Bibliometric analysis of peer-reviewed literature on Syrian refugees and displaced people (2011–2017)

Background

The Syrian conflict has created the worst humanitarian crisis of our time with approximately half of Syria’s pre-war population killed or forced to flee their homes. The current study aimed to analyze peer-reviewed literature published on Syrian refugees and displaced people.

Methods

A bibliometric methodology was implemented using Scopus database after retrieving documents relevant to Syrian refugees and displaced people.

Findings

In total, 323 documents were retrieved. Research articles constituted 71.2% (n?=?230) of the retrieved documents. The bulk (61.6%; n?=?199) of the retrieved documents were in health-related fields. Research domains of the retrieved health-related documents were mainly in the field of mental and psychosocial (17.3%; n?=?56), infectious diseases (15.2%; n?=?49), health policy and systems (16.4%; n?=?53), maternal and reproductive health (15.2%; n?=?49), and non-communicable diseases (NCD) (7.4%; n?=?24). Authors from research institutions in the United States produced the highest number of publications (24.5%; n?=?79), followed by Turkey (21.4%; n?=?69) and Lebanon (10.2%; n?=?33). The American University of Beirut was the most active (5.6%; n?=?18) research institution. Aside from Lebanon and Jordan, there was very little contribution from other Arab states. Conflict and Health was the most active journal (5.3%; n?=?17) in publishing on Syrian refugees and displaced people.

Conclusion

The study highlighted some particular research gaps – most notably the limited research on NCDs. There was also modest international research collaboration and engagement from Arab countries aside from Lebanon and Jordan.

     

Research trends on human trafficking: a bibliometric analysis using Scopus database

Background

Human trafficking is a crime against humanity. It is also a serious threat to global health and security. Globalization has made human trafficking an easier task for the criminal organizations. No data are available on the volume, research trends, and key players in this field. Therefore, the aim of this study was to assess the research activity and research trends on human trafficking.

Methods

A bibliometric method was adopted. Literature published in academic journals indexed in Scopus database was retrieved. The study period was set from 2000 to 2017.

Results

Two thousand forty-four documents were retrieved. The average number of authors per document was 1.9. Over one third (n?=?771; 37.7%) of the retrieved documents were about sex trafficking, 616 (30.1%) were about labor trafficking/forced labor, 199 (9.7%) were about child trafficking, and 138 (6.8%) were about organ trafficking. One third (n?=?707; 34.6%) of the documents were in health-related fields while 1526 (74.7%) were in social sciences and humanities. The USA ranked first (n?=?735; 36.0%) regarding the number of published documents. Geographic distribution of the retrieved document showed that world regions with a high prevalence of human trafficking had the least research contribution. International research collaboration has a limited contribution to the retrieved literature. The Harvard University (USA) was the most active institution (n?=?39; 1.9%). International Migration (n?=?35; 1.7%) was the most active journal in publishing documents on HT. Documents published in Transplantation journal received the highest number of citations per document (25.5) and two of the most cited documents were about organ trafficking.

Conclusion

There was an under-representation of health-related literature on human trafficking. Literature on sex trafficking dominated the field of human trafficking. Research networks and research collaboration between the source and destination countries is important. Future research plans need to focus on health issues and on exploited/trafficked laborers.

     

Health and well-being benefits of spending time in forests: systematic review

Background

Numerous studies have reported that spending time in nature is associated with the improvement of various health outcomes and well-being. This review evaluated the physical and psychological benefits of a specific type of exposure to nature, forest therapy.

Method

A literature search was carried out using MEDLINE, PubMed, ScienceDirect, EMBASE, and ProQuest databases and manual searches from inception up to December 2016. Key words: “Forest” or “Shinrin -Yoku” or “Forest bath” AND “Health” or “Wellbeing”. The methodological quality of each randomized controlled trials (RCTs) was assessed according to the Cochrane risk of bias (ROB) tool.

Results

Six RCTs met the inclusion criteria. Participants’ ages ranged from 20 to 79 years. Sample size ranged from 18 to 99. Populations studied varied from young healthy university students to elderly people with chronic disease. Studies reported the positive impact of forest therapy on hypertension (n?=?2), cardiac and pulmonary function (n?=?1), immune function (n?=?2), inflammation (n?=?3), oxidative stress (n?=?1), stress (n?=?1), stress hormone (n?=?1), anxiety (n?=?1), depression (n?=?2), and emotional response (n?=?3). The quality of all studies included in this review had a high ROB.

Conclusion

Forest therapy may play an important role in health promotion and disease prevention. However, the lack of high-quality studies limits the strength of results, rendering the evidence insufficient to establish clinical practice guidelines for its use. More robust RCTs are warranted.

     

Developing a diabetes prevention education program for community health care workers in Thailand: translation of the knowledge to at-risk people

Aim

To evaluate the effects of a randomized education program for community health care workers (CHCWs) on the knowledge, awareness and understanding of key messages related to healthy eating among community members at risk for diabetes (at-risk-DM) identified through community diabetes screening.

Subjects and methods

Sixty-nine health centers from five districts in Chiang Mai Province, Thailand, were randomized into the intervention (CHCWs-IG, n?=?35) and control group (CHCWs-CG, n?=?34). CHCWs-IG participated in a diabetes prevention education program (DPEP) over 4 months. No training/support materials were provided to the CHCWs-CG. The knowledge of all CHCWs was assessed at baseline and the 4- and 8-month follow-ups. To test knowledge dissemination from CHCWs to at-risk-DM, awareness of key messages and other risk factors was tested between at-risk-DM in the CHCW intervention group (at-risk-DM-IG, n?=?511) compared with controls (at-risk-DM -CG, n?=?405) at baseline and 8 months.

Results

CHCWs-IG knowledge scores improved from baseline [mean (SD), 56.5% (6.26)] after 4-month training [75.5% (6.01), p?<?0.001] and 8-month follow-up [71.3%(7.36), p?<?0.001) while those of CHCW-CG remained unchanged. Body weight, body mass index, waist circumference and systolic blood pressure within at-risk-DM-IG and at-risk-DM-CG at baseline and 8 months were not significantly different. Knowledge test scores of both groups after 8 months had increased from baseline (p?=?0.001) but were not different from each other.

Conclusion

DPEP for CHCWs was effective in improving knowledge. However, it was likely that multiple influences resulted in improvements in community member knowledge. As expected, no difference between groups in physical measures was observed at 8 months. Long-term lifestyle changes towards the health outcome of diabetes prevention are suggested for future study.

     

Cytological evaluation of breast lesions in symptomatic patients presenting to Kenyatta National Hospital,Kenya: a retrospective study

Background

Palpable breast lump, breast pain, and nipple discharge are common symptoms of breast disease. Breast cytology (fine-needle aspiration, nipple discharge smear, and touch preparation) accurately identifies benign, atypical, and malignant pathological changes in breast specimens. This study aims to determine the types of breast lesions diagnosed by breast cytology and assess the clinical adequacy of narrative reporting of breast cytology results.

Methods

Medical records of 390 patients presenting to breast or general surgery clinics in Kenyatta National Hospital, Nairobi, Kenya, between January 2010 and March 2014 were evaluated retrospectively.

Results

Of the 390 diagnosed breast lesions, 89.7 % (n?=?350) occurred in females, while 10.3 % (n?=?40) occurred in males, giving rise to a female-to-male ratio of 8.8:1. Neoplastic breast lesions (n?=?296) comprised 75.9 %, while non-neoplastic breast lesions (n?=?94) comprised 24.1 % of all diagnosed breast lesions. The neoplastic lesions were classified as 72.3 % (n?=?214) benign and 27.7 % (n?=?82) malignant, resulting in a benign-to-malignant ratio of 2.6:1. Fibroadenoma (n?=?136) and gynecomastia (n?=?33) were the most frequently diagnosed breast lesions for women and men, respectively.

Conclusions

Breast cytology effectively diagnosed neoplastic and non-neoplastic breast lesions. Neoplastic breast lesions occurred more frequently in women whereas non-neoplastic lesions occurred more frequently in men. To address the limitations associated with narrative reporting of breast cytology results, a synoptic reporting format incorporating the United Kingdom’s National Health Service Breast Screening Programme’s diagnostic categories (C1 to C5) is recommended for adoption by this hospital.

     

Epworth sleepiness scale in medical residents: quality of sleep and its relationship to quality of life

Background

Resident doctors are continuously exposed to prolonged working hours and night shifts, making them susceptible to the many physical, psychological, and cognitive side effects of sleep deprivation, which may affect their quality of life. Therefore, this study aimed to determine the prevalence of sleep penury in resident doctors and to assess the association between self-apprehended sleepiness and quality of life.

Methods

A cross-sectional study was carried out in the governmental hospitals in the North of the West Bank between May 2017 and September 2017. Doctors enrolled in residency programmes completed questionnaires about general, sociodemographic, and sleep characteristics. The doctors completed the Arabic Version of the Epworth Sleepiness Scale (ArESS) to assess subjective daytime sleepiness and the RAND 36-item short-form health survey (SF-36) to determine quality of life.

Results

A total of 101 participants were enrolled. Daytime sleepiness was observed in 37.6% (n?=?38) of the participants with an ESS score of ≥10. There was a notable negative correlation between the ESS and quality of health index in the physical composition (r?=???0.351, p?<?0.001) demonstrated in the following four subscales: the physical functioning (p?<?0.001), role limitations due to physical health (p?=?0.045), body pain (p?=?0.036), and general health (p?<?0.001) components of the SF-36 scale. Females and residents of the centre region had poorer mental quality (p?=?0.006 and 0.020, respectively).

Conclusions

More than one third of the resident doctors suffer from daytime sleepiness according to the ESS. This was proven to significantly affect several aspects of their quality of life, including physical function and health, body pain, and general health. Sleep deprivation and improvement of quality of life require health promotion actions among medical residents.

     

Within-person fluctuations in wellbeing and task-specific work ability

Purpose

To research within-person fluctuations in occupational health, work ability and wellbeing, we need new measurement strategies. We studied absolute agreement for weekly measurements of task-specific work ability and relationships between wellbeing, work demands and personal factors and task-specific work ability over time.

Methods

Forty-eight Dutch academic researchers answered questions during 12 consecutive weeks. Physical and mental work demands, indicators of wellbeing and task-specific work ability in each week were measured. Intra-class correlation coefficients (ICC) for absolute agreement between task-specific work ability measures were calculated. For application in individual workers, an ICC?>?0.90 was regarded as suitable. Multilevel models were used to relate both time-invariant and time-varying predictors to task-specific work ability.

Results

Multiple measurements increased the reliability. Absolute agreement, however, did not reach the optimal level, except for the task ‘ability to conduct data analyses’ which had an ICC value of 0.95 (95% CI 0.91–0.98). Individuals’ leisure time physical activity (p?=?0.03) and relational (p?=?0.02) and social (p?=?0.02) wellbeing were related to their average task-specific work ability. Weekly physical demands (p?=?0.01) and personal (p?=?0.04) and general wellbeing (p?=?0.03) were related to weekly fluctuations in work ability.

Conclusions

We demonstrated intra-individual variability in repeated assessments of task-specific work ability, pointing to the need for multiple measurements when characterizing work ability. The finding that some time-invariant and time-varying predictors can be related to the estimate of aspects of task-specific work ability and its fluctuations is helpful in understanding the dynamics of this concept.

     

Young people’s awareness of the timing and placement of gambling advertising on traditional and social media platforms: a study of 11–16-year-olds in Australia

Background

Research has demonstrated that the promotion of gambling, particularly within sport, may have a significant impact on positively shaping young people’s attitudes towards gambling. While some governments have implemented restrictions to limit young people’s exposure to gambling advertising, few studies have investigated where young people recall seeing gambling advertising, and whether they perceive that advertising restrictions have gone far enough in reducing exposure to these promotions.

Method

Mixed methods, interviewer-assisted surveys were conducted with n?=?111 young people aged 11–16 years, who were self-reported fans of basketball in Victoria, Australia. Interviews were conducted at basketball stadiums between May and July 2018. The study assessed media viewing patterns; recall and awareness of the timing, placement, and content of gambling advertising; the impact of gambling advertising restrictions; and attitudes towards sporting organisations’ roles in the promotion of gambling.

Results

The majority of young people recalled seeing gambling advertising on television (n?=?101, 91.0%), with most recalling advertising within sporting matches or games (n?=?79, 71.2%). Most young people recalled seeing gambling advertising in the early evening before 8:30 pm (n?=?75, 67.6%). Just over half of young people described seeing gambling advertisements on social media (n?=?61, 55.0%), and over a third (n?=?40, 36.0%) recalled gambling advertising on YouTube, predominantly before watching sporting or gaming videos. The majority stated that they continued to watch sport after 8:30 pm (n?=?93, 83.7%), which is when restrictions on advertising in live sport in Australia end. The majority (n?=?88, 79.3%) stated that there were too many gambling advertisements in sport. Three quarters believed that sporting codes should do more to prevent young people from being exposed to advertising for gambling in sport (n?=?84, 75.7%).

Conclusions

There is now a clear body evidence that current regulatory systems for gambling advertising are ineffective, with further restrictions urgently needed across a range of media channels to prevent exposure to promotions that may encourage young people’s interest and involvement in gambling.

     

Skin cancer risk perception and sun protection behavior at work,at leisure,and on sun holidays: a survey for Danish outdoor and indoor workers

Background

To prevent occupational skin cancer, it is essential that the sun-protective behavior of outdoor workers is adequate. The aim is to study the sun-protective behavior of Danish outdoor workers at work, at leisure, and on sun holiday and compare it to that of indoor workers.

Methods

This is a cross-sectional study, based on a 53-item survey completed by Danish outdoor (n?=?380) and indoor workers (n?=?119) in 2016–2017. Status as outdoor or indoor worker was decided based on self-report and behavioral differences were tested using (paired) t tests and multiple regression adjusted for age, sex, educational level, history of smoking, and skin type.

Results

Danish outdoor workers at work use sun protection less than they do at leisure and on sun holiday (α?<?.05) where their sun protection behavior is similar to that of indoor workers. The proportion of Danish outdoor workers that always/often use sun protection at work is for shade seeking around noon 4.2%, sunscreen 34.5%, wide-brimmed hat 25.3%, and long trousers and shirt with sleeves 42.4%. Of Danish outdoor workers, 49.5% do not think about the risk of occupational skin cancer and 11.8% think the risk is insignificant, 32.4% think that the use of sun protection is of low or no importance, 84.2% consider sunburn important as skin cancer risk factor still 88.9% have a history of sunburn at work, >?80.0% agree that risk of skin cancer is reduced by the use of sun protection, and only 4.0% dismiss the possibility of sun protection use at work.

Conclusions

Skin cancer risk and use of sun protection at work are largely neglected in Danish outdoor workers, more so than at leisure and on sun holiday where their risk behavior resembles that of indoor workers. This indicates an untapped workplace preventive potential.

     

Fluid intake of Latin American adults: results of four 2016 Liq.In<Superscript>7</Superscript> national cross-sectional surveys

Purpose

To report total fluid intake (TFI) and the intake of different fluid types in adults (≥?18 years old) from Mexico, Argentina, Brazil and Uruguay. To compare intakes between countries and with recommended adequate intake (AI) of water from fluids.

Methods

Cross-sectional data were collected using a validated liquid intake 7-day record (Liq.In ⁷ ) in populations from Argentina (n?=?1089), Brazil (n?=?477), Mexico (n?=?1677) and Uruguay (n?=?554). Population characteristics, including age, gender, body mass index and socioeconomic level were recorded. Mean TFI was compared with the AI of water from fluids set by the USA Institute of Medicine.

Results

The lowest TFI was recorded in Mexican women (1748 mL/day) and the highest in Argentinean men (2318 mL/day). Median daily TFI was significantly different between countries; Uruguay and Argentina had higher values than Mexico and Brazil. In the former, plain water contributed to only 25% of TFI, the remainder being predominantly from hot beverages. Approximately, a third of adults did not drink enough fluid to meet the recommended AI. High SSB consumption was reported, which was significantly different between countries (p?<?0.05), the highest being in Mexico (median 25–75th percentiles): 531 (300–895 mL/day.

Conclusions

This survey highlights the need to increase water consumption and reduce SSB intake in this region to avoid potential associated health risks. These findings may be useful information in monitoring public health policy strategies.

     

Infectious disease consultations in a Japanese tertiary care teaching hospital: a retrospective review of 508 cases

Objective

Limited epidemiological data are available at tertiary care teaching hospitals in Japan. We reviewed infectious disease (ID) consultations in a tertiary acute care teaching hospital in Japan.

Methods

This is a retrospective review of the ID consultations from October 2016 to December 2017. The demographic data, such as requesting department, consultation wards, and final diagnosis, were analyzed.

Results

There were 508 ID consultations during the 15-month study period. Among the 508 consultations, 201 cases (39.6%) were requested from the internal medicine department and 307 cases (60.4%) were requested from departments other than internal medicine. The most frequent requesting departments were Surgery (n?=?102, 20.1%), Pulmonary Medicine (n?=?41, 8.1%), and Plastic Surgery (n?=?35, 6.7%). The most common diagnoses were intra-abdominal (n?=?81, 16.0%), respiratory (n?=?62, 12.2%), and skin and soft tissue infections (n?=?59, 11.6%). ID consultations for disease diagnosis and management were more frequent in the internal medicine group than in the non-internal medicine group (37 cases, 20.8% vs. 40 cases, 13.7%, p?=?0.046), and the number of requests for consultations for noninfectious diseases at the time of final diagnosis was higher in the internal medicine group than in the non-internal medicine group (21 cases, 11.8% vs. 16 cases, 5.5%, p?=?0.0153).

Conclusion

Some physicians prefer ID specialists to identify and solve various medical problems. Internists had a greater tendency to request consultations for diagnostic problems, and noninfectious disease specialists have more requests for consultation at the point of final diagnosis. The role of ID specialists is expanding, from individual patient management to antibiotic stewardship, antibiotic prophylaxis, and development of and adherence to antibiotic protocol implementation based on the hospital’s microbial susceptibility and infection control. Although the number of specialists is limited in Japan, ID services now play an important role for achieving a good outcome in patient management.

     

Body mass index and physical activity and the risk of diverticular disease: a systematic review and meta-analysis of prospective studies

Purpose

We conducted a systematic review and meta-analysis of prospective studies of the association between body mass index (BMI) and physical activity and diverticular disease risk.

Methods

PubMed and Embase databases were searched up to February 7, 2017. Summary relative risks and 95% confidence intervals (95% CIs) were calculated using a random effects model and nonlinear associations were modeled using fractional polynomial models.

Results

Six cohort studies of BMI and diverticular disease risk (28,915 cases, 1,636,777 participants) and five cohort studies of physical activity and diverticular disease risk (2080 cases, 147,869 participants) were included. The summary relative risk (RR) of incident diverticular disease for a 5 unit BMI increment was 1.28 (95% CI: 1.18–1.40, I ²?=?77%, n?=?6) for diverticular disease, 1.31 (95% CI: 1.09–1.56, I ²?=?74%, n?=?2) for diverticulitis, and 1.20 (95% CI: 1.04–1.40, I ²?=?56%, n?=?3) for diverticular disease complications. There was no evidence of a nonlinear association between BMI and diverticular disease risk (p _nonlinearity?=?0.22), and risk increased even within the normal weight range. Compared to a BMI of 20, the summary RR for a BMI of 22.5, 25.0, 27.5, 30.0, 32.5, 35.0, 37.5, and 40.0 was 1.15 (1.07–1.23), 1.31 (1.17–1.47), 1.50 (1.31–1.71), 1.71 (1.52–1.94), 1.96 (1.77–2.18), 2.26 (2.00–2.54), 2.60 (2.11–3.21), and 3.01 (2.06–4.39), respectively. The summary RR was 0.76 (95% CI: 0.63–0.93, I ²?=?54%, n?=?5) for high vs. low physical activity and 0.74 (95% CI: 0.57–0.97, I ²?=?39.5%, p _{heterogeneity}?=?0.20, n = 2) for high vs. low vigorous physical activity.

Conclusions

These results suggest that even moderate increases in BMI may increase the risk of diverticular disease as well as diverticular disease complications and that a higher level of physical activity may reduce the risk.

     

Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers

Purpose

The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later.

Methods

We used a dataset of a prospective cohort study (1997–2008) among employees of an engineering plant (n?=?157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0–10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used.

Results

Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p?<?0.01) and lower handgrip strength (OR 0.91 p?<?0.05) predicted future poor WA among office workers.

Conclusions

Our results showed cross-sectional and longitudinal relationships between musculoskeletal health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers’ about their musculoskeletal health seems relevant when monitoring work ability.

     

Effect of socio-demographic factors and obesity on blood pressure among adults based on health status in Gaza,Palestine

Aims

To identify risk factors of elevated blood pressure due to differences in socio-demographic factors, obesity, and health status.

Methods

Cross-sectional study. A total of 482 participants were chosen from Primary Healthcare Centers in Gaza City, Palestine, based on objective criteria.

Results

Systolic and diastolic blood pressure (SBP and DBP) showed significant differences according to different educational, menopausal, obesity, and health statuses, but no significant differences due to sex, marital status, and family size. Correlations of SBP with age, waist circumference, and weight were significant at P?=?0.001 (r _s?=?0.444, r _s?=?0.434, and r _s?=?0.323, respectively). Correlations of DBP with age, waist circumference, and weight were also significant at P?=?0.001 (r _s?=?0.170, r _s?=?0.374, and r _s?=?0.362, respectively). A total of 169 subjects out of 482 have SBP?≥130 mmHg and DBP?≥85 mmHg. By the multivariate logistic regression model, the odds ratio (OR) for obesity equaled 2.768 (95% CI: 1.183 to 6.475, P?=?0.019), OR for having a mother with one or more chronic diseases equaled 1.886 (95% CI: 1.185 to 3.003, P?=?0.007), and OR for a medium-sized family (6–10 members) equaled 0.611 (95% CI: 0.376 to 0.994, P?=?0.013).

Conclusion

Blood pressure increased by elevated body mass index and waist circumference; participants who have a mother with hypertension and/or diabetes are most likely to have higher blood pressure.

     

Supplementation of standard antibiotic therapy with oral probiotics for bacterial vaginosis and aerobic vaginitis: a randomised,double-blind,placebo-controlled trial

Background

This multicentre, randomised, double-blind, placebo-controlled trial was performed to determine whether the use of oral probiotic preparation (prOVag®) containing three Lactobacillus strains together with standard metronidazole treatment and also targeted antibiotic treatment (following the failure of metronidazole therapy) could reduce the recurrence rates of bacterial vaginosis (BV) and aerobic vaginitis (AV).

Methods

Patients at private gynaecological clinics in Poland with histories of recurrent BV/AV and current symptoms were randomly allocated to receive metronidazole and probiotic or placebo, and assessed monthly on visits II and III-V. The total number of study visits was 5–6 (I, II, II bis – if applicable, III, IV, V). One probiotic or placebo capsule was administered with metronidazole/targeted antibiotic twice daily for 10 days; during follow up, patients took one capsule daily for 10 days perimenstrually. Clinical examination and vaginal swabbing were performed at each visit. Primary outcomes were clinical or microbiological BV/AV recurrence and probiotic safety. Secondary outcomes were vaginal pH, Nugent score, and Lactobacillus counts in the vaginal microbiota. Safety analysis was performed in 578 (probiotic, n?=?285; placebo, n?=?293) 18–50-year-old women who were randomised.

Results

BV/AV was confirmed microbiologically in 241 (probiotic, n?=?118; placebo, n?=?123) participants, who continued the trial. Data from 154 (probiotic, n?=?73; placebo, n?=?81) participants who completed the study were analysed to determine the efficacy of prOVag. Additional analyses included 37 (probiotic, n?=?22; placebo, n?=?15) participants who received targeted antibiotics and probiotics or placebo. prOVag lengthened the time to clinical relapse of BV/AV symptoms up to 51 % (p?<?0.05) compared with placebo; AV relapse was delayed by up to 76 % (p?<?0.05). Probiotic use also reduced and maintained low vaginal pH and Nugent score, and increased vaginal Lactobacillus counts following standard treatment.

Conclusion

This study demonstrated that oral probiotics lengthened remission in patients with recurrent BV/AV and improved clinical and microbiological parameters.

Trial registration

NCT01993524; 20 November 2013.

     

Predictors of vitamin D supplementation amongst infants in Ireland throughout the first year of life

Aim

To investigate predictors of compliance with the recommendation that all infants in Ireland are supplemented daily from birth to 12 months of age with 5 μg of vitamin D.

Subjects and methods

A prospective observational study was conducted. Self-complete questionnaires recorded socio-demographic characteristics, health behaviours and supplementation practices for 158 mother-infant dyads at 4, 9 and 12 months post-partum. A 2-day food diary was also obtained on 12-month-old infants to examine the contribution of diet to vitamin D intakes.

Results

At 4, 9 and 12 months of age, 57.6% (n = 91), 34.2% (n = 54) and 23.4% (n = 37) of infants, respectively, were supplemented as recommended. In multivariate analyses, receiving supplementation advice from health professionals in the early post-partum period was the most significant predictor of correctly supplementing 4-month-old [p?<?0.01; odds ratio, OR: 61.94 (95% confidence interval, CI: 11.53–332.83)], 9-month-old [p?<?0.01, OR: 10.30 (95% CI: 2.29–46.27)] and 12-month-old [p?=?0.04, OR: 3.85 (95% CI: 1.05–14.08)] infants. Amongst 12 month olds, mean intakes from diet and supplementation combined (7.6?±?4.7 μg/day) were suboptimal.

Conclusion

Suboptimal vitamin D supplementation practices were evident throughout infancy. Dietary intakes of vitamin D did not compensate for suboptimal supplementation practices. Supplementation practices may improve if health professionals advocate safe supplementation during routine infant health checks.

     

Triglycerides and blood pressure in relation to circulating CD34-positive cell levels among community-dwelling elderly Japanese men: a cross-sectional study

Background

Triglycerides are reported to be positively associated with blood pressure (both systolic and diastolic). However, in a previous study, we reported a significant positive association between triglycerides and circulating CD34-positive cells (endothelial repair) among non-hypertensive, but not hypertensive, participants. Since hypertension and endothelial dysfunction have a bi-directional association (vicious cycle), the status of circulating CD34-positive cells may influence the association between triglycerides and hypertension.

Methods

Since antihypertensive medication use may influence results of the present study, we conducted a cross-sectional study of 327 community dwelling elderly (aged 60–69 years) Japanese participants who were not taking anti-hypertensive medication and who had participated in a general health check-up in 2013–2015.

Results

Participants were classified into two groups based on median values of circulating CD34-positive cells (0.93 cells/μL). For participants with lower circulating CD34-positive cells (n?=?165), a significant positive association was seen between triglycerides and blood pressure, but not for participants with higher circulating CD34-positive cells (n?=?162). The multivariable standardized parameter estimates (β) and p values of systolic blood pressure and diastolic blood pressure were 0.23 (p?=?0.007) and 0.18 (p?=?0.036) for participants with lower circulating CD34-positive cells and 0.08 (p?=?0.409) and 0.03 (p?=?0.786) for those with higher circulating CD34-positive cells.

Conclusion

A significant positive association between triglycerides and blood pressure exists among those with lower, but not higher, circulating CD34-positive cells. The level of circulating CD34-positive cells acts as a determinant factor for the association between triglycerides and blood pressure.

     

Effects of long-term multicomponent exercise on health-related quality of life in older adults with type 2 diabetes: evidence from a cohort study

Purpose

To establish the effect of a long-term multicomponent exercise (LTMEX) intervention (24 months) on health-related quality of life (HRQoL), in older adults with type 2 diabetes (T2D).

Methods

This longitudinal retrospective cohort study analyzes the effects of a supervised LTMEX program on HRQoL in older adults with T2D (n?=?279). Participants underwent one of two conditions: LTMEX (n?=?241) trained three times per week; and unchanged lifestyle—the control group (CO; n?=?38). Participants completed baseline, and 2-year follow-up evaluations including the Short Form Health Survey 36 (SF-36), anthropometric, hemodynamic components, and cardiorespiratory fitness (VO₂ peak).

Results

LTMEX improves HRQoL, specifically physical functioning (P?<?0.001), general health (P?<?0.05), vitality (P?<?0.001), mental health (MH; P?<?0.05), physical component score (P?<?0.001), mental component score (P?<?0.001), and total SF-36 (P?<?0.001). LTMEX group also decreased body weight (BW; P?<?0.005), waist circumference (WC; P?<?0.001), waist-to-hip ratio (WHR; P?<?0.001), and systolic blood pressure (SBP; P?<?0.001), and increased VO₂ peak (P?<?0.001). CO group increased WC (P?=?0.012), BMI (P?=?0.024), waist-to-hip ratio (WHR; P?=?0.003) and SBP (P?<?0.001), and decreased vitality (P?<?0.001) and MH (P?<?0.05).

Conclusions

A LTMEX intervention improves physical and mental HRQoL in older adults with T2D, and also anthropometric, hemodynamic profile, and cardiorespiratory fitness.