Background Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning...Background Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC opened in England in 2009, RCs have expanded to 28 countries and territories. However, most RC research has been conducted in Western countries with similar cultural characteristics, limiting understanding of how RCs can be culturally adapted. The 12-item Recovery Colleges Characterisation and Testing (RECOLLECT) Fidelity Measure (RFM) evaluates the operational fidelity of RCs based on 12 components, but cultural influences on these components remain underexplored.Aims To assess associations between Hofstede’s cultural dimensions and RFM items to identify cultural influences on fidelity components.Methods A cross-sectional survey of RC managers was conducted across all 221 RCs. Mixed-effects regression models examined associations between Hofstede’s country-level cultural dimensions and item-level RFM scores, adjusted for healthcare expenditure and income inequality. Four cultural dimensions, obtained from Hofstede, were analysed: individualism (prioritising personal needs), indulgence (enjoyment-oriented), uncertainty avoidance (preference for predictability) and long-term orientation (future-focused).Results The RFM was completed by 169 (76%) RC managers. Seven RFM items showed associations with cultural dimensions. Equality was linked to short-term orientation, while learning was associated with individualism and uncertainty avoidance. Both individualism and indulgence influenced co-production and community focus. Commitment to recovery was shaped by all four cultural dimensions, with the strongest associations seen for individualism and indulgence. Individualism enhanced explicit focus on strengths-based practice, while uncertainty avoidance influenced course distinctiveness.Conclusions This study demonstrates how culture shapes RC fidelity components, providing actionable insights for cultural adaptation. Incorporating under-represented dimensions, such as collectivism and restraint, could improve the RFM’s global applicability, facilitating implementation. Future research should explore cultural nuances, engage diverse stakeholders and refine fidelity measures to enhance RC inclusivity and effectiveness worldwide.展开更多
One of the most important points in the meta-analyses is certainly represented by the assessment of the quality of the studies included in such research. The meta-analyses are considered the highest level of evidence ...One of the most important points in the meta-analyses is certainly represented by the assessment of the quality of the studies included in such research. The meta-analyses are considered the highest level of evidence in science. Also for this reason, the quality of the studies included should be accurately evaluated by standardized tools. The overall results of the metaanalysis depend indeed also on a rigorous evaluation of the studies quality. Among all the possible tools for this complex evaluation, the Newcastle Ottawa Scale(NOS) is one of the most used worldwide, above all for observational studies. In this review, we will discuss the strengths and limitation of the NOS, also on the basis of the branch of science in which it has been applied.展开更多
Background There are limited data on factors that predict an increased risk of multiple injuries among distance runners.The objective of this study was to determine risk factors that are predictive of individual runne...Background There are limited data on factors that predict an increased risk of multiple injuries among distance runners.The objective of this study was to determine risk factors that are predictive of individual runners with a high annual multiple injury risk(MIR).Methods A retrospective,cross-sectional study at 4 annual(2012-2015)Two Oceans 21.1 km and 56.0 km races in South Africa with 75,401 consenting race entrants.Running-related injury data were collected retrospectively through an online pre-race medical screening questionnaire.The average number of injuries for each runner every year was calculated by taking a runner's race entry history and injury history into account and categorizing entrants into 4 MIR categories(high,intermediate,low,and very low(reference)).Multiple logistic regression modeling(odds ratios)was used to determine whether the following factors were predictive of a high MIR(average>1 injury/year):demographics,training and racing,chronic-disease history(composite chronic disease score(CCDS)),and history of allergies.Results Of all entrants,9.2%reported at least 1 injury,and 0.4%of entrants were in the high MIR category;the incidence rate was 2.5 injuries per 10 runner-years(95%confidence interval(95%CI):2.4-2.7).Significant factors predictive of runners in the high MIR category were:running for>20 years:OR=2.0(95%CI:1.3-3.1;p=0.0010);a higher CCDS:OR=2.2(95%CI:2.0-2.4;p<0.0001);and a history of allergies:OR=2.8(95%CI:2.0-3.8;p<0.0001).Conclusion Runners who have been running recreationally for>20 years and those with multiple chronic diseases or a history of allergies were at higher risk of multiple running-related injuries.This high-risk group can be targeted for further study and possible injury-prevention interventions.展开更多
OBJECTIVE To investigate which history of cardiovascular disease[coronary heart disease(CHD),stroke,or peripheral arterial disease]in a first-degree family member predicts cardiovascular mortality.METHODS We studied a...OBJECTIVE To investigate which history of cardiovascular disease[coronary heart disease(CHD),stroke,or peripheral arterial disease]in a first-degree family member predicts cardiovascular mortality.METHODS We studied a prospective cohort(the Lipid Research Clinics Prevalence Study)from ten primary care centers across North America.The primary outcome was cardiovascular mortality,assessed using Cox survival models.RESULTS There were 8,646 participants(mean age:47.4±12.1 years,46%women,52%of participants with hyperlipidemia)who were followed up for a mean duration of 19.4±4.9 years.There were 1,851 deaths(21%),including 852 cardiovascular deaths.A paternal,maternal or sibling history of premature CHD(before 60 years)was present in 26%of participants,of stroke in 27%of participants,and of peripheral arterial disease in 24%of participants.After adjusting for risk factors(age,sex,systolic blood pressure,diastolic blood pressure,body mass index,smoking,fasting glucose,low-density lipoprotein cholesterol and triglycerides),only a paternal history of premature or any CHD,a maternal history of diabetes mellitus or premature or any CHD,and a sibling history of premature CHD,hypertension,or hyperlipidemia were individually predictive of cardiovascular mortality.After adjusting for risk factors and the mentioned familial factors,only paternal and maternal histories of CHD,espe-cially before 60 years,remained predictive of cardiovascular mortality,with a somewhat higher association for a maternal history[adjusted hazard ratio(aHR)=1.99,95%CI:1.36−2.92,P<0.001 for maternal history of premature CHD;aHR=1.52,95%CI:1.10−2.10,P=0.011 for paternal history of premature CHD].Family history of stroke or peripheral arterial disease did not predict cardiovascular mortality.Parental history of premature CHD predicted cardiovascular mortality independently of baseline age(<60 years and≥60 years),hypertension,or hyperlipidemia and carried more important prognostic value in men rather than wo-men.CONCLUSIONS In this study,a parental history of CHD,especially before 60 years,best predicted cardiovascular mortality.This finding could help more accurately identify high-risk patients who would benefit from preventive strategies.展开更多
Background: Neural tube defects have a considerable importance because they can be prevented by supplementing Folic acid & Vitamin B12 during periconceptional period and fortification of staple foods. In Morocco, ...Background: Neural tube defects have a considerable importance because they can be prevented by supplementing Folic acid & Vitamin B12 during periconceptional period and fortification of staple foods. In Morocco, the Ministry of Health launched a national program for fortification of flour with folic acid. Our goal should be to evaluate the prevalence of neural tube defects after fortification. Description: This is a retrospective descriptive at the National Reference Centre for Nutrition and Neonatology of the Children’s Hospital of Rabat over 4 years. Data were identified from the registry of congenital malformations held at the perinatology unit. Results: During the 4 years, 674 congenital malformations were identified. The neural tube defects NTDs account for 11.9%. Their annual prevalence decreased significantly from 21.78 in 2008 to 12.1 per 10,000 total births in 2011. The most common form was anencephaly (60%). Neural tube defects were isolated in 85% of cases and associated with other malformations in 15% of cases. 49.4% of infants with neural tube defects were female and 50.6% were male. Perinatal mortality in newborns with neural tube defects was 63.8% versus 25.2% in malformed newborns without neural tube defects. Conclusions: The neural tube defects seem to be common in our context. Permanent epidemiological surveillance is needed to determine the true prevalence at the national as well as its temporal trends level.展开更多
Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Metho...Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.展开更多
Malaria has been an important disease throughout the history, particularly in the Mediterranean. The island of Sardinia (Italy) was characterized by severe endemic malaria from antiquity until its eradication in 1950....Malaria has been an important disease throughout the history, particularly in the Mediterranean. The island of Sardinia (Italy) was characterized by severe endemic malaria from antiquity until its eradication in 1950. It provides an exceptional and unique site to examine the history of the disease and its effects on human biology and ecology. Endemic malaria can cause chronic hemolytic anemias that may result in osteological signatures. This paper examines these markers, Porotic Hyperostosis (PH) and Cribra Orbitalia (CO), which are identified from skeletons uncovered in archaeological excavations in Northern Sardinia. Previous hypotheses based on historical references and genetic data suggest that the disease was absent on the island in prehistory and was imported, probably by slaves, during the Carthaginian period (6th to 3rd century BC). This article reports on the paleontological analysis of 283 skeletons excavated from seven archeological sites dating from 4700 BP to 1582 AD. Osteological remains were examined for markers CO and PH as a proxy variable for malaria. The findings support previous hypotheses about history of malaria over time.展开更多
Background:Anaemia and malaria are common and life-threatening diseases among preschool-aged children in many tropical and subtropical areas,and Malawi is no exception.Accordingly,this study aimed to examine the assoc...Background:Anaemia and malaria are common and life-threatening diseases among preschool-aged children in many tropical and subtropical areas,and Malawi is no exception.Accordingly,this study aimed to examine the association of referral clinical malaria with anemia(hemoglobin[Hb]<110g/L)in preschool-aged children in Malawi.Methods:Using cross-sectional data obtained from the 2015-2016 Malawi Micronutrient Survey(MNS),multivariate logistic regression models were construaed using surveylogistic to account for the complex survey design.Blood samples of 1051 children aged 6-59 months were evaluated for malaria(using rapid diagnostic test[RDT]-SD BIOLINE Malaria Ag P.f/Pan test histidine-rich protein(HRP-Ⅱ)^™),Hb(using HemoCue 301),a-1-acid glycoprotein(AGP),and serum ferritin biomarkers(using simple sandwich enzyme-linked immunosorbent assay technique,ELISA)and inherited blood disorders from dry blood samples(DBS)using polymerize chain reaaion(PCR).Diagnosis of clinical malaria was made on the basis of fever and a positive rapid diagnostic test(RDT).Results:Of the 1051 PSC analysed,29%had anaemia while 24.4%had a referral to the hospital due to malaria.After adjustments for known confounders,PSC with a history of referral clinical malaria had increased odds of being anaemic(adjusted odds ratio[aOR]=4.63,95%confidence interval[Cf]:2.90-7.40),P<0.0001.Conclusions:This study found that clinical malaria increased the risk of anaemia in PSC Thus,elimination of malariacausing parasites from the PSCs blood should be rapid and complete in order to prevent the progression of uncomplicated malaria to a chronic infection that can lead to the development of malaria-related anaemia.展开更多
Background:Urinary schistosomiasis has been a major public health problem in Zambia for many years.However,the disease profile may vary in different locale due to the changing ecosystem that contributes to the risk of...Background:Urinary schistosomiasis has been a major public health problem in Zambia for many years.However,the disease profile may vary in different locale due to the changing ecosystem that contributes to the risk of acquiring the disease.The objective of this study was to quantify risk factors associated with the intensity of urinary schistosomiasis infection in school children in Lusaka Province,Zambia,in order to better understand local transmission.Methods:Data were obtained from 1912 school children,in 20 communities,in the districts of Luangwa and Kafue in Lusaka Province.Both individual-and community-level covariates were incorporated into an ordinal logistic regression model to predict the probability of an infection being a certain intensity in a three-category outcome response:0=no infection,1=light infection,and 2=moderate/heavy infection.Random effects were introduced to capture unobserved heterogeneity.Results:Overall,the risk of urinary schistosomiasis was strongly associated with age,altitude at which the child lived,and sex.Weak associations were observed with the normalized difference vegetation index,maximum temperature,and snail abundance.Detailed analysis indicated that the association between infection intensities and age and altitude were category-specific.Particularly,infection intensity was lower in children aged between 5 and 9 years compared to those aged 10 to 15 years(OR=0.72,95%CI=0.51-0.99).However,the age-specific risk changed at different levels of infection,such that when comparing children with light infection to those who were not infected,age was associated with a lower odds(category 1 vs category 0:OR=0.71,95%CI:0.50-0.99),yet such a relation was not significant when considering children who were moderately or heavily infected compared to those with a light or no infection(category 2 vs category 0:OR=0.96,95%CI:0.45-1.64).Overall,we observed that children living in the valley were less likely to acquire urinary schistosomiasis compared to those living in plateau areas(OR=0.48,95%CI:0.16-0.71).However,category-specific effects showed no significant association in category 1(light infection),whereas in category 2(moderate/high infection),the risk was still significantly lower for those living in the valley compared to those living in plateau areas(OR=0.18,95%CI:0.04-0.75).Conclusions:This study demonstrates the importance of understanding the dynamics and heterogeneity of infection in control efforts,and further suggests that apart from the well-researched factors of Schistosoma intensity,various other factors influence transmission.Control programmes need to take into consideration the varying infection intensities of the disease so that effective interventions can be designed.展开更多
Unintended pregnancy often ends with induced abortion,an outcome that affects a woman’s physical and mental health and consumes social resources.A national fertility survey conducted by the former National Health and...Unintended pregnancy often ends with induced abortion,an outcome that affects a woman’s physical and mental health and consumes social resources.A national fertility survey conducted by the former National Health and Family Planning Com-mission in 2017,gathered data on pregnancies among married women aged 15-49 to analyze the changing circumstances of such pregnancies and the factors that influ-ence their occurrence.The analysis found that the incidence of unintended pregnan-cies among married women in China was 42.4‰in 2017,and that such pregnancies accounted for 22.9%of all pregnancies in China for the years 2010-2017.Of all abortions,91.9%were used to terminate unintended pregnancies,and of unintended pregnancies,67.1%ended with induced abortions.The incidence of unintended pregnancy and that of induced abortion to terminate the unintended pregnancy were higher among women living in an urban rather than a rural area,having previously given birth to a boy,having a large number of children,being at the older end of their childbearing years,or having a shorter interpregnancy interval.Only 37.3%of women chose long-term contraceptive methods after an induced abortion caused by an unintended pregnancy;their sense of self-protection was not strong.It is neces-sary to strengthen education and advocacy,enhance women’s awareness of the pro-tection contraceptives offer,and improve the quality of and access to contraceptive services to reduce the incidence of unintended pregnancy,and reduce the incidence of induced abortion to terminate unintended pregnancy.展开更多
The incidence of acute respiratory infections(ARinf),including SARS-CoV-2,in unvaccinated student rugby players during phases from complete lockdown during the COVID-19 pandemic to returning to competition is unknown....The incidence of acute respiratory infections(ARinf),including SARS-CoV-2,in unvaccinated student rugby players during phases from complete lockdown during the COVID-19 pandemic to returning to competition is unknown.The aim of the study was to determine the incidence of ARinf(including SARS-CoV-2)during noncontact and contact phases during the COVID-19 pandemic to evaluate risk mitigation strategies.In this retrospective cohort study,319 top tier rugby players from 17 universities completed an online questionnaire.ARinf was reported during 4 phases over 14 months(April 2020–May 2021):phase 1(individual training),phase 2(non-contact team training),phase 3(contact team training)and phase 4(competition).Incidence(per 1000 player days)and Incidence Ratio(IR)for‘All ARinf’,and subgroups(SARS-CoV-2;‘Other ARinf’)are reported.Selected factors associated with ARinf were also explored.The incidence of‘All ARinf’(0.31)was significantly higher for SARS-CoV-2(0.23)vs.‘Other ARinf’(0.08)(p<0.01).The incidence of‘All ARinf’(IR¼3.6;p<0.01)and SARS-CoV-2(IR¼4.2;p<0.01)infection was significantly higher during contact(phases 3þ4)compared with non-contact(phases 1þ2).Demographics,level of sport,co-morbidities,allergies,influenza vaccination,injuries and lifestyle habits were not associated with ARinf incidence.In student rugby,contact phases are associated with a 3–4 times higher incidence of ARinf/SARS-CoV-2 compared to non-contact phases.Infection risk mitigation strategies in the contact sport setting are important.Data from this study serve as a platform to which future research on incidence of ARinf in athletes within contact team sports,can be compared.展开更多
基金This study is part of the RECOLLECT 2 programme,a five-year(2020-2025)project funded by the National Institute for Health and Care Research,which investigates the effectiveness and cost-effectiveness of recovery colleges.
文摘Background Recovery colleges (RCs) support personal recovery through education, skill development and social support for people with mental health problems, carers and staff. Guided by co-production and adult learning principles, RCs represent a recent mental health innovation. Since the first RC opened in England in 2009, RCs have expanded to 28 countries and territories. However, most RC research has been conducted in Western countries with similar cultural characteristics, limiting understanding of how RCs can be culturally adapted. The 12-item Recovery Colleges Characterisation and Testing (RECOLLECT) Fidelity Measure (RFM) evaluates the operational fidelity of RCs based on 12 components, but cultural influences on these components remain underexplored.Aims To assess associations between Hofstede’s cultural dimensions and RFM items to identify cultural influences on fidelity components.Methods A cross-sectional survey of RC managers was conducted across all 221 RCs. Mixed-effects regression models examined associations between Hofstede’s country-level cultural dimensions and item-level RFM scores, adjusted for healthcare expenditure and income inequality. Four cultural dimensions, obtained from Hofstede, were analysed: individualism (prioritising personal needs), indulgence (enjoyment-oriented), uncertainty avoidance (preference for predictability) and long-term orientation (future-focused).Results The RFM was completed by 169 (76%) RC managers. Seven RFM items showed associations with cultural dimensions. Equality was linked to short-term orientation, while learning was associated with individualism and uncertainty avoidance. Both individualism and indulgence influenced co-production and community focus. Commitment to recovery was shaped by all four cultural dimensions, with the strongest associations seen for individualism and indulgence. Individualism enhanced explicit focus on strengths-based practice, while uncertainty avoidance influenced course distinctiveness.Conclusions This study demonstrates how culture shapes RC fidelity components, providing actionable insights for cultural adaptation. Incorporating under-represented dimensions, such as collectivism and restraint, could improve the RFM’s global applicability, facilitating implementation. Future research should explore cultural nuances, engage diverse stakeholders and refine fidelity measures to enhance RC inclusivity and effectiveness worldwide.
文摘One of the most important points in the meta-analyses is certainly represented by the assessment of the quality of the studies included in such research. The meta-analyses are considered the highest level of evidence in science. Also for this reason, the quality of the studies included should be accurately evaluated by standardized tools. The overall results of the metaanalysis depend indeed also on a rigorous evaluation of the studies quality. Among all the possible tools for this complex evaluation, the Newcastle Ottawa Scale(NOS) is one of the most used worldwide, above all for observational studies. In this review, we will discuss the strengths and limitation of the NOS, also on the basis of the branch of science in which it has been applied.
文摘Background There are limited data on factors that predict an increased risk of multiple injuries among distance runners.The objective of this study was to determine risk factors that are predictive of individual runners with a high annual multiple injury risk(MIR).Methods A retrospective,cross-sectional study at 4 annual(2012-2015)Two Oceans 21.1 km and 56.0 km races in South Africa with 75,401 consenting race entrants.Running-related injury data were collected retrospectively through an online pre-race medical screening questionnaire.The average number of injuries for each runner every year was calculated by taking a runner's race entry history and injury history into account and categorizing entrants into 4 MIR categories(high,intermediate,low,and very low(reference)).Multiple logistic regression modeling(odds ratios)was used to determine whether the following factors were predictive of a high MIR(average>1 injury/year):demographics,training and racing,chronic-disease history(composite chronic disease score(CCDS)),and history of allergies.Results Of all entrants,9.2%reported at least 1 injury,and 0.4%of entrants were in the high MIR category;the incidence rate was 2.5 injuries per 10 runner-years(95%confidence interval(95%CI):2.4-2.7).Significant factors predictive of runners in the high MIR category were:running for>20 years:OR=2.0(95%CI:1.3-3.1;p=0.0010);a higher CCDS:OR=2.2(95%CI:2.0-2.4;p<0.0001);and a history of allergies:OR=2.8(95%CI:2.0-3.8;p<0.0001).Conclusion Runners who have been running recreationally for>20 years and those with multiple chronic diseases or a history of allergies were at higher risk of multiple running-related injuries.This high-risk group can be targeted for further study and possible injury-prevention interventions.
基金This study was supported by the Fogarty International Center and Office of Dietary Supplements of the National Institutes of Health(D43 TW009118)via the Scholars in HeAlth Research Program(SHARP)at the American University of Beirut,and the NHLBI K24HL 136852 of Dr.Mora.
文摘OBJECTIVE To investigate which history of cardiovascular disease[coronary heart disease(CHD),stroke,or peripheral arterial disease]in a first-degree family member predicts cardiovascular mortality.METHODS We studied a prospective cohort(the Lipid Research Clinics Prevalence Study)from ten primary care centers across North America.The primary outcome was cardiovascular mortality,assessed using Cox survival models.RESULTS There were 8,646 participants(mean age:47.4±12.1 years,46%women,52%of participants with hyperlipidemia)who were followed up for a mean duration of 19.4±4.9 years.There were 1,851 deaths(21%),including 852 cardiovascular deaths.A paternal,maternal or sibling history of premature CHD(before 60 years)was present in 26%of participants,of stroke in 27%of participants,and of peripheral arterial disease in 24%of participants.After adjusting for risk factors(age,sex,systolic blood pressure,diastolic blood pressure,body mass index,smoking,fasting glucose,low-density lipoprotein cholesterol and triglycerides),only a paternal history of premature or any CHD,a maternal history of diabetes mellitus or premature or any CHD,and a sibling history of premature CHD,hypertension,or hyperlipidemia were individually predictive of cardiovascular mortality.After adjusting for risk factors and the mentioned familial factors,only paternal and maternal histories of CHD,espe-cially before 60 years,remained predictive of cardiovascular mortality,with a somewhat higher association for a maternal history[adjusted hazard ratio(aHR)=1.99,95%CI:1.36−2.92,P<0.001 for maternal history of premature CHD;aHR=1.52,95%CI:1.10−2.10,P=0.011 for paternal history of premature CHD].Family history of stroke or peripheral arterial disease did not predict cardiovascular mortality.Parental history of premature CHD predicted cardiovascular mortality independently of baseline age(<60 years and≥60 years),hypertension,or hyperlipidemia and carried more important prognostic value in men rather than wo-men.CONCLUSIONS In this study,a parental history of CHD,especially before 60 years,best predicted cardiovascular mortality.This finding could help more accurately identify high-risk patients who would benefit from preventive strategies.
文摘Background: Neural tube defects have a considerable importance because they can be prevented by supplementing Folic acid & Vitamin B12 during periconceptional period and fortification of staple foods. In Morocco, the Ministry of Health launched a national program for fortification of flour with folic acid. Our goal should be to evaluate the prevalence of neural tube defects after fortification. Description: This is a retrospective descriptive at the National Reference Centre for Nutrition and Neonatology of the Children’s Hospital of Rabat over 4 years. Data were identified from the registry of congenital malformations held at the perinatology unit. Results: During the 4 years, 674 congenital malformations were identified. The neural tube defects NTDs account for 11.9%. Their annual prevalence decreased significantly from 21.78 in 2008 to 12.1 per 10,000 total births in 2011. The most common form was anencephaly (60%). Neural tube defects were isolated in 85% of cases and associated with other malformations in 15% of cases. 49.4% of infants with neural tube defects were female and 50.6% were male. Perinatal mortality in newborns with neural tube defects was 63.8% versus 25.2% in malformed newborns without neural tube defects. Conclusions: The neural tube defects seem to be common in our context. Permanent epidemiological surveillance is needed to determine the true prevalence at the national as well as its temporal trends level.
基金supported by funding from the International Olympic Committee(IOC)CS received a scholarship made possible through funding by the South African Medical Research Council(SAMRC)through its Division of Research Capacity Development under the SAMRC Clinician Researcher ProgrammeResearch reported in this publication was also supported by the SAMRC under a Self-Initiated Research Grant to MS.
文摘Purpose The aim of the study was to identify factors associated with prolonged time to return to full performance(RTFP)in athletes with recent severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.Methods Prospective cohort study with cross sectional analysis.A total of 84 athletes with confirmed SARS-CoV-2 infection assessed at a coronavirus disease 2019 recovery clinic gave a history of age,sex,type/level of sport,co-morbidities,pre-infection training hours,and 26 acute SARS-CoV-2 symptoms from 3 categories(“nose and throat”,“chest and neck”,and“whole body”/systemic).Data on days to RTFP were obtained by structured interviews.Factors associated with RTFP were demographics,sport participation,history of co-morbidities,pre-infection training history,and acute symptoms(type,number).Outcomes were:(a)days to RTFP(median,interquartile range(IQR))in asymptomatic(n=7)and symptomatic athletes(n=77),and(b)hazard ratios(HRs;95%confidence interval)for symptomatic athletes with vs.without a factor(univariate,multiple models).HR<1 was predictive of higher percentage chance of prolonged RTFP.Significance was p<0.05.Results Days to RTFP were 30 days(IQR:23–40)for asymptomatic and 64 days(IQR:42–91)for symptomatic participants(p>0.05).Factors associated with prolonged RTFP(univariate models)were:females(HR=0.57;p=0.014),endurance athletes(HR=0.41;p<0.0001),co-morbidity number(HR=0.75;p=0.001),and respiratory disease history(HR=0.54;p=0.026).In symptomatic athletes,prolonged RTFP(multiple models)was significantly associated with increased“chest and neck”(HR=0.85;p=0.017)and“nose and throat”(HR=0.84;p=0.013)symptoms,but the association was more profound between prolonged RFTP and increased total number of“all symptoms”(HR=0.91;p=0.001)and“whole body”/systemic(HR=0.82;p=0.007)symptoms.Conclusion A larger number of total symptoms and specifically“whole body”/systemic symptoms during the acute phase of SARS-CoV-2 infection in athletes is associated with prolonged RTFP.
文摘Malaria has been an important disease throughout the history, particularly in the Mediterranean. The island of Sardinia (Italy) was characterized by severe endemic malaria from antiquity until its eradication in 1950. It provides an exceptional and unique site to examine the history of the disease and its effects on human biology and ecology. Endemic malaria can cause chronic hemolytic anemias that may result in osteological signatures. This paper examines these markers, Porotic Hyperostosis (PH) and Cribra Orbitalia (CO), which are identified from skeletons uncovered in archaeological excavations in Northern Sardinia. Previous hypotheses based on historical references and genetic data suggest that the disease was absent on the island in prehistory and was imported, probably by slaves, during the Carthaginian period (6th to 3rd century BC). This article reports on the paleontological analysis of 283 skeletons excavated from seven archeological sites dating from 4700 BP to 1582 AD. Osteological remains were examined for markers CO and PH as a proxy variable for malaria. The findings support previous hypotheses about history of malaria over time.
文摘Background:Anaemia and malaria are common and life-threatening diseases among preschool-aged children in many tropical and subtropical areas,and Malawi is no exception.Accordingly,this study aimed to examine the association of referral clinical malaria with anemia(hemoglobin[Hb]<110g/L)in preschool-aged children in Malawi.Methods:Using cross-sectional data obtained from the 2015-2016 Malawi Micronutrient Survey(MNS),multivariate logistic regression models were construaed using surveylogistic to account for the complex survey design.Blood samples of 1051 children aged 6-59 months were evaluated for malaria(using rapid diagnostic test[RDT]-SD BIOLINE Malaria Ag P.f/Pan test histidine-rich protein(HRP-Ⅱ)^™),Hb(using HemoCue 301),a-1-acid glycoprotein(AGP),and serum ferritin biomarkers(using simple sandwich enzyme-linked immunosorbent assay technique,ELISA)and inherited blood disorders from dry blood samples(DBS)using polymerize chain reaaion(PCR).Diagnosis of clinical malaria was made on the basis of fever and a positive rapid diagnostic test(RDT).Results:Of the 1051 PSC analysed,29%had anaemia while 24.4%had a referral to the hospital due to malaria.After adjustments for known confounders,PSC with a history of referral clinical malaria had increased odds of being anaemic(adjusted odds ratio[aOR]=4.63,95%confidence interval[Cf]:2.90-7.40),P<0.0001.Conclusions:This study found that clinical malaria increased the risk of anaemia in PSC Thus,elimination of malariacausing parasites from the PSCs blood should be rapid and complete in order to prevent the progression of uncomplicated malaria to a chronic infection that can lead to the development of malaria-related anaemia.
基金The first author(CS)received a travel award from the Danish Bilharziasis Laboratory,now the DBL-Centre for Health Research and Development,University of Copenhagen,DenmarkThe second author’s(LNK)efforts were partly funded by the University of Namibia.
文摘Background:Urinary schistosomiasis has been a major public health problem in Zambia for many years.However,the disease profile may vary in different locale due to the changing ecosystem that contributes to the risk of acquiring the disease.The objective of this study was to quantify risk factors associated with the intensity of urinary schistosomiasis infection in school children in Lusaka Province,Zambia,in order to better understand local transmission.Methods:Data were obtained from 1912 school children,in 20 communities,in the districts of Luangwa and Kafue in Lusaka Province.Both individual-and community-level covariates were incorporated into an ordinal logistic regression model to predict the probability of an infection being a certain intensity in a three-category outcome response:0=no infection,1=light infection,and 2=moderate/heavy infection.Random effects were introduced to capture unobserved heterogeneity.Results:Overall,the risk of urinary schistosomiasis was strongly associated with age,altitude at which the child lived,and sex.Weak associations were observed with the normalized difference vegetation index,maximum temperature,and snail abundance.Detailed analysis indicated that the association between infection intensities and age and altitude were category-specific.Particularly,infection intensity was lower in children aged between 5 and 9 years compared to those aged 10 to 15 years(OR=0.72,95%CI=0.51-0.99).However,the age-specific risk changed at different levels of infection,such that when comparing children with light infection to those who were not infected,age was associated with a lower odds(category 1 vs category 0:OR=0.71,95%CI:0.50-0.99),yet such a relation was not significant when considering children who were moderately or heavily infected compared to those with a light or no infection(category 2 vs category 0:OR=0.96,95%CI:0.45-1.64).Overall,we observed that children living in the valley were less likely to acquire urinary schistosomiasis compared to those living in plateau areas(OR=0.48,95%CI:0.16-0.71).However,category-specific effects showed no significant association in category 1(light infection),whereas in category 2(moderate/high infection),the risk was still significantly lower for those living in the valley compared to those living in plateau areas(OR=0.18,95%CI:0.04-0.75).Conclusions:This study demonstrates the importance of understanding the dynamics and heterogeneity of infection in control efforts,and further suggests that apart from the well-researched factors of Schistosoma intensity,various other factors influence transmission.Control programmes need to take into consideration the varying infection intensities of the disease so that effective interventions can be designed.
文摘Unintended pregnancy often ends with induced abortion,an outcome that affects a woman’s physical and mental health and consumes social resources.A national fertility survey conducted by the former National Health and Family Planning Com-mission in 2017,gathered data on pregnancies among married women aged 15-49 to analyze the changing circumstances of such pregnancies and the factors that influ-ence their occurrence.The analysis found that the incidence of unintended pregnan-cies among married women in China was 42.4‰in 2017,and that such pregnancies accounted for 22.9%of all pregnancies in China for the years 2010-2017.Of all abortions,91.9%were used to terminate unintended pregnancies,and of unintended pregnancies,67.1%ended with induced abortions.The incidence of unintended pregnancy and that of induced abortion to terminate the unintended pregnancy were higher among women living in an urban rather than a rural area,having previously given birth to a boy,having a large number of children,being at the older end of their childbearing years,or having a shorter interpregnancy interval.Only 37.3%of women chose long-term contraceptive methods after an induced abortion caused by an unintended pregnancy;their sense of self-protection was not strong.It is neces-sary to strengthen education and advocacy,enhance women’s awareness of the pro-tection contraceptives offer,and improve the quality of and access to contraceptive services to reduce the incidence of unintended pregnancy,and reduce the incidence of induced abortion to terminate unintended pregnancy.
基金supported by funding of the International Olympic Committee(IOC).CS received a scholarship made possible through funding by the South African Medical Research Council through its Division of Research Capacity Development under the SAMRC Clinician Researcher Programme.Research reported in this publication was also supported by Self-Initiated Research Grants from the South African Medical Research Council awarded to NS.The content hereof is the sole responsibility of the authors and does not necessarily represent the official views of the SAMRC.Funders were not involved in the preparation of this manuscript.
文摘The incidence of acute respiratory infections(ARinf),including SARS-CoV-2,in unvaccinated student rugby players during phases from complete lockdown during the COVID-19 pandemic to returning to competition is unknown.The aim of the study was to determine the incidence of ARinf(including SARS-CoV-2)during noncontact and contact phases during the COVID-19 pandemic to evaluate risk mitigation strategies.In this retrospective cohort study,319 top tier rugby players from 17 universities completed an online questionnaire.ARinf was reported during 4 phases over 14 months(April 2020–May 2021):phase 1(individual training),phase 2(non-contact team training),phase 3(contact team training)and phase 4(competition).Incidence(per 1000 player days)and Incidence Ratio(IR)for‘All ARinf’,and subgroups(SARS-CoV-2;‘Other ARinf’)are reported.Selected factors associated with ARinf were also explored.The incidence of‘All ARinf’(0.31)was significantly higher for SARS-CoV-2(0.23)vs.‘Other ARinf’(0.08)(p<0.01).The incidence of‘All ARinf’(IR¼3.6;p<0.01)and SARS-CoV-2(IR¼4.2;p<0.01)infection was significantly higher during contact(phases 3þ4)compared with non-contact(phases 1þ2).Demographics,level of sport,co-morbidities,allergies,influenza vaccination,injuries and lifestyle habits were not associated with ARinf incidence.In student rugby,contact phases are associated with a 3–4 times higher incidence of ARinf/SARS-CoV-2 compared to non-contact phases.Infection risk mitigation strategies in the contact sport setting are important.Data from this study serve as a platform to which future research on incidence of ARinf in athletes within contact team sports,can be compared.
