Clinical Epidemiology and Global Health最新文献

{"title":"Evaluation of health-related quality of life among patients with chronic obstructive pulmonary disease at District Headquarter Hospital haripur, Pakistan","authors":"Mehwish Fayaz ,&nbsp;Shahbaz Ahmad Zakki ,&nbsp;Ijaz Ul Haq,&nbsp;Muhammad Afzal,&nbsp;Mudassar Latif,&nbsp;Ehtisham Altaf","doi":"10.1016/j.cegh.2025.101917","DOIUrl":"10.1016/j.cegh.2025.101917","url":null,"abstract":"<div><h3>Background &amp; objectives</h3><div>Chronic obstructive pulmonary disease (COPD) is a notable worldwide public health issue and a major cause of morbidity and mortality in Pakistan. The objective of this study was to assess the health-related Quality of Life (HRQoL) among patients diagnosed with COPD and to explore the determinants that impact it.</div></div><div><h3>Methods</h3><div>This cross-sectional study comprised 400 individuals diagnosed with COPD who were aged 30–75. The St. George's Respiratory Questionnaire (SGRQ), which is specific to COPD, was employed to assess the patient's quality of life. The overall score of all three domains, namely activity, impact, and symptoms, was calculated. The chi-square test was used to find out the association between the SGRQ scores and the respondent's characteristics.</div></div><div><h3>Results</h3><div>The mean score of SGRS was 59.04 ± 1.03, indicating worse health. About 60 % (n = 240) of the participants had phlegm most of the day. Additionally, most of them 62 % (248) suffered from cough most days a week, with a p-value of 0.010, and the shortness of breath (p &lt; 0.001) was significantly associated with the total SGRQ score. Shortness of breath (p-value &lt;0.001) and cough (p-value 0.010) were significantly associated with the total SGQR score.</div></div><div><h3>Conclusion</h3><div>The impairment of quality of life is a notable issue among patients diagnosed with COPD, and it tends to worsen as the disease progresses in severity. The need of the hour is to promote awareness about COPD in the community and sensitize healthcare professionals towards its effects on HRQoL.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"32 ","pages":"Article 101917"},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triggers for Palliative Care consultation and its modalities in non-malignant mechanically ventilated patients in the Intensive Care Unit: A prospective observational study","authors":"Mansi Suresh ,&nbsp;Souvik Chaudhuri ,&nbsp;Krithika Rao ,&nbsp;Pratibha Todur","doi":"10.1016/j.cegh.2025.101914","DOIUrl":"10.1016/j.cegh.2025.101914","url":null,"abstract":"<div><h3>Aim and objectives</h3><div>To determine the triggers for palliative care consultation (PCC) in non-malignant mechanically ventilated (MV) patients admitted to intensive care unit (ICU) and factors affecting modalities of palliative care (PC) delivery.</div></div><div><h3>Material and methods</h3><div>Single-centre prospective observational study was conducted on 104 adult non-malignant patients on MV and received PC during the ICU stay. Withhold of life-sustaining treatment (WHLS) and withdrawal of life-sustaining treatment (WDLS) were the two modalities of PC delivery.</div></div><div><h3>Results</h3><div>Of 104 non- malignant ICU patients on MV, WDLS was opted in 56 (53 %) and WHLS in 48 (46 %) by the patients’ legally authorized representatives. Patients with neurological dysfunction (either with or without septic shock) formed most cases receiving PC 64 (61.5 %). The median (IQR) of the number of hospitalizations in the preceeding two years was 2.5 (1-4 ) in the WDLA compared to WHLS 1 (1-2) [p &lt; 0.001]. APACHE II score ≥25 even after seven days of invasive mechanical ventilation and aggressive medical therapy in ICU, Charlson comorbidity index (CCI) score ≥5 and ≥2 hospitalizations in the preceding two years are triggers of PC consultation. In multivariate analysis, higher APACHE score, higher the number of hospitalisations in the last 2 years and lower CCI score appear to predict WDLS against WHLS.</div></div><div><h3>Conclusion</h3><div>In our patient population of non-malignant patients admitted to ICU and receiving IMV (a) the neurological dysfunction comprised the largest group of non-malignant critically ill patients on IMV for PCC (b) Higher APACHE score and number of hospitalisations probably predicts the choice of WDLS (c) Further, large multicentred study with larger sample is required to generalise the study findings.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"32 ","pages":"Article 101914"},"PeriodicalIF":2.3,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143135643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The magnitude of relapse after substance abuse and its influencing factors among rehabilitees who completed treatment at a rehabilitation center in tigray, Ethiopia","authors":"Seare Abdu Adem ,&nbsp;Kissanet Tesfay Weldearegay ,&nbsp;Girmatsion Fisseha ,&nbsp;Zinabu Hadush","doi":"10.1016/j.cegh.2024.101909","DOIUrl":"10.1016/j.cegh.2024.101909","url":null,"abstract":"<div><h3>Background</h3><div>Substance abuse is a significant public health concern. One of the key strategies for controlling drug abuse epidemics is rehabilitation. Although substance abuse rehabilitation institutions exist in Ethiopia, little is known about relapse rates. Therefore, this study aims to determine the magnitude of relapse and identify factors influencing it among individuals who have completed treatment at a rehabilitation center in Tigray of Ethiopia.</div></div><div><h3>Methods</h3><div>An institution-based cross-sectional study was conducted at a rehabilitation center in Ethiopia in 2021. A systematic random sampling method was used to select rehabilitees, with every second individual included until the desired sample size of 176 was reached. Data were collected using semi-structured questionnaires and medical record reviews. Odds ratios (OR) with 95 % confidence intervals (CI) were calculated, and statistical significance was set at a p-value of &lt;0.05.</div></div><div><h3>Results</h3><div>The relapse rate following substance abuse rehabilitation was 73.3 % (129 out of 176 individuals). Factors significantly associated with relapse included being older than 30 years [AOR = 0.45, 95 % CI (0.21–0.97), p = 0.04], having a degree or higher educational status [AOR = 0.31, 95 % CI (0.13–0.74), p = 0.008], and rating the accommodation of the treatment center as medium [AOR = 0.14, 95 % CI (0.19–0.96), p = 0.046] or high [AOR = 0.29, 95 % CI (0.02–0.96), p = 0.045].</div></div><div><h3>Conclusion</h3><div>The relapse rate among rehabilitees was high. Protective factors against relapse included being over 30 years of age, having a degree or higher educational attainment, and rating the treatment center's accommodation as medium or high. We recommend that rehabilitation centers prioritize support for individuals under 30 years of age and those with lower educational levels to reduce relapse risk.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"31 ","pages":"Article 101909"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143102942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of brown-fat-secreted adipokine neuregulin 4 with gestational diabetes mellitus: A systematic review and meta-analysis","authors":"Roshan Kumar Mahat ,&nbsp;Vedika Rathore ,&nbsp;Manisha Arora ,&nbsp;Rahul Mishra ,&nbsp;Sudeep Kumar","doi":"10.1016/j.cegh.2024.101908","DOIUrl":"10.1016/j.cegh.2024.101908","url":null,"abstract":"<div><h3>Aim</h3><div>Neuregulin-4, a newly identified adipokine, is thought to play a role in the regulation of energy balance and glycolipid metabolism. This meta-analysis aimed to investigate the association between Neuregulin-4 (Nrg4) and gestational diabetes mellitus (GDM).</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted across four electronic databases- PubMed (Medline), Scopus, Europe PMC, and Google Scholar to identify relevant studies published up until August 2, 2024. A random effects model was utilized to compute the standardized mean difference (SMD) and 95 % confidence interval (CI). Statistical heterogeneity was assessed using Cochran's Q test, the I² statistic, and prediction intervals (PI). Additionally, a meta-correlation analysis was performed to explore the relationship between Nrg4 and various biochemical parameters.</div></div><div><h3>Results</h3><div>This meta-analysis incorporated seven studies comprising 347 subjects with GDM and 362 subjects without GDM. No significant difference was observed in circulating Nrg4 levels between the GDM and non-GDM groups (SMD = −0.35, 95 % CI = −1.17 to 0.48, p = 0.41, I² = 96 %). The 95 % prediction interval ranged from −3.35 to 2.66. Sensitivity analysis and subgroup analysis by sample size, continent, and study design reported significantly reduced levels of Nrg4 in GDM compared to non-GDM. The meta-correlation analysis revealed that Nrg4 was not significantly correlated with most biochemical and metabolic parameters studied in GDM. However, sensitivity analyses in certain instances suggested potential associations after the exclusion of specific studies.</div></div><div><h3>Conclusion</h3><div>Sensitivity analysis and subgroup analysis by sample size, continent, and study design reported significantly reduced levels of Nrg4 in GDM compared to non-GDM, suggesting a possible protective function of Nrg4 in GDM.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"31 ","pages":"Article 101908"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103099","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An interrupted time series analysis to assess the impact of implementing the clinical audit process for stillbirths and neonatal deaths in Morocco","authors":"Mina EL Hiyani ,&nbsp;Othmane Benlenda ,&nbsp;Asmaa Mdaghri Alaoui ,&nbsp;Redouane Abouqal ,&nbsp;Amal Thimou Izgua","doi":"10.1016/j.cegh.2024.101898","DOIUrl":"10.1016/j.cegh.2024.101898","url":null,"abstract":"<div><h3>Objectives</h3><div>This article aims to evaluate the clinical audit process for stillbirths and neonatal deaths and its impact on reducing neonatal mortality at the Hassan I Hospital, Tiznit, Morocco. This process was initially implemented in Morocco in 2017.</div></div><div><h3>Methods</h3><div>The clinical audit process was evaluated using a semi-structured interview with the managers monitoring the clinical audit of stillbirths and neonatal deaths. The impact of the clinical audit on reducing neonatal mortality rates was assessed by analysing neonatal mortality rates using interrupted time series analysis (ITSA).</div></div><div><h3>Results</h3><div>A study of the interrupted time series showed that there was a slight downward trend in the monthly neonatal mortality rate before implementation of the clinical audit (estimate - 0.20, CI 95 %: 0.23–0.16, P &lt; 0.001) with a very significant drop just at the time of performance of the clinical audit (assessment - 11, CI 95 %: 15.1–8.87, P &lt; 0.001)The monthly neonatal mortality rates recorded, which are similar to the recommended international standards, stabilised after the clinical audit was implemented (estimate 0.16, CI 95 %:0.11–0.21, P &lt; 0.001) with an improvement in the care of newborns through the availability of human resources, materials and equipment.</div></div><div><h3>Conclusion</h3><div>The audit of stillbirths and neonatal deaths reduced neonatal mortality by improving the mother-newborn couple's management quality. In addition, the study highlighted the need to introduce several community participation mechanisms that could be adapted and piloted to establish a more comprehensive and effective audit practice.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"31 ","pages":"Article 101898"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and validation of android mobile application in the management of mental health","authors":"G. Hari Prakash ,&nbsp;D. Sunil Kumar ,&nbsp;Vanishri Arun ,&nbsp;Deepika Yadav ,&nbsp;Arun Gopi ,&nbsp;Rishi Garg","doi":"10.1016/j.cegh.2024.101894","DOIUrl":"10.1016/j.cegh.2024.101894","url":null,"abstract":"<div><h3>Background</h3><div>The critical window of adolescence demands accessible and effective interventions to address mental health needs. This study aimed to develop and validate a mobile application to promote adolescents' mental well-being.</div></div><div><h3>Methods</h3><div>The Android app was developed using a user-centred approach focused on engaging the target audience of adolescents. A quasi-experimental study was conducted with 60 adolescent participants assigned to the experimental (app users) or control group. Satisfaction with the app and mental health outcomes were assessed at baseline and after app usage.</div></div><div><h3>Results</h3><div>At baseline, participants struggled to answer very simple questions about their mental health concerns. After using the app, participants' satisfaction was significantly higher in the experimental group compared to the control group. At follow-up, participants struggled to comprehensively answer complex and open-ended questions about their experience using the app. Their code transcribed from the app effectively captured their mental health concerns.</div></div><div><h3>Conclusion</h3><div>The app-enabled participants to express their thoughts concisely through code transcribed from their mental health concerns. Despite participants' struggles with complex questioning, the app's contents addressed their needs through transcribed code. The app engaged users effectively by allowing code from their mental health concerns to be the content.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"31 ","pages":"Article 101894"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143163376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-care practices on hypertension: Prevalence and predictors in Puducherry, South India","authors":"Chandru Sivamani ,&nbsp;Ganesh Kumar Saya ,&nbsp;Revathi Ulaganeethi ,&nbsp;Palanivel Chinnakali","doi":"10.1016/j.cegh.2024.101883","DOIUrl":"10.1016/j.cegh.2024.101883","url":null,"abstract":"<div><h3>Background</h3><div>Self-care practices plays an important role in reducing the mortality and morbidity associated with hypertensive complications. Therefore, this study aimed to assess poor self-care practices on hypertension and its predictors among patients attending the non-communicable disease clinics in urban and rural primary healthcare settings in Puducherry, South India.</div></div><div><h3>Methods</h3><div>A cross-sectional analytical study was conducted among people with hypertension aged ≥18 years from September to December 2023. Systematic random sampling technique was used to recruit the participants. The data on self-care practices were captured using the “Hypertension Self-Care Activity Level Effects (H-SCALE)” questionnaire. The subscales were medication adherence, low-salt diet, physical activity, smoking, alcohol and weight management. Participants who adhered &lt;4 out of six subscales of H-SCALE, was considered as poor self-care practices. Multivariable analysis was carried out to adjust for potential covariates, and adjusted prevalence ratio with a 95 % confidence interval was reported.</div></div><div><h3>Results</h3><div>Out of 267 participants with hypertension, 158 (59.2 %) were &gt;60 years of age and 182 (68.2 %) were females. About 79 (29.6 %) had poor self-care practices. Among 267, 63 (23.6 %) had uncontrolled hypertension and it was more among those with poor self-care practices (46.1 % Vs 24.5 %). After adjusting for co-variates, urban residents (APR: 1.7, 95 % CI: 1.1–2.4, p = 0.004) and uncontrolled hypertension status (APR: 1.8, 95 % CI: 1.1–2.4, p &lt; 0.001) were significantly associated with poor self-care practices.</div></div><div><h3>Conclusion</h3><div>More than one-fourth of the participants with hypertension had poor self-care practices and it was significantly higher in participants with uncontrolled hypertension.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"31 ","pages":"Article 101883"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"L-shaped relationship of Vitamin D and blood lead levels among preschool children age 3–6: A cross-sectional study","authors":"Shengying Zhang,&nbsp;Bibo Mao,&nbsp;Fei Xu,&nbsp;Chenbo Zhou,&nbsp;Wenyuan Liu","doi":"10.1016/j.cegh.2024.101864","DOIUrl":"10.1016/j.cegh.2024.101864","url":null,"abstract":"<div><h3>Background</h3><div>Childhood lead exposure negatively impacts health, and its link to Vitamin D levels in preschoolers is not well understood.</div></div><div><h3>Objective</h3><div>To investigate the association between Vitamin D and blood lead levels (BLLs) in Chinese preschool children aged 3-6.</div></div><div><h3>Methods</h3><div>A cross-sectional study of 604 children from three Ningbo kindergartens in 2019 measured serum Vitamin D using Chemiluminescence Immunoassay and BLLs via ICP-MS. We used multivariate linear regression, adjusting for factors like age, gender, BMI, hemoglobin, family income, parental occupations, and residential location, and smooth curve fitting to analyze the dose-response relationship.</div></div><div><h3>Results</h3><div>The average age was 5.4 ± 0.8 years, with BLLs at 19.7 ± 12.1 µg/L. Each 1 ng/mL increase in Vitamin D correlated with a 0.29 µg/L decrease in BLLs (95% CI: -0.43 to -0.16, p &lt; 0.001). The inverse association was significant in males and suburban residents. A threshold effect was identified at 38.679 ng/mL Vitamin D, beyond which BLLs did not decrease further (β = -0.506, 95% CI: -0.777 to -0.235, p &lt;0.001).</div></div><div><h3>Conclusions</h3><div>Higher Vitamin D levels are significantly linked to lower BLLs, especially in males and suburban residents, with a threshold at 38.679 ng/mL. Above this, no further BLL reduction is observed, highlighting the importance of optimal Vitamin D levels in mitigating lead exposure.</div></div>","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"31 ","pages":"Article 101864"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to the Editor: “A study on socio-demographic-based knowledge and awareness for cervical cancer among women from Uttar Pradesh, India”","authors":"Kushal Krishna Banerjee,&nbsp;Rabia Batool Hussain","doi":"10.1016/j.cegh.2024.101891","DOIUrl":"10.1016/j.cegh.2024.101891","url":null,"abstract":"","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"31 ","pages":"Article 101891"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Epidemiology of prurigo nodularis: An analysis of global trends from 1998–2023","authors":"Shiyan Yang ,&nbsp;Chunxiao Wang ,&nbsp;Sihan Wang ,&nbsp;Yuanting Yu ,&nbsp;Xiaoce Cai ,&nbsp;Yifei Wang ,&nbsp;Xin Li","doi":"10.1016/j.cegh.2024.101906","DOIUrl":"10.1016/j.cegh.2024.101906","url":null,"abstract":"","PeriodicalId":46404,"journal":{"name":"Clinical Epidemiology and Global Health","volume":"31 ","pages":"Article 101906"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143103197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}