.Unwanted behaviour in mares is a commonly presenting problem to the veterinarian. This behaviour may range from the mare being uncooperative or aggressive when handled on the ground, kicking, bucking or rearing when ridden or being aggressive towards other horses. This purpose of the study was to evaluate whether bilateral ovariectomy in mares with unwanted behaviour improved the mare's behaviour and/or rideability from the owner's perspective. The mares were grouped and compared statistically based on their histological classification as having either "normal" or neoplastic ovaries. This study is a retrospective case series report of twenty-eight ovariectomized mares. A semi-quantitative value (1-10) pre- and post-ovariectomy for A) behaviour on ground/in stable and B) rideability was given, based on the owner's observations. The horses were grouped based on their histopathologic diagnosis as "Normal ovaries" or "Neoplasia". Following ovariectomy, rideability improved, with a score of ≥5 in 80% (8/10) of mares with normal ovaries and in 57% (8/14) of mares with ovarian neoplasm. A behavioural improvement of ≥5 was observed in 40% (4/10) of mares with normal ovaries, and in 43% (6/14) of mares with ovarian neoplasm. A significant difference was observed between the semi-quantitative value pre- and post-ovariectomy in both groups. No difference was observed in change in behaviour and rideability score between the group with normal ovaries and neoplastic ovaries. Mares with unwanted behaviour not obviously related to the oestrus cycle and to painful conditions may benefit from ovariectomy to alter their behaviour and rideability.Many adolescents with type 1 diabetes experience challenges in achieving good glycemic control and have insufficient understanding in executing interventions for glycemic control. This study aimed to understand self-management experiences of adolescents with type 1 diabetes in Taiwan. In this descriptive phenomenological study, we conducted in-depth interviews with 18 adolescents with type 1 diabetes from the pediatric outpatient clinic of a medical center. Data were analyzed using the Colaizzi's method. Four themes were identified (1) misconception regarding self-management of blood glucose; (2) conflict between depending on and breaking away from parental assistance for glycemic control; (3) encounter with disruptions in glycemic control regimen due to the presence of schedule changes; and (4) lack of motivation to achieve good glycemic control. The findings indicated that the misconceptions of adolescents with type 1 diabetes about managing glycemic levels resulted from an insufficient understanding of self-management of diabetes. In Taiwan, the heavy emphasis of academic achievement and changes of schedules during breaks tended to disrupt the regimen for glycemic control. Healthcare professionals are encouraged to provide individualized education focusing on the adolescents' misconceptions regarding self-management of diabetes.This research was conducted to estimate the effects of Persicaria odorata leaf meal (POLM) on haematological indices, serum biochemical attributes, and internal organs parameters, including histomorphological features of the liver, in broiler chickens. A total of 120 one-day-old male broiler chicks (Cobb-500) were randomly allocated into four experimental groups. The dietary treatments were basal diet (BD), which served as the control (C), along with BD + 2 g/kg POLM (Po2), BD + 4 g/kg POLM (Po4), BD + 8 g/kg POLM (Po8), which were the supplemented groups. The body weight gain (BWG) showed a linear increase and feed conversion ratio (FCR) showed a linear decrease with increasing POLM dosage at day 42 (p ˂ 0.05) and for the overall growth performance period (p ˂ 0.01). On day 21 and day 42, the values of red blood cells (RBCs), white blood cells (WBCs), haemoglobin (Hb), and packed cell volume (PCV) showed linear increases (p ˂0.05) as the dosage of POLM increased in the diet. On day 21, dietary supplementatioe evidence that POLM can be safely used at a dose rate of 8 g/kg of feed as an alternative to conventional antimicrobial growth promoters (AGPs).

12 mins ago


tion with baseline CD4 and the risk of maternal transmission of HIV. Health education should be given about balanced diet, weight control, and take medication for HIV positive patients by the responsible bodies.
To evaluate the use of facemasks by the Brazilian population during the COVID-19 pandemic.

This cross-sectional study involved 1277 participants who answered a web-based open survey with questions about the use of facemasks during the COVID-19 pandemic. Descriptive statistics with percentages was performed, and the responses were analyzed with chi-square and independent t-tests.

A total of 1277 answered the questionnaire, and most participants were female (81.8%). Almost all the participants (99.1%) reported wearing facemasks, and 34.2% are wearing just because it is mandatory; 65.8% would continue to wear masks even if it was not mandatory. Most subjects (50.4%) believe that masks' use effectively prevents infection by the novel coronavirus. Reusable fabric facemasks are the most used by the participants (49.5%). Almost all subjects were wearing masks to go to crowded and public places. Most respondents (67.3%) are bothered with the use of facemasks, and the most cited reason for the discomfort was fee that its use effectively prevents infection by the novel coronavirus. Reusable fabric facemasks are the most used by the participants. https://www.selleckchem.com/products/vx-561.html Almost all subjects were wearing masks to go to crowded and public places. The great majority of the participants feel more protected with the use of facemasks.
Having access to convenient and quality healthcare at all times is not only a human right but also a goal that many countries strive to achieve for their population. However, access to healthcare might face blocks in the presence of financial exclusions. Saudi Arabia has, over the years, continued to pursue policy and system reforms to enhance its population's access to financial inclusion, as well as proper health coverage to improve health outcomes. This study seeks to estimate the effects of financial inclusion on the financial hardships in accessing healthcare in Saudi Arabia.

This study uses a nationally representative survey conducted with 1009 adults, using the 2017 World Bank Global Findex Study data. The study estimates the conditional probability of coming up with emergency funds and the conditional probability of borrowing for medical purposes to understand access to healthcare. A composite value is created for financial inclusion using several variables for individuals' interactions with financluded but that will also aim at promoting various financial products so that those who are already financially included have a wide range from which they can choose.
Interprofessional education (IPE) is suggested as a good means to prepare future healthcare professionals for collaborative work in interprofessional teams enabling them to solve complex health problems. Previous studies have advocated experiential IPE, including community-based IPE (CBIPE). This study aims to evaluate a CBIPE programme by exploring the students' perception toward CBIPE design and toward groups' teamwork.

To identify students' perceptions of teamwork, the Interprofessional Teamwork Evaluation questionnaire was administered to 254 students of medical, nursing and midwifery programme. Three uni-professional focus group (FG) discussions were conducted to analyse the students' perception of the design of community-based education and underlying reasons for teamwork.

FGs reported three aspects that influence skills development in collaborative practice among students that shed light on why midwifery and nursing students held less positive perceptions of communication and mutual support 1) communication gap due to lack of confidence, 2) contrasting ways of thinking affect communication in decision-making, and 3) the leadership culture in the health services.

A CBIPE programme was successfully implemented at Universitas Islam Sultan Agung. It demonstrated that students in the health professions can develop skills in collaborative practice despite having some problems with communication and mutual support.
A CBIPE programme was successfully implemented at Universitas Islam Sultan Agung. It demonstrated that students in the health professions can develop skills in collaborative practice despite having some problems with communication and mutual support.
Competencies that integrate research findings and practice expertise are necessary to maintain comprehensive evidence-based practice for allied health professions, such as social work. The context of modern multidisciplinary healthcare, especially in acute or emergency settings, means that an individual clinician may only have a single session with a patient. Maximizing the benefit of single sessions requires advanced competence that extends beyond diagnostics and biomedical treatments to the impact of social systems on health outcomes; multi-level advocacy for reduction of existing health disparities and equity in access to health and mental health services; and "working knowledge" of non-pharmacological treatments.

This study employed a practice-based research methodology whereby health social workers group coded 32 simulation videos, drawn from an advanced social work practice course, to develop a practice-based competency framework that incorporates these advanced skills. Constructivist grounded theorroach facilitated the understanding of critical actions that allied health clinicians could undertake to improve single-session interactions. This practice-based competency framework may have significant utility for multidisciplinary healthcare education and practice.
The group coding process allowed for immediate discussions and clarifications, supporting the clinicians to synthesize their experiences toward shared understandings of "best practices" in single-session healthcare contexts. This approach facilitated the understanding of critical actions that allied health clinicians could undertake to improve single-session interactions. This practice-based competency framework may have significant utility for multidisciplinary healthcare education and practice.