Search results for: health risk

Authors: Prosper Tafadzwa Denhere, Ephias Ruhode, Munyaradzi Zhou

Abstract:

Health Information Systems (HISs) interoperability is emerging to be the future of modern healthcare systems Enterprise Architecture (EA), where healthcare entities are seamlessly interconnected to share healthcare data. The reality that the healthcare industry has been characterised by an influx of fragmented stand-alone e-Health systems, which present challenges of healthcare information sharing across platforms, desires much attention for systems integration efforts. The lack of an EA conceptual framework resultantly crates the need for investigating an ideal solution to the objective of Health Information Systems interoperability development assessment. The study takes a qualitative exploratory approach through a design science research context. The research aims to study the various themes withdrawn from the literature that can help in the assessment of interoperable HISs development through a literature study. Themes derived from the study include HIS needs, HIS readiness, HIS constraints, and HIS technology integration elements and standards tied to the EA development architectural layers of The Open Group Architecture Framework (TOGAF) as an EA development methodology. Eventually, the themes were conceptualised into a framework reviewed by two experts. The essence of the study was to provide a framework within which interoperable EA of HISs should be developed.

Keywords: enterprise architecture, eHealth, health information systems, interoperability

Procedia PDF Downloads 112

Authors: Shahril Anuar Bahari, Mohd Azrie Mohd Kepli, Mohd Ariff Jamaludin, Kamarulzaman Nordin, Mohamad Jani Saad

Abstract:

Formaldehyde release from wood-based panel composites can be very toxicity and may increase the risk of human health as well as environmental problems. A new bio-composites product without synthetic adhesive or resin is possible to be developed in order to reduce these problems. Apart from formaldehyde release, adhesive is also considered to be expensive, especially in the manufacturing of composite products. Natural bonded composites can be termed as a panel product composed with any type of cellulosic materials without the addition of synthetic resins. It is composed with chemical content activation in the cellulosic materials. Pulp and paper making method (chemical pulping) was used as a general guide in the composites manufacturing. This method will also generally reduce the manufacturing cost and the risk of formaldehyde emission and has potential to be used as an alternative technology in fiber composites industries. In this study, the natural bonded bamboo fiber composite was produced from virgin Malaysian bamboo fiber (Bambusa vulgaris). The bamboo culms were chipped and digested into fiber using this pulping method. The black liquor collected from the pulping process was used as a natural binding agent in the composition. Then the fibers were mixed and blended with black liquor without any resin addition. The amount of black liquor used per composite board was 20%, with approximately 37% solid content. The composites were fabricated using a hot press machine at two different board densities, 850 and 950 kg/m³, with two sets of hot pressing time, 25 and 35 minutes. Samples of the composites from different densities and hot pressing times were tested in flexural strength and internal bonding (IB) for strength performance according to British Standard. Modulus of elasticity (MOE) and modulus of rupture (MOR) was determined in flexural test, while tensile force perpendicular to the surface was recorded in IB test. Results show that the strength performance of the composites with 850 kg/m³ density were significantly higher than 950 kg/m³ density, especially for samples from 25 minutes hot pressing time. Strength performance of composites from 25 minutes hot pressing time were generally greater than 35 minutes. Results show that the maximum mean values of strength performance were recorded from composites with 850 kg/m³ density and 25 minutes pressing time. The maximum mean values for MOE, MOR and IB were 3251.84, 16.88 and 0.27 MPa, respectively. Only MOE result has conformed to high density fiberboard (HDF) standard (2700 MPa) in British Standard for Fiberboard Specification, BS EN 622-5: 2006. Microstructure characteristics of composites can also be related to the strength performance of the composites, in which, the observed fiber damage in composites from 950 kg/m³ density and overheat of black liquor led to the low strength properties, especially in IB test.

Keywords: bamboo fiber, natural bonded, black liquor, mechanical tests, microstructure observations

Procedia PDF Downloads 257

Authors: Gracie Tredget, Raymond McGrath, Karen Ang, Julie Williams, Nick Sevdalis, Fiona Gaughran, Jorge Aria de la Torre, Ioannis Bakolis, Andy Healey, Zarnie Khadjesari, Euan Sadler, Natalia Stepan

Abstract:

Background: Preventable physical health problems have been found to increase morbidity rates amongst adults living with serious mental illness (SMI). Community mental health clinicians have a role in identifying, and preventing physical health problems worsening, and supporting primary care services to administer routine physical health checks for their patients. However, little is known about how mental health staff perceive and approach their role when providing physical healthcare amongst patients with SMI, or the impact these attitudes have on routine practice. Methods: The present study involves a prospective service evaluation specific to Adult Community Mental Health Services at South London and Maudsley NHS Foundation Trust (SLaM). A qualitative methodology will use semi-structured interviews, focus groups and observations to explore attitudes, perceptions and experiences of staff, patients, and carers (n=64) towards physical healthcare, and barriers or facilitators that impact upon it. 1South London and Maudsley NHS Foundation Trust, London, SE5 8AZ, UK 2 Centre for Implementation Science, King’s College London, London, SE5 8AF, UK 3 Psychosis Studies, King's College London, London, SE5 8AF, UK 4 Department of Biostatistics and Health Informatics, King’s College London, London, SE5 8AF, UK 5 Kings Health Economics, King's College London, London, SE5 8AF, UK 6 Behavioural and Implementation Science (BIS) research group, University of East Anglia, Norwich, UK 7 Department of Nursing, Midwifery and Health, University of Southampton, Southampton, UK 8 Mind and Body Programme, King’s Health Partners, Guy’s Hospital, London, SE1 9RT *[email protected] Analysis: Data from across qualitative tasks will be synthesised using Framework Analysis methodologies. Staff, patients, and carers will be invited to participate in co-development of recommendations that can improve routine physical healthcare within Adult Community Mental Health Teams at SLaM. Results: Data collection is underway at present. At the time of the conference, early findings will be available to discuss. Conclusions: An integrated approach to mind and body care is needed to reduce preventable deaths amongst people with SMI. This evaluation will seek to provide a framework that better equips staff to approach physical healthcare within a mental health setting.

Keywords: severe mental illness, physical healthcare, adult community mental health, nursing

Procedia PDF Downloads 100

Authors: Aliya Moreira, Blake Duffy, Sam Kosinski, Kate Heckman, Erika Steensma

Abstract:

Introduction: The One Health initiative promotes recognition of the interrelatedness between people, animals, plants, and their shared environment. The field of comparative medicine studies the similarities and differences between humans and animals for the purpose of advancing medical sciences. Currently, medical school education is narrowly focused on human anatomy and physiology, but as the COVID-19 pandemic has demonstrated, a holistic understanding of health requires comprehension of the interconnection between health and the lived environment. To prepare future physicians for unique challenges from emerging zoonoses to climate change, medical students can benefit from exposure to and experience with One Health and Comparative Medicine content. Methods: In January 2020, an elective course for medical students on One Health and Comparative Medicine was created to provide medical students with the background knowledge necessary to understand the applicability of animal and environmental health in medical research and practice. The 2-week course was continued in January 2021, with didactic and experiential activities taking place virtually due to the COVID-19 pandemic. In response to student feedback, lectures were added to expand instructional content on zoonotic and wildlife diseases for the second iteration of the course. Other didactic sessions included interprofessional lectures from 20 physicians, veterinarians, public health professionals, and basic science researchers. The first two cohorts of students were surveyed regarding One Health and Comparative Medicine concepts at the beginning and conclusion of the course. Results: 16 medical students have completed the comparative medicine course thus far, with 87.5% (n=14) completing pre-and post-course evaluations. 100% of student respondents indicated little to no exposure to comparative medicine or One Health concepts during medical school. Following the course, 100% of students felt familiar or very familiar with comparative medicine and One Health concepts. To assess course efficacy, questions were evaluated on a five-point Likert scale. 100% agreed or strongly agreed that learning Comparative Medicine and One Health topics augmented their medical education. 100% agreed or strongly agreed that a course covering this content should be regularly offered to medical students. Conclusions: Data from the student evaluation surveys demonstrate that the Comparative Medicine course was successful in increasing medical student knowledge of Comparative Medicine and One Health. Results also suggest that interprofessional training in One Health and Comparative Medicine is applicable and useful for medical trainees. Future iterations of this course could capitalize on the inherently interdisciplinary nature of these topics by enrolling students from veterinary and public health schools into a longitudinal course. Such recruitment may increase the course’s value by offering multidisciplinary student teams the opportunity to conduct research projects, thereby strengthening both the individual learning experience as well as sparking future interprofessional research ventures. Overall, these efforts to educate medical students in One Health topics should be reproducible at other institutions, preparing more future physicians for the diverse challenges they will encounter in practice.

Keywords: medical education, interprofessional instruction, one health, comparative medicine

Procedia PDF Downloads 115

Authors: Benjamin Osei Tutu, Sharon Annison

Abstract:

On 21^st November, 2016, an outbreak of foodborne illness occurred after a buffet lunch served during a stakeholders’ consultation meeting held in Accra. An investigation was conducted to characterise the affected people, determine the etiologic food, the source of contamination and the etiologic agent and to implement appropriate public health measures to prevent future occurrences. A retrospective cohort study was conducted via telephone interviews, using a structured questionnaire developed from the buffet menu. A case was defined as any person suffering from symptoms of foodborne illness e.g. diarrhoea and/or abdominal cramps after eating food served during the stakeholder consultation meeting in Accra on 21^st November, 2016. The exposure status of all the members of the cohort was assessed by taking the food history of each respondent during the telephone interview. The data obtained was analysed using Epi Info 7. An environmental risk assessment was conducted to ascertain the source of the food contamination. Risks of foodborne infection from the foods eaten were determined using attack rates and odds ratios. Data was obtained from 54 people who consumed food served during the stakeholders’ meeting. Out of this population, 44 people reported with symptoms of food poisoning representing 81.45% (overall attack rate). The peak incubation period was seven hours with a minimum and maximum incubation periods of four and 17 hours, respectively. The commonly reported symptoms were diarrhoea (97.73%, 43/44), vomiting (84.09%, 37/44) and abdominal cramps (75.00%, 33/44). From the incubation period, duration of illness and the symptoms, toxin-mediated food poisoning was suspected. The environmental risk assessment of the implicated catering facility indicated a lack of time/temperature control, inadequate knowledge on food safety among workers and sanitation issues. Limited number of food samples was received for microbiological analysis. Multivariate analysis indicated that illness was significantly associated with the consumption of the snacks served (OR 14.78, P < 0.001). No stool and blood or samples of etiologic food were available for organism isolation; however, the suspected etiologic agent was Staphylococcus aureus or Clostridium perfringens. The outbreak could probably be due to the consumption of unwholesome snack (tuna sandwich or chicken. The contamination and/or growth of the etiologic agent in the snack may be due to the breakdown in cleanliness, time/temperature control and good food handling practices. Training of food handlers in basic food hygiene and safety is recommended.

Keywords: Accra, buffet, conference, C. perfringens, cohort study, food poisoning, gastroenteritis, office workers, Staphylococcus aureus

Procedia PDF Downloads 235

Authors: Delphine Duval, Morgan Mangeas, Charlie Huveneers, Adam Barnett, Laurent Vigliola

Abstract:

The global number of shark bites has increased over the past four decades with, however, high regional variability both in space and time. A systematic review, aligned with the 2020 PRISMA guidelines, explored the peer-reviewed literature published between 1960 and 2023 to identify factors potentially explaining trends in human-shark interactions. Results revealed that variations in the frequency of human-shark interactions could be explained by a plethora of factors, including changes in prey availability, environmental conditions, human and shark population density and behavior, as well as habitat destruction. However, to our best knowledge, only five studies have conducted statistical assessments of the relative contribution of these factors. The increased number in human-shark interactions and the frequent clusters of shark bites within short timeframes offer opportunities to test the causative factors that may explain trends in unprovoked shark bites. it study aims to evaluate the impact of marine protected areas (MPAs) on the number of human-shark interactions, using data from the Global Shark Attack File and the World Database on Protected Areas. Results indicate contrasting effects of MPAs at different spatial scales. Enhancing our understanding of the factors contributing to shark bites is essential for improving risk reduction policies for humans and conservation plans for shark populations.

Keywords: unprovoked shark interactions, marine protected areas, attack risk, human-wildlife interaction

Procedia PDF Downloads 48

Authors: Jenny Lee

Abstract:

Fat Studies is emerging as an interdisciplinary area of study, intersecting with Gender Studies, Sociology, Human Development and the Creative Arts. A focus on weight loss, and, therefore, fat hatred, has resulted in a form of discriminatory institutional practice that impacts women in the Western world. This focus is sanctioned by a large dieting industry, medical associations, the media, and at times, government initiatives. This paper will discuss the emergence of the so-called ‘Obesity Epidemic’ in Australia and the Western world and the stereotypes that thin equals healthy and fat equals unhealthy. This paper will argue that, for those with a health focus, ‘Health at every size’ is a more effective principle, which involves striving for healthy living, without a focus on weight loss. This discussion will contextualise an autoethnographic exploration of how fat acceptance and Health at Every Size can be encouraged through fat activism and fat political art. As part of this paper, a selection of the recent performance, writing and art in Australia will be presented, including Aquaporko, the fat femme synchronised swim team and VaVaBoomBah, the Melbourne fat burlesque performances.

Keywords: activism, fat, health, obesity, performance

Procedia PDF Downloads 184

Authors: Faheem Ur Rehman, Muhammad Khalil Khan, Miao Qing

Abstract:

This study investigated the asymmetric links and portfolio strategies between green bonds and the markets of three different cryptocurrencies, i.e., green, Islamic, and conventional, using data from January 1, 2018, to April 8, 2022, and employing asymmetric TVP-VAR model to quantify risk spillovers in the network analysis. In addition, we use the minimum variance, minimum correlation, and minimum connectedness methodologies to assess the portfolio implications. The results of the asymmetric dynamic connectedness index (TCI) model show that by adopting cryptocurrencies for digital finance, risk spillovers are found to be reduced. The findings of net directional connectedness demonstrate that during the study period, green bonds consistently get return spillovers from all other network variables. Positive return spillovers are bigger in magnitude than negative ones. These results imply that the influence of the green bond market on the cryptocurrency markets is decreasing. Positive return spillovers generate higher connectedness values for (HG, BNB, and TRX) coins and persistent net recipients in the specific network. On the other hand, Cardano and ADA coins are persistent net transmitters in the system. XLM and MIOTA's responsibilities shift over time, and there is evidence of asymmetry when both positive and negative returns are considered. According to the pairwise portfolio weights, BNB vs. BTC has the largest portfolio weights in the system, followed by BNB vs. Ethereum, suggesting the best investment strategies in the network.

Keywords: asymmetric TVP-VAR, global sustainable index, cryptocurrency, portfolios

Procedia PDF Downloads 81

Authors: Dipak Subedi, Anil Giri, Christine Whitt, Tia McDonald

Abstract:

This study aims to understand the impact of the pandemic on the overall economic well-being of the agricultural sector of the United States. The two key metrics used to examine the economic well-being are the bankruptcy rate of the U.S. farm operations and the operating profit margin. One of the primary reasons for farm operations (in the U.S.) to file for bankruptcy is continuous negative profit or a significant decrease in profit. The pandemic caused significant supply and demand shocks in the domestic market. Furthermore, the ongoing trade disruptions, especially with China, also impacted the prices of agricultural commodities. The significantly reduced demand for ethanol and closure of meat processing plants affected both livestock and crop producers. This study uses data from courts to examine the bankruptcy rate over time of U.S. farm operations. Preliminary results suggest there wasn’t an increase in farm operations filing for bankruptcy in 2020. This was most likely because of record high Government payments to producers in 2020. The Federal Government made direct payments of more than $45 billion in 2020. One commonly used economic metric to measure farm profitability is the operating profit margin (OPM). Operating profit margin measures profitability as a share of the total value of production and government payments. The Economic Research Service of the United States Department of Agriculture defines a farm operation to be in a) a high-risk zone if the OPM is less than 10 percent and b) a low-risk zone if the OPM is higher than 25 percent. For this study, OPM was calculated for small, medium, and large-scale farm operations using the data from the Agriculture Resource Management Survey (OPM). Results show that except for small family farms, the share of farms in high-risk zone decreased in 2020 compared to the most recent non-pandemic year, 2019. This was most likely due to higher commodity prices at the end of 2020 and record-high government payments. Further investigation suggests a lower share of smaller farm operations receiving lower average government payments resulting in a large share (over 70 percent) being in the critical zone. This study should be of interest to multiple stakeholders, including policymakers across the globe, as it shows the resilience of the U.S. agricultural system as well as (some) impact of government payments.

Keywords: U.S. farm sector, COVID-19, operating profit margin, farm bankruptcy, ag finance, government payments to the farm sector

Procedia PDF Downloads 92

Authors: Kirsty Biggs, Peter Larsen-Disney

Abstract:

Background: The UK cervical screening programme significantly reduces cancer mortality through the early detection of abnormal cells. Despite this, over a quarter of eligible women choose not to attend their appointment. Objective: To qualitatively explore patients’ barriers to attending cervical smear appointments and identify key trends of cervical screening behaviour, knowledge, and attitudes in primary and secondary care. Methods: A cross-sectional study was conducted to evaluate smear services in Brighton and Hove using questionnaires in general practice and colposcopy. 226 patients participated in the voluntary questionnaire between 10/11/2017 and 02/02/2018. 118 patients were recruited from general practice surgeries and 108 from the colposcopy department. Women were asked about their smear knowledge, self-perceived risks factors, prior experiences and reasons for non-attendance. Demographic data was also collected. Results: Approximately a third of women did not engage in smear testing services. This was consistent across primary and secondary care groups. Over 90% were aware of the role of the screening process in relation to cervical cancer; however, over two thirds believed the smear was also a tool to screen for other pathologies. The most commonly cited reasons for non-attendance were negative emotions or previous experiences. Inconvenient appointment times were also commonly described. In a comparison of attenders versus non-attenders previous negative experiences (p < 0.01) and number of identified risk factors (p = 0.02) were statistically significant with non-attenders describing more prior negative smears and identifying more risk factors. Smear knowledge, risk perception and perceived importance of screening were not significant. Negative previous experiences were described in relation to poor bedside manner, pain, embarrassment and staff competency. Conclusions: In contrary to the literature, our white Caucasian cohort experienced significant barriers to accessing smear services. Women’s prior negative experiences are overriding their perceived importance to attend the screening programme; therefore, efforts need to focus on improving clinical experiences through auditing tools, training and providing a supportive appointment setting. Positive changes can also be expected by improving appointment availabilities with extended hours and self-booking systems.

Keywords: barriers, cervical, Papanicolaou, screening, smear

Procedia PDF Downloads 151

Authors: Muntanavadee Maytapattana

Abstract:

The purposes of the study were to evaluate the effectiveness of the Parent Training Program for Obesity Reduction (PTPOR) on health behaviors of school-age children. An Ecological Systems Theory (EST) was approached the study and a randomized control trial was used in this study. Participants were school-age overweight or obese children and their parents. One hundred and one parent-child dyads were recruited and random assigned into the PTPOR (N=30), Educational Intervention or EI (N=32), and control group (N=39). The parents in the PTPOR group participated in five sessions including an educational session, a cooking session, aerobic exercise training, 2-time group discussion sessions, and 4-time telephoned counseling sessions. Repeated Measure ANCOVA was used to analyze data. The results presented that the outcomes of the PTPOR group were better than the EI and the control groups at 1st, 8th, and 32nd weeks after finishing the program such as child exercise behavior (F(2,97) = 3.98, p = .02) and child dietary behavior (F(2,97) = 9.42, p = .00). The results suggest that nurses and health care providers should utilize the PTPOR for child weight reduction and for the health promotion of a lifestyle among overweight and obese children.

Keywords: parent training program, obesity reduction, child health behaviors, school-age children

Procedia PDF Downloads 447

Authors: Jia-Jin He, Tzu-Yuan Stessa Chao

Abstract:

It is generally accepted that community residents with abundant open space have better health status on average, and thus more and more cities around the world began their pursuit of the greatest possible amount of green space within urban areas through urban planning approach. Nevertheless, only a few studies managed to provide empirical evidence regarding the actual relationship between 'providing' green space and 'improving' human health at city level. There is also lack of evidence of direct positive improvement of health by increasing the amount of green space. For urban planning professional, it is important to understand citizens’ usage behaviour towards green space as a critical evidence for future planning and design strategies. There is a research need to further investigate the amount of green space, user behaviour of green spaces and the health outcome of urban dwellers. To this end, we would like to find out other important factors for urban dwellers’ usage behaviours of green spaces. 'Average green spaces per person' is one of the National well-being Indicators in Taiwan as in many other countries. Through our preliminary research, we collected and analyzed the official data of planned open space coverages, average life expectancy, exercise frequency and obesity ratio in all cities of Taiwan. The study result indicates an interesting finding that Kaohsiung city, the second largest city in Taiwan, tells a completely different story. Citizens in Kaosiung city have more open spaces than any other city through urban planning, yet have relatively unhealthy condition in contrary. Whether it pointed out that the amount of the open spaces per person has would not direct to the health outcome. Therefore, the pre-established view which states that open spaces must have positive effects on human health should be examined more prudently. Hence, this paper intends to explore the relationship between user behaviour of open spaces and citizens’ health conditions by critically analyzing past related literature and collecting selective data from government health database in 2015. We also take Kaohsiung city, as a case study area to conduct statistical analysis first followed by questionnaire survey to gain a better understanding. Finally, we aim to feedback our findings to the current planning system in Taiwan for better health promotion urbanized areas.

Keywords: open spaces, urban planning systems, healthy cities, health outcomes

Procedia PDF Downloads 170

Authors: Elucir Gir, Myllena Nilce de Freitas Surmano, Laelson Rochelle Milanês Sousa, Mayra Gonçalves Menegueti, Ana Cristina de Oliveira E Silva, Renata Karina Reis

Abstract:

Objective: To analyze the factors associated with the worsening of the quality of life of health professionals in the Southeast region of Brazil during the COVID-19 pandemic and its associated factors. Method: Analytical cross-sectional study carried out with health professionals from the southeastern region of Brazil. Data collection took place through an online survey with a form stored on the Survey Monkey platform. Bivariate analysis was used, and the chi-square test was adopted, followed by the multiple binary logistic regression model based on the stepwise method. Results: 3,493 health professionals participated in the study. Factors associated with worsening quality of life were: Professional Category (Nursing assistant) [OR 1.851 (95%CI 1.035-3.311) p= 0.038]; types of people who provided care (people in general) [OR 1.445 (95%CI 1.072-1.945) p=0.015]; Supply of good quality PPE by the institution where he works (no) [OR 1.595 (CI 95% 1.144-2.223) p= 0.006] and Supply of good quality PPE by the institution where he works (in part) [OR 1.563 (CI 95% 1.257-1.943) p < 0.001]. Conclusion: The factors associated with the worsening of the quality of life of health professionals during the COVID-19 pandemic were: Professional Category (Nursing assistant); types of people who provided assistance (people in general); Supply of sufficient PPE by the institution where you work (no) and Supply of good quality PPE by the institution where you work (in part). Future studies should investigate to what extent QoL can be improved based on modifiable factors.

Keywords: COVID-19, quality of life, health professionals, respiratory infections

Procedia PDF Downloads 97

Authors: Min Ju Kim, Beom Jin Park, Deuk Jae Sung, Na Yeon Han, Kichoon Sim

Abstract:

Purpose: The purpose of this study is to determine the significant magnetic resonance (MR) imaging factors of lateral pelvic lymph node (LPLN) on the assessment of survival outcomes of neoadjuvant combined chemotherapy and radiation therapy (CRT) in patients with mid/low rectal cancer. Materials and Methods: The institutional review board approved this retrospective study of 63 patients with mid/low rectal cancer who underwent MR before and after CRT and patient consent was not required. Surgery performed within 4 weeks after CRT. The location of LPLNs was divided into following four groups; 1) common iliac, 2) external iliac, 3) obturator, and 4) internal iliac lymph nodes. The short and long axis diameters, numbers, shape (ovoid vs round), signal intensity (homogenous vs heterogenous), margin (smooth vs irregular), and diffusion-weighted restriction of LPLN were analyzed on pre- and post-CRT images. For treatment response using size, lymph node groups were defined as group 1) short axis diameter ≤ 5mm on both MR, group 2) > 5mm change into ≤ 5mm after CRT, and group 3) persistent size > 5mm before and after CRT. Clinical findings were also evaluated. The disease-free survival and overall survival rate were evaluated and the risk factors for survival outcomes were analyzed using cox regression analysis. Results: Patients in the group 3 (persistent size >5mm) showed significantly lower survival rates than the group 1 and 2 (Disease-free survival rates of 36.1% and 78.8, 88.8%, p < 0.001). The size response (group 1-3), multiplicity of LPLN, the level of carcinoembryonic antigen (CEA), patient’s age, T and N stage, vessel invasion, perineural invasion were significant factors affecting disease-free survival rate or overall survival rate using univariate analysis (p < 0.05). The persistent size (group 3) and multiplicity of LPLN were independent risk factors among MR imaging features influencing disease-free survival rate (HR = 10.087, p < 0.05; HR = 4.808, p < 0.05). Perineural invasion and T stage were shown as independent histologic risk factors (HR = 16.594, p < 0.05; HR = 15.891, p < 0.05). Conclusion: The persistent size greater than 5mm and multiplicity of LPLN on both pre- and post-MR after CRT were significant MR factors affecting survival outcomes in the patients with mid/low rectal cancer.

Keywords: rectal cancer, MRI, lymph node, combined chemoradiotherapy

Procedia PDF Downloads 155

Authors: Sandra D. Prewitt

Abstract:

Introduction—The purpose of the extant study was to explore the relationship between religiosity and suicidal ideation. Through this exploration, further knowledge was sought relevant to gaining a better understanding regarding the higher suicide rate continuing to be experienced by young adults. Endeavoring to discover why the suicide rate continues to increase for the subject population, depression and anxiety emerged as major contributory risk factors. Although religiosity has been shown to be related to the reduced risk of suicidal behavior, the curative value of religion relevant to suicide prevention and treatment has not been sufficiently recognized. Considering the enormity of the current suicide problem, pursuits relevant to discovering effective tools enabling impactful prevention and treatment strategies remain essential to reducing suicide deaths. Methodology—The subject study was conducted utilizing a systematic literature review (SLR) which required the researcher to perform searches of appropriate databases, toward the goal of acquiring advanced knowledge based upon existing studies relevant to the subject matter under consideration. Major Findings—Depression and anxiety have been identified as two potential pathways leading to increased suicidal behavior. On the contrary, religiosity emerged as an important protective factor associated with less depression and therefore, fewer instances of suicidal thoughts. The protective nature of religion has been shown to extend to young adults without regard to the presence of identified potential suicidal behavior pathways.

Keywords: anxiety, depression, religion, suicide

Procedia PDF Downloads 224

Authors: Da Tao, Mingfu Qin, Wenkai Li, Tieyan Wang

Abstract:

While the use of electronic personal health portals has gained increasing popularity in the healthcare industry, users usually experience difficulty in comprehending and correctly responding to personal health information, partly due to inappropriate or poor presentation of the information. The way personal health information is visualized may affect how users perceive and assess their personal health information. This study was conducted to examine the effects of information visualization format and visualization mode on the comprehension and perceptions of personal health information among personal health information users with eye tracking techniques. A two-factor within-subjects experimental design was employed, where participants were instructed to complete a series of personal health information comprehension tasks under varied types of visualization mode (i.e., whether the information visualization is static or dynamic) and three visualization formats (i.e., bar graph, instrument-like graph, and text-only format). Data on a set of measures, including comprehension performance, perceptions, and eye movement indicators, were collected during the task completion in the experiment. Repeated measure analysis of variance analyses (RM-ANOVAs) was used for data analysis. The results showed that while the visualization format yielded no effects on comprehension performance, it significantly affected users’ perceptions (such as perceived ease of use and satisfaction). The two graphic visualizations yielded significantly higher favorable scores on subjective evaluations than that of the text format. While visualization mode showed no effects on users’ perception measures, it significantly affected users' comprehension performance in that dynamic visualization significantly reduced users' information search time. Both visualization format and visualization mode had significant main effects on eye movement behaviors, and their interaction effects were also significant. While the bar graph format and text format had similar time to first fixation across dynamic and static visualizations, instrument-like graph format had a larger time to first fixation for dynamic visualization than for static visualization. The two graphic visualization formats yielded shorter total fixation duration compared with the text-only format, indicating their ability to improve information comprehension efficiency. The results suggest that dynamic visualization can improve efficiency in comprehending important health information, and graphic visualization formats were favored more by users. The findings are helpful in the underlying comprehension mechanism of visualized personal health information and provide important implications for optimal design and visualization of personal health information.

Keywords: eye tracking, information comprehension, personal health information, visualization

Procedia PDF Downloads 113

Authors: Gabriela Ilie, Robert D. H. Rutledge

Abstract:

A review of the literature reveals a need for longitudinal studies to properly understand the quality of life of prostate cancer survivors during their prostate cancer journey in order to identify opportunities for patient support and care during prostate cancer survivorship. In this study, mental health and relationship satisfaction were assessed longitudinally and by treatment modality among a population-based sample of Canadian adult men with a history of prostate cancer diagnosis. A total of 98 men, aged 51 or older with a history of prostate cancer completed an on-line 15-minute survey between May 2017 and February 2018, assessing mental health (Kessler Psychological Distress Scale) and relationship satisfaction (Dyadic Adjustment Scale) at baseline and at three months post-treatment with either active or nonactive prostate cancer treatment. Almost 1 in 6 men in this sample screened positive for mental health issues (17.34%, n=17) irrespective of treatment modality and most (n=11) were not currently on medication for depression, anxiety or both. Mental health outcomes were poorer for men with multimorbidity. For every instance of screening positive for mental health issues, 2.021 (95% CI:1.1 to 3.8) times more comorbidities were recorded. Relationship satisfaction and dyadic cohesion were statistically significantly lower from first assessment to 3 months for men who underwent multiple treatment modalities (surgery and radiation with hormonal therapy). Relationship satisfaction was also lower at 3 months for men who underwent radiation therapy. Almost 1 in 2 men in this sample (74%) indicated they did not attend a prostate cancer support group. Results suggest that treatment for mental health is underutilized in men with prostate cancer. Men who undergo multiple forms of active treatment appear more vulnerable to relationship dissatisfaction and feeling disconnected from their partner. Data points to important opportunities for patient education and care support during survivorship.

Keywords: prostate cancer survivorship, mental health, quality of life, relationship satisfaction

Procedia PDF Downloads 119

Authors: Rabeab Khunpukdee, Aranya Sukchoui, Nonluk Somgit, Chitima Bunnaul

Abstract:

Endotracheal displacement is a major risk of life threatening among critically ill patients. Standard nursing protocol is needed to minimize this risk and to improve clinical outcomes. To evaluate the effectiveness of the endothacheal care nursing guideline. The incidence rates of endochacheal displacement, oxygen deficiency after extubation, re-intubation, and nurse’s satisfaction on the utilization of the endotracheal care nursing guideline. An evidence-based nursing practice framework was used to develop the endotracheal care nursing guideline. The guideline valid content was review by a 3 panel of experts. The index of item objective (IOC) of the guideline was 0.93. The guideline was implemented in 130 patients (guideline group) and 19 registered nurses at a medicine ward, Had Yai hospital, Thailand. Patient’s outcomes were evaluated by comparison with those 155 patients who received the routine nursing care (routine care group). Descriptive statistics, frequency, percentage, mean, standard deviation and Mann Whitney U-test was analyzed using the computer program. All significantly and better outcomes were found in the guideline group compared to the routine care group. The guideline group has less incidence rates of endotracheal displacement (1.54 % vs 9.03 %, p < 0.05), and none of the guideline group had oxygen deficiency after extubation (0 % vs 83.33%) compared to the routine care group. All of the 2 patients in the guideline group, compared to 6 of 14 patients in the routine care group were re-intubation. The overall rate of re-intubation in the total group (n = 130 vs 155) was seen less in the guideline group than the routine care group (1.54 % vs 3.87). Overall, nurses satisfaction was at high-level (89.50%) on the utilization of the guideline.

Keywords: endotracheal care, nursing guideline, re-intubation, satisfaction

Procedia PDF Downloads 515

Authors: Ali Reza Ghanbarnezhad Ghazvini, Seyyed Hamid Reza Mosayyebi

Abstract:

In recent years, an earthquake has occurred approximately every five years in certain regions of Iran. To mitigate the impact of these seismic events, it is crucial to identify and thoroughly assess the vulnerability of buildings and infrastructure, ensuring their safety through principled reinforcement. By adopting new methods of risk assessment, we can effectively reduce the potential risks associated with future earthquakes. In our research, we have observed that the coefficient of behavior in the fourth chapter is 1.65 for the initial structure and 1.72 for the Superframe structure. This indicates that the Superframe structure can enhance the strength of the main structural members by approximately 10% through the utilization of super beams. Furthermore, based on the comparative analysis between the two structures conducted in this study, we have successfully designed a stronger structure with minimal changes in the coefficient of behavior. Additionally, this design has allowed for greater energy dissipation during seismic events, further enhancing the structure's resilience to earthquakes. By comprehensively examining and reinforcing the vulnerability of buildings and infrastructure, along with implementing advanced risk assessment techniques, we can significantly reduce casualties and damages caused by earthquakes in Iran. The findings of this study offer valuable insights for civil engineering professionals in the field of structural engineering, aiding them in designing safer and more resilient structures.

Keywords: modal pushover analysis, response modification factor, high-strength concrete, concrete shear walls, high-rise building

Procedia PDF Downloads 153

Authors: Harini Aiyer, Kalyani Premkumar

Abstract:

Health professionals are the key players who can help achieve the goals of population health equity. Social accountability (SA) of health professionals emphasizes their role in addressing issues of equity in the population they serve. Therefore, health professional education must focus on instilling SA in health professionals. There is limited literature offering a longitudinal perspective of how students sustain the practice of SA in later life. This project aims to identify the drivers of social accountability among physicians. This study employed an exploratory mixed methods design (QUAL-> Quant) to explore alumni perceptions and experiences. The qualitative data, collected via 20 in-depth, semi-structured interviews, provided an understanding of the perceptions of the alumni regarding the influence of their undergraduate learning environment on their SA. This was followed by a quantitative portion -a questionnaire designed from the themes identified from the qualitative data. Emerging themes from the study highlighted community-centered education and a focus on social and preventative medicine in both curricular and non-curricular facilitators of SA among physicians. Curricular components included opportunities to engage with the community, such as roadside clinics, community-orientation programs, and postings at a secondary hospital. Other facilitators that emerged were the faculty leading by example, a subsidized fee structure, and a system that prepared students for practice in rural and remote areas. The study offers a fresh perspective and dimension on how SA is addressed by medical schools. The findings may be adapted by medical schools to understand how their own SA initiatives have been sustained among physicians over the long run.

Keywords: community-based work, global health, health education, medical education, providing health in remote areas, social accountability

Procedia PDF Downloads 85

Authors: Nazif Fuat Turkmen

Abstract:

Domestic violence is the most common form of violence that risks the health and psychological well-being of victims and its witnesses. Psychology as a scientific field has made contributions in research, exploration, assessment, intervention, and prevention of domestic violence. The present study will be exploring the level of recognition of Turkish Cypriots on domestic violence and their understanding about it in general terms. While discussing the level of awareness of Turkish Cypriots on domestic violence and the effects of this level of awareness on the general well-being of the members of the society, the most common types of domestic violence as well as how Turkish Cypriots recognize and interpret these different types will be explored. The participants consisted of 224 Turkish Cypriots; 48.4% (n= 109) were female, 51.1% (n=115) were male. For the purpose of the study, a 28-item questionnaire was prepared and used for data collection. According to the results, there is a strong relationship between the education level of the respondents and their awareness on domestic violence. The study shows that cultural approaches on child rearing effect people’s recognition of violence in general and awareness on domestic violence in particular.

Keywords: culture, domestic violence, health psychology, public health, Turkish Cypriots, violence

Procedia PDF Downloads 457

Authors: Mohammad Tahir Yousafzai, Amna Rehana Siddiqui, Naveed Zafar Janjua

Abstract:

We assessed the frequency and predictors of sharp injuries (SIs) among health care workers (HCWs) at first level care facilities (FLCF) in rural Pakistan. HCWs working at public clinic (PC), privately owned licensed practitioners’ clinic (LPC) and non-licensed practitioners’ clinic (NLC) were interviewed on universal precautions (UPs) and constructs of health belief model (HBM) to assess their association with SIs through negative-binomial regression. From 365 clinics, 485 HCWs were interviewed. Overall annual rate of Sis was 192/100 HCWs/year; 78/100 HCWs among licensed prescribers, 191/100 HCWs among non-licensed prescribers, 248/100 HCWs among qualified assistants, and 321/100 HCWs among non-qualified assistants. Increasing knowledge score about bloodborne pathogens (BBPs) transmission (rate-ratio (RR): 0.93; 95%CI: 0.89–0.96), fewer years of work experience, being a non-licensed prescriber (RR: 2.02; 95%CI: 1.36–2.98) licensed (RR: 2.86; 9%CI: 1.81–4.51) or non-licensed assistant (RR: 2.78; 95%CI: 1.72–4.47) compared to a licensed prescriber, perceived barriers (RR: 1.06;95%CI: 1.03–1.08), and compliance with UPs scores (RR: 0.93; 95%CI: 0.87–0.97) were significant predictors of SIs. Improved knowledge about BBPs, compliance with UPs and reduced barriers to follow UPs could reduce SIs to HCWs.

Keywords: health belief model, sharp injuries, needle stick injuries, healthcare workers

Procedia PDF Downloads 315

Authors: Torsten Mielitz, Dietmar Schulz, York C. Roth

Abstract:

Market forecasts show a significant increase in the demand for aircraft within the next two decades and production rates will be adapted accordingly. Improvements and optimizations in the industrial system are becoming more important to cope with future challenges in manufacturing and assembly. Highest quality standards have to be met for aerospace parts, whereas cost effective production in industrial systems and methodologies are also a key driver. A look at other industries like e.g., automotive shows well established processes to streamline existing manufacturing systems. In this paper, the implementation of 'PULL' principles in an existing manufacturing process chain for a large scale composite part is presented. A nonlinear extrapolation based on 'Little's Law' showed a risk of a significant increase of parts needed in the process chain to meet future demand. A project has been set up to mitigate the risk whereas the methodology has been changed from a traditional milestone approach in the beginning towards an agile way of working in the end in order to facilitate immediate benefits in the shop-floor. Finally, delivery rates could be increased avoiding more semi-finished parts in the process chain (work in progress & inventory) by the successful implementation of the 'PULL' philosophy in the shop-floor between the work stations. Lessons learned during the running project as well as implementation and operations phases are discussed in order to share best practices.

Keywords: aerospace composite part manufacturing, PULL principles, shop-floor implementation, lessons learned

Procedia PDF Downloads 177

Authors: Josiane Yaguibou, Ngoy Kishimba, Issiaka V. Coulibaly, Sabrina Pestilli, Falinirina Razanalison, Hantanirina Andremanisa

Abstract:

Background: Madagascar has one of the least developed road networks in the world with a majority of its national and local roads being earth roads and in poor condition. In addition, the country is affected by frequent natural disasters that further affect the road conditions limiting the accessibility to some parts of the country. In 2021 and 2022, 2.21 million people were affected by drought in the Grand Sud region, and by cyclones and floods in the coastal regions, with disruptions of the health system including last mile distribution of lifesaving maternal health commodities and reproductive health commodities in the health facilities. Program intervention: The intervention uses drone technology to deliver maternal health and family planning commodities in hard-to-reach health facilities in the Grand Sud and Sud-Est of Madagascar, the regions more affected by natural disasters. Methodology The intervention was developed in two phases. A first phase, conducted in the Grand Sud, used drones leased from a private company to deliver commodities in isolated health facilities. Based on the lesson learnt and encouraging results of the first phase, in the second phase (2023) the intervention has been extended to the Sud Est regions with the purchase of drones and the recruitment of pilots to reduce costs and ensure sustainability. Key findings: The drones ensure deliveries of lifesaving commodities in the Grand Sud of Madagascar. In 2023, 297 deliveries in commodities in forty hard-to-reach health facilities have been carried out. Drone technology reduced delivery times from the usual 3 - 7 days necessary by road or boat to only a few hours. Program Implications: The use of innovative drone technology demonstrated to be successful in the Madagascar context to reduce dramatically the distribution time of commodities in hard-to-reach health facilities and avoid stockouts of life-saving medicines. When the intervention reaches full scale with the completion of the second phase and the extension in the Sud-Est, 150 hard-to-reach facilities will receive drone deliveries, avoiding stockouts and improving the quality of maternal health and family planning services offered to 1,4 million people in targeted areas.

Keywords: commodities, drones, last-mile distribution, lifesaving supplies

Procedia PDF Downloads 70

Authors: Sharmin Sultana, Palash Chandra Banik, Shirin Jahan Mumu, Liaquat Ali

Abstract:

Santals are one of the oldest indigenous groups of South Asia who, according to anthropological evidence, are thought to be the origins of the Bengali race. The aim of the study was to explore, according to our best knowledge for the first time, the prevalence and determinants of hypertension in this relatively isolated and marginalized indigenous group who still live mostly in a traditional style. Under a cross-sectional analytical design, the study was conducted on the adult (age≥18 years) Santals (n=389, M/F 184/205, age in years, 38±15.3) of a village located in a remote rural area of northern Bangladesh. Subjects were selected by purposive sampling, and data were collected by interviewer-administered pretested questionnaire. Blood pressure was measured by following the WHO guideline of JNC-7 has been used to classify the blood pressure. The prevalence of hypertension was 4.9% among the respondents. Females had a much higher prevalence (5.4%) of hypertension compared to males (4.3%). Among the risk indicators of hypertension, more than half (50.9%) of the study population took extra salt in their meals, whereas 10.5% of respondents used extra salt occasionally, which is an important risk factor for high blood pressure. High waist circumference was found in 19% of the study subjects in terms of central obesity. Older age group (p=0.003, OR=1.1, 95%CI-1.02-1.10), respondents who completed more than primary school (p=0.038, OR=7.1, CI-1.11, 44.6), overweight and obesity (p=0.004, OR=17.1, CI-2.5, 118.1), were the major determinant for hypertension as found from the binary logistic model. None of the respondents received any medication, neither they visit any doctor ever for their hypertension control. The prevalence of hypertension was found to be low but not ignorable. Pre-hypertension in the case of systolic blood pressure needs attention among Santal indigenous population.

Keywords: hypertension, indigenous group, Santals, Bangladesh

Procedia PDF Downloads 112

Authors: Lise Retat, Maria Carmen Huerta, Laura Webber, Franco Sassi

Abstract:

Background: Intra-generational social mobility (ISM) can be defined as the extent to which individuals change their socio-economic position over a period of time or during their entire life course. The relationship between poor health and ISM is established. Therefore, quantifying the impact that potential health policies have on ISM now and into the future would provide evidence for how social inequality could be reduced. This paper takes the condition of overweight and obesity as an example and estimates the mean earning change per individual if the UK were to introduce policies to effectively reduce overweight and obesity. Methods: The HealthLumen individual-based model was used to estimate the impact of obesity on social mobility measures, such as earnings, occupation, and wealth. The HL tool models each individual's probability of experiencing downward ISM as a result of their overweight and obesity status. For example, one outcome of interest was the cumulative mean earning per person of implementing a policy which would reduce adult overweight and obesity by 1% each year between 2020 and 2030 in the UK. Results: Preliminary analysis showed that by reducing adult overweight and obesity by 1% each year between 2020 and 2030, the cumulative additional mean earnings would be ~1,000 Euro per adult by 2030. Additional analysis will include other social mobility indicators. Conclusions: These projections are important for illustrating the role of health in social mobility and for providing evidence for how health policy can make a difference to social mobility outcomes and, in turn, help to reduce inequality.

Keywords: modelling, social mobility, obesity, health

Procedia PDF Downloads 124

Authors: Sandra Regina Cavalcante, Rodolfo A. G. Vilela

Abstract:

Introduction: Work accidents and occupational diseases are a big problem for public health around the world and the main health problem of workers with high social and economic costs. Brazil has shown progress over the last years, with the development of the regulatory system to improve safety and quality of life in the workplace. However, the situation is far from acceptable, because the occurrences remain high and there is a great gap between legislation and reality, generated by the low level of voluntary compliance with the law. Brazilian laws provide procedural legal instruments for both, to compensate the damage caused to the worker's health and to prevent future injuries. In the Judiciary, the prevention idea is in the collective action, effected through Brazilian Class Actions. Inhibitory guardianships may impose both, improvements to the working environment, as well as determine the interruption of activity or a ban on the machine that put workers at risk. Both the Labor Prosecution and trade unions have to stand to promote this type of action, providing payment of compensation for collective moral damage. Objectives: To verify how class actions (known as ‘public civil actions’), regulated in Brazilian legal system to protect diffuse, collective and homogeneous rights, are being used to protect workers' health and safety. Methods: The author identified and evaluated decisions of Brazilian Superior Court of Labor involving collective actions and work accidents. The timeframe chosen was December 2015. The online jurisprudence database was consulted in page available for public consultation on the court website. The categorization of the data was made considering the result (court application was rejected or accepted), the request type, the amount of compensation and the author of the cause, besides knowing the reasoning used by the judges. Results: The High Court issued 21,948 decisions in December 2015, with 1448 judgments (6.6%) about work accidents and only 20 (0.09%) on collective action. After analyzing these 20 decisions, it was found that the judgments granted compensation for collective moral damage (85%) and/or obligation to make, that is, changes to improve prevention and safety (71%). The processes have been filed mainly by the Labor Prosecutor (83%), and also appeared lawsuits filed by unions (17%). The compensation for collective moral damage had average of 250,000 reais (about US$65,000), but it should be noted that there is a great range of values found, also are several situations repaired by this compensation. This is the last instance resource for this kind of lawsuit and all decisions were well founded and received partially the request made for working environment protection. Conclusions: When triggered, the labor court system provides the requested collective protection in class action. The values of convictions arbitrated in collective actions are significant and indicate that it creates social and economic repercussions, stimulating employers to improve the working environment conditions of their companies. It is necessary to intensify the use of collective actions, however, because they are more efficient for prevention than reparatory individual lawsuits, but it has been underutilized, mainly by Unions.

Keywords: Brazilian Class Action, collective action, work accident penalization, workplace accident prevention, workplace protection law

Procedia PDF Downloads 277

Authors: F. Argurio, F. G. Vaccaro

Abstract:

In a global environment defined by ever-increasing health issues, in spite of the progress made by modern medicine, this paper seeks to readdress the question of global health in an international relations perspective. The research hypothesis is: the lower the security environment, the higher the spread of communicable diseases. This question will be channeled by re-scaling the connotation of 'global' and 'international' dimension through the theoretical lens of glocalization, a theory by Bauman that starts its analysis from simple systems to get to the most complex ones. Glocalization theory will be operationalized by analyzing health in an armed-conflict context. In this respect, the independent variable 'low security environment' translates into the cases of Syria and Yemen, which provide a clear example of the all-encompassing nature of conflict on national health and the effects on regional development. In fact, Syria and Yemen have been affected by poliomyelitis and cholera outbreaks respectively. The dependent variable will be constructed on said communicable diseases which belong to the families of sanitation-related and vaccine-preventable diseases. The research will be both qualitative and quantitative, based on primary (interviews) and secondary (WHO and other NGO’s reports) sources. The methodology is based on the assessment of the vaccine coverage and case-analysis in time and space using epidemiological data. Moreover, local health facilities’ functioning and efficiency will be studied. The article posits that the intervention and cooperation of international organizations with the local authorities becomes crucial to provide the local populations with their primary health needs. In Yemen, the majority of fatal cholera cases were in the regions controlled by the Houthi rebels, not officially accredited by the International Community. Similarly, the polio outbreak in Syria primarily affected the areas not controlled by the Syrian Arab Republic forces, recognized as the leading interlocutor by the WHO. The jeopardized possibilities to access these countries have been pivotal to the determining the problem in controlling sanitation-related and vaccine preventable diseases. This represents a potential threat to global health.

Keywords: health in conflict-affected areas, cholera, polio, Yemen, Syria, glocalization

Procedia PDF Downloads 137

Authors: Michiko Miyamoto

Abstract:

The market for "functional foods" and "foods with functional claims" that are effective in maintaining and improving health, has expanded year by year due to the entry of major food and beverage manufacturers following the introduction of the specified health food system in 1991 in Japan. To bring health claims related products or services to the market, it is necessary to let consumers to learn about these products or services; an effective marketing through advertising are important. This research proposes a framework for an effective advertisement medium for the food supplement industry by using survey data of 2,500 people.

Keywords: functional foods, dietary supplements, marketing strategy, structural equation modeling

Procedia PDF Downloads 148

Authors: Sahar El Shair, Laura Greco, William Reay, Murray Cairns

Abstract:

Background: Rheumatoid arthritis (RA) is a chronic, systematic, inflammatory, autoimmune disease that involves damages to joints and erosions to the associated bones and cartilage, resulting in reduced physical function and disability. RA is a multifactorial disorder influenced by heterogenous genetic and environmental factors. Whilst different medications have proven successful in reducing inflammation associated with RA, they often come with significant side effects and limited efficacy. To address this, the novel pharmagenic enrichment score (PES) algorithm was tested in self-reported RA patients from the UK Biobank (UKBB), which is a cohort of predominantly European ancestry, and identified individuals with a high genetic risk in clinically actionable biological pathways to identify novel opportunities for precision interventions and drug repurposing to treat RA. Methods and materials: Genetic association data for rheumatoid arthritis was derived from publicly available genome-wide association studies (GWAS) summary statistics (N=97173). The PES framework exploits competitive gene set enrichment to identify pathways that are associated with RA to explore novel treatment opportunities. This data is then integrated into WebGestalt, Drug Interaction database (DGIdb) and DrugBank databases to identify existing compounds with existing use or potential for repurposed use. The PES for each of these candidates was then profiled in individuals with RA in the UKBB (Ncases = 3,719, Ncontrols = 333,160). Results A total of 209 pathways with known drug targets after multiple testing correction were identified. Several pathways, including interferon gamma signaling and TID pathway (which relates to a chaperone that modulates interferon signaling), were significantly associated with self-reported RA in the UKBB when adjusting for age, sex, assessment centre month and location, RA polygenic risk and 10 principal components. These pathways have a major role in RA pathogenesis, including autoimmune attacks against certain citrullinated proteins, synovial inflammation, and bone loss. Encouragingly, many also relate to the mechanism of action of existing RA medications. The analyses also revealed statistically significant association between RA polygenic scores and self-reported RA with individual PES scorings, highlighting the potential utility of the PES algorithm in uncovering additional genetic insights that could aid in the identification of individuals at risk for RA and provide opportunities for more targeted interventions. Conclusions In this study, pharmacologically annotated genetic risk was explored through the PES framework to overcome inter-individual heterogeneity and enable precision drug repurposing in RA. The results showed a statistically significant association between RA polygenic scores and self-reported RA and individual PES scorings for 3,719 RA patients. Interestingly, several enriched PES pathways were targeted by already approved RA drugs. In addition, the analysis revealed genetically supported drug repurposing opportunities for future treatment of RA with a relatively safe profile.

Keywords: rheumatoid arthritis, precision medicine, drug repurposing, system biology, bioinformatics

Procedia PDF Downloads 78