Study Participants Research Articles

Influence of social media on health-related decision-making among adults attending an outpatient department of a tertiary care centre in India: A cross-sectional analytical study

Background Social media platforms, especially Facebook and WhatsApp, can spread public health information effectively. We aimed to estimate the influence of health-related messages circulated through these social media platforms on health-related decision-making and its associated factors. Methods We did a cross-sectional analytical study among adults (aged >18 years) who visited the outpatient department of a tertiary care hospital in suburban West Bengal, during July–September 2021. A structured questionnaire was used regarding receiving health-related messages on social media and the subsequent effect on health-related decision-making in the past year. Results A total of 673 individuals participated in the study. Their mean (SD) age was 34.4 (10.2) years and 56.8% (382) were men, 50.8% (342) were graduates, 63.6% (428) were from rural areas and 82.9% (558) were active users of more than one social media platform. A total of 474 (70.4%; 95% CI 67.0–73.9) study participants reported health-related decision-making based on social media messages, whereas 44.7% (301) reported checking the authenticity of forwarded messages or posts or updates with healthcare professionals before making a decision. On adjusted analysis, participants who had secondary education (adjusted prevalence ratio [aPR] 1.40; 95% CI 1.01–1.94), used both the media (aPR 1.31; 95% CI 1.09–1.58) and checked the authenticity of the messages with a healthcare professional (aPR 1.52, 95% CI 1.38–1.68) were significantly more influenced by the messages, posts or updates received on social media platforms. Conclusion WhatsApp forwards or updates and Facebook posts or updates influence health-related decision-making among the Indian adult population.

Evaluation of the psychometric properties of the UBACC questionnaire in a multi-country psychiatric study in Africa

BackgroundThe University of California, San Diego Brief Assessment of Capacity to Consent (UBACC) is a tool to assess the capacity of participants to consent in psychiatric research. However, little is known about the psychometric properties in low and middle-income countries. This study aimed to examine the psychometric properties of the UBACC. MethodsWe examined the reliability, latent factor structure, and item response of the first attempt of the UBACC items in a sample of 32,208 adults (16,467 individuals with psychosis and 15,741 controls) in Ethiopia, Kenya, South Africa, and Uganda; exploring these properties in the full sample and stratified by country, diagnostic status, sex, and ethnolinguistic language groups. ResultsExploratory factor analysis (EFA) suggested a two-factor model for the overall sample. However, a three-factor model was more appropriate when examining the latent structure across country, language, and sex. Confirmatory factor analyses (CFA) revealed an adequately fitting three-factor model for the full sample and across country, sex, and language. A two-factor model, however, was more appropriate for English and Amharic languages. Across all groups, the internal consistency of the UBACC was low, indicating below-threshold reliability (Cronbach's α (95 % CI = 0.58 (0.57–0.59). Using a multidimensional item-response theory framework for the full sample revealed that UBACC item 8, measuring understanding of the benefits of study participation, was the most discriminating item. Many of the other items had below-threshold discriminating characteristics. ConclusionEFA and CFA converged towards a two and three-dimensional structure for the UBACC, in line with the developers of the original scale. The differences in properties between populations and language groups, low internal consistency, and below-threshold item functioning suggest that investigations into the cultural and linguistic nuances are still warranted. Understanding the utility of consent tools, such as the UBACC, in underrepresented populations will be a part of the larger process which ensures that research participants are adequately protected.

Development of Marbel Sitasya Interactive Learning Media Based on Canva to Improve Science Learning Outcomes

Study This developing learning media interactive based Canva provided​ term Marble Sitasya To use overcome problem low results study science material solar system in class VI Wonotulus State Elementary School Regency Purworejo. Study This use Research and Development ( RnD ) method with Borg and Gall stages. The data analysis technique uses a feasibility test product, initial and final data analysis namely the t test and the N-Gain test. Based on results study show that learning media very worthy used. This proven with results evaluation appropriateness products by media experts and expert material obtained percentage by 76% and 90%. This media is also effectiv used in accordance with t test results on both the test stage is the scale test small and test scale great showing​ results sig value. (2-tailed) is 0.000 < 0.05, meaning Ho is rejected and Ha is accepted. Besides Therefore, the N-Gain test results are obtained amounted to 0.51 on the scale test small and fruitful amounted to 0.6082 on the scale test big with criteria currently. based on results study this stated that learning media interactive Marble Sitasya based canva very feasible and effective for increase results study participant educate on science content material solar system in class VI Wonotulus State Elementary School Regency Purworejo.

Long-term exposures to low concentrations of source-specific air pollution, road-traffic noise, and systemic inflammation and cardiovascular disease biomarkers

ObjectivesAir pollution and traffic noise are detrimental to cardiovascular health. However, the effects of different sources of these exposures on cardiovascular biomarkers remain unclear. We explored the associations of long-term exposure to source-specific air pollution (vehicular exhausts and residential woodsmoke) at low concentrations and road-traffic noise with systemic inflammation and cardiovascular disease biomarkers. Material and methodsModeled outdoor exposure to fine particulate matter (aerodynamic diameter ≤2.5 μm; PM2.5) from vehicular exhausts and residential woodsmoke, nitrogen dioxide (NO2) from road traffic, and road-traffic noise were linked to the home addresses of the participants (Finnish residents aged 25–74) in the FINRISK study 1997–2012. The participants were located in the cities of Helsinki, Vantaa, and the region of Turku, Finland. The outcomes were high-sensitivity C-reactive protein (CRP), a biomarker for systemic inflammation, and cardiovascular disease biomarkers N-terminal pro-B-type natriuretic peptide (NT-proBNP) and troponin I. We performed cross-sectional analyses with linear and additive models and adjusted for potential confounders. ResultsWe found no association between PM2.5 from vehicular exhausts (% CRP difference for 1 μg/m3 increase in PM2.5: −0.9, 95% confidence interval, CI: −7.2, 5.8), or from residential woodsmoke (% difference: −8.1, 95% CI: −21.7, 7.9) and CRP (N = 4147). Road-traffic noise >70 dB tended to be positively associated with CRP (% CRP difference versus noise reference category of ≤45 dB: 18.3, 95% CI: −0.5, 40.6), but the association lacked significance and robustness (N = 7142). Otherwise, we found no association between road-traffic noise and CRP, nor between NO2 from road traffic and NT-proBNP (N = 1907) or troponin I (N = 1951). ConclusionLong-term exposures to source-specific, fairly low-level air pollution from vehicular exhausts and residential woodsmoke, or road-traffic noise were not associated with systemic inflammation and cardiovascular disease biomarkers in this urban area.

Acceptability and Feasibility of an Ecological Momentary Intervention for Managing Emotional Distress Among Psychiatric Inpatients at Risk for Suicide

The weeks following an inpatient psychiatric hospitalization are known to be the highest-risk time for suicide. Interventions are needed that are well-matched to the dynamic nature of suicidal thoughts and easily implementable during this high-risk time. We sought to determine the feasibility and acceptability of a novel registered clinical trial that combined three brief in-person sessions to teach core cognitive-behavioral therapy (CBT) skills during hospitalization followed by smartphone-based ecological momentary intervention (EMI) to facilitate real-time practice of the emotion management skills during the 28 days after hospital discharge. Results from this pilot study (N = 26) supported some aspects of feasibility and acceptability. Regarding feasibility, 14.7% of all screened inpatients met study eligibility criteria. Half (50.3%) of those who were ineligible were ineligible because they were not part of the population for whom this treatment was designed (e.g., symptoms such as psychosis rendered them ineligible for the current study). Those who were otherwise eligible based on symptoms were primarily ineligible due to inpatient stays that were too short. Nearly half (48%) of study participants did not receive all three in-person sessions during their hospitalization. Among enrolled participants, rates of engagement with the smartphone-based assessment and EMI prompts were 51.47%. Regarding acceptability, quantitative and qualitative data supported the perceived acceptability of the intervention, and provided recommendations for future iterations. Well-powered effectiveness (and effectiveness-implementation) studies are needed to determine the effects of this promising and highly scalable intervention approach.

Nocturnal Hemodynamics in Somali Americans: Implications for Cardiovascular Risk.

Cardiovascular health disparities are present within several minority communities but, it's unclear if such disparities are present in a growing African American subpopulation, Somali Americans, who differ genetically and culturally from African Americans of western African ancestry. Ambulatory blood pressure monitoring remains a gold-standard measure to examine 24-hour blood pressure (BP) patterns to stratify cardiovascular risk profile. We sought to examine differences in the 24-hour BP profile in a sample of young Somali Americans and compare their BP patterns to White study participants. We hypothesized that their BP and heart rate (HR) would be higher compared to closely matched White participants. We recruited 50 (25 Somali) participants in whom BP recordings were obtained every 20 minutes throughout the entire 24-hour monitoring period to quantify BP, HR and ambulatory arterial stiffness. Daytime BP/HR was quantified between 10AM and 8PM, and nighttime BP/HR was assessed between 12AM and 6AM. Daytime BP and HR were similar between racial groups (p>0.05). Nighttime BP was similar between groups (p>0.05), but Somali Americans individuals exhibited a higher nocturnal HR compared to White participants (p=0.013). Nocturnal dipping in diastolic BP and HR dipping was attenuated in Somali Americans compared to White adults (p=0.038, 0.007). Somali participants also had higher ambulatory arterial stiffness (p=0.045). 24-hour hemodynamics, specifically ambulatory arterial stiffness, nocturnal BP and nocturnal HR, differ in young Somali Americans, compared to White adults. These findings provide new insight into potential cardiovascular health disparities and future cardiovascular risk within the burgeoning Somali American community.

Multi-trajectories in different domains of social supports and subjective motoric cognitive risk syndrome: a 16-year group-based multi-trajectory analysis

ObjectiveThe aim of this study was to examine the longitudinal relationships between the trajectories of distinct subtypes of various domains of social supports and risk of subjective motoric cognitive risk (MCR) syndrome. DesignLongitudinal cohort study. Setting and participants2,279 participants in the Taiwan Longitudinal Study on Aging (TLSA) between 1999 and 2011. MethodA group-based multi-trajectory modeling (GBMTM) was implemented to identify distinct trajectory subtypes within various social support domains, encompassing social networks, emotional support, instrumental support, as well as working and economic status. Logistic regression models were then utilized to evaluate the associations between these trajectory subtypes and the risk of subjective MCR. ResultsAmong 2,279 participants, GBMTM identified four distinct trajectory subtypes: "low social support" (n = 371), "medium social support " (n = 862), "high social support" (n = 292), and "high social support with employment" (n = 754). The incidence rates of subjective MCR for these groups were 9.4%, 9.0%, 4.1%, and 0.8%, respectively. After adjusting for age, sex, education level, and comorbidities, both “low social support” (adjusted odds ratio (aOR) 4.07, 95% CI [1.60–10.34]) and “medium social support” (aOR 3.10, 95% CI [1.26−7.66]) were significantly associated with an increased risk of subjective MCR compared to the "high social support with employment" group. Conclusions and implicationsThe current study demonstrates that social support significantly reduces the risk of subjective MCR, with lower support levels correlating to higher risk, necessitating further intervention studies to confirm the link between social support and risk of subjective MCR.

Unravelling interacting barriers and facilitators to adherence and delivery of exercise-based care in the treatment of Subacromial Pain Syndrome – an exploratory qualitative study

Purpose Subacromial Pain Syndrome (SAPS) is a common persistent pain condition. Exercise-based care is first-line recommendation, but an insufficient exercise dose hampers effectiveness. This study explores individual and contextual barriers and facilitators for delivery of and adherence to exercise-based care in people with SAPS. Materials and Methods Participants in this exploratory qualitative study were involved in the management of SAPS in Denmark. Triangular interviews and analyses were conducted within 3 themes (delivery of recommended services, adherence to recommendations, and frames of the clinical pathways) using the Theoretical Domains Framework (TDF) and the Behavioural Change Wheel model (BCW) to map barriers and facilitators into the Capability, Opportunity, Motivation and Behaviour (COM-B) model. Results From interviews with 10 persons with SAPS and 37 healthcare practitioners and double-deductive analyses, 30 subjects of target behaviour within 13 TDF domains emerged across perspectives and COM-B components. Central barriers to delivery and adherence were inconsistencies in diagnostic terminology, cross-professional disagreements, beliefs, and expectations towards pathway services. Conclusion We identified interrelated individual and contextual barriers to delivery and adherence across all aspects of the BCW, underpinning the complexity of the subject. Findings support that effectiveness of exercise-based care is linked to contextual barriers to delivery and adherence.

Keratinocyte Carcinomas in Survivors of Childhood Cancer: A Report from the Childhood Cancer Survivor Study

BackgroundChildhood cancer survivors (CCS) are at increased risk for keratinocyte carcinomas (KC) however, the long-term incidence of single and multiple KC is not well established. ObjectiveIdentify risk factors and quantify KC cumulative incidence and multiple-incidence burden in CCS. MethodsKC were identified among Childhood Cancer Survivor Study participants, a cohort of five-year cancer survivors diagnosed <21 years of age between 1970-1999 in North America. Cumulative incidence was estimated, and multivariable models assessed relative rates of KC associated with survivor and treatment characteristics. ResultsAmong 25,658 participants, 1,446 developed 5,363 KC (93.5% basal cell carcinoma, 6.7% squamous cell carcinoma; mean age 37.0 years (range 7.3-67.4), mean latency 25.7 years; 95.3% White and 88.4% with radiotherapy [RT]). Mean lesion count was 3.7 with 26.1% experiencing ≥4. RT imparted a 4.5-fold increase in the rate of any KC and 9.4-fold increase in the rate of ≥4 KC. Allogeneic and autologous hematopoietic cell transplant were associated with a 3.4- and 2.3-fold increased rate of KC, respectively. LimitationsParticipant self-reporting of some data including race without skin phototype and past medical history may have impacted analysis. ConclusionsThe burden of KC in CCS remains high, but predictable risk factors should guide screening

“Determinants of antibiotic use/misuse from patients' and health providers’ perspective – A descriptive analysis from coastal Karnataka, India”

ObjectivesTo evaluate the awareness and practices of patient's antibiotic usage and assess the perception of health providers with regard to antibiotic use and misuse in a tertiary hospital. MethodsA cross sectional study was conducted in a tertiary care hospital in coastal Karnataka, India. The study participants included consenting volunteers of either gender, aged >18 years, including 384 patients, 25 nurses and 25 physicians. ResultsKnowledge about indications for antibiotic usage was found to be poor as 85.9 % believed that antibiotics were effective against viral diseases as well. It was found that about 71.6 % patients had self-medicated themselves for minor illnesses, but majority preferred tertiary health care facilities for major illnesses. Practice of the patients was found to be good with 78.1 % patients consulting a physician before consuming antibiotics and 96 % completing the course as advised. Among the 25 nurses interviewed, 92 % reported discussion with patients regarding their antibiotic prescription. About 21.4 % nurses reported to have prescribed antibiotics to other friends, neighbours and patients, on the basis of their clinical exposure. The causes of emerging Antimicrobial Resistance (AMR) as reported by the doctors were-inappropriate prescription, self-medication, and non-adherence to the course as prescribed. ConclusionBetter doctor patient communication, educating both doctors and patients, antibiotic sensitivity-based prescription and practicing evidence-based medicine are required to combat antimicrobial resistance.

Antibodies to PfEMP1 and Variant Surface Antigens: Protection after Controlled Human Malaria Infection in Semi-immune Kenyan Adults

ObjectivesAcquisition of antibodies to Plasmodium falciparum variant surface antigens (VSA) expressed on infected red blood cells (iRBCs) is associated with naturally acquired immunity to malaria. We have previously shown that antibodies to VSA on iRBCs are associated with protection against parasite growth in the context of controlled human malaria infection (CHMI). This study explored whether antibodies to recombinant antigens derived from PfEMP1 domains were independently associated with protection during CHMI in semi-immune Kenyan adults. MethodsWe used a multiplex bead assay to measure levels of IgG antibody against a panel of 27 recombinant PfEMP1 antigens derived from the PfEMP1 repertoire of the 3D7 parasite clone. We measured IgG levels in plasma samples collected from the CHMI participants before inoculation with Sanaria® PfSPZ Challenge, on the day of diagnosis, and 35 days post-inoculation. Univariable and multivariable Cox regression analysis was used to evaluate the relationship between the levels of antibodies to the antigens and CHMI outcome. We also adjusted for previous data including antibodies to VSA on iRBCs, and we assessed the kinetics of antibody acquisition to the different PfEMP1 recombinant antigens over time. ResultsAll study participants had detectable antibodies to multiple PfEMP1 proteins before inoculation. All PfEMP1 antigens were associated with protection against parasite growth to the threshold criteria for treatment in CHMI albeit with substantial collinearity. However, individual PfEMP1 antigens were not independently associated with protection following adjustment for breadth of reactivity to VSA on iRBCs and schizont extract. In addition, antibodies to PfEMP1 antigens derived from group B PfEMP1 were induced and sustained in the participants who could not control parasite growth. ConclusionThis study shows that the breadth of antibody response to VSA on iRBCs, and not to specific PfEMP1 antigens, is predictive of protection against malaria in CHMI.

Weekly Vitamin D Supplementation to Prevent Acute Respiratory Infections in Young Children at Different Latitudes: A Randomized Controlled Trial

To evaluate the effectiveness of weekly vitamin D supplementation in reducing the number of acute respiratory infections (ARI) in preschool children. Randomized, double-blind, placebo-controlled trial in 303 children aged 1.5-3.5 years from 2014 to 2105 in three Chilean cities at different latitudes: Santiago (33ºS, n=101), Talcahuano (37ºS, n=103), and Punta Arenas (53ºS, n=99). Participants were allocated (1:1:1) to receive placebo, cholecalciferol (VD3) 5,600 IU/week (low-dose), or 11,200 IU/week (high-dose) for 6 months. Primary outcome was parent-reported number of ARI; secondary outcomes included number of ARI hospitalizations, change of serum 25(OH)D and LL37/cathelicidin levels, and adverse events. The mean age of participants was 26 ± 6 months; 45% were female. Baseline 25(OH)D was 24.9 ± 6.1 ng/ml, with 23% having 25(OH)D <20 ng/ml. No significant baseline clinical or laboratory differences were observed among groups. Overall, 64% (n=194) completed study participation, without baseline differences between subjects lost to follow-up versus those completing participation or differences in completion rates across groups. After 6 months, a dose-dependent increase in serum 25(OH)D was observed from the VD3 intervention (p<0.001), with a higher proportion of subjects ending the trial with 25(OH)D <20 ng/ml in the placebo group (30.8%) versus the low-dose (7.4%) and high-dose groups (5.1%). However, no group differences were observed in number of ARI (p=0.85), ARI hospitalizations (p=0.20), LL-37/cathelicidin change (p=0.30), or adverse events (p=0.41). While weekly VD3 supplementation, in doses equivalent to 800 IU and 1600 IU daily, was associated with improved 25(OH)D levels in preschoolers, we did not find a reduced number of ARI in this sample.

Factors associated with seizure response in adults with epilepsy on a modified Atkins diet

PurposeThis study investigated factors associated with improved seizure control in adults with epilepsy following a modified Atkins diet (MAD). MethodsFollow-up data collected from participants enrolled in a prospective study between March 2016 and November 2023 was analyzed. Demographic and clinical differences between diet responders and non-responders were evaluated. MAD response was defined as ≥ 50 % reduction in seizure frequency from baseline. ResultsMAD use led to clinical response in 48 % of study participants with 2–3 month follow-up and in 56 % of study participants with 6 month follow-up. No significant differences were found for gender, age at diet initiation, age at epilepsy diagnosis, or for number of current or past medications tried. However, a significant relationship emerged between epilepsy type and diet response at 6 months with a response of 100 % seen in adults with generalized epilepsy and a response of only 42 % in adults with focal epilepsy (p = 0.004). Those who responded to the diet showed non-significant increases in many of the measured lipid biomarkers. Levels of apolipoprotein-B and small low-density lipoprotein particles showed significant increases from baseline after 3 months in responders compared to non-responders (p = 0.004 and 0.049, respectively). ConclusionsThese findings support the continued use of MAD particularly for seizure management in adults with generalized epilepsy and highlight potential mechanisms of clinical response involving lipoprotein and energy metabolism.

Healthcare Outcomes of Patients and Antecedents via Teleophthalmology in Eastern Taiwan during COVID-19.

The coronavirus disease 2019 (COVID-19) pandemic has caused significant transformations in healthcare. Many countries began the rapid development and adoption of telemedicine to avoid the spread of the pandemic and created an innovative model for healthcare delivery. This study identified the critical antecedents that affected the considered healthcare outcomes via teleophthalmology in Eastern Taiwan during the COVID-19 pandemic. This study's participants included residents of five towns in Taitung County who had experience with teleophthalmology. This study analyzed the structured questionnaires completed by the participants to validate the proposed research framework. Statistical methods were used to verify the research models, including descriptive statistical analysis, confirmatory factor analysis, and structural equation modeling. The date of this study was from 1 October 2020 to 31 July 2023. The results of this study reveal that the average monthly use of teleophthalmology by individuals in rural areas increased annually. Females tended to utilize teleophthalmology services more than males. There were no significant differences across any of the constructs with respect to age or educational level. Additionally, the patients' awareness of healthcare accessibility via and the communication quality of teleophthalmology simultaneously affected teleophthalmology's adoption and service quality, which in turn jointly affected health outcomes. Both healthcare accessibility and communication quality were the antecedents of the healthcare outcomes. The health outcomes refer to the impact of teleophthalmology on the quality of the patients' health and well-being. Additionally, teleophthalmology's adoption and service quality acted as mediators. This study's findings are expected to increase attention to the healthcare outcomes and antecedents of teleophthalmology to promote better telemedicine practices and services for rural residents.

Relationship between serum urate and changes in dual-energy CT monosodium urate crystal volume over 1 year in people with gout: an individual participant data analysis

ObjectivesThe dynamics of monosodium urate (MSU) crystal changes across a range of serum urate concentrations in people with gout are unknown. This study aimed to systematically examine the relationship between...

Differences in Presenting Health Warning Labels on Hookah Venue Menus Between Immersive Virtual Reality and Online Surveys

Background Virtual reality (VR) platforms can simulate the real world, whereas online surveys are efficient settings for assessing and testing information. In this study, the effects of presenting health warning labels (HWLs) on hookah venue menus were compared between these two message-testing settings. Methods Separate studies were conducted in VR (n = 96) and online survey (n = 213) settings. Participants in both studies were randomly assigned to view menus with or without HWLs. This secondary data analysis compared outcomes between settings after propensity score weighting to account for differences in age, race, marital status, and education between studies. Results Significant between-study differences were noted for the effects of HWLs on people’s perceptions of the absolute harm of hookah smoking (p = 0.0363), the relative harm of hookah compared to cigarettes (p < 0.001), the absolute addictiveness of hookah (p < 0.001), and the relative addictiveness of hookah compared to cigarettes (p = 0.0352). When outcome variables differed significantly between the HWL and control conditions in only one of the two studies, smaller p-values were identified for the online survey setting than for the VR setting. Conclusions This study represents the first direct comparison of the effects of hookah HWLs between two message-testing settings. HWLs tested in the online survey setting were associated with larger shifts in attitudes and beliefs than those tested in the VR setting, suggesting that the effectiveness of hookah HWLs on attitudes and beliefs may be moderated by the message-testing platform. Additional real-world experiments remain necessary to determine whether either setting can accurately assess the effectiveness of HWLs.

Operationalizing the Behaviour Change Wheel and APEASE criteria to co-develop recommendations with stakeholders to address barriers to school-based immunization programs

Introduction: School-based immunization programs offer an accessible route to routine vaccines for students. During the COVID-19 pandemic, school closures to comply with public health measures had a drastic effect on school-based immunization program delivery and associated vaccine uptake. We sought to integrate findings from a mixed methods study to co-develop evidence-based and theory-informed recommendations with a diverse group of stakeholders (i.e., decision makers, healthcare providers, school staff, parents and adolescent students) to address barriers to new and existing school-based immunization programs. Methods: Findings from a mixed methods study were integrated using a joint display and narrative summary. These findings were mapped through the Behaviour Change Wheel, a series of tools designed to facilitate the development of behaviour change interventions. Draft recommendations were provided to previous mixed methods study participants who consented to participating in future phases of the research study (n = 26). Feedback was captured using a Likert-scale survey of acceptability, practicality, effectiveness, affordability, safety and equity (APEASE) criteria, with feedback and additional insights captured using open-ended textboxes. Data was used to revise and finalize recommendations. Results: Applying the Behaviour Change Wheel, we drafted 26 evidence-based, theory-informed recommendations to address barriers to school-based immunization programs. Participants (n = 16) provided feedback, with half of the recommendations scoring 80% or higher across all six APEASE criteria. The remaining 13 recommendations received a moderate score across one or more criteria. Stakeholders identified a high level of interest in expanding the use of e-consent forms, expanding programming to offer a meningitis B vaccine, and recommendations to ease student anxiety. Conclusion: We co-developed a range of recommendations to improve school-based immunization programs with stakeholders using data generated from a mixed methods study. Implementation of any single or combination of recommendations will need to be tailored to local clinic procedures, school system and health system resources.

Prevalence and associated factors of cancer-related fatigue among adult patients with cancer attending oncology units: an institution-based cross-sectional study design in the Amhara region, Ethiopia, 2022

IntroductionCancer-related fatigue (CRF) continues to be a common problem among most patients with cancer. It is a subjective feeling of tiredness, weakness or lack of energy. CRF has a significant...

Iron and Vitamin A Status of Children Aged 0 to 36 Months in Thulamela Municipality, Vhembe District, South Africa.

Objective: The present study assessed the iron and Vitamin A status of children aged 0 to 36 months in Thulamela municipality, Vhembe District. Methods: A cross-sectional study was conducted among 250 children aged 0 to 36 months attending well-baby clinic services with their mothers. Convenience sampling was used to select study participants, and simple random sampling was used to choose clinics. Data were gathered via a questionnaire administered by the researcher and field workers from August to September 2019. Standard techniques were used to measure body weight and height. In addition, serum retinol, haemoglobin, iron, ferritin, transferrin saturation, and transferrin levels were also assessed. Information on dietary diversity was gathered through a 24 h dietary recall. Results: The prevalence of underweight, wasting, and stunting was 3.6%, 2%, and 9.2%, respectively. Using serum retinol <10 µg/dL, 22% of children had vitamin A deficiency. The prevalence of anaemia was 53.6%, while 13.1% of children had iron deficiency anaemia when using serum ferritin of less than 12 μg/dL. Most children (90.8%) had an inadequate dietary diversity score, while 9.2% had sufficient dietary diversity. The most consumed food groups were grains, roots and tubers, vitamin A rich fruits and vegetable, and flesh foods. A higher percentage (44%) of children with low iron ferritin were underweight compared to those with normal iron ferritin (df = 1, p-value = 0.007). Conclusion: Iron, anaemia, and vitamin A deficiencies, accompanied by a high prevalence of stunting, were common among children in Thulamela Municipality. Thus, improving nutritional status in this area is a critical need.

Investigation of Electrocardiographic Changes in Individuals with Three or More Cardiovascular Risk Factors on Santiago Island-The Cross-Sectional PrevCardio.CV Study.

Cerebrocardiovascular diseases represent one of the greatest public health concerns globally. In Cabo Verde, non-communicable diseases, such as cerebrocardiovascular diseases, have become leading causes of morbidity and mortality. This study aimed to correlate risk factors with cardiac electrical changes in adult individuals residing on Santiago Island-Cabo Verde. A cross-sectional population-based study using simple random sampling was conducted in 2021 with individuals aged 18 and over, of both sexes, having authorization 35/2021 from the Cabo Verde Ethics Commission. The sample size was calculated based on Santiago Island's projected population for 2021, considering an estimated prevalence of 50%, a 95% confidence interval, and a standard error of 4%, resulting in a sample of 599 individuals. The data were collected through a questionnaire on risk factors and cerebrocardiovascular diseases, blood pressure measurement, capillary blood glucose evaluation, and a 12-lead electrocardiogram. The study sample was predominantly female (54.8%), with the largest age group being 18-27 years (21%). Among the sample, 9.3% had no risk factors, 27.5% had one risk factor, 36.2% had two risk factors, and 26.9% had three or more risk factors. Of those who underwent electrocardiography, 60.24% showed electrocardiographic changes, with the most prevalent being ventricular repolarization changes, nonspecific repolarization changes, and early repolarization. A relationship was observed between cerebrocardiovascular disease risk factors and the electrocardiographic changes found in the study participants.