The aim of this study was to assess whether adjusting the weight categorisation of children for their biological maturity status could improve the accuracy of predicting weight status and cardiometabolic risk at age 17.
Data from 1525 participants (787 female) from the ALSPAC study were analysed. Participants' weight status at age 11 was estimated using first standard chronological age and sex adjusted BMI cut-offs, and again using maturity adjusted BMI cut-offs. Each BMI category at age 11 was regressed against cardiometabolic risk score and BMI category at age 17, controlling for sex, ethnicity and socio-economic status.
At age 11 years, 22% of boys and 46% of girls who were categorised as overweight or having obesity based on chronological age were re-categorised into a lower BMI category after adjusting for biological maturity. Biologically adjusted BMI categories better predicted BMI category at age 17 compared with non-adjusted BMI categories (∆BIC = - 21.69); the odds of having obesity at age 17 were 18.28 times greater with each increase in BMI category at age 11. Adjusted and non-adjusted BMI status at 11 years showed equivalent accuracy in predicting cardiometabolic risk at age 17; the odds ratio of high cardiometabolic risk was 1.85, with heightened risk in boys, particularly early maturers.
The traditional method of categorising adolescents into a BMI category may over-predict overweight and obesity, particularly in girls. Adjusting for biological maturity when estimating weight status through calculating adolescents' BMI classification was equivalent to standard approaches in predicting other cardiovascular risk at age 17.
The traditional method of categorising adolescents into a BMI category may over-predict overweight and obesity, particularly in girls. Adjusting for biological maturity when estimating weight status through calculating adolescents' BMI classification was equivalent to standard approaches in predicting other cardiovascular risk at age 17.
The study aimed to evaluate whether the presence of DKA at diabetes diagnosis was associated with poorer metabolic control during a 5-year follow-up.
The study included children treated due to newly diagnosed T1D complicated with DKA between 2010 and 2014 with a complete 5-year follow-up. In every case we performed individual matching for age, gender and BMI with a person without DKA (nDKA) on recognition. We collected data regarding treatment modality, HbA
, total daily insulin dose, basal insulin and BMI-SDS.
85 children at the median age of 7.93 years had DKA at diabetes diagnosis. The median pH was 7.19.Continuous subcutaneous insulin infusion (CSII) was used in 87% of participants in each group. No differences in HbA
level (7,3%vs7,2%;p = .413) were noted after 5 years of disease duration. The severity of ketoacidosis exerted no significant effect on HbA
. The method of insulin delivery at baseline was significantly associated with HbA
levels after 5 years of observation, β
= - 1.46,95%CI[- 2.01 to - 0.92],p < .001.
The presence of DKA at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of DKA and lead to a long-term HbA
improvement.
The presence of DKA at diabetes diagnosis is not associated with deteriorated long-term metabolic control in children using modern technologies. The early implementation of CSII into diabetes treatment may change the effect of DKA and lead to a long-term HbA1C improvement.
Periodic testing of female sex workers (FSW) for sexually transmitted infections (STIs) is a core component of global and national responses to achieve population-level STI elimination. We conducted a qualitative study to explore barriers and facilitators of regular syphilis and HIV testing among FSW in Uganda.
Within a quasi-experimental study among 436 FSW to assess the effect of peer education and text message reminders on uptake of regular STI and HIV testing among FSW, we conducted 48 qualitative interviews in four cities in Uganda from August-December 2018. We purposively selected FSW who tested for syphilis and HIV every 3-6 months; 12 FSW were interviewed in each city. Sex worker interviews explored 1) reasons for periodic syphilis and HIV testing; 2) barriers and facilitators of testing; 3) experiences of testing; and 4) challenges faced while seeking testing services. Data were analyzed using thematic content analysis.
Thematic analysis revealed individual- and health system-level barriers andr testing barriers and facilitators.
HIV programs are likely to be important entry points for syphilis testing among FSW. Multi-level interventions to address testing barriers should consider focusing on these service delivery points. Extending the dual syphilis and HIV testing approach to FSW may improve testing uptake for both infections at public health facilities and decrease population-level incidence.
HIV programs are likely to be important entry points for syphilis testing among FSW. Multi-level interventions to address testing barriers should consider focusing on these service delivery points. Extending the dual syphilis and HIV testing approach to FSW may improve testing uptake for both infections at public health facilities and decrease population-level incidence.
The unexpected changes caused by the COVID-19 pandemic related to the fear of developing the disease, and the need for social distancing and isolation have had an effect on people's mental health. These drastic changes can result in the development of anxiety, depressive symptoms and sense of loneliness. Elderly and chronically ill individuals are at a particularly high risk of developing COVID-19, suffering severe illness and dying as a result of it.
The aim of the study was to assess the prevalence of anxiety, depressive symptoms, irritability and loneliness in the elderly aged 60 years and older as a group exposed to the negative impact of the COVID-19 pandemic, and to analyze the relationships between loneliness and mental health of the respondents and sociodemographic variables and chronic diseases.
The study was conducted in Poland among 221 individuals aged 60+. The study material was collected using a sociodemographic questionnaire, Hospital Anxiety and Depression Scale (HADS-M) and a revised Undepressive symptoms. Two out of three participants experienced a moderate sense of loneliness. Individuals who displayed a higher level of loneliness also had a higher severity of anxiety level depressive symptoms and irritability. Elderly individuals should be under special care due to their high risk of experiencing physical and mental effects of the COVID-19 pandemic.
Musculoskeletal disorders (MSDs) can create a temporary or permanent disability that reduce a person's ability to work. Physiotherapists (PTs), occupational therapists (OTs) and exercise therapists (ETs) are often involved in the early management of MSDs. There is a need for additional insights into therapists' experiences, barriers and needs to work-focused care. Moreover, there is no evidence on how OTs and ETs address work participation. Therefore, the aim of this qualitative study was 1) to investigate how generalist PTs, OTs and ETs provide work-focused healthcare and 2) to obtain insight into their perceived barriers and needs that affect their ability to address occupational factors.
An exploratory qualitative study using three focus groups. Generalist PTs, OTs and ETs were eligible to participate if they treated working patients with MSDs. A semi-structured interview guide with open-ended questions was developed. Two moderators facilitated each focus group using the interview guide, and all the gr factors into account. However, how PTs, OTs and ETs address work participation and the extent to which they do so can be improved. There was a lack of knowledge about and cooperation with occupational health professionals, including PTs, OTs or ETs specialised in occupational health.
Participants in this qualitative study were aware of the importance of taking occupational factors into account. However, how PTs, OTs and ETs address work participation and the extent to which they do so can be improved. There was a lack of knowledge about and cooperation with occupational health professionals, including PTs, OTs or ETs specialised in occupational health.
During March of 2020 the Centers for Disease Control and Prevention (CDC) announced non-pharmaceutical intervention (NPI) guidance as the primary mitigation strategy against growing COVID-19 community spread due to the absence of a vaccine or effective treatment at that time. CDC guidance states that NPIs are most effective when instituted in an early, targeted, and layered fashion. NPIs are effective in slowing spread, and measures should be custom-tailored to each population. This study examines factors associated with implementation and timing of NPI interventions across large public and private U.S. universities at the onset of the COVID-19 pandemic.
NPI decisions of interest include when U.S. universities canceled international travel, shifted to online learning, moved faculty/staff to remote work, limited campus housing, and closed campus for all non-essential personnel. Cox proportional hazard analyses of retrospective data were conducted to assess the time to NPI events. Hazard ratios were calculal COVID-19 epidemiology, culture and political concerns. The timing of university NPI decisions varied by regional politics, faculty demographics, university governance, campus setting, and foreign student prevalence adjusting for COVID-19 state case prevalence and spring break timing. Religious affiliation and presence of university health infrastructure were not associated with timing.
University NPI implementation was largely driven by local COVID-19 epidemiology, culture and political concerns. The timing of university NPI decisions varied by regional politics, faculty demographics, university governance, campus setting, and foreign student prevalence adjusting for COVID-19 state case prevalence and spring break timing. Religious affiliation and presence of university health infrastructure were not associated with timing.
The genetic control of sex determination in teleost species is poorly understood. This is partly because of the diversity of mechanisms that determine sex in this large group of vertebrates, including constitutive genes linked to sex chromosomes, polygenic constitutive mechanisms, environmental factors, hermaphroditism, and unisexuality. Here we use a de novo genome assembly of New Zealand silver trevally (Pseudocaranx georgianus) together with sex-specific whole genome sequencing data to detect sexually divergent genomic regions, identify candidate genes and develop molecular makers.
The de novo assembly of an unsexed trevally (Trevally_v1) resulted in a final assembly of 579.4Mb in length, with a N50 of 25.2Mb. AMG-900 Of the assembled scaffolds, 24 were of chromosome scale, ranging from 11 to 31Mb in length. A total of 28,416 genes were annotated after 12.8 % of the assembly was masked with repetitive elements. Whole genome re-sequencing of 13 wild sexed trevally (seven males and six females) identified two sexually divergent regions located on two scaffolds, including a 6kb region at the proximal end of chromosome 21.AMG-900