Understanding the influence of ethnicity on adherence to antidiabetic medication: Meta-ethnography and systematic review.

INTRODUCTION: A high prevalence of diabetes and diabetes-related complications in people from minority ethnic communities in high income countries is of significant concern. Several studies have indicated low adherence rates to antidiabetic medication in ethnic minority groups. Poor adherence to antidiabetic medication leads to a higher risk of complications and potential mortality. This review aims to qualitatively explore the barriers to and facilitators of adherence to antidiabetic medication among ethnic minority groups in high-income countries. METHODS: A comprehensive search of MEDLINE, Embase, CINAHL, PsycINFO, and Global Health databases for qualitative studies exploring the barriers to or facilitators of adherence to antidiabetic medication in minority ethnic groups was conducted from database inception to March 2023 (PROSPERO CRD42022320681). A quality assessment of the included studies was conducted using the Critical Appraisal Skills Programme (CASP) tool. Key concepts and themes from relevant studies were synthesised using a meta-ethnographic approach. The Grading of Recommendations Assessment, Development and Evaluation Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) approach was used to assess the Confidence in the review findings. RESULT: Of 13,994 citations screened, 21 studies that included primary qualitative studies were selected, each of which involved people from minority ethnic communities from eight high income countries. This qualitative evidence synthesis has identified three overarching themes around the barriers to and facilitators of adherence to antidiabetic medication among ethnic minority groups.: 1) cultural underpinnings, 2) communication and building relationships, and 3) managing diabetes during visiting home countries. Based on the GRADE-CERQual assessment, we had mainly moderate- and high-confidence findings. CONCLUSION: Multiple barriers and facilitators of adherence to antidiabetic medication among people from minority ethnic communities in high-income countries have been identified. A medication adherence intervention focusing on identified barriers to adherence to antidiabetic medication in these communities may help in improving diabetes outcomes in these groups.

Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis.

BACKGROUND: Socioeconomic status (SES) may influence prescribing, concordance and adherence to medication regimens. This review set out to investigate the association between polypharmacy and an individual's socioeconomic status. METHODS: A systematic review and meta-analyses of observational studies was conducted across four databases. Older people (≥ 55 years) from any healthcare setting and residing location were included. The search was conducted across four databases: Medline (OVID), Web of Science, Embase (OVID) and CINAHL. Observational studies from 1990 that reported polypharmacy according to SES were included. A random-effects model was undertaken comparing those with polypharmacy (≥ 5 medication usage) with no polypharmacy. Unadjusted odds ratios (ORs), 95% confidence intervals (CIs) and standard errors (SE) were calculated for each study. RESULTS: Fifty-four articles from 13,412 hits screened met the inclusion criteria. The measure of SES used were education (50 studies), income (18 studies), wealth (6 studies), occupation (4 studies), employment (7 studies), social class (5 studies), SES categories (2 studies) and deprivation (1 study). Thirteen studies were excluded from the meta-analysis. Lower SES was associated with higher polypharmacy usage: individuals of lower educational backgrounds displayed 21% higher odds to be in receipt of polypharmacy when compared to those of higher education backgrounds. Similar findings were shown for occupation, income, social class, and socioeconomic categories. CONCLUSIONS: There are socioeconomic inequalities in polypharmacy among older people, with people of lower SES significantly having higher odds of polypharmacy. Future work could examine the reasons for these inequalities and explore the interplay between polypharmacy and multimorbidity.

Investigation and Optimization of Mxene Functionalized Mesoporous Titania Films as Efficient Photoelectrodes.

Three-dimensional mesoporous TiO2 scaffolds of anatase phase possess inherent eximious optical behavior that is beneficial for photoelectrodes used for solar energy conversion applications. In this regard; substantial efforts have been devoted to maximizing the UV and/or visible light absorption efficiency; and suppressing the annihilation of photogenerated charged species; in pristine mesoporous TiO2 structures for improved solar illumination conversion efficiency. This study provides fundamental insights into the use of Mxene functionalized mesoporous TiO2 as a photoelectrode. This novel combination of Mxene functionalized TiO2 electrodes with and without TiCl4 treatment was successfully optimized to intensify the process of photon absorption; charge segregation and photocurrent; resulting in superior photoelectrode performance. The photocurrent measurements of the prepared photoelectrodes were significantly enhanced with increased contents of Mxene due to improved absorption efficiency within the visible region; as verified by UV-Vis absorption spectroscopy. The anatase phase of TiO2 was significantly augmented due to increased contents of Mxene and postdeposition heat treatments; as evidenced by structural analysis. Consequently; an appreciable coverage of well-developed grains on the FTO surface was observed in SEM images. As such; these newly fabricated conductive mesoporous TiO2 photoelectrodes are potential candidates for photoinduced energy conversion and storage applications.

Evaluation of the nanofluid-assisted desalination through solar stills in the last decade.

Remote areas and poor communities are occasionally deprived of access to freshwater. It is, therefore, critical to providing a cheap and efficient desalination system that encourages the development of those communities and benefiting society at large. Solar stills are an affordable, direct method of water desalination, but its productivity is the critical challenge hindering its application. To ease this, research has focused on the role of nanofluids to improve heat transfer. Other works have focused on improving the design in consort with utilizing the nanofluids. This review reports and discusses the substantial role of nanofluids to enhance the productivity and energy utilization efficiency of the solar stills. Specifically, the mechanism of energy transfer between the nanoparticles and the base fluid. This includes both plasmonic and thermal effects. It is evident that nanofluid utilization in small fraction enhanced the thermal conductivity compared to base fluid alone. Alumina was found to be the most suitable nanoparticle used as nanofluid inside the solar stills due to its availability and lower cost. Still, other competitors such as carbon nanostructures need to be investigated as it provides higher enhancement of thermal conductivity. Also, several aspects of energy utilization enhancement have been discussed, including innovative application techniques. The challenges of such integrated systems are addressed as well.

A Cross-Sectional Survey on Telemedicine Use for Doctor-Patient Communication.

Introduction Use of computers for doctor-patient communication is increasing. Considering effective doctor-patient communication is important for good health outcomes. This study helps to determine the level of acceptance of telemedicine in general public and factors associated with it. Methods: This survey with cross-sectional analysis comprised a brief survey with 15 questions. The survey was distributed in public places to determine the opinions of the general public. Results Randomly selected 125 participants completed the questionnaire. Synchronous telemedicine was favored by young people (82% in the 18-34 age group vs 37.5% of participants aged >55 years; p<0.01), those with a higher education level (46.7% of non-college-educated persons vs 80.6% of college-educated persons; p<0.01), and frequent computer users (67% who used a computer for less than two hours a month vs 86.5% of those who used a computer more than hours a month; p=0.03). Asynchronous communication, like sending health information to doctors via a safe portal was acknowledged mostly by people who had used patient portals in the past (84.1% vs 65.4%; p=0.02). Use of patient portals was less among older users and senior citizens (20.8% use in the age group >55 vs. 51.3% in the age group 35-53 years vs. 71% in age group 18-34 years). Receiving video education for specific health concerns was favored by those who used a computer frequently (94.6% who used a computer more than two hours a month vs 77% who used a computer less than two hours a month; p =0.02). Conclusion Telemedicine is generally favored, but physicians should be mindful about older people as they may not feel comfortable. Step by step guidance should be provided especially to senior citizens for telemedicine and portal use.

Phytoremediation potential of Pistia stratiotes and Eichhornia crassipes to remove chromium and copper.

Phytoremediation is a cost-effective and eco-friendly process to remove heavy metals from water. A small-scale experiment was conducted to determine the phytoremediation efficiency of two macrophytes, i.e. Pistia stratiotes and Eichhornia crassipes for the removal of chromium and copper from the prepared metal solutions of different concentrations (2, 4, 6, 8 mg/L) for a period of one month. Both aquatic macrophytes showed different efficiency for the removal and accumulation of Chromium (Cr) and Copper (Cu). The dry biomass of both macrophytes increased over the period of time. The average accumulation of chromium in roots and leaves of P. stratiotes was 85 mg, 56 mg and copper was 96 mg and 70 mg, respectively whereas the average accumulation of chromium in roots and leaves of E. crassipes was 90 mg, 53 mg and copper was 86 mg, 50 mg, respectively. Higher absorbance of metals was observed in roots as compared to the leaves of both macrophytes. The concentration of metals in the solution significantly decreased from day 1 to day 30. The results of one-way ANOVA showed that removal of Cr was significantly (p < .05) greater in E. crassipes and removal of Cu was significantly (p < .05) greater in P. stratiotes.

Correlation Between Vitamin D Deficiency and Diabetic Ketoacidosis.

Both type 1 and type 2 diabetes mellitus have been associated with vitamin D deficiency. Diabetic ketoacidosis, which is a complication of type 1 and, rarely, type 2 diabetes, is also found to be associated with vitamin D levels. This review discusses studies on the correlation between diabetic ketoacidosis and vitamin D levels. Studies show that vitamin D deficiency is associated with the occurrence of diabetic ketoacidosis. Diabetic ketoacidosis is also found to affect vitamin D levels. The possible explanation of diabetic ketoacidosis affecting vitamin D levels is the inactivity of the 1-alpha-hydroxylase enzyme and an increase in the renal excretion of vitamin D binding proteins. The presence of vitamin D receptors on pancreatic beta cells explains the role of vitamin D in the causation of diabetic ketoacidosis.

Treatment of textile effluents with Pistia stratiotes, Eichhornia crassipes and Oedogonium sp.

Phytoremediation by aquatic macrophytes is a promising technology with higher efficiency and no energy consumption. For this purpose, two macrophytes (Pistia stratiotes, Eichhornia crassipes), and an alga (Oedogonium sp.) were used to treat textile effluents rich in COD, BOD, dyes, and heavy metals (Pb, Fe, Cd, Cu). The aim of the study was to focus on comparative phytoremediation potential of these species by their metal removal capability. During 7 days experiment (day 0-day 6), the results showed that Oedogonium sp. was the best for COD removal and decolorization. Eichhornia crassipes was the best for BOD and heavy metal removal and proves more efficient than Pistia stratiotes and Oedogonium sp. However, Pistia stratiotes was found to accumulate more concentrations of Pb and Fe than Eichhornia stratiotes.

Study of Graphene Oxide Structural Features for Catalytic, Antibacterial, Gas Sensing, and Metals Decontamination Environmental Applications.

This study represents a comprehensive review about the structural features of graphene oxide (GO) and its significance in environmental applications. Two dimensional (2D) GO is tremendously focused in advanced carbon-based nanomaterials for environmental applications due to its tunable physicochemical characteristics. Herein, we report foundational structural models of GO and explore the chemical bonding of oxygen moieties, with graphite basal plane using various characterization tools. Moreover, the impact of these oxygen moieties and the morphology of GO for environmental applications such as removal of metal ions and catalytic, antibacterial, and gas sensing abilities have here been critically reviewed for the first time. Environmental applications of GO are highly significant because, in the recent era, the fast progress of industries, even in the countryside, results in air and water pollution. GO has been widely investigated by researchers to eradicate such environmental issues and for potential industrial and clinical applications due to its 2D structural features, large surface area, presence of oxygen moieties, nonconductive nature, intense mechanical strength, excellent water dispersibility, and tunable optoelectronic properties. Thence, particular emphasis is directed toward the modification of GO by varying the number of its oxygen functional groups and by coupling it with other exotic nanomaterials to induce unique properties in GO for potential environmental remediation purposes.

Determinants of Pediatric Psychiatry Length of Stay in 2 Urban Emergency Departments.

OBJECTIVES: Pediatric mental illness poses a significant burden with an overall prevalence of approximately 10%. Increasingly, children with mental disorders seek care in the emergency department (ED). However, the ED is not an ideal setting. Pediatric mental health patients receive limited treatment and experience significantly longer length of stay (LOS) than other patients seen in the ED. This study examines patient and hospital factors associated with LOS and prolonged LOS (PLOS). METHODS: This is a retrospective chart review of patients between the ages of 3 and 17 presenting at 2 participating urban EDs with a psychiatric diagnosis from May 2010 to May 2012. RESULTS: This study includes 939 patients with an average age of 14.1 years and a median LOS of 295 minutes. The diagnosis was the strongest predictor of LOS and PLOS. Patients with a psychotic disorder or suicide attempt or ideation experienced a longer LOS, 35% and 55% increases, respectively, and an increased odds of PLOS (odds ratio, 3.07 and 8.36, respectively). Patient sex, previous history of self-harm, and the daily census were associated with both a longer LOS and PLOS. Ethnicity, site of admission, and year of admission were only associated with LOS. CONCLUSIONS: Diagnosis-specific management factors are the primary determinant of LOS. However, some patient characteristics and hospital operational factors are also associated with LOS. Organizational reforms and an evaluation of the required human and material resources are necessary to improve access to and availability of pediatric mental health care.