RESEARCH METHOD: The study has adopted a mixed-method research design. Data was collected from 15 frontline healthcare workers through semi-structured interviews to achieve study objectives. Descriptives and content analysis were conducted to explore voice barriers and alternative practices to solve their concerns. After that, a quantitative study was conducted to determine the statistical significance of the identified voice barriers and the magnitude of their effect. For this purpose, data was collected from 480 frontline healthcare workers in the primary, secondary, and territory healthcare units. A questionnaire survey was used for data collection. Then, multistage hierarchical regression analysis was employed for data analysis.
RESULTS: Study findings highlight the determinants of two key factors: withholding patient safety concerns and withholding worker safety concerns. First, the study identifies several factors that increase the likelihood of healthcare workers withholding concerns about patient safety. These factors include professional designation, work experience, blackmailing, overconfidence, longer work tenure, feelings of insult, early career stage, fear of patient reactions, bad past experiences, job insecurity, and uncooperative management. Fear of increased workload also plays a significant role. Second, when it comes to work-related safety concerns, factors such as gender, shyness, lack of confidence, fear of duty changes, management issues, interpersonal conflicts, and resource shortages contribute to the withholding of concerns. To navigate these challenges, healthcare workers often resort to strategies such as seeking political connections, personal settlements, transfers, union protests, quitting, using social media, engaging in private practice, or referring patients to other hospitals.
CONCLUSION: Findings demonstrates that healthcare workers in Pakistan often withhold safety concerns due to hierarchical pressures, personal insecurities, and fear of repercussions. Their reliance on external mechanisms, such as political influence or social media, underscores the need for significant reforms to improve safety culture and management support. Addressing these issues is crucial for ensuring both patient and worker safety.
METHODS: The protocol was registered with PROSPERO and followed PRISMA 2020 guidelines. A comprehensive electronic literature search was conducted in PubMed, Scopus, Web of Science databases and grey literature via Google Scholar. Out of 298 abstracts, 37 articles were selected following screening. A risk of bias assessment was conducted using Joanna Briggs Institute tools. Following blinded data extraction, descriptive data analysis and narrative synthesis were performed.
RESULTS: This review included studies published between 2016-2023. Of the included studies, 17 (45.9%) reported data on samples obtained from humans, 9 (24.3%) from animals, and 6 (16.2%) from environmental sources, two studies (5.4%) from humans and animals, one study on animal and environment; whereas two studies including all three domains. ABR of 32 different bacteria (Gram negative⸺17, Gram positive⸺14) was retrieved; E. coli was the most frequently studied bacteria followed by MRSA and ESBL. For E. coli, a median resistance over 50% was reported for sulfamethoxazole (88.8%), trimethoprim (79.1%), ampicillin (60%) and tetracycline (50.3%) with the highest resistance for erythromycin (98%). Of a total of 21 antibiotic-resistance genes in E. coli, the highest genotypic resistance was for tet-A (48.5%).
CONCLUSIONS: A comprehensive description of ABR for a total of 32 bacteria, 62 antibiotics and 46 ABR genes is presented. This review discusses the contemporary ABR landscape in Sri Lanka through the One Health lens, highlighting key methodological and empirical research gaps.
RESEARCH DESIGN AND METHODS: We carried out analysis based on the data from the 2021 Global burden of disease study. Joinpoint regression was used to identify significant changes in trends over time, and ARIMA models were applied to forecast incidence rates.
RESULTS: Between 1990 and 2021, the average annual percentage change (AAPC) of age-standardized prevalence rates and incidence rates increased by 2.15 and 1.72 respectively. The age-standardized mortality rate rose more slowly, at 1.05 AAPC, with females experiencing a slightly higher AAPC than males. ARIMA forecasts suggest that by 2031, T2DM incidence rates will continue to rise significantly across all South Asian countries.
CONCLUSIONS: This study highlights the need for public health policies focused on preventing obesity, promoting physical activity, and improving healthcare access. It also calls for addressing regional disparities in T2DM prevalence and mortality to better allocate resources and prioritize policies to combat the diabetes epidemic inSouth Asia.
METHOD: Twenty-two healthy adult participants walked along an indoor walkway whilst eight video cameras recorded their gait in either tight- or loose-fitting clothing. A commercial markerless motion capture system (Theia3D) provided gait kinematics for evaluation.
RESULTS: Reliability results showed average inter-trial variation of <2°, inter-session variation of <3° and inter-session-clothing variation <3.5°. Root mean square differences (RMSD) between clothing conditions were <2°.
DISCUSSION: Pelvis variations were smaller than those at the hip, knee and ankle. Our results showed smaller variation than in previous studies which may be due to updates to software. The demonstration of the reliability of markerless motion capture for gait analysis in healthy adults should prompt further evaluation in clinical conditions and reconsideration of multi-assessor marker-based gait analysis protocols, where variation is highest.
METHODOLOGY: A panel of 30 laypersons, including raters from both genders equally, aged 19-24 years, evaluated extraoral photographs taken before the treatment of 60 patients (evenly divided between males and females employing a disproportionate stratified sampling method through a computer-generated list) with skeletal class I malocclusion, vertical growth pattern based on the Bjork sum, aged 18-25 years (with an average age of 22 ± 1.53 years), with the photographs taken in three positions (frontal relaxed, frontal during a smile, and relaxed profile). The raters utilized the visual analog scale (VAS) to assign an esthetic quality score to each photograph. Based on the average esthetic scores of each photo, two groups were created: the most attractive group, which received the highest esthetic score, and the least attractive group, which received the lowest esthetic score. After selecting 12 patients for each group, the angles and proportions of the frontal and lateral photos were calculated, and the results were compared between the two groups using an independent-sample t-test to see any significant differences.
RESULTS: The most attractive females had a significantly lower value of mouth width to lower facial height than the least attractive females (P = 0.039). In addition, the most attractive males had a substantially greater value of facial convexity angle than the least attractive males (P = 0.041). Regarding other profile and frontal variables, no statistically significant differences existed between the most and least attractive males and females.
CONCLUSIONS: In patients with vertical growth pattern malocclusion, it is important to consider the chin protrusion of male patients during treatment planning and diagnosis because it enhances masculine features in these patients, as well as the lower facial height of female patients.
METHODS: Prior to the current effort, the burden of PAH was included in GBD as a non-specific contributor to "other cardiovascular and circulatory disease" burden. In this study, PAH was distinguished as its own cause of death and disability in GBD, producing comparable and consistent estimates of PAH burden. We used epidemiological and vital registry data to estimate the non-fatal and fatal burden of PAH in 204 countries and territories from 1990 to 2021 using standard GBD modelling approaches. We specifically focused on PAH (group 1 pulmonary hypertension), and did not include pulmonary hypertension groups 2-5.
FINDINGS: In 2021, there were an estimated 192 000 (95% uncertainty interval [UI] 155 000-236 000) prevalent cases of PAH globally. Of these, 119 000 (95 900-146 000) were in females (62%) and 73 100 (58 900-89 600) in males (38%). The age-standardised prevalence was 2·28 cases per 100 000 population (95% UI 1·85-2·80). Prevalence increased with age such that the highest prevalence was among individuals aged 75-79 years. In 2021, there were 22 000 deaths (18 200-25 400) attributed to PAH globally, with an age-standardised mortality rate of 0·27 deaths from PAH per 100 000 population (0·23-0·32). The burden of disease appears to be improving over time (38·2% improvement in age-standardised years of life lost [YLLs] in 2021 relative to 1990). YLLs attributed to PAH were similar to estimates for conditions such as chronic myeloid leukaemia, multiple sclerosis, and Crohn's disease.
INTERPRETATION: PAH is a rare but fatal disease that accounts for a considerable health-associated burden worldwide. PAH is disproportionally diagnosed among females and older adults.
FUNDING: Cardiovascular Medical Research and Education Fund and the Bill & Melinda Gates Foundation.
METHODS: A total of 17294 histopathological reports from Diagnostic Oral Pathology Unit between 1991 and 2021 were retrieved. One thousand eleven histopathological reports that fulfilled the inclusion and exclusion criteria were included. Information of interest was extracted from histopathological reports. The lesions were categorised into 10 diagnosis categories. Descriptive and correlation analysis were performed.
RESULTS: Paediatric oral and maxillofacial biopsies accounted for 5.9% of the total biopsies received. The peak incidence of diagnosis was in age range of 12 to 16 years old and mean age of 11.6 years old (±3.5), with female preponderance. The most common category of diagnosis was salivary gland pathology with mucocele (30%) being the most frequently diagnosed lesions. Lip and labial mucosa were the commonest site of occurrence. Specimen sizes smaller than 1 cm were the most common specimen diameter with mean size of 1.6 cm (±1.5). Age, site of occurrence and specimen size were statistically significant (P
OBJECTIVES: This review aims to provide a comprehensive systematic analysis of different music styles in counteracting mental fatigue and their effects on performance decrements induced by mental fatigue. Additionally, the mechanisms by which music counteracts mental fatigue will be discussed.
METHODS: A comprehensive search was conducted across five databases-Web of Science, PubMed, SCOPUS, SPORTDiscus via EBSCOhost, and the Psychological and Behavioral Sciences Collection via EBSCOhost-up to November 18, 2023. The selected studies focused solely on music interventions, with outcomes including subjective feelings of mental fatigue, physiological markers, and both cognitive and behavioral performance.
RESULTS: Nine studies met the predetermined criteria for inclusion in this review. The types of music interventions that counteract mental fatigue include relaxing, exciting, and personal preference music, all of which were associated with decreased subjective feelings of mental fatigue and changes in objective physiological markers. Cognitive performance, particularly in inhibition and working memory tasks impaired by mental fatigue, was countered by both relaxing and exciting music. Exciting music was found to decrease reaction time more effectively than relaxing music in working memory tasks. The physiological marker of steady-state visually evoked potential-based brain-computer interface (SSVEP-BCI) amplitude increased, confirming that exciting music counteracts mental fatigue more effectively than relaxing music. Behavioral performance in tasks such as arm-pointing, the Yo-Yo intermittent test, and the 5 km time-trial, which were impaired by mental fatigue, were counteracted by personal preference music.
CONCLUSION: Relaxing music, exciting music, and personal preference music effectively counteract mental fatigue by reducing feelings of fatigue and mitigating performance decrements. Individuals engaged in mentally demanding tasks can effectively counteract concurrent or subsequent cognitive performance decrements by simultaneously listening to relaxing or exciting music without lyrics or by using music during recovery from mental fatigue. Exciting music is more effective than relaxing music in counteracting mental fatigue. Personal preference music is effective in counteracting behavioral performance decrements in motor control and endurance tasks. Mentally fatigued individuals could apply personal preference music to counteract subsequent motor control performance decrements or simultaneously listen to it to counteract endurance performance decrements. Future studies should specify and examine the effects of different music genres, tempos, and intensities in counteracting mental fatigue. Additionally, the role of music in counteracting mental fatigue in contexts such as work productivity, traffic accident risk, and sports requires further investigation, along with the underlying mechanisms.