Objective This study aimed to assess the availability and preparedness of health facilities offering diabetes mellitus (DM) to manage tuberculosis (TB) in Ethiopia. Design Secondary data analysis of institution-based cross-sectional national survey data. Setting Data were obtained from the 2021–2022 Ethiopian Service Provision Assessment (ESPA) survey which includes all active health facilities in Ethiopia. Participants This study included all health facilities that provide DM services (both diagnosis and treatment) and recently collected DM data during the 2021–2022 ESPA survey. Outcome measures The service availability was computed as the percentage of facilities offering DM services to provide TB management. The preparedness of these facilities for managing TB was measured using three service tracer indicators (staff training and guidelines, diagnostics and essential medicines used in TB management) defined by the WHO Service Availability and Readiness Assessment Manual. The extent

Objectives This study aimed to develop a machine learning (ML) model to predict disengagement from HIV care, high viral load or death among people living with HIV (PLHIV) with the goal of enabling proactive support interventions in Tanzania. The algorithm addressed common challenges when applying ML to electronic medical record (EMR) data: (1) imbalanced outcome distribution; (2) heterogeneity across multisite EMR data and (3) evolving virological suppression thresholds. Design Observational study using a national EMR database. Setting Conducted in two regions in Tanzania, using data from the National HIV Care database. Participants The study included over 6 million HIV care visit records from 295 961 PLHIV in two regions in Tanzania’s National HIV Care database from January 2015 to May 2023. Results Our ML model effectively identified PLHIV at increased risk of adverse outcomes. Key predictors included past disengagement from care, antiretroviral therapy (ART) status (which tracks a p

Objectives Older adults with tuberculosis and diabetes have special needs regarding dietary nutrition. This study aimed to investigate the knowledge, attitude and practice (KAP) regarding dietary nutrition among older adults with those two conditions. Design Cross-sectional study. Setting Three tertiary medical centres in China. Participants Adults over 60 year old diagnosed with tuberculosis and diabetes. Interventions Between July 2023 and October 2023. Primary and secondary outcome measures Demographic characteristics and KAP scores collected by self-designed questionnaire. Results A total of 456 valid questionnaires were analysed, with 261 (57.24%) participants being over 70 years old. The mean scores were 6.84±3.16 (possible range: 0–24) for knowledge, 23.23±2.23 (possible range: 8–40) for attitude and 22.73±3.14 (possible range: 8–40) for practice, respectively. Correlation analysis revealed significant positive correlations between knowledge and attitude (r=0.287, p<0.001), know

Background Early recognition and accurate diagnosis are particularly important in the context of gastric cancer. This study mainly aimed to investigate primary care physicians’ (PCPs’) clinical behaviour and their readiness to consider investigation or referral for symptoms possibly indicative of gastric cancer. Design Cross-sectional study. Setting A self-administered online survey was carried out in five selected cities in the Fujian province of China between February 2022 and May 2022. Participant PCPs working in the departments, such as Internal Gastroenterology and Hepatology, General Internal Medicine, Internal Medical Oncology Gastrointestinal Surgery or other clinical departments, have the chance to diagnose or treat patients with suspected gastric cancer. Main outcome measures Percentage of PCPs identifying gastric cancer patients either by undertaking an endoscopy at the primary hospital or by referring patients to an upper-level hospital. Results A total of 1210 complete res

Background Despite a potentially greater burden of dementia, racial and ethnic minority populations around the world may be more likely to be excluded from research examining risk factors for incident dementia. We aimed to systematically investigate and quantify racial and ethnic minority representation in dementia risk factor research. Methods We performed a two-stage systematic search of databases—MEDLINE (Ovid SP), Embase (Ovid SP) and Scopus—from inception to March 2021 to identify population-based cohort studies looking at risk factors for dementia incidence. We included cohort studies which were population-based and incorporated a clinical dementia diagnosis. Results Out of the 97 identified cohort studies, fewer than half (40 studies; 41%) reported the race or ethnicity of participants and just under one-third (29 studies; 30%) reported the inclusion of racial and ethnic minority groups. We found that inadequate reporting frequently prevented assessment of selection bias and onl

Introduction The postnatal period often presents significant psychological and social distress for mothers, a burden that is potentially heightened by having a preterm baby. Mothers of preterm babies face various psychosocial challenges that need to be explored. While some studies have explored the experiences of mothers of preterm babies, there is a need for more context-specific research to inform targeted interventions, especially in resource-constrained settings like northern Ghana. This study aimed to explore the psychosocial experiences of mothers of preterm babies admitted to the neonatal intensive care unit (NICU) of the Upper East Regional Hospital, Ghana. Methods This descriptive phenomenological study was conducted in the NICU of the Upper East Regional Hospital in Ghana. Thirteen mothers of preterm babies were purposively sampled and interviewed using a semi-structured interview guide. The interviews were transcribed verbatim and analysed using Colaizzi’s descriptive phenom

Objectives This study was conducted to examine urban–rural differences in the real-world prescribing pattern of oral anticoagulants and geographic variations in the prescribing pattern among clinicians serving Medicare beneficiaries in the USA. Design A cross-sectional study. Setting A real-world setting. Participants 232 665 clinicians who prescribed oral anticoagulants for Medicare beneficiaries from the 2020 Medicare Provider Utilisation and Payment Data were classified as warfarin only, direct oral anticoagulants (DOACs) only or warfarin+DOAC prescribers. Main outcome measures Urban–rural differences in the prescribing patterns were examined using multivariate multinominal logistic regression analysis. A geospatial analysis was conducted to estimate standardised prescriber ratios (SPR) for DOAC only or warfarin only prescribers versus warfarin+DOAC prescribers to illustrate hot and cold spots for DOAC adoption in the USA. Results 92% of clinicians who prescribed oral anticoagulants

Objectives To assess the feasibility of assessing long-term outcomes of peripheral vascular intervention (PVI) by linking data from a clinical registry to electronic health records (EHR) data from a clinical research network. Design Observational cohort study. Setting Vascular Quality Initiative registry linked to INSIGHT Clinical Research Network, which aggregated EHR data from multiple institutions in New York City. Participants Patients receiving PVI during 1 January 2013–30 November 2021 in four centres in New York City. Primary and secondary outcome measures We examined the proportion of registry patients retained in EHR over time and predictors of EHR retention after year 1. We evaluated the implications of EHR attrition by examining amputation-free survival (AFS) in the observed data and predicted data when patients discontinued in the EHR were hypothesised to have increased risks of events than the observed average. Results We included 1405 patients receiving PVI (age=70.8±11.2