Quality of life impacts associated with comorbid insomnia and depression in adult population.

PURPOSE: Health-related quality of life (HRQoL) impacts of insomnia and depression (as separated entities) have been well investigated in previous studies. However, little is known about the effect of comorbid insomnia and depression on HRQoL. This study aimed to assess the impacts of insomnia and depression, in combination or alone, on HRQoL in Australian adults. METHODS: Data used in this study were obtained from the large-scale longitudinal Household, Income and Labour Dynamics in Australia (HILDA) survey. Insomnia was defined using key insomnia criteria of DSM-V. Depression was based on validated cut-off points of the Mental Health Inventory-5 (MHI-5) (scores ≤ 62) in the base case analysis. HRQoL expressed as utility scores (ranging from 0 to 1) were measured using the Short-Form 6-Dimension (SF-6D) converted from the SF-36 and valued using an Australian scoring algorithm. Multi-level modelling was applied to assess the effect of insomnia and/or depression on utility scores. RESULTS: The study analysed 30,972 observations from 10,324 individuals (age [mean ± SD]: 45.7 ± 16.5, female: 54.6%). The proportion of individuals with insomnia only, depression only, and comorbid insomnia and depression was 11.3%, 11.6%, and 8.2%, respectively. The interaction effect suggested the combined impact of insomnia and depression on health-related quality of life beyond the sum of their individual effects. Marginal mean difference in utility scores for insomnia only, depression only, and the comorbidity relative to no insomnia or depression was -0.058 (SE: 0.003, Cohen's d: 0.420, small effect), -0.210 (SE: 0.003, Cohen's d: 1.530, large effect), and -0.291 (SE: 0.004, Cohen's d: 2.120, large effect), respectively. CONCLUSION: Comorbid depression and insomnia appear to have very large quality-of-life impacts. Furthermore, this is the first study that has estimated the magnitude of the impact of comorbid insomnia and depression on utility scores which can be utilised in future clinical or economic studies.

Insomnia and depression often occur together and have an evidence-based bidirectional relationship. The impairment of health-related quality of life (HRQoL) associated with insomnia or depression, as an individual effect, has been previously examined by several studies. However, the reduction in HRQoL associated with comorbid insomnia and depression has been understudied. With the use of representative longitudinal data containing a large sample size of 10,324 Australian adults, we found that insomnia and depression were associated with statistically significant reductions in health-related quality of life, whether occurring individually or concurrently. The effect of comorbid insomnia and depression on quality of life was significantly larger than the summative effect of insomnia and depression. This study provides new insights into the quality-of-life burden of insomnia and/or depression and emphasises the importance of addressing insomnia in adults with depression.

The impact of green finance on green growth: The role of green energy and green production.

This study examines the linkage of green finance and green growth under the regulatory role of green energy and green production in 52 countries worldwide from 2005 to 2019. Applying the Bayesian regression and GMM regression, the results of these two methods are similar. When ignoring the regulatory role of green energy and green production, green finance negatively impacts green growth. This result is entirely opposite when considering the regulatory role of green energy and green production, green finance impacts green growth positively. However, Bayesian regression is more effective when providing different posterior probability intervals and probability ranges for independent variables to affect the dependent variable. Specifically, the probability that green financial growth has a negative impact on green growth is above 75.86 %. Similarly, under the role of green energy, the probability that green finance growth has a positive impact on green growth is 80.45 % and under the role of green production, this probability is 76.64 %. These findings imply that countries should build a financial system associated with the goal of green energy and green production, thereby helping the economy become greener.

Secondhand Smoke and Socio-Demographic Associated Factors: Results From the Vietnam Population-Based Provincial Global Adult Tobacco Survey in 2022.

Background: Secondhand smoke (SHS) has detrimental effects on community health, including coronary heart diseases, stroke, lung cancer etc. This manuscript exploited data from the Vietnam Population-based Provincial Global Adult Tobacco Survey (PGATS) in 2022 to update the prevalence of adult exposure to SHS and associated socio-demographic factors. Methods: With the sample size of 71,981 adults aged 15+ throughout 30 provinces and cities in Vietnam, data was collected using the Global Adult Tobacco Survey (GATS) questionnaire. Bivariate analysis and multivariate logistic regression modelling were performed. Results: In the past 30 days, 44.4% (95% CI: 44.0%-44.9%) adults aged 15+ exposed to SHS at home while 23.1% (95% CI: 22.6%-23.6%) exposed to SHS at work. Female exposure to SHS in the past 30 days was higher at homes but lower at indoor workplaces. Participants aged 15-24 were likely to have higher odds of SHS exposure in the past 30 days to other age groups. Those living in the urban areas had 1.15 times higher odds (95% CI: 1.08-1.22) of exposure to SHS than those in the rural areas. Current smokers tended to have 2.2 times higher odds of exposure to SHS at the indoor workplaces compared to non-smokers (95% CI: 2.05-2.37). Conclusions: The prevalence of exposure to SHS at home was still relatively high amongst the adult population. While there was a significant reduction of SHS exposure at indoor workplaces, there was a higher prevalence of women being exposed to SHS at home. The Government of Vietnam should continue to strictly implement the smoke-free environment resolution at indoor workplaces and appropriate communication campaigns to protect people, especially women from SHS exposure at homes.

The Cost-Effectiveness of Psychosocial Interventions Following Self-Harm in Australia.

Background: Psychosocial interventions following self-harm in adults, in particular cognitive behavioral therapy (CBT), can be effective in lowering the risk of repeated self-harm. Aims: To evaluate the cost-effectiveness of CBT for reducing repeated self-harm in the Australian context. Method: The current study adopted the accessing cost-effectiveness (ACE) approach using return-on-investment (ROI) analysis. Uncertainty and sensitivity analyses (Sas) tested the robustness of the model outputs to changes in three assumptions: general practitioner referral pathway (SA1), private setting intervention delivery (SA2), and training costs (SA3). Results: The intervention produced cost savings of A$ 46M (95% UI -223.7 to 73.3) and A$ 18.3M (95% UI -86.2 to 24.6), subject to the effect of intervention lasting 2- or 1-year follow-up. The ROI ratio reduced to 5.22 in SA1 (95% UI -10.1 to 27.9), 2.5 in SA2 (95% UI -4.8 to 13.3), and 5.1 in SA3 (95% UI -9.8 to 27.8). Limitations: We assumed that the effectiveness would reduce 50% within 5 years in the base case, and we used Australian data and a partial social perspective. Conclusions: The current study demonstrated cost-effectiveness of CBT for adults who have self-harmed with the return-on-investment ratio of A$ 2.3 to $6.0 for every A$ 1 invested.

The Urban-Rural Difference in Child Mental Health in Vietnam: The Continuing Impacts of the COVID-19 Pandemic on Health.

OBJECTIVES: We aimed to explore the difference between rural and urban children's mental health and quality of life after the pandemic. METHODS: A total of 200 parents and their 11- to 15-year-old children were interviewed face to face in October 2022. This study measures child mental health and quality of life using the Strengths and Difficulties Questionnaire and Child Health Utility 9 Dimensions tools. The unadjusted effect sizes on health outcomes among demographic groups are calculated using Cohen's d. The school-specific fixed effects linear regression model with bootstrapped standard errors is applied. RESULTS: Rural children have significantly higher mean internalizing behavior scores than urban children (emotional problems, Cohen's d score = 0.38; peer difficulties, Cohen's d score = 0.39; P < .05). Although children living in urban areas who had COVID-19 had significantly higher peer problem scores (Cohen's d score = 0.82, P < .05), the result was not found in those residing in rural areas. After controlling all variables, the econometrics method confirms that infection status significantly affects children's peer problems, obviously in the urban sample. CONCLUSIONS: Children may experience the consequences of the pandemic on their mental health related to peer difficulties, differently between urban and rural areas. Further research is required to investigate the different impacts of COVID-19 on health in urban and rural areas.

Improving the diagnosis of endometriosis in Asia-Pacific: Consensus from the Asia-Pacific Endometriosis Expert Panel for Endometriosis.

Endometriosis should be diagnosed as early as possible in the continuum of care; but substantial delays of approximately 6-8 years between symptom onset and endometriosis diagnosis have been widely reported. With the purpose of improving the prompt diagnosis of endometriosis, the Asia-Pacific Endometriosis Expert Panel (APEX) sought to address the reasons for diagnostic delays across the region, and formulate a multi-pronged approach to overcoming these challenges. In the first instance, clinical diagnosis is preferable to surgical diagnosis, in order to facilitate earlier empirical treatment and minimize the negative sequelae of undiagnosed/untreated disease. There should be a high clinical index of suspicion in women presenting with cyclical symptoms, including those involving extrapelvic organs. Diagnostic delays in Asia-Pacific countries are attributable to a variety of patient, physician, and healthcare factors, including poor awareness, normalization/trivialization of pain, individual/cultural attitudes toward menstruation, default use of symptom-suppressing treatments, misdiagnosis, and a lack of diagnostic resourcing or adequate referral pathways in some areas. Suggested initiatives to reduce diagnostic delays are geared toward improving public awareness, improving clinical diagnostic skills, streamlining multidisciplinary care pathways for timely referral, updating and implementing diagnostic guidelines, lobbying policymakers and insurance companies for endometriosis support, and increasing efforts to bridge data gaps and perform further research in this field. Formulating specific action plans and gathering traction are the responsibility of individual countries within local parameters. The APEX group advocates for any initiatives and policies that support the unmet needs of women with endometriosis, to improve patient experience and outcomes.

Modeled health economic and equity impact on dental caries and health outcomes from a 20% sugar sweetened beverages tax in Australia.

Dental caries is the most prevalent oral disease across the life course. This study modeled the population health and economic impact of a 20% sugar sweetened beverages tax (SSB) for preventing dental caries compared to no intervention (societal and healthcare perspective). A cost-effectiveness analysis according to quintiles of area-level socioeconomic disadvantage was performed for the 2020 Australian population (0-100 years old) using a closed cohort Markov model. A qualitative assessment of implementation considerations (e.g., acceptability, equity, sustainability) was undertaken. Health outcomes were modeled as decayed teeth prevented and disability-adjusted life years (DALYs) averted. The 10-year and lifetime scenarios were modeled with probabilistic sensitivity analysis (Monte Carlo simulation, 2000 cycles). The 10-year scenario from a societal perspective yielded cost-savings of AUD$63.5M, healthcare cost-savings of AUD$42.2M, 510,977 decayed teeth averted and 98.1 DALYs averted. The lifetime scenario resulted in societal cost savings of AUD$176.6M, healthcare cost-savings of AUD$122.5M, 1,309,211 decayed teeth averted and 254.9 DALYs averted. Modeling indicated 71.5% and 74.5% cost-effectiveness for the 10-year and lifetime scenarios, respectively. A three-fold health benefit for the least advantaged was found compared to the most advantaged. A 20% SSB tax in Australia is cost-effective and promotes health equity.

Hematohidrosis induced by separation anxiety disorder during COVID-19 quarantine: a case report and brief literature review.

Here, we report a case involving a 10-year-old Vietnamese girl who developed hematohidrosis during the coronavirus disease quarantine. She was hospitalized with a 3-week recurrent bleeding on the abdominal skin. Physical examination revealed no signs of injuries on the skin. Hematological and biochemical test results and coagulation profiles were all within normal ranges. No abnormal findings were observed on abdominal ultrasonography and computed tomography. Numerous erythrocytes were observed during the microscopic examination of fluid samples from the abdominal skin. It was speculated that hematohidrosis was precipitated by separation anxiety disorder, because the onset and remission of symptoms correlated with the beginning and end of the local quarantine, respectively. Our case report and brief literature review highlight the transient and benign nature of hematohidrosis. Although specific guidelines are not well established, hematohidrosis is a transient phenomenon that is treatable with pharmaceutical and non-pharmaceutical interventions, and its overall prognosis is favorable.

Mental health systems modelling for evidence-informed service reform in Australia.

Australia's Fifth National Mental Health Plan required governments to report, not only on the progress of changes to mental health service delivery, but to also plan for services that should be provided. Future population demand for treatment and care is challenging to predict and one solution involves modelling the uncertain demands on the system. Modelling can help decision-makers understand likely future changes in mental health service demand and more intelligently choose appropriate responses. It can also support greater scrutiny, accountability and transparency of these processes. Australia has an emerging national capacity for systems modelling in mental health which can enhance the next phase of mental health reform. This paper introduces concepts useful for understanding mental health modelling and identifies where modelling approaches can support health service planners to make evidence-informed decisions regarding planning and investment for the Australian population.

A systematic review and meta-analysis of depression and apathy frequency in adult-onset Huntington's disease.

Depression and apathy are associated with decreased functional capacity in Huntington's disease (HD) but frequency of depression and apathy in HD is largely unknown. Systematic literature searching was conducted across 21 databases until 30 June 2021. Inclusion criteria was limited to clinician-rated assessments of depression and apathy and adult-onset HD. Inverse-variance heterogeneity meta-analyses were conducted exploring depression and apathy frequency within individuals from families affected by HD, and within individuals with confirmed HD gene-positive status. Screening identified 289 articles for full-text review; nine remained for meta-analysis. Depression frequency in the lifetime in adults affected by or at-risk for HD was 38%, I2 = 99%. Apathy frequency in the lifetime in adults affected by or at-risk for HD was 40%, I2 = 96%. The robustness of the findings improved when limiting the analysis to gene-positive individuals only where apathy was found to be slightly more common than depression, 48% and 43% respectively. Future studies may consider reporting results from juvenile-onset HD and adult-onset HD cohorts separately to further explore phenotypic profiles.

Characteristics and Relationships between Total Polyphenol and Flavonoid Contents, Antioxidant Capacities, and the Content of Caffeine, Gallic Acid, and Major Catechins in Wild/Ancient and Cultivated Teas in Vietnam.

Vietnam has diverse and long-established tea plantations but scientific data on the characteristics of Vietnamese teas are still limited. Chemical and biological properties including total polyphenol and flavonoid contents (TPCs and TFCs), antioxidant activities (DPPH, ABTS, FRAP, and CUPRAC), as well as the contents of caffeine, gallic acid, and major catechins, were evaluated for 28 Vietnamese teas from North and South Vietnam. Higher values of TPCs and TFCs were found for green (non-oxidised) and raw Pu'erh (low-oxidised) teas from wild/ancient tea trees in North Vietnam and green teas from cultivated trees in South Vietnam, as compared to oolong teas (partly oxidised) from South Vietnam and black teas (fully oxidised) from North Vietnam. The caffeine, gallic acid, and major catechin contents depended on the processing, geographical origin, and the tea variety. Several good Pearson's correlations were found (r2 > 0.9) between TPCs, TFCs, the four antioxidant capacities, and the content of major catechins such as (-)-epicatechin-3-gallate and (-)-epigallocatechin-3-gallate. Results from principal component analysis showed good discriminations with cumulative variances of the first two principal components varying from 85.3% to 93.7% among non-/low-oxidised and partly/fully oxidised teas, and with respect to the tea origin.

The efficiency of government finanical expenditures before and during the COVID-19 pandemic: A cross-country investigation.

This paper examines the way government spending affected productivity and its decomposition before and during the COVID-19 outbreak. Using panel data from 158 economies, the research shows that spending on health care increases productivity, while spending on the military slows down productivity and its decompositions. These effects are even greater in the context of COVID-19, showing that spending on health care and avoiding conflict and military escalation will be important for future economies to grow in a sustainable way.

Results from Viet Nam's 2022 report card on physical activity for children and youth.

Background: The Active Healthy Kids 2022 Viet Nam Report Card provides an evidence-based assessment of 10 indicators of community and government-led initiatives that impact the physical activity levels of children and youth in Vietnam. Methods: A systematic framework developed by the Active Healthy Kids Global Alliance was used. Each indicator: Overall Physical Activity, Organized Sport Participation, Active Play, Active Transportation, Sedentary Behaviors, Physical Fitness, Family and Peers, School, Community and Environment, and Government, and a new indicator: Obesity was assessed against predefined benchmarks. EBSCOhost databases and Google Scholar were searched for relevant academic and grey literature (e.g., government reports) respectively to inform indicator grading. Results: The School indicator received the highest grade 'A', followed by the Government indicator which was graded as 'B-'. Three indicators (Sedentary Behaviors, Family and Peers, Community and Environment) received 'C' grades. Active Transportation was graded 'D+'. Overall Physical Activity received the lowest grade of 'F'. Organized Sport and Physical Activity, Active Play, and Physical Fitness were not graded due to lack of data. Obesity was graded B-. Conclusions: This is the first physical activity report card for children and adolescents in Viet Nam. Evidence suggests that Vietnamese children and adolescents have low physical activity levels and high levels of sedentary behaviors. Initiatives to promote physical activity in children predominantly focus on promoting physical education in schools. Increased community-based programs promoting physical activity outside of school settings are required. Future research should address the surveillance gap in Organized Sport and Physical Activity, Active Play, and Physical Fitness.

Smartphone-based digital images as a low-cost and simple colorimetric approach for the assessment of total phenolic contents in several specific Vietnamese dried tea products and their liquors.

The total phenolic contents (TPCs) represent the bioactive substances and antioxidant capacities of flora products. The present study employed digital images from a smartphone to determine the TPCs in tea products and their liquors. Various parameters related to the portable home-made colorimetric analysis box design were optimized to achieve the most favorable capturing condition. The proposed method performance was evaluated, which agreed with the Appendix F of AOAC (2016). In comparison with the standard UV-vis, no statistical differences (t-tests, P = 95 %) were observed, and there were advantages of simplicity, portability, sample volume reduction, decreased analysis time, low-cost operation, especially the potential to be used by tea producers, managers, and consumers to quickly analyze the TPCs. The results demonstrate the descending TPCs orders of green > white > oolong > black teas (recoveries of 95-98 %) and the increase of TPCs in tea liquors regarding the rising brewing temperature and duration.

Clinical Diagnosis and Early Medical Management for Endometriosis: Consensus from Asian Expert Group.

This work provides consensus guidance regarding clinical diagnosis and early medical management of endometriosis within Asia. Clinicians with expertise in endometriosis critically evaluated available evidence on clinical diagnosis and early medical management and their applicability to current clinical practices. Clinical diagnosis should focus on symptom recognition, which can be presumed to be endometriosis without laparoscopic confirmation. Transvaginal sonography can be appropriate for diagnosing pelvic endometriosis in select patients. For early empiric treatment, management of women with clinical presentation suggestive of endometriosis should be individualized and consider presentation and therapeutic need. Medical treatment is recommended to reduce endometriosis-associated pelvic pain for patients with no immediate pregnancy desires. Hormonal treatment can be considered for pelvic pain with a clinical endometriosis diagnosis; progestins are a first-line management option for early medical treatment, with oral progestin-based therapies generally a better option compared with combined oral contraceptives because of their safety profile. Dienogest can be used long-term if needed and a larger evidence base supports dienogest use compared with gonadotropin-releasing hormone agonists (GnRHa) as first-line medical therapy. GnRHa may be considered for first-line therapy in some specific situations or as short-term therapy before dienogest and non-steroidal anti-inflammatory drugs as add-on therapy for endometriosis-associated pelvic pain.

The Impact of Technological Progress and Climate Change on Food Crop Production: Evidence from Sichuan-China.

Agriculture is an integral sector in China mandated to feed over 1.3 billion of its people and provide essential inputs for many industries. Sichuan, a central grain-producing province in Southwest China, is a significant supplier of cereals in the country. Yet, it is likely to be threatened by yield damages induced by climate change. Therefore, this study examines the effects of technological progress (via fertilizers usage and mechanization) and climatic changes (via temperature and precipitation) on the productivity of main food crops, such as rice (Oryza sativa), wheat (Triticum aestivum), and maize (Zea mays) in Sichuan province. We employ the generalized method of moments (GMM) model to analyze Sichuan provincial data from 1980 to 2018. Our findings show a positive nexus between fertilizers use and yields of main food crops. Only rice and maize yields are significantly improved by mechanization. Increased average temperature reduces rice and wheat yields significantly. Rainfall is unlikely to have a significant impact on agricultural production. The study suggests that the Chinese government should consider revising its strategies and policies to reduce the impact of climate change on food crop production and increase farmers' adaptive ability.

Critical measurement issues in the assessment of social media influence on body image.

Progress towards understanding how social media impacts body image hinges on the use of appropriate measurement tools and methodologies. This review provides an overview of common (qualitative, self-report survey, lab-based experiments) and emerging (momentary assessment, computational) methodological approaches to the exploration of the impact of social media on body image. The potential of these methodologies is detailed, with examples illustrating current use as well as opportunities for expansion. A key theme from our review is that each methodology has provided insights for the body image research field, yet is insufficient in isolation to fully capture the nuance and complexity of social media experiences. Thus, in consideration of gaps in methodology, we emphasise the need for big picture thinking that leverages and combines the strengths of each of these methodologies to yield a more comprehensive, nuanced, and robust picture of the positive and negative impacts of social media.

Development of a novel real-time PCR assay targeting p54 gene for rapid detection of African swine fever virus (ASFV) strains circulating in Vietnam.

African swine fever (ASF) continues to cause outbreaks throughout regions of Africa, Europe and Asia. The disease can cause severe morbidity and mortality resulting in serious economic losses. Since there is no vaccine available to control ASF, early detection is critical to contain and control the disease. The aim of this study was to develop a novel real-time PCR assay based on highly conserved ASFV gene E183L (p54). The limit of detection of the assay, VNUA-p54 real-time PCR, was 2.63 copies/reaction and 2 Log10 HAD50 /ml. The VNUA-p54 real-time PCR was able to detect fifteen different ASFV reference strains representing p72 genotypes I, II and V. The assay was specific and did not amplify other swine viruses including CSFV, FMDV, PRRSV and PEDV. The diagnostic sensitivity of the real-time PCR assay was evaluated using 200 field clinical specimens collected from swine farms located in different provinces in Vietnam. The VNUA-p54 real-time PCR assay is an additional tool for ASF diagnostics and can be used in combination with other p72 based ASFV real-time PCR assays as a rapid confirmatory assay.

Decreased inflammatory cytokine production of antigen-specific CD4+ T cells in NMDA receptor encephalitis.

Anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis is the most common autoimmune encephalitis with psychosis, amnesia, seizures and dyskinesias. The disease is mediated by pathogenic autoantibodies against the NR1 subunit that disrupt NMDAR function. Antibody infusion into mouse brains can recapitulate encephalitis symptoms, while active immunization resulted also in strong T cell infiltration into the hippocampus. However, whether T cells react against NMDAR and their specific contribution to disease development are poorly understood. Here we characterized the ex vivo frequency and phenotype of circulating CD4+ T helper (TH) cells reactive to NR1 protein using antigen-reactive T cell enrichment (ARTE) in 24 patients with NMDAR encephalitis, 13 patients with LGI1 encephalitis and 51 matched controls. Unexpectedly, patients with NMDAR encephalitis had lower frequencies of CD154-expressing NR1-reactive TH cells than healthy controls and produced significantly less inflammatory cytokines. No difference was seen in T cells reactive to the synaptic target LGI1 (Leucine-rich glioma-inactivated 1), ubiquitous Candida antigens or neoantigens, suggesting that the findings are disease-specific and not related to therapeutic immunosuppression. Also, patients with LGI1 encephalitis showed unaltered numbers of LGI1 antigen-reactive T cells. The data reveal disease-specific functional alterations of circulating NMDAR-reactive TH cells in patients with NMDAR encephalitis and challenge the idea that increased pro-inflammatory NMDAR-reactive T cells contribute to disease pathogenesis.