The rising prevalence of mental health conditions in children and young people requires responsive, high-quality care from child and adolescent mental health services (CAMHS) that consider the needs of service-users and their caregivers. This systematic review seeks to contribute evidence-based recommendations from caregivers' perspectives to inform the development of quality standards for CAMHS in the World Health Organization (WHO) European Region. A systematic review of qualitative literature on caregiver perspectives on CAMHS quality published in the WHO European Region between 1 January 2010 and 9 October 2023 in Embase, OVID MEDLINE, APA PsycINFO, Global Health, and CINAHL databases was conducted. Quantitative studies, studies focusing on neurodevelopmental disorders, inpatient, general practitioner, joint working, early-intervention, or transitional care services were excluded. The search strategy was registered on PROSPERO (ref: CRD42023467689). Data from 18 papers including the perspectives of 754 caregivers, mostly from Western Europe and particularly the UK, were thematically analysed into three main themes and sub-themes covering help-seeking, service provision, and caregiving. The study outcomes highlight the need to consider the wellbeing of caregivers as well as service-users, address the mental health literacy of caregivers, the wider community, and frontline professionals, ensure sufficient resources for a competent and appropriate workforce to address stigma and support the delivery of appropriate care, engage caregivers in care provision, design responsive and holistic services that enhance smooth care transitions, and support the active participation of young people and their caregivers in care delivery.
BACKGROUND:The evidence gap relating to the risk of congenital anomalies (CA) associated with first trimester medication exposure in pregnancy is well recognized. AIMS:We describe the EUROmediCAT network and databases, and the methodological approach to pregnancy pharmacovigilance. MATERIAL AND METHODS:Multidisciplinary expertise includes CA diagnosis and epidemiology, pharmacoepidemiology, pharmacology and teratology. The EUROmediCAT central database comprises standardized data from 19 EUROCAT CA registries in 14 countries, including more than 40 000 CA cases 1995-2021 with first trimester medication exposure data recorded, and a population coverage of 14.6 million births, growing by more than 650 000 births per year. The distributed database enables federated data analysis across eight countries which can link data from CA registries to electronic healthcare data, with population coverage of up to 900 000 births per year for linkage to maternal prescriptions, of which 300 000 births per year for linkage also to data on all births. RESULTS:The databases have enabled a variety of study designs: case-malformed control studies, cohort studies, disease cohort studies, signal detection studies, prevalence and ecological studies, and medication utilization studies. DISCUSSION:A key strength is that studies of CA risk can address accurately the specificity of risk by type of CA. CONCLUSION:EUROmediCAT presents a unique data and expert resource for tackling the enormous evidence gap regarding the safety of medication during pregnancy.
Introduction: Sexual dysfunction (SD) is a common problem among males with type-2 diabetes mellitus (T2DM) but often goes underdiagnosed and underreported. This study aimed to measure the prevalence and risk factors of SD among males with T2DM attending diabetes clinics in Bahrain. Methods: A cross-sectional study was conducted in ten primary health centers in Bahrain using a self-administered questionnaire. The questionnaire consisted of three parts: sociodemographic characteristics and the Sexual Assessment and Dysfunction in Diabetic Men (SAD-M) questionnaire. Descriptive and inferential analyses, including logistic regression, were performed. Results: A total of 313 patients with an average age of 54.3 ± 10.0 years were included. More than half of the patients had dyslipidemia (n = 220, 70.3%) and hypertension (n = 178, 56.9%). Approximately half of the participants had no morning erections (n = 161, 51.4%), and about a third had less than three sexual intercourse attempts in the last six months (n = 90, 28.8%). Of the participants, 32.6% had moderate SD, 42.5% had mild SD, and 25% had no SD. Univariate analysis showed that male patients with SD were older (P < 0.001) and had a higher body mass index (P = 0.036) compared to those without SD. In addition, unemployed patients (P < 0.001), Bahraini (P < 0.001), had diabetes for 10 years or more (P < 0.001) and had prostate and spinal diseases (P = 0.004 and P = 0.010, respectively) had higher rates of SD. Logistic regression analysis showed that older patients (P = 0.007) and patients with a diabetes duration of more than 10 years were more likely to have SD than their counterparts (OR = 14.908, P < 0.001). Conclusion: SD is a common problem among males with T2DM in Bahrain, especially among older patients and those with a prolonged history of diabetes. Therefore, primary care providers should consider screening for SD in male patients with T2DM.
Chronic kidney disease (CKD) affects 6–10
Sub-optimal weight, as a result of prematurity or restricted growth affects 15% newborns globally, and eventually contributes in up to 70% of neonatal deaths. In November 2015, the World Health Organization (WHO) officially recommended Kangaroo Mother Care (KMC) for newborns with a birth weight of less than 2 kg. Objectives: To evaluate the impact of Kangaroo Mother Care (KMC) on early neonatal death rate among preterm and low-birth-weight infants. Methods: This descriptive cross-sectional analysis was carried out over the period of six months, from July 2021 to January 2022. All the patients visiting Tertiary Care Hospital of Karachi, Sindh, who met the inclusion criteria were enrolled in this study. Informed consent was taken after explaining the procedures, potential risks, and anticipated benefits of the study. The three key elements of Kangaroo Mother Care were explained which included direct skin contact, breastmilk feeding exclusively, and expedited hospital discharge, with a demonstration of the proper technique for keeping infants on the mother’s chest, and using a sheet for wrapping around the baby and the mother. For research purposes, all data were recorded in a proforma and used electronically. Results: Mean ± SD of age of mother was 26.99±4.3 years. In the distribution of the gender of the baby, 121 (57.6%) were male, while 89 (42.4%) were female. Kangaroo-mother care in reducing early neonatal fatalities was noted as effective in 60 (28.6%) participants. Conclusions: In conclusion, Kangaroo Mother Care was successful in lowering early neonatal fatalities.
