Factors associated with self-rated health among migrant workers: results from a population-based cross-sectional study in Almaty, Kazakhstan

Objectives To determine factors associated with SRH among migrant workers in Almaty, Kazakhstan. Methods In 2007, 805 vendors were screened. Approximately half were eligible (n =450), defined as at least 18 years old, a worker/owner in a randomly selected stall, having traveled 2 + hours outside of Almaty within the past year, and being an internal/external migrant. 28 non-migrants were excluded, leaving 422 participants. Logistic regression was used to examine the relationship between SRH, mental health, and psychosocial problems. Results Approximately 46% reported having poor or fair SRH. Clinical depression (OR 0.859, 95% CI 0.342–2.154), alcohol problems (OR 1.169, 95% CI 0.527–2.593), and legal status (OR 0.995, 95% CI 0.806–1.229) were not significantly associated with SRH, nor was exposure to interpersonal violence among women (OR 1.554, 95% CI 0.703–3.435). After adjusting for key variables, only ethnicity and social support were found to be significantly protective against poor or fair SRH. Conclusions SRH was not a comprehensive health measure for these Central Asian migrant workers. More specific questions are needed to identify mental illness and interpersonal violence

Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

[This corrects the article DOI: 10.1186/s13601-016-0116-9.]

Erratum to: Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5).

[This corrects the article DOI: 10.1186/s13601-016-0116-9.]

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Pre-school experience and cognitive development at the start of primary school

This longitudinal study assesses the attainment and development of children followed between the ages of 3 and 7 years. Over 700 children were recruited to the study during 1998 and 1999 from 80 pre-school centres. Both qualitative and quantitative methods (including multilevel modelling) are used to explore the effects of pre-school experience on children\u27s cognitive attainment and social/behavioural development at entry to school and any continuing effects on such outcomes up to 7 years of age. In addition to the effects of preschool experience, the study investigates the contribution to children\u27s development of individual and family characteristics such as gender, family size, parental education and employment. This overview describes the research design and discusses a variety of research issues (methodological and practical) in investigating the impact of pre-school provision on children\u27s developmental progress. A parallel study is being carried out in England (EPPE)