Effects of time to treatment initiation on outcomes for soft tissue sarcomas.

BACKGROUND AND OBJECTIVES: Few studies have investigated the effects of time to treatment initiation (TTI) for soft tissue sarcomas (STS). Our objective was to investigate the risk factors for prolonged TTI and the effects of prolonged TTI on local recurrence free survival (LRFS), distant metastasis free survival (DMFS), and disease specific survival (DSS). METHOD: Patients diagnosed with high-grade STS of the extremities and trunk from 2011 to 2020 were included. TTI was grouped into two groups (treatment provided in less than vs. more than or equal to 30 days). Two-year and 5-year survival probabilities were calculated for LRFS, DMFS, and DSS. Cox regression and Kruskal-Wallis tests in univariate analysis were conducted to find risk factors affecting TTI and the survival outcomes. RESULTS: In the univariate analysis, diagnosis in the later 5-year period of the study, tumor size, and treatment modality were associated with prolonged TTI. TTI ≥30 days was associated with higher DMFS but no association was found with LRFS or DSS. Tumor size, surgical margins, and provision of surgery were associated with DSS. CONCLUSION: Despite the delay in treatment for STS patients caused by the COVID-19 pandemic, our study showed TTI of more than 30 days does not negatively impact patients.

Knowledge, attitudes, and practices towards fetal alcohol spectrum disorder in the New Zealand social and community sector: An online survey.

Background: Fetal Alcohol Spectrum Disorder (FASD) is a common neurodevelopmental disorder but may be underrecognized and misunderstood by people who provide health and social support services. The aim of the research is to understand the FASD knowledge, attitudes, and practices among people employed by the social and community sector in New Zealand. Methods: We conducted an online survey of people working in the New Zealand social and community sector (i.e., social workers, support workers). The survey focused on the following areas: awareness of FASD; knowledge and beliefs about FASD; the impact of FASD on professional practice; and training needs. Results: Most participants reported a basic understanding of FASD, however only 5% felt very well prepared to support someone with FASD. A large majority of participants believed that FASD diagnosis may be stigmatising for individuals or families. Conclusion: There is a need to improve training, professional development, and workplace support for social and community workers in New Zealand to support people with FASD.

Prioritising a culturally safe e-Mental Health research agenda in Aotearoa New Zealand: A sector survey report.

OBJECTIVE: To collect mental health and addiction service providers' opinions about priorities for an e-Mental Health (eMH) research agenda focused on delivering culturally safe eMH in Aotearoa New Zealand. METHOD: Service providers were recruited to participate in an anonymous online survey, which asked participants to rate the importance of potential research domains and items on a continuous scale from 1 to 10. The mean values of each item were normalised to develop a priority index. RESULTS: 48 participants rated at least one of the listed research items. The highest-rated items were (i) identifying strategies to improve access; co-developing eMH with the community (ii) a set of competencies required for delivering culturally safe care, (iii) a set of meaningful clinical outcomes that can be achieved via eMH, (iv) guidelines for the delivery of eMH services and (v) investigating the extent to which eMH could meet the mental health needs of these communities. 'Standards and guidelines' was the domain with the highest priority index. CONCLUSIONS: Mental health and addiction service providers in Aotearoa New Zealand prioritised an eMH research agenda that is focused on pro-equity outcomes and incorporating the voices and experiences of the communities they seek to serve.

A clinical review of elbow ligament repairs and reconstructions in the acute and chronic settings.

Background: The ligamentous and osseous structures of the elbow joint are the major contributors to its inherent stability and damage to any of these structures can result in elbow instability. The aim of this study is to present objective and subjective outcomes following ligament repairs and/or reconstructions for acute elbow instability and chronic elbow instability. Methods: This study included patients who underwent an elbow ligament repair and/or reconstruction for acute or chronic elbow instability. We performed a comprehensive retrospective data analysis of the patient's files, followed by a clinical examination and X-ray of these patients. Results: We identified 12 acute stabilizations and 22 stabilizations for chronic instability. Patients who underwent stabilization for chronic instability had statistically significant improvements in their preoperative flexion and extension; 14.8 ± 6.4° and 5.9 ± 2.5°. Patients with chronic instability achieved better extension-flexion and pronation-supination arcs compared with their acute instability counterparts and this reached statistical significance. When the elbow pain and function scores were compared, we found stabilizations in the acute setting had better outcomes. There were two cases of postoperative instability, one in the acute instability group and one in the chronic instability group. Conclusion: This study provides evidence for elbow ligament repairs and reconstructions in both acute and chronic settings. It is an effective way of stabilizing the elbow joint in chronic instability patients, and results in an improvement in their overall range of motion. These patients achieved a greater range of motions compared with their acute instability counterparts.

Factors associated with self-reported sun exposure in a multi-ethnic community sample from New Zealand.

Sun exposure, the main source of vitamin D, may have beneficial effects in humans, including for cardiovascular health. However, little is known about the characteristics related to sun exposure. Previous studies have surveyed participants with a demographic profile that is restricted by sex and ethnicity. We carried out an analysis to identify factors associated with self-reported sun exposure in a large multi-ethnic study of men and women. The study was a cross-sectional analysis of baseline data collected in a large vitamin D supplementation randomized controlled trial. The weekly amount of sun exposure in the past three months was assessed using a questionnaire. Multivariable prevalence ratios (PR) of high sun exposure (≥ 15 h/ week) associated with demographic and lifestyle variables were calculated using Poisson regression to adjust for covariates. A P-value of < 0.05 (2-tail) was used to determine statistical significance. A total of 5039 participants aged 50-84 years were analysed, who comprised 330 Pacific Islanders, 267 Maori, 242 South Asian and 4200 Other ethnicities (mostly European ancestry). For demographic variables, high sun exposure was associated with sex (higher in males), ethnicity (highest in Maori, lowest in South Asian), and education (highest in those completing secondary level education), but was lowest in the oldest age-group (80-84 years). For lifestyle variables, high sun exposure was associated with higher levels of alcohol drinking, TV watching and physical activity, but was not associated with tobacco smoking. Weekly sun exposure was lower in participants who were overweight or obese (compared to those with normal body mass index), and in those who reported a skin reaction to sun exposure of burning only (compared to those who reported tanning). These associations remained when all variables were included in the same model. In conclusion, several demographic and lifestyle factors were associated independently with the sun exposure, the primary source of vitamin D. Understanding how these factors are associated with sun exposure may refine strategies to minimise vitamin D deficiency.

How Frequently Do We Touch Facial T-Zone: A Systematic Review.

Background: Researchers across the world are emphasising the importance of hand-washing and limited touching of face to curb the spread of COVID-19. However, access to safe water and hygiene is inadequate in many places around the globe; hence T-zone touching restriction is considered more worthwhile compared to other prevention strategies. Aim: A systematic review was carried out to appraise the frequency of T-zone (eyes, nose, mouth, chin) touching in humans to comprehend the challenge of its restriction, and thus support public health professionals to produce evidence synthesis guidance for public.For this systemic review, data were collected by keyword searching, and several online databases were searched. The PRISMA checklist, PECO protocol and STROBE guideline were followed in this review, and pooled data were analysed in R version 4. Result: Total of 10 single arms observational studies were included. The pooled average (SD) facial self-touch per hour was 50.06 (±47) times, and a specific touch of T-zone was 68.7 (±27). T-zone self-touch within the total facial self-touch was found higher R = 0.680, with 95% CI 0.14, 0.91, P = 0.02 and X2 = 167.63, P < 0.0001. Conclusion: The review found that face-touch is a type of consistent regulatory movements. Control of T-zone touch requires extensive behaviour intervention and community awareness.

Association of sun and UV exposure with blood pressure and cardiovascular disease: A systematic review.

BACKGROUND: Ecological studies show that sun or ultraviolet (UV) exposure have inverse associations with blood pressure (BP) and cardiovascular disease (CVD). Although sunlight is the primary source of vitamin D, recent meta-analyses of clinical trials have not reported a beneficial effect from vitamin D supplementation on BP or CVD. Sunlight may have beneficial effects independent of vitamin D. We carried out a systematic review to appraise the extent and quality of the evidence from human studies. METHODS: Observational and interventional studies that measured sun or UV exposure, along with BP or CVD, were selected after searching databases. RESULTS: Identified studies could not be combined quantitatively in meta-analysis because of different exposure measures. Solar exposure was inversely associated with BP in 3 out of 4 cross-sectional publications, and with CVD and/or total mortality in 5 out of 6 publications of cohort studies. Two of the cohort studies reported inverse associations between sun exposure and CVD, after adjusting for serum 25-hydroxyvitamin D. Five clinical trials with an appropriate control group were identified, the outcome being BP. Two trials compared UVB with UVA (as control), with only one finding a significant reduction in BP (after 6 weeks). Three trials compared short-term UVA exposure (<30 min) with placebo (or crossover control), of which two reported short-term lowering of BP. CONCLUSION: This review has identified a small body of evidence that suggests sun exposure protects against high BP and CVD, but further research is required to determine if this is independent of vitamin D.

Mass Gatherings and Public Health: Case Studies from the Hajj to Mecca.

BACKGROUND: Many new and challenging risks can be introduced during mass gatherings. The Hajj, as one of the largest mass gatherings, provides an excellent annual opportunity to reflect on the public health risk posed by international and multicultural crowds and the value of mitigation strategies. OBJECTIVES: To identify the gap between preparation and training taken before being exposed to the mass gathering and postexposure experiences, and the breach between the expectations and reality of the holy place. METHODS: This was a qualitative study with in-depth interviews using semistructured questionnaires among Hajjis from 4 different countries (Bangladesh, Pakistan, Myanmar, and New Zealand). Purposive sampling was done. The present study was also supported by literature review. FINDINGS: Findings pointed to weaknesses in implementation and enforcement of law, for both the custodian country and countries of origin of Hajjis. Disparities among developed and developing countries were also noticeable. CONCLUSIONS: From a global health and human security perspective, strengthening of core capacities in managing mass gatherings as well as researching risks posed by such gatherings are paramount to safeguard the public's health. Attention of health professionals worldwide and adoption of strategic planning at custodian country and sending countries are obligatory.

Environmental Heat Stress Among Young Working Women: A Pilot Study.

BACKGROUND: Heat waves are increasing significantly in frequency and severity and threaten the health and income of outdoor workers. Pregnant women workers are particularly at risk due to their delicate physiological systems and accountabilities to future generations. Animal and human studies propose that elevated body temperatures during pregnancy can induce adverse pregnancy outcomes. OBJECTIVE: To measure the change in internal body temperature (Tcore) in young working women before, after, and during work (both outdoor and indoor) on hot humid days and relate threshold temperature to the upshot adverse effects of pregnancy (teratogenicity and related miscarriage). METHODS: Tympanic temperatures were measured using infrared ear thermometers and workplace temperatures were collected using Lascar Data Logger. Brief exploratory interviews were conducted to gather qualitative data, and content analysis was also carried out. FINDINGS: Body temperatures were found elevated among outdoor women workers compared with that of indoor women workers. CONCLUSIONS: The present study found that outdoor work during pregnancy in hot, humid days might increase body temperature up to levels that could induce fetal destruction or anomaly.