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Physical activity (PL) is essential to achieve good health, prevent cardiovascular diseases, obesity and overweight, as well as to achieve a better quality of life. Therefore, PL could become the tool to increase the practice of physical activity among young people, thus increasing life satisfaction (LS) given its positive relationship with physical activity. A single-measure cross-sectional correlational study was carried out, involving 135 children aged 8–12 years from Extremadura. They were administered the SWLS questionnaire and the Canadian assessment of physical literacy (CAPL-2). Significantly higher levels of PL (p = 0.010) were found in normal-weight children compared to overweight and obese children, due to the physical competence domain score (p < 0.001). PL was directly related to SWLS (p < 0.001), but inversely related to BMI (p = 0.018). The daily physical activity behaviour domain was explained by SWLS (p < 0.001) and sex (p < 0.001). Physical competence was described by SWLS (p < 0.001) and BMI (p = 0.045). Finally, the motivation and confidence domain were only significantly associated with SWLS (p < 0.001). It was concluded that boys and girls of normal weight achieved higher levels of PL and LS than those with overweight and obesity, establishing a negative relationship of PL with BMI and positive with LS. [ABSTRACT FROM AUTHOR]

Physical literacy provides a foundation for lifelong engagement in physical activity, resulting in positive health outcomes. Direct pathways between physical literacy and health have not yet been investigated thoroughly. Associations between physical literacy and well‐being in children (n = 1073, mean age 10.86 ± 1.20 years) were analysed using machine learning. Motor competence (TGMD‐3 and BOT‐2) and health‐related fitness (PACER and plank) were assessed in the physical competence domain. Motivation (adapted‐Behavioural Regulation in Exercise Questionnaire) and confidence (modified‐Physical Activity Self‐Efficacy Scale) were assessed in the affective domain. Well‐being was measured using the KIDSCREEN‐27. Accuracy of predicting well‐being from physical literacy was investigated using five machine learning classifiers (decision tree, random forest, XGBoost, AdaBoost, k‐nearest neighbour) in the full sample and across subgroups (sex, socioeconomic status [SES], age). XGBoost predicted well‐being from physical literacy with an accuracy of 87% in the full sample. Predictive accuracy was lowest in low SES participants. Contribution of physical literacy features differed substantially across subgroups. Physical literacy predicts well‐being in children but the relative contribution of physical literacy features to well‐being differs substantially between subgroups. [ABSTRACT FROM AUTHOR]

School-based health promotion interventions (HPIs) are commonly used in schools, but scientific evidence about the structures of effective interventions is lacking. Therefore, we conducted a mixed methods systematic literature review to recognize the HPI structures related to their effectiveness. Based on the inclusion criteria, 49 articles were selected for the literature review. The articles, published in 2011–2022, described 46 different school-based interventions conducted in 20 different countries. The average duration of the interventions was 12 months, and they were implemented mostly with an RCT study design (61.2%) and by targeting children (69.4%). Three main groups of interventions were identified and explained: (1) extensive and long-term interventions; (2) school policy-changing interventions; and (3) highly effective interventions. Effective school-based HPIs included multiple target groups, multiple providers with external experts, and an efficient duration and timing of follow-ups. The implications for educational research and school practice are presented. Evidence on the effectiveness of health-related interventions is still lacking and needs to be addressed in further studies. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to investigate daily physical activity (PA) patterns of 8- to 9-year-old Irish children from socially disadvantaged areas. Methods: Children (N = 408) were asked to wear an ActiGraph accelerometer for a minimum of 4 days. Based on mean daily moderate- to vigorous-intensity PA accumulation, participants were grouped into sex-specific quartiles (Q4, most active; Q1, least active). Principal component analysis was used to identify distinct time blocks for weekdays and weekend days. Results: Overall, 213 participants (8.7 [0.5] y) met accelerometer inclusion criteria. Of these, 56.7% met the 60 minutes of moderate- to vigorous-intensity PA per day guidelines, with males statistically significantly more likely to do so than females (P <.01). Principal component analysis revealed 3 distinct time periods on weekdays and 4 distinct periods on weekends that children were active. The total difference in moderate- to vigorous-intensity PA accumulation between Q4 (most active) and Q1 (least active) was greatest in the after-school time period (male: 49 min and female: 33 min) on weekdays and in the evening time period on weekends (male: 33 min and female: 19 min). Conclusions: After-school and weekend evenings are critical "activity rich" time periods in terms of the gap between our most and least active disadvantaged children. [ABSTRACT FROM AUTHOR]

Aim: This study explored nursing students' eHealth literacy, lifestyle behaviours and COVID‐19‐related preventive behaviours and associated factors. Design: A cross‐sectional comparative correlational study. Methods: Nursing students (n = 358) from a metropolitan area of South Korea were recruited for an online survey. The online questionnaire included: The eHealth Literacy Scale, the Health Promoting Lifestyle Profile‐II and the COVID‐19‐related preventive behaviour scale. Results: COVID‐19‐related preventive behaviours correlated positively with satisfaction with one's major, time spent seeking health information online, eHealth literacy and lifestyle behaviours. Significant factors affecting COVID‐19‐related preventive behaviours were the following: being female (β = 0.194, p <.001), time spent seeking health information online (β = 0.114, p =.002), eHealth literacy (β = 0.167, p =.001) and lifestyle behaviours (β = 0.266, p <.001). Conclusions: Findings highlight the need to strengthen searching behaviours to access accurate health information online and reinforce eHealth literacy and health‐promoting lifestyle behaviours to improve COVID‐19 preventive behaviours among nursing students. [ABSTRACT FROM AUTHOR]

The aim of this study is to investigate the relationship between psychological hardiness, basic psychological need (BPN) satisfaction (Self-Determination theory, Deci & Ryan, 2000), soldiers' engagement, and general self-reported health. We hypothesized that the effect of psychological hardiness on soldiers' engagement and general health is mediated by the satisfaction of basic psychological needs (autonomy, competence, and relatedness). Data from a questionnaire survey was collected among soldiers of the Lithuanian Armed forces (N = 506) using The Hardiness – Resilience Gauge (HRG), Basic Need Satisfaction at Work Scale, Utrecht Work Engagement Scale (UWES – 9) and General Health Questionnaire (GHQ – 12). Structural equation modelling was used to evaluate the hypothesis of a mediating role of BPN satisfaction within the relationship between hardiness and soldier's engagement and general health. The results showed mediating effects of satisfaction of BPN on psychological hardiness and health, and engagement relationship, thus providing support for our hypothesis. Implications of the results are discussed. [ABSTRACT FROM AUTHOR]

Gay and bisexual migrants from low‐ and middle‐income countries living in high‐income countries are disproportionately diagnosed with HIV. Most research focuses on preventing HIV acquisition among HIV‐negative migrant gay and bisexual men (GBM). This study is uniquely positioned to report on migrant GBM's experiences and needs at and after an HIV diagnosis. Semi‐structured interviews were conducted with 24 migrant GBM diagnosed at sexual health clinics in Australia from 2017 onwards. Interviews were analysed using a codebook thematic analysis. Due to the stigma of HIV and homosexuality in their countries of origin, about half of participants had poor HIV knowledge prior to diagnosis. Absorbing diagnosis information was consequently difficult, and feelings of shame, hopelessness, lost sexual opportunities and infectiousness were common. However, many were thankful for the comprehensive clinical support they received and believed that over time life would 'normalise' with sustained undetectable viral load. None reported that their clinician stigmatised them, but the anticipation of stigma nonetheless infused their experiences after diagnosis. Many were selective about HIV disclosure, and some mentioned that clinic systems posed a risk to confidentiality. Non‐permanent residents were concerned about the impacts of HIV status on future visa applications. We recommend that newly HIV‐diagnosed migrant GBM receive referral to legal and culturally appropriate migration services to help absorb what a diagnosis might mean for their health and visa status. We also recommend sexual health clinics continue to assess confidentiality in their systems. Health promotion initiatives should highlight to migrant GBM that high‐HIV caseload sexual health clinicians provide confidential and comprehensive care. [ABSTRACT FROM AUTHOR]

Colonization has left in its wake alarming suicide rates for Indigenous youth. The suicide rate of Indigenous youth in Canada is five to six times higher than their non-Indigenous counterparts. This article presents the findings of a research project that explored and promoted wellness and life promotion with Indigenous youth living on a reserve in Saskatchewan, Canada. Data collection occurred through an arts-based workshop, where youth collectively created stories about healing, life, relationships, hope, and ceremony. Specifically, authors discuss a two-eyed seeing approach and emphasize the importance of cultural continuity, cultural connectedness, and cultural revitalization when considering the process in which leisure programmes and services are organized. [ABSTRACT FROM AUTHOR]

The present study examined the relationship between the increment in cyclic alternating patterns (CAPs) in sleep electroencephalography (EEG) and neurocognitive decline in Obstructive Sleep Apnea Syndrome (OSAS) patients through source localization of the phase-A of CAPs. All-night polysomnographic recordings of 10 OSAS patients and 4 control subjects were acquired, along with their cognitive profile using the Addenbrooke Cognitive Examination (ACE) test. The neuropsychological assessment involved five key domains including attention and orientation, verbal fluency, memory, language and visuo-spatial skills. The standardized low-resolution brain electromagnetic tomography (sLORETA) tool was used to source-localize the phase-A of CAPs in sleep EEG aiming to investigate the correlation between CAP phase-A and cognitive functions. Our findings suggested a significant increase in CAP rates among OSAS subjects versus control subjects. Moreover, sLORETA revealed that CAP phase-A is mostly activated in frontoparietal cortices. As CAP rate increases, the activity of phase-A in such areas is dramatically enhanced leading to arousal instability, lower sleep efficiency and a possibly impaired cortical capacity to consolidate cognitive inputs in frontal and parietal areas during sleep. As such, cognitive domains including verbal fluency, memory and visuo-spatial skills which predominantly relate to frontoparietal areas tend to be affected. Based on our findings, CAP activity may possibly be considered as a predictor of cognitive decline among OSAS patients. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to evaluate the level of maturity of the concept of health in the nursing discipline. Method The four principles of Morse and colleagues were used to evaluate the level of maturity of the health concept-epistemological, logical, pragmatical, and linguistical. Findings This evaluation suggests that the concept of health in nursing is immature, defined inconsistently, and with different instruments. Conclusion Health is a central concept for nursing. Additional concept development and clarification are needed. Practice Implications For the concept of health to be conceptualized, it is important that nurses have consensus regarding the definition of health. The nursing discipline should define health in a manner that is consistent with its philosophical presuppositions. Further, it should be measurable, empirically based, and capture the outcomes that are sensitive to the nursing interventions. [ABSTRACT FROM AUTHOR]

Aims To provide the first known concept analysis of psychosocial adaptation, exploring its evolution from the concept adaptation. We also determine how psychosocial adaptation is conceptualized across nursing, health, sociobehavioural and education disciplines. Background Psychosocial adaptation is an important conceptual term that is poorly defined in nursing and other health, sociobehavioural and education disciplines. A thorough understanding of the concept's application in nursing and across disciplines can help to clarify its meaning, facilitate a more effective common language between disciplines and inform future psychosocial adaptation research. Design Rodger's evolutionary view guided this concept analysis. Data sources Peer-reviewed English and Spanish manuscripts published between 2011-2013 were retrieved from the following databases: CINAHL, Psych INFO, PubMed, Scopus and LILACS. Review methods Eighty-nine articles related to psychosocial adaptation were included in the analysis. Findings identify key attributes, antecedents and consequences associated with the use of the concept. Findings were compared vis-a-vis reported characteristics of adaptation. Results The attributes characterizing psychosocial adaptation are: change, process, continuity, interaction and influence. In psychosocial adaptation, new life conditions serve as antecedents, while consequences are good or bad outcomes. Important features of the evolution of this concept include its broad appropriation across the reviewed disciplines. The attributes of psychosocial adaptation, have some similarities to those of general adaptation. Both concepts include an aspect of change, but unlike adaptation, psychosocial adaptation has branched away from biological descriptors, such as homeostasis and tends to focus on relational characteristics, such as interaction and influences. [ABSTRACT FROM AUTHOR]

Background: Schools play an important role in promoting the health of children. However, little consideration is often given to the influence that headteachers' and school staff's prior beliefs have on the implementation of public health interventions. This study examined primary school headteachers' and school health co-ordinators' views regarding child health in order to provide greater insights on the school's perspective for those designing future school-based health interventions. Methods: A qualitative study was conducted using 19 semi-structured interviews with headteachers, deputy headteachers and school health co-ordinators in the primary school setting. All transcripts were analysed using thematic analysis. Results: Whilst many participants in this study believed good health was vital for learning, wide variance was evident regarding the perceived health of school pupils and the magnitude of responsibility schools should take in addressing child health behaviours. Although staff in this study acknowledged the importance of their role, many believed the responsibility placed upon schools for health promotion was becoming too much; suggesting health interventions need to better integrate school, parental and societal components. With mental health highlighted as an increasing priority in many schools, incorporating wellbeing outcomes into future school based health interventions is advocated to ensure a more holistic understanding of child health is gained. Conclusion: Understanding the health beliefs of school staff when designing interventions is crucial as there appears to be a greater likelihood of interventions being successfully adopted if staff perceive a health issue as important among their pupils. An increased dependability on schools for addressing health was expressed by headteachers in this study, highlighting a need for better understanding of parental, child and key stakeholder perspectives on responsibility for child health. Without this understanding, there is potential for certain child health issues to be ignored. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this study is to explore the relationship between nutritional status and associated risk factors such as:, socio-economic, physical, pathological and psychological factors, among elderly residing in Lebanese nursing homes. Design/methodology/approach – This cross-sectional study was carried out in 36 elderly care nursing homes with 2,094 residents. Of these, only 221 (11 per cent) elderly met the inclusion criteria and successfully completed the interview question. Data on socio-demographic characteristics and health conditions: oral, nutritional, depression, chronic diseases and activities of daily living, were collected. The analysis used a chi-square test and a binary logistic regression. Findings – High levels of malnourishment were found among elderly who had no jobs (p = 0.012) and had oral health problems (p = 0.038), functional impairment (p < 0.001) and depression (p = 0.021). Comorbid illnesses, however, had no significant association with nutritional status. In addition, the first and strongest predictor entered in the regression on malnutrition was functional impairment (p = 0.002) followed by oral health problems (p = 0.030) and depression (p = 0.036). Originality/value – The study is original in the sense that it emphasized the importance of three factors, autonomy, better oral and psychological health, in mediating nutritional outcomes for elderly residing in nursing homes. [ABSTRACT FROM AUTHOR]

Ragweed Ambrosia artemisiifolia L. is rapidly spreading in Europe. Its pollen is highly allergenic, with 4-5% of Europeans being sensitized. There is an urgent need to curtail the further spread to minimize allergy costs., We simulated the spread of ragweed in Austria and southern Germany ( Bavaria) until 2050 with particular emphasis on expected climate change. Using different management scenarios and levels of management effort, we analysed the potential for reducing human allergy costs, that is, expenses caused by allergies from ragweed pollen, by curtailing the accelerating spread of ragweed. We accounted for three contrasting climate assumptions: no change in temperature and moderate (annual temperature increase of 0·025 °C) and more extreme (annual temperature increase of 0·04 °C) climate change., We found that a carefully designed management plan consisting of survey and eradication can drastically reduce the spread of ragweed. Without management, mean allergy costs for the management period (2011-2050) amount to about 290, 335 and 365 million € annually under the three climate change assumptions., Following an optimally allocated management strategy with an annual budget of 30 million € reduces mean allergy costs by 258, 295 and 325 million € per year. Thus, the management may yield substantial savings, in particular under more extreme warming, where total savings over 40 years amount to about 12 billion €., Synthesis and applications. Our study illustrates that management of invasive alien species has an economic benefit beside natural conservation. We provide guidance for the future management using the example of ragweed in Austria and Bavaria and show that although the species has expanded its range and abundance substantially in recent years, a well-designed and ambitious management programme still may yield substantial benefits. This is true for current climatic conditions as well as for future climate change scenarios, albeit management costs increase with a warming climate. However, possible gains are increasing in parallel. Given the scale of impacts on human health, and the substantial gains accrued from management, our results suggest that it is wise to halt further spread of ragweed. [ABSTRACT FROM AUTHOR]

African Americans are overrepresented among heterosexual cases of HIV/AIDS in the USA. Inconsistent condom use and concurrent partnering are two sexual behaviors driving the heterosexual HIV epidemic in the African American community. To inform the development of an HIV prevention behavioral intervention to decrease concurrent partnering and increase condom use among African American heterosexual men, we conducted formative research, including 61 structured interviews, 5 focus groups with 25 men, and 30 in-depth qualitative interviews between July and December 2009. We used a grounded theoretical approach and categorizing strategies to code and analyze the qualitative data. Results around condom use confirmed earlier findings among heterosexual men in general: condoms diminish pleasure, interfere with erection, and symbolize infidelity. Although valued by some as a form of disease prevention and pregnancy prevention, condoms are often used only with specific types of female partners, such as new or casual partners, or due to visual risk assessment. Sex partner concurrency was described as normative and ascribed to men's 'natural' desire to engage in a variety of sexual activities or their high sex drive, with little recognition of the role it plays in the heterosexual HIV epidemic. Fatherhood emerged among many men as a crucial life event and compelling motivation for reducing sexual risk behavior. Based on these results, we conclude that existing HIV prevention efforts to improve attitudes towards and motivate use of condoms either have not reached or have not been successful with African American heterosexual men. In designing behavioral interventions to decrease concurrent partnering and increase condom use, addressing negative attitudes towards condoms and partner risk assessment is critical, as is integrating novel motivational approaches related to identity as fathers and men in the African American community. [ABSTRACT FROM AUTHOR]

'Risk' has become one of the defining cultural characteristics of Western society at the end of the twentieth century. As in other areas of life, 'risk' has become central to discourses related to individual health; that is, risk has become a common construct around which health in Western society is described, organised, and practised, both personally and professionally. The purpose of this paper is to explore the notion of a 'phenomenology of risk' by considering the results of a preliminary study undertaken to explore the themes which emerge in women's accounts of their own individual risks for breast cancer. A second purpose is to move towards situating the phenomenology of risk within the social and political context within which individual experience occurs. To that end, this study was framed theoretically within the emerging social science literature which examines the broader social and political meanings and implications of health risk discourses. This paper demonstrates that by embodying prevailing discourses on health risks in general, and on breast cancer risk in particular, the women in this study have embodied a political rationality, which, among other things, reconstitutes them as autonomous, responsible 'entrepreneurial subjects'. The phenomenological and political implications of the findings of this study are considered. [ABSTRACT FROM AUTHOR]

The article presents a reprint of the article "A three-dimensional tattoo: molluscum contagiosum," by Vincenzo De Giorgi, Marta Grazzini, and Torello Lotti, which appeared in the website www.cmaj.ca. The article presents a study which investigates the condition of a 30-year old man who was diagnosed with molluscum contagiosum induced by poxvirus infection. Hence, he was treated with multiple sessions of curettage and was advised to prevent skin-to-skin contact and sharing of towels with others.

Simpler, shorter, safer and more effective treatments for tuberculosis that are easily accessible to all people with tuberculosis are desperately needed. In 2016, the World Health Organization (WHO) developed target regimen profiles for the treatment of tuberculosis to make drug developers aware of both the important features of treatment regimens, and patient and programmatic needs at the country level. In view of recent ground-breaking advances in tuberculosis treatment, WHO has revised and updated these regimen profiles. We used a similar process as for the 2016 profiles, including a baseline treatment landscape analysis, an initial stakeholder survey, modelling studies estimating the impact and cost-effectiveness of novel tuberculosis treatment regimens, and an extensive stakeholder consultation. We developed target regimen profiles for the treatment of rifampicin-susceptible and rifampicin-resistant tuberculosis, as well as a pantuberculosis regimen that would be appropriate for patients with any type of tuberculosis. We describe the revised target regimen profile characteristics, with specific minimal and optimal targets to be met, rationale and justification, and aspects relevant to all target regimen profiles (drug susceptibility testing, adherence and forgiveness, treatment strategies, post-tuberculosis lung disease, and cost and access considerations). We discuss the trade-offs of proposed characteristics for decision-making at developmental or operational levels. We expect that, following these target regimen profile revisions, tuberculosis treatment developers will produce regimens that are quality-assured, affordable and widely available, and that meet the needs of affected populations. Des traitements de la tuberculose plus simples, plus courts, plus surs et plus efficaces, facilement accessibles a toutes les personnes atteintes de tuberculose, font cruellement defaut. En 2016, l'Organisation mondiale de la sante (OMS) a elabore des profils de schema therapeutique cible pour le traitement de la tuberculose, afin de sensibiliser les concepteurs de medicaments aux caracteristiques importantes des schemas therapeutiques et aux besoins des patients et des programmes au niveau national. Compte tenu des avancees recentes dans le traitement de la tuberculose, l'OMS a revise et mis a jour ces profils de schema therapeutique. Nous avons applique un processus similaire a celui des profils de 2016, y compris une analyse de base des differentes possibilites therapeutiques, une enquete initiale aupres des parties prenantes, des etudes de modelisation estimant l'impact et le rapport cout-efficacite des nouveaux schemas therapeutiques pour la tuberculose, ainsi qu'une vaste consultation des parties prenantes. Nous avons elabore des profils de schema therapeutique cible pour le traitement de la tuberculose sensible a la rifampicine ou resistant a la rifampicine, ainsi qu'un schema multiforme qui conviendrait aux patients atteints de n'importe quel type de tuberculose. Nous decrivons les caracteristiques du profil revise de schema therapeutique cible, avec les objectifs minimaux et optimaux specifiques a atteindre, le raisonnement et les aspects pertinents pour tous les profils de schema therapeutique cible (tests de sensibilite aux medicaments, observance therapeutique et manque d'observance (<>), strategies de traitement, maladie pulmonaire post-tuberculeuse et considerations de cout et d'acces). Nous discutons des compromis des caracteristiques proposees pour la prise de decisions au niveau du developpement ou au niveau operationnel. Nous esperons qu'a la suite de ces revisions du profil de schema therapeutique cible, les concepteurs de traitements antituberculeux produiront des schemas dont la qualite est assuree, qui sont abordables et largement disponibles et qui repondent aux besoins des populations touchees. Se necesitan con urgencia tratamientos mas sencillos, breves, seguros y eficaces contra la tuberculosis que sean facilmente accesibles para todas las personas con tuberculosis. En 2016, la Organizacion Mundial de la Salud (OMS) elaboro perfiles objetivo de esquemas terapeuticos para el tratamiento de la tuberculosis con el fin de que los fabricantes de medicamentos conocieran tanto las caracteristicas importantes de estos esquemas como las necesidades programaticas y de los pacientes en cada pais. Teniendo en cuenta los recientes avances pioneros en el tratamiento de la tuberculosis, la OMS ha revisado y actualizado estos perfiles de esquemas terapeuticos. Se ha seguido un proceso similar al de los perfiles de 2016, que incluye un analisis de referencia del panorama terapeutico, una encuesta inicial a las partes interesadas, estudios de modelizacion para estimar el impacto y la rentabilidad de los nuevos esquemas terapeuticos para el tratamiento de la tuberculosis, y una amplia consulta a las partes interesadas. Se desarrollaron perfiles objetivo de esquemas terapeuticos para el tratamiento de la tuberculosis sensibles a la rifampicina y resistente a la rifampicina, asi como un esquema farmacologico capaz de tratar todas las formas de tuberculosis que seria apropiado para pacientes con cualquier tipo de tuberculosis. Se describieron las caracteristicas revisadas de los perfiles objetivo de los esquemas terapeuticos, con los objetivos minimos y optimos especificos que deben alcanzarse, los fundamentos y la justificacion, y los aspectos relevantes para todos los perfiles objetivo de los esquemas terapeuticos (pruebas de sensibilidad a los farmacos, adherencia y olvido, estrategias de tratamiento, enfermedad pulmonar postuberculosa, y consideraciones de coste y acceso). Se discutieron las ventajas y desventajas de las caracteristicas propuestas para la toma de decisiones a nivel de desarrollo u operativo. Se espera que, tras estas revisiones de los perfiles objetivo de los esquemas terapeuticos, las personas encargadas del desarrollo de tratamientos para la tuberculosis elaboren esquemas terapeuticos de calidad garantizada, asequibles y ampliamente disponibles, y que respondan a las necesidades de las poblaciones afectadas., Introduction Significant progress has been achieved over the last two decades in the development of tuberculosis treatment, with the discovery of new chemical entities and trials testing new combinations of [...]

As part of the mission to cure and ultimately eliminate tuberculosis (TB), maintaining treatment adherence poses a substantial barrier (1). Persons with TB must complete multidrug regimens typically lasting [greater [...]

The World Health Organization has developed target product profiles containing minimum and optimum targets for key characteristics for tests for tuberculosis treatment monitoring and optimization. Tuberculosis treatment optimization refers to initiating or switching to an effective tuberculosis treatment regimen that results in a high likelihood of a good treatment outcome. The target product profiles also cover tests of cure conducted at the end of treatment. The development of the target product profiles was informed by a stakeholder survey, a cost-effectiveness analysis and a patient-care pathway analysis. Additional feedback from stakeholders was obtained by means of a Delphi-like process, a technical consultation and a call for public comment on a draft document. A scientific development group agreed on the final targets in a consensus meeting. For characteristics rated of highest importance, the document lists: (i) high diagnostic accuracy (sensitivity and specificity); (ii) time to result of optimally [less than or equal to] 2 hours and no more than 1 day; (iii) required sample type to be minimally invasive, easily obtainable, such as urine, breath, or capillary blood, or a respiratory sample that goes beyond sputum; (iv) ideally the test could be placed at a peripheral-level health facility without a laboratory; and (v) the test should be affordable to low- and middle-income countries, and allow wide and equitable access and scale-up. Use of these target product profiles should facilitate the development of new tuberculosis treatment monitoring and optimization tests that are accurate and accessible for all people being treated for tuberculosis. L'Organisation mondiale de la sante a elabore des profils de produits cibles contenant des cibles minimales et optimales pour les caracteristiques principales des essais destines au suivi et a l'optimisation du traitement de la tuberculose. L'optimisation du traitement de la tuberculose fait reference a l'instauration d'un regime de traitement efficace de la tuberculose ou a l'adoption d'un tel regime, avec une probabilite elevee d'obtenir de bons resultats therapeutiques. Les profils de produits cibles couvrent egalement les essais de guerison effectues a l'issue du traitement. Les profils de produits cibles ont ete elabores sur la base d'un sondage aupres des parties prenantes, d'une analyse cout-efficacite et d'une analyse du parcours de soins du patient. Des retours supplementaires des parties prenantes ont ete obtenus au moyen d'un processus cree selon la methode Delphi, d'une consultation technique et d'un appel a commentaires publics sur un projet de document. Un groupe d'elaboration scientifique s'est mis d'accord sur les objectifs finaux lors d'une reunion de concertation. En ce qui concerne les caracteristiques jugees les plus importantes, le document enumere ce qui suit: (i) une grande precision diagnostique (sensibilite et specificite); (ii) un delai ideal d'obtention des resultats [less than or equal to] 2 heures et au maximum de 1 jour; (iii) le type d'echantillon requis doit etre peu invasif et facile a obtenir, comme l'urine, l'haleine ou le sang capillaire, ou bien un echantillon respiratoire au-dela des expectorations; (iv) idealement, l'essai pourrait avoir lieu dans un etablissement de sante peripherique sans laboratoire ; et (v) l'essai devrait etre abordable pour les pays a revenu faible et intermediaire et permettre un acces large et equitable ainsi qu'une mise a l'echelle. L'utilisation de ces profils de produits cibles devrait faciliter la mise au point de nouveaux essais de surveillance et d'optimisation du traitement de la tuberculose qui soient precis et accessibles a toutes les personnes suivant un traitement pour la tuberculose. La Organizacion Mundial de la Salud ha elaborado perfiles de productos objetivo que contienen objetivos minimos y optimos para las caracteristicas principales de las pruebas de seguimiento y optimizacion del tratamiento de la tuberculosis. La optimizacion del tratamiento de la tuberculosis consiste en iniciar o cambiar a un regimen eficaz de tratamiento de la tuberculosis que ofrezca una alta probabilidad de un buen resultado terapeutico. Los perfiles de productos objetivo tambien abarcan las pruebas de curacion realizadas al final del tratamiento. La elaboracion de los perfiles de los productos objetivo se baso en una encuesta a las partes interesadas, un analisis de rentabilidad y un analisis de la via de atencion al paciente. Se obtuvo informacion adicional de las partes interesadas mediante un proceso tipo Delphi, una consulta tecnica y una convocatoria de comentarios publicos sobre un borrador del documento. Un grupo de desarrollo cientifico acordo los objetivos finales en una reunion de consenso. Para las caracteristicas clasificadas de mayor importancia, el documento enumera: (i) alta precision diagnostica (sensibilidad y especificidad); (ii) tiempo hasta el resultado de optimamente [less than or equal to] 2 horas y no mas de 1 dia; (iii) el tipo de muestra requerida debe ser minimamente invasiva, facil de obtener, como orina, aliento o sangre capilar, o una muestra respiratoria que vaya mas alla del esputo; (iv) idealmente la prueba podria realizarse en un centro sanitario periferico sin laboratorio; y (v) la prueba debe ser asequible para los paises de ingresos bajos y medios y permitir un acceso amplio y equitativo y su expansion. El uso de estos perfiles de producto objetivo deberia facilitar el desarrollo de pruebas nuevas de seguimiento y optimizacion del tratamiento de la tuberculosis que sean precisas y accesibles para todas las personas que reciben tratamiento antituberculoso. [phrase omitted], Introduction Tuberculosis continues to be a major cause of morbidity and mortality globally, despite being curable and preventable. In 2021, an estimated 10.6 million people had tuberculosis disease and 1.6 [...]

Background Pompe disease (PD) is a lysosomal glycogen storage disorder caused by a deficiency in acid [alpha]-glucosidase (GAA) activity. Various organs, including the skeletal muscle, cardiac muscle, and liver, are commonly involved. Early initiation of enzyme replacement therapy (ERT) with recombinant human [alpha]-glucosidase (rhGAA) can improve the outcome. However, some patients experience a poor clinical course despite ERT because of the emergence of anti-rhGAA antibodies that neutralize rhGAA. Treatment against anti-rhGAA antibodies is challenging. Case-diagnosis/treatment A 14-year-old boy with late-onset PD was referred to our hospital with proteinuria detected by school urinalysis screening. He was diagnosed with PD at the age of 4 years based on muscle biopsy and decreased GAA activity. Treatment with rhGAA was initiated, but anaphylaxis occurred frequently. Anti-rhGAA antibodies were detected and immune tolerance therapy was therefore given, but his antibody titer remained high. Kidney biopsy revealed stage II membranous nephropathy. Immunohistochemistry staining revealed anti-rhGAA antibody/rhGAA immune complexes along the glomerular capillary loop. Aggressive immunotherapy combined with bortezomib and rituximab was then initiated. Serum levels of anti-rhGAA antibodies decreased significantly and his proteinuria finally resolved. Conclusions There have been few reports of membranous nephropathy associated with ERT for PD. We clarified the cause in the current patient. Bortezomib and rituximab effectively suppressed anti-rhGAA antibody production resulting in the resolution of proteinuria and maintenance of ERT efficacy., Author(s): Keigo Sasaki [sup.1] , Toru Uchimura [sup.1] , Aya Inaba [sup.1] , Masako Otani [sup.2] , Junko Hanakawa [sup.3] , Shuichi Ito [sup.1] Author Affiliations: (1) grid.413045.7, 0000 0004 [...]

The experience of trauma is common for US adults and even more pervasive for patients presenting in psychiatric settings. Estimates of previous experience of traumatic events is 51% to 84% [...]

Tuberculosis (TB) is the leading cause of death from a single infectious agent, requiring at least 6 months of multidrug treatment to achieve cure.sup.1. However, the lack of reliable data on antimicrobial pharmacokinetics (PK) at infection sites hinders efforts to optimize antimicrobial dosing and shorten TB treatments.sup.2. In this study, we applied a new tool to perform unbiased, noninvasive and multicompartment measurements of antimicrobial concentration-time profiles in humans.sup.3. Newly identified patients with rifampin-susceptible pulmonary TB were enrolled in a first-in-human study.sup.4 using dynamic [.sup.11C]rifampin (administered as a microdose) positron emission tomography (PET) and computed tomography (CT). [.sup.11C]rifampin PET-CT was safe and demonstrated spatially compartmentalized rifampin exposures in pathologically distinct TB lesions within the same patients, with low cavity wall rifampin exposures. Repeat PET-CT measurements demonstrated independent temporal evolution of rifampin exposure trajectories in different lesions within the same patients. Similar findings were recapitulated by PET-CT in experimentally infected rabbits with cavitary TB and confirmed using postmortem mass spectrometry. Integrated modeling of the PET-captured concentration-time profiles in hollow-fiber bacterial kill curve experiments provided estimates on the rifampin dosing required to achieve cure in 4 months. These data, capturing the spatial and temporal heterogeneity of intralesional drug PK, have major implications for antimicrobial drug development. Distinct patterns of exposure to a first-line tuberculosis drug in separate lung lesions within patients are revealed by PET-CT imaging. Use of the technique might help optimize the duration and dosing of antimicrobial drugs., Author(s): Alvaro A. Ordonez [sup.1] [sup.2] [sup.3] , Hechuan Wang [sup.4] , Gesham Magombedze [sup.5] , Camilo A. Ruiz-Bedoya [sup.1] [sup.2] [sup.3] , Shashikant Srivastava [sup.5] , Allen Chen [sup.1] [...]

The use of alternative interventions, such as gluten-free and casein-free (GFCF) diets, is frequent due to limited therapies for Autism Spectrum Disorder (ASD). Our aims were to determine the influence of a GFCF diet on behavior disorders in children and adolescents diagnosed with ASD and the potential association with urinary beta-casomorphin concentrations. Thirty-seven patients were recruited for this crossover trial. Each patient consumed a normal diet (including gluten and casein) for 6 months and a GFCF diet for another 6 months. The order of the intervention (beginning with normal diet or with GFCF diet) was assigned randomly. Patients were evaluated at three time-points (at the beginning of the study, after normal diet and after GFCF diet). Questionnaires regarding behavior and autism and dietary adherence were completed and urinary beta-casomorphin concentrations were determined at each time-point. No significant behavioral changes and no association with urinary beta-casomorphin concentrations were found after GFCF diet. A 6-month GFCF diet do not induce significant changes in behavioral symptoms of autism and urinary beta-casomorphin concentrations. Further studies with a long follow-up period similar to ours and including placebo and blinding elements are needed to identify better those respondents to GFCF diets., Author(s): Pablo José González-Domenech [sup.1] [sup.2] , Francisco Díaz Atienza [sup.1] , Carlos García Pablos [sup.1] , María Luisa Fernández Soto [sup.3] , José María Martínez-Ortega [sup.2] , Luis Gutiérrez-Rojas [...]

Introduction: Identification of persons living with human immunodeficiency virus (HIV)-associated tuberculosis (TB) at increased risk for unfavourable TB outcomes would inform efforts to improve such outcomes. We sought to identify factors associated with a decreased risk of unfavourable TB treatment outcomes among people living with HIV-infection (PLHIV) in low- and middle-income countries (LMIC), with a specific focus on directly observed therapy (DOT) compared with self-administered therapy (SAT) during the continuation phase of anti-TB therapy. Methods: We conducted a retrospective cohort study among adults diagnosed with HIV-associated TB in Africa, Asia and the Americas from 2012 to 2013; data were collected from 2012 to 2016. Unfavourable TB treatment outcomes (death during TB treatment, and TB treatment failure or recurrence) were defined according to World Health Organization criteria. Receipt of DOT was obtained at the site level and defined as [greater than or equal to]5 days of DOT per week. The person administering DOT and treatment location varied by site. Lack of receipt of DOT was defined as SAT. Multivariable logistic regression estimated the adjusted odds of unfavourable TB treatment outcomes. Results: Among 1862 adults with HIV-associated TB included, 252 (13.5%) had unfavourable TB outcomes (226 deaths, 26 recurrences/failures). Overall, 1825 (98%) received DOT in the intensive phase and 1617 (87%) received DOT in the continuation phase. DOT in the continuation phase was not significantly associated with unfavourable TB outcomes (aOR 1.43, 95% CI 0.86 to 2.38) compared to SAT. Body mass index (BMI) change during anti-TB treatment (per 2 units increase, aOR 0.74, 95% CI 0.68 to 0.82) and CD[4.sup.+] count at TB diagnosis (200 vs. 50 cells/[micro]L, aOR 0.54, 95% CI 0.39 to 0.73) were both independently associated with decreased odds of unfavourable TB treatment outcomes. Conclusions: In this large, international cohort of people living with HIV-associated TB in LMIC who received intensive phase DOT, DOT during the continuation phase of anti-TB therapy was not associated with a decreased odds of unfavourable TB treatment outcomes compared to SAT. Randomized trials evaluating the effect of continuation-phase DOT on TB outcomes among PLHIV are needed. Keywords: tuberculosis; directly observed therapy; body mass index; human immunodeficiency virus infection; antiretroviral therapy, 1 | INTRODUCTION Tuberculosis (TB) remains a serious public health problem, particularly among people living with human immunodeficiency virus (PLHIV). TB is the leading cause of death among PLHIV worldwide, [...]

The cellular immune response to Mycobacterium tuberculosis infection has been well characterized, while the humoral antibody response remains underexplored. We aimed to examine the total and anti-phospholipid IgM levels in the pleural lavage from mice with Mycobacterium bovis BCG extrapulmonary infection. We found that the levels of total and anti-phosphatidylcholine IgM antibodies remained significantly higher in infected mice as compared to non-infected mice up to day 90 after BCG infection, while the anti-cardiolipin IgM antibody levels decreased with bacteria clearance. Our findings suggest that IgM antibodies are secreted and their composition vary during early and late immune response to BCG pleurisy., Author(s): Ciara Ordoñez [sup.1] [sup.2] , Musharaf Tarajia [sup.1] [sup.2] , René Rivera [sup.3] , Dilcia Sambrano [sup.1] , Victoria Batista [sup.1] , Mónica Chávez [sup.4] , Denis Tapia [sup.4] [...]

The Mycobacterium tuberculosis complex is composed of several genetically related and pathogenic mycobacterial species, including M. tuberculosis and M. bovis (1). Tuberculosis (TB) caused by these species is often clinically [...]

Byline: Nayankumar. Patel, Jignaben. Padhiyar, Tejas. Patel, Nishi. Trivedi, Vidhi. Chandibhamar, Ranjan. Raval Sir, Linear IgA bullous dermatosis (LABD) is a rare autoimmune bullous disease also known as linear IgA [...]

Author(s): Andrew Vernon 1,*, Katherine Fielding 2,3, Rada Savic 4, Lori Dodd 5, Payam Nahid 6 Summary Points Adherence to prescribed treatment remains a critical component of clinical trials in [...]

Background Selective estrogen receptor modulators, such as tamoxifen, reduce breast cancer risk by up to 50% in women at increased risk for breast cancer. Despite tamoxifen's well-established efficacy, many studies show that most women are not taking up tamoxifen. This systematic literature review aimed to identify the motivators and barriers to tamoxifen use 's amongst high-risk women. Methods Using MEDLINE, PsycINFO, and Embase plus reviewing reference lists of relevant articles published between 1995 and 2016, 31 studies (published in 35 articles) were identified, which addressed high-risk women's decisions about risk-reducing medication to prevent breast cancer and were peer-reviewed primary clinical studies. Results A range of factors were identified as motivators of, and barriers to, tamoxifen uptake including: perceived risk, breast-cancer-related anxiety, health professional recommendation, perceived drug effectiveness, concerns about side-effects, knowledge and access to information about side-effects, beliefs about the role of risk-reducing medication, provision of a biomarker, preference for other forms of breast cancer risk reduction, previous treatment experience, concerns about randomization in clinical trial protocols and finally altruism. Conclusions Results indicate that the decision for high-risk women regarding tamoxifen use or non-use as a risk-reducing medication is not straightforward. Support of women making this decision is essential and needs to encompass the full range of factors, both informational and psychological. Keywords: Tamoxifen, Prevention, Risk-reducing medication, Breast cancer, High risk, Author(s): B. Meiser[sup.1] , W. K. T. Wong[sup.1,2] , M. Peate[sup.1,3] , C. Julian-Reynier[sup.4] , J. Kirk[sup.5,6] and G. Mitchell[sup.7,8] Background The use of selective estrogen receptor modulators (SERMs) as [...]

In its 1999 report entitled To Err Is Human, the Institute of Medicine estimated that between 44 000 and 98 000 patients die annually from avoidable medical errors. As a [...]

This study evaluates the changes in cytochrome P450 (CYP) enzyme activity in orthotopic liver transplant (OLTx) patients in relation to recipient age and postoperative time. Thirty-eight stable OLTx patients, separated [...]

Pulse oximetry is a noninvasive technology used to estimate oxyhemoglobin saturation. As many as 87% of nurses report that they regularly use this technology to assess the status of patients; [...]