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This study presents the most recent data on the incidence, prevalence, and years lived with disability (YLDs) due to anxiety disorders across the Middle East and North Africa (MENA) region from 1990-2021, analysed by sex, age, and sociodemographic index (SDI).
Methods:
We assessed the burden of anxiety disorders using data sourced from the Global Burden of Disease 2021 study. The estimates of prevalence, DALYs, and YLDs are provided as numbers and age-standardised rates, accompanied by their 95% uncertainty intervals (UIs).
Results:
In 2021, the age-standardised point prevalence of anxiety disorders in the region was 5.95 thousand, with an incidence rate of 883.4 per 100,000. The number of YLDs in 2021 reached 4.5 million. From 1990 to 2021, the burden of anxiety disorders increased significantly. Lebanon had the highest burden in 2021. Among both sexes, the 10–14 age group had the highest incidence rate, while the 15–19 age group had the highest prevalence and YLD rates. In 2021, most age groups in the MENA region had YLD rates that were higher than the global average.
Conclusion:
This study highlights the urgent need for a multidisciplinary approach to prevent and manage anxiety disorders. Ensuring accessible and affordable treatment options for all affected individuals is crucial. Governments should prioritise supporting programmes to effectively address mental health issues, given the unique socioeconomic and geopolitical challenges in the MENA region. By including effective preventive methods alongside treatment in healthcare strategies, the burden of anxiety disorders can be significantly reduced.
To describe vestibular dysfunction accompanied by sudden sensorineural hearing loss and explore its potential prognostic role.
Methods
A total of 44 Idiopathic Sudden Sensorineural Hearing loss cases were enrolled. Pure tone audiometry (PTA) was performed at the first visit and three months after standard therapy. Patients’ improvement and severity of hearing loss were categorised based on Siegel and American Speech and Hearing Association criteria. Their recovery rate and factors affecting recovery were explored.
Results
The mean age of the participants was 52.1 years. The caloric and cervical vestibular-evoked myogenic potential test abnormalities were detected in 36.4 and 31.8 per cent of participants. Vertigo was present in 36.4 per cent at the first visit. Based on American Speech and Hearing Association criteria, 16 patients experienced at least 1 grade improvement to a less severe hearing loss status at the follow up. A total of 31.7 per cent of patients demonstrated complete or partial recovery. Vestibular dysfunction was associated with poorer PTA results.
Conclusion
Abnormal caloric and cervical vestibular-evoked myogenic potential tests, as well as the presence of vertigo, can indicate more profound inner-ear damage.
Metabolic syndrome (MetS) is associated with deteriorated mental health and health-related quality of life (HRQOL). Curcumin and probiotics improved MetS, mental health and HRQOL. The present study aimed to investigate the effect of curcumin-probiotic (CurPro) co-supplementation in the form of drink powder on mental health and HRQOL in adults with overweight/obesity and MetS. A four-arm, randomised, double-blinded, placebo-controlled clinical trial with factorial design was conducted for adults with overweight/obesity and MetS (n 128). Participants were randomly allocated into four groups to receive one drink powder sachet containing 1 g curcumin, 109 colony-forming unit (CFU) probiotic (Lactobacillus acidophilus and Lactobacillus rhamnosus strains), CurPro (1 g curcumin and 109 CFU probiotic) or placebo along with a low-calorie diet. Participants were assessed for dietary intake, physical activity, mental health and HRQOL before and after the study. After 8 weeks of intervention, 104 participants finished the study. The CurPro intervention reduced stress (P = 0·001) and anxiety (P = 0·019) and improved general health (P = 0·024) and overall HRQOL (P = 0·011) scores of participants in comparison with the Placebo group. Results were NS for depression and HRQOL subdomains such as physical functioning, role limitations due to physical problems, bodily pain, vitality, social functioning and role limitations due to emotional problems. Curcumin-probiotics co-supplementation could improve the mental health and HRQOL of adults with overweight/obesity and MetS. Further investigations in various populations or with different dosages or durations are recommended.
Spontaneous abortion (SA) is considered one of the most prevalent adverse outcomes of pregnancy. SA may occur due to genetic susceptibility and various maternal factors such as nutritional status. The aim of this study was to assess how dietary carotenoids and the FTO gene are related to SA. This case–control study included 192 women with a history of SA as the case group and 347 healthy women without history of SA as the control group. To evaluate carotenoid intake, a valid 168-item food frequency questionnaire (FFQ) was used. The FTO gene was genotyped for the presence of the rs9939609 polymorphism using the tetra-primer amplification refractory mutation system-polymerase chain (ARMS-PCR). The results indicated a significant negative association between dietary intake of β-cryptoxanthin and SA in carriers of the TT genotype of the FTO rs9939609 polymorphism after adjustment for age, BMI, physical activity, smoking, alcohol drinking, and calorie intake (β = −0.28, P = 0.02). No association was found between SA with dietary intake of beta-carotene, alpha-carotene, lutein, and lycopene among carriers of different FTO genotypes. The FTO genotype may have an effect on the association between SA and carotenoid intake. Dietary intake of β-cryptoxanthin may act as a protective factor against SA only in carriers of the TT genotype of the FTO rs9939609 polymorphism.
This study investigates the genetic and phenotypic aspects of early growth performance in the Murciano-Granadina goat breed, using data collected between 2016 and 2022 from a private dairy farm in Ghale-Ganj city, located in the southern area of Kerman province, Iran. Pedigree and data information were collected on several early body weight traits, including birth weight (BW), weaning weight (WW), average daily gain (ADG), Kleiber ratio (KR) and growth efficiency from birth to weaning (GE). Nine univariate animal models included direct additive genetic effects and different combinations of maternal effects were compared by using Akaike information criterion (AIC). Among the tested models, the best genetic analysis model for BW, included direct additive, maternal additive, maternal permanent and maternal temporary environmental effects. The best model for ADG, KR and GE included direct additive, maternal permanent and litter effects. For WW, the best model was determined to be one that included direct additive and maternal additive genetic effects. The estimated direct heritabilities were low values of 0.04, 0.07, 0.08, 0.05 and 0.07 for BW, ADG, KR, GE and WW, respectively. The estimates of genetic correlations among the studied traits were positive and low to high in magnitude which ranged from 0.11 for BW-KR to 0.91 for BW-GE. The phenotypic correlations ranged from 0.03 for KR-WW to 0.87 for ADG-KR. The positive correlations observed among the studied growth traits of the Murciano-Granadina goat breed indicate no negative genetic or phenotypic changes associated with selection for these traits.
Nutritional education is pivotal in the medical nutritional therapy of type 2 diabetes mellitus (T2DM). The extended parallel process model (EPPM) is a health education method for inducing desirable health behaviours. The present study aimed to investigate the effect of nutritional education based on the EPPM in T2DM patients on knowledge, attitude, practice, anthropometric indices, glycaemic factors, lipid profile and adherence to the diabetic diet. A randomised, double-blind, controlled, factorial field trial was designed for T2DM patients aged 30–59 years (n 88). Participants were randomly allocated into four groups to receive EPPM-based nutritional education through gain framed message (GFM), loss framed message (LFM), their combination (G\LFM) or usual diabetic education in the control group (CG). Participants were assessed before and after the study duration. After 3 months of intervention, eighty participants finished the study. The EPPM-based intervention increased participants’ knowledge, behavioural intention, perceived sensitivity, severity, self-efficacy (P < 0·001 for all) and response efficacy (P = 0·029) in comparison with CG. GFM (P = 0·004) and G\FLM (P = 0·034) reduced carbohydrate intake and LFM (P = 0·034) and G\LFM (P = 0·047) decreased fat intake. Between-group analysis indicated interventions reduced weight (P = 0·046), BMI (P = 0·038), fasting blood sugar (P = 0·030), 2-hour postprandial blood glucose (P = 0·027) and TAG (P = 0·002) in comparison with the CG. Results were NS for protein intake, waist and hip circumference, waist:hip ratio, HbA1c, total cholesterol, LDL and HDL. Nutritional education based on EPPM could increase the knowledge and awareness of T2DM patients. Also, it could be beneficial for blood glucose amendment. Further investigations are recommended.
This review aims to assess the prevalence of malaria in pregnancy during antenatal visits and delivery, species-specific burden together with regional variation in the burden of disease. It also aims to estimate the proportions of adverse pregnancy outcomes in malaria-positive women. Based on the PRISMA guidelines, a thorough and systematic search was conducted in July 2023 across two electronic databases (including PubMed and CENTRAL). Forest plots were constructed for each outcome of interest highlighting the effect measure, confidence interval, sample size, and its associated weightage. All the statistical meta-analysis were conducted using R-Studio version 2022.07. Sensitivity analyses, publication bias assessment, and meta-regression analyses were also performed to ensure robustness of the review. According to the pooled estimates of 253 studies, the overall prevalence of malaria was 18.95% (95% CI: 16.95–21.11), during antenatal visits was 20.09% (95% CI: 17.43–23.06), and at delivery was 17.32% (95% CI: 14.47–20.61). The highest proportion of malarial infection was observed in Africa approximating 21.50% (95% CI: 18.52–24.81) during ANC and 20.41% (95% CI: 17.04–24.24) at the time of delivery. Our analysis also revealed that the odds of having anaemia were 2.40 times (95% CI: 1.87–3.06), having low birthweight were 1.99 times (95% CI: 1.60–2.48), having preterm birth were 1.65 times (95% CI: 1.29–2.10), and having stillbirths were 1.40 times (95% CI: 1.15–1.71) in pregnant women with malaria.
The use of telemedicine for the prehospital management of emergency conditions, especially stroke, is increasing day by day. Few studies have investigated the applications of telemedicine in Emergency Medical Services (EMS). A comprehensive study of the applications of this technology in stroke patients in ambulances can help to build a better understanding. Therefore, this systematic review was conducted to investigate the use of telemedicine in ambulances for stroke patients in 2023.
Methods:
A systematic search was conducted in PubMed, Cochrane, Scopus, ProQuest, Science Direct, and Web of Science from 2013 through March 1, 2023. The authors selected the articles based on keywords and criteria and reviewed them in terms of title, abstract, and full text. Finally, the articles that were related to the study aim were evaluated.
Results:
The initial search resulted in the extraction of 2,795 articles. After review of the articles, and applying the inclusion and exclusion criteria, seven articles were selected for the final analysis. Three (42.85%) studies were on the feasibility and intervention types. Also, randomized trials, feasibility, feasibility and prospective-observational, and feasibility and retrospective-interventional studies were each one (14.28%). Six (85.71%) of the studies were conducted in the United States. The National Institutes of Health Stroke Scale (NIHSS) and RP-Xpress were the most commonly used tools for neurological evaluations and teleconsultations.
Conclusion:
Remote prehospital consultations, triage, and sending patient data before they go to the emergency department can be provided through telemedicine in ambulances. Neurological evaluations via telemedicine are reliable and accurate, and they are almost equal to in-person evaluations by a neurologist.
This study aimed to determine the effect of psychological first-aid (PFA) E-learning on the competence and empathy of nurses in disasters.
Methods:
In a randomized controlled trial, 50 nurses were randomly assigned to 2 intervention and control groups, and psychological first-aid training sessions were implemented for the intervention group. The data were collected using the personal information form, a researcher-made questionnaire to measure competence, and the Davis Empathy Questionnaire.
Results:
Two groups were homogeneous in terms of competency (P = 0.691) and empathy (P = 0.363) in the preintervention phase. The intervention group had more competence in the next stage than before the intervention (P < 0.0001). In the post-intervention phase, the intervention group had more competence compared with the control group (P < 0.0001). The overall effect size of PFA E-learning training on the nurses’ competency was 1.9. Regarding empathy, in the post-intervention phase, the subscale of personal distress (P = 0.014) was significantly lower in the intervention group and the perspective-taking subscale was higher than in the control group (P < 0.0001). However, there was no significant difference between the groups in terms of all scores of empathy and the subscale of empathic concern (P > 0.05). The overall effect size of PFA E-learning training on the nurses’ empathy was 0.44.
Conclusions:
It is suggested to provide training, including a PFA E-learning model, for nurses and other therapists in disaster situations.
Assess and improve the educational supervision for the core psychiatry trainees (CT) in the west midlands.
Methods
The data were collected from core psychiatry trainees in West Midland (CT1 – 3) through a Microsoft form sent via the Faculty support team and data are collected (June 2021) from CT's perspective. It involved demographics and questions evaluating quantitative and qualitative overview of educational supervision. We used HEE guidelines and RCPsych recommendations. Similarly, we used a modified questionnaire to anonymise educational supervisors’ (ES) perspectives in the West Midlands School of psychiatry annual Education day conference (January 2022).
Results
Trainees Perspective: 40% out of 123 trainees responded, of which 35% were CT1, 40% were CT2, and 25% were CT3. 59% said that CT in psychiatry was their first training job in the UK. In the quantitative overview, 25% of the trainees responded their 1st contact with their ES was more than six weeks after beginning their 1st post, and 29% expressed their 1st meeting more than six weeks following the start of their 1st post in the academic year. 67% met adequate standards in the quantity of educational supervision in an academic year. In qualitative overview, 19% didn't understand the role of ES, and 54% didn't know how to raise concerns about ES. The thematic analysis of the feedback suggested points of improvement as supervisions not being ‘tick-box’ exercises and accessibility of ES.
The trainer's perspective: 60% of attendees responded, 71.4% were ES. All the responding ES answered that they would arrange their 1st meeting six weeks before the start of the academic year. Almost all suggested the most common difficulty in educational supervision as availability of time, considering clinical workload for both ES and CTs. All respondents knew that the number of meetings would be as many as trainees wanted in an ideal/needful situation. From the thematic analysis of free text, almost all responded lack of time was a barrier in providing the supervision reflecting on their ability to engage with the trainees.
Conclusion
Suggested recommendations were to raise awareness among the trainees through workshops at induction to explain the aim and objective of educational supervision and to have a guided list of suggested topics to discuss in supervision. For trainers, further training about HEE & RCPsych guidance about Educational supervision would be helpful. Educational leads need to engage in job planning. A comparison between Trainees and trainers feedback through the GMC survey may help to compare with the national picture.
Previous studies have advocated that collagen peptide supplementation (CPS) can positively affect cardiovascular health. However, the widespread impact of CPS on CVD-related markers is not fully resolved. Consequently, the current systematic review and meta-analysis aimed to assess the efficacy of CPS on CVD-related markers. A systematic search in the Scopus, PubMed and ISI Web of Science databases were completed to identify relevant randomised, placebo-controlled trials (RCT) published up to November 2021. Mean Differences were pooled using a random-effects model, while publication bias, sensitivity analyses and heterogeneity were assessed using previously validated methods. Twelve RCT, comprising of a total of eleven measured markers, were selected for the quantitative analysis. Pooled data revealed that CPS significantly decreased fat mass (–1·21 kg; 95 % CI: −2·13, −0·29; I2 = 0·0 %; P = 0·010) and increased fat-free mass, based on body mass percentage (1·49 %; 95 % CI: 0·57, 2·42; I2 = 0·0 %; P = 0·002). Moreover, collagen peptide supplementation led to a significant decrease in serum LDL (–4·09 mg/dl; 95 % CI: −8·13, −0·04; I2 = 93·4 %; P = 0·048) and systolic blood pressure (SBP) (–5·04 mmHg; 95 % CI: −9·22, −0·85; I2 = 98·9 %; P = 0·018). Our analysis also indicated that CPS did not affect glycemic markers. Our outcomes indicate that CPS reduces fat mass, LDL and SBP while increasing fat-free mass. Future investigations with longer CPS duration are needed to expand on our results.
The citrus red mite, Panonychus citri McGregor, is a key pest of different citrus species in various parts of the world. Considering the key role of resistant host plants in integrated pest management strategies, we evaluated the effects of five citrus species including grapefruit (Citrus paradisi), lime (Citrus aurantifolia), tangerine (Citrus reticulata), orange (Citrus sinensis), and sour orange (Citrus aurantium) on life table parameters of P. citri under laboratory conditions (25 ± 1°C, 65 ± 5% RH, 16:8 L:D). In addition, biochemical traits of the citrus plant species were evaluated in order to understand any possible relationship between important life history parameters with biochemical metabolites of citrus plant leaves. Phytochemicals were determined in leaf extract of citrus plant species. Various citrus species had significant effects on life history and demographical parameters of P. citri. The longest pre-adult time was observed on grapefruit (16.52 ± 0.43 days). Higher fecundity rate was on orange (15.05 ± 2.41 eggs) and tangerine (14.60 ± 3.07 eggs) and the lowest was on grapefruit (7.21 ± 2.00 eggs). The highest intrinsic rate of increase (r) was recorded as 0.071 (day−1) on tangerine, and the lowest value of this parameter was obtained on grapefruit (0.016 day−1). Significant correlations were observed between life history parameters with biochemical metabolites (carbohydrate, phenolic compounds, anthocyanin, and flavonoid). The results revealed that grapefruit was a relatively resistant host plant and tangerine was the most suitable host plant for feeding of P. citri. Our findings could be helpful for sustainable management of P. citri in citrus orchards.
Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) leading to acute respiratory distress syndrome (ARDS). Understanding the evolution of the virus, and immune-pathogenic processes are critical for designing future therapeutic interventions. In this review, we collate information on the structure, genome, viral life cycle, and adult and pediatric host immune responses in response to SARS-CoV-2. The immunological responses are a prototype of the developmental origins of health and disease (DOHaD) hypothesis to explain the socio-geographic differences impacting the severity and mortality rates in SARS-CoV-2 infections. The DOHaD hypothesis identifies the relevance of trained innate immunity, age groups, and geography for effective vaccinations. As COVID-19 vaccines are being rolled out, it may be pertinent to assess population-based immunological responses to understand the effectiveness and safety across different populations and age groups.
The purpose of this study was to compare statistical knowledge of health science faculty across accredited schools of dentistry, medicine, nursing, pharmacy, and public health.
Methods:
A probability sample of schools was selected, and all faculty at each selected school were invited to participate in an online statistical knowledge assessment that covered fundamental topics including randomization, study design, statistical power, confidence intervals, multiple testing, standard error, regression outcome, and odds ratio.
Results:
A total of 708 faculty from 102 schools participated. The overall response rate was 6.5%. Most (94.2%) faculty reported reading the peer-reviewed health-related literature. Respondents answered 66.2% of questions correctly across all questions and disciplines. Public health had the highest performance (80.7%) and dentistry the lowest (53.3%).
Conclusions:
Knowledge of statistics is essential for critically evaluating evidence and understanding the health literature. These study results identify a gap in knowledge by educators tasked with training the next generation of health science professionals. Recommendations for addressing this gap are provided.
In James Clifford's article “On Ethnographic Allegory,” allegory is defined as “a story in which people, things and happenings have another meaning, as in a fable or a parable: allegories are used for teaching or explaining.” Read as such, the allegorical claims of the magistrate in Waiting for the Barbarians backfire. In the magistrate's writing and teaching, as will be discussed in this chapter, events are “not themselves but stand for other things.” This chapter offers a reading of Waiting for the Barbarians that serves as a remodeling of imperialist masculinity and relations for the sake of redeeming empire. This definition of allegory and my reading of the disabled woman's character in Coetzee's novel are inspired by Ato Quayson's concept of “aesthetic nervousness.” As Quayson advances, “Because disability in the real world already incites interpretation, literary representations of disability are not merely reflecting disability.” Accordingly, I read the disability of the female character in question within Coetzee's narrative as allegorical and conducive to thought-provoking interpretations.
The magistrate's ethnographic project is merely an autoethnography in progress. His goal is the production of the knowledge and meaning that would allow him to relate to the new young men of empire and construct an appropriate model of masculinity to serve empire. The magistrate in the narrative tries to forge a masculine bond through explaining his ideas to the young officer. This endeavor stands in contrast to the magistrate's relations with the old colonel and the barbarian woman, with whom no dialogues are attempted. The colonel and the barbarian woman are representative of old colonial models and relations. Accordingly, the magistrate does some ethnographic work on them. As he studies these two, he explores his reactions. The underlying autoethnography voices a rejection of what the colonel and the woman stand for and what he shares with them. He rejects old age, feminization, and open brutality as inadequate for the purpose of continuing occupation and distant nonviolent coexistence. His autoethnography could also mean self-rejection; however, the magistrate seems to regard his ability to see these aforementioned shortcomings and his ideas about them as a redeeming act.
nowadays drug abuse and addiction is one of the most important health,social and political problems in the world. substance use among university students is a mental health concern. people with depression have high rates of comorbidity with other mental disorders and substance use disorders. the purpose of this study was to determine the prevalence of depression, substance use and the relationship between depression and substance use among student of guilan university of medical sciences(GUMS).
Methods
this was a cross-sectional study carried out on a representative sample of 254 students(n=167girls;n=87boys) of GUMS. The samples were selected randomly by stratified sampling. data was collected using a confidential multiple choice questionnaire detecting the frequency of various substance use. the beck depression inventory(BDI)were used to determine depressive symptoms. Data were analyzed by chi-square and exact fisher test using SPSS ver 16software.
Results
results showed that the prevalence rate of each substance in use was: Opium (1.2%), Morphine (0.4%), cannabis (1.2%), Cocaine (0.4%), codeine (7.5%), Ritalin (2%), tramadol (4.7%) cristal (0.4%), Amphetamines (0.8%),cigarette (8.3%), alcohol(7.1%). according to BDI,(29.9%)of students had depression.there were significant differences between the prevalence of substance use with gender(p=0/0001),parent marital status(p=0/01)and depression(p=0/01).
Conclusion
This study demonstrated that the substance use among students is considerably high and specific interventions seem to be necessary in preventing or reducing the rate of substance use in students. Reading the result of this study,it is suggested that parents and universities authorities have a better over solving students emotional and social problems.
The conclusion reflects on the recent invasion of Mosul by the Islamic State organization and its terrible treatment of Yazidi women. I propose to use my theoretical feminist approach in order to understand such violence. I also reflect on the rise of a strong civil society movement and its repression by the Iraqi regime in the name of the “War on terror”. Finally, I summarize my proposition of a transborder feminist approach going beyond the following opposition: culture/economy, secular/islamist, local/global.
This chapter starts with a reflection of the commonalities between the different activists’ discourses on what an “Iraqi woman” should be. I explore Iraqi women activists’ different feminisms, and their definition of gender norms and relations in an analytical framework linking the personal to the political. First, I propose to reflect on the relationship between gender and conservatisms, issues of piety, morality and respectability, as well as on Muslimness, Islam and feminisms. Then, I present the different trends of feminisms existing in Iraq in relation to women’s rights activists’ discourses on gender equality, norms and relations. Finally, I look at the ways in which Iraqi women activists define respectability and womanhood in relation to their lives and struggles.