Search results for: children health
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11001

Search results for: children health

5241 The Prevalence of Postpartum Stress among Jordanian Women

Authors: Khitam Ibrahem Shlash Mohammad

Abstract:

Background: Postnatal depression is a focus of considerable research attention, but little is known about the pattern of stress across this period. Objective: to investigate the prevalence of stress after childbirth for Jordanian women and identify associated risk factors. Method: Design: A descriptive cross-sectional study. Participants were recruited six to eight weeks postpartum, provided personal, social and obstetric information, and completed the stress subscale of Depression Anxiety and Stress Scale (DASS-S), the Maternity Social Support Scale (MSSS), and Perceived Self-Efficacy Scale (PSES). Setting: maternal and child health care clinics in four health care centres in Maan city in Southern Jordan. Participants: Arabic speaking women (n = 324) between the ages of 18 and 45 years, six to eight weeks postpartum, primiparous or multiparous at low risk for obstetric complications. Data collection took place between October 2015 and January 2016. Ethical clearance was obtained prior to data collection. Results: The prevalence of postpartum stress among Jordanian women was 39.8 %. A regression analysis revealed that occupation, low social support, financial problems, difficult marital relationships, difficult relationship with family-in-law, giving birth to a female baby, difficult childbirth, and low self-efficacy were associated with postpartum stress. Conclusions and implications for practice: Jordanian women need support during pregnancy, during and after childbirth. Postpartum emotional support and assessment of symptoms of stress need to be incorporated into routine practice. The opportunity for open discussion along with increased awareness and clarification of common misconceptions about postpartum stress is necessary.

Keywords: prevalence, postpartum, stress, Jordanian women

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5240 A Refrigerated Condition for the Storage of Glucose Test Strips at Health Promoting Hospitals: An Implication for Hospitals with Limited Air Conditioners

Authors: Wanutchaya Duanginta, Napaporn Apiratmateekul, Tippawan Sangkaew, Sunaree Wekinhirun, Kunchit Kongros, Wanvisa Treebuphachatsakul

Abstract:

Thailand has a tropical climate with an average outdoor ambient air temperature of over 30°C, which can exceed manufacturer recommendations for the storage of glucose test strips. This study monitored temperature and humidity at actual sites of five sub-district health promoting hospitals (HPH) in Phitsanulok Province for the storage of glucose test strips in refrigerated conditions. Five calibrated data loggers were placed at the actual sites for glucose test strip storage at five HPHs for 8 weeks between April and June. For the stress test, two lot numbers of glucose test strips, each with two glucose meters, were kept in a plastic box with desiccants and placed in a refrigerator with the temperature calibrated to 4°C and at room temperature (RT). Temperature and humidity in the refrigerator and at RT were measured every hour for 30 days. The mean temperature for storing test strips at the five HPHs ranged from 29°C to 33°C, and three of the five HPHs (60%) had a mean temperature above 30°C. The refrigerator temperatures were 3.8 ± 2.0°C (2.0°C to 6.5°C), and relative humidity was 51 ± 2% (42 to 54%). The maximum of blood glucose testing by glucose meters when the test strips were stored in a refrigerator were not significantly different (p > 0.05) from unstressed test strips for both glucose meters using amperometry-GDH-PQQ and amperometry-GDH-FAD principles. Opening the test strip vial daily resulted in higher variation than when refrigerated after a single-use. However, the variations were still within an acceptable range. This study concludes that glucose tested strips can be stored in plastic boxes in a refrigerator if it is well-controlled for temperature and humidity. Storage of glucose-tested strips in the refrigerator during hot and humid weather may be useful for HPHs with limited air conditioners.

Keywords: environmental stressed test, thermal stressed test, quality control, point-of-care testing

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5239 Retrospective Study on the Impacts of Age, Gender, Economic Status, Education Level and Drug Availability in Public Hospital on Seeking Care of Dermatological Condition in Rwanda

Authors: Uwizera Egide

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Introduction: Dermatological conditions are one of the most burdensome diseases in our health system. Global studies suggest that around 1 in 3 people gets a skin disease at a certain point in their life, though this does not necessarily guarantee the urge to consult. For a high-ranking disease, it is surprising how there is not enough data to support its effect on the economy and the general health system impact. It is for that reason that this study’s aim is to identify the burden of dermatological conditions in Rwanda so as to have a general picture of what our population is going through in regards to dermatological conditions. Methods: We used a cross sectional retrospective study. Data were obtained from patient’s information recorded in an open clinic at CHUB in a period of six months from July to December of the year 2021. Results: The study had a total of 4600 patients who attended dermatology service in a period of six months from July to December of the year 2021. We found a list of 102 dermatological diseases that presented at variable rates. The most prevalent disease was atopic dermatitis, at a rate of 23%. About 90% of presented conditions had only one choice of treatment from the hospital pharmacy. Most patients who presented were between 18-35 years old and with a predominance of the female gender; the level of education was either secondary or University Degree in our study, 65.4% of patients who presented were female; the majority, around 45% were between 18-35 years old, mostly being single 56%. The majority came from Southern province as it is the location of the hospital. The insurance mostly used was community-based health insurance with 63.8%, followed by RSSB with 18.5%, MS/UR, and other private insurances. The frequency of group drugs prescribed among all dermatological medications, steroids were the most commonly given medications at a rate of 39%, followed by emollients, antibiotics, and antifungal. The drugs prescribed were mostly available in the pharmacy of CHUB, with 60% and 40% being found in pharmacies outside the hospital. Conclusion: Dermatological conditions are prevalent in all age groups and distributed through all socioeconomic classes. About 9.2% of patient who consulted CHUB in 2021 presented one Dermatological condition of which 40 % of prescribed medications is never found in Hospital urging a need to buy medication in private pharmacies with more expenses and a risk of not complying on prescribed medication if in case they can’t afford paying them outside the CHUB. This finding urges a need to avail all essential dermatological drugs in hospital pharmacies to allow our patients to get them for the proper compliance of prescribed drugs in the management of skin diseases.

Keywords: atopic dermatitis, CHUB (centre hopitalier univerisitaire de butare), dermatological condition, fungal infections

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5238 Awareness and Access to Rapid Diagnostic Tests of HIV, Malaria and Tuberculosis among Rural Pregnant Women of Savannakhet Province, Lao PDR

Authors: Vanphanom Sychareun, Viengnakhone Vongxay, Kongmany Chaleunvong, Pascale Hancart Petitet

Abstract:

Background: Lao PDR still has challenges in preventing and managing health against risk of emerging and re-emerging diseases, particularly HIV/AIDS, tuberculosis and malaria among pregnant women. Community-based intervention for mothers requires more evidences on awareness of such diseases and access to rapid diagnostic tests. The study aims to determine the awareness of pregnant women regarding HIV, TB and Malaria, the access to rapid diagnostic test of such diseases among pregnant women of local community and their factors related. Method: This is a cross sectional study using quantitative approach to explore the awareness of pregnant women on HIV/AIDS/TB and Malaria in Savannakhet province, Lao PDR in three remote districts (Phin, Thapangthong and Atsaphone) of Savannakhet province. The study targeted group was pregnant women at the community level. Sample size for primary data collection of pregnant women was 189. Face-to-face administered questionnaires were applied. Descriptive and inferential statistics were applied to determine the associated factors with awareness of pregnant women on HIV/AIDS/TB and Malaria. This study is under the HEALTH project/ Expertise France. Result: Most of our participants were pregnant at 28 – 42 weeks (50.3%); ranged 4 – 38 weeks. Mean age of pregnant women was 24.3 years old (range: 14 - 48 years old); 15.9% of whom were at age below 19 years. Around 94.2% of respondents works were farming, 54.5% were illiterate, 74.0% were Mon-Kmer ethnic, and 60% had income lower than average. Only 56.6% that have access to ANC, 39.1% started the access to ANC during the first trimester and only 19.6% had visited the ANC for at least four times. Almost pregnant women (and 92.1% and 93.1%) had low to moderate knowledge of HIV and TB respectively, while three-fourth of pregnant women (74.6%) had low to moderate knowledge of malaria. Slightly higher than half of participants (53.4% and 52.9%) had easy access to HIV and TB respectively ; while 72.5% had easy access to malaria. Majority of participants knew where to get tested for malaria (73.5%) and TB (54.5%), but 73.5% did not know where to get tested for HIV. Very few pregnant women (1.6%, 2.1% and 8.5%) experienced having tested for HIV/TB/malaria. respectively. Factors associated with awareness on HIV were occupation as staff, business (OR:5.9; 95% CI:1.2-28.1), upper secondary education (OR: 14.6; 95% CI:3.1-69.2); Mone-Khmer ethnic (OR: 0.4, 95% CI: 0.2-0.8); and attending ANC more than 4 times (OR:4.1, 95%:1.7-9.7). Factors associated with awareness on TB were occupation as staff, business (OR:2.4; 95% CI: 0.7-8.0), upper secondary education (OR: 6.2; 95% CI: 1.9-20.5); Mone-Khmer ethnic (OR: 0.5, 95% CI:0.3-0.9); attending ANC more than 4 times (OR:2.8, 95%:1.2-6.4). Factors associated with awareness on malaria were upper secondary education (OR: 18.1; 95% CI: 2.3-142.9); Mone-Khmer ethnic (OR: 0.2, 95% CI:0.1-0.4); attending ANC more than 4 times (OR:3.6, 95%:1.5-8.8). Conclusion: A very low awareness on HIV, TB and malaria among pregnant women in rural community of Savannakhet triggers the requirement of comprehensive public health intervention on awareness and access to prevention against emerging diseases for all pregnant women. Future intervention should focus on providing more knowledge to pregnant women during ANC and encouraging them to attend ANC more than 4 times.

Keywords: pregnant women, HIV, tuberculosis, malaria, awareness, Laos

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5237 Integrating Music on Construction Sites: Key Benefits and Cautions: A Literature Perspective

Authors: Oluwatayomi Daniel Fadumo, Chinyere Celestina Esimone

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The construction industry, as a massive human capital-related sector, requires an always motivated workforce. The inability to maintain this state has been found to hamper productivity which ultimately leads to poor project delivery, infrastructural development decline, and low morale among citizens. The need to develop an approach to keep this set of people inspired before, during, and after work becomes a necessity; this paper aims to evaluate the key benefits and cautions in integrating music on construction sites in Nigeria to improve effective project delivery. In attaining this, the study identified the advantages of music on construction sites, evaluated the key considerations in introducing music on construction sites, and recommended measures for the effective integration of music on construction sites in Nigeria. The study is a descriptive research through the use of secondary data gleaned from relevant literature, journals, and research sites. The study concluded that different forms of music genres can be implemented ranging from Pop music, rock, metal, and classical music. Introducing music has the advantage of industrial branding, improving workers` morale, setting the pace for working, helping in information retention, and improving mental health and happiness. The key consideration, however, is to provide the right volume and music that doesn’t pose health and safety challenges. The study finally recommended that for effective integration of music on construction sites in Nigeria, policies should be drafted regulating its use, specific radio customized for the site be introduced and that research-based music, proven to have previously helped, should be given to a group of workers.

Keywords: music, construction sites, workers, construction industry, construction management practice

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5236 Blockchain Technology Applications in Patient Tracking Systems Regarding Privacy-Preserving Concerns and COVID-19 Pandemic

Authors: Farbod Behnaminia, Saeed Samet

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The COVID-19 pandemic has paralyzed many lives until a vaccine was available, which caused the so-called “new normal.” According to the World Health Organization (WHO), COVID-19 is an infectious disease. It can cause significant illness or death in anyone. Governments and health officials tried to impose rules and regulations to avoid and slow down transmission. Therefore, software engineers worldwide developed applications to trace and track patients’ movements and notify others, mainly using Bluetooth. In this way, everyone could be informed whether they come in close contact with someone who has COVID-19 and takes proper safety precautions. Because most of the applications use technologies that can potentially reveal the user’s identity and location, researchers have debated privacy preservation and how to improve user privacy during such pandemics. Thanks to Distributed Ledger Technology (DLT), there have been some proposed methods to develop privacy-preserving Patient Tracking Systems in the last two years. As an instance of the DLT, Blockchain is like a decentralized peer-to-peer database that maintains a record of transactions. Transactions are immutable, transparent, and anonymous in this system. We conducted a comprehensive evaluation of the literature by looking for papers in the relevant field and dividing them into pre- and post-pandemic systems. Additionally, we discussed the many uses of blockchain technology in pandemic control. We found that two major obstacles facing blockchain implementation across many healthcare systems are scalability and privacy. The Polkadot platform is presented, along with a review of its efficacy in tackling current concerns. A more scalable healthcare system is achievable in the near future using Polkadot as well as a much more privacy-preserving environment.

Keywords: blockchain, electronic record management, EHR, privacy-preserving, patient tracking, COVID-19, trust and confidence, Polkadot

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5235 The High Potential and the Little Use of Brazilian Class Actions for Prevention and Penalization Due to Workplace Accidents in Brazil

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

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

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

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5234 Suicide, Help-Seeking and LGBT Youth: A Mixed Methods Study

Authors: Elizabeth McDermott, Elizabeth Hughes, Victoria Rawlings

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Globally, suicide is the second leading cause of death among 15–29 year-olds. Young people who identify as lesbian, gay, bisexual and transgender (LGBT) have elevated rates of suicide and self-harm. Despite the increased risk, there is a paucity of research on LGBT help-seeking and suicidality. This is the first national study to investigate LGBT youth help-seeking for suicidal feelings and self-harm. We report on a UK sequential exploratory mixed method study that employed face-to-face and online methods in two stages. Stage one involved 29 online (n=15) and face-to-face (n=14) semi-structured interviews with LGBT youth aged under 25 years old. Stage two utilized an online LGBT youth questionnaire employing a community-based sampling strategy (n=789). We found across the sample that LGBT youth who self-harmed or felt suicidal were reluctant to seek help. Results indicated that participants were normalizing their emotional distress and only asked for help when they reached crisis point and were no longer coping. Those who self-harmed (p<0.001, OR=2.82), had attempted or planned suicide (p<0.05, OR=1.48), or had experience of abuse related to their sexuality or gender (p<0.01, OR=1.80), were most likely to seek help. There were a number of interconnecting reasons that contributed to participants’ problems accessing help. The most prominent of these were: negotiating norms in relation to sexuality, gender, mental health and age; being unable to talk about emotions, and coping and self-reliance. It is crucial that policies and practices that aim to prevent LGBT youth suicide recognize that norms and normalizing processes connected to sexual orientation and gender identity are additional difficulties that LGBT youth have accessing mental health support.

Keywords: help-seeking, LGBT, suicide, youth

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5233 Prediction of Covid-19 Cases and Current Situation of Italy and Its Different Regions Using Machine Learning Algorithm

Authors: Shafait Hussain Ali

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Since its outbreak in China, the Covid_19 19 disease has been caused by the corona virus SARS N coyote 2. Italy was the first Western country to be severely affected, and the first country to take drastic measures to control the disease. In start of December 2019, the sudden outbreaks of the Coronary Virus Disease was caused by a new Corona 2 virus (SARS-CO2) of acute respiratory syndrome in china city Wuhan. The World Health Organization declared the epidemic a public health emergency of international concern on January 30, 2020,. On February 14, 2020, 49,053 laboratory-confirmed deaths and 1481 deaths have been reported worldwide. The threat of the disease has forced most of the governments to implement various control measures. Therefore it becomes necessary to analyze the Italian data very carefully, in particular to investigates and to find out the present condition and the number of infected persons in the form of positive cases, death, hospitalized or some other features of infected persons will clear in simple form. So used such a model that will clearly shows the real facts and figures and also understandable to every readable person which can get some real benefit after reading it. The model used must includes(total positive cases, current positive cases, hospitalized patients, death, recovered peoples frequency rates ) all features that explains and clear the wide range facts in very simple form and helpful to administration of that country.

Keywords: machine learning tools and techniques, rapid miner tool, Naive-Bayes algorithm, predictions

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5232 Artificial Intelligence in Bioscience: The Next Frontier

Authors: Parthiban Srinivasan

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With recent advances in computational power and access to enough data in biosciences, artificial intelligence methods are increasingly being used in drug discovery research. These methods are essentially a series of advanced statistics based exercises that review the past to indicate the likely future. Our goal is to develop a model that accurately predicts biological activity and toxicity parameters for novel compounds. We have compiled a robust library of over 150,000 chemical compounds with different pharmacological properties from literature and public domain databases. The compounds are stored in simplified molecular-input line-entry system (SMILES), a commonly used text encoding for organic molecules. We utilize an automated process to generate an array of numerical descriptors (features) for each molecule. Redundant and irrelevant descriptors are eliminated iteratively. Our prediction engine is based on a portfolio of machine learning algorithms. We found Random Forest algorithm to be a better choice for this analysis. We captured non-linear relationship in the data and formed a prediction model with reasonable accuracy by averaging across a large number of randomized decision trees. Our next step is to apply deep neural network (DNN) algorithm to predict the biological activity and toxicity properties. We expect the DNN algorithm to give better results and improve the accuracy of the prediction. This presentation will review all these prominent machine learning and deep learning methods, our implementation protocols and discuss these techniques for their usefulness in biomedical and health informatics.

Keywords: deep learning, drug discovery, health informatics, machine learning, toxicity prediction

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5231 Association between Maternal Personality and Postnatal Mother-to-Infant Bonding

Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

Abstract:

Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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5230 Nutrition Strategy Using Traditional Tibetan Medicine in the Preventive Measurement

Authors: Ngawang Tsering

Abstract:

Traditional Tibetan medicine is primarily focused on promoting health and keeping away diseases from its unique in prescribing specific diet and lifestyle. The prevalence of chronic diseases has been rising day by day and kills a number of people due to the lack of proper nutritional design in modern times. According to traditional Tibetan medicine, chronic diseases such as diabetes, cancer, cardiovascular diseases, respiratory diseases, and arthritis are heavily associated with an unwholesome diet and inappropriate lifestyles. Diet and lifestyles are the two main conditions of diseases and healthy life. The prevalence of chronic diseases is one of the challenges, with massive economic impact and expensive health issues. Though chronic diseases are challenges, it has a solution in the preventive measurements by using proper nutrition design based on traditional Tibetan medicine. Until today, it is hard to evaluate whether traditional Tibetan medicine nutrition strategy could play a major role in preventive measurement as of the lack of current research evidence. However, compared with modern nutrition, it has an exclusive valuable concept, such as a holistic way and diet or nutrition recommendation based on different aspects. Traditional Tibetan medicine is one of the oldest ancient existing medical systems known as Sowa Rigpa (Science of Healing) highlights different aspects of dietetics and nutrition, namely geographical, seasonal, age, personality, emotional, food combination, the process of individual metabolism, potency, and amount of food. This article offers a critical perspective on the preventive measurement against chronic diseases through nutrition design using traditional Tibetan medicine and also needs attention for a deeper understanding of traditional Tibetan medicine in the modern world.

Keywords: traditional Tibetan medicine, nutrition, chronic diseases, preventive measurement, holistic approach, integrative

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5229 Hypervirulent Klebsiella Pneumoniae in a South African Tertiary Hospital – Clinical Profile, Genetic Determinants and Virulence in Caenorhabditis Elegans

Authors: Dingiswayo Likhona, Arko-Cobbah Emmanuel, Carolina Pohl, Nthabiseng Z. Mokoena, Jolly Musoke

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A distinct strain of Klebsiella pneumoniae (K. pneumoniae), referred to as hypervirulent (hvKp), is associated with invasive infections such as an invasive pyogenic liver abscess in young and healthy individuals. In South Africa, limited information is known about the prevalence and virulence of this hvKp strain. Thus, this study aimed to determine the prevalence of hvKp and virulence-associated factors in K. pneumoniae isolates from one of the largest Tertiary hospitals in a South African province. A total of 74 K. pneumoniae isolates were received from Pelonomi National Health Laboratory Services (NHLS), Bloemfontein. Virulence-associated genes (rmpA, capsule serotype K1/K2, iroB, and irp2) were screened, and the virulence of hvKp vs. classical Klebsiella pneumoniae (cKp) was investigated using Caenorhabditis elegans nematode model. The iutA (aerobactin transporter) gene was used as a primary biomarker of hvKp. An average of 12% (9/74) of cases were defined as hvKp. Moreover, hvKp was found to be significantly more virulent in vivo Caenorhabditis elegans relative to cKp. The virulence-associated genes (rmpA, iroB, hmv phenotype, and capsule K1/K2) were significantly (p< 0.05) associated with hvKp. Findings from this study confirm the presence of hvKp in one large Tertiary hospital in South Africa. However, the low prevalence and mild to moderate clinical presentation suggest a marginal threat to public health. Further studies in different settings are required to establish the true potential impact of hvKp in developing countries.

Keywords: hypervirulent klebsiella pneumoniae, virulence, caenorhabditis elegans, aerobactin (iutA)

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5228 Single-Case Experimental Design: Exploratory Pilot Study on the Feasibility and Effect of Virtual Reality for Pain and Anxiety Management During Care

Authors: Corbel Camille, Le Cerf Flora, Corveleyn Xavier

Abstract:

Introduction: Aging is a physiological phenomenon accompanied by anatomical and cognitive changes leading to anxiety and pain. This could have significant impacts on quality of life, life expectancy, and the progression of cognitive disorders. Virtual Reality Intervention (VRI) is increasingly recognized as a non-pharmacological approach to alleviate pain and anxiety in children and young adults. However, while recent studies have explored the feasibility of applying VRI in the older population, confirmation through studies is still required to establish its benefits in various contexts. Objective: This pilot study, following a clinical trial methodology international recommendation for VRI in healthcare, aims to evaluate the feasibility and effects of using VRI with a 101-year-old woman residing in a nursing home undergoing weekly painful and anxious wound dressing changes. Methods: Following the international recommendations, this study focused on feasibility and preliminary results. A Single Case Experimental Design protocol consists of two distinct phases: control (Phase A) and personalized VRI (Phase B), each lasting for 6 sessions. Data were collected before, during and after the care, using measures of pain (Algoplus and numerical scale), anxiety (Hospital anxiety scale and numerical scale), VRI experience (semi-structured interview) and physiological measures. Results: The results suggest that the utilization of VRI is both feasible and well-tolerated by the participant. VRI contributed to a decrease in pain and anxiety during care sessions, with a more significant impact on pain compared to anxiety, which showed a gradual and slight decrease. Physiological data, particularly those related to stress, also indicate a reduction in physiological activity during VRI. Conclusion: This pilot study confirms the feasibility and benefits of using virtual reality in managing pain and anxiety in an older adult in a nursing home. In light of these results, it is essential that future studies focus on setting up randomized controlled trials (RCTs). These studies should involve a representative number of older adults to ensure generalizable data. This rigorous, controlled methodology will enable us to assess the effectiveness of virtual reality more accurately in various care settings, measure its impact on clinical parameters such as pain and anxiety, and explore the long-term implications of this intervention.

Keywords: anxiety reduction, nursing home, older adult, pain management, virtual reality

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5227 Ethical Implications of Gaps in the Implementation Process of the Circular Economy: Special Focus on Underdeveloped Countries

Authors: Sujith Gunawardhana

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The circular economy is a system in which resources and energy are derived from renewable sources, utilized efficiently, recycled, and reused to reduce waste, reduce nonrenewable resource consumption, and mitigate negative environmental impacts. However, it poses moral questions about sustainability, the environment, and societal issues. Many societies face challenges when implementing the circular economy, as the concept is still young. The equitable distribution of the advantages and costs of circularity should be ensured during implementation, as some communities, particularly disadvantaged or marginalized ones, may suffer unfairly disproportionately from the harmful effects of production and recycling facilities. Prioritizing the health and safety of workers, communities, and the environment is essential, and strict rules must be implemented to guard against harm. However, most underdeveloped countries need a legal safeguard for this situation. The ultimate objective of the circular economy is to improve social, environmental, and economic performance, but its implementation also requires consideration of the ethics of care and non-epistemic values. Those are often hindered in underdeveloped countries, as the availability of infrastructure and technology, affordability, and legislative framework are poor. To achieve long-term success in the circular economy, evaluating implementation steps and considering health, safety, environmental, and social risks is crucial. To implement the circular economy, respect ethics of care and non-epistemic values. Adopt Kantian Ethics and control technology design to ensure equal benefits for all involved. Ethical gaps may lead underdeveloped countries to generate social pressure against the circular economy.

Keywords: circular economy, ethics, values, sustainability

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5226 Nutritional Importance and Functional Properties of Baobab Leaves

Authors: Khadijat Ayanpeju Abdulsalam, Bolanle Mary Olawoye, Paul Babatunde Ayoola

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The potential of Baobab leaves is understudied and not yet fully documented. The purpose of this work is to highlight the important nutritional value and practical qualities of baobab leaves. In this research, proximate analysis was studied to determine the macronutrient quantitative analysis in baobab leaves. Studies were also conducted on other characteristics, such as moisture content, which is significant to the food business since it affects food quality, preservation, and resistance to deterioration. Dietary fiber, which was also studied, has important health benefits, such as lowering blood cholesterol levels by lowering low-density lipoprotein or "bad" cholesterol. It functions as an anti-obesity and anti-diabetic agent, lowering the likelihood of haemorrhoids developing. Additionally, increasing face bulk and short-chain fatty acid synthesis improves gastrointestinal health and overall wellness. Baobab leaves had a moisture content of 6.4%, fat of 16.1%, ash of 3.2%, protein of 18.7%, carbohydrate 57.2% and crude fiber of 4.1%. The minerals determined in the sample of baobab leaves are Ca, Fe, Mg, K, Na, P, and Zn with Potassium (347.6±0.70) as the most abundant mineral while Zn (9.31±0.60) is the least abundant. The functional properties studied include pH, gelation temperature, bulk density, water absorption capacity, oil absorption capacity, foaming property, emulsifying property, and stability and swelling capacity, which are 8.72, 29, 0.39, 138, 98.20, 0.80, 72.80, and 73.50 respectively. The Fourier Transform InfraRed absorption spectra show bands like C=O, C-Cl and N-H. Baobab leaves are edible, nutritious, and non-toxic, as the mineral contents are within the required range.

Keywords: dietary fibre, proximate analysis, macronutrients, minerals, baobab leaves, frequency range

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5225 Oral Sex Practice among Men Who Have Sex with Men: A Cross-Sectional Study in Indonesian Urban Settings

Authors: I Putu Yuda Hananta, Inke Kusumastuti

Abstract:

The latest Indonesian Biology and Behavior Surveillance (IBBS) conducted by Indonesian Ministry of Health reported a large proportion of men who have sex with men (MSM) engaging in oral sex in their recent sexual history. While it is considered as a pleasuring and safe, oral sex might facilitate the transmission of various sexually transmitted infection (STI) pathogens. This study was aimed to investigate the oral sex practice among MSM in Indonesian urban settings to help delineate demographic and behavior determinants of such practice. In 2014, 501 MSM in 8 clinic-based and outreach STI services were recruited in Jakarta, Yogyakarta and Denpasar, Indonesia. Respondents completed a self-administered questionnaire inquiring about their demographics and sexual history. Median age (interquartile range) of the respondents was 27 (24-30) years; most completed senior high school (54.3%), worked in informal jobs (57.9%), and single (60.9%); and 32.3% reported receiving money in exchange for sex. Oral sex was practiced by most respondents: insertive only (10.0%), receptive only (6.0%), and both (82.4%). A separate multivariable analysis was performed using logistic regression to identify the determinants for receptive and insertive oral sex. Factors associated with receptive oral sex were having more than 10 sex partner(s) in the preceding 6 months vs 1 partner, adjusted odds ratio (aOR) [95% CI]=3.40 [1.22-9.42], p=0.03; and history of receptive-insertive anal sex vs no history, aOR=4.37 [1.76-10.82], p=0.01. Factors associated with insertive oral sex were receiving money for sex vs. not receiving, aOR=2.98 [1.10-8.04], p=0.02; and history of receptive-insertive anal sex vs. no history, aOR=2.10 [0.51-8.74], p<0.001. Only a few respondents reported consistent condom use (11.6% and 12.0% for receptive and insertive oral sex, respectively). Our findings demonstrated that while oral sex is a common practice among MSM, the consistency of condom use in oral sex is very low. In addition, certain sex behavior (number of sex partners, sex work and history of anal sex) were associated with oral sex, and this might need to be addressed during health promotion efforts on STI prevention through oral-genital contact.

Keywords: behavior, Indonesia, men who have sex with men, oral sex

Procedia PDF Downloads 227
5224 To Live on the Margins: A Closer Look at the Social and Economic Situation of Illegal Afghan Migrants in Iran

Authors: Abdullah Mohammadi

Abstract:

Years of prolong war in Afghanistan has led to one of the largest refugee and migrant populations in the contemporary world. During this continuous unrest which began in 1970s (by military coup, Marxist revolution and the subsequent invasion of USSR), over one-third of the population migrated to neighboring countries, especially Pakistan and Iran. After the Soviet Army withdrawal in 1989, a new wave of conflicts emerged between rival Afghan groups and this led to new refugees. Taliban period, also, created its own refugees. During all these years, I.R. of Iran has been one of the main destinations of Afghan refugees and migrants. At first, due to the political situation after Islamic Revolution, Iran government didn’t restrict the entry of Afghan refugees. Those who came first in Iran received ID cards and had access to education and healthcare services. But in 1990s, due to economic and social concerns, Iran’s policy towards Afghan refugees and migrants changed. The government has tried to identify and register Afghans in Iran and limit their access to some services and jobs. Unfortunately, there are few studies on Afghan refugees and migrants’ situation in Iran and we have a dim and vague picture of them. Of the few studies done on this group, none of them focus on the illegal Afghan migrants’ situation in Iran. Here, we tried to study the social and economic aspects of illegal Afghan migrants’ living in Iran. In doing so, we interviewed 24 illegal Afghan migrants in Iran. The method applied for analyzing the data is thematic analysis. For the interviews, we chose family heads (17 men and 7 women). According to the findings, illegal Afghan migrants’ socio-economic situation in Iran is very undesirable. Its main cause is the marginalization of this group which is resulted from government policies towards Afghan migrants. Most of the illegal Afghan migrants work in unskilled and inferior jobs and live in rent houses on the margins of cities and villages. None of them could buy a house or vehicle due to law. Based on their income, they form one of the lowest, unprivileged groups in the society. Socially, they face many problems in their everyday life: social insecurity, harassment and violence, misuse of their situation by police and people, lack of education opportunity, etc. In general, we may conclude that illegal Afghan migrant have little adaptation with Iran’s society. They face severe limitations compared to legal migrants and refugees and have no opportunity for upward social mobility. However, they have managed some strategies to face these difficulties including: seeking financial and emotional helps from family and friendship networks, sending one of the family members to third country (mostly to European countries), establishing self-administered schools for children (schools which are illegal and run by Afghan educated youth).

Keywords: illegal Afghan migrants, marginalization, social insecurity, upward social mobility

Procedia PDF Downloads 304
5223 Seroprevalence of Bovine Brucellosis and its Public Health Significance in Selected Sites of Central High Land of Ethiopia

Authors: Temesgen Kassa Getahun, Gezahegn Mamo, Beksisa Urge

Abstract:

A cross-sectional study was conducted from December 2019 to May 2020 with the aim of determining the seroprevalence of brucellosis in dairy cows and their owners in the central highland of Oromia, Ethiopia. A total of 352 blood samples from dairy cattle, 149 from animal owners, and 17 from farm workers were collected and initially screened using the Rose Bengal Plate test and confirmed by the Complement Fixation test. Overall seroprevalence was 0.6% (95% CI: 0.0016–0.0209) in bovines and 1.2% (95% CI: 0.0032–0.0427) in humans. Market-based stock replacement (OR=16.55, p=0.002), breeding by artificial insemination (OR=7.58, p=0.05), and parturition pen (OR = 11.511, p=0.027) were found to be significantly associated with the seropositivity for Brucella infection in dairy cattle. Human housing (OR=1.8, p=0.002), contact with an aborted fetus (OR=21.19, p=0.017), drinking raw milk from non-aborted (OR=24.99, p=0.012), aborted (OR=5.72, p=0.019) and retained fetal membrane (OR=4.22, p=0.029) cows had a significant influence on human brucellosis. A structured interview question was administered to 284 respondents. Accordingly, most respondents had no knowledge of brucellosis (93.3%), and in contrast, 90% of them consumed raw milk. In conclusion, the present seroprevalence study revealed that brucellosis was low among dairy cattle and exposed individuals in the study areas. However, since there were no control strategies implemented in the study areas, there is a potential risk of transmission of brucellosis in dairy cattle and the exposed human population in the study areas. Implementation of a test and slaughter strategy with compensation to farmers is recommended, while in the case of human brucellosis, continuous social training and implementing one health approach framework must be applied.

Keywords: abortion, bovine brucellosis, human brucellosis, risk factors, seroprevalence

Procedia PDF Downloads 90
5222 Improving Screening and Treatment of Binge Eating Disorders in Pediatric Weight Management Clinic through a Quality Improvement Framework

Authors: Cristina Fernandez, Felix Amparano, John Tumberger, Stephani Stancil, Sarah Hampl, Brooke Sweeney, Amy R. Beck, Helena H Laroche, Jared Tucker, Eileen Chaves, Sara Gould, Matthew Lindquist, Lora Edwards, Renee Arensberg, Meredith Dreyer, Jazmine Cedeno, Alleen Cummins, Jennifer Lisondra, Katie Cox, Kelsey Dean, Rachel Perera, Nicholas A. Clark

Abstract:

Background: Adolescents with obesity are at higher risk of disordered eating than the general population. Detection of eating disorders (ED) is difficult. Screening questionnaires may aid in early detection of ED. Our team’s prior efforts focused on increasing ED screening rates to ≥90% using a validated 10-question adolescent binge eating disorder screening questionnaire (ADO-BED). This aim was achieved. We then aimed to improve treatment plan initiation of patients ≥12 years of age who screen positive for BED within our WMC from 33% to 70% within 12 months. Methods: Our WMC is within a tertiary-care, free-standing children’s hospital. A3, an improvement framework, was used. A multidisciplinary team (physicians, nurses, registered dietitians, psychologists, and exercise physiologists) was created. The outcome measure was documentation of treatment plan initiation of those who screen positive (goal 70%). The process measure was ADO-BED screening rate of WMC patients (goal ≥90%). Plan-Do-Study-Act (PDSA) cycle 1 included provider education on current literature and treatment plan initiation based upon ADO-BED responses. PDSA 2 involved increasing documentation of treatment plan and retrain process to providers. Pre-defined treatment plans were: 1) repeat screen in 3-6 months, 2) resources provided only, or 3) comprehensive multidisciplinary weight management team evaluation. Run charts monitored impact over time. Results: Within 9 months, 166 patients were seen in WMC. Process measure showed sustained performance above goal (mean 98%). Outcome measure showed special cause improvement from mean of 33% to 100% (n=31). Of treatment plans provided, 45% received Plan 1, 4% Plan 2, and 46% Plan 3. Conclusion: Through a multidisciplinary improvement team approach, we maintained sustained ADO-BED screening performance, and, prior to our 12-month timeline, achieved our project aim. Our efforts may serve as a model for other multidisciplinary WMCs. Next steps may include expanding project scope to other WM programs.

Keywords: obesity, pediatrics, clinic, eating disorder

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5221 A Review of Brain Implant Device: Current Developments and Applications

Authors: Ardiansyah I. Ryan, Ashsholih K. R., Fathurrohman G. R., Kurniadi M. R., Huda P. A

Abstract:

The burden of brain-related disease is very high. There are a lot of brain-related diseases with limited treatment result and thus raise the burden more. The Parkinson Disease (PD), Mental Health Problem, or Paralysis of extremities treatments had risen concern, as the patients for those diseases usually had a low quality of life and low chance to recover fully. There are also many other brain or related neural diseases with the similar condition, mainly the treatments for those conditions are still limited as our understanding of the brain function is insufficient. Brain Implant Technology had given hope to help in treating this condition. In this paper, we examine the current update of the brain implant technology. Neurotechnology is growing very rapidly worldwide. The United States Food and Drug Administration (FDA) has approved the use of Deep Brain Stimulation (DBS) as a brain implant in humans. As for neural implant both the cochlear implant and retinal implant are approved by FDA too. All of them had shown a promising result. DBS worked by stimulating a specific region in the brain with electricity. This device is planted surgically into a very specific region of the brain. This device consists of 3 main parts: Lead (thin wire inserted into the brain), neurostimulator (pacemaker-like device, planted surgically in the chest) and an external controller (to turn on/off the device by patient/programmer). FDA had approved DBS for the treatment of PD, Pain Management, Epilepsy and Obsessive Compulsive Disorder (OCD). The target treatment of DBS in PD is to reduce the tremor and dystonia symptoms. DBS has been showing the promising result in animal and limited human trial for other conditions such as Alzheimer, Mental Health Problem (Major Depression, Tourette Syndrome), etc. Every surgery has risks of complications, although in DBS the chance is very low. DBS itself had a very satisfying result as long as the subject criteria to be implanted this device based on indication and strictly selection. Other than DBS, there are several brain implant devices that still under development. It was included (not limited to) implant to treat paralysis (In Spinal Cord Injury/Amyotrophic Lateral Sclerosis), enhance brain memory, reduce obesity, treat mental health problem and treat epilepsy. The potential of neurotechnology is unlimited. When brain function and brain implant were fully developed, it may be one of the major breakthroughs in human history like when human find ‘fire’ for the first time. Support from every sector for further research is very needed to develop and unveil the true potential of this technology.

Keywords: brain implant, deep brain stimulation (DBS), deep brain stimulation, Parkinson

Procedia PDF Downloads 141
5220 Applications of Polyvagal Theory for Trauma in Clinical Practice: Auricular Acupuncture and Herbology

Authors: Aurora Sheehy, Caitlin Prince

Abstract:

Within current orthodox medical protocols, trauma and mental health issues are deemed to reside within the realm of cognitive or psychological therapists and are marginalised in these areas, in part due to limited drugs option available, mostly manipulating neurotransmitters or sedating patients to reduce symptoms. By contrast, this research presents examples from the clinical practice of how trauma can be assessed and treated physiologically. Adverse Childhood Experiences (ACEs) are a tally of different types of abuse and neglect. It has been used as a measurable and reliable predictor of the likelihood of the development of autoimmune disease. It is a direct way to demonstrate reliably the health impact of traumatic life experiences. A second assessment tool is Allostatic Load, which refers to the cumulative effects that chronic stress has on mental and physical health. It records the decline of an individual’s physiological capacity to cope with their experience. It uses a specific grouping of serum testing and physical measures. It includes an assessment of neuroendocrine, cardiovascular, immune and metabolic systems. Allostatic load demonstrates the health impact that trauma has throughout the body. It forms part of an initial intake assessment in clinical practice and could also be used in research to evaluate treatment. Examining medicinal plants for their physiological, neurological and somatic effects through the lens of Polyvagal theory offers new opportunities for trauma treatments. In situations where Polyvagal theory recommends activities and exercises to enable parasympathetic activation, many herbs that affect Effector Memory T (TEM) cells also enact these responses. Traditional or Indigenous European herbs show the potential to support the polyvagal tone, through multiple mechanisms. As the ventral vagal nerve reaches almost every major organ, plants that have actions on these tissues can be understood via their polyvagal actions, such as monoterpenes as agents to improve respiratory vagal tone, cyanogenic glycosides to reset polyvagal tone, volatile oils rich in phenyl methyl esters improve both sympathetic and parasympathetic tone, bitters activate gut function and can strongly promote parasympathetic regulation. Auricular Acupuncture uses a system of somatotopic mapping of the auricular surface overlaid with an image of an inverted foetus with each body organ and system featured. Given that the concha of the auricle is the only place on the body where the Vagus Nerve neurons reach the surface of the skin, several investigators have evaluated non-invasive, transcutaneous electrical nerve stimulation (TENS) at auricular points. Drawn from an interdisciplinary evidence base and developed through clinical practice, these assessment and treatment tools are examples of practitioners in the field innovating out of necessity for the best outcomes for patients. This paper draws on case studies to direct future research.

Keywords: polyvagal, auricular acupuncture, trauma, herbs

Procedia PDF Downloads 67
5219 Understanding Stock-Out of Pharmaceuticals in Timor-Leste: A Case Study in Identifying Factors Impacting on Pharmaceutical Quantification in Timor-Leste

Authors: Lourenco Camnahas, Eileen Willis, Greg Fisher, Jessie Gunson, Pascale Dettwiller, Charlene Thornton

Abstract:

Stock-out of pharmaceuticals is a common issue at all level of health services in Timor-Leste, a small post-conflict country. This lead to the research questions: what are the current methods used to quantify pharmaceutical supplies; what factors contribute to the on-going pharmaceutical stock-out? The study examined factors that influence the pharmaceutical supply chain system. Methodology: Privett and Goncalvez dependency model has been adopted for the design of the qualitative interviews. The model examines pharmaceutical supply chain management at three management levels: management of individual pharmaceutical items, health facilities, and health systems. The interviews were conducted in order to collect information on inventory management, logistics management information system (LMIS) and the provision of pharmaceuticals. Andersen' behavioural model for healthcare utilization also informed the interview schedule, specifically factors linked to environment (healthcare system and external environment) and the population (enabling factors). Forty health professionals (bureaucrats, clinicians) and six senior officers from a United Nations Agency, a global multilateral agency and a local non-governmental organization were interviewed on their perceptions of factors (healthcare system/supply chain and wider environment) impacting on stock out. Additionally, policy documents for the entire healthcare system, along with population data were collected. Findings: An analysis using Pozzebon’s critical interpretation identified a range of difficulties within the system from poor coordination to failure to adhere to policy guidelines along with major difficulties with inventory management, quantification, forecasting, and budgetary constraints. Weak logistics management information system, lack of capacity in inventory management, monitoring and supervision are additional organizational factors that also contributed to the issue. There were various methods of quantification of pharmaceuticals applied in the government sector, and non-governmental organizations. Lack of reliable data is one of the major problems in the pharmaceutical provision. Global Fund has the best quantification methods fed by consumption data and malaria cases. There are other issues that worsen stock-out: political intervention, work ethic and basic infrastructure such as unreliable internet connectivity. Major issues impacting on pharmaceutical quantification have been identified. However, current data collection identified limitations within the Andersen model; specifically, a failure to take account of predictors in the healthcare system and the environment (culture/politics/social. The next step is to (a) compare models used by three non-governmental agencies with the government model; (b) to run the Andersen explanatory model for pharmaceutical expenditure for 2 to 5 drug items used by these three development partners in order to see how it correlates with the present model in terms of quantification and forecasting the needs; (c) to repeat objectives (a) and (b) using the government model; (d) to draw a conclusion about the strength.

Keywords: inventory management, pharmaceutical forecasting and quantification, pharmaceutical stock-out, pharmaceutical supply chain management

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5218 Trends in All-Cause Mortality and Inpatient and Outpatient Visits for Ambulatory Care Sensitive Conditions during the First Year of the COVID-19 Pandemic: A Population-Based Study

Authors: Tetyana Kendzerska, David T. Zhu, Michael Pugliese, Douglas Manuel, Mohsen Sadatsafavi, Marcus Povitz, Therese A. Stukel, Teresa To, Shawn D. Aaron, Sunita Mulpuru, Melanie Chin, Claire E. Kendall, Kednapa Thavorn, Rebecca Robillard, Andrea S. Gershon

Abstract:

The impact of the COVID-19 pandemic on the management of ambulatory care sensitive conditions (ACSCs) remains unknown. To compare observed and expected (projected based on previous years) trends in all-cause mortality and healthcare use for ACSCs in the first year of the pandemic (March 2020 - March 2021). A population-based study using provincial health administrative data.General adult population (Ontario, Canada). Monthly all-cause mortality, and hospitalizations, emergency department (ED) and outpatient visit rates (per 100,000 people at-risk) for seven combined ACSCs (asthma, COPD, angina, congestive heart failure, hypertension, diabetes, and epilepsy) during the first year were compared with similar periods in previous years (2016-2019) by fitting monthly time series auto-regressive integrated moving-average models. Compared to previous years, all-cause mortality rates increased at the beginning of the pandemic (observed rate in March-May 2020 of 79.98 vs. projected of 71.24 [66.35-76.50]) and then returned to expected in June 2020—except among immigrants and people with mental health conditions where they remained elevated. Hospitalization and ED visit rates for ACSCs remained lower than projected throughout the first year: observed hospitalization rate of 37.29 vs. projected of 52.07 (47.84-56.68); observed ED visit rate of 92.55 vs. projected of 134.72 (124.89-145.33). ACSC outpatient visit rates decreased initially (observed rate of 4,299.57 vs. projected of 5,060.23 [4,712.64-5,433.46]) and then returned to expected in June 2020. Reductions in outpatient visits for ACSCs at the beginning of the pandemic combined with reduced hospital admissions may have been associated with temporally increased mortality—disproportionately experienced by immigrants and those with mental health conditions. The Ottawa Hospital Academic Medical Organization

Keywords: COVID-19, chronic disease, all-cause mortality, hospitalizations, emergency department visits, outpatient visits, modelling, population-based study, asthma, COPD, angina, heart failure, hypertension, diabetes, epilepsy

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5217 Differences in Patient Satisfaction Observed between Female Japanese Breast Cancer Patients Who Receive Breast-Conserving Surgery or Total Mastectomy

Authors: Keiko Yamauchi, Motoyuki Nakao, Yoko Ishihara

Abstract:

The increase in the number of women with breast cancer in Japan has required hospitals to provide a higher quality of medicine so that patients are satisfied with the treatment they receive. However, patients’ satisfaction following breast cancer treatment has not been sufficiently studied. Hence, we investigated the factors influencing patient satisfaction following breast cancer treatment among Japanese women. These women underwent either breast-conserving surgery (BCS) (n = 380) or total mastectomy (TM) (n = 247). In March 2016, we conducted a cross-sectional internet survey of Japanese women with breast cancer in Japan. We assessed the following factors: socioeconomic status, cancer-related information, the role of medical decision-making, the degree of satisfaction regarding the treatments received, and the regret arising from the medical decision-making processes. We performed logistic regression analyses with the following dependent variables: extreme satisfaction with the treatments received, and regret regarding the medical decision-making process. For both types of surgery, the odds ratio (OR) of being extremely satisfied with the cancer treatment was significantly higher among patients who did not have any regrets compared to patients who had. Also, the OR tended to be higher among patients who chose to play a wanted role in the medical decision-making process, compared with patients who did not. In the BCS group, the OR of being extremely satisfied with the treatment was higher if, at diagnosis, the patient’s youngest child was older than 19 years, compared with patients with no children. The OR was also higher if patient considered the stage and characteristics of their cancer significant. The OR of being extremely satisfied with the treatments was lower among patients who were not employed on full-time basis, and among patients who considered the second medical opinions and medical expenses to be significant. These associations were not observed in the TM group. The OR of having regrets regarding the medical decision-making process was higher among patients who chose to play a role in the decision-making process as they preferred, and was also higher in patients who were employed on either a part-time or contractual basis. For both types of surgery, the OR was higher among patients who considered a second medical opinion to be significant. Regardless of surgical type, regret regarding the medical decision-making process decreases treatment satisfaction. Patients who received breast-conserving surgery were more likely to have regrets concerning the medical decision-making process if they could not play a role in the process as they preferred. In addition, factors associated with the satisfaction with treatment in BCS group but not TM group included the second medical opinion, medical expenses, employment status, and age of the youngest child at diagnosis.

Keywords: medical decision making, breast-conserving surgery, total mastectomy, Japanese

Procedia PDF Downloads 133
5216 Legume and Nuts Consumption in Relation to Depression and Anxiety in Iranian Adults

Authors: Ahmad Esmaillzadeh, Javad Anjom-Shoae, Omid Sadeghi,

Abstract:

Background: Although considerable research has been devoted to the link between consumption of legume and nuts and metabolic abnormalities, few studies have examined legume and nuts consumption in relation to psychological disorders. Objective: The current study aimed to examine the association of legume and nuts consumption with depression, anxiety and psychological distress in Iranian adults. Methods: This cross-sectional study was carried out among 3172 adult participants aged 18-55 years. Assessment of legume and nuts consumption was conducted using a validated dish-based 106-item semi-quantitative food frequency questionnaire. The Iranian validated version of Hospital Anxiety and Depression Scale (HADS) was used to examine psychological health. Scores of 8 or more on either subscale in the questionnaire were considered to indicate the presence of depression or anxiety. Data on psychological distress were collected through the use of General Health Questionnaire (GHQ), in which the score of 4 or more was considered as having psychological distress. Results: Mean age of participants was 36.5±7.9 years. Compared with the lowest quintile, men in the highest quintile of legume and nuts consumption had lower odds of anxiety; such that after adjusting for potential confounding variables, men in the top quintile of legume and nuts consumption were 66% less likely to be anxious than those in the bottom quintile (OR: 0.34; 95% CI: 0.14-0.82). Such relationship was not observed among women. We failed to find any significant association between legume plus nuts consumption and depression or psychological distress after adjustment for potential confounders. Conclusion: We found that consumption of legume and nuts was associated with lower odds of anxiety in men, but not in women. No significant association was seen between consumption of legume and nuts and odds of depression or psychological disorder. Further prospective studies are required to confirm these findings.

Keywords: anxiety, depression, legumes, nuts, psychological distress

Procedia PDF Downloads 156
5215 Assessment of the Efficacy of Routine Medical Tests in Screening Medical Radiation Staff in Shiraz University of Medical Sciences Educational Centers

Authors: Z. Razi, S. M. J. Mortazavi, N. Shokrpour, Z. Shayan, F. Amiri

Abstract:

Long-term exposure to low doses of ionizing radiation occurs in radiation health care workplaces. Although doses in health professions are generally very low, there are still matters of concern. The radiation safety program promotes occupational radiation safety through accurate and reliable monitoring of radiation workers in order to effectively manage radiation protection. To achieve this goal, it has become mandatory to implement health examination periodically. As a result, based on the hematological alterations, working populations with a common occupational radiation history are screened. This paper calls into question the effectiveness of blood component analysis as a screening program which is mandatory for medical radiation workers in some countries. This study details the distribution and trends of changes in blood components, including white blood cells (WBCs), red blood cells (RBCs) and platelets as well as received cumulative doses from occupational radiation exposure. This study was conducted among 199 participants and 100 control subjects at the medical imaging departments at the central hospital of Shiraz University of Medical Sciences during the years 2006–2010. Descriptive and analytical statistics, considering the P-value<0.05 as statistically significance was used for data analysis. The results of this study show that there is no significant difference between the radiation workers and controls regarding WBCs and platelet count during 4 years. Also, we have found no statistically significant difference between the two groups with respect to RBCs. Besides, no statistically significant difference was observed with respect to RBCs with regards to gender, which has been analyzed separately because of the lower reference range for normal RBCs levels in women compared to men and. Moreover, the findings confirm that in a separate evaluation between WBCs count and the personnel’s working experience and their annual exposure dose, results showed no linear correlation between the three variables. Since the hematological findings were within the range of control levels, it can be concluded that the radiation dosage (which was not more than 7.58 mSv in this study) had been too small to stimulate any quantifiable change in medical radiation worker’s blood count. Thus, use of more accurate method for screening program based on the working profile of the radiation workers and their accumulated dose is suggested. In addition, complexity of radiation-induced functions and the influence of various factors on blood count alteration should be taken into account.

Keywords: blood cell count, mandatory testing, occupational exposure, radiation

Procedia PDF Downloads 447
5214 Method Validation for Heavy Metal Determination in Spring Water and Sediments

Authors: Habtamu Abdisa

Abstract:

Spring water is particularly valuable due to its high mineral content, which is beneficial for human health. However, anthropogenic activities usually imbalance the natural levels of its composition, which can cause adverse health effects. Regular monitoring of a naturally given environmental resource is of great concern in the world today. The spectrophotometric application is one of the best methods for qualifying and quantifying the mineral contents of environmental water samples. This research was conducted to evaluate the quality of spring water concerning its heavy metal composition. A grab sampling technique was employed to collect representative samples, including duplicates. The samples were then treated with concentrated HNO3 to a pH level below 2 and stored at 4oC. The samples were digested and analyzed for cadmium (Cd), chromium (Cr), manganese (Mn), copper (Cu), iron (Fe), and zinc (Zn) following method validation. Atomic Absorption Spectrometry (AAS) was utilized for the sample analysis. Quality control measures, including blanks, duplicates, and certified reference materials (CRMs), were implemented to ensure the accuracy and precision of the analytical results. Of the metals analyzed in the water samples, Cd and Cr were found to be below the detection limit. However, the concentrations of Mn, Cu, Fe, and Zn ranged from mean values of 0.119-0.227 mg/L, 0.142-0.166 mg/L, 0.183-0.267 mg/L, and 0.074-0.181 mg/L, respectively. Sediment analysis revealed mean concentration ranges of 348.31-429.21 mg/kg, 0.23-0.28 mg/kg, 18.73-22.84 mg/kg, 2.76-3.15 mg/kg, 941.84-1128.56 mg/kg, and 42.39-66.53 mg/kg for Mn, Cd, Cu, Cr, Fe, and Zn, respectively. The study results established that the evaluated spring water and its associated sediment met the regulatory standards and guidelines for heavy metal concentrations. Furthermore, this research can enhance the quality assurance and control processes for environmental sample analysis, ensuring the generation of reliable data.

Keywords: method validation, heavy metal, spring water, sediment, method detection limit

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5213 The Impact of Continuous Exercise on Depression Levels Among Young Female Athletes in Hamadan Province, Iran

Authors: Mahboubeh Varmaziar

Abstract:

Depression is a significant public health concern affecting people of all ages and genders. Physical activity has been shown to have a positive effect on mental health, particularly in alleviating symptoms of depression. This study aims to explore the impact of continuous exercise on depression levels among young female athletes in Hamadan Province, Iran. In this randomized controlled trial, 72 women aged 20 to 35 years attending sports centers in Hamadan Province were selected through convenient sampling and randomly assigned to either the control or experimental group. The experimental group participated in a continuous exercise program consisting of 20 sessions over six weeks, with each session lasting 30 minutes. In contrast, the control group maintained their usual daily activities at the sports center. Both groups completed demographic and Beck Depression Inventory questionnaires. Data were analyzed using descriptive and inferential statistics, including two-way ANOVA. The results of the two-way ANOVA, after controlling for the pre-test effect, revealed a significant difference in the mean depression scores between the control and experimental groups (p < 0.001). This suggests that the continuous exercise program significantly reduced depression levels in the young female athletes. The findings suggest that continuous exercise is an effective non-pharmacological intervention for reducing depression in young female athletes. Incorporating regular physical activity into treatment plans may serve as a complementary therapy alongside conventional treatments, offering a low-risk and beneficial approach to managing depression.

Keywords: depression, exercise, female athletes, yong women

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5212 Analysis of Peoples' Adherence to Safety Measures that Curb Ebola Virus Diseases in Nigeria (A Case Study of State of Osun)

Authors: Shittu Bisi Agnes

Abstract:

Ebola virus Diseases outbreak in Nigeria caused a lot of concerns considering the mode of transmission and no known cure discovered. Therefore a lot of safety measures were taken which eventually led to the eradication of the virus in Nigeria. This therefore attempted to determine the various safety measures, how socio-economic characteristic of the people affected adherence to safety measures. And provide reasonable recommendations for total eradication of the virus, future outbreak and general environmental safety Data were collected with the aid of well structured questionnaires and administered 180 randomly selected of the state and oral interview was also utilize. Data collected were analysed using both descriptive tools and inferential statistics vis-a-vis regression analysis. Finding showed that 70.5% was strongly adhere to almost all the measures, 15.2% was fairly advent, 3% was poorly observing the selected measures while 1.3% was in different. 65% of the respondents was strongly aware of the advent of ebola virus diseases, 20% was fairly in awareness, 8.5% was poorly in awareness while 6.55% was in aware of any disease outbreak. Safety measures put forwards were; hand washing, use of hand sanitize-rs, no shaking of hands non-consumption of wildlife games(Bush Meat) and general health and environmental safety measures. It was recommended that policy instrument to increase peoples income will accelerate eradication of diseases as this will enable households to pay for monetary safety measures, health and environmental education, in form of talk shop, workshop, lectures could be organised at the political ward levels, schools, market women, religious bodies functional unions and mass media.

Keywords: ebola diseases, pay, safety, outbreak

Procedia PDF Downloads 579