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Dec 2025 DOI 10.14302/issn.2381-862X.jwrh-25-5447
J. Factoriza OliviaCorresponding author
Objective This study aimed to explore the respondents’ reproductive health profiles, examining the physiological and psychosocial perimenopausal symptoms affecting productivity, and identifying occupational needs. It also determined the relationship between menopausal symptoms and the productivity and occupational needs of peri-menopausal women. Methodology A descriptive cross-sectional design was used, surveying 50 women over 40 years old with a validated four-point Likert scale instrument. The instrument undergone content validation, reliability test, and ethical approval. Survey was administered personally and online using purposive sampling. Statistical treatments included weighted mean, F-test, T-test, Pearson r correlation, and ranking. Key results The majority of participants had their first menstruation between 11 to 15 years old and experienced regular menstrual cycles. Most had one child, with an equal number of cesarean and normal deliveries, and reported no pregnancy complications. The study found that participants seldom experienced physiological and psychosocial menopausal symptoms. They agreed on the occupational needs during the perimenopausal period. It was found that physiological symptoms were influenced by factors such as early menarche, cesarean delivery, and pregnancy complications. Additionally, psychosocial symptoms varied based on menstrual status, the number of children, and pregnancy complications, with those experiencing earlier menstruation or complications reporting more intense symptoms. The study revealed a significant relationship between both physiological and psychosocial perimenopausal symptoms, which negatively impacted productivity and increased occupational needs. Women with higher menopausal symptoms expressed a greater need for workplace policies that support perimenopausal women, highlighting the need for tailored workplace interventions for this demographic. Future Direction The study recommends including pap smears and mammograms in annual exams for peri-menopausal women, offering awareness seminars on managing perimenopausal symptoms to reduce workplace disruptions, and suggests future research exploring additional variables affecting perimenopausal women’s health and productivity
Dec 2021 DOI 10.14302/issn.2639-3166.jar-21-4018
Gupta RajCorresponding author
Centre for Advancement of Sustainable Agriculture, National Agriculture Science Centre Complex, New Delhi, 110012, India
In India, loss of fertility through soil erosion is primarily a summer monsoons mediated phenomenon. Reversing the land degradation processes contribute to water availability, soil fertility maintenance, adapting to climate change and overall food security. Whereas kharif (monsoon/rainy season crop) foodgrain production largely depends on summer monsoons, the rabi season (post-rainy season/winter crop) rainfall is too little to exert a direct influence. In spite of larger acreage under kharif foodgrain crops, total fertiliser consumption during kharif and rabi seasons is comparable. Negative rainfall anomalies (deficit) adversely affected total fertiliser consumption and their use efficiency. Despite significant differences in fertiliser application rates, the response to applied fertiliser nutrients is almost similar in the two seasons. This implies that nutrient use efficiency (NUE) has a ‘manageable’ and an ‘unmanageable’ component wherein 4R practices are difficult to implement under unfavourable kharif weather conditions. Partial factor productivity of fertilizer nutrients (PFPF) has continuously declined over decades mainly because of depletion of soil organic carbon, imbalanced use of nutrients and inability to maintain soil moisture supplies. These observations plus yield-gap analysis permitted us to conclude that past trends of declining NUE can only be reversed through a shift either in sustainable land management practices or enhancing the genetic yield potential/ biomass of crop cultivars or by combining both and making kharif crop planting independent of monsoons rains through direct dry seeding.
Aug 2021 DOI 10.14302/issn.2643-6655.jcap-21-3888
Monique J. Grant CokeCorresponding author
The number of children with SEN is continuously growing, leading to pressure on the few special schools available in the USA. Furthermore, the adoption of a special school system has been criticized on the basis that it isolates and discriminates against children with special educational needs and disabilities. Even though inclusive education can address such limitations, the application of the most appropriate pedagogical approaches for SEN learners is still a challenge. The presented study focused on critically appraising the pedagogical approaches for SEN learners in the 21st century and beyond. In order to achieve this goal, a systematic review of the literature approach was adopted. The literature search process was conducted on three databases: Education Full Text, Linguistics and Language Behavior Abstracts, and PsycINFO. The selection of these databases was influenced by their reputation of hosting high quality and up-to-date literature about special education. The initial literature search process generated 6129 hits, but only ten studies were finally selected for review after the application of inclusion and exclusion criteria. A critical review of the evidence presented in the selected studies generated eight themes describing various pedagogical approaches for special education, within both blended and mainstream learning environment. Knowledge generated in this systematic review can be used by the special education sector of the U.S to develop pedagogical approaches for SEN students, leading to improved performance and social skill development.
May 2021 DOI 10.14302/issn.2641-4538.jphi-21-3632
Placide MUTABAZICorresponding author
Save the Children International, Nkumba University, School of postgraduate and research, P.O. Box 237 Entebbe-Uganda
Introduction Reporting of suspected or confirmed communicable diseases is paramount. Although physicians have primary responsibility for reporting, school nurses, laboratory directors, infection control practitioners, daycare center directors, health care facilities, state institutions and any other individuals providing health care services are also required to report communicable disease. Therefore, community health needs assessment in urban communities remains an essential instrument for the rapid and accurate dissemination of epidemiological information on cases and outbreaks of diseases under the national health regulations and other communicable diseases of public health importance, including emerging or re-emerging infections. Purpose of the Study Todescribe relevant medical needs of townspeople so that treatment plans can be developed accordingly. Methods The Study was a cross-sectional with qualitative approach. In-depth interviews and focus group interviews was used as research technique. Data was categorized to look for emerging themes then further distilled to identify any abstract themes that could be understood holistically. Results Urban decision-makers need to advocate the problem of human resources in public health facilities and the mutual health insurance to revise its insurance policy to allow their clients to be received even in private clinics. Dental services was wished to be available in public health centers. Study participants suggested that new useful information could be posted in private public premises rather than to be in public institutions only. Conclusion The patient waiting time, dental services in health centers, and the way of dissemination new health information, mutual health insurance and insufficient human resources are the major concerns of townspeople that they wish improvement.
Apr 2020 DOI 10.14302/issn.2641-4538.jphi-20-3296
Rezapour BarataliCorresponding author
Department of Public Health, Faculty of Health, Assistant Professor, PhD in Health education and promotion, Urmia University of Medical Sciences, Urmia, Iran
Preventable factors such as infectious diseases (pneumonia, diarrhea, and malaria), malnutrition and neonatal complications are still the leading cause of child mortality worldwide 1 In 2013, it is estimated that 6.3 million babies born worldwide died before the age of 5, and approximately 9.2% of these deaths were due to diarrheal diseases 23 in simple, accessible ways, and effective treatment can reduce diarrhea-related mortality and make hospital admissions unnecessary, and the role of mothers is the most important 4. Since the presentation of Oral Rehydration Therapy (ORT) in 1979, mortality has reduced. Diarrhea has had a steady downward trend 5. If mothers who have children under 5 years of age, used correctly ORS, they could easily resolve the problem of dehydration in acute diarrhea 6. Mothers didn’t use correctly ORS because of their Low literacy and lack of knowledge and wrong attitude about ORT7. Some health care workers provide mothers’ required equipments, regardless of their educational needs, and mothers may not use ORS. In this study, health workers identified mothers' educational needs and subsequently they trained them about using ORS at home in acute diarrhea in children under 5 years of age.
Feb 2019 DOI 10.14302/issn.2470-5020.jnrt-19-2618
Patel NaiyaCorresponding author
Graduate Research Assistant, Department of Public Health, Long Island University, Brooklyn, New York, United States, PMBA candidate, MPH, BDS.
Objective Testing a new drug, treatment, and medical device clinically is critically important before prescribing it to patient. Not determining the drug’s safety and efficacy through clinical trials might impose life threatening outcomes on its consumers. The research paper describes the critical factors associated for testing any new drugs clinically, as limited research is performed in this field of public health. Study Design A qualitative systematic literature review was performed by mining relevant original peer reviewed research papers as well as some online resources like MedlinePlus due to limited availability of studies on such critical topic. Methods The databases used were Web of Sciences core collection, PubMed, Google scholar. The keywords used to search research papers were “clinical trials”, “testing new drugs”, “history of testing drugs”, “evidence-based medicine”. Conclusion Drugs which are prescribed to critical target population like pregnant women and children should be more often clinically tested if possible as majority of them are available in the market without Food and Drug Administration (FDA) approval. The abusive potential of any new drug could end up taking lives of innocent individuals. More evidence-based medicine can help translate research results on a heterogeneous population efficiently.
Mar 2017 DOI 10.14302/issn.2474-7785.jarh-17-1461
Lessard SabrinaCorresponding author
Research Centre – InterActions, CUISSS du Nord-del’Île-de-Montréal
Given the aging of the population, an increase in the number of persons in need of long-term care and end-of-life care can be expected in the coming years. The scientific literature underlines the lack of end-of-life care for elderly people in long-term care centres. The aim of this study is to explore needs in terms of new knowledge and research on end-of-life care for elderly persons in long-term care settings, from the perspective not only of the scientific and international community, but also of Quebec professionals concerned by the issue. An online survey using the LimeSurvey® tool was conducted in 2015 among health professionals involved in end-of-life care for elderly persons in long-term care settings in Quebec. 208 professionals rated the priority of new knowledge and research needs related to 1) health professionals; 2) delivery and quality of care; 3) residents and their loved ones; and 4) organization and management of care. The results show that the statements collected in scientific literature resonate with health professionals. The most important need is to identify the symptoms of distress in residents in the final stages of their lives, as well as their causes and treatments. This study also shows professionals’ concerns about attitudes, beliefs, and values of practitioners and the related impacts on end-of-life care in long-term care settings. This study shows that there is a significant need for new knowledge and research. It revealed that there are few studies on end-of-life care for elderly persons in long-term care settings and that there is much more to be discovered in this field.
Feb 2016 DOI 10.14302/issn.2381-862X.jwrh-15-672
Panda SunitaCorresponding author
Clinical Midwife Manager, Delivery Suite, Coombe Women and Infants University Hospital, Dublin-8. Ireland.
The study was conducted in four selected hospitals in the Southern part of India with an aim to determine the support needs of women in early labour as perceived by women. A descriptive design was used to determine the support needs of women in early labour. Following ethical approval, sixty women between 29-40 weeks of gestation with singleton pregnancy were interviewed in early labour, using a validated Labour Support Need Assessment Tool to gather data on background information and perception of women related to need and support needs (physical, emotional and informational support). Results indicated that women perceived all types of support such as physical, emotional and informational as significant factors in their care during labour, regardless of their parity and gestation. The major findings of the study suggested that there was a slightly higher need for support among women for informational (90.33%) and emotional support (88.78%) compared to physical support (80.19%). For primigravid women, and multiparous women who were experiencing labour for the first time (previous birth by caesarean section), the ‘need for support’ was greater than for women who had previous experience of labour. Early labour is the time when most women use their own coping skills and seek support. Determining the quantity and quality of support women need at this phase of labour can help care providers to provide the best comprehensive care to women in early labour. The findings of the study provide a guide on what women feel is helpful in early labour.
Nov 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5745
Poole JolyonCorresponding author
Background Healthcare worker stress, anxiety, burnout, and trauma have been widely documented across global healthcare systems. Staff in maternal and neonatal units frequently encounter emotionally distressing events and work under high pressure with limited resources. In Zambia, despite some gains in reducing maternal and neonatal mortality, fatality rates remain above national targets, exposing staff to repeated occupational trauma. Objective(s) This study aimed to assess the psychological well-being of staff in maternal and neonatal intensive care units, identify specific needs and stressors, and develop practical recommendations to improve resilience and support staff mental health. Methods A mixed-methods cross-sectional study was conducted at Ndola Teaching Hospital (NTH) and Arthur Davison Children's Hospital (ADCH), two major tertiary hospitals in Zambia. Data were collected over four days in February 2025. The study included 87 (out of 161) healthcare professionals, including nurses, midwives, and doctors. The Goldberg Anxiety and Depression Scale (GADS) and the Professional Quality of Life Scale Version 5 (ProQOL 5) were used to collect quantitative data, which were analysed using descriptive statistics and 95% confidence intervals (CI). Open-ended survey questions provided qualitative data, which were analysed using thematic analysis. Ethical approval was granted by the hospital ethics committee. Results High rates of clinical symptoms were observed. The overall prevalence of symptoms in the past 30 days was: anxiety (62%), depression (68%), burnout (50%), and secondary traumatic stress (46%). Junior doctors demonstrated the highest rates of depression (83%) and burnout (67%). The obstetrics and gynaecology and labour wards had the highest rates of secondary traumatic stress symptoms. Key qualitative themes identified were professional stressors, team and leadership issues, and the emotional burden of the work. Conclusion This study highlights an urgent need for both psychological and organizational support for maternal and neonatal healthcare staff in Zambia. The findings indicate that burnout and secondary traumatic stress are highly prevalent, particularly among junior doctors and those in high-risk wards. Targeted interventions at both systemic and individual levels are necessary to protect the well-being of healthcare workers and improve patient outcomes.
Mar 2025 DOI 10.14302/issn.2641-9467.jgrc-24-5386
Guo ZhongshengCorresponding author
Farming development has gone through a long process. After a review of literatures, the results showed that according to the efficiency of resource utilization by plants, the whole process of farming development can be divided into three stages, the whole process of farming development can be divided into three stages: Low level development stage or primitive farming, Level improvement stage and high-quality development new stage. The direction of Farming development is High-quality development. Farming High-quality development is to take some effective measures or methods to make land produce maximum yield and benefit to meet the people’s needs for a better life and safe food, which is the general trend of the times.
Dec 2024 DOI 10.14302/issn.2474-9273.jbtm-24-5317
Ndje Mireille NdjeCorresponding author
Adolescence in Cameroon, as in many parts of sub-Saharan Africa, is often marked by early childbearing. Studies have shown a national prevalence of adolescent deliveries to be around 14.2% - 14.4%, a higher rate than the average for sub-Saharan Africa This presents a unique challenge for young mothers, who must navigate the complex process of identity reorganization while still navigating their own adolescence with its multiple changes. This article explores the experiences of primiparous (first-time) Cameroonian adolescents as they transition from daughters to mothers. The objective of this article is to understand how identity reorganization takes place among primiparous Cameroonian adolescents who pass without transition from the status of daughter to the status of mother. Drawing on qualitative data from semi-structured interviews, with seven participants chosen on the basis of selection criteria, the article examines the psychological, social, and cultural factors that shape this identity shift. An interview guide with three main themes made it possible to collect verbatim comments from the participants. The thematic analysis highlights the challenges faced by these young mothers, such as navigating social stigma, managing emotional upheaval, and balancing motherhood with their own developmental needs. The findings of this study highlight the complex and multifaceted nature of identity reorganization among primiparous Cameroonian adolescents. The social stigma associated with early childbearing, coupled with the emotional and practical demands of motherhood, can pose significant challenges to these young women. However, a study on a larger sample could reveal the resilience and resourcefulness of some adolescents, who find support within their communities and employ various coping mechanisms to navigate this transition. Finally, the article discusses the implications of these findings for adolescent maternal health interventions and social policy in Cameroon.
Feb 2024 DOI 10.14302/issn.2381-862X.jwrh-24-4918
Jennifer Chinoye AmadiCorresponding author
Access to sexual and reproductive healthcare for sexual minority women is essential to fulfilling their human rights. This qualitative study was conducted in Rivers State, Nigeria, with fifteen participants as key informants. The study addressed the barriers to the sexual and reproductive healthcare needs of lesbians, bisexual women and sex workers in Port Harcourt metropolis. To address these barriers, the study answered the research questions on what access barriers prevent lesbians, bi-women, and sex workers from adequate utilization of sexual and reproductive healthcare services and common mental health issues sexual minority women experience. The study found that the barriers that prevent sexual minority women from accessing sexual and reproductive healthcare services include limited sexual and reproductive health information on available services offered by the health facilities, prejudice from healthcare providers and lack of social acceptance. Common mental health issues experienced as a result of these limitations are self-doubt over sexual orientation, trauma from threats, and parental pressure over marriage. To mitigate these barriers, the study recommends training healthcare providers on inclusive sexual and reproductive healthcare and to eliminate stigma and discrimination to improve access. Additionally, an improvement in laws and increased agency of sexual minority women to minimize negative mental health experiences. Finally, it also recommends creating a social group for sexual minority women to share experiences, support each other and learn about their sexual and reproductive healthcare will minimise barriers.
Nov 2023 DOI 10.14302/issn.2381-862X.jwrh-23-4766
G. Ong EmilyCorresponding author
This study explored concerns and unsolicited advice relating to miscarriage shared on multiple social media platforms for mentions of questions, advocacy, medical advice, conflicts of interest, and terminology used to describe miscarriage. Public social media posts in English from January 1st, 2019 to June 30th, 2021 were searched using keywords related to miscarriage. A dataset of questions, advice, conflicts of interest, and terminology used was created from eligible posts determined by inclusionary and exclusionary criteria. The dataset was analyzed to identify themes and calculate statistics. Approximately 1000 posts were reviewed and 149 posts were found eligible for analysis. Of the total, 116 posts included advice and a subset of 71 posts offered questions. A total of 152 mentions of advice were identified from the total eligible posts with 82.9% of advice related to advocacy for destigmatizing miscarriage, enhancing community support, or expressing grief. 17.1% of posts offered medical advice eligible for evaluation of which 73% were accurate across all platforms. From the dataset, 103 questions were analyzed for common themes. The four most common themes of questions included grief, self-blame, quality of post-miscarriage counseling in different care settings, and inadequate medical counseling. This study indicates that women who experience miscarriage have many unanswered questions and powerful feelings relating to grief and self-blame that could have long-term impacts. Social media has become a place for women to self-advocate and connect with others for support, from which clinicians could increase their understanding of women’s unmet needs.
May 2023 DOI 10.14302/issn.2642-9241.jrd-23-4566
Krishna C VeligandlaCorresponding author
Safe and effective antitussive therapy remains a significant area of unmet need for cough management. Antitussive drugs are commonly used cough suppressants and include centrally acting (opioids and non-opioids) cough suppressants and peripherally acting antitussives. Authors searched PubMed, Google Scholar and additional studies from reference lists via cross-referencing to identify studies assessing levodropropizine for the treatment of cough. Of the 748 studies identified, 13 were included. Recent clinical evidence, guideline recommendations and findings from this review suggest that levodropropizine is a peripheral antitussive which reduces cough intensity, frequency, and nocturnal awakenings in children and adults and provides better efficacy outcomes with a more favourable risk/benefit ratio compared to centrally acting antitussive agents which pose greater safety concerns and present an unacceptable risk–benefit profile. This review is aimed at Indian primary care physicians for making effective cough management decisions where the clinical evidence needs to be translated to clinical practice. Key Messages The usage of currently available centrally acting antitussive agent is greatly limited by their central depressing action and frequent side effect. The findings of this review indicate that levodropropizine is an effective antitussive agent and well tolerated in the management of cough in patients of all ages.
Jun 2022 DOI 10.14302/issn.2471-2140.jaa-21-3911
Izadi MortezaCorresponding author
Ozone CRC BMSU Tehran, Iran
Testicular ischemia-reperfusion injury is an urgent situation which needs a timely and precise diagnosis for prevention of testis damages. Here in we investigated ozone/oxygen therapy in Testicular Ischemia/Reperfusion Injury. For this purpose, animals (rats) were divided to four groups; control, torsion/detortion, torsion/detortion + ozone/oxygen (30 µg/ml) and only ozone/oxygen. Four hours after detorsion, in all groups orchiectomy was done -- for measuring the oxidative stress and mitochondrial toxicity parameters. Also, we preformed analysis of testicular spermatogenesis after 90 days. Our data showed that testicular torsion-detorsion induced significant increase in mitochondrial toxicity and decrease of spermatogenesis, malondialdehyde and GSSG levels were shown. Also, spermatogenesis, a remarkable decrease in malondialdehyde GSSG levels and mitochondrial toxicities were observed when compared with torsion-detorsion group. Obtained results for this research showed that ozone/oxygen therapy enhance antioxidant properties in the spermatogenic cells and protects testes from ischemia-reperfusion injury.
Feb 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4078
Gabriel Olajide ToyeCorresponding author
Department of Ear, Nose and Throat, Afe Babalola University, Ado Ekiti and Federal Teaching Hospital, Ido Ekiti
Background The COVID-19 pandemic has had significant impact on healthcare worldwide. Surgeons are at increased occupational risk of contracting COVID-19. The impact of the disease on surgical practice will continue to evolve. We assessed the impact of the disease on surgical practice and training in Nigeria. Method Survey questionnaire was designed, transcribed to Google form and electronically circulated online to surgeons practicing in Nigeria. Surgeons from various subspecialties from the six regions in Nigeria were included. Survey questions pertaining to pre-COVID-19 era surgical practices, impact on current practice and changes occurring in health facilities during this COVID-19 pandemic. Responses were collated and analyzed statistically. Results One hundred and nine (109) surgeons completed the survey, of which 2.8% were women. Majority (68.8%) of the respondents are in the consultant cadre, majority (86.2%) are working in public hospital, 88.1% running their SOPD, 81.7% have isolation wards in their centers, 66.1% have dedicated team for COVID-19 management. Only 48.6% of the frontline health workers have access to personal protective equipment (PPE), and 33.9% had formal training on the use of PPE. Only 11.0% were satisfied with level of preparation of the management. Elective cases were done only in 45% of respondents. 103(94.4 %) confirmed that the numbers of elective cases are less than pre Covid-19 period. Emergency cases were carried out by 93.6% of respondents. Only 1.8% of respondents carried out screening tests for their patients before embarking on emergency surgery. Conclusion COVID-19 has led to reduction in surgical outpatients, significant reduction in elective surgeries in Nigeria. Adequate PPE needs to be provided, there should be guidelines for safety for future. There should be adequate preparation should there be any pandemic in the near future.
Feb 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4101
Khalid Mehmood RaoCorresponding author
Laparoscopic General and Colorectal Surgical Consultant , Barnsley Hospital NHS Foundation Trust, England
Medical education has been extraordinarily disrupted during the COVID-19 era worldwide. The pandemic limited routine ward or patient-based medical education. These limitations have resulted in new challenges for medical students, especially the final year students in completing their mandated curriculum. We are suggesting a revised curriculum for final year medical students, by following which we can address COVID restriction while making sure all competencies have been achieved by students. This revised curriculum centers around the usual placement of students in Surgical Assessment Unit (SAU), however all students will be posted in simulation wards/labs on their turn to enhance and consolidate their understanding and learning of common surgical cases in these wards, so that they can replicate these skills in SAU and wards on their turns. This article highlights how the proposed curriculum addresses the learning needs of final year medical students in their surgery rotation. The article will also summarize the critical appraisal process of our curriculum in the context of curriculum design theories. Finally, the article will highlight the quality assurance measures adhered to while developing the curriculum.
Jan 2022 DOI 10.14302/issn.2578-8590.ipj-21-4026
Karabayev M.Corresponding author
Fergana Medical Institute of Public Health, Uzbekistan.
A theoretical paper proposes applications of golden proportion principles to physiological diagnostics. It outlines proposed metrics and discusses validation needs and limitations.
Jan 2022 DOI 10.14302/issn.2372-6601.jhor-22-4061
B. Danilova AnnaCorresponding author
N.N. Petrov National Medicine Research Center of Oncology, Department of Oncoimmunology, 197758, Leningradskaya str., 68, Pesochny, Saint-Petersburg, Russian Federation
Background Human malignant cell models which reflect the structural and physiological complexity of tumor tissue are of great importance for preclinical research in oncology. Spheroids/tumoroids derived from solid tumors are of great interest as cellular models mimicking the first vascular-free growth phase of a tumor node. The fact of the identity between artificially created tumor multicellular aggregates and the real tumor tissue, however, needs to be specified, described and validated in order to see how closely the spheroids are biologically similar to the malignized tissues in vivo compared to the monolayer cell cultures traditionally used. We present here a comparison study of the characteristics of solid tumor cells of different histogenesis (melanomas, soft tissue sarcomas and bone sarcomas, epithelial tumors) cultured in two dimensions (monolayer culture) and three dimensional space (spheroid), namely: spatial organization, multiplication, metabolic activity. Patients and Methods For the creation of 2 D and 3D cell models the cells isolated from the patient's solid tumor fragments obtained intraoperatively were used. 15 samples of skin melanoma, 20 samples of soft tissue and osteogenic sarcomas (STBS), and 9 samples of epithelial tumors (ET). The tumor cells were all cultivated for at least 10 passages. We used phase contrast, confocal microscopy, and immunohistochemistry to investigate spheroids and monolayer cultures. The supernatants of tumor cells grown in 2D and 3D cultures were studied using ELISA and multiplex analysis for the production of a spectrum of chemokines and cytokines supporting the immunosuppression, invasion and metastasis processes. Results Tumor specimens received were predominantly of metastatic origin (75%). In 100% of cases 2D cultures were received, in 88.6% of cases (39 out of 44) we succeeded in obtaining spheroids. There was no direct correlation between the efficiency of tumoroid formation and the tumor's histogenetic origin and the stage of the cancer process (primary tumor, recurrence, metastasis). The median size of spheroids by 4-5 days of cultivation with a starting concentration of 10000 cells per well was 657.14 μm for melanoma (min 400 - max 1000 μm), 571.42 μm (min 400 - max 700 μm), 507.14 μm (min 300 - max 600 μm) for soft tissue sarcomas, 650.0 μm (min 400 - max 900 μm) for osteogenic sarcomas. Immunochemical analysis of Ki-67, GLUT1, and Ecadherin markers was carried out for tumor tissue samples, single-layer tumor cultures, and tumoroids of every patient. The distribution of the stained groups in the spheroids was distinct from the monolayer cultures and more in accordance with the distribution of such in the tissue tumor, the number of Ki-67+ cells was increasing in the spheroids. We detected no dependence of Ki-67+ and GLUT1+ cell localization grade on spheroid size. We identified E-cadherin in tumor tissue and tumoroids of breast carcinoma and one melanoma culture. Monolayer cultures did not express it. The increase in secretory cell activity of the solid tumor cells from 2D to 3D system was observed when CCL2, CCL3, CXCL1, CXCL16, MIF, IL10, MICA (p<0.01) were investigated. Conclusion The presence of patient-specific cells of solid tumors in a 3D environment causes activation of the proliferative and metabolic processes as compared to monolayer cultures, which makes these models approximate the real world clinical picture. The production of chemokines that can attract to the tumor various types of immune system cells, to include their immature versions, as well as production of cytokines and Immunosuppression factors that, when present in the tumor microenvironment in the high concentrations, contribute to the formation of immune cells having suppressive capacities occurs in the 3D cell system. Three-dimensional model of the initial tumor nodule formation stage thus demonstrates the forming process of tumor cells favorable for them microenvironment. Construction of three-dimensional models - spheroids of tumor cells of differing histogenesis demands individual approach and more thorough investigation.
Dec 2021 DOI 10.14302/issn.2641-4538.jphi-21-4036
Lamothe NeryCorresponding author
División de Ciencias de la Salud, Medical Surgeon Career, Universidad Autónoma Metropolitana, Xochimilco, Mexico
A narrative review considers metabolic and neurochemical pathways implicated in passive exposure to alcohol consumers, discussing health effects and research needs.
Aug 2021 DOI 10.14302/issn.2379-8572.joa-21-3913
Mohamed Bofares KhaledCorresponding author
Professor of otorhinolaryngology Omar Almoukhtar University, Elbyda, Libya
This article has been retracted on 20 January 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2379-8572.joa-25-5850) Back ground and Objectives Tonsillectomy is the most common surgical procedure in specialty of otorhinolaryngology. Therefore there are frequent premises regarding this procedure to be improved from different aspects, indications, time of surgery, techniques, safety measures, and postoperative care. Hence the tonsils and peritonsillar tissues are highly vascular zone that supplied by direct branches of external carotid artery thus the post-tonsillectomy bleeding remains one of significant issues in relation to this widely performed procedure. The post-tonsillectomy bleeding needs frequently to be postulated for its incidence, prevalence, etiology, predisposing factors, management and prevention. This subject constitutes one of most risky aspects that increase wariness of the surgeons regarding this commonly conducted procedure. Although there are huge numbers of presentative literatures coming from American as well as western institutes that tried to put guidelines for purpose of prevention and management of post-tonsillectomy bleeding but broadly at our middle-east region and locally at our Libyan society we found for some extent difficulties to apply all these guidelines. For this reason this issue has been take the wider spectrum of ENT surgeons’ concentration, discussions, and researches. Therefore this study was conducted prospectively and for long time to confirm the possible predisposing factors that could be responsible for increasing the risk of post-tonsillectomy bleeding at our region and in the same time to illustrate the concluded recommendations to prevent the occurrence of this important complication. Patients and Methods 2880 patients aged from 8 months to 85 years presented at ENT department-AL-hawari ENT and urology teaching center- Benghazi-city – Libya as well as AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city – Libya at period in between September 2003 to March 2015 as cases of chronic adeno-tonsillitis and solitary acute as well as chronic related palatine tonsillar disease with variable patterns of indications for tonsillectomy namely snoring and apnea attacks, recurrent attacks of acute tonsillitis, persistent otitis media with effusion, recurrent attacks of acute suppurative otitis media, failure to thrive, recurrent attacks of chest infection, mal-occlusive dental deformity, unilateral enlarged tonsils, post-traumatic avulsed tonsils, history of quinsy abscess and persistent halitosis. All patients were assessed intra-operatively and post-operatively too for any evidences of primary, reactionary, or secondary hemorrhage in relation to wide spectrum of factors as patient's demographic, medical, and socio-habitual factors, in addition to technical as well as post-operative care factors. Results This presenting study confirmed that the most common type of post-tonsillectomy bleeding was the secondary variety (71%) as compared to primary (22%) and reactionary (7%) among all presented post-tonsillectomy bleeding cases. Although through this presenting serial study there were multifactorial pre-dispositions elucidated for secondary post-tonsillectomy hemorrhage but as general poor post-operative care can be considered as the cornerstone for the pathogenesis of this significantly raised incidence of secondary post-tonsillectomy bleeding this may be in form of inadequate patient's hydration and nutritional supply (47%), poor patient's antibiotic compliance (23%), and child's maternal negligence (19%). The time of surgery was found to be another important pre-disposing factor for post-tonsillectomy bleeding, it was postulated that the incidence of reactionary as well as secondary post-tonsillectomy hemorrhage significantly increased at summer and autumn seasons (69%) as compared to other seasons. The place of surgery was another interesting proposed studied factor among this serial presentation it was observed that the incidence of post-tonsillectomy bleeding among patients who operated at AL-hawari ENT and urology teaching center-Benghazi-city significantly higher (63%) than that among cases who interfered at AL-thowra central teaching hospital and AL-tarahom private center – Elbyda city. Conclusion Generally speaking, post-tonsillectomy bleeding is considered as one of important issues in ENT and one of significant post-tonsillectomy complications which may create a critical morbidity that may rarely extend to post-operative mortality. Hence the most common pattern of post-tonsillectomy bleeding is the secondary type; however this type of post-tonsillectomy hemorrhage is pre-disposed and induced by many factors. Most of these factors are treatable and curable thus the prophylaxis against this significant complication can be achievable.
Jun 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3862
Wang LingCorresponding author
Department of Intensive Care Unit, People's hospital of Qiandongnan Miao and Dong Autonomous Prefecture, Kaili, Guizhou, China
COVID-19 is a new infectious disease, which needs to explore the clinical value of white blood cell count and lymphocyte to provide help for diagnosis and treatment.COVID-19 cases were Selected that admitted to 2 hospitals in Guizhou, China. WBC and LYM in the 1st day, in the 4th day and in the 7th day after onset were collected. There were not any differences in The WBC and LYM in the 4th day and the 7th day between the two groups.WBC and LYM in the 1st day in the moderate group were lesser than in the mild group. WBC and LYM were no dynamic changes in the mild group. In moderate group, WBC and LYM in the 1st day were lesser than in the 4th day. The levels in the 4th day and the 7th day were no differences. The conclusion was In the early stage of COVID-19, the WBC and LYM in moderate patients were significantly decreased within 4 days after onset, and could be restored to normal level after 4-7 days. However, no dynamic changes were observed in mild patients within 7 days.
Jun 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3796
Raj StanleyCorresponding author
Department of Physics, Loyola College, Chennai, Tamil Nadu-India
Geoelectrical resistivity data collected from the ground contain lot of noises and errors. It requires efficient algorithm to reduce the errors to make an actual inversion models. Though different algorithm can be applied, nature inspired algorithm is more potential in inverting geoelectrical data in an elegant and comprehensive way. Bargain Optimization (BO) algorithm is framed on the concept of bargaining things to purchase for needs. In general, effective bargaining results in more profit and leads to loss when it fails. In this research work, Bargain Optimization algorithm is applied to invert geoelectrical data and the effective bargaining will take time to process and to obtain the required model. The input data is AB/2, apparent resistivity data and the inverted model through BO algorithm is successfully matched with the available litholog section of the study area. The output graphs have profit/loss bar graph, which reveals the status of bargaining during a particular number of epochs.
Feb 2021 DOI 10.14302/issn.2690-0904.ijoe-21-3727
Keshavarz VajihehCorresponding author
Department of Occupational Health, Faculty of Health, Mazandaran University of Medical Sciences, Sari, Iran.
Background and Purpose Providing health care is the basic right of people(1). Diagnostic radiology is one of the main procedures in health care services and proper benefiting from this technology is brought only under well planning and management(1). Supervision of the available condition and its comparison with the recommended standards is a key role in assessing assurance from the benefit of these instruments (2). Data show that more than 80% of patients referring to these hospitals need radiology image (3).Improper service causes repetition of radiography and even wrong diagnosis, as a results threatening health of the patients (3) lack of protective barrier leads to the exposure of the staff to X-ray which is obviously carcinogen us (4). It happens that the instruments are not working properly, like of symmetry in X-ray field, defects in collimators, lack of adjusting ray field and X-ray, low quality or defective developing machine, lack of proper protective barrier, using low quality film and drugs, lack of protective barrier for children, all of which cause severe hazards for the patients and staff (4). Materials and Methods The crucial aim of medical services is to provide the public with their needs which are very important. The sensitivity of such services is to such an extent that in case of lack of care, the hazards are too high. In evaluation of health services, the first thing is to evaluate the device used. Methods, efficiency, profits and their combination for prevention and eradication of diseases are also important. Therefore to gain this goal, it is necessary the obtain results comparable with recommended standards. The purpose of this study was to access the conditions of radiology units at Mazandaran University hospitals and compare them with the standards of ICRU NCRP and ICRP. Radiology unit is the most expensive section of any hospital for its instruments, manpower and space provided. In a study conducted in 51centers on radiology staff, radiography room and protective barrier, ray leakage, the outcome were 89%, 82%, 77% and 37% respectively. It was found that the condition of these centers regarding the protective barriers is very unsuitable due to unawareness of the leakage (5, 6).Considering the mentioned necessities, in this study, the condition of radiography centers affiliated to the Mazandaran University of Medical Sciences was studied for the type and the rate of problem, in order to provide a proper solving method. Results Data were collected through, observation, interviewing and filling questionnaire. Results show that, the situations of the radiology units are for from international standard, to such an extent that it is matched clout 50%. Conclusion The results showed that, none of the dark rooms are standard, and do not have proper alarm signal. In 63% of these units there no tiling system about staff protection from radiation. Defects in radiography room, protective barrier and lack looking rays were 60%, 51% and 47% respectively. Referring to the obtained data, periodic supervision, and obeying of the standards are necessary.
Jan 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3716
Zhao BinCorresponding author
School of Science, Hubei University of Technology, Wuhan, Hubei, China.
After entering the new century, people are facing a new external environment. Recently human society is coming into knowledge economy era, and the industrial structure has deeply been adjusted. Today, the past teaching method of imparting knowledge and getting people to accept education, or exam-oriented teaching ideas have been unable to keep up with the needs of the development of the Times. In the future, the key point of education is to promote people to understand the knowledge, and grasp rules between things. Based on this, it is particularly necessary for the talents cultivation to adopt a new idea of training. The paper takes the major in mathematics as an example, designs two classes of new teaching methods CT&CL and BOOF with the diversified assessment to cultivate students’ innovative thinking, providing a reference for the other students. The two classes of new teaching methods and the diversified assessment are worthy of further spreading and exercising during the coronavirus disease 2019 epidemic.
Dec 2020 DOI 10.14302/issn.2641-5518.jcci-20-3636
El Guindi WaelCorresponding author
Department of Obstetrics and Gynecology, Franck Joly Hospital, Saint-Laurent-du-Maroni, France
Objective To highlight the value of 3D ultrasound and Doppler angiography imagingin the prenatal assessment of left fetal isomerism. Methods A retrospective offline analysis of volume datasets of 3 fetuses with left atrial isomerism by 3D ultrasound was conducted. Conclusion We believe that parasagittal view demonstrating the heart and the abdominal vessels is easy to obtain and interpret, offer a realistic anatomic image, needs no mental reconstruction of spatial relationships and is very beneficial mainly in detecting the situs. We propose to use 3D ultrasound systematically in suspected cases of atrial isomerism, and better understand and interpret fetal anatomy.
Nov 2020 DOI 10.14302/issn.2381-862X.jwrh-20-3501
Aboma DanielCorresponding author
Shenen Gibe General Hospital, Msc, IESO
Background A well-functioning drug supply management is the corner stone for any meaningful health service. However, Pharmaceutical supply systems in many developing countries have severe problems, including inefficient selection, procurement and use of drugs. The magnitude and extent of the problem is huge and chronic in the Ethiopian health care system for a long time. Objective To evaluate auditable pharmaceutical transaction service process in Seka primary hospital, Jimma zone south west Ethiopia. Evaluation Methodology Case study design involving both quantitative and qualitative methods was conducted in Seka primary hospital. The focus of this evaluation was on the process of Auditable pharmaceutical transaction service. The evaluation was focused on process part of the program with dimensions; availability, compliance and client satisfaction in the dimension of accommodation. Resource inventory, document review; key informant interviews and observations were conducted. Client satisfaction was assessed through exit interview; with sample size of 326. The qualitative data was analyzed manually using thematic analysis and quantitative data were analyzed by using SPSS version 23 software. Results In Seka primary hospital, percentage availability of the 32 selected Key medicinewas 10.7(82.0%) and there were no expired drugs found on their shelves. The availability of 17 of the required 20(85%) professionals was adequate according the Auditable pharmaceutical transaction service. The average lead time was found to be less than five days. The average counselling and dispensing time were 5:43 minutes and 1:17 minutes, respectively. The average number of drugs per prescription was 2.0. The 1154(97.9%) of drugs prescribed by generic name and 1175(99.7%) of prescribed drugs on Essential Drug List indicates prescribers ‘adherence to facility specific List. Conclusion This evaluation revealed that (based on the pre-set judgment criteria) the achievement of the Auditable pharmaceutical transaction service in Seka primary Hospital was GOOD 82.6 % (achieved 355.2 of 430 weight given), i.e. even though it is Good achievement ,there are areas that needs improvement. Areas for improvement identified were: Pre- and in-service training for all health workers involved in store room and dispensary to improve on the medium counselling time, poor record keeping and the extremely poor labelingof drugs which this all improve the overall client satisfaction.
Nov 2020 DOI 10.14302/issn.2641-4538.jphi-20-3621
Stapff ManfredCorresponding author
LG Chem Life Sciences Innovation Center, Cambridge, MA, USA
Context In the face of further waves of the COVID-19 pandemic it becomes essential to find a balance between protective actions to guard public health and restrictive measures which can collapse our economy. Background As a basis for public health decisions, officials still rely on metrics which were helpful in the beginning of the pandemic but are now not precise enough for a focused and targeted approach to keep the spread of the infection under control. This can lead to public mistrust, “pandemic tiredness”, and can cause unnecessary damage to the economy without having the desired protective effect on public health. Methods This article discusses various metrics, their advantages and caveats, and it provides suggestions for use in a more targeted and risk-based approach, as an alternative to the current “general lock-down” practice. It suggests the notion of including a concept of “risk contacts per area” to better describe the possibility of virus transmission than currently published metrics do. The article also suggests specific analyses of real-world data for identification of populations at risk for severe courses of COVID-19 to allow more targeted protective actions. Discussion Data currently used to describe the COVID-19 pandemic lack important parameters like population density and local likelihood of potentially infectious contacts. The currently often used “all or nothing” approach of shut-down orders needs to be replaced by more sophisticated tactics considering individual local exposure risks and need to be balanced towards metrics on economic short term and long-term impact. In addition, smart analyses of real-world data may contribute to effective protection of individuals at risk.
Oct 2020 DOI 10.14302/issn.2576-9383.jhhr-20-3573
Williams AllisonCorresponding author
School of Earth, Environment & Society, McMaster University
The purpose of this scoping review was to examine the use of Photovoice in caring research. The review assessed the existing literature using the Arksey and O’Malley scoping review methodology. Database searches of relevant literature published worldwide between 1997–2019 yielded 25 articles in the English language that were included in this review. The authors summarized thematic findings. Three themes emerged from data analysis: 1) strengths of using Photovoice; 2) challenges of using Photovoice, and; 3) methodological complexities in Photovoice studies. The small number of studies included in the review (n=25) indicate the limited use of Photovoice in caring research, reflecting missed opportunities for action-oriented research. The scoping review recommends ways that researchers can better address the needs of carers using Photovoice, particularly as a tool for knowledge translation, advocacy, and empowerment.
Sep 2020 DOI 10.14302/issn.2328-0182.japst-20-3526
Bekele AnbessaCorresponding author
Pharmacy School, Health Institute, Jimma University, Ethiopia
Background Self-medication (SM) can be defined as the use of drugs to treat self-diagnosed disorders or symptoms, or the intermittent or continued use of a prescribed drug for chronic or recurrent disease or symptoms. A number of individuals in developing countries do not attend physicians for their illnesses; instead they commonly use self-medication. Self-medication could be using drugs existing in home like over the counter (OCT) drugs, traditional medicine, prescription only drug. Self-medication is not always bad, hence for the over the counter drugs it is beneficial. Inappropriate storage and use of medicines at home could have a direct influence on public health, the environment and the health-care services and it increases the risk of self-medication. Objective To assess the practice of self-medication and drug storage among South Sudanese community in Addis Ababa. Materials and Methods A cross sectional study design was conducted in Addis Ababa city from April 22 to April 26/2019. Data was collected by semi structure-questionnaire consisting questions on general demographic, socio-economic as well as on perceived illness/ symptoms in the past four weeks and actions taken for it. The data collected was screened before it is analyzed. Data analysis was done by using calculator. Results From the total 297 respondents 286 (96.2%) had reported self-medication in the last one month before the study period. The most common types of ailments for which the respondents reported to have practiced self-medication were cough, cold and sore throat 90(30.3%), followed by headache 66(22.2%), diarrhea 52(17.5%) ,abdominal pain 47(15.8%), fever 21(7.07%) and vomiting 10(3.3%). The reasons given for self-medication were; the illness was minor 226(76%) and previous experiences with similar ailments 31 (10.4%) were found to be the two major reasons given by the respondents for self-medication in this study. The majority of the respondents 242(81.4%) who practiced self-medication obtained information on self-medication from friends and 29(9.7%) obtained information from family members. The most frequently used group of drugs used for self-medication were analgesics/antipyretics 177(59.5%) and antimicrobial which account 75(25.2%) each followed by antihelmenthics 24(8.08%).The main source of drugs for SM was in pharmacy 220(74.07%) followed by leftover drugs 41(13.8%) while drug retail outlet, and neighbors and relatives were the suppliers to 12.13% respondents each. Conclusion and Recommendation A significant number of respondents (96.2%) use S/M from those perceived illness. Majority of the self-medicated individuals used due to minor illness. The most common category of drugs used was analgesics/antipyretics and antimicrobials. And the reason reported for using S/M was minor illness and previous experience with the illness. Most of respondents obtained drugs easily from pharmacy. So, pharmacies are the major sources of drugs used for S/M. The increased of drugs storage to treat similar illness/symptom and drugs left over from previous use contribute to the increase in the S/M practice. Common drugs store reported by respondents who store modern drugs were analgesic/antipyretic. Most of the respondents stored the drug in locked cabinets. A lot is need to be done in educating the public including the health care providers on the type of illnesses that can be self-diagnosed and self-treated, the type of drugs to be used for S/M, and the proper use of drugs. During dispensing of drugs emphasis should be given to all drug consumers and dispenser because of resistance and side effects of drug is the main challenging problem even in the world. Food, Medicines and Healthcare Administration and Control Authority (FMHACA) needs to effectively implement laws on drug handling and dispensing so as to take necessary measures on illegal providers of drugs.
Sep 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3545
Ezinna E EnwerejiCorresponding author
Department of Public Health, College of Medicine, Abia State University, Uturu, Nigeria
Public health professionals working in rural communities are aware of the health disparities which result from lack of physicians, limited services, and income during the pandemic. Also they are aware that some populations are more vulnerable than others. People in the rural areas are experiencing problems on their physical, social and economic life styles because the pandemic is exacerbating some inequities. Individuals especially women and children in the rural areas are facing barriers in accessing health care services due to lack of resources and availability of health care providers in the communities. With COVID-19, women are less likely to seek services, including sexual and reproductive health services. Such services may be postponed to limit exposure to COVID-19 infection. This is particularly disturbing because in addition to the women maintaining their own health, they are also responsible for taking care of the mental, emotional and physical health needs of their families as well as all domestic responsibilities. As such, women in rural settings face special challenges as a result of these significant roles they play. Therefore, the impacts of COVID-19 are exacerbated on women by virtue of their sex and the roles they play in the family. This is a qualitative study that reviewed the reports of the 36 health care professionals under the aegis of members of COVID-19 committee working in partnership with state government to control, prevent and cushion the effects of COVID-19 in the society. This study is therefore, a summary of the observations of the COVID-19 committee members made up of 10(27.8%) females and 26(72.2%) males. The study focused on exploring how individual lifestyles in the rural areas have been affected in the face of COVID- 19 pandemic by identifying the vulnerabilities in social, political and economic systems which can amplify the impacts of the pandemic. Findings showed that preventive measures like lockdown and social distancing rules, wearing of face mask, hand washing with soap, and environmental cleanliness were not observed. The study noted that health seeking behaviours, sexual and marital life including income, education, employment and social interactions were all negatively affected. Most hospitals were battered and health care professionals boycotted the hospitals for fear of being infected. It was found that lack of health workers in the hospitals caused a good number of individuals to engage in self-medications. Also most pregnant women delivered their babies at home and few with traditional birth attendants. Some of the women who had deliveries at home experienced complications during and after delivery. Unfortunately, the report showed that governments’ financial supports to these women and their family members were insignificant as the government was more concerned with mitigating the spread of COVID-19 than assisting women to have safe deliveries. Therefore, the vulnerable groups especially women, children, and the elderly who experienced threats to their safety and wellbeing as a result of the services that were disrupted during the pandemic, should be assisted so as not to lose their lives to preventable diseases.
Sep 2020 DOI 10.14302/issn.2377-2549.jndc-20-3516
Bhargava AksheyCorresponding author
Ex. Rajasthan Pollution Control Board, CEPT University, India
Municipal solid waste generation and disposal is a problem not only in India but all over the world. Presently majority of such waste is being dumped indiscriminately over vacant lands causing problems of odor, methane generation leading to air pollution, leaching effect polluting ground water and runoff polluting water bodies. Technological options are available to treat this solid waste and convert it into usable products but the biggest problem is its segregation preferably at the source of generation or even at the disposal area. Municipal solid waste generated in India consists of 15 percent non biodegradable which has high calorific contents and can be converted into power generation. Remaining 85 percent is degradable which can either be converted into compost or bio fuels. Under the present context, sustainable municipal waste management strategy needs to be evolved and put in place with effective implementation to address the issue of environmental pollution. An attempt has therefore been made by the authors of the present paper to take up a case study of Kanpur, India for managing such wastes having sustainable approach. The authors have worked out trends of population starting from the year 1951 and projected to 2051. Similarly waste generation trends established on the lines of population. An effort has also been made as to how much compost, bio fuel and power can be generated along with economic value to make it sustainable on a time scale.
Jul 2020 DOI 10.14302/issn.2641-5526.jmid-20-3424
Fakir YoussefCorresponding author
Faculy of Sciences and Technics, Sultan Moulay Slimane University, Morocco
In the last decade, the amount of collected data, in various computer science applications, has grown considerably. These large volumes of data need to be analysed in order to extract useful hidden knowledge. This work focuses on association rule extraction. This technique is one of the most popular in data mining. Nevertheless, the number of extracted association rules is often very high, and many of them are redundant. In this paper, we propose an algorithm, for mining closed itemsets, with the construction of an it-tree. This algorithm is compared with the DCI (direct counting & intersect) algorithm based on min support and computing time. CHARM is not memery-efficient. It needs to store all closed itemsets in the memory. The lower min-sup is, the more frequent closed itemsets there are so that the amounts of memory used by CHARM are increasing.
Jun 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3411
Franjić SinišaCorresponding author
Heart failure is a serious condition in which the amount of blood squeezed out of the heart every minute is insufficient to meet the body’s normal needs for oxygen and nutrients. Although some people wrongly believe that the term heart failure means that the heart has stopped, we must say that the term heart failure actually means that the heart has weakened and lost its ability to work. Heart failure has many causes including a many of diseases. Heart failure occurs most often in older people because they are much more likely to suffer from diseases that cause heart failure. Although heart failure gets worse over time, people with the condition can live for years.
May 2020 DOI 10.14302/issn.2641-4538.jphi-20-3289
Rajendran ThilagaCorresponding author
Department of Otorhinolaryngology, Hospital Sultanah Aminah (Ministry of Health, Malaysia), Johor, Malaysia
Mucoepidermoid carcinoma (MEC) accounts for only 5% of all salivary gland tumors and is most often seen in the parotid glands. MEC occurrence in the larynx is, however, rare. The incidence of primary squamous cell carcinoma (SCC) of salivary glands is also scarce and comprises only about 1.6% of all salivary gland malignancies. Hereby, we share our experience in managing two patients with rare and opposite variants of malignancy which were diagnosed at the same time; MEC of the larynx and SCC of the parotid. In MEC tumors, the presence of the intermediate and mucous cells with positivity in mucicarmine stain are the significant features. For SCC tumors, identification of the usual tumor markers (p40, CK 5/6 and p63) are pathognomonic. Although MEC and SCC are common in the head and neck regions, the existence of these malignancies in exceptional locations must be considered. The key features mentioned in our comparison table can help distinguish both these tumors and to deliver the correct treatment modalities. The prevalence of genomic and carcinogenic factors in the occurrence of these tumors in uncommon locations needs to be explored in future studies.
Apr 2020 DOI 10.14302/issn.2691-8862.jvat-20-3314
M. Motawei ShimaaCorresponding author
Associate Professors of Forensic Medicine &Clinical Toxicology, Faculty of Medicine, Mansoura University, Egypt
This article reviews toxicology practice challenges during COVID‑19, including laboratory safety, chemical exposures, therapeutics, and public health messaging. It identifies research needs and operational adaptations to support preparedness for future events.
Mar 2020 DOI 10.14302/issn.2470-5020.jnrt-20-3231
Patel NaiyaCorresponding author
University of Louisville, Department of Health management and Policy
Health services research is a multidisciplinary field which involves policy makers, health care providers, as well as quality outcomes professionals of the health services provided in an organizational setting to name some. Using qualitative research methodology to get insights of both the provider and patient experience down the pipeline can help strengthen what is lacking. Bridging the gap of translation research by not just surveys 1 might be an appropriate research methodology, however, inclusion of case studies, ethnographies might help stakeholders in the field, to visualize in depth phenomenon occurring in health services research field. Telly medicine, commercial digital health status trackr might be some of the inetrventions to improvise health care services, however, knowing what are the actual needs at individual level might efficiently help in redistribution of resources or policy laws. Recruiting for clinical trials through story telling communication technology2,3, might help in recruitment for novel drug therapies to explore possibilities, however, exploring the barriers to enroll for the clinical trials, or why the drug might work effectively in some cultural population and why not on others, can only be efficiently explored through qualitative research methodologies.
Feb 2020 DOI 10.14302/issn.2379-7835.ijn-20-3199
BUTNARIU MonicaCorresponding author
Banat’s University of Agricultural Sciences and Veterinary Medicine “King Michael I of Romania” from Timisoara, Timis, Romania
The need to understand the relation of man to food, determines the existence of appropriate behavior as well as an attitude in accordance with the modalities that determine human development and evolution, under this structural aspect. A proper diet is the one that provides the amount of nutrients corresponding to personal needs. The food pyramid is the scheme we refer to most in order to know the proportions of foods recommended for consumption. It is a pyramid divided into "layers", each corresponding to a category of foods and the respective quantity.
Jan 2020 DOI 10.14302/issn.2641-5526.jmid-19-3119
I. Khder SalahCorresponding author
Department of Pharmacology, Faculty of Pharmacy, National University, Khartoum, Sudan
Introduction The objective of this study was to compare the availability and prices of locally produced and imported medicines, in particular after one year from medicines importation restriction and to answer the key questions, did local manufacturers able to coverage national needs of medicines and what is the patient prices for locally produced compared to imported medicines in different sectors and regions of Sudan. Methodology The WHO/HAI methodology survey tool was adapted to measure the availability and price of locally produced and imported medicines. Patient price and availability were collected from capital cities of 6 states as per WHO/HAI methodology. Data were collected and analyzed for 50 medicines from the 104 medicines restricted to local manufacturer. Availability was based on whether the medicine was in stock on the day of data collection at the surveyed facility. Prices were expressed as median price ratio (MPR). Results Availability of locally manufactured medicines (LMM) was much better than imported medicines (IM), in the public, (47.2% vs. 14%, respectively) and private (63.9% vs. 23.5%, respectively) sectors. Based on median price ratio (MPR), public sector patient prices for locally manufactured medicines were lowered priced and had a median MPR of 2.4 (n=42) than imported medicines which had a median MPR of 4.99 (n=20). In private sector patient prices for locally manufactured medicines were also lowered priced and had a median MPR of 2.76 (n=45) than imported medicines which had a median MPR of 5.53 (n=27). Thus; patients were paying about 52% less for locally produced than for imported medicines in both sectors Conclusion The survey showed low availability of the basket of medicines surveyed in the public and private sectors for imported medicines (I.M), while not achieving WHO’s target of 80 % for locally manufactured medicines (LMM). In developing countries a lot of barriers are well known to business and industrial need to be resolved in order to maintain availability and self-reliance in drug production as a mean of increasing access to medicines.
Jul 2019 DOI 10.14302/issn.2641-4538.jphi-19-2860
Takele Melku AbulieCorresponding author
Madda Walabu University Goba Referral Hospital School of Health Science Department of Nursing, Assistant Professor (PhD) Mobile: +251911060837
Background Adolescents is the transition from childhood to adulthood .Which is a time of opportunity, but also one of risk. In Ethiopia, sexual and reproductive health problems of adolescents are increasing from time to time related to many parents not feeling happy to discuss sexual matters in addition to early sexual commencement among adolescents. Objective This study was intended to assess parent-adolescent communication on sexual and reproductive health matters and associated factors among secondary and preparatory school students in Robe Town, Bale Zone, South East Ethiopia, 2017. Methods Institution based cross sectional study was conducted among 394 secondary and preparatory school students in Robe town from April 10-25, 2017. Simple random sampling technique was used. Data was obtained through the use of a self administered questionnaire and supplemented by focus group discussion with parents. Data was entered using Epi Data 3.1 and analyzed by SPSS 20. Descriptive statistics and logistic regression analyses were done. Data quality was assured through careful questionnaire design, pretest and training. Results One hundred eighty six (47%) of the study participants had discussed at least two SRH issues with their parents. Grade eleven students were about nearly five times more likely discussed on sexual and reproductive matters with their parent compared with grade nine students (AOR: 4.88, 95% CI: 1.76, 13.54). Those living with relatives were 3.13 times less likely discussed as compared to those students are living with both parents (AOR: 0.32, 95%CI: (0.12, 0.80) and the odds of discussion on SRH matters is 2 times higher among females compared with their counterpart (AOR=2.02, 95% CI: 1.25, 3.26). Conclusions Communication on sexual and reproductive health matters between adolescent and parent was low. Majority of student preferred to discuss with their peers than parent. Being ashamed, parents lack of communication skill and parent knowledge on SRH issues were the major reasons mentioned by the students for not discussing about SRH matters with their parents. Therefore; comprehensive family life education needs to be initiated for the students and parents. Sexual information exchange between peers needs to be strengthened.
May 2019 DOI 10.14302/issn.2324-7339.jcrhap-19-2847
Sharma BechanCorresponding author
Department of Biochemistry, Faculty of Science, University of Allahabad, Allahabad-211002, UP, India.
Background Carissa carandas L. is a well-known wild fruit plant distributed through-out the India and also present in other countries. The fruits are rich in nutrients and minerals. A number of medicinally important phytochemicals such as carrisone, carindone, carandinol, lupeol, scopoletin, stigmasterol, β-sitosterol, myo-inositol, β-amyrin, Des-n-methylnoracronycine etc. have been reported from the extract of this plant. Being safe and cost effective molecules, the activity of phytochemicals against HIV-1 enzymes needs to be screened. Objective The aim of this study was to screen the potent phytocompound of C. carandas against human immunodeficiency virus-1 using docking method. Methods Total nine compounds viz. carandinol, caridone, carrisone, lupeol, p-coumaric acid, gallic acid, rutin, scopoletin and ursolic acid were used for in-silico study towards drug development against human immunodeficiency virus-1 reverse transcriptase (HIV-1RT; PDB ID: 1REV) and human immunodeficiency virus-1 protease (PDB ID:1EBY) using Autodock software. Results The qualitative characterization of the extracts showed the presence of a number of phytochemicals such as phenolics, flavonoids, alkaloids, terepnoids, terpenes, steroids, glycosides etc. Carandinol was observed as most effective anti-HIV-1 molecule having lowest binding energy and small inhibition coefficient. Another compound, p-coumaric acid, showed least effectiveness against human immunodeficiency virus- 1 reverse transcriptase or human immunodeficiency virus-1 protease showing highest binding energy and inhibition coefficients among all the evaluated phytocompounds. Conclusion The in-silico study demonstrated that some phytoconstituents of C. carandas exhibit potential anti-human immunodeficiency virus -1 activity and hence can be optimized to develop as a drug candidate in future.
Apr 2019 DOI 10.14302/issn.2640-690X.jfm-19-2725
Murphy DominicCorresponding author
Combat Stress, Leatherhead, UK.
Background Romantic partners living alongside veterans with Post Traumatic Stress Disorder (PTSD) appear at increased risk of secondary traumatic stress (sPTSD) and common mental health difficulties (CMD) compared to the general population. The severity of symptoms implies the need for structured, bespoke and evidence-based interventions. Objective The aim of this study was to explore the feasibility of offering a community support programme (The Together Programme, TTP) for military partners. TTP was developed based upon a number of US programmes and consisted of 10 hours of group-based support delivered over a five-week course. 56 participants engaged in TTP over a year at nine locations across the UK and were followed up three months later. Methods Measures of CMD, sPTSD, alcohol use and relationship satisfaction were used to assess benefits. Data were also collected on attendance and participant feedback. Results Significant reductions were observed for symptoms of sPTSD and CMD at follow up. 51/56 (90.1%) participants completed TTP. The majority of participants reported positive experiences. However, several individuals stated wanting more sessions and that barriers such as work, and family commitments made it difficult to attend. Conclusions Whilst limitations exist, the data presented suggests cautious optimism for the efficacy of offering a structured programme of support to address the needs of military partners living alongside PTSD.
Apr 2019 DOI 10.14302/issn.2379-7835.ijn-19-904
Coppinger TaraCorresponding author
Cork Institute of Technology, Ireland
Background To date, no research has explicitly examined children’s knowledge and consumption of fluids at school, particularly during times of exercise (physical education (PE)). Methods Between May and July, 2018, 322 (213 females, 104 males; mean age = 8 years 5 months, SD ± 2 years 1 month) elementary school children from Ireland (n=237) and England (n=85) completed a questionnaire on their understanding of fluid intake and how much they perceived they drank on days when they did/did not participate in PE. Results Younger (<9 years) English children were most thirsty at the end of the school (68%), compared to younger and older (≥9 years) Irish children who were most thirsty after (38% <9 years; 39% ≥9 years) or during (21% < 9 years; 21% ≥9 years) PE. In both countries for <9 year olds, similar amounts were consumed on days when they did, and did not, partake in PE with 41% of all participants reporting intakes below daily guidelines. No child, of any age, was correct at predicting what their fluid intake should be on days when they took part in PE. Conclusion Young children in England and Ireland do not understand fluid recommendations, especially the increased need for fluid on days when they partake in PE. Further objective research is needed to ascertain whether actual fluid intake in children matches perceived intakes and whether the structure of the school day, and intensity levels of PE lessons, influence these intakes. Additional research needs to gauge the importance of the teacher and how they are a key influencer in supporting children in their learning of how, why and when to drink.
Mar 2019 DOI 10.14302/issn.2640-690X.jfm-19-2726
Spencer-Harper LucyCorresponding author
Combat Stress, Leatherhead, UK.
Background Research has demonstrated that partners living alongside veterans with mental health difficulties are at high risk of developing mental health difficulties themselves and secondary trauma. A variety of interventions have been developed to support partners. Research to date has relied on quantitative methodologies to evaluate the efficacy of such interventions with less emphasis on learning about the experiences of individuals on the courses. Objective The aim of this qualitative paper was to understand the experiences of partners who engaged in a five-week structured support intervention, ‘The Together Programme’ (TTP) which had been piloted across UK cities. This programme involved tailored psycho educational materials adapted to the needs of veteran’s partners living alongside PTSD. Further the potential mechanisms of change for participants engaged with the programme were explored as well as the impact of treatment on their relationships. Methods Eight female partners were recruited from an original sample of 57 partners who were intimate relationships with treatment seeking veterans with mental health difficulties. These participants had completed TTP. Qualitative data was collected using a semi structured interview and explored using Interpretative Phenomenological Analysis. Results Three key themes emerged from the data, these were self-growth, changing role in relationships and connecting with others. The themes included several sub themes. Self-growth sub-themes were mastering the ‘inner judge’, ‘confidence in ability to cope’ and ‘taking care of my needs’. Changing role in relationship sub-themes were ‘acceptance and understanding’ and ‘improved communication in relationship’. Connecting with others was described by the sub-themes of ‘knowing I am not alone’, ‘peer support’ and ‘hope’. Conclusions This study suggeststhere were three key areas where thestructured evidence-based support programme had an impact on participants experiences. These were factors that helped participants to normalise their experiences and increase participants understanding and interpersonal skills that promote changes in relationship functioning with the veteran.
Jan 2019 DOI 10.14302/issn.2641-4538.jphi-18-1973
Victoria NthalaCorresponding author
Introduction Adherence to ART is a challenge among pregnant women living with HIV/AIDS. This has an effect on the health of the mother and the unborn child. While studies have been done, it has shown that adherence during pregnancy is a challenge Virological and clinical success depend critically on high adherence to ART because with low adherence. The success of expanded ART coverage in improving health outcomes depends on adherence to treatment. During pregnancy, a compromised Virological response to ART also increases risk of mother-to-child transmission (MTCT) of HIV. This study was carried out to determine factors that influence adherence to antiretroviral therapy among HIV positive pregnant women in Lusaka district of Zambia. Methodology This was a qualitative study which used a case study approach. Data was collected through in-depth interviews. The collected data was analysed using a thematic analytical approach. Results 17 pregnant women living with HIV /AIDS in Lusaka had Challenges with adherence to ART. The study explored factors related to adherence to ART among pregnant women living with HIV/AIDS. ART adherence was found to be low. The findings call for the need to reduce on social stigma. The results confirmed that there is low adherence to ART among pregnant women living with HIV /AIDS in Lusaka. Conclusion Adherence to ART among pregnant women living with HIV/AIDS is a challenge for Zambian pregnant women. Improved levels of adherence to ART is hampered by fear of social stigma, and fear of being blamed by partners if they disclosed their status. Stigmatisation needs to be addressed because nearly all the participants expressed this factor. There is need to address the HIV/AIDS stigma very seriously in order for society to look at HIV/AIDS like any other illness.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-19-2608
W. Harvey PeterCorresponding author
Conjoint Clinical Professor, Deakin University, School of Medicine, Faculty of Health
In the light of various complaints about the quality of care provided by and operation of aged care facilities across Australia, the Commonwealth Government has announced a Royal Commission into the activities of the sector. As the proportion of Australians over 65 continues to grow with the ageing of the ‘Baby Boomer’ generation, more Australians are seeking secure aged care arrangements to meet their increasingly complex living and healthcare needs. We hear much comment today about the concept of healthy ageing and the importance of older people staying connected to and active in their communities. Not only does this ongoing connectivity support better lifestyles and health status, it provides an avenue for older people to contribute to the support of others once their more formal working lives are concluded. Unfortunately, the gap between the rhetoric and the reality of ageing in Australia is strained and it appears that much about the operations of the aged care sector today is less than satisfactory. While some well-funded retirees can afford comfortable and fulfilling living arrangements, many others are left in less ideal circumstances. With aged care organisations currently building the next generation of ‘hotel’ style living arrangements for cashed up self-funded retirees, others are being left behind financially and in terms of the quality of their care. At the same time, maltreatment and abuse of residents is coming to light, as in the ‘Oakden Nursing Home’ situation in South Australia, for example. Consequently, the Federal Government has now launched a formal inquiry into the activities of organisations running aged care facilities in Australia. The inquiry is designed to assess the operation of this industry with a focus on the economics of aged care centres, the quality of care, the food and recreational activities provided and the challenge of staffing these facilities to keep residents safe and well as they age in dignity.
Aug 2018
F. Favaro PatriciaCorresponding author
Department of Veterinary Medicine and Animal Health, School of Veterinary Medicine and Animal Science (FMVZ), University of São Paulo (USP), São Paulo - SP, Brazil
This brief report summarizes equine influenza activity in South America, noting clinical presentation, transmission dynamics, and recent outbreaks. It reviews vaccination strategies, biosecurity measures, and surveillance needs for controlling spread. Practical guidance is provided for veterinarians and stable managers to reduce risk during regional circulation.
Jun 2018 DOI 10.14302/issn.2574-612X.ijpr-18-2110
Xu WeiCorresponding author
School of Psychology, Nanjing Normal University
Purpose: There are nearly 170,000 new cases of breast cancer in China every year, and this number is showing an increasing trend. Mental health plays an important role in promoting the physical rehabilitation of patients. Therefore, attention paid to their psychological problems needs to be reinforced. The current study aims to investigate the mental health states of the breast cancer patients and provides the references for their psychosomatic rehabilitation in the future work. Methods: A total of 643 breast cancer patients completed the whole study. A questionnaire survey on anxiety, depression, posttraumatic stress disorder (PTSD), and posttraumatic growth (PTG) was conducted in Jiangsu Women and Children Health Hospital. Results: 13.53% breast cancer patients had anxiety; 21.5% had depression; the prevalence of PTSD was 7.15%, while the prevalence of PTG was 26.12%; Anxiety levels in older patients were significantly lower than those in the other two groups; PTG levels in older patients were significantly lower than those in the other two groups. Conclusion: Breast cancer patients have certain emotional distress and stress symptoms, but they also experience psychologically positive changes. And age shows various differences on anxiety and PTG. Clinical medical personnel should pay attention to the patient's psychological rehabilitation when concerning about the physical rehabilitation of patients. Patients in different ages have different mental health problems, thus the medical staff shall provide differential nursing plans for them.
May 2018 DOI 10.14302/issn.2381-862X.jwrh-18-2090
Yao Gbagbo FredCorresponding author
University of Education Winneba, Department of Health Administration & Education. P.O. Box 25 Winneba, Ghana.
Background: The Ghanaian culture expects women of reproductive age to reproduce. This makes pregnancy an acceptable occurrence in most tertiary institutions in Ghana. Although Ghanaian Universities allow pregnancy in school, challenges associated with pregnancies do not exempt pregnant students from following the academic requirements of the universities. This study therefore explores students’ experiences of copying with pregnancy in an academic environment in Ghana. Methods: This was a case study, quantitative and qualitative design using structured questionnaires and semi-structured interview guides respectively for data collection. Respondents comprised twenty (30) pregnant full time and part time female students from campuses of University of Education, Winneba. Data collection was between October 2016 and May 2017. Quantitative data were analysed using statistical package for social sciences (SPSS) version 23. The qualitative data was transcribed and manually analysed thematically. Results: The study found that majority of participants were adults between ages 26 and 30 years. More than half of them (66.7%) had no child and this was their first pregnancy which they felt was mistimed as it occurred during schooling, posing some physiological, financial and academic challenges which compelled students to devise various coping strategies to combine academic work and pregnancy amidst limited University provisions for pregnant students. Conclusions: The study results have policy and programme implications for meeting women’s needs for pursuing academic and reproductive goals concurrently. The study recommends that public universities in Ghana should institutionalise programmes on preconception counselling and coping with pregnancy in academic environment to enable female students make informed decisions on exercising their reproductive rights in whilst in the university to ensure positive maternal health outcomes.
Apr 2018
Li DongyeCorresponding author
Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 221006, Xuzhou, Jiangsu, PR China
Heart failure(HF) is a disease with high morbility and mortality. The benefits of current pharmacological and device therapy for survival outcomes of patients with HF are limited. Gene therapy represents a novel promising strategy in treating HF, as it can theoretically normalize the aberrantly expressed genes and their regulatory mechanisms permanently. However, the translation of gene therapy for HF from bench to bedside has been less successful. There are many challenges ahead for gene therapy, especially in the areas of selection of the optimal targets, the needs for developing delivery systems and the improvement in design of clinical trials. In this review, we summarize the most promising gene targets which have been used in experimental and clinical studies for treating HF, highlighting the results from several clinical trials. We also review the latest development in gene therapy vectors and delivery methods, aiming to provide directions for future studies.
Mar 2018 DOI 10.14302/issn.2690-0904.ijoe-18-2009
Valenti AntonioCorresponding author
Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, Italian Workers’ Compensation Authority (INAIL)
This perspective connects green economy transitions with occupational health and safety. It outlines potential hazards, workforce training needs, and prevention policies to ensure safe, sustainable jobs.
Feb 2018 DOI 10.14302/issn.3066-8042.jac-17-1843
Mackenzie GenevieveCorresponding author
ADHD and Literacy Lab, Ontario Institute for Studies in Education
Children and youth with ADHD are a vulnerable group susceptible to adversity in wide-ranging life domains. However, many children and youth, irrespective of having ADHD become successful both academically andinterpersonally, and improve their cognition. This group can be considered as being “resilient”, that is, adapting to the adversity they may face in a positive manner. The overarching goal of this paper is to highlight domains at the academic, interpersonal and cognition levels that are indicative of resiliency among children and youth with ADHD. The secondary goal is to highlight interventions that result in promoting resiliency among this group at these levels. It is necessary for future interventions to be designed and implemented with developing the resiliency of children and youth with ADHD in mind. To achieve this, research needs to begin to identify the strengths of children and youth with ADHD to provide insight into how their strengths can compensate for their weaknesses, and to promote their resiliency leading to success academically, interpersonally and cognitively.
Feb 2018 DOI 10.14302/issn.2379-7835.ijn-17-1872
Agaba EdgarCorresponding author
FTF Nutrition Innovation Lab, Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, USA
Objective: To elaborate on the procedures undertaken to establish blood draws and cold chain for nutrition assessments. Setting: A total of 5,044 birth cohort households were enrolled and assessed using household questionnaires, anthropometry, and blood sampling to assess nutritional issues and exposures to environmental contaminants. The challenge was to obtain, transport, process, store, and analyze tens of thousands of serum samples obtained in sites that were often difficult to reach. Approach: Before enrollment began, 24 healthcare facilities in the North and Southwest of Uganda were assessed for suitability as local nodes for processing and storage. Equipment needs included functional centrifuges, refrigeration, ice machines, and -20oC freezers. Other important physical infrastructure included the presence of backup power (generator or solar generated) in the event of electricity failure. Once samples were obtained, they were transported within 5 hours to the facility laboratories, where serum was separated and aliquoted into properly labelled storage tubes and then frozen. Relevant Changes: At community level, our team visited households or small group of household members close to their homes to reduce on travel time hence contributed to high retention rates. Our immediate testing for anemia and malaria results benefited enrollees and enhanced community acceptance. By using Village Health Teams (VHTs), we could accommodate household preferences for the timing of sample collection. Our engagement with phlebotomists transformed their role from a simple service into active team members. Lessons Learned: Our first lesson was that in our setting, the success of this nutrition biological sampling system required community engagement and acceptance. By combining an immediately actionable set of tests (for anemia and malaria), and visiting cohort households, we greatly enhanced the success of the system.
Jan 2018 DOI 10.14302/issn.2577-137X.ji-17-1800
R Patil RajanCorresponding author
School of Public Health, SRM University.
This article has been retracted on December 28, 2018. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2577-137X.ji-25-5837) This paper attempts to summarizes possible reasons for BCG trial failure in India. It also lists out some of the important controversies and questions raised with regards to BCG trial in the context of Non Specific sensitivity. It emphasizes on the fact, that Tuberculin test does not accurately reflect individual’s responded immunologically to mycobacterium, it only indicates nature of immune response that has been elicited in an infected individual. The dynamics of tuberculin reaction needs to be understood through immunological considerations. Categorization of Tuberculin test results factoring in immunological considerations,will have great implication on the interpretation of tuberculin test and therefore on the estimation of annual risk of infection of tuberculosis.
Nov 2017 DOI 10.14302/issn.2576-6694.jbbs-17-1748
Nair AjayCorresponding author
Oklahoma Medical Research Foundation, Arthritis and Clinical Immunology Research Program, Oklahoma City, Oklahoma 73104, USA
Neo-Darwinian natural selection theory indicates that sudden, drastic changes in the environment place selective pressure on genetic variants in a population. As time progresses, this pressure sculpts individuals to better fit this new environment. Waddington’s classic experiment was repeated using white-eyed (the w1118strains) flies which produced the crossveinless (cve; disturbed wing crossveins) trait from the parent generation. The F1 generation was split into two selection lines: an Upward Selection Line, that produced more cve in successive generations, and a Downward Selection Line that responded with a consistent but non-linear decline in the percentage of crossveinless. This article will introduce and enlarge observations made on flies with cve; especially the manner in which the Waddington experiment impacts the population. It seems that Waddington evaluated crossveinless just by what it is good for, but not by the price of using it. That is to say, there is an inevitable cost that needs to be paid in order to acquire crossveinless-ness (cve and the associated phenotypes).
Sep 2017 DOI 10.14302/issn.2574-612X.ijpr-17-1746
Spallek JacobCorresponding author
Department Epidemiology & International Public Health, School of Public Health, Bielefeld University, Germany
Objective: Aim of this study was to assess appraisal and utilization of psycho-oncological care of Turkish female breast cancer patients in Germany. The presented results are part of a larger study about care of female German and Turkish cancer patients in Germany (4B-study). Methods: In this qualitative study semi-structured face to face interviews were conducted with Turkish breast cancer patients in Germany. Interviews were transcribed and analyzed in Turkish by two Turkish speaking researchers via content analysis using MAXQDA qualitative analysis software (version 11). Results were discussed among a bilingual research team. Selected citations were translated. Results: Turkish patients showed a great need for support, particularly emotional and informational support. However, the available psycho-oncological care was rarely used due to lack of information, prejudice, language and cultural barriers. A missing belief in effectiveness of psycho-oncological care was also noted. Conclusions: According to this study, psycho-oncological services do not adequately correspond to the needs of Turkish breast cancer patients. If confirmed in more extensive studies, these findings call for the development of migrant-sensitive approaches and therapeutic action to provide ease to cancer patients. Additionally, prejudice against psycho-oncological care needs to be reduced in the Turkish community.
Aug 2017 DOI 10.14302/issn.2324-7339.jcrhap-17-1430
Myezwa HellenCorresponding author
Department of Physiotherapy, University of the Witwatersrand, Johannesburg, South Africa
HIV and AIDS remains a major health problem in South Africa even after two decades since the introduction of antiretroviral therapy. Long term survival with HIV is associated with new health related issues and a risk of functional limitation/disability. The aim of this study was to assess the impact and predictors of functional limitation associated with HIV/AIDS among people living with HIV (PLHIV) in South Africa. This study is a cross-sectional survey using a cohort in an urban area in Gauteng province South Africa. Questionnaires that were interview administered were used to collect information on demographics, disability, mental and physical health state, adherence and livelihood. A total of 1044 participants with an average age of 42±12 years, were included in the study and 51.9% of the participants reported functional limitation (WHODAS ≥ 2). These were reported mainly in the participation (40.2%) and mobility domains (38.7%). In addition, adherence to ARV, physical health symptoms and depression were strongly associated with functional limitations/disability. HIV as a chronic disease is associated with functional limitations that are not addressed and pose a risk of long term disability and negative adherence outcomes. Therefore, wellness for people living with HIV/AIDS (PLHIV) needs to include interventions that can prevent and manage disability.
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-17-1489
NE PhilipCorresponding author
Achutha Menon Centre for Health Science Studies, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram 695011, Kerala, India
We aimed to find the population coverage, health service utilization and out-of-pocket spending among the elderly who are insured under Comprehensive Health Insurance Scheme (CHIS), Kerala through a longitudinal study of 600 non-rich households for nine months. The study found that only 57.7% the elderly were insured under CHIS which is lower than the population average of 80%. Single elderly from a socially backward caste, living alone in kutcha or semi-pucca houses were excluded from CHIS. Even though insured elderly had more episodes of hospitalization, only 38.4% of the elderly could make use of CHIS smart card for payment during hospitalization and 43.6% of the episodes were covered by CHIS. The mean indirect out-of-pocket expenses among insured elderly who had used smart cards for hospitalization (INR 7679.25) was higher than that for the un-insured (INR 4455.26), p = 0.027. The mean monthly drug expenditure (INR 1105.09) was also significantly higher among the insured as compared to the un-insured elderly (INR 650.03), p=.004. More than 80% of the hospitalized households had to use distress finance mechanisms to meet health- related expenses. We found that population coverage among elderly did not translate into service coverage and thus financial risk protection was not achieved even in a state like Kerala which is considered to be well-performing in terms of health insurance coverage. This study points out that elderly being a vulnerable group with special needs require a more comprehensive service package including chronic disease care, and a higher level of financial coverage.
Apr 2017 DOI 10.14302/issn.2474-3585.jpmc-16-1213
Wood-Nartker JeanneaneCorresponding author
Department of Human Environmental Studies, Central Michigan University
As people age, environments supporting changing needs can potentially impact their quality of life. The purpose of this exploratory study was to develop and assess the validity of a checklist instrument used to evaluate senior-supportive environmental risk factors within assisted living facilities (ALFs). Aging often leads to a decrease in the ability of a person to interpret sensory cues within his or her environment. This checklist instrument examined the relationship between sensory cue frequency and the influence on fall incidence within ALFs to maximize safety and quality of life. Observers visited 140 ALFs, utilizing the checklist instrument to document the presence or non-presence of 110 sensory cues. Contrary to the original hypothesis, a positive correlation was found between sensory cues and reported falls in each space. As the number of cues increased, the number of falls also increased. Additionally, the frequency of sensory cues within each room increased as facility size increased. Lastly, data revealed that more sensory cues were present in ALFs designed or renovated by design professionals. Although the results were contrary to expectations, the checklist instrument demonstrated face and predictive validity as a future research tool.
Mar 2017 DOI 10.14302/issn.2474-7785.jarh-17-1420
Vivanti AngelaCorresponding author
Centre for Dietetics Research, School of Human Movement and Nutrition Studies, University of Queensland, St Lucia, Queensland, Australia 4072.
Dehydration in acute care is associated with increased morbidity and mortality. However, no standard approach to hydration assessment exists in clinical settings. The pilot study aimed to explore total body water content as means for immediately assessing hydration status in clinical settings. People aged 60 years or more, voluntarily admitted to a tertiary teaching hospital’s Geriatric and Rehabilitation Unit were eligible for participation. Total body water assessment by tracer dilution was compared with standard clinical assessment of hydration status. The study participants (78.6±8.5 years, 6/14, 43% male) clinically assessed with poor hydration (3/14) had a higher percentage of body weight as water (59.0±2.3 vs 50.6±6.4%), and lower mean weight (54.1±12.9 vs 77.5±24.1 kg) and lower body mass index (20.0±3.7 vs 30.2±6.5 kg/m2) than the well-hydrated (11/14). Weight (n=14) and body mass index (n=11) explained a substantial proportion of variation in total litres of body weight as water (r=0.92, R2=0.85; r=0.80, R2= 0.64) and percentage of body weight at water (r=0.6, R2= 0.36; r=0.72, R2= 0.52) respectively. This pilot study revealed higher percentages of body weight as water amongst those clinically assessed with poorer hydration. Future regression analysis of total body water and hydration needs to adjust for the potential confounding effect of weight and body mass index. Implications for practice from this preliminary study indicate that findings did not support single point measurements of either total body water or percentage of body weight as water as potentially simple methods for clinically assessing hydration status amongst older hospitalised people.
Nov 2016 DOI 10.14302/issn.2381-862X.jwrh-16-1294
Figueiredo ReginaCorresponding author
The paper presents the incorporation of sexual and reproductive rights in the legislation of Brazil, considering the influence of the discussions that involved the United Nations conferences of Cairo and Beijing. Are described and analyzed the Federal Constitution and federal laws, as the Criminal Code and the Code of Child and Adolescent, besides other legal norms of Brazilian executive power bodies, like the Ministry of Health and Ministry of Education, particularly in the areas of health and citizenship. This process allowed the introduction of new health and education practices in public institutions, offered to the entire population -primarily benefiting women and teenage girls and, then, integrating people in situation of sexual diversity -although there are still problems, such as the occurrence of pregnancies and abortions in adolescence and the underreporting of sexual and gender violence. It is concluded that Brazil has incorporated into its laws the precepts of the sexual and reproductive rights more easily due to the proper moment, which coincided with the creation of new legal instruments and the organization of the national state. Nevertheless, it is still necessary translating these legal advances into practical advances in the public policies and policies focused on people’s needs.
Nov 2016 DOI 10.14302/issn.2644-0105.jbfb-16-1257
Aumeistere LivaCorresponding author
Institute of Food Safety, Animal Health and Environment BIOR, Riga, Latvia
Background: Breast milk is the ideal food source that contains all components an infant needs. Infants are at risk of receiving possible pollutants and high levels of trans fatty acids through breast milk that may affect their cardiovascular health and cognitive development. Statistics indicate that the proportion of children who are breastfed up to one year of age shows an annual increase in Latvia. Objectives: 1. To review studies conducted among the Latvian population regarding breast milk composition. 2. To evaluate the necessary future studies emphasizing the importance of the trans fatty acid content in a mother’s diet and correspondingly in breast milk and taking into consideration the new changes in Latvian legislation setting the maximum trans fat content in foodstuffs. Conclusions: There is very little research done about the human milk composition in Latvia that could be referable to a general population. It is known that the exposure of breast milk to persistent organic pollutants in Latvia corresponds to the lowest levels detected in the European countries and is not a cause of health disorders. Taking into consideration the adverse effect trans fatty acids have on human’s health regardless of the age, consumption should be as low as possible. Latvia has become the latest European Union country to set the maximum amount of trans fats in foodstuffs, yet there is no information about trans fatty acids content in human milk among women in Latvia. This problem needs to be addressed and set in motion. Therefore, it would be a novel idea to study if the TFA content also declines in milk among Latvian women after the introduction of the new legislation.
Oct 2016 DOI 10.14302/issn.2474-7785.jarh-16-1128
M. J. Pollux PetraCorresponding author
School of Psychology, University of Lincoln
A popular scale for assessing knowledge about Alzheimer’s disease is the Alzheimer’s Disease Knowledge Scale (ADKS). The aim of the study was to investigate the effect of adding ‘don’t know’ to the original ‘true’ or ‘false’ response option. It was assumed that this modification would provide insight into the reasons underlying incorrect responses and could distinguish between misconceptions and knowledge gaps. To investigate this, carers (care home carers and informal carers) and members of the general population were recruited. The results showed that percentage correct responses was lower than previously reported, suggesting potential inflation of knowledge by guesses without the ‘don’t know’ option. Moreover, care-home workers were more likely to select the incorrect response than ‘don’t know’ compared to informal carers for several items related to the earlier stages of AD, suggesting a higher level of misconceptions around this topic and highlighting potential training needs for care home carers.
Oct 2016 DOI 10.14302/issn.2572-5424.jgm-16-1170
Majid Khan GulCorresponding author
Department of Pharmacy, Quaid-i-Azam University, Islamabad 45320, Pakistan
Background: Skin is one the most important sites for administration of drugs to obtain desired pharmacological effects either locally or through systemic bioavailability; and this has placed the transdermal route of drug delivery as an attractive and as one of the most innovative areas for conducting drug delivery research. However the stratum corneum in skin creates hurdles and acts as significant barrier for the permeation of drugs through skin. Penetration enhancers play a pivotal role to overcome such barriers and help enhance the permeation of drug through skin. However, penetration enhancement technology is challenging development and needs to be properly and skillfully addressed. Objective: The present investigation aimed to study the penetration enhancing effect of a newly synthesized alcohol derivative of an acyclic monoterpene (Tetrahydrogeraniol-THG). Methodology: The new derivative, 5,9-Dimethyl-1-Decanol (DIMDOL), has been synthesized by a chemical reaction of the THG with Grignard reagent and ethylene oxide. Permeation enhancing effect of the synthesized derivative was explored for better transdermal penetration of the two model drugs viz. tramadol hydrochloride and 5-fluorouracil (5-FU) through the excised rat skin by conducting in-vitro permeation experiments employing Franz diffusion cells apparatus. The standard enhancers Azone and THG were used to compare penetration enhancing effect of the enhancers. Results: It was revealed that DIMDOL could effectively enhance the permeability of both the drugs by 18.60 and 73.19 folds across the skin used with a lag time of 3.35 and 1.20 h, respectively. The newly synthesized derivative was found to significantly increase the partition coefficient and diffusion coefficient values. Conclusion: The results obtained suggest that DIMDOL can more effectively enhance the permeation of these model drugs, expectedly by affecting the stratum corneum and interacting with both lipid-rich layers and keratin-rich layers of the excised rat skin.
Aug 2016 DOI 10.14302/issn.2473-1005.jdoi-16-1167
Singh Nayyar AbhishekCorresponding author
Reader, Department of Oral Medicine and Radiology, Saraswati-Dhanwantari Dental College and Hospital and Post-Graduate Research Institute, Parbhani, Maharashtra, India
Context: The present study was undertaken to do a comparative evaluation of the role of Cone Beam Computed Tomography (CBCT) imaging and Orthopantomography (OPG) for pre-operative implant planning in combination with sinus grafting procedures in order to assess sinus anatomy and morphology and the existing bone height in three dimensions. Aims: To assess sinus anatomy and morphology and the existing bone height in three dimensions. Materials and Methods: Pre-operative assessment of maxillary sinuses for implant planning using CBCT imaging was performed on 20 sinuses (17 patients). These patients were subjected to orthopantomographs and CBCT imaging both pre-operatively and post-operatively. CBCT imaging helped to decide the type of sinus augmentation procedure best suited for the patients as per the individual needs and depending on the residual alveolar bone height, timing of implant placement, sinus morphology, anticipation of complication and comparative analysis between pre-and post-procedural gain in vertical alveolar bone height and increase in bone density. Statistical Analysis: The results were tabulated and statistically analyzed using Paired and Unpaired t-tests. Results: In the majority of cases, there was a concordance between the treatment type based on pre-operative and post-operative CBCT scans. The assessment of sinus morphology revealed a significantly higher detection rate of abberations in the form of sinus mucosal hypertrophy and septae on CBCT which were imperceptible on routine radiographs. The most appealing result was that vertical alveolar bone height could be measured precisely and there was a significant increase in surgical confidence and a significantly better prediction of complications when using CBCT imaging. Conclusions: A pre-operative planning based on CBCT imaging seems to improve sinus diagnostics and helps to execute a better treatment plan. Also, it is a good tool for the comparison of vertical alveolar bone height pre-and post-operatively following sinus augmentation procedures using various graft materials.
May 2016 DOI 10.14302/issn.2574-450X.jom-16-1039
V. Seeman MaryCorresponding author
Professor Emerita, Department of Psychiatry, University of Toronto, 260 Heath St. W., Suite 605, Toronto, Ontario, M5P 3L6, Canada.
Over the last three decades, an epidemic of obesity has markedly affected patients suffering from mental illnesses such as schizophrenia. Antipsychotic medications used to treat schizophrenia are considered as major culprits. The aim of this review is to first consider risk factors, to then outline negative sequelae of obesity for this population, and finally to address timing and content of recommended clinical interventions. Medical databases were searched with the terms “”weight,” “obesity,” and “schizophrenia.” Selection of articles was guided by date of publication; recent papers are preferentially cited. The main findings were that, in addition to antipsychotic medications, socio-economics, lifestyle, immune factors, and circadian rhythms also contribute to obesity risk. A barrier to effective health promotion within psychiatry has been the concern that fears about gaining weight might stop individuals with schizophrenia from taking needed antipsychotic medication. Recommendations, therefore, are to keep the dose of antipsychotic medication as low as possible, avoid polypharmacy, encourage healthy eating and physical activity, address sleep problems and substance use, monitor weight, blood pressure, and metabolic parameters regularly, utilize motivational interviewing techniques and peer support, pay special attention to special needs such as those of women during pregnancy, and include bariatric surgery as a potential intervention. Conclusion: Besides careful attention to medication regimens, the literature supports the active encouragement and support of patient self-management strategies to both prevent and manage obesity in schizophrenia.
May 2015 DOI 10.14302/issn.2379-7835.ijn-14-588
Baroni LucianaCorresponding author
Primary Care Unit, Northern District, AULSS 9, via Manin 46, I-31046, Oderzo, Treviso, Italy
Plant foods are staples of many cultures in the world. Conversely, the appearance of vegetarianism in Western countries is a relatively recent phenomenon, showing an upward trend: people following vegetarian diets (both lacto-ovo-vegetarian-LOV and vegan-VEG), account today for about 10% of the Western population. According to the principle of non-discrimination, the most recent national dietary guidelines for the general population (DGLs) of some Western countries have adapted their contents to comprise vegetarian eating patterns. Moreover, since 1997, specific vegetarian food guidelines (VFGs) were developed. The aim of this review was to summarize and compare the information and recommendations of the food-based dietary guidelines (FBDGs) contained in the DGLs usable by vegetarians, and in the main VFGs; to extract a list of basic criteria for the planning of a well-balanced vegetarian diet, and to identify the most valid FBDG for vegetarians. An Internet search was conducted in the English language, in order to identify national DGLs applicable to vegetarian dietary patterns, and international VFGs. Four Western DGLs and six VFGs were selected. Compared to the majority of DGLs, VFGs are not an "adaptation" of omnivorous (OMN) eating patterns to vegetarian ones, but rather devoted guides: they include only foods consumed by vegetarians, and take into account their specific nutritional needs. VFGs offer qualified advice to meet the most updated standards of adequacy and safety of the diet: the varied consumption of all plant foods, mainly unprocessed; the respect of individual’s calorie requirements; the optional addition of small amounts of foods of animal origin (dairy/eggs); the attention towards some potentially critical nutrients. According to this criteria, the VFG for North American Vegetarians can represent the most accurate and practical model: not only is it consistent with research on the adequacy of vegetarian diets, but it is applicable both to LOV and VEG eating patterns and to all lifecycle stages beyond 4 years of age.
May 2015 DOI 10.14302/issn.2644-0105.jbfb-14-547
Di Luigi GianlucaCorresponding author
University of L’Aquila; Department of Life, Health and Environmental Sciences. Gynecology & Obstetrics. Ospedale Civile “San Salvatore”. L’Aquila, Italy.
Background: Scientific research is constantly expanding our knowledge of nutritional needs in pregnancy and lactation. In June 2014 the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA) issued draft-revised advice encouraging pregnant women, those who might become pregnant, breastfeeding mothers and young children to eat more fish, a total of least 8 ounces per week and to eat a variety of fish lower in mercury in particular anchovies, butterfish, catfish, clam, haddock (Atlantic), herring, mullet, oyster, perch (ocean), sardine, shad, trout (freshwater). However, the presence of radionuclides released from the damaged Fukushima Daiichi nuclear power plant in Pacific biota has aroused worldwide attention and concern. Objective and Methods: Evaluating all the scientific literature available after the Fukushima nuclear disaster, the aim of this review is to demonstrate the safety of seafood products and the use of omega-3 supplements potentially derived from contaminated radioactive fish. Results and Conclusions: There are no reasons to fear the amount of radiation in Japanese fish. The dose received from seafood consumption can be estimated to result in two additional fatal cancer cases per 10,000,000 similarly exposed people. The safest way to get omega-3 fatty acids during pregnancy is by taking a high-quality fish oil supplement, approved by a governing body that provides proof of quality such as the Council for Responsible Nutrition, the European Pharmocopeia Standard or the Norwegian Medicinal Standard and by the Food and Drug Administration or the Environmental Protection Agency 12. Pregnant and breastfeeding women do not need to cut fish out of their diet completely, and it may be safely eaten up to three times per week safely 3.
Jun 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-239
Lehmann CorinneCorresponding author
University of Cincinnati, College of Medicine, Department of Pediatrics
As advances in treatment and prevention are starting to decrease the magnitude of the Acquired Immunodeficiency Syndrome (AIDS) epidemic in Sub-Saharan Africa, the number of orphans and children surviving Human Immunodeficiency Virus (HIV) infection is growing. To date, little research has been conducted in the care of HIV-infected children in orphanages in Sub-Saharan Africa. In this qualitative study, managing personnel in 10 programs caring for HIV-infected children were interviewed to ascertain perceived barriers to care of these children. While all programs commented on medical infrastructure barriers, respondents felt sociocultural issues were more pressing. After analysis of transcribed interviews, three major themes of poverty, denial/stigma, and cultural differences with outsiders emerged. These findings have implications for international programs that both serve and seek to serve the needs of HIV-infected children and orphans in Africa. Outside funding organizations will need to address local poverty, stigma, and African “ownership” of HIV-positive orphans to ultimately ensure the best care of these vulnerable children.