Search results for: sleep hygiene

Authors: Cliff Shunsheng Han

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Identifying the direct allergy cause that can be easily mitigated is the foundation to stop the allergy epidemic that has been started in the seventies. It has confirmed that the personal and social hygiene practices are associated with the allergy prevalence. But direct causes have been found, and proposed translational measures have not been effective. This study, assisted by a particular case of allergies, has seen the direct cause of allergies, developed a valid test resulted in lasting relief for allergies, and constructed theory describing general relationship between microbiota and host immune system. Saliva samples were collected from a subject for three years during which time the person experienced yearlong allergy, seasonal allergy, and remission of allergy symptoms. Bacterial DNA was extracted and 16S rRNA genes were profiled with Illumina sequencing technology. The analyzing results indicate that the possible direct cause of allergy is the lacking probiotic bacteria in the oral cavity, such as genera Streptococcus and Veilonella, that can produce metabolites to pacify immune system. Targeted promotion of those bacteria with a compound designed for them, has led to lasting remissions of allergic rhinitis. During the development of the translational measure, the subject's oral biofilm was completely destructed by a moderate fever due to an unrelated respiratory infection. The incident not only facilitated the development of the heat based microbiota reseeding procedure but also indicated a possible natural switch that subsequently increases the efficacy of the immune system previously restrained by metabolites from microbiota. These results lead to the proposal of a Theory of Negative Trigger (TNT) to describe the relationship between oral probiotics and immune system, in which probiotics are the negative trigger that will release the power of immune system when removed by fever or modern lifestyles. This study could open doors leading to further understanding of how the immune system functions under the influence of microbiota as well as validate simple traditional practices for healthy living.

Keywords: oral microbiome, allergy, immune system, infection

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Authors: Eftychia Pappa, Heleni Vastardis, Christos Rahiotis, Andriani Vazaiou

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The aim of this study was to evaluate the prevalence of dry-mouth symptoms (xerostomia) and compare it with alterations in salivary characteristics of children and adolescents with type 1 diabetes (DM1), as measured with the use of chair-side saliva tests. This study also investigated the possible association between salivary dysfunction and incidence of caries, in relation to the level of metabolic control. A cross-sectional study was performed on young patients (6-18 years old) allocated among 3 groups: 40 patients poorly-controlled (DM1-A, HbA1c>8%), 40 well-controlled (DM1-B, HbA1c≤8%) and 40 age- and sex-matched healthy controls. The study was approved by the Research Ethics Committee of University of Athens and the parents signed written informed consent. All subjects were examined for dental caries, oral hygiene and salivary factors. Assessments of salivary function included self-reported xerostomia, quantification of resting and stimulated whole saliva flow rates, pH values, buffering capacity and saliva’s viscosity. Salivary characteristics were evaluated with the use of GC Saliva Check Buffer (3Μ ESPE). Data were analysed by chi-square and Kruskal-Wallis tests. Subjects with diabetes reported xerostomia more frequently than healthy controls (p<0.05). Unstimulated salivary flow rate and pH values remained significantly lower in DM1-A compared to DM1-B and controls. Low values of resting salivary flow rate were associated with a higher prevalence of dental caries in children and adolescents with poorly-controlled DM1 (p<0.05). The results suggested that diabetes-induced alterations in salivary characteristics are indicative of higher caries susceptibility of diabetics and chair-side saliva tests are a useful tool for the evaluation of caries risk assessment.

Keywords: caries risk assessment, saliva diagnostic tests, type 1 diabetes, xerostomia

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Authors: R. R. Billones, N. Lukkahatai, L. N. Saligan

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Mindfulness based interventions (MBIs) have been used in medically unexplained symptoms (MUS). This systematic review describes the literature investigating the general effect of MBIs on MUS and identifies the effects of specific MBIs on specific MUS conditions. The preferred reporting items for systematic reviews and meta-analysis guidelines (PRISMA) and the modified Oxford quality scoring system (JADAD) were applied to the review, yielding an initial 1,556 articles. The search engines included PubMed, ScienceDirect, Web of Science, Scopus, EMBASE, and PsychINFO using the search terms: mindfulness, or mediations, or mindful or MBCT or MBSR and medically unexplained symptoms or MUS or fibromyalgia or FMS. A total of 24 articles were included in the final systematic review. MBIs showed large effects on socialization skills for chronic fatigue syndrome (d=0.65), anger in fibromyalgia (d=0.61), improvement of somatic symptoms (d=1.6) and sleep (d=1.12) for painful conditions, physical health for chronic back pain (d=0.51), and disease intensity for irritable bowel disease/syndrome (d=1.13). A manualized MBI that applies the four fundamental elements present in all types of interventions were critical to efficacy. These elements were psycho-education sessions specific to better understand the medical symptoms, the practice of awareness, the non-judgmental observance of the experience at the moment, and the compassion to ones’ self. The effectiveness of different mindfulness interventions necessitates giving attention to improve the gaps that were identified related to home-based practice monitoring, competency training of mindfulness teachers, and sound psychometric properties to measure the mindfulness practice.

Keywords: mindfulness-based interventions, medically unexplained symptoms, mindfulness-based cognitive therapy, mindfulness-based stress reduction, fibromyalgia, irritable bowel syndrome

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Authors: Sara Santos, Cristina Saraiva, Sónia Saraiva

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The objective of this study was to evaluate the welfare of reared broilers using scoring systems at the slaughterhouse. The welfare of broilers from 70 different flocks was assessed in three different slaughterhouses, regarding 373043 animals, although not in equal proportions in each slaughterhouse due to the difference in the amount of flocks slaughtered per day because of different company size. Twenty-one flocks were evaluated in slaughterhouse A (30%), thirty in slaughterhouse B (42,9%) and nineteen in slaughterhouse C (27,1%). The parameters evaluated were feather cleanness, foot pad dermatitis, hock burn, breast burn and causes of carcass condemnation. Feather cleanness was scored into three classes: 0=clean; 1=moderately dirty and 2=dirty feathers. Foot pad dermatitis, hock burn and breast ulcer were graded in three classes: 0=no lesions, 1=moderate lesions and 2=severe lesions. Causes of carcass condemnation were divided into emaciation, ascites, colour alteration and febrile state, arthritis, aerosaculitis, dermatitis, peritonitis, myositis, cellulitis, extensive trauma and technopathies as mechanical trauma, insufficient bleeding and deficient plucking. Broilers evaluated had a body weight ranging between 0,909kg and 2,588kg (median 1,522kg) and age between 25 days and 45 days (median 33 days). Rejection rate of flocks ranged between 0,1% and 10,48% (median 1,4029%) and footpad dermatitis total score between 2 and 197, resulting in 20 flocks presenting moderate lesions and 15 flocks with severe lesions. Moderate hock burn was associated with severe foot pad dermatitis and with breast burn. The associations between these lesions suggest that the development of contact dermatitis is caused by a common cause, the prolonged contact with litter of poor quality. In conclusion, contact dermatitis lesions, mostly foot pad dermatitis, feather hygiene conditions and rejection rate were the main restrictions of good welfare and considered important indicators for the follow-up on the farm conditions.

Keywords: broiler, dermatitis, welfare, slaughterhouse

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Authors: Aisha Khodijah Kholib Jati, Suharni Mohamad, Azlan Husin, Wan Suriana Wan Ab Rahman

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Introduction: Toxoplasmosis is caused by an obligate intracellular parasite, Toxoplasma gondii (T. gondii). It is commonly asymptomatic in normal individual, but it can be fatal to immunocompromised patients as it can lead to severe complications such as encephalitis, chorioetinitis and myocarditis. Objective: The aim of the study was to determine the seroprevalence of toxoplasmosis and its association with socio-demographic and behavioral characteristics among hemato-oncology patients in Hospital USM. Methods: In this cross-sectional study, 56 hemato-oncology patients were screened for immunoglobulin M (IgM) antibodies, immunoglobulin G (IgG) antibodies, and IgG avidity of T. gondii by using ELISA Kit (BioRad, USA). For anti-T. gondii IgG antibody, titer ≥ 9 IU/ml was considered as recent infection, while for IgM, ratio ≥ 1.00 was considered as reactive for the anti-T. gondii IgM antibodies. Low avidity index is considered as recent infection within 20 weeks while high avidity considered as past infection. T. gondii exposure, socio-demographic and behavioral characteristics was assessed by a questionnaire and interview. Results: A total of 28 (50.0%) hemato-oncology patients were seropositive for T. gondii antibodies. Out of that total, 27 (48.21%) patients were IgG+/IgM- and one patient (1.79%) was IgG+/IgM+ with high avidity index. Univariate analysis showed that age, gender, ethnicity, marital status, educational level, employment status, stem cell transplant, blood transfusion, close contact with cats, water supply, and consumption of undercooked meat were not significantly associated with Toxoplasma seropositivity rate. Discussion: The seropositivity rate of IgG anti-T. gondii was high among hemato-oncology patients in Hospital USM. With impaired immune system, these patients might have a severe consequence if the infection reactivated. Therefore, screening for anti-T. gondii may be considered in the future. Moreover, health programme towards healthy food and good hygiene practice need to be implemented.

Keywords: immunocompromised, seroprevalence, socio-demographic, toxoplasmosis

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Authors: Wen Hsin Hsu, Pin Lin

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Objective: Thirst discomfort is the most common yet often overlooked symptom in patients in the intensive care unit (ICU), with an incidence rate of 69.8%. If not properly cared for, it can easily lead to irritability, affect sleep quality, and increase the incidence of delirium, thereby extending the length of hospital stay. Research points out that the sensation of coldness is an effective strategy to alleviate thirst. Using a combined care approach for thirst can prolong the sensation of coldness in the mouth and reduce thirst discomfort. Therefore, it needs to be further analyzed and its effectiveness reviewed. Methods: This study uses systematic literature review and meta-analysis methodologies and searched databases including PubMed, MEDLINE, EMBASE, Cochrane, CINAHL, and two Chinese databases (CEPS and CJTD) based on keywords. JBI was used to appraise the quality of the literature. RevMen 5.4 software package was used, and Fix Effect Model was applied for data analysis. We selected experimental articles, including those in English and Chinese, that met the inclusion and exclusion criteria. Three research articles were included in total, with a sample size of 416 people. Two were randomized controlled trials, and one was a quasi-experimental design. Results: The results show that the combined care for thirst, which includes ice water spray or oral swab wipes, menthol mouthwash, and lip balm, can significantly relieve thirst intensity MD=-1.36 (3 studies, 95% CI (-1.77, -0.95), p <0.001) and thirst distress MD=-0.71 (2 studies, 95% CI (-1.32, -0.10), p =0.02). Therefore, it is recommended that medical staff identify high-risk groups for thirst early on. Implications for Practice: For patients who cannot eat orally, providing combined care for thirst can increase oral comfort and improve the quality of care.

Keywords: thirst bundle care, intensive care units, meta-analysis, ice water spray, menthol

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Authors: Kathleen Canul

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Bullying is on the rise according to several recent studies. Workplace bullying has garnered less attention than other forms yet incidence rates range from 35-45%. The consequences of being bullied at work are broad, ranging from physiological to psychological to occupational. As the bullying progresses, employees begin to exhibit physical and psychological symptoms. Blood pressure rises, along with other cardiac related concerns. For men, covert coping with job unfairness was associated with a four-fold risk of heart attack and death. Gastrointestinal distress, headaches, muscle tension, sleep disorders and exhaustion are also common. Workplace bullying appears to contribute to the risk of subsequent psychotropic medication, as well. Emotionally, anxiety and depression increase along with lowered self-esteem and problems concentrating on the duties of the job. In an attempt to cope, individuals may succumb to unhealthy practices involving food, alcohol and other drugs. Patterns of bullying vary by gender, race, and ethnicity, as well as sexual orientation, with women, ethnic minorities and LGBTQ employees reporting higher rates of bullying in the workplace. Not only is this an issue of inequity on the job, but also a problem of health disparities as there are few mental health professionals confident and competent in dealing with workplace bullying issues, and the lack of culturally competent clinicians exacerbates this inequality in receiving adequate care. Alone, the topic of workplace bullying is not unique; however, the diverse experiences of underrepresented groups who disproportionately are affected on the job and suffer untreated, health related concerns represent a significant and emerging problem requiring attention. Conference participants who have experienced, witnessed or help those bullied on the job would benefit most from this review of the literature on the consequences of bullying experienced by diverse and underrepresented groups in the workplace.

Keywords: bullying, ethnic minorities, health disparities, workplace conflict

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Authors: Yun-Tsuen Chen, Shih-Ting Huang, Pi-Fen Cheng, Heng-Hua Wang, Hui-Zhu Chen

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This paper discusses the experience of caring for a patient diagnosed with breast cancer and later received total mastectomy during a 2nd trimester pregnancy. She was hospitalized from January 31 to February 4, 2018. Using 'Gordon’s 11 Functional Health Patterns' through physical exams and interviews, the researcher assessed the patient’s physical and mental health and determined the patient to have anxiety, acute pain, and body image disturbance. After establishing a strong relationship with the patient, the researcher helped the patient express her anxiety and personal feelings. A multi-specialist team was formed to evaluate both the patient and her unborn child, before, during, and after surgery. This individualized care allowed the patient and her child to optimize the post-operative results. Aside from medication, the patient also received non-medicinal treatment, including improvement of sleep quality with body positioning, diaphragmatic breathing exercises for pain and stress relief after surgery. Throughout hospitalization, the patient’s physical and emotional needs were addressed daily with listening sessions and empathy. The patient’s husband was also incorporated in the patient’s recovery by teaching both he and the patient how to change the sterile wound dressing, which may have the added benefit of improving marital relationships through shared activities of nurturing. The patient was also given advice about how to improve self-confidence through clothing. Lastly, the patient was encouraged to join a support group for breast cancer patients. Through the sharing of experience in groups and within the family, the patient was helped to adapt to the change of her appearance and re-establish her self-confidence. This level of care expedited the patient’s return to her family life and role of being a mother.

Keywords: anxiety, body image disturbance, breast cancer during pregnancy, multi-specialist team

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Authors: Ouassila Bekkal Brikci Benhabib, Zahia Boucherit Otmani, Kebir Boucherit, A. Seghir

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The establishment of intravenous catheters in hospitalized patient is an act common in many clinical situations. These therapeutic tools, from their insertion in the body, represent gateways including fungal germs prone. The latter can generate the growth of biofilms, which can be the cause of fungal infection. Faced with this problem, we conducted a study at the University Hospital of Tlemcen in the neurosurgery unit and aims to isolate and identify Candida yeasts from intravenous catheters. Then test their ability to form biofilms. Materials and methods: 256 patient hospitalized in surgery of the hospital in west Algeria were submitted to this study. All samples were taken from peripheral venous catheters implanted for 72 hours or more days. A total of 31 isolates of Candida species were isolated. MIC and SMIC are determined at 80% inhibition by the test XTT tetrazolium measured at 490 nm. The final concentrations of antifungal agent being between 0.03 and 16 mg / ml for amphotericin B and from 0.015 to 8 mg / mL caspofungin. Results: 31 Candida species isolates from catheters including 14 Candida albicans and 17 Candida non albicans . 21 strains of all the isolates were able to form biofilms. In their form of Planktonic cells, all isolates are 100% susceptible to antifungal agents tested. However, in their state of biofilms, more isolates have become tolerant to the tested antifungals. Conclusion: Candida yeasts isolated from intravascular catheters are considered an important virulence factor in the pathogenesis of infections. Their involvement in catheter-related infections can be disastrous for their potential to generate biofilms. They survive high concentrations of antifungal where treatment failure. Pending the development of a therapeutic approach antibiofilm related to catheters, their mastery is going through: -The risk of infection prevention based on the training and awareness of medical staff, -Strict hygiene and maximum asepsis, and -The choice of material limiting microbial colonization.

Keywords: candida, biofilm, hospital, infection, amphotericin B, caspofungin

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Authors: Mahmoud A. Amin, Essam Taman, Ahmed Omran, Mahmoud Shawky, Ahmed Mekawy, Abdallah M. Kotkat, Saber Younes, Nehad N. Ghonemy, Amin Saad, Ezz-Aleslam, Abdullah M. Elosh

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Introduction: TMJ is a one-of-a-kind, complicated synovial joint that helps with masticatory function by allowing the mandible to open and close the mouth. True ankylosis is a situation in which condylar movement is limited by a mechanical defect in the joint, whereas false ankylosis is a condition in which there is a restriction in mandibular movement due to muscular spasm myositis ossificans, and coronoid process hyperplasia. Ankylosis is characterized by the inability to open the mouth due to fusion of the TMJ condyle to the base of the skull as a result of trauma, infection, or systemic diseases such as rheumatoid arthritis (the most common) and psoraisis. Ankylosis causes facial asymmetry and affects the patient psychologically as well as speech, difficult mastication, poor oral hygiene, malocclusion, and other factors. TMJ is a technically challenging joint; hence TMJ ankylosis management is complicated. Case presentation: this case is a male patient 25 years old reported to our maxillofacial clinic in Damietta faculty of medicine, Al-Azhar University with the inability to open the mouth at all, with a history of difficulty of mouth breathing and eating foods, there was a history of falling from height at 2006, and the patient underwent corrective surgery before with no improvement because the ankylosis was relapsed short period after the previous operations with that done out of our hospital inter-incisor distant ZERO so, this condition need mandatory management. Clinical examination and radiological investigations were done after complete approval from the patient and his brother; tracheostomy was done for our patient before the operation. The patient entered the operation in our hospital and drastic improvement in mouth opening was noticed, helping to restore the physical psychological health of the patient.

Keywords: temporomandibular joint, TMJ, Ankylosis, mouth opening, physiotherapy, condylar plate

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Authors: Faeze omid, Morteza Banakar

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Background: The COVID-19 pandemic has had a significant impact on global health and healthcare systems, including oral health. The lockdown measures implemented in many countries have led to changes in oral health behaviors, access to dental care, and the delivery of dental services. However, the extent of these changes and their effects on oral health outcomes remains unclear. This systematic review aims to synthesize the available evidence on the state of oral health after the COVID-19 lockdown. Methods: We conducted a systematic search of electronic databases (PubMed, Embase, Scopus, and Web of Science) and grey literature sources for studies reporting on oral health outcomes after the COVID-19 lockdown. We included studies published in English between January 2020 and March 2023. Two reviewers independently screened the titles, abstracts, and full texts of potentially relevant articles and extracted data from included studies. We used a narrative synthesis approach to summarize the findings. Results: Our search identified 23 studies from 12 countries, including cross-sectional surveys, cohort studies, and case reports. The studies reported on changes in oral health behaviors, access to dental care, and the prevalence and severity of dental conditions after the COVID-19 lockdown. Overall, the evidence suggests that the lockdown measures had a negative impact on oral health outcomes, particularly among vulnerable populations. There were decreases in dental attendance, increases in dental anxiety and fear, and changes in oral hygiene practices. Furthermore, there were increases in the incidence and severity of dental conditions, such as dental caries and periodontal disease, and delays in the diagnosis and treatment of oral cancers. Conclusion: The COVID-19 pandemic and associated lockdown measures have had significant effects on oral health outcomes, with negative impacts on oral health behaviors, access to care, and the prevalence and severity of dental conditions. These findings highlight the need for continued monitoring and interventions to address the long-term effects of the pandemic on oral health.

Keywords: COVID-19, oral health, systematic review, dental public health

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Authors: Shizrah Jamal, Robia Ghafoor, Farhan Raza

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Porcelain fused to metal crown is the most versatile variety of crown that is commonly placed worldwide. Various complications have been reported in the PFM crowns with use over the period of time. These include chipping of the porcelain, recurrent caries, loss of retention, open contacts, and tooth fracture. The objective of the present study was to determine the frequency of these complications in crowns cemented over a period of five years in a tertiary care hospital and also to report the survival of these crowns. A retrospective study was conducted in Dental clinics, Aga Khan University Hospital in which 150 PFM crowns cemented over a period of five years were evaluated. Patient demographics, oral hygiene habits, para-functional habits, crown insertion and follow-up dates were recorded in a specially designed proforma. All PFM crowns fulfilling the inclusion criteria were assessed both clinically and radiographically for the presence of any complication. SPSS version 22.0 was used for statistical analysis. Frequency distribution and proportion of complications were determined. Chi-square test was used to determine the association of complications of PFM crowns with multiple variables including tooth wear, opposing dentition and betel nut chewing. Kaplan- meier survival analysis was used to determine the survival of PFM crowns over the period of five years. Level of significance was kept at 0.05. A total of 107 patients, with a mean age of 43.51 + 12.4 years, having 150 PFM crowns were evaluated. The most common complication observed was open proximal contacts (8.7%) followed by porcelain chipping (6%), decementation (5.3%), and abutment fracture (1.3%). Chi square test showed that there was no statistically significant association of PFM crown complication with tooth wear, betel nut and opposing dentition (p-value <0.05). The overall success and survival rates of PFM crowns turned out to be 78.7 and 84.7% respectively. Within the limitations of the study, it can be concluded that PFM crowns are an effective treatment modality with high success and survival rates. Since it was a single centered study; the results should be generalized with caution.

Keywords: chipping, complication, crown, survival rate

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Authors: Hela Ghali, Oumayma Ben Amor, Salwa Khefacha, Mohamed Ben Rejeb, Sirine Frigui, Meriam Tourki Dhidah, Lamine Dhidah, Houyem Said Laatiri

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Background: Blood exposure accidents are the most common problem in hospitals that threaten healthcare professionals with a high risk of infectious complications which weighs heavily on health systems worldwide. Paramedics are the highest risk group due to the nature of their daily activities. We aimed to determine knowledge and attitudes about the management of blood-exposure accidents among nurses and technicians in two pediatric departments. Materials/Methods: This is a cross-sectional descriptive study conducted on March 2017, carried out with the care staff of the pediatric ward of the Farhat Hached Teaching Hospital of Sousse and pediatric surgery of the Fattouma Bourguiba University Hospital in Monastir, using a pre- tested and self-administered questionnaire. Data entry and analysis were performed using Excel software. Results: The response rate was 85.1%. A female predominance (82.5%) was reported among respondents with a sex ratio of 0.21. 80% of the participants were under 35 years old. Seniority of less than 10 years was found in 77.5% of respondents. Only 22.5% knew the definition of a blood- exposure accident. 100% and 95% of participants reported the relative risk, respectively, to hepatitis and AIDS viruses. However, only 15% recognized the severity factors of a blood-exposure accident. Hygiene compliance was the most important dimension for almost the entire population for the prevention. On the other hand, only 12.5% knew the meaning of 'standard precautions' and ¼ considered them necessary for at-risk patients only. 40% reported being exposed at least once, among them, 87.5% used betadine, and 77.5% said that anti-infectious chemoprophylaxis is necessary regardless of the patient's serological status. However, 52.5% did not know the official reporting circuit of management of blood-exposure accident in their institutions. Conclusion: For better management of risks in hospitals and an improvement of the safety of the care, a reinforcement of the sensibilization of the caregivers with regard to the risks of blood exposure accident is necessary, while developing their knowledge to act in security.

Keywords: attitudes, blood-exposure accident, knowledge, pediatric department

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Authors: Ramona-Niculina Jurcau, Ioana-Marieta Jurcau, Dong Hun Kwak, Nicolae-Alexandru Colceriu

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Background: Stress management (SM) is a topic of great academic interest and equally a task to accomplish. In addition, it is recognized the beneficial role of unconventional therapies (UCT) in stress modulation. Aims: The aim was to evaluate medical (MS) versus non-medical students’ (NMS) opinions about academic stress management (ASM) using UCT. Methods: MS (n=103, third year males and females) and NMS (n=112, males and females, from humanities faculties, different years of study), out of their academic program, voluntarily answered to a questionnaire concerning: a) Classification of the four most important academic stress factors; b) The extent to which their daily life influences academic stress; c) The most important SM methods they know; d) Which of these methods they are applying; e) the UCT they know or about which they have heard; f) Which of these they know to have stress modulation effects; g) Which of these UCT, participants are using or would like to use for modulating stress; and if participants use UTC for their own choose or following a specialist consultation in those therapies (SCT); h) If they heard about the following UCT and what opinion they have (using visual analogue scale) about their use (following CST) for the ASM: Phytotherapy (PT), apitherapy (AT), homeopathy (H), ayurvedic medicine (AM), traditional Chinese medicine (TCM), music therapy (MT), color therapy (CT), forest therapy (FT). Results: Among the four most important academic stress factors, for MS more than for NMS, are: busy schedule, large amount of information taught; high level of performance required, reduced time for relaxing. The most important methods for SM that MS and NMS know, hierarchically are: listen to music, meeting friends, playing sport, hiking, sleep, regularly breaks, seeing positive side, faith; of which, NMS more than MS, are partially applying to themselves. UCT about which MS and less NMS have heard, are phytotherapy, apitherapy, acupuncture, reiki. Of these UTC, participants know to have stress modulation effects: some plants, bee’s products and music; they use or would like to use for ASM (the majority without SCT) certain teas, honey and music. Most of MS and only some NMS heard about PT, AT, TCM, MT and much less about H, AM, CT, TT. NMS more than MS, would use these UCT, following CST. Conclusions: 1) Academic stress is similarly reflected in MS and NMS opinions. 2) MS and NMS apply similar but very few UCT for stress modulation. 3) Information that MS and NMS have about UCT and their ASM application is reduced. 4) It is remarkable that MS and especially NMS, are open to UCT use for ASM, following an SCT.

Keywords: academic stress, stress management, stress modulation, medical students, non-medical students, unconventional therapies

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Authors: Farzaneh Askari, Jila Ganji, Sedigheh Hasani Moghadam

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Background and Aim: Endometriosis has been reported as one of the most common chronic gynecological conditions characterized by physical and psychological complications. Given that the impact of this disease on marital relationships and quality of life is multidimensional, the present review study aimed to reflect on the effect of psychosomatic aspects of endometriosis on marital relationships and quality of life. Materials and Methods: A narrative review methodology using keywords determined by the Medical Subject Headings (MeSH) thesaurus was adopted in this study. For this purpose, the databases of ScienceDirect, Scientific Information Database (SID), Google Scholar, and PubMed were searched by means of key terms including endometriosis, marital relationships, physical complications, psychological complications, and quality of life in English and Persian from 2005 to 2020. At the end of the search, 38 articles were retrieved, and ultimately a total number of 16 studies were recruited for this review. Results: A review of the selected articles demonstrated that endometriosis could affect marital relationships and quality of life among couples featuring in three different categories, i.e. “category I: physical health dimension” (chronic pelvic pain, dysmenorrhea, cramps but not period, reduction and loss of fertility), “category II: sexual health dimension” (no sexual intercourse, dyspareunia, lack of sexual satisfaction), and “category III: psychosocial health dimension” (negative self-esteem, low energy, sense of loneliness, depression, social isolation, insufficient sleep, marital distress, divorce and marriage breakdown, inability to work and socialize). Conclusion: In general, it is suggested to pay particular attention to psychosomatic aspects of marital problems in patients affected with endometriosis. Accordingly, implementing educational and counseling strategies to minimize the complications of this disease can provide the grounds for improving marital relationships and maintaining the quality of life in these patients.

Keywords: Endometriosis, marital relationships, psychosomatic complications, quality of life

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Authors: Ali Ilter Akdag, Pratima Ray

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Background:This acute gastroenteritis viruses such as rotavirus, astrovirus, and adenovirus are mainly responsible for diarrhea in children below < 5 years old. Molecular detection of these viruses is crucially important to the understand development of the effective cure. This study aimed to determine the prevalence of common these viruses in children < 5 years old presented with diarrhea from Lala Lajpat Rai Memorial Medical College (LLRM) centre (Meerut) North India, India Methods: Total 312 fecal samples were collected from diarrheal children duration 3 years: in year 2014 (n = 118), 2015 (n = 128) and 2016 (n = 66) ,< 5 years of age who presented with acute diarrhea at the Lala Lajpat Rai Memorial Medical College (LLRM) centre(Meerut) North India, India. All samples were the first detection by EIA/RT-PCR for rotaviruses, adenovirus and astrovirus. Results: In 312 samples from children with acute diarrhea in sample viral agent was found, rotavirus A was the most frequent virus identified (57 cases; 18.2%), followed by Astrovirus in 28 cases (8.9%), adenovirus in 21 cases (6.7%). Mixed infections were found in 14 cases, all of which presented with acute diarrhea (14/312; 4.48%). Conclusions: These viruses are a major cause of diarrhea in children <5 years old in North India. Rotavirus A is the most common etiological agent, follow by astrovirus. This surveillance is important to vaccine development of the entire population. There is variation detection of virus year wise due to differences in the season of sampling, method of sampling, hygiene condition, socioeconomic level of the entire people, enrolment criteria, and virus detection methods. It was found Astrovirus higher then Rotavirus in 2015, but overall three years study Rotavirus A is mainly responsible for causing severe diarrhea in children <5 years old in North India. It emphasizes the required for cost-effective diagnostic assays for Rotaviruses which would help to determine the disease burden.

Keywords: adenovirus, Astrovirus, hospitalized children, Rotavirus

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Authors: Narae Yang, Hyun Kyung Sung, Seon Mi Shin, Hee Jung, Yong Ji Kim, Tae-Yong Park, Ho Yeon Go

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The aim of this study was to build base-line data for the Korean Medicine Doctors` Visiting School Program (KMDVSP) by analyzing a student health survey filled out by the students. Korean medicine doctors assigned to 20 middle and high schools in Seong-nam visited these schools eight times in five months. During each visit, the assigned doctors performed health consultations and Korean medicine treatment, and taught health education classes. 12115 students answered self-reported questionnaires about their own physical condition at the beginning of the program. In a question about pain, 7080(58%) reported having a headache, while 4048(33%) said they had a backache, nuchal pain/shoulder pain was reported by 5993(49%), dyspepsia was present in 2736(23%), rhinitis/sinusitis was reported by 4176(34%), coughing/dyspnea by 7102(59%), itching/skin rash by 2840(23%), and constipation was reported by 1091(9%), while 2264(18%) said they had diarrhea. Increased urinary frequency/feeling of residual urine was reported by 569 students (5%), and 3324(27%) said they had insomnia/fitful sleep/morning fatigue. When asked about menstruation, 4450(83%) of the female students reported irregular menstruation or said they experienced menstrual pain. Understanding the health condition of adolescent students is the starting point to determining national health policy to prevent various diseases in the future. We have developed the pilot project of KMDVSP and collected research about students’ health. Based on this data, further studies should be performed in order to develop a cooperative program between schools and the Korean medical center.

Keywords: korean medicine doctors` visiting school program(kmdvsp), student`s health condition, questionnaires, cohort study

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Authors: Yan Zhang, Felix Kin Peng Hui, Colin Duffield, Caroline X. Gao

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In post-pandemic Australia, it is unclear how building occupant have changed their behaviour in their interaction with buildings and other occupants. This research provides information on occupant behaviour change compared to before the pandemic and examines the predictors for those behaviour changes. This paper analyses survey responses from 2298 building occupants in Melbourne to investigate occupant behaviour change and determinants for those changes one year after the pandemic in Australia. The behaviour changes were grouped into three categories based on respiratory infection routes: (1) fomite: hand-shaking and hand hygiene behaviours; (2) airborne: individual interventions to indoor air quality such as face masking, window openings for occupants working in naturally ventilated space; (3) droplets: social distancing, reducing working hours in the workplace. The survey shows that the pandemic has significantly changed occupants' behaviour in all three categories compared to before the pandemic. The changes are significantly associated with occupants' perceived indoor air quality, indoor environmental cleanliness, and occupant density, demonstrating their growing awareness of respiratory infection risk that influences their health behaviours. The two most significant factors identified from multivariate regressions to drive the behaviour change include occupant risk perception of respiratory infections at the workplace and their observed co-worker's behaviour change. Based on the survey results, the paper provides adjusted estimates for related occupant behaviour parameters. The study also discusses alternatives for managing window operations in naturally ventilated buildings to improve occupant satisfaction. This paper could help Building Managers, and Building Designers understand occupant behaviour change to improve building operations and new building design to enhance occupant experience. Also, building energy modellers and risk assessors may use the findings to adjust occupant behaviour-related parameters to improve the models. The findings contribute to the knowledge of Human-Building Interaction.

Keywords: human-building interaction, risk perception, occupant behaviour, IAQ, COVID-19

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Authors: Bhavishya Ramchandani

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A little electronic device that is worn on the finger is called a smart ring. It incorporates mobile technology and has features that make it simple to use the device. These gadgets, which resemble conventional rings and are usually made to fit on the finger, are outfitted with features including access management, gesture control, mobile payment processing, and activity tracking. A poor sleep pattern, an irregular schedule, and bad eating habits are all part of the problems with health that a lot of people today are facing. Diets lacking fruits, vegetables, legumes, nuts, and whole grains are common. Individuals in India also experience metabolic issues. In the medical field, smart rings will help patients with problems relating to stomach illnesses and the incapacity to consume meals that are tailored to their bodies' needs. The smart ring tracks all bodily functions, including blood sugar and glucose levels, and presents the information instantly. Based on this data, the ring generates what the body will find to be perfect insights and a workable site layout. In addition, we conducted focus groups and individual interviews as part of our core approach and discussed the difficulties they're having maintaining the right diet, as well as whether or not the smart ring will be beneficial to them. However, everyone was very enthusiastic about and supportive of the concept of using smart rings in healthcare, and they believed that these rings may assist them in maintaining their health and having a well-balanced diet plan. This response came from the primary data, and also working on the Emerging Technology Canvas Analysis of smart rings in healthcare has led to a significant improvement in our understanding of the technology's application in the medical field. It is believed that there will be a growing demand for smart health care as people become more conscious of their health. The majority of individuals will finally utilize this ring after three to four years when demand for it will have increased. Their daily lives will be significantly impacted by it.

Keywords: smart ring, healthcare, electronic wearable, emerging technology

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Authors: Isabel Lopez-Oliva, Akshay Paropkari, Shweta Saraswat, Stefan Serban, Paola de Pablo, Karim Raza, Andrew Filer, Iain Chapple, Thomas Dietrich, Melissa Grant, Purnima Kumar

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Objective: We aimed to explicate the role of the subgingival microbiome in the causal link between rheumatoid arthritis (RA) and periodontitis (PD). Methods: Subjects with/without RA and with/without PD were randomized for treatment with scaling and root planing (SRP) or oral hygiene instructions. Subgingival biofilm, gingival crevicular fluid, and serum were collected at baseline and at 3- and 6-months post-operatively. Correlations were generated between 72 million 16S rDNA sequences, immuno-inflammatory mediators, circulating antibodies to oral microbial antigens, serum inflammatory molecules, and clinical metrics of RA. The dynamics of inter-microbial and host-microbial interactions were modeled using differential network analysis. Results: RA superseded periodontitis as a determinant of microbial composition, and DAS28 score superseded the severity of periodontitis as a driver of microbial assemblages (p=0.001, ANOSIM). RA subjects evidenced higher serum anti-PPAD (p=0.0013), anti-Pg-enolase (p=0.0031), anti-RPP3, anti- Pg-OMP and anti- Pi-OMP (p=0.001) antibodies than non-RA controls (with and without periodontitis). Following SRP, bacterial networks anchored by IL-1b, IL-4, IL-6, IL-10, IL-13, MIP-1b, and PDGF-b underwent ≥5-fold higher rewiring; and serum antibodies to microbial antigens decreased significantly. Conclusions: Our data suggest a circular relationship between RA and PD, beginning with an RA-influenced dysbiosis within the healthy subgingival microbiome that leads to exaggerated local inflammation in periodontitis and circulating antibodies to periodontal pathogens and positive correlation between severity of periodontitis and RA activity. Periodontal therapy restores host-microbial homeostasis, reduces local inflammation, and decreases circulating microbial antigens. Our data highlights the importance of integrating periodontal care into the management of RA patients.

Keywords: rheumatoid arthritis, periodontal, subgingival, DNA sequence analysis, oral microbiome

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Authors: Kamila Weissova, Jitka Skrabalova, Katerina Skalova, Jana Koprivova, Zdenka Bendova

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Any Arctic visitor has to deal with extreme conditions, including constant light during the summer season or constant darkness during winter time. Light/dark cycle is the most powerful synchronizing signal for biological clock and the absence of daily dark period during the polar day can significantly alter the functional state of the internal clock. However, the inner clock can be synchronized by other zeitgebers such as physical activity, food intake or social interactions. Here, we investigated the effect of polar day on circadian clock of 10 researchers attending the polar base station in the Svalbard region during July. The data obtained on Svalbard were compared with the data obtained before the researchers left for the expedition (in the Czech Republic). To determine the state of circadian clock we used wrist actigraphy followed by sleep diaries, saliva, and buccal mucosa samples, both collected every 4 hours during 24h-interval to detect melatonin by radioimmunoassay and clock gene (PER1, BMAL1, NR1D1, DBP) mRNA levels by RT-qPCR. The clock gene expression was analyzed using cosinor analysis. From our results, it is apparent that the constant sunlight delayed melatonin onset and postponed the physical activity in the same order. Nevertheless, the clock gene expression displayed higher amplitude on Svalbard compared to the amplitude detected in the Czech Republic. These results have suggested that the common daily schedule at the Svalbard expedition can strengthen circadian rhythm in the environment that is lacking light/dark cycle. In conclusion, the constant sunlight delays melatonin onset, but it still maintains its rhythmic secretion. The effect of constant sunlight on circadian clock can be minimalized by common daily scheduled activity.

Keywords: actighraph, clock genes, human, melatonin, polar day

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Authors: Simmi Chopra

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In the last few years, there has been a surge of Autoimmune diseases that have become more like an epidemic all over the world. The reasons vary from stress, insufficient sleep, smoking, genetics, environmental pollution, adulterated foods, and a diet full of “the deadly white,” which is white sugar and white flour. Most of the people diagnosed with these diseases are given steroids, opioids, supplements, or elimination diets to manage their lives, but most of them continue suffering to varying degrees. On the other hand, Ayurveda can help manage autoimmune problems effectively. Ayurveda is a 5000 years old holistic medical system from India that has an individualistic approach where health problems are looked at from the lens of balancing body and mind and by targeting the root cause of the problem. A combination of diet and lifestyle according to Ayurvedic principles, Ayurvedic herbal formulations and Ayurvedic therapies can help in the management of autoimmune and other chronic diseases. Panchkarma, which is an intense six weeks detox method, helps balance our body and mind, and has been very effective in managing autoimmune problems. The paper will introduce the basic concepts of Ayurveda and describe the terminologies- doshas, agni and ama. The paper will discuss the importance of diet and lifestyle according to the individual’s imbalance in the three functional parameters - doshas, which govern every aspect of our body and mind, our cells and tissues. The significance of agni, which can be correlated to digestive strength and ama, which can be correlated to toxins that are formed in our body leading to health problems, will be outlined. The Ayurvedic pathophysiology of autoimmune diseases will be discussed with emphasis on Rheumatoid arthritis, Multiple sclerosis and Psoriasis. Ayurvedic management will be discussed for these autoimmune conditions. As Ayurveda is an individualistic system, one protocol will not work for everyone. Therefore, case studies with Ayurvedic protocols for the above autoimmune disease will be presented. Conclusion: Ayurveda can help in managing as well as arresting the progression of autoimmune problems. Ayurveda is an ancient medical system, is much more needed today than ever. It is a tried and tested holistic system which has been practiced for the past many generations in India.

Keywords: ayurveda, autoimmune, diseases, nutrition

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Authors: Afsaneh Soltani, Zahra Mohajer

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Migraine is one of the most common chronic neurological diseases. Migraines affect different aspects of life. Severe migraine headaches lead to dysfunction, a reduced presence at work, and decreased ability to think and make decisions. Non-pharmacological treatments play a very important role in controlling and preventing migraine headaches. A healthy lifestyle helps control migraine headaches. Migraine headaches can be reduced by following these steps: Avoiding stress, eating regularly and avoiding hunger and thirst, avoiding stimulants such as chocolate, caffeine, and cigarettes, following a regular bedtime routine, or avoiding sleep deprivation. Exercise a lot, and do regular exercise (and prevent obesity). Non-pharmacological treatment is especially important in pregnant women and children because in these cases, medical treatments are not preferred due to the many side effects. Exercise is one of the most effective and uncomplicated non-pharmacological alternatives in the treatment of migraine headaches. Exercising for episodic migraines is a safe, effective, and promising complementary treatment option. Numerous studies have shown that aerobic exercise reduces the severity and duration of migraine headaches. Effective aerobic exercise includes cycling and brisk walking. Exercise improves the quality of life and reduces the use of medication in people with migraines. Patients who exercise have fewer migraine days, resulting in better personal, social, and occupational performance. Several studies have shown that pain intensity and frequency in patients who exercise regularly decreased significantly after exercise compared to controls who did not exercise. According to a study, regular exercise reduces the levels of interleukins, especially IL-12P70, which reduces anxiety and reduces the number of days of migraine in patients. An article has shown that endurance exercise reduces the number of migraine days and also increases cerebrovascular health in migraine patients. According to studies, the minimum duration of exercise to achieve a positive effect of exercise in patients with migraine is 3 months (12 weeks) and 40 minutes three times a week.

Keywords: exercise, headache, migraine, physical activity

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Authors: Sumattana Glangkarn, Vorapoj Promasatayaprot

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Background: Proportion of population ageing in Thailand has been increased rapidly in the past decades according to living longer and the fertility rates have decreased. The most important challenge related to this situation is to consider how to improve quality and years of healthy of life. This study aimed to implement the older persons’ long term care (LTC) system for elderly care by family and community. Method: The Consolidated Framework for Implementation Research (CFIR) was employed for guiding and evaluating an implementation process in ageing care. The CFIR composed of five major domains: intervention characteristics, outer setting, inner setting, characteristics of the individuals involved, and the process of implementation. Results: most elderly participants were couples, educating primary school and living with children and grandchildren. More than half of them had chronic diseases such as diabetes mellitus and hypertension. Factor analysis revealed factors related to health care of older participants which consisted of exercise, diet, accidental prevention, relaxation, self-care capacity, joyfulness, family relationship, and personal hygiene. A pre-implementation phase showed intervention characteristics included facilities and services of the LTC policy from the Ministry of Public Health. The complexities of the LTC and relative advantages were explained. Community leaders, public health volunteers, care givers and health professionals had participated in the LTC activities. Outer and inner settings consisted of context of community, culture, and readiness. Characteristics of the individuals related to knowledge, self-efficacy, perceptions, and believes. The process consisted of planning, acting, observing, and reflecting. The implementation outcomes and service outcomes had been evaluated during-implementation phase. Conclusion: the participation of caregivers, community leaders, public health volunteers, and health professionals had supported the LTC services. Thus, family and community care could improve quality of life of the ageing.

Keywords: ageing, CFIR, long term care, implementation

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Authors: Neumoin Anton Ivanovich, Opra Denis Pavlovich

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Materials based on titanium oxide compounds are widely used in such areas as solar energy, photocatalysis, food industry and hygiene products, biomedical technologies, etc. Demand for them has also formed in the battery industry (an example of this is the commercialization of Li4Ti5O12), where much attention has recently been paid to the development of next-generation systems and technologies, such as sodium-ion batteries. This dictates the need to search for new materials with improved characteristics, as well as ways to obtain them that meet the requirements of scalability. One of the ways to solve these problems can be the creation of nanomaterials that often have a complex of physicochemical properties that radically differ from the characteristics of their counterparts in the micro- or macroscopic state. At the same time, it is important to control the texture (specific surface area, porosity) of such materials. In view of the above, among other methods, the hydrothermal technique seems to be suitable, allowing a wide range of control over the conditions of synthesis. In the present study, a method was developed for the preparation of mesoporous nanostructured sodium trititanate (Na2Ti3O7) with a hierarchical architecture. The materials were synthesized by hydrothermal processing and exhibit a complex hierarchically organized two-layer architecture. At the first level of the hierarchy, materials are represented by particles having a roughness surface, and at the second level, by one-dimensional nanotubes. The products were found to have high specific surface area and porosity with a narrow pore size distribution (about 6 nm). As it is known, the specific surface area and porosity are important characteristics of functional materials, which largely determine the possibilities and directions of their practical application. Electrochemical impedance spectroscopy data show that the resulting sodium trititanate has a sufficiently high electrical conductivity. As expected, the synthesized complexly organized nanoarchitecture based on sodium trititanate with a porous structure can be practically in demand, for example, in the field of new generation electrochemical storage and energy conversion devices.

Keywords: sodium trititanate, hierarchical materials, mesoporosity, nanotubes, hydrothermal synthesis

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Authors: Recep Kesli, Gulsah Asik, Cengiz Demir, Onur Turkyilmaz

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Objective: Stenotrophomonas maltophilia (S. maltophilia) has recently emerged as an important nosocomial microorganism. Treatment of invasive infections caused by this organism is problematic because this microorganism is usually resistant to a wide range of commonly used antimicrobials. We aimed to evaluate clinical isolates of S. maltophilia in respect to sampling sites and antimicrobial resistant. Method: During a two years period (October 2013 and September 2015) eighteen samples collected from the intensive care unit (ICU) patients hospitalized in Afyon Kocatepe University, ANS Practice and Research Hospital. Identification of the bacteria was determined by conventional methods and automated identification system-VITEK 2 (bio-Mérieux, Marcy l’toile, France). Antibacterial resistance tests were performed by Kirby Bauer disc (Oxoid, England) diffusion method following the recommendations of CLSI. Results: Eighteen S. maltophilia strains were identified as the causative agents of different infections. The main type of infection was lower respiratory tract infection (83,4 %); three patients (16,6 %) had bloodstream infection. While, none of the 18 S. maltophilia strains were found to be resistant against to trimethoprim sulfametaxasole (TMP-SXT) and levofloxacine, eight strains 66.6 % were found to be resistant against ceftazidim. Conclusion: The isolation of S.maltophilia starains resistant to TMP-SXT is vital. In order to prevent or minimize infections due to S. maltophilia such precuations should be utilized: Avoidance of inappropriate antibiotic use, prolonged implementation of foreign devices, reinforcement of hand hygiene practices and the application of appropriate infection control practices. Microbiology laboratories also may play important roles in controlling S. maltophilia infections by monitoring the prevalence, continuously, the provision of local antibiotic resistance paterns data and the performance of synergistic studies also may help to guide appropirate antimicrobial therapy choices.

Keywords: Stenotrophomonas maltophilia, trimethoprim-sulfamethoxazole, antimicrobial resistance, Stenotrophomonas spp.

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Authors: Nanche Billa Robert

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More and more youth are doubtful of making a satisfactory labour market transition because of the present global economic instability and this is more so in Africa of the Sahara and metropolis like Douala. We use the explanatory sequential mixed method: in the first phase we randomly administered 610 questionnaires in the Douala metropolis respecting the population size of each division and its gender composition. We constructed the questionnaire using the desired values for living a comfortable life in Douala. In the second phase, we purposefully selected and interviewed 50 poor youth in order to explain in detail the initial quantitative results. We obtain the following result: The modal income class is 24,000-74,000 frs Central Africa Franc (CFA) and about 67% of the youth of the Douala metropolis earn below 75,000 frs CFA. They earn only 31.02% of the total income. About 85.7% earn below 126,000 frs CFA and about 92.14% earn below 177,000 frs CFA. The poverty-line is estimated at 177,000 frs CFA per month based on the desired predominant values in Douala and only about 9% of youth earn this sum, therefore, 91% of the youth are poor. We discovered that the salary a youth earns influences his level of poverty. Low income earners eat once or twice per day, rent low-standard houses of below 20,000 frs, are dependent and possess very limited durable goods, consult traditional doctors when they are sick, sleep and gamble during their leisure time. Intermediate income earners feed themselves either twice or thrice per day, eat healthy meals weekly, possess more durable goods, are independent, gamble and drink during their leisure time. High income earners feed themselves at least thrice per day, eat healthy food daily, inhabit high quality and expensive houses, are more stable by living longer in their neighbourhoods, like travelling and drinking during their leisure time. Unsalaried youth, are students, housewives or unemployed youth, they eat four times per day, take healthy meals daily, weekly, fortnightly or occasionally, are dependent or homeless depending on whether they are students or unemployed youth. The situation of the youth can be ameliorated through investing in the productive sector and promoting entrepreneurship as well as formalizing the informal sector.

Keywords: income, inequality, poverty, metropolis

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Authors: Adepeju Simon-Oke, Olatunji Odeyemi, Mobolanle Oniya

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Urinary tract infection has become the most common bacterial infections in humans, both at the community and hospital settings; it has been reported in all age groups and in both sexes. This study was carried out in order to determine and evaluate the prevalence, current drug susceptibility pattern of the isolated organisms and identify the associated risk factors of UTIs among the pregnant women in Akure, Ondo State, Nigeria. A cross-sectional study was conducted on the urine of pregnant women, and socio-demographic information of the women was collected. A total of 300 clean midstream urine samples were collected, and a general urine microscopic examination and culture were carried out, the Microbact identification system was used to identify gram-negative bacteria. Out of the 300 urine samples cultured, 183(61.0%) yielded significant growth of urinary pathogens while 117(39.0%) yielded either insignificant growth or no growth of any urinary pathogen. Prevalence of UTI was significantly associated with the type of toilet used, symptoms of UTI, and previous history of urinary tract infection (p<0.05). Escherichia coli 58(31.7%) was the dominant pathogen isolated, and the least isolated uropathogens were Citrobacter freudii and Providencia retgerri 2(1.1%) respectively. Gram-negative bacteria showed 77.6%, 67.9%, and 61.2% susceptibility to ciprofloxacin, augmentin, and chloramphenicol, respectively. Resistance against septrin, chloramphenicol, sparfloxacin, amoxicillin, augmentin, gentamycin, pefloxacin, trivid, and streptomycin was observed in the range of 23.1 to 70.1%. Gram-positive uropathogens isolated showed high resistance to amoxicillin (68.4%) and high susceptibility to the remaining nine antibiotics in the range 65.8% to 89.5%. This study justifies that pregnant women are at high risk of UTI. Therefore screening of pregnant women during antenatal clinics should be considered very important to avoid complications. Health education with regular antenatal and personal hygiene is recommended as precautionary measures to UTI.

Keywords: pregnant women, prevalence, risk factor, UTIs

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Authors: L. R. Ferreira, R. Biscaro, C. C. Danziger, C. M. Galhardi, L. C. Biscaro, R. C. Biscaro, I. S. Vasconcelos, L. C. R. Ferreira, R. Reis, L. H. Oliveira

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Introduction: There is a worldwide trend for the employer to be aware of investing in health promotion that goes beyond occupational hygiene approaches with the implementation of a comprehensive program with integration between occupational health and safety, and social/psychosocial responsibility in the workplace. Work accommodation is a necessity in most companies as it allows the worker to return to its function respecting its physical limitations. This study had the objective to verify if the integration of health and safety in the companies, with the inclusion of the concept of TWH promoted by an occupational health service has impacted in the management of absenteeism of workers in work accommodation. Method: A retrospective and paired cohort study was used, in which the impact of the implementation of the Program for the Health/Safety Integration and Total Worker Health Concept (PHSITWHC) was evaluated using the indices of absenteeism, health attestations, days and hours of sick leave of workers that underwent job accommodation/rehabilitation. This was a cohort study and the data were collected from January to September of 2017, prior to the initiation of the integration program, and compared with the data obtained from January to September of 2018, after the implementation of the program. For the statistical analysis, the student's t-test was used, with statistically significant differences being made at p < 0.05. Results: The results showed a 35% reduction in the number of absenteeism rate in 2018 compared to the same period in 2017. There was also a significant reduction in the total numbers of days of attestations/absences (mean of 2,8) as well as days of attestations, absence and sick leaves (mean of 5,2) in 2018 data after the implementation of PHSITWHC compared to 2017 data, means of 4,3 and 25,1, respectively, prior to the program. Conclusion: It can be concluded that the inclusion of the PHSITWHC was associated with a reduction in the rate of absenteeism of workers that underwent job accommodation. It was observed that, once health and safety were approached and integrated with the inclusion of the TWH concept, it was possible to reduce absenteeism, and improve worker’s quality of life and wellness, and work accommodation management.

Keywords: absenteeism, health/safety integration, work accommodation management, total worker health

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Authors: Raquel Vianna Duarte Cardoso, Eduarda Lobato Faria, José Jorge Boueri

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Rapid urbanization has transformed the global landscape, presenting significant challenges to public health. This article delves into the impact of urbanization on the spread of infectious diseases in cities and identifies crucial strategies to enhance urban community resilience. Massive urbanization over recent decades has created conducive environments for the rapid spread of diseases due to population density, mobility, and unequal living conditions. Urbanization has been observed to increase exposure to pathogens and foster conditions conducive to disease outbreaks, including seasonal flu, vector-borne diseases, and respiratory infections. In order to tackle these issues, a range of cross-disciplinary approaches are suggested. These encompass the enhancement of urban healthcare infrastructure, emphasizing the need for robust investments in hospitals, clinics, and healthcare systems to keep pace with the burgeoning healthcare requirements in urban environments. Moreover, the establishment of disease monitoring and surveillance mechanisms is indispensable, as it allows for the timely detection of outbreaks, enabling swift responses. Additionally, community engagement and education play a pivotal role in advocating for personal hygiene, vaccination, and preventive measures, thus playing a pivotal role in diminishing disease transmission. Lastly, the promotion of sustainable urban planning, which includes the creation of cities with green spaces, access to clean water, and proper sanitation, can significantly mitigate the risks associated with waterborne and vector-borne diseases. The article is based on a review of scientific literature, and it offers a comprehensive insight into the complexities of the relationship between urbanization and health. It places a strong emphasis on the urgent need for integrated approaches to improve urban resilience in the face of health challenges.

Keywords: infectious diseases dissemination, public health, urbanization impacts, urban resilience

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