Disposable Platform Provides Visual and Color-Based Point-of-Care Anemia Self-Testing

Anemia, or low blood hemoglobin (Hgb) levels, afflicts 2 billion people worldwide. Currently, Hgb levels are typically measured from blood samples using hematology analyzers, which are housed in hospitals, clinics, or commercial laboratories and require skilled technicians to operate. A reliable, inexpensive point-of-care (POC) Hgb test would enable cost-effective anemia screening and chronically anemic patients to self-monitor their disease. We present a rapid, standalone, and disposable POC anemia test that, via a single drop of blood, outputs color-based visual results that correlate with Hgb levels. METHODS. We tested blood from 238 pediatric and adult patients with anemia of varying degrees and etiologies and compared hematology analyzer Hgb levels with POC Hgb levels, which were estimated via visual interpretation using a color scale and an optional smartphone app for automated analysis. RESULTS. POC Hgb levels correlated with hematology analyzer Hgb levels (r = 0.864 and r = 0.856 for visual interpretation and smartphone app, respectively), and both POC test methods yielded comparable sensitivity and specificity for detecting any anemia (n = 178) (/dl) (sensitivity: 90.2% and 91.1%, specificity: 83.7% and 79.2%, respectively) and severe anemia (n = 10) (/dl) (sensitivity: 90.0% and 100%, specificity: 94.6% and 93.9%, respectively). CONCLUSIONS. These results demonstrate the feasibility of this POC color-based diagnostic test for self-screening/self-monitoring of anemia. TRIAL REGISTRATION. Not applicable. FUNDING. This work was funded by the FDA-funded Atlantic Pediatric Device Consortium, the Georgia Research Alliance, Children\u27s Healthcare of Atlanta, the Georgia Center of Innovation for Manufacturing, and the InVenture Prize and Ideas to Serve competitions at the Georgia Institute of Technology

Major Depression Is a Risk Factor for Shorter Time to First Cigarette Irrespective of the Number of Cigarettes Smoked Per Day: Evidence From a National Population Health Survey

Article deposited according to Oxford Open Self-Archiving policy: http://www.oxfordjournals.org/oxfordopen/policies.html, January 12, 2012.YesFunding provided by the Open Access Authors Fund

Self-Reported Lifetime History of Eating Disorders and Mortality in the General Population: A Canadian Population Survey with Record Linkage

Eating disorders (EDs) are often reported to have the highest mortality of any mental health disorder. However, this assertion is based on clinical samples, which may provide an inaccurate view of the actual risks in the population. Hence, in the current retrospective cohort study, mortality of self-reported lifetime history of EDs in the general population was explored. The data source was the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), linked to a national mortality database. The survey sample was representative of the Canadian household population (mean age = 43.95 years, 50.9% female). The survey inquired about the history of professionally diagnosed chronic conditions, including EDs. Subsequently, the survey dataset was linked to the national mortality dataset (for the date of death) up to 2017. Cox proportional hazards models were used to explore the effect of EDs on mortality. The unadjusted-hazard ratio (HR) for the lifetime history of an ED was 1.35 (95% CI 0.70–2.58). However, the age/sex-adjusted HR increased to 4.5 (95% CI 2.33–8.84), which was over two times higher than age/sex-adjusted HRs for other mental disorders (schizophrenia/psychosis, mood-disorders, and post-traumatic stress disorder). In conclusion, all-cause mortality of self-reported lifetime history of EDs in the household population was markedly elevated and considerably higher than that of other self-reported disorders. This finding replicates prior findings in a population-representative sample and provides a definitive quantification of increased risk of mortality in EDs, which was previously lacking. Furthermore, it highlights the seriousness of EDs and an urgent need for strategies that may help to improve long-term outcomes

Can the adverse childhood experiences (ACEs) checklist be utilized to predict emergency department visits among children and adolescents?

Abstract Background Extensive literature has shown an association of Adverse Childhood Experiences (ACEs) with adverse health outcomes; however, its ability to predict events or stratify risks is less known. Individuals with mental illness and ACE exposure have been shown to visit emergency departments (ED) more often than those in the general population. This study thus examined the ability of the ACEs checklist to predict ED visits within the subsequent year among children and adolescents presenting to mental health clinics with pre-existing mental health issues. Methods The study analyzed linked data (n = 6100) from two databases provided by Alberta Health Services (AHS). The Regional Access and Intake System (RAIS 2016–2018) database provided data on the predictors (ACE items, age, sex, residence, mental health program type, and primary diagnosis) regarding children and adolescents (aged 0–17 years) accessing addiction and mental health services within Calgary Zone, and the National Ambulatory Care Reporting System (NACRS 2016–2019) database provided data on ED visits. A 25% random sample of the data was reserved for validation purposes. Two Least Absolute Shrinkage and Selection Operator (LASSO) logistic regression models, each employing a different method to tune the shrinkage parameter lambda (namely cross-validated and adaptive) and performing 10-fold cross-validation for a set of 100 lambdas in each model were examined. Results The adaptive LASSO model had a slightly better fit in the validation dataset than the cross-validated model; however, it still demonstrated poor discrimination (AUC 0.60, sensitivity 37.8%, PPV 49.6%) and poor calibration (over-triaged in low-risk and under-triaged in high-risk subgroups). The model’s poor performance was evident from an out-of-sample deviance ratio of − 0.044. Conclusion The ACEs checklist did not perform well in predicting ED visits among children and adolescents with existing mental health concerns. The diverse causes of ED visits may have hindered accurate predictions, requiring more advanced statistical procedures. Future studies exploring other machine learning approaches and including a more extensive set of childhood adversities and other important predictors may produce better predictions. Furthermore, despite highly significant associations being observed, ACEs may not be deterministic in predicting health-related events at the individual level, such as general ED use

A comparison of recommendations and received treatment for mood and anxiety disorders in a representative national sample

Abstract Background The exact nature of treatment and management recommendations made, and received, for mood and anxiety disorders in a community population is unclear. In addition, there is limited evidence on the impact of recommendations on actual receipt of treatment or implementation of management strategies. We aim to describe the frequency with which specific recommendations were made and implemented; and thus assess the size of any gap between the recommendation and implementation of treatments and management strategies. Methods We used the Survey ‘Living with a Chronic Condition in Canada - Mood and Anxiety Disorders (SLCDC-MA), a unique crossectional survey of a large (N = 3358) and representative sample of Canadians with a diagnosed mood or anxiety disorder, which was conducted by Statistics Canada. The survey collected information on recommendations for medication, counselling, exercise, reduction of alcohol consumption, smoking cessation and reduction of street drug use. We also estimate the frequency that recommendations are made and followed, as well the impact of the prior on the latter. We consulted people with lived experience of the disorders to help interpret our results. Results The results generally showed that most people would receive recommendations, almost all for antidepressant medications (94.6%), with lower proportions for the other treatment and management strategies (e.g. 62.1 and 66% for counselling and exercise). Most recommendations were implemented and had an impact on behaviour. The exception to this was smoking reduction/cessation, which was often not recommended or followed through. Other than with medication, at least 20% of the population, for each recommendation, would not have their recommendation implemented. A substantive group also exists who access treatments, and employ various management strategies, without a recommendation. Conclusions The results indicate that there is a gap between recommendations made and the implementation of treatments. However, its size varies substantially across treatments

Associations between negative COVID-19 experiences and symptoms of anxiety and depression: a study based on a representative Canadian national sample

IntroductionAmid the widespread impact of the COVID-19 pandemic, a notable increase in symptoms of anxiety and depression has become a pressing concern. This study examined the prevalence of anxiety and depression symptoms in Canada from September to December 2020, assessing demographic and socioeconomic influences, as well as the potential role of COVID-19 diagnoses and related negative experiences. MethodsData were drawn from the Survey on COVID-19 and Mental Health by Statistics Canada, which used a two-stage sample design to gather responses from 14 689 adults across ten provinces and three territorial capitals, excluding less than 2% of the population. Data were collected through self-administered electronic questionnaires or phone interviews. Analytical techniques, such as frequencies, cross-tabulation and logistic regression, were used to assess the prevalence of anxiety and depression symptoms, the demographic characteristics of Canadians with increased anxiety and depression symptoms and the association of these symptoms with COVID-19 diagnoses and negative experiences during the pandemic. ResultsThe study found that 14.62% (95% CI: 13.72%–15.51%) of respondents exhibited symptoms of depression, while 12.89% (95% CI: 12.04%–13.74%) reported anxiety symptoms. No clear differences in symptom prevalence were observed between those infected by COVID-19, or those close to someone infected, compared to those without these experiences. However, there were strong associations between traditional risk factors for depressive and anxiety symptoms and negative experiences during the pandemic, such as physical health problems, loneliness and personal relationship challenges in the household. ConclusionThis study provides insight into the relationship between COVID-19 and Canadians’ mental health, demonstrating an increased prevalence of anxiety and depression symptoms associated with COVID-19-related adversities and common prepandemic determinants of these symptoms. The findings suggest that mental health during the pandemic was primarily shaped by traditional determinants of depression and anxiety symptoms and also by negative experiences during the pandemic

Associations entre les expériences négatives liées à la COVID-19 et les symptômes d’anxiété et de dépression : étude fondée sur un échantillon national canadien représentatif

IntroductionParmi les répercussions généralisées de la pandémie de COVID-19, l’aggravation marquée des symptômes d’anxiété et de dépression est devenue une préoccupation urgente. Dans cette étude, les auteurs ont analysé la prévalence des symptômes d’anxiété et de dépression au Canada de septembre à décembre 2020, en évaluant les influences démographiques et socio-économiques ainsi que le rôle potentiel des diagnostics de COVID-19 et des expériences négatives liées à la maladie. MéthodologieLes données ont été tirées de l’Enquête sur la COVID-19 et la santé mentale réalisée par Statistique Canada, qui a utilisé un plan d’échantillonnage à deux degrés pour recueillir les réponses de 14 689 adultes dans les dix provinces et les trois capitales territoriales, en excluant moins de 2 % de la population. Ces données ont été recueillies au moyen de questionnaires électroniques auto-administrés ou d’entrevues téléphoniques. Nous avons utilsé des techniques d’analyse comme les fréquences, les tableaux croisés et la régression logistique pour évaluer la prévalence des symptômes d’anxiété et de dépression, les caractéristiques sociodémographiques des Canadiens présentant des symptômes accrus d’anxiété et de dépression et l’association de ces symptômes avec les diagnostics de COVID-19 et les expériences négatives vécues pendant la pandémie. RésultatsL’étude a révélé que 14,62 % (intervalle de confiance [IC] à 95 % : 13,72 % à 15,51 %) des répondants présentaient des symptômes de dépression et que 12,89 % (IC à 95 % : 12,04 % à 13,74 %) ont fait état de symptômes d’anxiété. Aucune différence nette n’a été observée quant à la prévalence des symptômes entre les personnes infectées par la COVID-19 ou les proches d’une personne infectée et les personnes n’ayant pas vécu ces situations. Toutefois, il y avait de fortes associations entre les facteurs de risque classiques de symptômes de dépression et d’anxiété et les expériences négatives vécues pendant la pandémie, comme des problèmes de santé physique, la solitude et des difficultés dans les relations personnelles au sein du ménage. ConclusionL’étude fournit un aperçu du lien entre COVID-19 et santé mentale au sein de la population canadienne en révélant une prévalence accrue des symptômes d’anxiété et de dépression associés aux épreuves liées à la COVID-19 et aux déterminants courants de ces symptômes avant la pandémie. D’après nos résultats, la santé mentale en période de pandémie a été principalement façonnée par les déterminants classiques des symptômes de dépression et d’anxiété ainsi que par les expériences négatives vécues au cours de la pandémie