MO691CORRELATION OF INTRAPERITONEAL PRESSURE AND APEX TIME WITH ULTRAFILTRATION AND BIOCHEMICAL VARIABLES IN PATIENTS IN PERITONEAL DIALYSIS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Lionel Cristian Vargas Arispe ◽  
Laura Gabriela Amador Reyes ◽  
Rafael Valdez Ortiz ◽  
Lucia Monserrat Perez Navarro ◽  
Carlos Mauricio Paredes Fernã¡ndez
Keyword(s):  
Peritoneal Dialysis ◽  
Residence Time ◽  
Fluid Overload ◽  
Abdominal Cavity ◽  
Public Health Problem ◽  
Functional Tests ◽  
Balance Test ◽  
Cross Sectional ◽  
Intraperitoneal Pressure ◽  
Biochemical Variables

Abstract Background and Aims Chronic Kidney Disease represents a growing and serious public health problem, which progresses to terminal stage with glomerular filtration rate <15 ml/min/1.73m2. It makes it necessary to implement substitute therapies for renal function with hemodialysis (HD), peritoneal dialysis (PD) or kidney transplantation. It is known that the ultrafiltration (UF) capacity of PD is much lower than that of HD, which explains the higher incidence of overhydration in PD patients, which increases morbidity and mortality in this group of patients, being the second cause of change to HD. Due to this limitation, it is essential to know and fully exploit all the factors that influence the UF in PD. The net UF in DP is the result of 4 forces: 1) the osmotic force, the strongest and only one that is deliberately controlled; 2) intraperitoneal pressure (IPP) modulated by intraperitoneal volume (IPV), UF volume itself, posture, BMI, physical activity, etc.; 3) capillary hydrostatic pressure, modulated by the degree of fluid overload, and 4) capillary oncotic pressure proportional to hypoalbuminemia, in turn related to fluid overload. The IPP with typical values of 10-16 cm H2O, should not exceed 18 cmH2O, this excess leads to the development of mechanical, infectious and functional complications, among them, a decrease in UF. Elevated IPP is a little known cause of UF failure and, due to its easy diagnosis and application, it should be ruled out in cases of overhydration in PD. Another parameter to consider when favoring UF in PD is the residence time of the dialysate solution in the abdominal cavity through the APEX time calculation (functional test derived from the classic peritoneal balance test). In the present study, we intend to define the role of IPP and APEX time as diagnostic and adjunctive evaluation techniques to optimize UF in PD patients. We determined the correlation of IPP and APEX time with ultrafiltration and biochemical variables in PD patients. Method Pilot, observational, cross-sectional, analytical study. Results Thirty patients were included, 10 (33%) patients on PD in the IPD modality and 20 (66.7%) in the CAPD modality. Of which mostly men (53%). The mean residual uresis of the general population was 534.33 ml. The average UF with a 1.5% solution is 238.1, for a 2.5% solution the average UF is 296.2 and for a 4.25% solution the average UF is 535 ml. No statistically significant mean differences were found between both groups. (p ≤ 0.05). The average IPP in the supine position was 13.1 cmH2O, the sitting position was 22.8 cmH2O, and the vertical 25.4 cmH2O, the variability of the PIP in the prone position at 15.8 cmH2O is striking. No statistically significant differences were found between the averages of the analysis groups (p ≤ 0.05). The average calculated APEX time was 42.4 minutes. When performing the correlation of UF with IPP, APEX, Dif. Na, D/P and D/Do, as well as the correlation between APEX time and time in DP. Being able to determine that there is no correlation between the different variables. No statistically significant differences were found. (p ≤ 0.05). Conclusion It is the first study in Mexico that evaluates the usefulness of APEX and IPP time in Adult patients on CAPD and IPD. It was determined that Intraperitoneal Pressure does not influence Ultrafiltration levels. In our study we demonstrated that the APEX time, an index of the optimal ultrafiltration residence time, was not correlated with the UF volumes. Therefore, the adequacy of peritoneal dialysis must not only be based on functional tests, it must be personalized and be based in conjunction with clinical, biochemical, nutritional parameters and functional tests.

scholarly journals Prevalence of falls among elderly participants of a health promotion group and comparison of balance tests to detect risk of falls

2017 ◽  
Vol 30 (3) ◽  
pp. 519-525
Author(s):  
Vanessa Lobo Carvalho ◽  
Analita Alves Clementino ◽  
Edel Quinn Ferreira Ferro de Magalhães ◽  
Edlanne Morais Belo da Silva ◽  
Jussara Almeida de Oliveira Baggio
Keyword(s):  
Health Promotion ◽  
Elderly Patients ◽  
Public Health Problem ◽  
Berg Balance Scale ◽  
Cross Sectional Study ◽  
Mean Value ◽  
Timed Up And Go ◽  
Balance Test ◽  
Cross Sectional ◽  
Risk Of Falls

Abstract Introduction: Falls of elderly people are common, representing a serious public health problem. The use of appropriate instruments in the assessment of elderly patients supports the early detection of individuals under risk of falls and its prevention. Objective: To verify the incidence of falls in a group of elderly patients and detect which balance test is the most appropriate for the studied sample. Methods: Quantitative, cross-sectional study with an observational approach. A total of 30 elderly patients aged over 60 years old participating in a health promotion group were included in the sample. The participants were initially interviewed and subsequently assessed by means of the following instruments: Berg Balance Scale (BBS), Timed Up and Go test (TUG), and the Dynamic Gait Index (DGI). Results: The mean age of the participants was 69.30 ± 7.47 years; 90% were women and 46.7% of the individuals reported falls. The participants obtained a mean value of 10.2 ± 2.5 seconds in the TUG, 51.4 ± 2.6 in the BBS, and 18.6 ± 4.2 in the DGI. The sensitivity of the scales was 0.71 in the TUG, 0.50 in the DGI, and 0.42 in the BBS; specificity was 0.44 in the TUG, 0.32 in the DGI and 0.63 in the BBS. Conclusion: A high prevalence of falls was observed in the sample. In addition, the TUG was the most sensitive test to assess balance in the assessed sample. However, its use alone requires caution in this sample.

scholarly journals Validity and Reliability of a Tool for Accelerometric Assessment of Balance in Scholar Children

2021 ◽  
Vol 10 (1) ◽  
pp. 137
Author(s):  
Jesús García-Liñeira ◽  
Raquel Leirós-Rodríguez ◽  
Vicente Romo-Pérez ◽  
Jose L. García-Soidán
Keyword(s):  
Root Mean Square ◽  
Center Of Mass ◽  
Healthy Children ◽  
Mean Square ◽  
Functional Tests ◽  
Clinical Tests ◽  
Validity And Reliability ◽  
Balance Test ◽  
Cross Sectional ◽  
Bar Test

In Pediatrics, balance is assessed through low-sensitivity clinical tests which identify developmental alterations at already advanced stages that cannot be detected at earlier stages. Therefore, the aim of this study was to develop an easily applicable quantitative tool that can be used to evaluate postural control. Consequently, a cross-sectional study was carried out with 91 healthy children. All of them performed a series of six accelerometric functional tests and four clinical tests of balance (Modified Flamingo Test, Bar Test, Babinski–Weil Test, and Fukuda Stepping Test). The Bar Test obtained mild inverse correlations with accelerations produced in the mediolateral axis and the root mean square of all the tests in monopodal support. The Flamingo Test obtained direct correlations with the root mean square of the tests in monopodal support and with the mediolateral axis of the monopodal tests and gait. The pediatric balance assessment scale consists of three factors and eleven items extracted from five accelerometric functional tests: the monopodal balance test with six items, normal gait test with three items, and bipodal balance test with two items. This tool is easy to apply and allows analysis in the evaluation of the balance state based on the accelerations of the center of mass.

MO711COMPARISON OF PERITONEAL DIALYSIS EFFICACY MARKERS IN DIABETIC AND NON-DIABETIC PATIENTS

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
João Carvão ◽  
Adriana Paixão Fernandes ◽  
Rita Veríssimo ◽  
Rita Calça ◽  
Ana Rita Martins ◽  
...  
Keyword(s):  
Peritoneal Dialysis ◽  
Cardiac Dysfunction ◽  
Fluid Overload ◽  
Volume Overload ◽  
Cross Sectional Study ◽  
Hydration Status ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Lv Mass ◽  
End Stage

Abstract Background and Aims Diabetes mellitus (DM) is the leading cause of end-stage kidney disease. Peritoneal dialysis (PD) is an effective and convenient modality of renal replacement therapy, however in diabetic patients, higher technique failure is feared. This cross sectional study aimed to investigate if diabetic patients are good candidates for peritoneal dialysis in terms of dialysis efficacy and volume overload management when compared with non-diabetic patients. Method We conducted a cross-sectional study including 60 patients with end-stage kidney disease currently in peritoneal dialysis. Echocardiography was performed using HDI 5000, allowing M-mode, two-dimensional measurement. Peritoneal equilibration test exam was used to evaluate transport rate and dialysis efficacy. A multifrequency bioimpedance (BIA) analyzer was used. Overhydration (OH) was defined as an extra-cellular water (ECW)/total body water (TBW) over 15%. Clinical and biochemical variables were also explored. Results A total of 60 patients completed evaluation. Overall, 60% (n=36) were males with a mean age of 55,8 ± 15,3 years, BMI 25.9 ± 3.9 kg/m2, 31,7% (n=19) had DM. Median PD vintage was 21 months, automated PD 30%, 8.3% (n=5) were anuric and 10% (n=6) were overhydrated. The median serum N-terminal pro b-type natriuretic peptide (NT-proBNP) level was 1071 pg/mL. Left ventricule (LV) mass index and LV ejection fraction were 129.0 ± 51.1 g/m2 and 62.8 ± 13.0%, respectively. The median excess volume overload was 0.9L. Patients were divided in 2 groups (diabetic and non-diabetic). No differences were found between the 2 groups in terms of time in PD, peritoneal transportation, dialysis efficacy, diuresis, hemoglobin, albumin, normalized protein catabolic rate, hydration status, weight, body mass index, arterial hypertension, chronic heart failure, LV ejection fraction, LV mass index, CA-125 value, clinical signs of fluid overload, systolic and diastolic blood pressure. However, diabetic patients were younger (51,6 versus 58,0; p=0,02), more likely to have peripheral arterial disease (42,1 versus 7,3%, p=0,03), ischemic heart disease (52,6 versus 7,3%, p<0,001) and had higher levels of NT-proBNP (5932 versus 4216 pg/mL, p=0.04). However, when using a multivariable analysis, in a model adjusted to age, residual dialysis, efficacy of dialysis, diabetic patients did not have a significant difference in volume overload, dialysis efficacy and markers of cardiac dysfunction when compared with non-diabetic patients. Conclusion In this population, diabetes was associated with higher levels of NT-proBNP, however it did not translate in higher fluid overload, lower dialysis efficacy or worst cardiac dysfunction, when compared with non-diabetic patients. We conclude that PD is able to control hydration status, dialysis efficacy and cardiac dysfunction in diabetic patients with similar efficiency as in non-diabetic patients.

Relationship between Fill Volume, Intraperitoneal Pressure, Body Size, and Subjective Discomfort Perception in CAPD Patients

2000 ◽  
Vol 20 (2) ◽  
pp. 188-193 ◽  
Author(s):  
María De Jesús Ventura ◽  
Dante Amato ◽  
Ricardo Correa–Rotter ◽  
Ramón Paniagua ◽  
Keyword(s):  
Peritoneal Dialysis ◽  
Body Size ◽  
Random Order ◽  
Immunosuppressive Drugs ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Intraperitoneal Pressure ◽  
Fill Volume ◽  
Subjective Discomfort ◽  
Dialysate Volume

Objective To determine changes in intraperitoneal pressure (IPP) when dialysate fill volume is increased from 2.0 L to 2.5 L to 3.0 L per exchange, and to evaluate the relationship with subjective discomfort perception. Design Cross-sectional survey. Setting Seven Mexican hospital-based dialysis centers. Patients Eighty-one adult patients on continuous ambulatory peritoneal dialysis (CAPD) without restriction criteria for age, gender, or time on dialysis, were studied. Patients seropositive for HIV or hepatitis B, and those with cancer or receiving immunosuppressive drugs were excluded. Participants were studied as outpatients. Main Measures Blindly and in random order, 2.0-, 2.5-, and 3.0-L volumes of dialysate were infused consecutively. Body surface area (BSA) was calculated from patient height and weight. IPP was assessed with the patient lying supine, measuring the height of the dialysate column inside the peritoneal dialysis bag tubing. Blood pressure and subjective discomfort perception (using a visual analog scale of 0 – -100 mm) were also evaluated and registered after each of the three exchanges. Results The IPP rose with each increase of dialysate volume and was higher in males than in females for each fill volume level. For males IPP was 18.9 ± 6.9, 20.8 ± 7.1, and 22.9 ± 7.5 cm H2O; and for females it was 16.5 ± 5.7, 18.4 ± 5.5, and 19.7 ± 6.2 cm H2O for 2.0-, 2.5-, and 3.0-L fill volumes respectively ( p < 0.01 among fill volumes and between genders). Intraperitoneal pressure showed significant negative correlation with the fill volume corrected for patient body size as reflected by the dialysate volume/ BSA ratio ( r = –0.393, p < 0.01; r = 0.319, p < 0.01; and r = –0.274, p < 0.02 for 2.0-, 2.5-, and 3.0-L fill volumes respectively). Discomfort score rose as fill volume rose, with a median of 0, 2.5, and 13.0 for 2.0-, 2.5-, and 3.0-L fill volumes respectively ( p < 0.001). It is interesting, however, that with 2.5-L and 3.0-L dialysate infusion volumes, 64% and 44% of the patients, respectively, had no discomfort at all. Conclusion Dialysate volume increase is associated with higher IPP, which is modulated by the gender and body size of the patients. Although the mean discomfort score was higher with larger dialysate volumes, there was no significant correlation between discomfort and IPP or the dialysate volume/BSA ratio. Many patients had no discomfort with 2.5-L or even with 3.0-L dialysate infusions; theoretically, they can be treated with larger volumes.

Socio-demographic and Clinical Characteristics of Patient with Thyroid Cancer

2020 ◽  
Vol 11 (1) ◽  
pp. 54-58
Author(s):  
AKM Farhad Hossain ◽  
Md Mahmudur Rahman Siddiqui ◽  
Sayada Fatema Khatun
Keyword(s):  
Public Health ◽  
Thyroid Cancer ◽  
Clinical Characteristics ◽  
Family Income ◽  
Ethical Issues ◽  
Endocrine System ◽  
Public Health Problem ◽  
Follicular Carcinoma ◽  
Public Health Issue ◽  
Cross Sectional

Background: Thyroid cancer is the most common malignant disease in endocrine system. It is an emerging public health issue associated with burden on the family, community and the nation. The aim of this study is to determine the socio-demographic and clinical characteristics of patient with thyroid cancer attending in tertiary hospital. Methods: This cross sectional study was conducted among 246 thyroid cancer patients in two tertiary hospitals of Dhaka city from 01 July 2018 to 30 June 2019. The subjects were selected purposively following specific selection criteria and maintaining ethical issues. Data were collected by face to face interview using a semi-structured questionnaire and checklist. Data were analyzed by the statistical package for the social science (SPSS) version 23. Results: This study revealed that majority (74.4%) of respondents was female, married (72%), housewife (61.4%), rural respondent (41.1%) and had primary education (69%). Mean (± SD) age of the respondent was 37.85(±12.20) years (Range 14-70 years) and mean (± SD) monthly family income was Tk. 17681(±10602). Out of 246 cases, 204 (82.9%) was papillary and 42 (17.1%) was follicular carcinoma. Various clinical presentations included visible neck swelling in 225 (91.5%), swollen lymph node in 103 (41.9%), pain 90 (36.6%), Difficulties in swallowing 87 (35.4%), Hoarseness of voice in 141 (57.3%), cough along with swelling 47(19.1%), Difficulties in breathing due to swelling in 13(5.3%) of the patients. Conclusion: Incidence of thyroid cancer has increased worldwide specially in female patients in 3rd and 4th decades of life. As thyroid cancer is a growing public health problem in Bangladesh, proper screening and early diagnostic facilities at all level should be available to measure its actual burden in the country. Anwer Khan Modern Medical College Journal Vol. 11, No. 1: Jan 2020, P 54-58

Characteristics and risk factors associated with stroke subtypes among adult patients admitted to stroke unit of JUMC

2019 ◽  
Vol 15 ◽  
Author(s):  
Bekalu Getachew Gebreegziabher ◽  
Tesema Etefa Birhanu ◽  
Diriba Dereje Olana ◽  
Behailu Terefe Tesfaye
Keyword(s):  
Risk Factors ◽  
Stroke Unit ◽  
Medical Center ◽  
Data Entry ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Chi Square ◽  
Cross Sectional ◽  
Factors Associated ◽  
Stroke Subtypes

Background: Stroke is a great public health problem in Ethiopia. According to reports, in-hospital stroke mortality was estimated to be 14.7% in Ethiopia. Despite this, in this country researches done on factors associated with stroke sub-types were inadequate. Objective: To assess the Characteristics and risk factors associated with stroke sub-types among patients admitted to JUMC. Methods and materials: A retrospective cross sectional study was conducted from May 2017 to May 2018 in stroke unit of Jimma University Medical Center. A total of 106 medical charts of patients diagnosed with stroke were reviewed. Checklist comprising of relevant variables was used to collect data. SPSS version 21 was employed for data entry and analysis. Chi-square test was used to point-out association and difference among stroke sub-types. The data was presented using text, tables and figures. Result: From a total of 106 patients, 67(63.2%) were men. The mean ± SD of age was 52.67±12.46 years, and no significant association was found. Of all the patients, 59(55.6%) had ischemic strokes and 47(44.4%) had hemorrhagic strokes. The most common risk factor in the patients was alcohol use with a prevalence of 69.9%. Of all the risk factors, only sex, cigarettes smoking and dyslipidemia were significantly associated to sub-types of stroke. Conclusion: Ischemic stroke was the most common subtype of stroke. Sex of patient, cigarette smoking and dyslipidemia are significantly associated with the two stroke subtypes.

scholarly journals Monitoring migrant groups as a post-validation surveillance approach to contain the potential reemergence of lymphatic filariasis in Togo

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Monique Ameyo Dorkenoo ◽  
Martin Kouame Tchankoni ◽  
Degninou Yehadji ◽  
Kossi Yakpa ◽  
Mawèké Tchalim ◽  
...  
Keyword(s):  
Lymphatic Filariasis ◽  
Significant Risk ◽  
Public Health Problem ◽  
Test Strip ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Positive Case ◽  
Cross Sectional ◽  
Case Investigation ◽  
Migrant Groups

Abstract Background In March 2017, Togo was declared the first country in sub-Saharan Africa to eliminate lymphatic filariasis as a public health problem, but post-validation surveillance has been lacking. In some areas of the country, migrant groups from neighboring countries that are still endemic for LF pose a risk of reintroduction of LF to Togo. The objective of this study was to identify the risk posed by migrant groups by measuring their prevalence of LF infection and investigating any positive case using Togo’s case investigation algorithm to prevent resurgence of LF and sustain Togo’s elimination success. Method A cross-sectional study was conducted in 2018 in the northernmost region of the country. Three migrant populations were identified: (i) nomadic Peuhls, (ii) Togolese members of local communities who migrate annually to neighboring countries for seasonal labor, and (iii) refugees from Ghana who came to Togo because of a communal conflict in Ghana. A questionnaire was designed to collect data on demographics and history of LF and MDA; all participants were tested for circulating filariasis antigen (CFA) using the filariasis test strip (FTS). Any CFA-positive case was confirmed with nocturnal microfilaremia. Results Refugees, seasonal economic migrants and nomadic Peuhls represented 42.1%, 31.4% and 26.5% of the study participants, respectively. The overall prevalence of CFA was 4.2% (58/1391) with the highest prevalence in the nomadic Peuhl group (11.9%), but only one of them (0.07%) was confirmed positive with nocturnal microfilaremia. Using the case investigation algorithm, no other positive case was identified in the positive case’s surroundings. Conclusion This study demonstrates that nomadic Peuhls, with a CFA prevalence of 11.9%, pose a potential risk for reintroduction of LF into Togo while Ghanaian refugees and seasonal economic migrants do not appear to pose a significant risk. Periodic monitoring of migrants, especially the nomadic Peuhl population, is a potential post-validation surveillance approach that could be used to promptly detect any LF cluster that may arise.

Prevalence and risk factors of anaemia among men: A study based on Empowered Action Group states, India

2021 ◽  
pp. 026010602098234
Author(s):  
Pradeep Kumar ◽  
Himani Sharma ◽  
Kamalesh Kumar Patel
Keyword(s):  
Family Health ◽  
Public Health Problem ◽  
Binary Logistic Regression ◽  
Bivariate Analysis ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Action Group ◽  
Nationally Representative ◽  
The Government ◽  
Eag States

Background: Despite various programmes initiated by the Government of India, the nutritional indicators are not encouraging, as several problems like undernutrition, malnutrition and anaemia – still persist in the country, especially in the Empowered Action Group (EAG) states. Aim: Because of the dearth of studies regarding anaemia among men in India, the present study aimed to determine its prevalence in this population in the EAG states and to analyse its geographical and socio-demographic determinants. Methods: The study utilized nationally representative, cross-sectional survey data from round 4 of the National Family Health Survey conducted in 2015–16. Bivariate analysis along with binary logistic regression were performed to assess the predictors of anaemia among men in the EAG states. Results: Around a quarter of the men in the EAG states suffered from anaemia. A similar high-prevalence pattern was observed across the EAG states. Wherein, Bihar and Jharkhand had the highest prevalence of anaemia while Uttarakhand showed the lowest. Age, place of residence, marital status and caste were positively associated with the likelihood of anaemia among men in the EAG states. Conclusions: Focusing on the EAG states, this study considered the severity of anaemia as a public health problem among men. Strategies to reduce the burden of anaemia among this population are needed. The government should formulate programmes targeting anaemia specifically, and improving the nutritional status among men in general in the EAG states.

scholarly journals Self-harm among in-school and street-connected adolescents in Ghana: a cross-sectional survey in the Greater Accra region

BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041609
Author(s):  
Emmanuel Nii-Boye Quarshie ◽  
Farag Shuweihdi ◽  
Mitch Waterman ◽  
Allan House
Keyword(s):  
Public Health Problem ◽  
Self Report ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Self Injury ◽  
Significant Public Health Problem ◽  
Significant Public Health ◽  
Treatment Measures ◽  
Self Harm ◽  
Greater Accra Region

ObjectivesTo identify the prevalence, methods, associations and reported reasons for self-harm among in-school and street-connected adolescents in Ghana.DesignA cross-sectional survey. We applied multi-level regression models and model-based cluster analysis to the data.SettingThree contexts in the Greater Accra region were used: second cycle schools, facilities of charity organisations and street census enumeration areas (sleeping places of street-connected adolescents, street corners, quiet spots of restaurants, markets, train and bus stations, and lorry and car parks).ParticipantsA regionally representative sample of 2107 (1723 in-school and 384 street-connected) adolescents aged 13–21 years.Outcome measuresParticipants responded to a structured self-report anonymous questionnaire describing their experience of self-harm and eliciting demographic information and social and personal adversities.ResultsThe lifetime prevalence of self-harm was 20.2% (95% CI 19.0% to 22.0%), 12-month prevalence was 16.6% (95% CI 15.0% to 18.0%) and 1-month prevalence was 3.1% (95% CI 2.0% to 4.0%). Self-injury alone accounted for 54.5% episodes and self-poisoning alone for 16.2% episodes, with more than one method used in 26% of episodes. Self-cutting (38.7%) was the most common form of self-injury, whereas alcohol (39.2%) and medications (27.7%) were the most commonly reported means of self-poisoning. The factors associated with self-harm were interpersonal: conflict with parents (adjusted OR (aOR)=1.87, 95% CI 1.24 to 2.81), physical abuse victimisation (aOR=1.69, 95% CI 1.16 to 2.47), difficulty in making and keeping friends (aOR=1.24, 95% CI 0.85 to 1.80), sexual abuse victimisation (aOR=1.21, 95% CI 0.78 to 1.87) and conflict between parents (aOR=1.07, 95% CI 0.73 to 1.56).ConclusionsSelf-harm is a significant public health problem among in-school and street-connected adolescents in the Greater Accra region of Ghana. Its origins are very largely in social and familial adversity, and therefore prevention and treatment measures need to be focused in these areas.

scholarly journals Impact of COVID-19 Home Confinement in Children’s Refractive Errors

2021 ◽  
Vol 18 (10) ◽  
pp. 5347
Author(s):  
Cristina Alvarez-Peregrina ◽  
Clara Martinez-Perez ◽  
Cesar Villa-Collar ◽  
Cristina Andreu-Vázquez ◽  
Alicia Ruiz-Pomeda ◽  
...  
Keyword(s):  
Public Health Problem ◽  
Cross Sectional Study ◽  
World Population ◽  
Sectional Study ◽  
Cross Sectional ◽  
School Aged Children ◽  
Digital Devices ◽  
Visual Screening ◽  
Near Work ◽  
The Impact

Background: Myopia is a public health problem, with estimations that 50% of the world population will be myopic by 2050. Some environmental factors, such as time spent outdoors, doing near work, and using digital devices, influence the development of myopia in children. Home confinement in Spain has increased these risk factors, so this study aims to investigate the impact of home confinement during the COVID-19 outbreak in the vision of school-aged children; Methods: A cross-sectional study in children between 5 and 7 years old that completed a visual screening and a questionnaire about their lifestyles at opticians in Spain in September and October of 2019 and 2020. Statistical analysis to compare lifestyles pre and post confinement, and vision in 2020 versus a similar cohort examined at the same opticians in 2019, was conducted; Results: Spanish children spent less time outdoors and more time doing near work in 2020 than in 2019 (p ≤ 0.001). There was a significant decrease of the spherical equivalent (mean ± standard deviation; 0.66 ± 2.03 D in 2019 vs. 0.48 ± 1.81 D in 2020; p ≤ 0.001); Conclusions: Lifestyles of Spanish children changed during the home confinement at the beginning of 2020. Together with changes in their lifestyles, spherical equivalents have decreased, which implies higher figures of myopia for children aged between 5 and 7.

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