Search results for: chronic kidney disease

Authors: Rajkumar Ghosh, Bhabani Prasad Mukhopadhay

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Rice milling is an important activity in agricultural economy of India, particularly the Burdwan district. However, the environmental impact of rice mills is frequently underestimated. The environmental impact of rice mills in the Burdwan district is a major source of concern, given the importance of rice milling in the local economy and food supply. In the Burdwan district, more than fifty (50) rice mills are in operation. The goal of this study is to investigate the effects of rice mills on several environmental components, with a particular emphasis on groundwater, surface water, soil, and vegetation. The research comprises a thorough review of numerous rice mills located around the district, utilising both qualitative and quantitative approaches. Water samples taken from wells near rice mills will be tested for groundwater quality, with an emphasis on factors such as heavy metal pollution and pollutant concentrations. Monitoring rice mill discharge into neighbouring bodies of water and studying the potential impact on aquatic ecosystems will be part of surface water evaluations. Furthermore, soil samples from the surrounding areas will be taken to examine changes in soil characteristics, nutrient content, and potential contamination from milling waste disposal. Vegetation studies will be conducted to investigate the effects of emissions and effluents on plant health and biodiversity in the region. The findings will provide light on the extent of environmental degradation caused by rice mills in the Burdwan district, as well as valuable insight into the effects of such operations on water, soil, and vegetation. The findings will aid in the development of appropriate legislation and regulations to reduce negative environmental repercussions and promote sustainable practises in the rice milling business. In some cases, heavy metals have been related to health problems. Heavy metals (As, Cd, Cu, Pb, Cr, Hg) are linked to skin, lung, brain, kidney, liver, metabolic, spleen, cardiovascular, haematological, immunological, gastrointestinal, testes, pancreatic, metabolic, and bone problems. As a result, this study contributes to a better knowledge of industrial environmental impacts and establishes the framework for future studies aimed at developing a more ecologically balanced and resilient Burdwan district. The following recommendations are offered for reducing the rice mill's environmental impact: To keep untreated effluents out of bodies of water, adequate waste management systems must be established. Use environmentally friendly rice milling processes to reduce pollution. To avoid soil pollution, rice mill by-products should be used as fertiliser in a controlled and appropriate manner. Groundwater, surface water, soil, and vegetation are all regularly monitored in order to study and adapt to environmental changes. By adhering to these principles, the rice milling industry of Burdwan district may achieve long-term growth while lowering its environmental effect and safeguarding the environment for future generations.

Keywords: groundwater, environmental analysis, biodiversity, rice mill, waste management, diseases, industrial impact

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Authors: Joella Mukashyaka, Rose Mukarubayiza, Emmanuel Habumugisha, Francois-Xavier Sunday, Kellen Muganwa, Valens Mbarushimana, Pamela Meharry

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Background: Breastfeeding in the first hour post-birth can decrease neonatal morbidity and mortality. Disease prevention and health outcomes differ immensely between newborns who receive human milk and those who do not. Rwanda has high breastfeeding rates, though factors associated with early initiation of breastfeeding (EIBF) are unknown. Objective: To assess factors associated with EIBF among mothers in immediate postpartum units at two hospitals. Methods: A cross-sectional study design and a convenience sample of 187 mothers were used. An interviewer-administered questionnaire was used for data collection. A Chi-square test showed the relationship between EIBF and sociodemographic factors. Results: The findings showed less than one quarter (20.5%) breastfed within the first hour after birth. The majority was < 25 years (52.4%), had some primary education (27.7%) employed (66.7%), urban dweller (58.1%), attendance of one ANC visit or more (81.3%), vaginal birth (58.8%), and did not receive EIBF health education (92.0%). The majority (78.5%) was too tired to initiate breastfeeding, and many supplemented (41.9%) due to perceived insufficient breastmilk. Conclusion: Most mothers did not initiate breastfeeding within the first hour after birth. Sociodemographic factors were associated with EIBF. A program to promote, protect, and support EIBF is urgently needed the community.

Keywords: breastfeeding, early initiation, neonates, morbidity, mortality, sub-Saharan Africa

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Authors: Hilary Modir, Kyle Dutton, Michelle Swab, Shabnam Asghari

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Since its emergence, the cutaneous manifestations of COVID-19 have been documented in the literature. However, the majority are case reports with significant limitations in appraisal quality, thus leaving the role of dermatological manifestations of COVID-19 erroneously underexplored. The primary aim of this review was to systematically examine clinical patterns of dermatological manifestations as reported in the literature. This study was designed as a systematic review of case reports. The inclusion criteria consisted of all published reports and articles regarding COVID-19 in English, from September 1st, 2019, until June 22nd, 2020. The population consisted of confirmed cases of COVID-19 with associated cutaneous signs and symptoms. Exclusion criteria included research in planning stages, protocols, book reviews, news articles, review studies, and policy analyses. With the collaboration of a librarian, a search strategy was created consisting of a mixture of keyword terms and controlled vocabulary. Electronic databases searched were MEDLINE via PubMed, EMBASE, CINAHL, Web of Science, LILACS, PsycINFO, WHO Global Literature on Coronavirus Disease, Cochrane Library, Campbell Collaboration, Prospero, WHO International Clinical Trials Registry Platform, Australian and New Zealand Clinical Trials Registry, U.S. Institutes of Health Ongoing Trials Register, AAD Registry, OSF preprints, SSRN, MedRxiV and BioRxiV. The study selection featured an initial pre-screening of titles and abstracts by one independent reviewer. Results were verified by re-examining a random sample of 1% of excluded articles. Eligible studies progressed for full-text review by two calibrated independent reviewers. Covidence was used to store and extract data, such as citation information and findings pertaining to COVID-19 and cutaneous signs and symptoms. Data analysis and summarization methodology reflect the framework proposed by PRISMA and recommendations set out by Cochrane and Joanna Brigg’s Institute for conducting systematic reviews. The Oxford Centre for Evidence-Based Medicine’s level of evidence was used to appraise the quality of individual studies. The literature search revealed a total of 1221 articles. After the abstract and full-text screening, only 95 studies met the eligibility criteria, proceeding to data extraction. Studies were divided into 58% case reports and 42% series. A total of 833 manifestations were reported in 723 confirmed COVID-19 cases. The most frequent lesions were 23% maculopapular, 15% urticarial and 13% pseudo-chilblains, with 46% of lesions reporting pruritus, 16% erythema, 14% pain, 12% burning sensation, and 4% edema. The most common lesion locations were 20% trunk, 19.5% lower limbs, and 17.7% upper limbs. The time to resolution of lesions was between one and twenty-one days. In conclusion, over half of the reported cutaneous presentations in COVID-19 positive patients were maculopapular, urticarial and pseudo-chilblains, with the majority of lesions distributed to the extremities and trunk. As this review’s sample size only contained COVID-19 confirmed cases with skin presentations, it becomes difficult to deduce the direct relationship between skin findings and COVID-19. However, it can be correlated that acute onset of skin lesions, such as chilblains-like, may be associated with or may warrant consideration of COVID-19 as part of the differential diagnosis.

Keywords: COVID-19, cutaneous manifestations, cutaneous signs, general dermatology, medical dermatology, Sars-Cov-2, skin and infectious disease, skin findings, skin manifestations

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Authors: Dalia Jomehpour, Sara Sheikhlary, Esmaeil Heydari, Mohammad Hossien Majles Ara

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In this study, we report fulvic acid-coated iron oxide nanoparticles of 10.7 ± 2.7 nm size, which serve to inhibit amyloid fibrillation formation. Although the effect of fulvic acid on tau fibrils was investigated, to our best knowledge, its inhibitory impacts on amyloid aggregation formation have been assessed neither in-vitro nor in-vivo. On the other hand, iron oxide nanoparticles exhibit anti-amyloid activity on their own. This study investigates the inhibitory effect of fulvic acid coated iron oxide nanoparticles on amyloid aggregations formed from the commonly used in-vitro model, lysozyme from chicken egg white. FESEM, XRD, and FTIR characterization confirmed that fulvic acid was coated onto the surface of the nanoparticles. The inhibitory effects of the fulvic acid coated iron oxide nanoparticles were verified by Thioflavin T assay, circular dichroism (CD), and FESEM analysis. Furthermore, the toxicity of the nanoparticles on the neuroblastoma SH-SY5Y human cell line was assessed through an MTT assay. Our results indicate that fulvic acid coated iron oxide nanoparticles can efficiently inhibit the formation of amyloid aggregations while exhibiting negligible in-vitro toxicity; thus, they can be used as anti-amyloid agents in the development of the potential drug for neurodegenerative diseases.

Keywords: Alzheimer’s disease, fulvic acid coated iron oxide nanoparticles, fulvic acid, amyloid inhibitor, polyphenols

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Authors: W. J. Zhang, Y. Q. Du, M. L. Wang

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Noninvasive diagnostics of diseases via breath analysis has attracted considerable scientific and clinical interest for many years and become more and more promising with the rapid advancement in nanotechnology and biotechnology. The volatile organic compounds (VOCs) in exhaled breath, which are mainly blood borne, particularly provide highly valuable information about individuals’ physiological and pathophysiological conditions. Additionally, breath analysis is noninvasive, real-time, painless and agreeable to patients. We have developed a wireless sensor array based on single-stranded DNA (ssDNA)-decorated single-walled carbon nanotubes (SWNT) for the detection of a number of physiological indicators in breath. Eight DNA sequences were used to functionalize SWNT sensors to detect trace amount of methanol, benzene, dimethyl sulfide, hydrogen sulfide, acetone and ethanol, which are indicators of heavy smoking, excessive drinking, and diseases such as lung cancer, breast cancer, cirrhosis and diabetes. Our tests indicated that DNA functionalized SWNT sensors exhibit great selectivity, sensitivity, reproducibility, and repeatability. Furthermore, different molecules can be distinguished through pattern recognition enabled by this sensor array. Thus, the DNA-SWNT sensor array has great potential to be applied in chemical or bimolecular detection for the noninvasive diagnostics of diseases and health monitoring.

Keywords: breath analysis, diagnosis, DNA-SWNT sensor array, noninvasive

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Authors: Jai Hyung Park, Eugene Kim, Jin Hun Park, Min Joon Oh

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Introduction: Subchondral insufficiency fracture of the femoral head (SIF) is a rare complication; however, it has been recognized to cause femoral head collapse. Subchondral insufficiency fracture (SIF) is caused by normal or physiological stress without any trauma. It has been reported in osteoporotic patients after the fixation of the proximal femur with an Intramedullary nail. Case presentation: We reported 5 cases with SIF of the femoral head after proximal femur fracture fixation with Intra-medullary nail. All patients had osteoporosis as an underlying disease. Good reduction was achieved in all 5 patients. SIF was found from about 3 months to 4 years after the initial operation, and all the fractures were solidly united at the final diagnosis. We investigated retrospectively the feature of those cases and several factors that affected the occurrence of SIF. Discussion: There are a few discussions regarding the SIF of the femoral head. These discussions may include the predisposing risk factors, how to diagnose the SIF in osteoporotic patients, and the peri-operative factors to prevent SIF. Conclusion: Subchondral insufficiency fracture of the femoral head is a considerable complication after the internal fixation of the proximal femur. There are several factors that can be modified. If they could be controlled in the peri-operative period, SIF could be prevented or handled in advance. Other options related to arthroplasty can be considered in old osteoporotic patients.

Keywords: insufficiency fracture of femoral head, intra-medullary nail, osteoporosis, proximal femur fracture

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Authors: Pelin Kinay, Andy P. Morse, Elmer V. Villanueva, Karyn Morrissey, Philip L Staddon, Shanzheng Zhang, Jingjing Liu

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The present study aims to evaluate the climate change and health related knowledge, attitudes and practices (KAP) of the elderly population (60 years plus) in Hefei and Suzhou cities of China (n=300). This cross-sectional study includes 150 participants in each city. Data regarding demographic characteristics, KAP, and climate change perceptions were collected using a semi-structured questionnaire. When asked about the potential impacts of climate change over 79% of participants stated that climate change affected their lifestyle. Participants were most concerned about storms (51.7%), food shortage (33.3%) and drought (26%). The main health risks cited included water contamination (32%), air pollution related diseases (38.3%) and lung disease (43%). Finally, a majority (68.3%) did not report receiving government assistance on climate change issues. Logistic regression models were used to analyse the data in order to understand the links between socio-demographical factors and KAP of the participants. These findings provide insights for potential adaptation strategies targeting the elderly. It is recommended that government should take responsibility in creating awareness strategies to improve the coping capacity of elderly in China to climate change and its health impacts and develop climate change adaptation strategies.

Keywords: China, climate change, elderly, KAP

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Authors: Yantao Li, Jun Zheng

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Food poison caused by consumption of contaminated food, especially seafood, is one of most serious public health threats worldwide. Vibrio parahaemolyticus is emerging bacterial pathogen and the leading cause of human gastroenteritis associated with food poison, especially in the southern coastal region of China. To successfully cause disease in host, bacterial pathogens need to overcome the host-derived stresses encountered during infection. One of the toxic chemical species elaborated by the host is nitric oxide (NO). NO is generated by acidified nitrite in the stomach and by enzymes of the inducible NO synthase (iNOS) in the host cell, and is toxic to bacteria. Bacterial pathogens have evolved some mechanisms to battle with this toxic stress. Such mechanisms include genes to sense NO produced from immune system and activate others to detoxify NO toxicity, and genes to repair the damage caused by toxic reactive nitrogen species (RNS) generated during NO toxic stress. However, little is known about the NO resistance in V. parahaemolyticus. In this study, a transposon coupled with next generation sequencing (Tn-seq) technology will be utilized to identify genes for NO resistance in V. parahaemolyticus. Our strategy will include construction the saturating transposon insertion library, transposon library challenging with NO, next generation sequencing (NGS), bioinformatics analysis and verification of the identified genes in vitro and in vivo.

Keywords: vibrio parahaemolyticus, nitric oxide, tn-seq, virulence

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Authors: Mohamed El-Shikh

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Phaseolus vulgaris L. is the world’s second most important bean after soybeans; used for human food and animal feed. It has generally been linked to reduced risk of cardiovascular disease, diabetes mellitus, obesity, cancer and diseases of digestive tract. The effectiveness of ISSR in achievement of the genetic diversity among 60 common bean accessions; represent various germplasms around the world was investigated. In general, the studied Phaseolus vulgaris accessions were divided into 2 major groups. All of the South-American accessions were separated into the second major group. These accessions may have different genetic features that are distinct from the rest of the accessions clustered in the major group. Asia and Europe accessions (1-20) seem to be more genetically similar (99%) to each other as they clustered in the same sub-group. The American and African varieties showed similarities as well and clustered in the same sub-tree group. In contrast, Asian and American accessions No. 22 and 23 showed a high level of genetic similarities, although these were isolated from different regions. The phylogenetic tree showed that all the Asian accessions (along with Australian No. 59 and 60) were similar except Indian and Yemen accessions No. 9 and 20. Only Netherlands accession No. 3 was different from the rest of European accessions. Morocco accession No. 52 was genetically different from the rest of the African accessions. Canadian accession No. 44 seems to be different from the other North American accessions including Guatemala, Mexico and USA.

Keywords: phylogenetic tree, Phaseolus vulgaris, ISSR technique, genetics

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Authors: M. D. H. Beg, John O. Akindoyo, Suriati Ghazali, Nitthiyah Jeyaratnam

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Over the period of time, several approaches have been undertaken to mitigate the challenges associated with bone regeneration. This includes but not limited to xenografts, allografts, autografts as well as artificial substitutions like bioceramics, synthetic cements and metals. The former three techniques often come along with peculiar limitation and problems such as morbidity, availability, disease transmission, collateral site damage or absolute rejection by the body as the case may be. Synthetic routes remain the only feasible alternative option for treatment of bone defects. Hydroxyapatite (HA) is very compatible and suitable for this application. However, most of the common methods for HA synthesis are either expensive, complicated or environmentally unfriendly. Interestingly, extraction of HA from bio-wastes have been perceived not only to be cost effective, but also environment friendly. In this research, HA was synthesized from bio-waste: namely bovine bones through three different methods which are hydrothermal chemical processes, ultrasound assisted synthesis and ordinary calcination techniques. Structure and property analysis of the HA was carried out through different characterization techniques such as TGA, FTIR, and XRD. All the methods applied were able to produce HA with similar compositional properties to biomaterials found in human calcified tissues. Calcination process was however observed to be more efficient as it eliminated all the organic components from the produced HA. The HA synthesized is unique for its minimal cost and environmental friendliness. It is also perceived to be suitable for tissue and bone engineering applications.

Keywords: hydroxyapatite, bone, calcination, biowaste

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Authors: Awe Ayodeji Samson, Adeuja Yetunde Omowunmi

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Corruption is a ‘monster’ that can consume a whole nation, continent and even the world if it is not destroyed while it is still immature; It grows in the mind of the people, takes over their thinking and guides their decision-making process. Corruption snowballs into socio-economic catastrophe that might be difficult to deal with. Corruption which is a disease of the mind can be alleviated in Africa and the world at large by transforming a Corruption-Prone Mind to a Corruption-Immune Mind and to achieve this, we have to change our value system because the use of anti-graft agencies alone is not enough. Therefore, we have to fight corruption from the inside and the outside. Value System is the principle of right and wrong that are accepted by an individual or a social group; the reviewing and reordering of our value system is the solution to the problem of corruption as proposed by this research because the African society has become a ‘Money and Power Driven Society’ where the ‘I am worth concept’ which is a problematic concept has created an ‘Aggressive Society’ with grasping and money-grabbing individuals. We place more priority on money and the display of opulence. Hence, this has led to a ‘Triangular Society’ where minority is lavishing in plenty and majority is gasping for little. The get rich quick syndrome, the ethnicity syndrome, weakened educational system are signs of the prevalence of corruption in Africa This research has analyzed role and impact of the change in our value system in the fight against corruption in Africa and has therefore proposed the change in our value system as the way forward in the fight against corruption in Africa.

Keywords: corruption-prone mind, corruption-immune mind, triangular society, aggressive society, money and power-driven society

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Authors: I. K. Norziaton, M. D. Ridhuan, A. N. Nur Adura

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Assets misappropriation is becoming a major concern in organizations. Over the years, the Malaysian Auditor General has reported high occurrences of assets misappropriation at the federal, state and even local governments. It is surprising that assets misappropriation is not the only major concern in the public sector but it has also indicates a common sight in private sector. The current situation is rather disconcerting because employees are accountable to perform their jobs at the interest of the organizations. Various researches in the past has found that the incidence of assets misappropriation occurs when employees used the official vehicles, internet connection, computers, stationery and facilities for personal and family benefits. The issue of assets misappropriation has continue to be a major concern for organizations and its impact on the reputation and financial health can be enormous. Even though the issue seems to be trivial, yet, if it is left untreated, the symptoms will become an incurable disease that it will cause major leakages to the organizations. Hence, this paper highlights the common practices of assets misappropriation in public and private sectors. It also discusses why the acts of assets misappropriation occurs. Using the data through questionnaire survey, a total of 250 questionnaires were distributed to the private and public sectors employees. However 173 (69.2%) were returned and usable. This paper concludes that it is vital to promote awareness to the public and private sectors employees on issues of assets misappropriation. Assets misappropriation could have been avoided provided that the officers in charge are more vigilant, competent and practice high level of integrity in discharging their responsibilities towards the organizations.

Keywords: assets misappropriation, fraud, public sector, private sector

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Authors: Mi-Hye Hwang, Young Min Son, Kichan Lee, Bang-Hun Hyun, Byeong Yeal Jung

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Botulism is a paralytic disease of human beings and animals caused by neurotoxin produced by Clostridium botulinum. The neurotoxins are genetically distinguished into 8 types, A to H. Ingestion of performed toxin, usually types B, C, and D, have been shown to produce diseases in most cases of cattle botulism. Vaccination is the best measure to prevent cattle botulism. However, the commercially available toxoid-based vaccines are difficult and hazardous to produce. We produced recombinant protein using gene of heavy chain domain of botulinum toxin B of which binds to cellular receptor of neuron cells and used as immunogen. In this study, we evaluated the safety and efficacy of botulism vaccine composed of recombinant types B. Safety test was done by National Regulation for Veterinary Biologicals. For efficacy test, female ICR mice (5 weeks old) were subcutaneously injected, intraperitoneally challenged, and examined the survival rates compared with vaccination and non-vaccination group. Mouse survival rate of recombinant types B vaccine was above 80%, while one of non-vaccination group was 0%. A vaccine composed of recombinant types B was safe and efficacious in mouse. Our results suggest that recombinant heavy chain receptor binding domain can be used as an effective vaccine candidate for type B botulism.

Keywords: botulism, livestock, vaccine, recombinant protein, toxin

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Authors: Bayu Rizky Pratama, Hardiansyah Nur Sahaya

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Riau Province is the worst emitter for forest burning which causes the huge scale of externality such as declining of forest habitat, health disease, and climate change impact. Indonesia forum of budget transparency for Riau Province (FITRA) reported the length of forest burning reached about 186.069 hectares which is 7,13% of total national forest burning disaster, consisted of 107.000 hectares of peatland and the rest 79.069 hectares of mineral land. Anti-fire group, a voluntary group next to the forest, to help in protecting the forest burning and heavily smoke residual has been established but unfortunately the implementation still far from expectation. This research will emphasize on (1) how the anti-fire group contribute to fire hazard tackling; (2) the identification of SWOT analysis to enhance the group benefit; and (3) government policy implication to maximize the role of Anti-fire group and reduce the case of forest burning as well as heavily smoke which can raise climate change impact. As the observation found some weakness from SWOT identification such as (1) lack of education and training; (2) facility in extinguishing the fire damage; (3) law for economic incentive; (4) communication and field experience; (5) also the reporting the fire case.

Keywords: anti-fire group, forest burning impact, SWOT, climate change mitigation

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Authors: Fatima El Zahra Amin, Emine Efe

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This study was carried out to evaluate the effect of the education program for parents of children with Sickle Cell Anemia, on the knowledge level of parents and the reduction of pain relief by non-pharmacological methods used by parents at home. In Turkey, 54 parents and 109 from Chad agreed to participate in the survey. The data were collected by the researcher using a face-to-face interview method. Non-pharmacological treatment information form for parents, face expressions rating scale, and parent education program for non-pharmacological methods used in children with sickle cell anemia were used. It was determined that there was a statistically significant difference between the educational status, occupation, disease status, place of residence, family structure and age of parents of Chad and Turkey. According to the ratings of facial expressions scale, it was concluded that there was no significant difference between the children’s average degree of pain before and after administration of non-pharmacological methods by the groups of Chad and Turkey. It was determined that the educational programs prepared for parents of children with sickle cell anemia in both Turkey and Chad were effective in increasing the knowledge level of parents and also in reducing pain crisis with non-pharmacological methods parents used at home.

Keywords: Chad, child, non-pharmacological treatment methods, nurse, sickle cell anemia, Turkey

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Authors: Emmylou Rahtz, Sarah Goldingay, Sara Warber, Ann Arbor, Paul Dieppe

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Introduction: Lourdes is a Catholic, Marian healing venue in South West France. Many miraculous cures have been attributed to visits there. In addition, many visitors seem to experience improvements in health and wellbeing, in the absence of a cure of disease. We wanted to investigate that phenomenon. Methods: We spent 10 days in Lourdes in 2017, carrying out ethnographic research, talking to many visitors, and carrying out formal, recorded interviews with several pilgrims, doctors, nurses, helpers, and priests. Results: Profound experiences and improvements in health and wellbeing were commonly reported. A number of ‘noetic’ experiences were also described. The paper will illustrate these phenomena. In addition, many participants in the research talked about why being in Lourdes was so beneficial to them. The community spirit, ethos of prayer, flow, synchronicity, and ability to find new meaning for life’s ills were cited as likely reasons. Conclusions: We believe that the ‘real miracle’ of Lourdes is the fact that of the many hundreds of thousands of people who go there each year, many find great benefit in health and wellbeing. It is likely that this is due to the ethos of the place, the community spirit, non-judgmental approach and loving acceptance of all aspects of humanity. Acknowledgments: We thank the BIAL foundation for generous funding of this research, and Dr. Alessandro de Franciscis and his team for facilitating our work, as well as all those who participated.

Keywords: healing, miracles, noetic experiences, wellbeing

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Authors: Mohammed Qutishat, Loai Abu Sharour, Kholoud Al-Damery, Ibtisam Al Harthy, Sulaiman Al-Sabei

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Background: The 2019 coronavirus outbreak (COVID-19) has been declared a pandemic and has greatly affected both patients and healthcare workers. This study was conducted to explore the extent of posttraumatic stress disorder (PTSD) experiences among nurses as a result of the COVID-19 pandemic in Jordan. Method: This study used a cross-sectional study design with a convenience sampling approach. A sample of 259 participants completed the study questionnaires, including a sociodemographic questionnaire and the posttraumatic stress disorder checklist for DSM‐5, between May and July 2020. Result: The prevalence of PTSD among the study participants was 37.1%. The majority of study participants who exhibited PTSD symptoms presented the lowest level of PTSD (17%). The results indicated significant differences in overall COVID-19-related PTSD according to the participant’s age (F = 14.750, P = .000), gender (F = 30.340, P = .000), level of education (F = 51.983, P =.000), years of experience (F = 52.33, P = .000), place of work (F = 19.593, P = .000), and working position (F = 11.597, P = .000), as determined by one-way ANOVA. Conclusion: Nurses must be qualified and accredited to cope with reported PTSD cases and their consequences in relation to COVID-19 outbreaks. Close collaboration with a multidisciplinary team is required to recognise, manage, and encourage safety literacy among health care professionals and individuals diagnosed with or suspected of PTSD due to COVID-19 outbreaks or any other viral outbreaks.

Keywords: PTSD, nursing, coronavirus, pandemic, infectious disease

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Authors: Cory B. Portner, Julie A. Grauert, Lisa M. Stromme, Shelby D. Anderson, Franji H. Mayes

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Introduction: WASHINGTON state in the Pacific Northwest of the United States is internationally known for its technology industry, fisheries, agriculture, and vistas. On January 21, 2020, Washington state also became known as the first state with a confirmed COVID-19 case in the United States, thrusting the state into the international spotlight as the world came to grips with the global threat of this disease presented. Tourism is Washington state’s fourth-largest industry. Tourism to the state generates over 1.8 billion dollars (USD) in local and state tax revenue and employs over 180,000 people. Communicating with residents, stakeholders, and visitors on the status of disease activity, prevention measures, and response updates was vital to stopping the pandemic and increasing compliance and awareness. Significance: In order to communicate vital public health updates, guidance implementation, and safety measures to the public, the Washington State Department of Health established routine live virtual media briefings to reach audiences via social media, internet television, and broadcast television. Through close partnership with regional broadcast news stations and the state public affairs news network, the Washington State Department of Health hosted 95 media briefings from January 2020 through September 2022 and continues to regularly host live virtual media briefings to accommodate the needs of the public and media. Methods: Our methods quickly evolved from hosting briefings in the cement closet of a military base to being able to produce and stream the briefings live from any home-office location. The content was tailored to the hot topic of the day and to the reporter's questions and needs. Virtual media briefings hosted through inexpensive or free platforms online are extremely cost-effective: the only mandatory components are WiFi, a laptop, and a monitor. There is no longer a need for a fancy studio or expensive production software to achieve the goal of communicating credible, reliable information promptly. With minimal investment and a small learning curve, facilitators and panelists are able to host highly produced and engaging media availabilities from their living rooms. Results: The briefings quickly developed a reputation as the best source for local and national journalists to get the latest and most factually accurate information about the pandemic. In the height of the COVID-19 response, 135 unique media outlets logged on to participate in the briefing. The briefings typically featured 4-5 panelists, with as many as 9 experts in attendance to provide information and respond to media questions. Preparation was always a priority: Public Affairs staff for the Washington State Department of Health produced over 170 presenter remarks, including guidance on talking points for 63 expert guest panelists. Implication For Practice: Information is today’s most valuable currency. The ability to disseminate correct information urgently and on a wide scale is the most effective tool in crisis communication. Due to our role as the first state with a confirmed COVID-19 case, we were forced to develop the most accurate and effective way to get life-saving information to the public. The cost-effective, web-based methods we developed can be applied in any crisis to educate and protect communities under threat, ultimately saving lives from a laptop.

Keywords: crisis communications, public relations, media management, news media

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Authors: Meskure Pak, Nihal Buyukuslu

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During Ramadan Muslims refrain from eating and drinking from dawn to sunset. Transformation of the eating habits cause profound changes in body composition. This study was performed during Ramadan of June-July 2015 with the regular fasting healthy adults (15 women and 15 men). The participants who were not fasting the whole month, have chronic diseases, pregnant and lactated were excluded. All attendances were informed about study. Written informed consent was taken from the voluntary participants. The work was approved by the Ethics and Research Committee of Istanbul Medipol University, Turkey. A questionnaire was conducted to determine the nutritional status, demographic and anthropometric data at the beginning, in the middle and at the end of Ramadan. Statistical Package for Social Sciences version 18.0 (SPSS, Chicago, IL, USA) was used for analyses. The mean ages of women and men were 34.4±9.45 and 28.9±10.55 years respectively. The BMI values (kg/m2) were slightly increased in men (26.5±3.9 to 26.2±3.7) and decreased in women (22.5±3.5 to 23.3±4.5). However the differences in BMI values between genders were not significant. Waist circumferences (WC) (cm) decreased in both women (80.2±14.6 to 79.4±17.7) and men (98.9±8.4 to 95.2±11.0) through the Ramadan. Fat percentages of women (27.0±71) increased in the middle of Ramadan (28.4±7.8) and decreased at the end of Ramadan (27.8±8.3). The fat percentages of men (21.5±6.3) were not affected in the middle of Ramadan (21.5±6.4) however decreased at the end of Ramadan (20.8±6.2). The total change in fat mass from beginning to end of Ramadan was higher in women than in men. The daily energy intake was higher in men than in women during Ramadan. In the middle of Ramadan energy intake (kcal) was reached to the highest level (2057.8±693.1) and at the end of Ramadan it decreased to the beginning level (1656.7±553.2) for men. However, daily energy intake of women slightly decreased from the beginning (1410.0±359.7) to the end (1409.2±366.7) of Ramadan. The comparison of energy intake between men and women was significant in the middle of Ramadan (p < 0.05). Water consumptions for both groups were increased in Ramadan fasting period. In comparison with the beginning of Ramadan, daily carbohydrate and fat consumptions increased and the consumption of protein decreased for men and for women at the end of Ramadan. The gender comparison resulted in a significant increase for protein and carbohydrate consumption of men in the middle of Ramadan (p < 0.05). In the first two weeks, the daily energy intake, the consumption of carbohydrates and fats seemed to increase for both men and women. However the later days of Ramadan daily fat consumption decreased to the level of beginning consumption levels which may indicate the nutritional adaptation period. In spite of the consumption of protein sources such as meat, poultry and egg increased, the decrease in the total amount of protein consumed in Ramadan may be due to a decrease in the consumption of milk and dairy products. In conclusion, the nutritional habits and preferred foods changed during Ramadan as a result affected the body composition.

Keywords: body composition, fasting, nutritional status, Ramadan

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Authors: Jia-Ling Ho, Xiu-Ru Zhang, Zwe-Ling Kong

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Diabetes mellitus (DM) is a major health problem that affects patients’ life quality throughout the world due to its many complications. It characterized by chronic hyperglycemia with oxidative stress, which impaired male reproductive function. Fibroblast growth factor 21 (FGF21) is a metabolic regulator that is required for normal spermatogenesis and protects against diabetes-induced germ cell apoptosis. Echinacea purpurea ethanol extract (EE), which contain phenolic acid and isobutylamide, had been proven to have antidiabetic property. Silica-chitosan nanoparticles (Nano-CS) has drug delivery and controlled release properties. This study aims to investigate whether silica-chitosan nanoparticles encapsulated EE (Nano-EE) had more ameliorating male infertility by analyzing the effect of testicular FGF21. The Nano-EE was characterized before used to treatment the diabetic rat model. Male Sprague-Dawley (SD) rats were obtained and divided into seven groups. A group was no induced Streptozotocin (STZ), marked as normal group. Diabetic rats were induced into diabetes by STZ (33 mg/kg). A diabetic group was no treatment with sample (diabetic control group), and other groups were treatment by Nano-CS (465 mg/kg), Nano-EE (93, 279, 465 mg/kg), and metformin (Met) (200 mg/kg) used as reference drug for 7 weeks. Our results indicated that the average nanoparticle size and zeta potential of Nano-EE were 2630 nm and -21.3 mV, respectively. The encapsulation ratio of Nano-EE was about 70%. It also confirmed the antioxidative activity was unchanged by comparing the DPPH and ABTS scavenging of Nano-EE and EE. In vivo test, Nano-EE can improve the STZ induced hyperglycemia, insulin resistance, and plasma FGF21 levels. Nano-EE has increased sperm motility, mitochondria membrane potential (MMP), plasma testosterone level, and reduction of abnormal sperm, nitric oxide (NO), superoxide production as well as reactive oxygen species (ROS). In addition, in plasma antioxidant enzymes glutathione peroxidase (GPx) and superoxide dismutase (SOD) was increased whereas pro-inflammatory cytokines TNF-α, and IL-1β were decreased. Further, in testis, protein content of FGF21, PGC-1α, and SIRT1 were improved. Nano-EE might improve diabetes-induced down-regulation of testicular FGF21 and SIRT1/PGC-1α signaling hence maintain spermatogenesis.

Keywords: diabetes mellitus, Echinacea purpurea, reproductive dysfunction, silica-chitosan nanoparticles

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Authors: Dwi Kartika Rukmi, Miftafu Darussalam

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Background: The disclosure of women’s HIV status toward their sexual partners is an important issue that should be regarded as one of the efforts to prevent and control the spread of HIV. Research on the disclosure of seropositive HIV status as well as women-related factors in Indonesia, especially Yogyakarta is only a few. Methods: This is a correlational descriptive research along with its cross-sectional approach on 329 women with HIV/AIDS at the Victory Plus NGO from June to July 2016. This research used a purposive sampling method and a questionnaire as the data collection technique. The bivariate analysis test was undertaken by using a chi-square and multivariate test along with a logistic regression. Result: The multivariate analysis and logistic regression show five independent variables related to the disclosure of seropositive HIV status of women with HIV/AIDS toward their sexual partners, namely ethnicity (aOR = 36,859; 95% CI; (6,544-207,616)) religion (aOR =0,255; 95%CI; (0,075-0,868)), discussion with partners prior to the HIV test (aOR =0,069; 95%CI; (0,065-0,438)) , types of sexual partners (aOR = 0.191; 95% CI; (0.082-0,445)) and knowledge on the partners’ HIV status (aOR = 0.036; 95% CI; (0.008-0.160)). The highest level of reason for seropositive HIV women not to be open about their partners’ status is the fear of being rejected by their partners and the environmental stigma of HIV AIDS disease. Conclusion: The disclosure of seropositive HIV status in women with HIV/AIDS in the Victory Plus NGO of Yogyakarta was 79.4% or classified as a high category with some related factors such as ethnicity, religion, discussion with partners prior to the HIV test, types of partners and knowledge on the partners’ HIV status.

Keywords: women, HIV, disclosure, sexual partner

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Authors: Jhonas Geraldo Peixoto Flauzino, Pedro Pompeo Boechat Araujo, Alexia Allis Rocha Lima, Giovanna Biângulo Lacerda Chaves, Victor Ryan Ferrão Chaves

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Schizophrenia is characterized as a set of psychiatric signs and symptoms (syndrome) that commonly erupt in the stages of adolescence or early adulthood, being recognized as one of the most serious diseases, as it causes important problems during the life of the patient. carrier - both in mental health and in physical health and in social life. Objectives: This is an integrative literature review that aimed to verify what has been produced of scientific knowledge in the field of child and adolescent psychiatry regarding schizophrenia in these stages of life, correlated to the most discussed themes and methodologies of choice for the preparation of studies. Methods: Articles were selected from the following databases: Virtual Health Library and CAPES Journal Portal, published in the last five years; and on Google Scholar, published in 2021, totaling 62 works, searched in September 2021. Results: The studies focus mainly on diagnosis through the DSM-V (25.8%), on drug treatment (25.8%) and in psychotherapy (24.2%), most of them in the literature review format: integrative (27.4%) and systematic (24.2%). Conclusion: The themes and study methods are redundant, and do not cover in depth the immense aspects that encompass Schizophrenia in Childhood and Adolescence, giving attention to the disease in a general way or focusing on the adult patient.

Keywords: schizophrenia, mental health, childhood, adolescence

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Authors: May M. Youssef

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This article introduces a design, for additive manufacturing technology, face shield as Personal Protective Equipment from the respiratory viruses such as coronavirus 2. The face shields help to reduce ocular exposure and play a vital role in diverting away from the respiratory COVID-19 air droplets around the users' face. The proposed face shield comprises three assembled polymer parts. The frame with a transparency overhead projector sheet visor is suitable for frontline health care workers and ordinary citizens. The frame design allows tightening the shield around the user’s head and permits rubber elastic straps to be used if required. That ergonomically designed with a unique face mask support used in case of wearing extra protective mask was created using computer aided design (CAD) software package. The finite element analysis (FEA) structural verification of the proposed design is performed by an advanced simulation technique. Subsequently, the prototype model was fabricated by a 3D printing using Fused Deposition Modeling (FDM) as a globally developed face shield product. This study provides a different face shield designs for global production, which showed to be suitable and effective toward supply chain shortages and frequent needs of personal protective goods during coronavirus disease and similar viruses.

Keywords: additive manufacturing, Coronavirus-19, face shield, personal protective equipment, 3D printing

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Authors: Hussein Alahmer, Amr Ahmed

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Liver cancer is one of the common diseases that cause the death. Early detection is important to diagnose and reduce the incidence of death. Improvements in medical imaging and image processing techniques have significantly enhanced interpretation of medical images. Computer-Aided Diagnosis (CAD) systems based on these techniques play a vital role in the early detection of liver disease and hence reduce liver cancer death rate.  This paper presents an automated CAD system consists of three stages; firstly, automatic liver segmentation and lesion’s detection. Secondly, extracting features. Finally, classifying liver lesions into benign and malignant by using the novel contrasting feature-difference approach. Several types of intensity, texture features are extracted from both; the lesion area and its surrounding normal liver tissue. The difference between the features of both areas is then used as the new lesion descriptors. Machine learning classifiers are then trained on the new descriptors to automatically classify liver lesions into benign or malignant. The experimental results show promising improvements. Moreover, the proposed approach can overcome the problems of varying ranges of intensity and textures between patients, demographics, and imaging devices and settings.

Keywords: CAD system, difference of feature, fuzzy c means, lesion detection, liver segmentation

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Authors: Wangxu Xia

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BACKGROUND BI-RADS 4 lesions raise the possibility of malignancy that warrant further clinical and radiologic work-up. This study aimed to evaluate the predictive performance of diffusion-weighted imaging(DWI) and microcalcifications on mammography for predicting malignancy of BI-RADS 4 lesions. In addition, the predictive performance of DWI combined with microcalcifications was alsocompared with the Kaiser score. METHODS During January 2021 and June 2023, 144 patients with 178 BI-RADS 4 lesions underwent conventional MRI, DWI, and mammography were included. The lesions were dichotomized intobenign or malignant according to the pathological results from core needle biopsy or surgical mastectomy. DWI was performed with a b value of 0 and 800s/mm2 and analyzed using theapparent diffusion coefficient, and a Kaiser score > 4 was considered to suggest malignancy. Thediagnostic performances for various diagnostic tests were evaluated with the receiver-operatingcharacteristic (ROC) curve. RESULTS The area under the curve (AUC) for DWI was significantly higher than that of the of mammography (0.86 vs 0.71, P<0.001), but was comparable with that of the Kaiser score (0.86 vs 0.84, P=0.58). However, the AUC for DWI combined with mammography was significantly highthan that of the Kaiser score (0.93 vs 0.84, P=0.007). The sensitivity for discriminating malignant from benign BI-RADS 4 lesions was highest at 89% for Kaiser score, but the highest specificity of 83% can be achieved with DWI combined with mammography. CONCLUSION DWI combined with microcalcifications on mammography could discriminate malignant BI-RADS4 lesions from benign ones with a high AUC and specificity. However, Kaiser score had a better sensitivity for discrimination.

Keywords: MRI, DWI, mammography, breast disease

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Authors: George Zhou, Yunchan Chen, Candace Chien

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Kidney replacement therapy is the current standard of care for end-stage renal diseases. In-center or home hemodialysis remains an integral component of the therapeutic regimen. Arteriovenous fistulas (AVF) make up the vascular circuit through which blood is filtered and returned. Naturally, AVF patency determines whether adequate clearance and filtration can be achieved and directly influences clinical outcomes. Our aim was to build a deep learning model for automated AVF stenosis screening based on the sound of blood flow through the AVF. A total of 311 patients with AVF were enrolled in this study. Blood flow sounds were collected using a digital stethoscope. For each patient, blood flow sounds were collected at 6 different locations along the patient’s AVF. The 6 locations are artery, anastomosis, distal vein, middle vein, proximal vein, and venous arch. A total of 1866 sounds were collected. The blood flow sounds are labeled as “patent” (normal) or “stenotic” (abnormal). The labels are validated from concurrent ultrasound. Our dataset included 1527 “patent” and 339 “stenotic” sounds. We show that blood flow sounds vary significantly along the AVF. For example, the blood flow sound is loudest at the anastomosis site and softest at the cephalic arch. Contextualizing the sound with location metadata significantly improves classification performance. How to encode and incorporate categorical metadata is an active area of research1. Herein, we study ordinal (i.e., integer) encoding schemes. The numerical representation is concatenated to the flattened feature vector. We train a vision transformer (ViT) on spectrogram image representations of the sound and demonstrate that using scalar multiples of our integer encodings improves classification performance. Models are evaluated using a 10-fold cross-validation procedure. The baseline performance of our ViT without any location metadata achieves an AuROC and AuPRC of 0.68 ± 0.05 and 0.28 ± 0.09, respectively. Using the following encodings of Artery:0; Arch: 1; Proximal: 2; Middle: 3; Distal 4: Anastomosis: 5, the ViT achieves an AuROC and AuPRC of 0.69 ± 0.06 and 0.30 ± 0.10, respectively. Using the following encodings of Artery:0; Arch: 10; Proximal: 20; Middle: 30; Distal 40: Anastomosis: 50, the ViT achieves an AuROC and AuPRC of 0.74 ± 0.06 and 0.38 ± 0.10, respectively. Using the following encodings of Artery:0; Arch: 100; Proximal: 200; Middle: 300; Distal 400: Anastomosis: 500, the ViT achieves an AuROC and AuPRC of 0.78 ± 0.06 and 0.43 ± 0.11. respectively. Interestingly, we see that using increasing scalar multiples of our integer encoding scheme (i.e., encoding “venous arch” as 1,10,100) results in progressively improved performance. In theory, the integer values do not matter since we are optimizing the same loss function; the model can learn to increase or decrease the weights associated with location encodings and converge on the same solution. However, in the setting of limited data and computation resources, increasing the importance at initialization either leads to faster convergence or helps the model escape a local minimum.

Keywords: arteriovenous fistula, blood flow sounds, metadata encoding, deep learning

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Authors: Jinu Phonamontham

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Coronavirus, also referred to as COVID-19, is a virus caused by the SARS-Cov-2 virus. The pandemic has caused over 10 million cases and 500,000 deaths worldwide through the end of June 2020. In a previous study, HLA-DQA1*01:02 allele was associated with COVID-19 disease (p-value = 0.0121). Furthermore, there was a statistical significance between HLA- DQB1*06:02 and COVID-19 in the Italian population by Bonferroni’s correction (p-value = 0.0016). Nevertheless, there is no data describing the distribution of HLA alleles as a valid marker for prediction of COVID-19 in the Thai population. We want to investigate the prevalence of HLA-DQA1*01:02 and HLA-DQB1*06:02 alleles that are associated with severe COVID-19 in the Thai population. In this study, we recruited 200 healthy Thai individuals. Genomic DNA samples were isolated from EDTA blood using Genomic DNA Mini Kit. HLA genotyping was conducted using the Lifecodes HLA SSO typing kits (Immucor, West Avenue, Stamford, USA). The frequency of HLA-DQA1 alleles in Thai population, consisting of HLA-DQA1*01:01 (27.75%), HLA-DQA1*01:02 (24.50%), HLA-DQA1*03:03 (13.00%), HLA-DQA1*06:01 (10.25%) and HLA-DQA1*02:01 (6.75%). Furthermore, the distributions of HLA-DQB1 alleles were HLA-DQB1*05:02 (21.50%), HLA-DQB1*03:01 (15.75%), HLA-DQB1*05:01 (14.50%), HLA-DQB1*03:03 (11.00%) and HLA-DQB1*02:02 (8.25%). Particularly, HLA- DQA1*01:02 (29.00%) allele was the highest frequency in the NorthEast group, but there was not significant difference when compared with the other regions in Thais (p-value = 0.4202). HLA-DQB1*06:02 allele was similarly distributed in Thai population and there was no significant difference between Thais and China (3.8%) and South Korea (6.4%) and Japan (8.2%) with p-value > 0.05. Whereas, South Africa (15.7%) has a significance with Thais by p-value of 0.0013. This study supports the specific genotyping of the HLA-DQA1*01:02 and HLA-DQB1*06:02 alleles to screen severe COVID-19 in Thai and many populations.

Keywords: HLA-DQA1*01:02, HLA-DQB1*06:02, Asian, Thai population

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Authors: Tripta Dixit, Smita Sahu, William Selvamurthy, Sadhana Srivastava

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India is battling with the issues of accessibility, affordability and availability of quality health to the masses. Indian medical heritage which dated back to 3000 BC unveils the rich knowledge pool which has undergone a perceptible change over years, such as eradication of many communicable diseases, increasing individual awareness of quality health and import driven medical device market etc. Despite a slew of initiatives the holistic slogan of ‘health for all’ remains elusive and a concern for the nation. The 21st-century projects a myriad of challenges like cultural diversity, large population, demographic dividend and geographical segmentation leading to varied needs of people as per their regional conditions of climate, disease prevalence, nutrition and sanitation. But these challenges are also opportunities for the development of indigenous, low cost and accessible technologies to tackle them. This requires reinforcing the potential of indigenous technologies in coordination with prevailing health issues in various regions of country. This paper emphasis on the strategy for exploring the indigenous technologies with entrusted up-scaling to meet the diverse needs of the people. This review proposes to adopt technology transfer as a strategy to establish a vibrant ecosystem for identifying and up-scaling the indigenous medical technologies with diligent hand-holding for public health.

Keywords: health, indigenous, medical technology, technology transfer

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Authors: Kun Hua O., Dong Woon Kim, Won Hyung Lee

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Introduction: Neuropathic pain induced by spinal or peripheral nerve injury is highly resistant to common painkillers, nerve blocks, and other pain management approaches. Recently, several new therapeutic drug candidates have been developed to control neuropathic pain. In this study, we used the spinal nerve L5 ligation (SNL) model to investigate the ability of intrathecal or intravenous Evans blue to decrease pain behavior and to study the relationship between Evans blue and the neural structure of pain transmission. Method: Neuropathic pain (allodynia) of the left hind paw was induced by unilateral SNL in Sprague-Dawley rats(n=10) in each group. Evans blue (5, 15, 50μg/10μl) or phosphate buffer saline(PBS,10μl) was injected intrathecally at 3days post-ligation or intravenously(1mg/200 μl) 3days and 5days post-ligation . Mechanical sensitivity was assessed using Von Frey filaments at 3 days post-ligation and at 2 hours, days 1, 2, 3, 5,7 after intrathecal Evans blue injection, and on days 2, 4, 7, and 11 at 14 days after intravenous injection. In the intrathecal group, microglia and glutaminergic neurons in the dorsal horn and VNUT(vesicular nucleotide transporter) in the dorsal root ganglia were tested to evaluate co-staining with Evans blue. The experimental procedures were performed in accordance with the animal care guideline of the Korean Academy of Medical Science(Animal ethic committee of Chungnam National University Hospital: CNUH-014-A0005-1). Results: Tight ligation of the L5 spinal nerve induced allodynia in the left hind paw 3 days post-ligation. Intrathecal Evans blue most significantly(P＜0.001) alleviated allodynia at 2 days after intrathecal, but not an intravenous injection. Glutaminergic neurons in the dorsal horn and VNUT in the dorsal root ganglia were co-stained with Evans blue. On the other hand, microglia in the dorsal horn were partially co-stained with Evans blue. Conclusion: We confirmed that Evans blue might have an analgesic effect through the central nervous system, not another system in neuropathic pain of the SNL animal model. These results suggest Evans blue may be a potential new drug for the treatment of chronic pain. This research was supported by the National Research Foundation of Korea (NRF-2020R1A2C100757512), funded by the Ministry of Education.

Keywords: neuropathic pain, Evas blue, intrathecal, intravenous

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Authors: Hyunsik Park

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Objective: To provide information of charged nursing care facility for helping to establish geriatric health care policy, and to figure out which factors would be the main determinants for the choice of it. Method: 46 males and 53 females, and the same number of their caregivers admitted into the charged nursing care facility were recruited for intensive interview including personal information, disease information, and economic, familial, marital and emotional statuses. This is a cross-sectional study and we analyzed the data qualitatively. Results: Patients had 3.2 diseases and a hospitalization for 2.3 years on average. They were consists of 46 singles (46.9%), 8 unmarried (8.2%), 5 divorced (5.1%) and 32 married (32.7%). More than two third (70.1%) were supported by their eldest son or daughter. Mostly, the family caregivers decided to admit into the facilities by the doctor’s recommendation (68.4%). When they made a choice for a facility, most of them (42.9%) considered environmental and sanitary conditions. According to their expectation for management in nursing care facility, most caregivers (59.2%) wanted simple-staying for the duration, but most patients (61.3%) expected to be home after taking comprehensive rehabilitation. Three-quarter of the caregivers would agree to use nursing care facilities in the future, if they would be the same situation. Conclusion: Life style and environment are rapidly changing. In the near future, we need lots of the charged nursing care facilities for the old, thus this study can be the good reference for the preparing upcoming aged and super-aged society.

Keywords: nursing care facility, aged society, qualitative analysis, health

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