Pneumonia is the leading cause of childhood death in sub-Saharan Africa. Comparative estimates of the contribution of causative pathogens to the burden of disease are essential for targeted vaccine ...development.
To determine the viral etiology of severe pneumonia among infants and children at a rural Kenyan hospital using comprehensive and sensitive molecular diagnostic techniques.
Prospective observational and case-control study during 2007 in a rural Kenyan district hospital. Participants were children aged 1 day to 12 years, residing in a systematically enumerated catchment area, and who either were admitted to Kilifi District Hospital meeting World Health Organization clinical criteria for severe pneumonia or very severe pneumonia; (2) presented with mild upper respiratory tract infection but were not admitted; or (3) were well infants and children attending for immunization.
The presence of respiratory viruses and the odds ratio for admission with severe disease.
Of 922 eligible admitted patients, 759 were sampled (82% median age, 9 months). One or more respiratory viruses were detected in 425 of the 759 sampled (56% 95% confidence interval {CI}, 52%-60%). Respiratory syncytial virus (RSV) was detected in 260 participants (34% 95% CI, 31%-38%) and other respiratory viruses were detected in 219 participants (29%; 95% CI, 26%-32%), the most common being Human coronavirus 229E (n = 51 6.7%), influenza type A (n = 44 5.8%), Parainfluenza type 3 (n = 29 3.8%), Human adenovirus (n = 29 3.8%), and Human metapneumovirus (n = 23 3.0%). Compared with well control participants, detection of RSV was associated with severe disease (5% corrected in control participants; adjusted odds ratio, 6.11 95% CI, 1.65-22.6) while collectively, other respiratory viruses were not associated with severe disease (23% in control participants; adjusted odds ratio, 1.27 95% CI, 0.64-2.52).
In a sample of Kenyan infants and children admitted with severe pneumonia to a rural hospital, RSV was the predominant viral pathogen.
This study compared the effectiveness of the Specific Carbohydrate Diet (SCD) to the Mediterranean diet (MD) as treatment for Crohn’s disease (CD) with mild to moderate symptoms.
Adult patients with ...CD and with mild-to-moderate symptoms were randomly assigned 1:1 to consume the MD or SCD for 12 weeks. For the first 6 weeks, participants received prepared meals and snacks according to their assigned diet. After 6 weeks, participants were instructed to follow the diet independently. The primary outcome was symptomatic remission at week 6. Key secondary outcomes at week 6 included fecal calprotectin (FC) response (FC <250 μg/g and reduction by >50% among those with baseline FC >250 μg/g) and C-reactive protein (CRP) response (high-sensitivity CRP <5 mg/L and >50% reduction from baseline among those with high-sensitivity CRP >5 mg/L).
The study randomized 194 patients, and 191 were included in the efficacy analyses. The percentage of participants who achieved symptomatic remission at week 6 was not superior with the SCD (SCD, 46.5%; MD, 43.5%; P = .77). FC response was achieved in 8 of 23 participants (34.8%) with the SCD and in 4 of 13 participants (30.8%) with the MD (P = .83). CRP response was achieved in 2 of 37 participants (5.4%) with the SCD and in 1 of 28 participants (3.6%) with the MD (P = .68).
The SCD was not superior to the MD to achieve symptomatic remission, FC response, and CRP response. CRP response was uncommon. Given these results, the greater ease of following the MD and other health benefits associated with the MD, the MD may be preferred to the SCD for most patients with CD with mild to moderate symptoms. ClinicalTrials.gov Identifier: NCT03058679
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Objective
The Global Burden of Disease Study 2010 (GBD 2010) is the first to include conduct disorder (CD) and attention‐deficit/hyperactivity disorder (ADHD) for burden quantification.
Method
A ...previous systematic review pooled the available epidemiological data for CD and ADHD, and predicted prevalence by country, region, age and sex for each disorder. Prevalence was then multiplied by a disability weight to calculate years lived with disability (YLDs). As no evidence of deaths resulting directly from either CD or ADHD was found, no years of life lost (YLLs) were calculated. Therefore, the number of disability‐adjusted life years (DALYs) was equal to that of YLDs.
Results
Globally, CD was responsible for 5.75 million YLDs/DALYs with ADHD responsible for a further 491,500. Collectively, CD and ADHD accounted for 0.80% of total global YLDs and 0.25% of total global DALYs. In terms of global DALYs, CD was the 72nd leading contributor and among the 15 leading causes in children aged 5–19 years. Between 1990 and 2010, global DALYs attributable to CD and ADHD remained stable after accounting for population growth and ageing.
Conclusions
The global burden of CD and ADHD is significant, particularly in male children. Appropriate allocation of resources to address the high morbidity associated with CD and ADHD is necessary to reduce global burden. However, burden estimation was limited by data lacking for all four epidemiological parameters and by methodological challenges in quantifying disability. Future studies need to address these limitations in order to increase the accuracy of burden quantification.
Growing evidence indicates that tree-stem methane (CH₄) emissions may be an important and unaccounted-for component of local, regional and global carbon (C) budgets. Studies to date have focused on ...upland and freshwater swamp-forests; however, no data on tree-stem fluxes from estuarine species currently exist.
Here we provide the first-ever mangrove tree-stem CH₄ flux measurements from >50 trees (n = 230 measurements), in both standing dead and living forest, from a region suffering a recent large-scale climate-driven dieback event (Gulf of Carpentaria, Australia).
Average CH₄ emissions from standing dead mangrove tree-stems was 249.2 ± 41.0 μmol m−2 d−1 and was eight-fold higher than from living mangrove tree-stems (37.5 ± 5.8 μmol m−2 d−1). The average CH₄ flux from tree-stem bases (c. 10 cm above-ground) was 1071.1 ± 210.4 and 96.8 ± 27.7 μmol m−2 d−1 from dead and living stands respectively. Sediment CH₄ fluxes and redox potentials did not differ significantly between living and dead stands. Our results suggest both dead and living tree-stems act as CH₄ conduits to the atmosphere, bypassing potential sedimentary oxidation processes.
Although large uncertainties exist when upscaling data from small-scale temporal measurements, we estimated that dead mangrove tree-stem emissions may account for c. 26% of the net ecosystem CH₄ flux.
Climate Change and Mental Health: A Scoping Review Charlson, Fiona; Ali, Suhailah; Benmarhnia, Tarik ...
International journal of environmental research and public health,
04/2021, Letnik:
18, Številka:
9
Journal Article
Recenzirano
Odprti dostop
Climate change is negatively impacting the mental health of populations. This scoping review aims to assess the available literature related to climate change and mental health across the World ...Health Organisation's (WHO) five global research priorities for protecting human health from climate change. We conducted a scoping review to identify original research studies related to mental health and climate change using online academic databases. We assessed the quality of studies where appropriate assessment tools were available. We identified 120 original studies published between 2001 and 2020. Most studies were quantitative (
= 67), cross-sectional (
= 42), conducted in high-income countries (
= 87), and concerned with the first of the WHO global research priorities-assessing the mental health risks associated with climate change (
= 101). Several climate-related exposures, including heat, humidity, rainfall, drought, wildfires, and floods were associated with psychological distress, worsened mental health, and higher mortality among people with pre-existing mental health conditions, increased psychiatric hospitalisations, and heightened suicide rates. Few studies (
= 19) addressed the other four global research priorities of protecting health from climate change (effective interventions (
= 8); mitigation and adaptation (
= 7); improving decision-support (
= 3); and cost estimations (
= 1)). While climate change and mental health represents a rapidly growing area of research, it needs to accelerate and broaden in scope to respond with evidence-based mitigation and adaptation strategies.
Drug-resistant tuberculosis (TB) has lent urgency to finding new drug leads with novel modes of action. A high-throughput screening campaign of >65,000 actinomycete extracts for inhibition of ...Mycobacterium tuberculosis viability identified ecumicin, a macrocyclic tridecapeptide that exerts potent, selective bactericidal activity against M. tuberculosis in vitro, including nonreplicating cells. Ecumicin retains activity against isolated multiple-drug-resistant (MDR) and extensively drug-resistant (XDR) strains of M. tuberculosis. The subcutaneous administration to mice of ecumicin in a micellar formulation at 20 mg/kg body weight resulted in plasma and lung exposures exceeding the MIC. Complete inhibition of M. tuberculosis growth in the lungs of mice was achieved following 12 doses at 20 or 32 mg/kg. Genome mining of lab-generated, spontaneous ecumicin-resistant M. tuberculosis strains identified the ClpC1 ATPase complex as the putative target, and this was confirmed by a drug affinity response test. ClpC1 functions in protein breakdown with the ClpP1P2 protease complex. Ecumicin markedly enhanced the ATPase activity of wild-type (WT) ClpC1 but prevented activation of proteolysis by ClpC1. Less stimulation was observed with ClpC1 from ecumicin-resistant mutants. Thus, ClpC1 is a valid drug target against M. tuberculosis, and ecumicin may serve as a lead compound for anti-TB drug development.
Bullying victimisation is a global public health problem that has been predominantly studied in high income countries. This study aimed to estimate the population level prevalence of bullying ...victimisation and its association with peer and parental supports amongst adolescents across low and middle income to high income countries (LMICHICs).
Data were drawn from the Global School-based Student Health Survey of school children aged 12–17 years, between 2003 and 2015, in 83 LMICHICs in the six World Health Organization (WHO) regions. We estimated the weighted prevalence of bullying victimisation at country, region and global level. We used multiple binary logistic regression models to estimate the adjusted association of age, gender, socioeconomic status, and parental support and peer support, and country level variables (GDP and government expenditure on education) with adolescent bullying victimisation.
Of the 317,869 adolescents studied, 151,036 (48%) were males, and 166,833 (52%) females. The pooled prevalence of bullying victimisation on one or more days in the past 30 days amongst adolescents aged 12–17 years was 30·5% (95% CI: 30·2–31·0%). The highest prevalence was observed in the Eastern Mediterranean Region (45·1%, 44·3–46·0%) and African region (43·5%, 43·0–44·3%), and the lowest in Europe (8·4%, 8·0–9·0%). Bullying victimisation was associated with male gender (OR: 1·21; 1·11–1·32), below average socio-economic status (OR: 1·47, 1·35–1·61), and younger age (OR: 1·11, 1·0–1·24). Higher levels of peer support (0·51, 0·46–0·57), higher levels of parental support (e.g., understanding children's problems (OR: 0·85, 0·77–0·95), and knowing the importance of free time spent with children (OR: 0·77, 0·70–0·85)), were significantly associated with a reduced risk of bullying victimisation.
Bullying victimisation is prevalent amongst adolescents globally, particularly in the Eastern Mediterranean and African regions. Parental and peer supports are protective factors against bullying victimisation. A reduction in bullying victimisation may be facilitated by family and peer based interventions aimed at increasing social connectedness of adolescents.
Brain metastases are a challenging manifestation of renal cell carcinoma. We have a limited understanding of brain metastasis tumor and immune biology, drivers of resistance to systemic treatment, ...and their overall poor prognosis. Current data support a multimodal treatment strategy with radiation treatment and/or surgery. Nonetheless, the optimal approach for the management of brain metastases from renal cell carcinoma remains unclear. To improve patient care, the authors sought to standardize practical management strategies. They performed an unstructured literature review and elaborated on the current management strategies through an international group of experts from different disciplines assembled via the network of the International Kidney Cancer Coalition. Experts from different disciplines were administered a survey to answer questions related to current challenges and unmet patient needs. On the basis of the integrated approach of literature review and survey study results, the authors built algorithms for the management of single and multiple brain metastases in patients with renal cell carcinoma. The literature review, consensus statements, and algorithms presented in this report can serve as a framework guiding treatment decisions for patients. CA Cancer J Clin. 2022;72:454‐489.
Background:
Despite increased awareness of the adverse impact of bullying on mental health, the prevalence of bullying in Australia is uncertain. The aim of the current study was to conduct a ...systematic review and meta-analysis to estimate the prevalence of bullying (traditional and cyber) among Australian children and adolescents. This study synthesised bullying prevalence studies on victimisation experiences (being bullied) and perpetration experiences (bullying others).
Method:
A systematic review of electronic databases (A+ Education, EMBASE, ERIC, PubMed, PsycINFO and Scopus up to 27 May 2017) was conducted. In addition, reference lists of included studies, theses recorded at the National Library of Australia, and government websites were surveyed to identify local area data as well as state and nationally representative data. Overall, 898 studies were screened and out of the 126 studies assessed for eligibility, 46 satisfied the pre-determined inclusion criteria. Meta-analyses based on quality-effects models generated pooled prevalence estimates for each of the two types of bullying involvement (victimisation and perpetration), as well as distinct models for traditional bullying and cyberbullying experiences by the type of involvement.
Results:
Overall, the 12-month prevalence of bullying victimisation was 15.17% (95% confidence interval = 9.17, 22.30) and perpetration was 5.27% (95% confidence interval = 3.13, 7.92). The lifetime prevalence for traditional bullying victimisation was 25.13% (95% confidence interval = 18.73, 32.11) and perpetration was 11.61% (95% confidence interval = 7.41, 16.57). Cyberbullying victimisation and perpetration were less common with lifetime prevalence of 7.02% (95% confidence interval = 2.41, 13.54) and 3.45% (95% confidence interval = 1.13, 6.84), respectively.
Conclusion:
Bullying is common among children and adolescents in Australia. There is a need to improve the measurement of bullying using a standardised instrument and for prevalence estimates to be collected on a regular basis to assess change over time. Wide implementation of anti-bullying programmes in Australian schools is a viable public health approach for the prevention of mental health problems.
Asthma exacerbations exhibit a consistent annual pattern, closely mirroring the school calendar. Although respiratory viruses—the “common cold” viruses—are implicated as a principal cause, there is ...little evidence to link viral prevalence to seasonal differences in risk. We jointly fit a common cold transmission model and a model of biological and environmental exacerbation triggers to estimate effects on hospitalization risk. Asthma hospitalization rate, influenza prevalence, and air quality measures are available, but common cold circulation is not; therefore, we generate estimates of viral prevalence using a transmission model. Our deterministic multivirus transmission model includes transmission rates that vary when school is closed. We jointly fit the two models to 7 y of daily asthma hospitalizations in adults and children (66,000 events) in eight metropolitan areas. For children, we find that daily viral prevalence is the strongest predictor of asthma hospitalizations, with transmission reduced by 45% (95% credible interval =41–49%) during school closures. We detect a transient period of nonspecific immunity between infections lasting 19 (17–21) d. For adults, hospitalizations are more variable, with influenza driving wintertime peaks. Neither particulate matter nor ozone was an important predictor, perhaps because of the large geographic area of the populations. The school calendar clearly and predictably drives seasonal variation in common cold prevalence, which results in the “back-to-school” asthma exacerbation pattern seen in children and indirectly contributes to exacerbation risk in adults. This study provides a framework for anticipating the seasonal dynamics of common colds and the associated risks for asthmatics.
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