Search results for: adult ADHD

Authors: Ola Abdel-Tawab Hussein

Abstract:

Background: Boron is a naturally occurring agent and an essential trace element of human, animals and higher plants. It is released in the form of boric acid (BA) that is water soluble and biolologically available. Its largest uses are in glass, detergents, agriculture, leather tanning industries, cosmetics, photographic materials, soaps and cleaners. Human consume daily few milligrams in the water, fruits and vegetables. High doses of boron had been recorded to be developmental and reproductive toxin in animals(Only few studies on human had investigated the health effects associated with exposure to boron. Vitamin C is a major water soluble non-enzymatic antioxidant, acts to overcome the oxidative stress. Aim of the work: However , the liver is exposed to toxic substances that are absorbed, degraded or conjugated there were little information exists about the effects of boron that it would specifically have in the liver tissue of experimental rats. So the present work aimed to study the effects of long-term boron ingestion on histological structural of the liver of adult male albino rats and to evaluate the protective role of vitamin C against induced changes. Material and Methods: 30 adult male albino rats were divided into 3 equal groups; Group I: control, Group II: recieved drinking water containing 55x10-6 gm boron/liter for 90 days and Group III: recieved vitamin C (200mg/Kg.B.W) orally concomitant with boron for the same period. liver specimens were processed for light and electron microscopic(TEM) study. Results: Examination of the liver sections of group II revealed foci of severe dilatation and congestion of central and portal veins with mononuclear cellular infiltration and hepatocellular vacuolation. Increased collagen deposition specially around the portal areas. Marked electrolucent areas in the cytoplasm, heterochromatic nuclei and destroyed organelles of the hepatocytes. Apoptotic cells were observed and decreased lipid content of ito cells. In Group III the co administration of vitamin C improved most of the structural changes of the hepatocytes, Ito cells, increased binucleated cells and decreased collagen fibers deposition. Conclusion: Thus, the long term exposure to boron, induced histological changes on the structure of liver. The co administration of vitamin C improved most of these structural changes.

Keywords: boron, liver, vitamin C, rats

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Authors: Adnan A. E. Darwish

Abstract:

The predatory potential and preference of both larvae and adult of seven-spot ladybird, Coccinella septempunctata Linnaeus and the eleven-spot ladybird, Coccinella undecimpunctata Linnaeus to the green peach aphid, Myzus persicae (Sulzer), the cotton aphid, Aphis gossypii Glover, the bird cherry-oat aphid, Rhopalosiphum padi (Linnaeus) and onion thrips, Thrips tabaci Lindeman were investigated under laboratory conditions at varying prey densities at faculty of Agriculture, Damanhour university, Egypt. There were significant differences between the consumed numbers of the four different species by the two different lady beetle species. The most consumed prey by C. septempunctata was the A. gossypii followed by R. padi then M. persicae and finally T. tabaci and these results were repeated in case of C. undecimpunctata. As the grubs of C. septempunctata and C. undecimpunctata developed from 1st to 4th larval instars, the consumption rate from aphid species and thrips increased. The consumption rate of M. persicae, A. gossypii, R. padi and T. tabaci significantly increased with the advancement in the larval stage of the predator. The forth larval instar of C. septempunctata and C. undecimpunctata exhibited the highest predatory potential comparing to the first, second and third larval instars. The number of prey eaten by adult stage or different instars of larvae of the two predators increased significantly with prey density, reaching the maximum value when 150 preys were provided compared with 50 and 100 preys.

Keywords: predatory potential, Coccinella septempunctata, Coccinella undecimpunctata, Thrips tabaci, Myzus persicae, Aphis gossypii, Rhopalosiphum padi

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Authors: Victoria Adamu Pam, Victor Ameh Adejoh, Akwashiki Ombugadu

Abstract:

The prevalence of gastrointestinal parasites of ruminant has been on the increase leading to great economic and production losses with more fatal cases occurring in developing countries. This study was conducted to investigate and provide data on the prevalence and impact of haemo and gastro intestinal parasites of small ruminants in Akwanga LGA of Nasarawa State. One hundred fecal and blood samples were collected from goats and sheep. The fecal and blood samples were examined using floatation method and thin blood smear method respectively. Four gastro intestinal parasites were identified in the study, these are; Strongyloides spp, Paramphistome spp, Coccidia spp and Moniezia spp. while 2 heamo parasites were identified; Babesia spp. and Anaplasma spp. The most prevalent gastro intestinal parasite encountered was Strongyloide pp with 48(64.86%) and 48(77.42%) in sheep and goat respectively. This is followed by Paramphistome spp with 18(24.32%) in sheep only. The least prevalent was Coccidia spp with 8(10.8%) in sheep and Moniezia spp with 2 (3.23%) in goats. The most prevalent heamo parasites was Babesia spp with 10(71.43%) and 10(100.00%) in sheep and goat respectively while the least prevalent was Anaplasma spp with 4(28.57%) in sheep only. Statistically, there is no significant difference between haemo and gastrointestinal parasites of sheep and goats in the study area. (P > 0.05). The prevalence of gastrointestinal and haemo parasites in relation to sex showed that female had the highest prevalence of 50% than in the male 2.00% while In relation to age the prevalence was higher in adult 58% than in the Young 2.00%. Statistically, there is a significant difference (P < 0.05) between adult and young. The study indicates that parasitic infections are prevalent in ruminants in the study area.

Keywords: akwanga, gastrointestinal, haemo, parasites

Procedia PDF Downloads 175

Authors: Arefeh Sabzipour

Abstract:

In the present work, the effect of Lepidium meyenii on viability, motility, and sperm morphology in the treatment of infertility of adult male Wistar rats was evaluated. 21 male Wistar rats were adopted, fed and brought up in the same conditions to reach the weight of 230±5 g. after that, they were randomly divided into three groups, including two experimental groups and one control group, each group consisted of 7 rates. Lepidium meyenii was extracted and pulverized. Mice in the control group were treated with distilled water, and experimental groups were gavage with alcoholic juice extracted from Lepidium meyenii once a day for 10 consecutive days. After rates were killed, the testes were isolated. Different parameters includes semen volume in mice, sperm count, sperm motility, morphology, and viability, were evaluated. The results shows that sperm motility and sperm survival indices were significantly different between groups, and sperm count and sperm morphology indices were not significantly different. Sperm motility index in intervention group 1 was equal to 77.00±2.499 and was significantly higher than the one in intervention group two (70.14±3.579, P=0.018) and control group (69.43 ±7.323, P=0.018). Sperm survival index was 91.14 ± 2.410 in intervention group 1, 79.43± 5.062 in intervention group 2, and 76.71.6.651 in the control group (P<0.001). Based on the results of the present study, Lepidium meyenii had great effect on improving sperm indices of mice, especially sperm motility index and sperm survival index. Sperm count index and sperm morphology index, although increased, were not statistically significant.

Keywords: infertility, lepidium, sperm morphology, sperm survival

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Authors: Hala Hzam Al Otaibi

Abstract:

Background: Obesity is more common among Saudi women compared to men, with 75–88% of adult women suffering from overweight or obesity and most of them married. Weight status and body appreciation are an important factor in maintaining or loss weight behaviors and for husbands satisfaction. Aims: To assess weight status, body appreciation and related factors, including age, level of education, occupation status husbands satisfaction in adult women. Methods: A cross-sectional study conducted among 326 married women, aged 18 to 60 years old in Eastern of Saudi Arabia. Data were collected by face to face interview, height and weight were measured to calculate body mass index (BMI). Body Appreciation Scale (BAS) and husbands satisfied were evaluated through questioning. Results: The majority of women has a university education, not employed and less than 40 years old (66.5%, 69.9%, 67.5%; respectively). Fifty-four percent of women overweight/obese and the rest were normal weight, BAS mean score was lower in younger women (>40 years) 7.39+2.20 and obese women (6.83+2.16) which is reflected lower body appreciation. Husbands' satisfaction regarding the weight status shows 47.6% of normal weight believed their husbands were dissatisfied with their weight and consider them as overweight/obese, 28.3% of overweight/obese thought their husbands satisfied with their weight and consider them as normal weight. Body appreciation correlated with age (r.139,p<0.05) and no correlation found for level of education and employed status. Husbands satisfaction strongly correlated with body appreciation (r.189,p<0.01) and weight status (r .570,p <0.01). Conclusion: Our findings indicate that women had a low body appreciation related to age, weight status and husbands' dissatisfaction. Future interventions aimed to weight reduction, it is important to consider husband satisfaction, as well as we need more assessment of weight satisfaction in younger women.

Keywords: body appreciation, husbands satisfaction, weight status, women

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Authors: Jeremy Dixon

Abstract:

Safeguarding adults forms a core part of social work practice. The Government in England and Wales has made efforts to standardise practices through The Care Act 2014. The Act states that local authorities have duties to make inquiries in cases where an adult with care or support needs is experiencing or at risk of abuse and is unable to protect themselves from abuse or neglect. Despite the importance given to safeguarding adults within law there remains little research about how social workers conduct such decisions on the ground. This presentation reports on findings from a pilot research study conducted within two social work teams in a Local Authority in England. The objective of the project was to find out how social workers interpreted safeguarding duties as laid out by The Care Act 2014 with a particular focus on how workers assessed and managed risk. Ethnographic research methods were used throughout the project. This paper focusses specifically on decisions made by workers in the assessment team. The paper reports on qualitative observation and interviews with five workers within this team. Drawing on governmentality theory, this paper analyses the techniques used by workers to manage risk from a distance. A high proportion of safeguarding referrals came from care workers or managers in residential care homes. Social workers conducting safeguarding assessments were aware that they had a duty to work in partnership with these agencies. However, their duty to safeguard adults also meant that they needed to view them as potential abusers. In making judgments about when it was proportionate to refer for a safeguarding assessment workers drew on a number of common beliefs about residential care workers which were then tested in conversations with them. Social workers held the belief that residential homes acted defensively, leading them to report any accident or danger. Social workers therefore encouraged residential workers to consider whether statutory criteria had been met and to use their own procedures to manage risk. In addition social workers carried out an assessment of the workers’ motives; specifically whether they were using safeguarding procedures as a shortcut for avoiding other assessments or as a means of accessing extra resources. Where potential abuse was identified social workers encouraged residential homes to use disciplinary policies as a means of isolating and managing risk. The study has implications for understanding risk within social work practice. It shows that whilst social workers use law to govern individuals, these laws are interpreted against cultural values. Additionally they also draw on assumptions about the culture of others.

Keywords: adult safeguarding, governmentality, risk, risk assessment

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Authors: Arefeh Sabzipour

Abstract:

In the present work, the effect of Lepidium meyenii on viability, motility, and sperm morphology in the treatment of infertility of adult male Wistar rats was evaluated. 21 male Wistar rats were adopted, fed and brought up in the same conditions to reach the weight of 230±5 g. after that, they were randomly divided into three groups, including two experimental groups and one control group, each group consisted of 7 rates. Lepidium meyenii was extracted and pulverized. Mice in the control group were treated with distilled water, and experimental groups were gavage with alcoholic juice extracted from Lepidium meyenii once a day for 10 consecutive days. After rates were killed, the testes were isolated. Different parameters includes semen volume in mice, sperm count, sperm motility, morphology, and viability, were evaluated. The results shows that sperm motility and sperm survival indices were significantly different between groups, and sperm count and sperm morphology indices were not significantly different. Sperm motility index in intervention group 1 was equal to 77.00±2.499 and was significantly higher than the one in intervention group two (70.14±3.579, P=0.018) and control group (69.43 ±7.323, P=0.018). Sperm survival index was 91.14 ± 2.410 in intervention group 1, 79.43± 5.062 in intervention group 2, and 76.71.6.651 in the control group (P<0.001). Based on the results of the present study, Lepidium meyenii had great effect on improving sperm indices of mice, especially sperm motility index and sperm survival index. Sperm count index and sperm morphology index, although increased, were not statistically significant.

Keywords: infertility, lepidium meyenii, sperm morphology, sperm survival

Procedia PDF Downloads 80

Authors: Arefeh Sabzipour

Abstract:

In the present work, the effect of Lepidium meyenii on viability, motility, and sperm morphology in the treatment of infertility of adult male Wistar rats was evaluated. 21 male Wistar rats were adopted, fed and brought up in the same conditions to reach the weight of 230±5 g. after that they were randomly divided into three groups including two experimental groups and one control group, each group consisted of 7 rates. Lepidium meyenii was extracted and pulverized. Mice in the control group were treated with distilled water and experimental groups were gavage with alcoholic juice extracted from Lepidium meyenii once a day for 10 consecutive days. After rates were killed, the testes were isolated. Different parameters includes semen volume in mice, sperm count, sperm motility, morphology, and viability were evaluated. The results shows that sperm motility and sperm survival indices were significantly different between groups and sperm count and sperm morphology indices were not significantly different. Sperm motility index in intervention group 1 was equal to 77.00±2.499 and was significantly higher than the one in intervention group two (70.14±3.579, P=0.018) and control group (69.43 ±7.323, P=0.018). Sperm survival index was 91.14 ± 2.410 in intervention group 1, 79.43± 5.062 in intervention group 2, and 76.71.6.651 in control group (P<0.001). Based on the results of the present study, Lepidium meyenii had great effect on improving sperm indices of mice, especially sperm motility index and sperm survival index. Sperm count index and sperm morphology index, although increased, were not statistically significant.

Keywords: infertility, Lepidium meyenii, sperm morphology, sperm survival

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Authors: Rachna Agarwal, R. Naveen, Darpan Thakre, Rohit Shahi, Maryam Abbasi, Upendra Rathore, Latika Gupta

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Aim: Retinal changes are the window to systemic vasculature. Therefore, we explored retinal changes in patients with idiopathic inflammatory myopathies (IIM) as a surrogate for vascular health. Methods: Adult and juvenile IIM patients visiting a tertiary care centre in 2021 satisfying the International Myositis Classification Criteria were enrolled for detailed ophthalmic examination in comparison with healthy controls (HC). Patients with conditions that precluded thorough posterior chamber examination were excluded. Scale variables are expressed as median (IQR). Multivariate analysis (binary logistic regression-BLR) was conducted, adjusting for age, gender, and comorbidities besides factors significant in univariate analysis. Results: 43 patients with IIM [31 females; age 36 (23-45) years; disease duration 5.5 (2-12) months] were enrolled for participation. DM (44%) was the most common diagnosis. IIM patients exhibited frequent attenuation of retinal vessels (32.6% vs. 4.3%, p <0.001), AV nicking (14% vs. 2.2%, p=0.053), and vascular tortuosity (18.6% vs. 2.2%, p=0.012), besides decreased visual acuity (53.5% vs. 10.9%, p<0.001) and immature cataracts (34.9% vs. 2.2%, p<0.001). Attenuation of vessels [OR 10.9 (1.7-71), p=0.004] emerged as significantly different from HC after adjusting for covariates in BLR. Notably, adults with IIM were more predisposed to retinal abnormalities [21 (57%) vs. 1 (16%), p=0.068], especially attenuation of vessels [14(38%) vs. 0(0), p=0.067] than jIIM. However, no difference was found in retinal features amongst the subtypes of adult IIM, nor did they correlate with MDAAT, MDI, or HAQ-DI. Conclusion: Retinal microvasculopathy and diminution of vision occur in nearly one-third to half of the patients with IIM. Microvasculopathy occurs across subtypes of IIM, and more so in adults, calling for further investigation as a surrogate for damage assessment and potentially even systemic vascular health.

Keywords: idiopathic inflammatory myopathies, vascular health, retinal microvasculopathy, arterial attenuation

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Authors: Mehdi Abbasi, Shadan Navid, Mohammad Pourahmadi, M. Majidi Zolbin

Abstract:

We have recently reported that melatonin as antioxidant enhances the efficacy of colonization of spermatogonial stem cells (SSCs). Melatonin as an antioxidant plays a vital role in the development of SSCs in vitro. This study aimed to investigate evaluation of sertoli cells and melatonin simultaneously on SSC proliferation following transplantation to testis of adult mouse busulfan-treated azoospermia model. SSCs and sertoli cells were isolated from the testes of three to six-day old male mice.To determine the purity, Flow cytometry technique using PLZF antibody were evaluated. Isolated testicular cells were cultured in αMEM medium in the absence (control group) or presence (experimental group) of sertoli cells and melatonin extract for 2 weeks. We then transplanted SSCs by injection into the azoospermia mice model. Higher viability, proliferation, and Id4, Plzf, expression were observed in the presence of simultaneous sertoli cells and melatonin in vitro. Moreover, immunocytochemistry results showed higher Oct4 expression in this group. Eight weeks after transplantation, injected cells were localized at the base of seminiferous tubules in the recipient testes. The number of spermatogonia and the weight of testis were higher in the experimental group relative to control group. The results of our study suggest that this new protocol can increase the transplantation of these cells can be useful in the treatment of male infertility.

Keywords: colonization, melatonin, spermatogonial stem cell, transplantation

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Authors: Mangala Kohli, P. A. Athira, Reeha Mahajan

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The subthalamic nucleus (STN) is a biconvex nucleus situated in the diencephalon. The knowledge of the morphometry of the subthalamic nucleus is essential for accurate targeting of the nucleus during Deep Brain Stimulation. The present study aims to note the morphometry of the subthalamic nucleus in both the cerebral hemispheres which will prove to be of great value to radiologists and neurosurgeons. A cross‐sectional observational study was conducted in the Departments of Anatomy and Forensic Medicine, Lady Hardinge Medical College & Associated Hospitals, New Delhi on thirty adult cadaveric brain specimens of unclaimed and donated corpses. The specimens were categorized into 3 age groups: 20-35, 35-50 and above 50 years. All samples were collected after following the standard protocol for ethical clearance. The morphometric study of 60 subthalamic nucleus was thus conducted. Transverse section of the brain was made at a plane 4mm ventral to the plane containing mid commissural point. The dimensions of the subthalamic nucleus were measured bilaterally with the aid of digital Vernier caliper and magnifying glass. In the present study, the mean length and width and AC-PC length of the subthalamic nucleus was recorded on the right and left side in Group A, B and C. On comparison of mean of subthalamic nucleus dimensions between the right and left side in Group C, no statistically significant difference was observed. The length and width of subthalamic nucleus measured in the 3 age groups were compared with each other and the p value calculated. There was no statistically significant difference between the dimensions of Group A and B, Group B and C as well as Group A and C. The present study reveals that there is no significant reduction in the size of the nucleus was noted with increasing age. Thus, the values obtained in the present study can be used as a reference for various invasive and non-invasive procedures on subthalamic nucleus.

Keywords: cerebral hemisphere, deep brain stimulation, morphometry, subthalamic nucleus

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Authors: Vaishali Chaurasia

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Ageing is the universal phenomenon that is associated with deteriorating health status. As the human becomes old, certain changes take place in an organism leading to morbidities, disabilities, and event death. Furthermore, older people are more vulnerable for the various kinds of diseases and health problem. Due to the some unhealthy conventions like smoking, drinking and unhealthy foods is the genesis of the lifestyle diseases. These diseases associated with the way a person or group of people lives. The main purpose of the study is to determine the prevalence of lifestyle diseases and its association with physical activity as well as the risk factors associated with it among the adult population in India. Longitudinal Aging Study in India and Study on Global Aging and Adult Health in India were used in the study. We will take population aged 50 and older, began in 1935, and regularly refreshed at younger ages with new birth cohorts. Life style diseases are more prominent in 65+ age group. The study finds an association between prevalence of life style diseases and life style risk factors. The lifestyle disease prevalence is more among higher age group people, female, richest quintile, and doing lesser physical activity. A higher prevalence of lifestyle diseases associated with the multiple risk factors. The occurrence of three and four risk factors was more prevalent in India. The frequency of different type of life style disease is higher among those who hardly or never do any physical activity as compare to those who do physical activity every day. The pattern remains the same in Moderate as well as vigorous physical activity. Those who are regularly doing physical activities have lesser percentage of having any disease and those who hardly ever or never do any physical activities and equally involve with some risk factors have higher percentage of having all type of diseases.

Keywords: lifestyle disease, morbidity, disability, physical activity

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Authors: Zaralyn Bernardo, Dante Boac, Annabelle Del Rosario

Abstract:

Professional individuals who are in a primary role to impart learning with the new generation are alarmingly tend to have a vast decrease in their workforce due to stress at work. Thus, the study used mixed method research design to explore the ideal and actual coping patterns of college school teachers, both private and public, using Coping Response Inventory-Adult (CRI-Adult). It was suggested that in order for coping to be effective there must be a congruence or good match between coping efforts and preferred coping style. Results basically provided the same information on sources of teacher stress. However, workload and low salary were more likely heightened, for public and private school, respectively. There is also a significant difference between the ideal and actual coping style of college school teachers. Though the public school teachers leaned towards problem-focused as their ideal way of coping, both public and private teachers are somewhat inclined to use emotion-focused coping in actual situation. Results of FGD identified the factors that contribute to the incongruence or mismatch in their preferred style of coping and actual efforts to cope. Identified factors based on thematic analysis (TA) are clustered into themes such as affectivity and rehearsal of the preferred coping responses, sensitivity to pressure impairs coping efficacy, seeking for social acceptance and approval, indefinite appraisal of perceived stress, emotional dysregulation, and impulsivity, immediate desire to terminate negative emotion and adversity. Most of the factors somewhat provide partial elucidation on the engagement of the respondents on emotion-focused coping.

Keywords: coping responses subtypes, appraisal, teacher stress, ideal and actual coping

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Authors: Riin Seema

Abstract:

Guidance and counseling as a whole-school responsibility is a global trend. Counseling is a specific competence, that consist of cognitive, emotional, attitudinal, and behavioral components. To authors best knowledge, there are no self-assessment scales for teachers in the whole world to measure teachers’ counseling competency. In 2016 an Estonian scale on teachers counseling competence was developed during an Interdisciplinary Project at Tallinn University. The team consisted of 10 interdisciplinary students (psychology, nursery school, special and adult education) and their supervisor. In 2017 another international Interdisciplinary Project was carried out for adapting the scale in English for international students. Firstly, the Estonian scale was translated by 2 professional translators, and then a group of international Erasmus students (again from psychology, nursery school, special and adult education) selected the most suitable translation for the scale. The developed ‘Teacher’s Counselling Competence Self-Efficacy Scale’ measures teacher’s self-efficacy beliefs in their own competence to perform different counseling tasks (creating a counseling relationship, using different reflection techniques, etc.). The scale consists of 47 questions in a 5-point numeric scale. The scale is created based on counseling theory and scale development and validation theory. The scale has been used as a teaching and learning material for counseling courses by 174 Estonian and 10 international student teachers. After filling out the scale, the students also reflected on the scale and their own counseling competencies. The study showed that the scale is unidimensional and has an excellent Cronbach alpha coefficient. Student’s qualitative feedback on the scale has been very positive, as the scale supports their self-reflection. In conclusion, the developed ‘Teacher’s Counselling Competence Self-Efficacy Scale’ is a useful tool for supporting student teachers’ learning.

Keywords: competency, counseling, self-efficacy, teacher students

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Authors: Adama NS Bah

Abstract:

Background: Loss of teeth has a negative influence on essential oral functions such as phonetics, mastication, and aesthetics. Dentists treat people with prosthodontic rehabilitation to recover essential oral functions. The oral health quality of life inventory reflects the success of prosthodontic rehabilitation. In many countries, the current conventional care delivered to replace missing teeth for adult patients involves the provision of removable partial dentures. Aim: The aim of this systematic review and meta-analysis is to gather the best available evidence to determine patients’ oral health-related quality of life improvement after treatment with partial dentures. Methods: We searched electronic databases from January 2010 to September 2019, including PubMed, ProQuest, Science Direct, Scopus and Google Scholar. In this paper, studies were included only if the average age was 30 years and above and also published in English. Two reviewers independently screened and selected all the references based on inclusion criteria using the PRISMA guideline, and assessed the quality of the included references using the Joanna Briggs Institute quality assessment tools. Data extracted were analyzed in RevMan 5.0 software, the heterogeneity between the studies was assessed using Forest plot, I2 statistics and chi-square test with a statistical P value less than 0.05 to indicate statistical significance. Random effect models were used in case of moderate or high heterogeneity. Four studies were included in the systematic review and three studies were pooled for meta-analysis. Results: Four studies included in the systematic review and three studies included in the meta-analysis with a total of 285 patients comparing the improvement in oral health-related quality of life before and after rehabilitation with partial denture, the pooled results showed a better improvement of oral health-related quality of life after treatment with partial dentures (mean difference 5.25; 95% CI [3.81, 6.68], p < 0.00001) favoring the wearing of partial dentures. In order to ascertain the reliability of the included studies for meta-analysis risk of bias was assessed and found to be low in all included studies for meta-analysis using the Cochrane collaboration tool for risk of bias assessment. Conclusion: There is high evidence that rehabilitation with partial dentures can improve the patient’s oral health-related quality of life measured with Oral Health Impact Profile 14. This review has clinical evidence value for dentists treating the expanding vulnerable adult population.

Keywords: meta-analysis, oral health impact profile, partial dentures, systematic review

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Authors: Amit Zriker, Anat Freund

Abstract:

The aim of the study was to conduct a thorough examination into the multiple complexities of bringing a foreign caregiver into the home to care for older adults in the Haredi society, by relating to the perspectives of the older adult and his family members. Research questions were: What is the meaning of bringing a foreign caregiver into the home in Haredi society, from the point of view of the older adult’s family members, and what are the implications of these meanings in the context of developing social policies and interventions? The current study was a qualitative-phenomenological study, which relates to “the lived experience” of those involved in the studied phenomenon. In the framework of the study, the participants included 15 adult Haredi sons and daughters of elderly impaired parents who receive homecare from a foreign caregiver. Data collection was carried out using in-depth, semi-structured interviews; the interview guidelines are comprised of the following content worlds: the meanings of aging in Haredi families; the decision-making process in relation to providing home care assistance for elderly impaired parents; making decisions regarding bringing a foreign caregiver into the home to care for an elderly parent; the daily routine after bringing in a foreign caregiver; bringing in a foreign caregiver vs. the society and vs. the Haredi establishment; and more. The issue of bringing a foreign caregiver into the home in the context of a faith-based society has received only scant and partial research attention to date. Nevertheless, in light of the growing elderly population in the Haredi society in Israel, and in closed, faith-based societies, in general; there is a growing need to bring foreign caregivers into the home as a possible solution to the “aging-in-place” problem in these societies. The separatist nature, and the collectivist and faith-based lifestyle of the Haredi society present unique challenges and needs in the process of employing a foreign caregiver. Moreover, the foreign caregiver also brings his/her own cultural world to the encounter, meaning, this process involves the elderly impaired individual, his/her family members, as well as the foreign caregiver. Therefore, it is important to understand their attitudes, perceptions and interactions, in order to create a good fit among all involved parties. The innovation and uniqueness of the current study is in its in-depth exploration of a phenomenon through an emotional-cultural lens. The study findings also contribute to the creation of social policy in the field of nursing, which will be adapted and culturally sensitive to Haredi society, and other faith-based societies.

Keywords: culturally-sensitive intervention, faith-based society, foreign caregiver, Haredi society

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Authors: Papai Barman, Harihar Sahoo

Abstract:

With increasing life expectancy, urbanization, and adult out migration, elder people live without adult child and most of time responsible for grandchild caring while the care is needed for them. On this line, the current study examined the association between grandchild caring (GCC) with different household structures and depression among elderly (60+) grandparents (GP) living in India using Longitudinal Aging Study in India (LASI), 2017-18. HH structure was defined as the skipped-generation household (SGH) where GP and GC lived together without middle generation and the multi-generation household (MGH) where more than two generations lived together. GCC was defined by two categories, compulsive and non-compulsive caring. CES-D depression scale was utilized to measure GP’s mental health. Socio-economic characteristics, chronic diseases, and health behavior were controlled to get the effect of HH structure and GCC considered key explanatory variables. Bivariate analyses showed that the prevalence of elderly lived in SGH in India (2.5%). Prevalence of compulsive caring was found 16.3% in MGH and 51.1% in SGH. Prevalence of depressions was found nearly 37.1 and 49.5% among the GPs responsible for GCC in MGH and SGH, respectively. Using Biprobit and margins results, GPs lived in SGH were 0.40 times (dy/dx=0.40, p<0.001) more likely to report depression than GPs lived in MGH, given the condition on compulsive caring. Ensuring SDG goal-3, health aging, and giving more social security to the elder people responsible for caring while they are needed care at later life, the current study may improve the existing knowledge and help policy makers to make an intervention on this most vulnerable people, especially for the elderly people living in SGH and responsible for caring.

Keywords: household structure, grandchild caring, skipped-generation household, multi-generation household, depression, mental health, India

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Authors: Agumah N. B. Orji, M. U., Oru C. M., Ugbo, E. N., Onwuliri E. A Nwakaeze, E. A.,

Abstract:

ERG11 gene has been reported to be one of the genes whose expression is responsible for resistance of Candida to various triazole drugs, which are first line treatment for candidiasis. This study was carried out to determine the prevalence of Triazole (Fluconazole and voriconazole) resistant Candida albicans expressing ERG11 gene from adult females in Abakaliki. Urine and vaginal swab samples were randomly collected from volunteers after obtaining their consent to participate in the study. A total of 565 adult females participated in the study. A total of 340 urine specimens and 288 vaginal swab specimens were collected. Direct wet mount technique, as well as culture in Trichomonas broth, were used to examine the urine and vaginal swab specimens for the presence of motile Trichomonads. The Trichomonas broth used was selective for both T. vaginalis and C. albicans. Broths that yielded budding yeast cells after microscopy were subcultured on to Sabouraud dextrose agar, after which Germ tube test was carried out to confirm the presence of C. albicans. Biochemical tests, including carbohydrate fermentation and urease utilization, were also performed. Antibiogram of C. albicans isolates obtained from this study was carried out using commercially available azole drugs. Fluconazole and voriconazole were selected as Triazole drugs used for this study. Nystatin was used as a tangential control. An MIC test was carried out with E-strips on some of the resistant C. albicans isolates A total of 6 isolates that resisted all the azole drugs were selected and screened for the presence of ERG11 gene using Reverse transcriptase polymerase chain reaction technique. The total prevalence recorded for C. albicans was 13.0%. Frequency was statistically higher in Pregnant (7.96%) than non pregnant (5.09%) volunteers (X2=0.94 at P=0.05). With respect to clinical samples, frequency was higher in vaginal swabs samples (7.96%) than Urine samples (5.09%) (X2=9.05 at P=0.05). Volunteers within the age group 26-30 years recorded the highest prevalence (4.46%), while those within the age group 36-40 years recorded the lowest at 1.27%(X2=4.34 at P=0.05). In pregnant female participants, the highest frequency was recorded with those in their 3rd trimester (4.14%), while lowest incidence was recorded for those in their first trimester (0.80%). Antibiogram results from this study showed that C. albicans isolates obtained from this study resisted Fluconazole (72%) more than Voriconazole (57%). Only one out of the six selected isolates yielded resistance in the MIC test. Results obtained from the RT-PCR showed that there was no expression of ERG11 gene among the fluconazole resistant isolates of C. albicans. Observed resistance may be due to other factors other than expression of ERG11 gene.

Keywords: candida, ERG11, triazole, nigeria

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Authors: Deanne McArthur, Melinda Wall, Claire Hanlon, Dana Agnolin, Krista Davis, Melanie Dennis, Elizabeth Glidden, Anne Marie Smith, Claudette Thomson

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In Canada, as prevalence rates and severity of illness have increased among patients suffering from eating disorders, wait times have grown substantially. Patients in Canada often face wait times in excess of 12 months. It is known that delaying treatment for eating disorders contributes to poor patient outcomes and higher rates of symptom relapse. Improving interim services for adult patients awaiting outpatient treatment is a priority for an outpatient eating disorders clinic in Ontario, Canada. The clinical setting currently provides care for adults diagnosed with anorexia nervosa, bulimia nervosa and binge eating disorder. At present, the only support provided while patients are on the waitlist consists of communication with primary care providers regarding parameters for medical monitoring. The significance of this study will be to test the feasibility, acceptability and efficacy of an intervention to support adult patients awaiting outpatient eating disorder treatment for anorexia nervosa, bulimia nervosa and binge eating disorder. Methods: An intervention including psychoeducation, supportive resources, self-monitoring, and auxiliary referral will be pilot-tested with a group of patients in the summer of 2022 and detailed using a prospective cohort case study research design. The team will host patient focus groups in May 2022 to gather input informing the content of the intervention. The intervention will be pilot tested with newly-referred patients in June and July 2022. Patients who participate in the intervention will be asked to complete a survey evaluating the utility of the intervention and for suggestions, they may have for improvement. Preliminary findings describing the existing literature pertaining to waitlist interventions for patients with eating disorders, data gathered from the focus groups and early pilot testing results will be presented. Data analysis will continue throughout 2022 and early 2023 for follow-up publication and presentation in the summer of 2023. The aim of this study is to contribute to the body of knowledge pertaining to providing interim support to those patients waiting for treatment for eating disorders and, by extension, to improve outcomes for this population.

Keywords: eating disorders, waitlist management, intervention study, pilot test

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Authors: A. Goma Amira, U. E. Mahrous

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Measuring the effect of perinatal lead exposure on learning ability of offspring is considered as a sensitive and selective index for providing an early marker for central nervous system damage produced by this toxic metal. A total of 35 Sprague-Dawley adult rats were used to investigate the effect of lead acetate toxicity on behavioral patterns of adult female rats and learning ability of offspring. Rats were allotted into 4 groups, group one received 1g/l lead acetate (n=10), group two received 1.5g/l lead acetate (n=10), group three received 2g/l lead acetate in drinking water (n=10), and control group did not receive lead acetate (n=5) from 8th day of pregnancy till weaning of pups. The obtained results revealed a dose-dependent increase in the feeding time, drinking frequency, licking frequency, scratching frequency, licking litters, nest building, and retrieving frequencies, while standing time increased significantly in rats treated with 1.5g/l lead acetate than other treated groups and control. On the contrary, lying time decreased gradually in a dose-dependent manner. Moreover, movement activities were higher in rats treated with 1g/l lead acetate than other treated groups and control. Furthermore, time spent in closed arms was significantly lower in rats given 2g/l lead acetate than other treated groups, while they spent significantly much time spent in open arms than other treated groups which could be attributed to occurrence of adaptation. Furthermore, number of entries in open arms was-dose dependent. However, the ratio between open/closed arms revealed a significant decrease in rats treated with 2g/l lead acetate than the control group.

Keywords: lead toxicity, rats, learning ability, behavior

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Authors: Bedilu Tafesse

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Conservation of crop genetic resources presents a challenge of identifying specific determinants driving maintenance of diversity at farm and agroecosystems. The objectives of this study were to identify socioeconomic, market and agroecological determinants of farmers’ maintenance of wheat diversity at the household level and derive implications for policies in designing on-farm conservation programs. We assess wheat diversity at farm level using household survey data. A household decision making model is conceptualized using microeconomic theory to assess and identify factors influencing on-farm rice diversity. The model is then tested econometrically by using various factors affecting farmers’ variety choice and diversity decisions. The findings show that household-specific socioeconomic, agroecological and market factors are important in determining on-farm wheat diversity. The significant variables in explaining richness and evenness of wheat diversity include distance to the nearest market, subsistence ratio, modern variety sold, land types and adult labour working in agriculture. The statistical signs of the factors determining wheat diversity are consistent in explaining the richness, dominance and evenness among rice varieties. Finally, the study implies that the cost-effective means of promoting and sustaining on-farm conservation programmes is to target them in market isolated geographic locations of high crop diversity where farm households have more heterogeneity of agroecological conditions and more active family adult labour working on-farm.

Keywords: diversity indices, dominance, evenness, on-farm conservation, wheat diversity, richness

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Authors: Ekin Ece Gürer, Tarık Onur Tiryaki, Sevgi Kalayoğlu Beşışık, Fatma Savran Oğuz, Uğur Sezerman, Fatma Erdem, Gülşen Günel, Dürdane Serap Kuruca, Zerrin Aktaş, Oral Öncül

Abstract:

Aim: Chemotherapytreatment in HodgkinLymphomaandNon-HodgkinLymphoma (NHL) diseasescausesgastrointestinalepithelialdamage, disruptstheintestinalmicrobiotabalanceandcausesdysbiosis. Inourstudy, it wasaimedtoshowtheeffect of thedamagecausedbychemotherapy on themicrobiotaandtheeffect of thechangingmicrobiota flora on thecourse of thedisease. Materials And Methods: Seven adult HL and seven adult HL patients to be treatedwithchemotherapywereincluded in the study. Stoolsamplesweretakentwice, beforechemotherapytreatmentandafterthe 3th course of treatment. SamplesweresequencedusingNextGenerationSequencing (NGS) methodafternucleicacidisolation. OTU tableswerepreparedusing NCBI blastnversion 2.0.12 accordingtothe NCBI general 16S bacterialtaxonomyreferencedated 10.08.2021. Thegenerated OTU tableswerecalculatedwith R Statistical Computer Language version 4.04 (readr, phyloseq, microbiome, vegan, descrand ggplot2 packages) to calculate Alpha diversityandtheirgraphicswerecreated. Statistical analyzeswerealsoperformedusing R Statistical Computer Language version 4.0.4 and studio IDE 1.4 (tidyverse, readr, xlsxand ggplot2 packages). Expression of IL-12 and IL-17 cytokineswasperformedbyrtPCRtwice, beforeandaftertreatment. Results: InHL patients, a significantdecreasewasobserved in themicrobiota flora of Ruminococcaceae_UCG-014 genus (p:0.036) andUndefined Ruminococcaceae_UCG-014 species (p:0.036) comparedtopre-treatment. When the post-treatment of HL patientswerecomparedwithhealthycontrols, a significantdecreasewasfound in themicrobiota of Prevotella_7 genus (p:0.049) andButyricimonas (p:0.006) in the post-treatmentmicrobiota of HL patients. InNHL patients, a significantdecreasewasobserved in themicrobiota flora of Coprococccus_3 genus (p:0.015) andUndefined Ruminoclostridium_5 (p:0.046) speciescomparedtopre-treatment. When post-treatment of NHL patientswerecomparedwithhealthycontrols, a significantabundance in theBacilliclass (p:0.029) and a significantdecrease in theUndefinedAlistipesspecies (p:0.047) wereobserved in the post-treatmentmicrobiota of NHL patients. While a decreasewasobserved in IL-12 cytokineexpressionuntilbeforetreatment, an increase in IL-17 cytokineexpressionwasdetected. Discussion: Intestinal flora monitoringafterchemotherapytreatmentshowsthat it can be a guide in thetreatment of thedisease. It is thoughtthatincreasingthediversity of commensalbacteria can alsopositivelyaffecttheprognosis of thedisease.

Keywords: hodgkin lymphoma, non-hodgkin, microbiota, cytokines

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Authors: Ezeugwunne Ifeoma Priscilla, Charles Chinedum Onyenekwe, Joseph Eberendu Ahaneku, Rosemary Adanma Analike, Adesuwa Peace Eidangbe

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This study was designed to assess the effect of malaria parasitaemia on serum reproductive hormone levels of asymptomatic HIV adult subjects. A total of 271 participants aged between 17 and 58 ears were conveniently recruited. 135 asymptomatic HIV-infected subjects participated in the study; 67 of them had malaria parasitaemia. 136 HIV seropositive control subjects, 68 of them had malaria parasitaemia. Blood samples were collected from the participants for the determination of HIV status by immunoassay and immunochromatography. Enzyme-linked immunosorbent assay (ELISA) was used to assay for serum LH, FSH, Estrogen, testosterone, progesterone, prolactin, and PSA levels, CD4+T cell counts by Cyflow method, thick and thin films determination of malaria parasitaemia count and density by WHO. Student's t-tests and ANOVA were used to compare means. P<0.05 was considered statistically significant. The results showed significant differences in serum levels of LH, FSH, PSA, estrogen, progesterone, and testosterone amongst the groups at P<0.05, respectively. The serum levels of LH, FSH, and PSA were significantly higher in malaria-infected asymptomatic HIV subjects than in asymptomatic HIV subjects with malaria parasitaemia (P<0.05 in each case). Also, the serum levels of LH, FSH, PSA, estrogen, and progesterone were significantly higher in malaria-infected asymptomatic HIV subjects compared with malaria-infected HIV seronegative subjects (P<0.05, respectively). The mean MP counts and MP density were significantly higher in asymptomatic HIV subjects compared to HIV seronegative subjects (P<0.05, in each case). The mean serum levels of testosterone were significantly lower in both malaria-infected and malaria uninfected HIV seronegative subjects (P<0.05, in each case). In conclusion, Malaria and HIV co-infection might increase the burden of hypogonadism as well as primary testicular failure, hyperprogesteronaemia, elevated levels of estrogen, and PSA in adult males asymptomatic HIV subjects.

Keywords: malaria parasitaemia, HIV, CD4, reproductive hormones

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Authors: Alex Kiselyov, Suehyun Cho, Darrell Harrington; Florent Cros, Olin Palmer, John Caputo, Michael Kardosh, Eran Oren, William Loudon, Michael Shpigelmacher

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Despite the most aggressive surgical and adjuvant therapeutic strategies, treatment of both pediatric and adult brainstem tumors remains problematic. Novel strategies, including targeted biologics, immunotherapy, and specialized delivery systems such as convection-enhanced delivery (CED), have been proposed. While some of these novel treatments are entering phase I trials, the field is still in need of treatment(s) that exhibits dramatically enhanced potency with optimal therapeutic ratio. Bionaut Labs has developed a modular microrobotic platform for performing localized delivery of diverse therapeutics in vivo. Our biocompatible particles (Bionauts™) are externally propelled and visualized in real-time. Bionauts™ are specifically designed to enhance the effect of radiation therapy via anatomically precise delivery of a radiosensitizing agent, as exemplified by temozolomide (TMZ) and Avastin™ to the brainstem gliomas of diverse origin. The treatment protocol is designed to furnish a better therapeutic outcome due to the localized (vs systemic) delivery of the drug to the neoplastic lesion(s) for use as a synergistic combination of radiation and radiosensitizing agent. In addition, the procedure is minimally invasive and is expected to be appropriate for both adult and pediatric patients. Current progress, including platform optimization, selection of the lead radiosensitizer as well as in vivo safety studies of the Bionauts™ in large animals, specifically the spine and the brain of porcine and ovine models, will be discussed.

Keywords: Bionaut, brainstem, glioma, local delivery, micro-robot, radiosensitizer

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Authors: Hanen Bouaziz-Ketata, Ghada Ben Salah, Hichem Ben Salah, Kamel Jamoussi, Najiba Zeghal

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The present study investigated the protective role of Hyparrhenia hirta on nitrate-induced liver damage. Experiments were carried out on adult rats divided into 3 groups, a control group and two treated groups. NaNO3 was administered daily by oral gavage at a dose of 400 mg/kg bw in treated groups either alone or coadministered with Hyparrhenia hirta methanolic extract via drinking water at a dose of 200 mg/kg bw for 50 days. Liver toxicity induced by NaNO3 was characterized by higher serum levels of glucose, total cholesterol and triglyceride and lower serum total protein than those of controls. Transaminases and lactate deshydrogenase activities in serum were elevated indicating hepatic cells’ damage after treatment with NaNO3. The hyperbilirubinemia and the increased serum gamma glutamyl transferase activities suggested the presence of cholestasis in NaNO3 exposed rats. In parallel, NaNO3 caused oxidant/antioxidant imbalance in the liver as reflected by the increased lipid peroxidation, the decreased total glutathione content and superoxide dismutase, catalase and glutathione peroxidase activities. Nitrate caused also a significant induction of DNA fragmentation as evidenced by the presence of a smear without ladder formation on agarose gel. Hyparrhenia hirta supplementation showed an improvement of all parameters cited above. We conclude that the present work provides ethnopharmacological relevance of Hyparrhenia hirta against the toxic effect of nitrate, suggesting its role as a potential antioxidant.

Keywords: Hyparrhenia hirta, liver, nitrate toxicity, oxidative stress, rat

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Authors: Teka Haile, Behailu Hawulte, Solomon Alemayehu

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Background: HIV virological failure still remains a problem in HV/AIDS treatment and care. This study aimed to describe the prevalence and identify the factors associated with viral non-suppression among HIV-positive adult patients on antiretroviral therapy in Woliso Town, Oromia, Ethiopia. Methods: A retrospective cross-sectional study was conducted among 424 HIV-positive patient’s attending antiretroviral therapy (ART) in Woliso Town during the period from August 25, 2020 to August 30, 2020. Data collected from patient medical records were entered into Epi Info version 2.3.2.1 and exported to SPSS version 21.0 for analysis. Logistic regression analysis was done to identify factors associated with viral load non-suppression, and statistical significance of odds ratios were declared using 95% confidence interval and p-value < 0.05. Results: A total of 424 patients were included in this study. The mean age (± SD) of the study participants was 39.88 (± 9.995) years. The prevalence of HIV viral load non-suppression was 55 (13.0%) with 95% CI (9.9-16.5). Second-line ART treatment regimen (Adjusted Odds Ratio (AOR) = 8.98, 95% Confidence Interval (CI): 2.64, 30.58) and routine viral load testing (AOR = 0.01, 95% CI: 0.001, 0.02) were significantly associated with virological non-suppression. Conclusion: Virological non-suppression was high, which hinders the achievement of the third global 95 target. The second-line regimen and routine viral load testing were significantly associated with virological non-suppression. It suggests the need to assess the effectiveness of antiretroviral drugs for epidemic control. It also clearly shows the need to decentralize third-line ART treatment for those patients in need.

Keywords: virological non-suppression, HIV-positive, ART, Woliso town, Ethiopia

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Authors: Nevila Bardhi, Joanna Magda, Kolapo Alex-Oni, Slavenka Sedlar, Paromita Hore

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The New York City Department of Health and Mental Hygiene (NYC DOHMH) receives blood lead test results for NYC residents and conducts lead poisoning case investigations for individuals with elevated blood lead levels exposed to lead occupationally and non-occupationally. To (1) improve participant engagement, (2) aid the identification of potential lead sources, and (3) better tailor recommendations to reduce lead exposure, Motivational Interviewing (MI) techniques were incorporated during risk assessment interviews of non-pregnant adults by DOHMH’s Adult Lead Poisoning Prevention (ALP) Program. MI is an evidence-based counselling method used in clinical settings that have been effective in promoting behavior change by resolving ambivalence and enhancing motivation in treating both physiological and psychological health conditions. The incorporation of MI techniques in the ALP risk assessment interview was effective in improving the identification of lead sources for non-pregnant adult cases, thus, allowing for the opportunity to better tailor lead poisoning prevention recommendations. The embedding of MI cues in the ALP risk assessment interview also significantly increased engagement in the interview process, resulting in approximately 50 more interviews conducted per year and a decrease in interview refusals during case investigations. Additionally, the pre-MI interview completion rate was 57%, while the post-MI Interview completion rate was 68%. We recommend MI techniques to be used by other lead poisoning prevention programs during lead poisoning investigations in similar diverse populations.

Keywords: lead poisoning prevention, motivational interviewing, behavior change, lead poisoning risk factors, self-efficacy

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Authors: Richard Vuijk, Arnoud Arntz

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Rationale: To our knowledge treatment of personality disorder comorbidity in adults with autism spectrum disorder (ASD) is understudied and is still in its infancy: We do not know if treatment of personality disorders may be applicable to adults with ASD. In particular, it is unknown whether patients with ASD benefit from experiential techniques that are part of schema therapy developed for the treatment of personality disorders. Objective: The aim of the study is to investigate the efficacy of a schema mode focused treatment with adult clients with ASD and comorbid personality pathology (i.e. at least one personality disorder). Specifically, we investigate if they can benefit from both cognitive-behavioral, and experiential interventions. Study design: A multiple baseline case series study. Study population: Adult individuals (age > 21 years) with ASD and at least one personality disorder. Participants will be recruited from Sarr expertise center for autism in Rotterdam. The study requires 12 participants. Intervention: The treatment protocol consists of 35 weekly offered sessions, followed by 10 monthly booster sessions. A multiple baseline design will be used with baseline varying from 5 to 10 weeks, with weekly supportive sessions. After baseline, a 5-week exploration phase follows with weekly sessions during which current and past functioning, psychological symptoms, schema modes are explored, and information about the treatment will be given. Then 15 weekly sessions with cognitive-behavioral interventions and 15 weekly sessions with experiential interventions will be given. Finally, there will be a 10-month follow-up phase with monthly booster sessions. Participants are randomly assigned to baseline length, and respond weekly during treatment and monthly at follow-up on Belief Strength of negative core beliefs (by VAS), and fill out SMI, SCL-90 and SRS-A 7 times during screening procedure (i.e. before baseline), after baseline, after exploration, after cognitive and behavioral interventions, after experiential interventions, and after 5- and 10- month follow-up. The SCID-II will be administered during screening procedure (i.e. before baseline), at 5- and at 10-month follow-up. Main study parameters: The primary study parameter is negative core beliefs. Secondary study parameters include schema modes, personality disorder manifestations, psychological symptoms, and social interaction and communication. Discussion: To the best of author’s knowledge so far no study has been published on the application of schema mode focused interventions in adult patients with ASD and comorbid PD(s). This study offers the first systematic test of application of schema therapy for adults with ASD. The results of this study will provide initial evidence for the effectiveness of schema therapy in treating adults with both ASD and PD(s). The study intends to provide valuable information for future development and implementation of therapeutic interventions for adults with both ASD and PD(s).

Keywords: adults, autism spectrum disorder, personality disorder, schema therapy

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Authors: Latif Duran, Erdem Aydin, Ahmet Baydin, Ali Kemal Erenler, Iskender Aksoy

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Aim: In this retrospective study, we aim to contribute to the literature by presenting the proposals for taking measures to reduce the mortality by examining the demographic characteristics of the pediatric age group patients presenting with trauma and the factors that may cause mortality Material and Method: This study has been performed by retrospectively investigating the data obtained from the patient files and the hospital automation registration system of the pediatric trauma patients who applied to the Adult Emergency Department of the Ondokuz Mayıs University Medical Faculty between January 1, 2016, and December 31, 2016. Results: 289 of 415 patients involved in our study, were males. The median age was 11.3 years. The most common trauma mechanism was falling from the high. A significant statistical difference was found on the association between trauma mechanisms and gender. An increase in the number of trauma cases was found especially in the summer months. The study showed that thoracic and abdominal trauma was relevant to the increased mortality. Computerized tomography was the most common diagnostic imaging modality. The presence of subarachnoid hemorrhage has increased the risk of mortality by 62.3 fold. Eight of the patients (1.9%) died. Scoring systems were statistically significant to predict mortality. Conclusion: Children are vulnerable to trauma because of their unique anatomical and physiological differences compared to adult patient groups. It will be more successful in the mortality rate and in the post-traumatic healing process by administering the patient triage fast and most appropriate trauma centers in the prehospital period, management of the critical patients with the scoring systems and management with standard treatment protocols

Keywords: emergency service, pediatric patients, scoring systems, trauma, age groups

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Authors: Ana Violante, Jodie Maccarrone, Maria Fimiani

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In the United States, over 30 million people are hospitalized annually for conditions that require acute, 24-hour, supervised care. The experience of hospitalization can be traumatic, exposing the patient to loss of control, autonomy, and productivity. Furthermore, 40% of patients admitted to hospitals for general medical illness have a comorbid psychiatric diagnosis. Research suggests individuals admitted with psychiatric comorbidities experience poorer health outcomes, higher utilization rates and increased overall cost of care. Empirical work suggests hospital settings that include a consultation liaison (CL) service report reduced length of stay, lower costs per patient, improved medical staff and patient satisfaction and reduced readmission after 180 days. Despite the overall positive impact CL services can have on patient care, it is estimated that only 1% - 2.8% of hospital admits receive these services, and most research has been conducted by the field of psychiatry. Health psychologists could play an important role in increasing access to this valuable service, though the extent to which health psychologists participate in CL settings is not well known. Objective: Outline the preliminary findings from an empirical study to understand how many APPIC internship training programs offer adult consultation liaison rotations within inpatient hospital settings nationally, as well as describe the specific nature of these training experiences. Research Method/Design: Data was exported into Excel from the 2022-2023 APPIC Directory categorized as “health psychology” sites. It initially returned a total of 537 health training programs out 1518 total programs (35% of all APPIC programs). A full review included a quantitative and qualitative comprehensive review of the APPIC program summary, the site website, and program brochures. The quantitative review extracted the number of training positions; amount of stipend; location or state of program, patient, population, and rotation. The qualitative review examined the nature of the training experience. Results: 29 (5%) of all APPIC health psychology internship training programs (2%) respectively of all APPIC training internship programs offering internship CL training were identified. Of the 29 internship training programs, 16 were exclusively within a pediatric setting (55%), 11 were exclusively within an adult setting (38%), and two were a mix of pediatric and adult settings (7%). CL training sites were located to 19 states, offering a total of 153 positions nationally, with Florida containing the largest number of programs (4). Only six programs offered 12-month training opportunities while the rest offered CL as a major (6 month) to minor (3-4 month) rotation. The program’s stipend for CL training positions ranged from $25,000 to $62,400, with an average of $32,056. Conclusions: These preliminary findings suggest CL training and services are currently limited. Training opportunities that do exist are mostly limited to minor, short rotations and governed by psychiatry. Health psychologists are well-positioned to better define the role of psychology in consultation liaison services and enhance and formalize existing training protocols. Future research should explore in more detail empirical outcomes of CL services that employ psychology and delineate the contributions of psychology from psychiatry and other disciplines within an inpatient hospital setting.

Keywords: consultation liaison, health psychology, hospital setting, training

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