Early newborn care provided in the first 2 days of life is critical in reducing neonatal morbidity and mortality. This care can be used to monitor and evaluate the content and quality of neonatal ...postnatal care. This study aimed to identify determinants and geographic distributions of early newborn care uptake in Ethiopia. We used data from the 2019 Ethiopian Mini Demographic and Health Survey (EMDHS). We conducted a multilevel binary logistic regression model and geographic analysis to identify the determinants of receiving early newborn care. A total of 2105 children were included in the study. Of the included children, 39.6% (95% confidence interval (CI) 38%, 42%) received at least two components of early newborn care services in the first 2 days after birth. Greater odds of receiving early newborn care were experienced by infants to mothers with secondary or above education (adjusted odds ratio (AOR) = 1.72; 95% CI 1.44, 2.18), from households with highest wealth quantiles (AOR = 1.47; 95% CI 1.16, 1.79), with at least one antenatal care contact (AOR = 2.73; 95% CI 1.79, 4.16), with birth at health facility (AOR = 25.63; 95% CI 17.02, 38.60), and those births through cesarean section (AOR = 2.64; 95% CI 1.48, 4.71). Substantial geographic variation was observed in the uptake of early newborn care in Ethiopia. Several individual- and community-level factors were associated with newborn postnatal care. Policymakers should prioritise these areas and the enhancement of postnatal healthcare provisions for mothers with low socioeconomic status.
This study examined the association between family planning counselling receipt during the 12 months preceding the survey and postpartum modern contraceptive uptake in Ethiopia. We hypothesised that ...receiving family planning counselling either within the community setting by a field health worker or at a health facility by a healthcare attendant during the 12 months preceding the survey improves postpartum modern contraceptive uptake.
We used a cross-sectional study of the Ethiopian Demographic and Health Survey conducted in 2016.
Ethiopia.
A total of 1650 women who gave birth during the 12 months and had contact with service delivery points during the 12 months preceding the survey.
A weighted modified Poisson regression model was used to estimate an adjusted relative risk (RR) of postpartum modern contraceptives.
Approximately half (48%) of the women have missed the opportunity to receive family planning counselling at the health service contact points during the 12 months preceding the survey. The postpartum modern contraceptive uptake was 27%. Two hundred forty-two (30%) and 204 (24%) of the counselled and not counselled women used postpartum modern contraceptive methods, respectively. Compared with women who did not receive counselling for family planning, women who received counselling had higher contraceptive uptake (RR 1.32, 95% CI 1.04 to 1.67).
Significant numbers of women have missed the opportunity of receiving family planning counselling during contact with health service delivery points. Modern contraceptive uptake among postpartum women was low in Ethiopia. Despite this, our findings revealed that family planning counselling was associated with improved postpartum modern contraceptive uptake.
Recently, exploratory spatial data analysis is for problem solving, hypothesis generation and knowledge construction. Unless geographically weighted regression, sophisticated spatial regression ...models best control spatial heterogeneity in outcomes and the associated risk factors but cannot visually display and identify areas of the significant associations. The under-utilised excess risk maps (ERMs) and conditioned choropleth maps (CCMs) are useful to address this issue and simplify epidemiological information to public health stakeholders without much statistical backgrounds. Using malaria and sociodemographic determinants in Ghana as case study, this paper applied ERM and CCM techniques for identification of areas at elevated risk of disease-risk factor co-location.
We computed and smoothed mean district-specific malaria incidences for the period 2010 to 2014 as a function of sociodemographic determinants. The spatial distribution of malaria was investigated through global and local spatial autocorrelations, and the association with sociodemographic risk factors evaluated with bivariate correlations. ERMs and CCMs were produced for the statistically significant risk factors.
The incidence of malaria increased over time with cluster locations detected, predominantly at the northern parts but later few spread to the middle parts of the country. Our results suggested that with respect to sociodemographic determinants, district variations in malaria rates might be explained by inequalities in seven sociodemographics, including an unexpected significant negative association with non-religious affiliation. The sociodemographics had positive spatial autocorrelations, exhibited statistically significant interactions and the strongest was observed in urbanisation-basic education correlation (p< 0.01, r = +0.969). The ERMs and CCMs specifically identified locations with lower or higher than expected rates with respect to particular risk factor(s) where improving risk factor(s) such as employment-to-population ratio in rural areas, basic education could have cascade effects to reduce the expected malaria incidence in endemic areas.
Ghana remains malaria hyperendemic region with district-level spatial heterogeneity. Significant association between malaria and sociodemographics was detected and the ERMs and CCMs geo-visually pinpointed locations of these significant associations. To complement sophisticated spatial regression models, the easily interpretable ERMs and CCMs could be used to specify where disease-risk factor associations are significant, simplifying complex spatial epidemiological information for efficient public health administration.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disorder. About 90% of ALS cases are without a known genetic cause. The human endogenous retrovirus multi-copy HERV-K(HML-2) group was ...recently reported to potentially contribute to neurodegeneration and disease pathogenesis in ALS because of transcriptional upregulation and toxic effects of HML-2 Envelope (Env) protein. Env and other proteins are encoded by some transcriptionally active HML-2 loci. However, more detailed information is required regarding which HML-2 loci are transcribed in ALS, which of their proteins are expressed, and differences between the disease and non-disease states.
For brain and spinal cord tissue samples from ALS patients and controls, we identified transcribed HML-2 loci by generating and mapping HML-2-specific cDNA sequences. We predicted expression of HML-2 env gene-derived proteins based on the observed cDNA sequences. Furthermore, we determined overall HML-2 transcript levels by RT-qPCR and investigated presence of HML-2 Env protein in ALS and control tissue samples by Western blotting.
We identified 24 different transcribed HML-2 loci. Some of those loci are transcribed at relatively high levels. However, significant differences in HML-2 loci transcriptional activities were not seen when comparing ALS and controls. Likewise, overall HML-2 transcript levels, as determined by RT-qPCR, were not significantly different between ALS and controls. Indeed, we were unable to detect full-length HML-2 Env protein in ALS and control tissue samples despite reasonable sensitivity. Rather our analyses suggest that a number of HML-2 protein variants other than full-length Env may potentially be expressed in ALS patients.
Our results expand and refine recent publications on HERV-K(HML-2) and ALS. Some of our results are in conflict with recent findings and call for further specific analyses. Our profiling of HML-2 transcription in ALS opens up the possibility that HML-2 proteins other than canonical full-length Env may have to be considered when studying the role of HML-2 in ALS disease.
To investigate obstetric and perinatal outcomes among female survivors of adolescent and young adult (AYA) cancers and their offspring.
Using multivariate analysis of statewide linked data, outcomes ...of all first completed pregnancies (n = 1894) in female survivors of AYA cancer diagnosed in Western Australia during the period 1982-2007 were compared with those among females with no cancer history. Comparison pregnancies were matched by maternal age-group, parity and year of delivery.
Compared with the non-cancer group, female survivors of AYA cancer had an increased risk of threatened abortion (adjusted relative risk 2.09, 95% confidence interval 1.51-2.74), gestational diabetes (2.65, 2.08-3.57), pre-eclampsia (1.32, 1.04-1.87), post-partum hemorrhage (2.83, 1.92-4.67), cesarean delivery (2.62, 2.22-3.04), and maternal postpartum hospitalization>5 days (3.01, 1.72-5.58), but no excess risk of threatened preterm delivery, antepartum hemorrhage, premature rupture of membranes, failure of labor to progress or retained placenta. Their offspring had an increased risk of premature birth (<37 weeks: 1.68, 1.21-2.08), low birth weight (<2500 g: 1.51, 1.23-2.12), fetal growth restriction (3.27, 2.45-4.56), and neonatal distress indicated by low Apgar score (<7) at 1 minute (2.83, 2.28-3.56), need for resuscitation (1.66, 1.27-2.19) or special care nursery admission (1.44, 1.13-1.78). Congenital abnormalities and perinatal deaths (intrauterine or ≤7 days of birth) were not increased among offspring of survivors.
Female survivors of AYA cancer have moderate excess risks of adverse obstetric and perinatal outcomes arising from subsequent pregnancies that may require additional surveillance or intervention.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
•Severe episodic of air pollution has a profound impact on humans and their activities.•We quantified the trends in the frequency, intensity and duration of these events.•Trends were investigate over ...a period 2013–217 for 100 cities.•Reduction of baseline air pollution is the key measure against episodic air pollution.•No solution to preventing events caused by climate change affected natural sources.
Severe episodic air pollution blankets entire cities and regions and have a profound impact on humans and their activities. We compiled daily fine particle (PM2.5) data from 100 cities in five continents, investigated the trends of number, frequency, and duration of pollution episodes, and compared these with the baseline trend in air pollution. We showed that the factors contributing to these events are complex; however, long-term measures to abate emissions from all anthropogenic sources at all times is also the most efficient way to reduce the occurrence of severe air pollution events. In the short term, accurate forecasting systems of such events based on the meteorological conditions favouring their occurrence, together with effective emergency mitigation of anthropogenic sources, may lessen their magnitude and/or duration. However, there is no clear way of preventing events caused by natural sources affected by climate change, such as wildfires and desert dust outbreaks.
Although studies have examined the associations between fine particles (PM2.5) and lung cancer mortality in US and European countries, the evidence is still limited for China. In addition, no study ...has provided estimates of spatial variation in lung cancer mortality attributable to PM2.5 in China. In this study, we quantified the associations between lung cancer mortality and PM2.5, using a spatiotemporal model with observed data of lung cancer mortality from 75 communities from the National Cancer Registration of China from 1990 to 2009 and the annual concentrations of PM2.5 at 0.5°×0.5° spatial resolution. We also estimated lung cancer mortality burden attributable to PM2.5 in China, with predicted county level lung cancer deaths in 2005. We found that the PM2.5-lung cancer mortality associations were non-linear, with thresholds of 40μg/m3 overall, 45μg/m3 for male, 42μg/m3 for female, 45μg/m3 for those aged 30–64years, 48μg/m3 for those aged 65–74years, and 40μg/m3 for those aged 75years and more, above which the relative risks were 1.08 (95% CI: 1.07, 1.09), 1.07 (95% CI: 1.05, 1.08), 1.12 (95% CI: 1.1, 1.14), 1.05 (95% CI: 1.04, 1.07), 1.07 (95% CI: 1.06, 1.09), and 1.14 (95% CI: 1.12, 1.16) respectively. There were 51,219 (95% CI: 45,745–56,512) lung cancer deaths attributed to PM2.5 in 2005, with attributable fractions of 13.7% (95% CI: 12.23–15.11%) overall, 10.01% (95% CI: 8.37–11.58%) for men, 18.06% (95% CI: 15.81–20.18%) for women, 8.35% (95% CI: 6.07–10.51%) for those aged 65–74years, 9.73% (95% CI: 7.6–11.75%) for those aged 65–74years, 21.7% (95% CI: 19.27–23.99%) for those aged 75years or more. In conclusion, assuming a causal relation a reduction in exposure levels of PM2.5 below thresholds would avert a substantial number of deaths from lung cancer in China.
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•First study to examine the impacts of PM2.5 on lung cancer mortality in China•PM2.5 was associated with lung cancer mortality, with threshold effect.•The effect estimates were higher among women than men.•The effect estimates were higher among the elderly than the young.
A 2014 SSO-ASTRO guideline on surgical margins aimed to reduce unnecessary reoperation after breast conserving surgery (BCS). We investigate whether publication of the guideline was associated with a ...reduction in reoperation in Western Australia (WA).
In this retrospective, population-based cohort study, cases of newly-diagnosed breast cancer were identified from the WA Cancer Registry. Linkage to the Hospital Morbidity Data Collection identified index BCS for invasive cancer between January 2009 and June 2018 (N = 8059) and reoperation within 90 days. Pre-guideline (2009–2013) and post-guideline (2014–2018) reoperation proportions were compared, and temporal trends were estimated with generalised linear regression.
The pre-guideline reoperation proportion was 25.8% compared with 21.7% post-guideline (difference −4.0% 95% CI —5.9, −2.2, p < 0.001, odds ratio OR 0.80 95% CI 0.72, 0.89, p < 0.001). Absolute reductions were similar for repeat BCS (16.3% versus 14.6%; difference −1.8% 95% CI —3.4, −0.2, p = 0.03) and conversion to mastectomy (9.4% versus 7.2%; difference −2.2% 95% CI —3.4, −1.0, p < 0.001). Over the study period, there was an annual absolute change in reoperation of −0.8% (95% CI —1.2, −0.5, p < 0.001). Accounting for this linear trend, the difference in reoperation between time periods was −0.5% (95% CI —4.3, 3.3; p = 0.81), reflecting a non-significant reduction in conversion to mastectomy.
Comparisons of pre- versus post-guideline time periods in WA showed reductions in reoperation that were similar to international estimates; however, an annual decline in reoperation predated the guideline. Analyses that do not account for temporal trends are likely to overestimate changes in reoperation associated with the guideline.
•The reoperation rate was lower after than before the SSO-ASTRO margins guideline.•However, an annual decline in reoperation preceded publication of the guideline.•Accounting for this trend, a smaller reduction was associated with the guideline.
The World Health Organization recommends to wait at least 6 months after miscarriage and induced abortion before becoming pregnant again to avoid complications in the next pregnancy, although the ...evidence-based underlying this recommendation is scarce. We aimed to investigate the risk of adverse pregnancy outcomes-preterm birth (PTB), spontaneous PTB, small for gestational age (SGA) birth, large for gestational age (LGA) birth, preeclampsia, and gestational diabetes mellitus (GDM)-by interpregnancy interval (IPI) for births following a previous miscarriage or induced abortion.
We conducted a cohort study using a total of 49,058 births following a previous miscarriage and 23,707 births following a previous induced abortion in Norway between 2008 and 2016. We modeled the relationship between IPI and 6 adverse pregnancy outcomes separately for births after miscarriages and births after induced abortions. We used log-binomial regression to estimate unadjusted and adjusted relative risk (aRR) and 95% confidence intervals (CIs). In the adjusted model, we included maternal age, gravidity, and year of birth measured at the time of the index (after interval) births. In a sensitivity analysis, we further adjusted for smoking during pregnancy and prepregnancy body mass index. Compared to births with an IPI of 6 to 11 months after miscarriages (10.1%), there were lower risks of SGA births among births with an IPI of <3 months (8.6%) (aRR 0.85, 95% CI: 0.79, 0.92, p < 0.01) and 3 to 5 months (9.0%) (aRR 0.90, 95% CI: 0.83, 0.97, p = 0.01). An IPI of <3 months after a miscarriage (3.3%) was also associated with lower risk of GDM (aRR 0.84, 95% CI: 0.75, 0.96, p = 0.01) as compared to an IPI of 6 to 11 months (4.5%). For births following an induced abortion, an IPI <3 months (11.5%) was associated with a nonsignificant but increased risk of SGA (aRR 1.16, 95% CI: 0.99, 1.36, p = 0.07) as compared to an IPI of 6 to 11 months (10.0%), while the risk of LGA was lower among those with an IPI 3 to 5 months (8.0%) (aRR 0.84, 95% CI: 0.72, 0.98, p = 0.03) compared to an IPI of 6 to 11 months (9.4%). There was no observed association between adverse pregnancy outcomes with an IPI >12 months after either a miscarriage or induced abortion (p > 0.05), with the exception of an increased risk of GDM among women with an IPI of 12 to 17 months (5.8%) (aRR 1.20, 95% CI: 1.02, 1.40, p = 0.02), 18 to 23 months (6.2%) (aRR 1.24, 95% CI: 1.02, 1.50, p = 0.03), and ≥24 months (6.4%) (aRR 1.14, 95% CI: 0.97, 1.34, p = 0.10) compared to an IPI of 6 to 11 months (4.5%) after a miscarriage. Inherent to retrospective registry-based studies, we did not have information on potential confounders such as pregnancy intention and health-seeking bahaviour. Furthermore, we only had information on miscarriages that resulted in contact with the healthcare system.
Our study suggests that conceiving within 3 months after a miscarriage or an induced abortion is not associated with increased risks of adverse pregnancy outcomes. In combination with previous research, these results suggest that women could attempt pregnancy soon after a previous miscarriage or induced abortion without increasing perinatal health risks.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
BackgroundAdverse perinatal outcomes such as preterm, small for gestational age, low birth weight, congenital anomalies, stillbirth and neonatal death have devastating impacts on individuals, ...families and societies, with significant lifelong health implications. Despite extensive knowledge of the significant and lifelong health implications of adverse perinatal outcomes, information on the economic burden is limited. Estimating this burden will be crucial for designing cost-effective interventions to reduce perinatal morbidity and mortality. Thus, we will quantify the economic burden of adverse perinatal outcomes from births to age 5 years in high-income countries.Methods and analysisA systematic review of all primary studies published in English in peer-reviewed journals on the economic burden for at least one of the adverse perinatal outcomes in high-income countries from 2010 will be searched in databases—MEDLINE (Ovid), EconLit, CINAHL (EBSCO), Embase (Ovid) and Global Health (Ovid). We will also search using Google Scholar and snowballing of the references list of included articles. The search terms will include three main concepts—costs, adverse perinatal outcome(s) and settings. We will use the Consolidated Health Economics Evaluation Reporting Standards 2022 and 17 criteria from the critical appraisal of cost-of-illness studies to assess the quality of each study. We will report the findings based on the Preferred Reporting Items for Systematic Reviews and Meta-analyses 2020 statement. Costs will be converted into a common currency (US dollar), and we will estimate the pooled cost and subgroup analysis will be done. The reference lists of included papers will be reviewed.Ethics and disseminationThis systematic review will not involve human participants and requires no ethical approval. The results of this review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42023400215.
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