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Temporal trends and practice variation of paediatric diagnostic tests in primary care:retrospective analysis of 14 million tests

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Family Medicine and Community health 2024年第4期12卷 1-8页

作者： Elizabeth T Thomas Diana R Withrow Cynthia Wright Drakesmith Peter J Gill Rafael Perera-Salazar Carl Heneghan Centre for Evidence-Based Medicine Nuffield Department of Primary Care Health SciencesUniversity of OxfordOxfordUK nuffield department of primary care health sciences University of OxfordOxfordUK department of Pediatrics University of TorontoTorontoOntarioCanada Hospital for Sick Children TorontoOntarioCanada

Objective The primary objective was to investigate temporal trends and between-practice variability of paediatric test use in primary *** and analysis This was a descriptive study of population-based data from Clinical Practice Research Datalink Aurum primary care consultation records from 1 January 2007 to 31 December *** aged 0–15 who were registered to one of the eligible 1464 general practices and had a diagnostic test code in their clinical record were *** primary outcome measures were(1)temporal changes in test rates measured by the average annual percent change,stratified by test type,gender,age group and deprivation level and(2)practice variability in test use,measured by the coefficient of *** 14299598 diagnostic tests were requested over 27.8 million child-years of observation for 2542101 *** test use increased by 3.6%/year(95%CI 3.4 to 3.8%)from 399/1000 child-years to 608/1000 child-years,driven by increases in blood tests(8.0%/year,95%CI 7.7 to 8.4),females aged 11–15(4.0%/year,95%CI 3.7 to 4.3),and children from the most socioeconomically deprived group(4.4%/year,95%CI 4.1 to 4.8).Tests subject to the greatest temporal increases were faecal calprotectin,fractional exhaled nitric oxide and vitamin *** classified as high-use and high-practice variability were iron studies,coeliac testing,vitamin B12,folate,and vitamin *** In this first nationwide study of paediatric test use in primary care,we observed significant temporal increases and practice variability in *** reflects inconsistency in practice and diagnosis rates and a scarcity of evidence-based *** test use generates more clinical activity with significant resource implications but conversely may improve clinical *** research should evaluate whether increased test use and variability are warranted by exploring test indications and test results and directly examine how increased test use impacts

关键词： vitamin nationwide stratified

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Characterization of a smog chamber for studying formation of gas-phase products and secondary organic aerosol

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Journal of Environmental sciences 2024年第2期136卷 570-582页

作者： Qi Yuan Zhuozhi Zhang Meng Wang Kin Fai Ho Tao Wang Shuncheng Lee department of Civil and Environmental Engineering The Hong Kong Polytechnic UniversityKowloonHong KongChina School of Public health and primary care The Chinese University of Hong KongShatinHong KongChina

Smog chambers provide a potent approach to explore the secondary organic aerosol formation under varied *** study describes the construction and characterization of a new smog chamber facility for studying the formation mechanisms of gas-phase products and secondary organic aerosol from the photooxidation of volatile organic *** chamber is a 5.4 m^(3) Fluorinated Ethylene Propylene(FEP)Teflon reactor with the potential to perform photooxidation experiments at controlled temperature and relative *** characterizations were conducted for evaluation of stability of environmental parameters,mixing time,background contamination,light intensity,and wall losses of gases and *** photolysis rate of NO_(2)(J_(NO2))ranged from(1.02-3.32)×10^(-3)sec^(-1),comparable to the average J_(NO2)in ambient *** wall loss rates for NO,NO_(2),and O_(3)were 0.47×10^(-4),0.37×10^(-4),and 1.17×10^(-4)min^(-1),while wall loss of toluene was obsoletely found in a 6 hr *** particle number wall loss rates are(0.01-2.46)×10^(-3)min^(-1)for 40-350 nm with an average lifetime of more than one day.A series of toluene photooxidation experiments were carried out in absence of NO_xunder dry *** results of the simulation experiments demonstrated that the chamber is well designed to simulate photolysis progress in the atmosphere.

关键词： Smog chamber Gas-phase oxidation Chamber characterization Chemical mechanism

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Device-measured physical activity and sedentary time in the Nordic countries:A scoping review of population-based studies

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Journal of Sport and health Science 2024年第5期13卷 650-660页

作者： Ing-Mari Dohrn Jakob Tarp Jostein Steene-Johannessen Tommi Vasankari Maria Hagströmer Division of Physiotherapy Department of NeurobiologyCare Sciences and SocietyKarolinska Institutet14183 HuddingeSweden department of Sports Medicine Norwegian School of Sports Sciences0806 OsloNorway UKK Institute for health Promotion Research 33500 TampereFinland Faculty of Medicine and health Technology Tampere University33100 TampereFinland Academic primary health care Centre Region Stockholm13365 StockholmSweden

Purpose:The purpose of this scoping review was to summarize and describe the methodology and results from population-based studies of physical activity and sedentary time measured with devices in the Nordic countries(Denmark,Finland,Iceland,Norway,and Sweden)and published in 2000 or ***:A systematic search was carried out in PubMed and Web of Science in June 2023 using predefined search ***:Fourteen unique research projects or surveillance studies were ***,2 surveillance studies published by national agencies were included,resulting in a total of 16 studies for *** surveillance systems exist in Finland and Norway,with regular survey waves in school-aged children/adolescents and *** Denmark,recent nationally representative data have been collected in school children *** far,Sweden has no regular national surveillance system using device-based data *** studies were found from *** first study was conducted in 2001 and the most recent in 2022,with most data collected from 2016 to *** studies included children/adole scents 6-18 years,no study included *** total 11 studies included adults,of which 8 also covered older *** study focused specifically on older *** analytical sample size ranged from 205 to 27,*** methodology is presented,such as information on sampling strategy,device type and placement,wear protocols,and physical activity classification *** of physical activity and sedentary time in children/adolescents,adults,and older adults across the Nordic countries are ***:A growing implementation of device-based population surveillance of physical activity and sedentary behavior in the Nordic countries has been *** variety of devices,placement,and data procedures both within and between the Nordic countries highlights the challenges when it comes to comparing study outcomes as well as the need for more standa

关键词： Accelerometer Light intensity Moderate-vigorous intensity Surveillance Wearable devices

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Differential Impact of Fertility on health-Adjusted Life Expectancy of Older Adults Across Countries of Various Levels of Socio-Demographic Index—Worldwide,1995-2019

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China CDC weekly 2024年第39期6卷 991-995页

作者： Shuai Guo Chen Chen Yunhe Wang Yi Cao Zhiwei Leng Xiaoying Zheng department of Population health and Aging Science School of Population Medicine and Public HealthChinese Academy of Medical Sciences/Peking Union Medical CollegeBeijingChina School of Population Medicine and Public health Chinese Academy of Medical Sciences/Peking Union Medical CollegeBeijingChina nuffield department of Population health University of OxfordOxfordUK Center for health Policy and health Economics National Infrastructures for Translational MedicineInstitute of Clinical MedicinePeking Union Medical College HospitalChinese Academy of Medical Sciences/Peking Union Medical CollegeBeijingChina Institute for Global health and Development Peking UniversityBeijingChina

What is already known about this topic?health-adjusted life expectancy(HALE)is a crucial indicator of global health,which is strongly correlated with the socio-demographic index(SDI)and population *** is added by this report?This study revealed that the correlation between total fertility rate(TFR)and HALE of older adults varies across countries with different SDI levels,offering valuable insights for the development of more targeted health promotion programs and *** are the implications for public health practice?Different health interventions should be tailored to countries with different levels of *** countries with both low fertility rates and low SDI,advanced measures are needed to address the challenge of an aging population that may live longer but face poorer health in the future.

关键词： demographic fertility offering

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Prenatal multiple micronutrient-fortified balanced energy-protein supplementation and newborn telomere length and mitochondrial DNA content: a randomized controlled efficacy trial in rural Burkina Faso

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Food Science and Human Wellness 2024年

作者： Giles T.Hanley-Cook Yuri Bastos-Moreira Dries S.Martens Trenton Dailey-Chwalibóg Laeticia Celine Toe Brenda de Kok Lionel Ouédraogo Alemayehu Argaw Kokeb Tesfamariam Patrick Kolsteren Lieven Huybregts Tim S.Nawrot Sarah De Saeger Marthe De Boevre Carl Lachat department of Food Technology， Safety and health， Faculty of Bioscience Engineering， Ghent University Center of Excellence in Mycotoxicology and Public health， MYTOXSOUTH~(?) Coordination Unit， Faculty of Pharmaceutical sciences， Ghent University Centre for Environmental sciences， Hasselt University Unité Nutrition et Maladies Métaboliques， Institut de Recherche en sciences de la Santé (IRSS) Centre Muraz Center of Excellence in Mycotoxicology and Public health， MYTOXSOUTH? Coordination Unit， Faculty of Pharmaceutical sciences， Ghent University Nutrition， Diets， and health Unit， department of Food and Nutrition Policy， International Food Policy Research Institute (IFPRI) department of Public health & primary care， University of Leuven department of Biotechnology and Food Technology， Faculty of Science， University of Johannesburg， Doornfontein Campus

Background: Evidence regarding the effectiveness of prenatal nutritional supplements has mainly considered anthropometric pregnancy outcomes. The effect on markers of health and disease， such as offspring telomere length (TL) and mitochondrial DNA content (mtDNAc) is unknown. Objectives: We assessed the efficacy of maternal multiple micronutrient (MMN)-fortified balanced-energy protein (BEP) and iron-folic acid (IFA) supplementation on newborn TL as a secondary outcome and mtDNAc as a non-declared outcome. Design: We conducted a randomized controlled trial in rural Burkina Faso， among pregnant females (15-40 years old) enrolled at 0.05) by adjusting the regression models for potential prognostic factors of study outcomes at enrollment. Exploratory analyses indicated higher， but non-significantly different mtDNAc among children born either small-for-gestational age， low birthweight， or preterm. Conclusions: Newborns from mothers who received daily nutritional supplements across gestation did not have different relative TL or mtDNAc.

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Effect of cinnamaldehyde on Rhizopus stolonifer and on the conservation of sweet potato

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Food Quality and Safety 2024年第1期8卷 212-225页

作者：陈晨薛智超 Penta Pristijono John B.Golding 陈刚李永新杨虎清 College of Food and health Zhejiang A&F UniversityHangzhouChina Zhejiang Provincial Key Laboratory of Resources Protection and Innovation of Traditional Chinese Medicine Zhejiang A&F UniversityHangzhouChina School of Environmental and Life sciences University of NewcastleOurimbahNSWAustralia NSW department of primary Industries OurimbahNSWAustralia

Objectives:Rhizopus stolonifer,which causes soft rot of sweet potato,has resulted in substantial loss of economy *** and Methods:The antifungal effect and mechanism of cinnamaldehyde(CIN)against *** were explored by biochemical analysis and RNA-sequencing in this research,and the edible quality of CIN-treated sweet potato was ***:The results showed that CIN inhibited the growth of *** and reduced the incidence of soft rot in sweet potato at a minimum inhibitory concentration of 1000μL/*** damage of the cell walls of *** by CIN was associated with the upregulation of *** leakage and malondialdehyde content increased following CIN-treatment,which was correlated with increased reactive oxygen species levels and decreased catalase *** of ERG genes and oxidative stress-related genes following CIN treatment was associated with impaired cell membrane *** mitochondrial structure of *** was damaged by CIN treatment resulting in decreased respiration rates and ATP production,which was correlated with lower expression levels of IDH1,COX4,and ***:Our research suggests that the inhibition of CIN on *** was related to the disruption of its normal gene expression network,and CIN maintained the nutritional and edible quality of sweet *** study provides valuable insights into the antifungal mechanism of CIN on *** and the maintenance of root quality,which contributes to the effcient use of CIN for controlling soft rot in sweet potato.

关键词： Ipomoea batatas soft rot cinnamaldehyde antifungal mechanism transcriptome

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Identification of research gaps to improve care for healthy ageing:a scoping review

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Family Medicine and Community health 2024年第4期12卷 9-16页

作者： Matteo Cesari Marco Canevelli Jotheeswaran Amuthavalli Thiyagarajan Soung-Eun Choi Polina Grushevska Saloni Kumar Muyan Chen Hyobum Jang Yuka Sumi Anshu Banerjee Ageing and health Unit Department of MaternalNewbornChild and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland department of Neurobiology Care Sciences and SocietyStockholm UniversityStockholmSweden National Center for Disease Prevention and health Promotion Italian National Institute of HealthRomeItaly department of Human Neuroscience Sapienza UniversityRomeItaly Master in health and International Development London School of EconomicsLondonUK department of Maternal NewbornChild and Adolescent Health and AgeingWorld Health OrganizationGenevaSwitzerland

Objective Several research gaps affect the improvement of care for healthy *** identification is crucial to developing a specific research prioritisation agenda supporting progress at the micro(clinical),meso(service delivery)and macro(system)*** achieve this,a scoping review was carried out to describe the most significant gaps impeding the improvement of care for healthy *** A scoping review of the literature was conducted according to the Joanna Briggs Institute *** selected articles were analysed to identify topics or areas essential for improving care for healthy ageing but requiring further support from *** criteria Every type of scientific article,except for randomised controlled trials,was considered of potential interest without restrictions on publication date,type of publication and *** sources A systematic search(last search:6 December 2023)was conducted using PubMed,MEDLINE and *** Overall,1558 articles were retrieved from the *** these,310 were finally retained for this work.A total of 1195 research gaps were identified(average:3.85 per article)and clustered into the 13 primary areas:ageing,care approach,caregivers,health economics,health,interventions,policies,research,settings,training,technology,specific populations and understanding the older *** particular,research for improving the person-centred approach(n=38),better considering cultural diversities(n=27),implementing integrated care(n=25)and ensuring access to care(n=25)were the most prevalent priorities reported in the *** A wide range of factors spanning multiple disciplines,from clinical to policy levels,require special consideration,exploration and *** findings of this scoping review represent an essential step in identifying gaps for developing a research prioritisation agenda to improve care for healthy ageing.

关键词： policy service supporting

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Effect of Diabetes Self-Management Education on Glycaemic Control in Sudanese Adults with Type 2 Diabetes

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Journal of Biosciences and Medicines 2024年第3期12卷 316-327页

作者： Sahar Moawia Balla Elnour Tayseer Abdelmotalib Ahmed Taha Haiam Abdalla Wadatalla Ziryab Zainelabdin Mohamed Elmahdi Marwah Isam Abdulmajeed Mohammedahmed Rowa Abdelmonem Sidig Hamadto Nahla Yousif Osman Mohammed Saeed Omnia Mubarak Saad Abdallah Sulafa Abdelbagi Mustafa Ahmed Hanady Abdelhameed Ahmed Mohamed Sarah Khalil Fathi Khalil Family Medicine Health Gates Primary Care Riyadh SAU Family Medicine Dhaman Health Assurance Hospitals Company Kuwait KWT Family Medicine First Health Cluster Riyadh SAU Emergency department Sheikh Khalifa Medical City Abudahbi ARE Family Medicine University of Medical Sciences and Technology Khartoum SDN Family Medicine Sudan Medical Specialization Board-Sudan Khartoum SDN Family Medicine Ultra Care Home Care Company Riyadh SAU Medicine department Health Gates Primary Care Riyadh SAU Family Medicine Mouwasat Hospital Madinah SAU

Research Background: The high prevalence of diabetes in Sudan, estimated at 16%, highlights the importance of effective health education in diabetes management. Diabetes self-management education has been identified as a crucial tool in enhancing the knowledge, attitudes, and abilities necessary for self-management among individuals with diabetes. Aim: To assess the impact of diabetes self-management education on medication adherence and glycemic control in Sudanese adults with type 2 diabetes before and 3 months after the DSME intervention. Method: The study was conducted in Sudan between September 2022 and March 2023, it was an interventional, one-group, pre- and post-test study that aimed to assess the impact of diabetes self-management education (DSME) on medication adherence and diabetes control in Sudanese adults with type 2 diabetes. The research was conducted in primary health care centers in six cities in Sudan and involved 244 participants. The data entry and statistical analysis were conducted using the Statistical Package for Social sciences version 27.0. A paired t test was used for analysis. Results: The study included 244 participants, 67% of whom were males. The age mean ± SD was 48.6 ± 9.3 years, and 85.3% of participants were married. Age at onset of diabetes mean ± SD was 40.60 ± 7.81 years;44.6% had diabetes for less than 5 years;and 84.1% had a positive family history of diabetes mellitus. The levels of poor, low, and partial adherence to medication decreased by 8.2%, 4%, and 20.6%, respectively, after the intervention. The levels of good and high medication regime adherence increased by 13% and 19.8%, respectively;BMI decreased by 1.1 ± 0.73 kg/m2 (p = 0.005). The fasting blood sugar decreased by 69 ± 32.9 mg/dl (p = 0.049), and the glycated hemoglobin decreased by 1.21 ± 0.28% (p = 0.001). Conclusions: The findings of this study reinforce the importance of patient education in improving glycemic control and enhancing self-management

关键词： Sudan Adherence Intervention Education Self-Management Diabetes

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Reduced efficacy of single-dose albendazole against Ascaris lumbricoides, and Trichuris trichiura, and high reinfection rate after cure among school children in southern Ethiopia: a prospective cohort study

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Infectious Diseases of Poverty 2024年第1期13卷 95-96页

作者： Tigist Dires Gebreyesus Eyasu Makonnen Tafesse Tadele Kalkidan Mekete Habtamu Gashaw Heran Gerba Eleni Aklillu department of Global Public health Karolinska Institutet Karolinska University Hospital Stockholm Sweden Ethiopian Food and Drug Authority Addis Ababa Ethiopia Center for Innovative Drug Development and Therapeutic Trials for Africa College of Health Sciences Addis Ababa University Addis Ababa Ethiopia departments of Pharmacology and Clinical Pharmacy College of Health Sciences Addis Ababa University Addis Ababa Ethiopia College of Medicine and health sciences Hawassa University Hawassa Ethiopia Ethiopian Public health Institute Addis Ababa Ethiopia

Background Mass drug administration(MDA)program of albendazole to at-risk populations as preventive chemo-therapy is the core public health intervention to control soil-transmitted helminths(STHs).Achieving this goal relies on drug effectiveness in reducing the parasite reservoirs in the community and preventing *** assessed the effcacy of albendazole against STH parasite infection and reinfection status after *** A total of 984 schoolchildren infected with at least one type of STH parasite(hookworm,Ascaris lumbri-coides,Trichuris trichiura)in southern Ethiopia were enrolled and received albendazole and praziquantel in MDA campaign conducted from January to March *** exams at week-4 and at week-8 of post-MDA were done using Kato Katz *** primary outcome was effcacy assessed by cure rate(CR)and fecal egg reduction rates(ERRs)at four weeks of *** secondary outcome was reinfection status defined as parasite egg positivity at eight weeks among those who were cured at 4 weeks of *** comparisons in CR and related factors were assessed with chi-square or Fisher's exact *** of CR were examined through univariate and multi-variate regression *** The overall CR and ERR for hookworm infection were 97.2%(95%CI:94.6-99.4)and 97.02%,*** overall CR and ERR for *** were 71.5%(95%CI:68.3-74.6)and 84.5% *** overall CR and ERR and for *** were 49.5%(95%CI:44.8-54.2)and 68.3%,*** CR among moderate *** infec-tion intensity was 28.6%.Among children cured of hookworm,*** and *** at week 4 post-MDA,4.6%,18.3% and 52.4% became reinfected at week-8 post-MDA,*** lower CR(36.6%)and higher reinfection after cure(60.6%)among *** and *** coinfected children than *** only(CR=69.6%,reinfection rate=15.1%)or *** only infected children(CR=55.6%,reinfection rate=47.1%)was obse

关键词： Soil transmitted helminths Neglected tropical diseases Preventive chemotherapy Albendazole School age children Ethiopia

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The Use of Biologic Treatments for Osteoarthritis: A Review

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Open Journal of Regenerative Medicine 2024年第2期13卷 21-40页

作者： William Thornton Sion Glyn-Jones nuffield department of Orthopaedics Rheumatology and Musculoskeletal Sciences University of Oxford Oxford UK

Background: The number of people presenting with osteoarthritis is increasing due, largely, to an ageing population and advances in medical treatments. This is driving the demand for new clinical solutions and treatments for the disease. Biologic therapies have been touted as an adjunct, or even alternative to established treatments for osteoarthritis. The term “biologics” refers to protein-based therapeutics that are derived from the proteins of living organisms. These treatments include, but are not limited to: autologous blood products such as platelet rich plasma (PRP), cell therapies such as autologous chondrocyte implantation (ACI) and mesenchymal stem cells, growth factors and cytokines, gene therapy. Aim: This study aims to provide a clear definition of these technologies and describe the evidence supporting their clinical efficacy to treat osteoarthritis. This is to provide clarity to both clinicians and patients on the range of technologies available. Method: Literature databases Embase and PubMed were searched for keywords such as “biologic”, “osteoarthritis”. Results: The literature identified 4 primary categories of biologic treatments for osteoarthritis: stem cell therapy, somatic cell therapy, protein therapy and gene therapy. The evidence level varied in its quality from treatment to treatment, as did the conclusions of published studies. Conclusion: Autologous chondrocyte therapy had the most convincing evidence to support its use as a treatment for osteoarthritis, however, current methods of use produced variable results. Other treatments such as platelet rich plasma and bone marrow derived stem cells show promise as potential future therapies, with more refinement, but evidence does not support their use currently. Other treatments including autologous stem cells should be avoided until there is a greater quantity and quality of evidence supporting their use.

关键词： Osteoarthritis Biologics Gene Therapy Stem Cell Protein Therapy

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