Potvrđivanje učinkovitosti testa identifikacije poremećaja uzrokovanih alkoholom (AUDIT) – verzija na Dusun jeziku u konzumenata alkohola u Sabahu, Borneo

Introduction: The Alcohol Use Disorder Identification Test (AUDIT) developed by WHO is instrumental in identifying individuals on the alcohol misuse spectrum. However there is no culturally appropriate Dusun language version in Sabahan Borneo. This study aims to develop and validate a Dusun language version of AUDIT (AUDIT-D). Methods: AUDIT was translated to Dusun and back translated to English and Malay. The first version was pilot tested in 20 participants and harmonised. The harmonised version was administered to 50 Dusun first language speakers fluent in Malay from villages in rural Sabah. Participants filled in socio-demographic questionnaires, Dusun (AUDIT-D) and Bahasa Malaysia (AUDIT-M) versions of AUDIT, and validated Bahasa Malaysia versions of the M.I.N.I. alcohol dependence subscale and CAGE. Results: ROC curves calculated AUDIT-D dependence cut-off of 9 and more, with prevalence of dependence at 46%. Factor analysis of AUDIT-D yielded a one - or three-factor solution, distinct from the AUDIT-M factor structure. Cronbach alpha coefficients for the total AUDIT-D was 0.83. Significant Spearman’s correlations existed between AUDIT-D and AUDIT-M scores (Spearman’s rho=0.999, p<.001). AUDIT-D and AUDIT-M were both significantly correlated with M.I.N.I. alcohol dependence subscales (rho=0.624 and 0.617 respectively, with p<0.0001). Both were not significantly correlated with CAGE. Conclusion: The AUDIT-D questionnaire has acceptable psychometric properties, properties and demonstrates similar factor structures to other areas with high alcohol dependence prevalence. It is suitable for the assessment and identification of alcohol use disorders in the unique Sabahan Borneo cultural landscape.Uvod: Test identifikacije poremećaja uzrokovanih alkoholom (AUDIT eng. The Alcohol Use Disorder Identification Test) kojeg je razvila Svjetska zdravstvena organizacija (WHO), od iznimne je koristi u identifikaciji pojedinaca koji boluju od poremećaja ponašanja uzrokovanih alkoholom. Doduše, ne postoji kulturološki primjerena verzija testa na Dusun jeziku u saveznoj državi Sabah na otoku Borneu, Malezija. Cilj ovog istraživanja je razviti i potvrditi verziju AUDIT test na Dusun jeziku. Metode: AUDIT test je preveden na Dusun jezik, zatim s Dusun jezika na engleski i malezijski. Prva verzija je bila pilot test koji je uključio 20 ispitanika, te je bio usklađen. Usklađena verzija testa je provedena na 50 ispitanika čiji je prvi jezik bio Dusun, te su također bili tečni u malezijskom jeziku, a bili su žitelji ruralnih sela Sabaha. Ispitanici su ispunili socio-demografske upitnike, Dusun (AUDIT-D) i Bahasa malezijske (AUDIT-M) verzije testa, usklađene verzije M.I.N.I. testa alkoholne ovisnosti na Bahasa malezijskom jeziku, te CAGE upitnik. Rezultati: ROC krivulje izračunale su graničnu ovisnost AUDIT-D od 9 i više, s prevalencijom ovisnosti od 46%. Faktorska analiza AUDIT-D dala je jedno- ili trofaktorsko rješenje, za razliku od strukture faktora u AUDIT-M testu. Cronbach alfa koeficijenti za ukupni AUDIT-D bili su 0,83. Značajne Spearmanove korelacije postojale su između AUDIT-D i AUDIT-M rezultata (Spearmanov rho = 0,999, p <0,001). AUDIT-D i AUDIT-M bili su značajno povezani s M.I.N.I. podskupinama za ovisnosti o alkoholu (rho = 0,624 i 0,617, s p <0,0001). Oba nisu pokazala značajnu povezanost s CAGE upitnikom. Zaključak: AUDIT-D upitnik ima prihvatljiva psihometrijska svojstva i pokazuje slične faktorske strukture u odnosu na druga područja s visokom prevalencijom ovisnosti o alkoholu. Prikladan je za procjenu i utvrđivanje poremećaja ponašanja uzrokovanih konzumacijom alkohola u jedinstvenom kulturnom krajoliku Sabaha

An early glance into smartphone dependence in a rural LMIC and relationships with mindfulness and depressive symptoms

A rising issue in the child and adolescent global mental health pandemic is smartphone addiction. However, most evidence has come from urbanised countries in the developed world or university undergraduate students in LAMICs. This study aims to ascertain core psychometric properties of a previously unvalidated brief smartphone addiction scale for adolescents, determine gender-based prevalence of smartphone addiction in adolescents in rural areas, and assess relationships with concurrent measures of a state of mindfulness and depression. Secondary data from a health screening in a Dusun-speaking village in rural Borneo was analysed, with respondents filling in sociodemographic questionnaires and three Malay-language scales: MAAS, PHQ-9, and SAS-SV, which measure the state of mindfulness, depression, and smartphone addiction respectively. The SAS-SV-M exhibited satisfactory internal consistency and was consistent with a uni factorial model in the original paper. There were significant gender differences for smartphone addiction, but no significant difference between all 3 measured variables for age. Significant inverse correlations existed between mindfulness and depression, but not with neither and smartphone addiction, with these correlations persistent upon multiple regression. This study pioneeringly establishes prevalence by gender for smartphone addiction in a rural LAMIC setting, and concurs with extant findings that mindfulness and depression are inversely correlated

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals &lt;1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Design and baseline characteristics of the finerenone in reducing cardiovascular mortality and morbidity in diabetic kidney disease trial

Background: Among people with diabetes, those with kidney disease have exceptionally high rates of cardiovascular (CV) morbidity and mortality and progression of their underlying kidney disease. Finerenone is a novel, nonsteroidal, selective mineralocorticoid receptor antagonist that has shown to reduce albuminuria in type 2 diabetes (T2D) patients with chronic kidney disease (CKD) while revealing only a low risk of hyperkalemia. However, the effect of finerenone on CV and renal outcomes has not yet been investigated in long-term trials. Patients and Methods: The Finerenone in Reducing CV Mortality and Morbidity in Diabetic Kidney Disease (FIGARO-DKD) trial aims to assess the efficacy and safety of finerenone compared to placebo at reducing clinically important CV and renal outcomes in T2D patients with CKD. FIGARO-DKD is a randomized, double-blind, placebo-controlled, parallel-group, event-driven trial running in 47 countries with an expected duration of approximately 6 years. FIGARO-DKD randomized 7,437 patients with an estimated glomerular filtration rate >= 25 mL/min/1.73 m(2) and albuminuria (urinary albumin-to-creatinine ratio >= 30 to <= 5,000 mg/g). The study has at least 90% power to detect a 20% reduction in the risk of the primary outcome (overall two-sided significance level alpha = 0.05), the composite of time to first occurrence of CV death, nonfatal myocardial infarction, nonfatal stroke, or hospitalization for heart failure. Conclusions: FIGARO-DKD will determine whether an optimally treated cohort of T2D patients with CKD at high risk of CV and renal events will experience cardiorenal benefits with the addition of finerenone to their treatment regimen. Trial Registration: EudraCT number: 2015-000950-39; ClinicalTrials.gov identifier: NCT02545049

Reducing the Clinical and Public Health Burden of Familial Hypercholesterolemia A Global Call to Action

Q1Q1Artículo completoE1-E13IMPORTANCE Familial hypercholesterolemia (FH) is an underdiagnosed and undertreated genetic disorder that leads to premature morbidity and mortality due to atherosclerotic cardiovascular disease. Familial hypercholesterolemia affects 1 in 200 to 250 people around the world of every race and ethnicity. The lack of general awareness of FH among the public and medical community has resulted in only 10% of the FH population being diagnosed and adequately treated. The World Health Organization recognized FH as a public health priority in 1998 during a consultation meeting in Geneva, Switzerland. The World Health Organization report highlighted 11 recommendations to address FH worldwide, from diagnosis and treatment to family screening and education. Research since the 1998 report has increased understanding and awareness of FH, particularly in specialty areas, such as cardiology and lipidology. However, in the past 20 years, there has been little progress in implementing the 11 recommendations to prevent premature atherosclerotic cardiovascular disease in an entire generation of families with FH. OBSERVATIONS In 2018, the Familial Hypercholesterolemia Foundation and the World Heart Federation convened the international FH community to update the 11 recommendations. Two meetings were held: one at the 2018 FH Foundation Global Summit and the other during the 2018 World Congress of Cardiology and Cardiovascular Health. Each meeting served as a platform for the FH community to examine the original recommendations, assess the gaps, and provide commentary on the revised recommendations. The Global Call to Action on Familial Hypercholesterolemia thus represents individuals with FH, advocacy leaders, scientific experts, policy makers, and the original authors of the 1998 World Health Organization report. Attendees from 40 countries brought perspectives on FH from low-, middle-, and high-income regions. Tables listing country-specific government support for FH care, existing country-specific and international FH scientific statements and guidelines, country-specific and international FH registries, and known FH advocacy organizations around the world were created. CONCLUSIONS AND RELEVANCE By adopting the 9 updated public policy recommendations created for this document, covering awareness; advocacy; screening, testing, and diagnosis; treatment; family-based care; registries; research; and cost and value, individual countries have the opportunity to prevent atherosclerotic heart disease in their citizens carrying a gene associated with FH and, likely, all those with severe hypercholesterolemia as well

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

‘I TELL MYSELF I HAVE NO RIGHT TO A SEAT’: PREGNANT WOMEN’S EXPERIENCES OF MOBILITY ON BOARD PUBLIC TRANSPORT IN SINGAPORE

Bachelor'sBachelor of Social Sciences (Honours