Search results for: nursing health human resources

Authors: Gabriela Iordachescu, Mariana Cretu Stuparu, Mirela Praisler, Camelia Busila, Doina Voinescu, Camelia Vizireanu

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The aim of the study was to evaluate the consumers’ degree of confidence in food labeling, how they use and understand the label and respectively food labeling elements. The label is a bridge between producers, suppliers, and consumers. It has to offer enough information in terms of public health and food safety, statement of ingredients, nutritional information, warnings and advisory statements, producing date and shelf-life, instructions for storage and preparation (if required). The survey was conducted on 500 consumers group in Romania, aged 15+, males and females, from urban and rural areas and with different graduation levels. The questionnaire was distributed face to face and online. It had single or multiple choices questions and label images for the efficiency and best understanding of the question. The law 1169/2011 applied to food products from 13 of December 2016 improved and adapted the requirements for labeling in a clear manner. The questions were divided on following topics: interest and general trust in labeling, use and understanding of label elements, understanding of the ingredient list and safety information, nutrition information, advisory statements, serving sizes, best before/use by meanings, intelligent labeling, and demographic data. Three choice selection exercises were also included. In this case, the consumers had to choose between two similar products and evaluate which label element is most important in product choice. The data were analysed using MINITAB 17 and PCA analysis. Most of the respondents trust the food label, taking into account some elements especially when they buy the first time the product. They usually check the sugar content and type of sugar, saturated fat and use the mandatory label elements and nutrition information panel. Also, the consumers pay attention to advisory statements, especially if one of the items is relevant to them or the family. Intelligent labeling is a challenging option. In addition, the paper underlines that the consumer is more careful and selective with the food consumption and the label is the main helper for these.

Keywords: consumers, food safety information, labeling, labeling nutritional information

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Authors: Kensuke Otsuyama

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The United Nation World Conference on Disaster Risk Reduction was held in Sendai, Japan, in 2015 and priorities for actions until 2030 were adopted for the next 15 years. Although one of these priorities is to ‘build back better’, there is neither a consensus definition of better recovery, nor indicators to measure better recovery. However, the community is considered as a key driver of recovery nowadays, and participation is a key word for effective recovery. In order to understand more about participatory community recovery, the author investigated recovery from the Great East Japan Earthquake and Tsunami (GEJET) in Kesennuma, a severely affected city. The research sought to: 1) Identify the elements that contribute to better recovery at the community level, and 2) analyze the role of community volunteers for disaster risk reduction for better recovery. A Participatory Community Recovery Index (PCRI) was created as a tool to measure community recovery. The index adopts seven primary indicators and 20 tertiary indicators, including: socio-economic aspect, housing, health, environment, self-organization, transformation, and institution. The index was applied to nine districts in Kesennuma city. Secondary and primary data by questionnaire surveys with local residents’ organization leaders and interviews with crisis management department officials in city government were also obtained. The indicator results were transformed into scores among 1 to 5, and the results were shown for each district. Based on the result of PCRI, it was found that the s Local Social Welfare Council played an important role in facilitating better recovery, enhancing community volunteer involvement to allow elderly residents to initiate local volunteer work for more affected single-living elderly people. Volunteers for the elderly by the elderly played a crucial role to strengthen community bonding in Kesennuma. In this research, the potential of community volunteers and inter-linkage with DRR activities are discussed.

Keywords: recovery, participation, the great East Japan earthquake and tsunami, community volunteers

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Authors: Pradip Kumar Das

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Phenomenal growth of population and industry exploits the environment in varied ways. Consequently, the greenhouse effect and other allied problems are threatening mankind the world over. Protection and up gradation of environment have, therefore, become the prime necessity all of mankind for the sustainable development of environment. People in humbler walks of life including the corporate citizens have become aware of the impacts of environmental pollution. Governments of various nations have entered the picture with laws and regulations to correct and cure the effects of present and past violations of environmental practices and to obstruct future violations of good environmental disciplines. In this perspective, environmental audit directs verification and validation to ensure that the various environmental laws are complied with and adequate care has been taken towards environmental protection and preservation. The discipline of environmental audit has experienced expressive development throughout the world. It examines the positive and negative effects of the activities of an enterprise on environment and provides an in-depth study of the company processes any growth in realizing long-term strategic goals. Environmental audit helps corporations assess its achievement, correct deficiencies and reduce risk to the health and improving safety. Environmental audit being a strong management tool should be administered by industry for its own self-assessment. Developed countries all over the globe have gone ahead in environment quantification; but unfortunately, there is a lack of awareness about pollution and environmental hazards among the common people in India. In the light of this situation, the conceptual analysis of this study is concerned with the rationale of environmental audit on the industry and the society as a whole and highlights the emerging dimensions in the auditing theory and practices. A modest attempt has been made to throw light on the recent development in environmental audit in developing nations like India and the problems associated with the implementation of environmental audit. The conceptual study also reflects that despite different obstacles, environmental audit is becoming an increasing aspect within the corporate sectors in India and lastly, conclusions along with suggestions have been offered to improve the current scenario.

Keywords: environmental audit, environmental hazards, environmental laws, environmental protection, environmental preservation

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Authors: Annunziata Albano

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Intimate Partner Violence (IPV) and Non-Partner Sexual Violence (NPSV) are still the most common forms of interpersonal violence against women today, and numerous studies have shown how they can affect women's physical and psychological well-being, frequently leading to depression, posttraumatic stress disorder (PTSD), and substance abuse. The primary goal of Italian Anti-Violence Centres (AVCs) is to provide an appropriate context for women to embark on a personalised path out of violence by providing various services such as listening groups, psychological and legal support, housing support in collaboration with shelters, work orientation, and specific support in the case of minor children. However, their physical environment is frequently overlooked, partly because these centres are typically established in pre-existing buildings and have a limited budget. Several studies on healthcare design and mental health, on the other hand, emphasise the potential of the built environment to facilitate healing by providing a restorative setting that aids in coping with stress and traumatic experiences, investigating the positive role of natural features and sensorial qualities such as light, colours, sound, and smell. This research aims to collect and summarise the key evidence-based principles derived from a multidisciplinary literature review about interior design elements that can help women recover after their traumatic experience. Furthermore, the study examines multiple case studies of Italian AVCs through the lens of previously determined principles, to understand how and whether these guidelines have been applied and which outcomes can provide relevant insights for design practice, with an emphasis on sensory qualities, usually overlooked in favour of other requirements. The outlined guidelines may serve as a framework for various typologies of services provided to women who are the victims of interpersonal violence, such as women's crisis centres and shelters.

Keywords: anti-violence centres, environmental psychology, interior design, interpersonal violence, restorative environments

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Authors: Eryati Darwin, Arina Widya Murni, Adnil Edwin Nurdin

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Background: Functional dyspepsia (FD) is a highly prevalent and heterogeneous disorder. Most patients with FD complain of symptoms related to the intake of meals. Psychological stress may promote peptic ulcer and had an effect on ulcers associated Hp, and may also trigger worsen symptoms in inflammatory disorders of the gastrointestinal. Cells in mucosal gastric stimulate the production of several cytokines, which might associated with Helicobacter pylori infection. The cascade of biological events leading to stress-induced FD remains poorly understood. Aim of Study: To determine the prion-flammatory cytokine IL-6, and Helicobacter pylori activity on mucosal gastric of FD and their association with psychological stress. Methods: The subjects of this study were dyspeptic patients who visited M. Djamil General Hospital and in two Community Health Centers in Padang. On the basis of the stress index scale to identify psychological stress by using Depression Anxiety and Stress Scale (DASS 42), subjects were divided into two groups of 20 each, stress groups and non-stress groups. All diagnoses were confirmed by review of cortisol and esophagogastroduodenoscopy reports. Gastric biopsy samples and peripheral blood were taken during diagnostic procedures. Immunohistochemistry methods were used to determine the expression of IL-6 and Hp in gastric mucosal. The data were statistically analyzed by univariate and bivariate analysis. All procedures of this study were approved by Research Ethics Committee of Medical Faculty Andalas University. Results: In this study, we enrolled 40 FD patients (26 woman and 14 men) in range between 35-56 years old. Cortisol level of blood FD patients as parameter of stress hormone which taken in the morning was significantly higher in stress group than non-stress group. The expression of IL-6 in gastric mucosa was significantly higher in stress group in compared to non-stress group (p<0,05). Helicobacter pylori activity in gastric mucosal in stress group were significantly higher than non-stress group. Conclusion: The present study showed that psychological stress can induce gastric mucosal inflammation and increase of Helicobacter pylori activity.

Keywords: functional dyspepsia, Helicobacter pylori, interleukin-6, psychological stress

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Authors: Rosemond Mbii

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Menstruation is a critical topic. However normal menstruation is, it has become a determinant in the education of young women today. The research focuses on Breaking the silence and accessing menstrual hygiene management's challenges and experiences among rural schoolgirls in Ghana. The study's goal was to examine the menstrual hygiene practices of female students. Participants described their menstrual hygiene practices, their problems, and how they coped with their menstrual symptoms. The research used a qualitative technique through group interviews, personal interviews, and open-ended questionnaires since it is easier to understand a phenomenon from the subject's viewpoint. Sen's capacities approach and Feminist Political Ecology (FPE) were used to analyze the data. Menstruation was known to girls even before their menarche. A mother or grandmother, friends, and teachers were the primary sources of menstrual knowledge. The study also found that most girls use sanitary products made of fabrics, pads, and cotton during menstruation. Among the difficulties the girls faced, the study found were emotional upset, physical discomfort (cramps in the stomach, fatigue), embarrassment, and inadequate sanitation hygiene facilities. The girls wore many garments to avoid leaks; checked their skirts continuously, went to the bathroom with their friends to act as spics while they changed; sat differently on the chairs, and took medicine to reduce period discomfort. Introduction of a health care teacher who supplies sanitary products and medications to girls during school time. Euphemisms as a form of communication amongst girls were all coping mechanisms girls and the school developed. Another finding was that some girls continued to go to school even while having their periods, while others did not. Discomfort and menstruation cramps hampered class participation. In addition, the study revealed insufficient sanitation and hygiene for females to change sanitary products in private and manage menstrual hygiene comfortably.

Keywords: MHM (menstrual hygiene management), rural area, sanitation, menstruation, water, schoolgirl, rural area, sanitation, menstruation, water

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Authors: Aoife Prendergast

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The synergy between theory and practice can be considered elusive, the touchstone for the development of successful undergraduate programmes particularly in allied health professions such as social care. A 'pracademic' is a person who spans both the somewhat ethereal world of academia as a scholar and the pragmatic world of practice. This paper examines the concept of 'pracademia' in relation to the role of the social care practitioner and continuing professional development. It also assists in the understanding of the synergy between social care professionals and higher education. A consideration of the identity and position in terms of approach to regulation is explored as well as an acknowledgement of the strengths and opportunities for sharing power in hierarchical positions. The world of practice serves as the centre point of the academic compass for most professional programs. Just as schools of engineering and law are disciplined by the marketplace, which seeks well-trained students, so our social care programmes must perennially find ways to address the fast changing needs of practitioners, whether they be government, not-for-profit organizations, consulting firms or contractors. We may not expect such traditional academic disciplines as history, sociology, or political science to cater to the needs of external audiences or practitioners— indeed, these disciplines' insulation from public concerns and issues is considered a strength by some. This paper aims to explore the integration of academic teaching and research with the communities of practice in social care. This appears to be a fundamental aspiration of the social care profession. While building and integrating an important body of academic theory and concepts from a variety of disciplines, social care as a field has embraced a professional orientation by seeking to be relevant to practitioners at various levels. While teaching theory, social care programmes, and faculty are often acutely aware that their academic content and credibility, in part, rest on a deep connection with practitioners. While theory can be self-contained, the impact of our research and teaching arguably finds its most compelling and highest audience when it addresses the agenda items and concerns of practitioners.

Keywords: social care, pracademia, supervision, practice education

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Authors: Tong-Hsien Chow

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Background: Plantar pressure measurement is an effective method for assessing plantar loading and can be applied to evaluating movement performance of the foot. The purpose of this study is to explore the sprint athletes’ plantar loading characteristics and pain profiles in static standing. Methods: Experiments were undertaken on 80 first-division college sprint athletes and 85 healthy non-sprinters. ‘JC Mat’, the optical plantar pressure measurement was applied to examining the differences between both groups in the arch index (AI), three regional and six distinct sub-regional plantar pressure distributions (PPD), and footprint characteristics. Pain assessment and self-reported health status in sprint athletes were examined for evaluating their common pain areas. Results: Findings from the control group, the males’ AI fell into the normal range. Yet, the females’ AI was classified as the high-arch type. AI values of the sprint group were found to be significantly lower than the control group. PPD were higher at the medial metatarsal bone of both feet and the lateral heel of the right foot in the sprint group, the males in particular, whereas lower at the medial and lateral longitudinal arches of both feet. Footprint characteristics tended to support the results of the AI and PPD, and this reflected the corresponding pressure profiles. For the sprint athletes, the lateral knee joint and biceps femoris were the most common musculoskeletal pains. Conclusions: The sprint athletes’ AI were generally classified as high arches, and that their PPD were categorized between the features of runners and high-arched runners. These findings also correspond to the profiles of patellofemoral pain syndrome (PFPS)-related plantar pressure. The pain profiles appeared to correspond to the symptoms of high-arched runners and PFPS. The findings reflected upon the possible link between high arches and PFPS. The correlation between high-arched runners and PFPS development is worth further studies.

Keywords: sprint athletes, arch index, plantar pressure distributions, high arches, patellofemoral pain syndrome

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Authors: Bolajoko I. Malomo, Maryam O. Yusuf

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Lagos urban mini-bus drivers play a critical role in the transportation sector. The current major mode of transportation within Lagos metropolis remains road transportation and this confirms the relevance of urban mini-bus drivers in transporting the populace to their various destinations. Other modes of transportation such as the train and waterways are currently inadequate. Various threats to the well-being of urban bus drivers include congested traffic typical of modern day lifestyles, dwindling financial returns due to long hours in traffic, fewer hours of sleep, inadequate diet, time pressure, and assaults related to fare disputes. Several health-related problems have been documented to be associated with urban bus driving. For instance, greater rates of hypertension, obesity and cholesterol level has been reported. Research studies are yet to identify the influence of age and marital status on the well-being of urban mini-bus drivers in Lagos metropolis. A study of this nature is necessary as it is culturally perceived in Nigeria that older and married people are especially influenced by family affiliation and would behave in ways that would project positive outcomes. The study sample consisted of 150 urban mini-bus drivers who were conveniently sampled from six (6) different terminuses where their journey begins and terminates. The well-being questionnaire was administered to participants. The criteria for inclusion in the study included the ability to read in English language and the confirmation that interested participants were on duty and suited to be driving mini-buses. Due to the nature of the job of bus driving, the researcher administered the questionnaires on participants who were free and willing to respond to the survey. All participants were males of various age groups and of different marital statuses. Results of analyses conducted revealed no significant influence of age and marital status on the well-being of urban mini-bus drivers. This indicates that the well-being of urban mini-bus drivers is not influenced by age nor marital status. The findings of this study have cultural implications. It negates the popularly held belief that older and married people care more about their well-being than younger and single people. It brings to fore the need to also identify and consider other factors when certifying people for the job of urban bus driving.

Keywords: age, Lagos metropolis, marital status, well-being of urban mini bus drivers

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Authors: Kanokwan Sansuwan, Orapint Jintasataporn, Srinoy Chumkam

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Asian seabass is one of the economically important fish of Thailand and other countries in the Southeast Asia. Zinc is an essential trace metal to fish and vital to various biological processes and function. It is required for normal growth and indispensable in the diet. Therefore, the artificial diets offered to intensively cultivated fish must possess the zinc content required by the animal metabolism for health maintenance and high weight gain rates. However, essential elements must also be in an available form to be utilized by the organism. Thus, this study was designed to evaluate the application of different zinc forms, including organic Zinc (zinc amino acid complex) and inorganic Zinc (zinc sulfate), as feed additives in diets for Asian seabass. Three groups with five replicates of fish (mean weight 22.54 ± 0.80 g) were given a basal diet either unsupplemented (control) or supplemented with 50 mg Zn kg−¹ sulfate (ZnSO₄) or Zinc Amino Acid Complex (ZnAA) respectively. Feeding regimen was initially set at 3% of body weight per day, and then the feed amount was adjusted weekly according to the actual feeding performance. The experiment was conducted for 10 weeks. Fish supplemented with ZnAA had the highest values in all studied growth indicators (weight gain, average daily growth and specific growth rate), followed by fish fed the diets with the ZnSO₄, and lowest in fish fed the diets with the control. Lysozyme and superoxide dismutase (SOD) activity of fish supplemented with ZnAA were significantly higher compared with all other groups (P < 0.05). Fish supplemented with ZnSO₄ exhibited significant increase in digestive enzyme activities (protease, pepsin and trypsin) compared with ZnAA and the control (P < 0.05). However, no significant differences were observed for RNA and protein in muscle (P > 0.05). The results of the present work suggest that ZnAA are a better source of trace elements for Asian seabass, based on growth performance and immunity indices examined in this study.

Keywords: Asian seabass, growth performance, zinc amino acid complex (ZnAA), zinc sulfate (ZnSO₄)

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Authors: Evelyn Osehontue Uroro, Richard Bright, Jing Yang Quek, Krasimir Vasilev

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Bacterial infections have been a challenge both in the public and private sectors. The colonization of bacteria often occurs in medical devices such as catheters, heart valves, respirators, and orthopaedic implants. When biomedical devices are inserted into patients, the deposition of macromolecules such as fibrinogen and immunoglobin on their surfaces makes it easier for them to be prone to bacteria colonization leading to the formation of biofilms. The formation of biofilms on medical devices has led to a series of device-related infections which are usually difficult to eradicate and sometimes cause the death of patients. These infections require surgical replacements along with prolonged antibiotic therapy, which would incur additional health costs. It is, therefore, necessary to prevent device-related infections by inhibiting the formation of biofilms using intelligent technology. Antibiotic resistance of bacteria is also a major threat due to overuse. Different antimicrobial agents have been applied to microbial infections. They include conventional antibiotics like rifampicin. The use of conventional antibiotics like rifampicin has raised concerns as some have been found to have hepatic and nephrotoxic effects due to overuse. Hence, there is also a need for proper delivery of these antibiotics. Different techniques have been developed to encapsulate and slowly release antimicrobial agents, thus reducing host cytotoxicity. Examples of delivery systems are solid lipid nanoparticles, hydrogels, micelles, and polymeric nanoparticles. The different ways by which drugs are released from polymeric nanoparticles include diffusion-based release, elution-based release, and chemical/stimuli-responsive release. Polymeric nanoparticles have gained a lot of research interest as they are basically made from biodegradable polymers. An example of such a biodegradable polymer is polycaprolactone (PCL). PCL degrades slowly by hydrolysis but is often sensitive and responsive to stimuli like enzymes to release encapsulants for antimicrobial therapy. This study presents the synthesis of PCL nanoparticles loaded with rifampicin and the on-demand release of rifampicin for treating staphylococcus aureus infections.

Keywords: enzyme, Staphylococcus aureus, PCL, rifampicin

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Authors: Joy Cao, Min Zhou

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Purpose: Acute Type A aortic dissection is a well-known cause of extremely high mortality rate. A highly accurate and cost-effective non-invasive predictor is critically needed so that the patient can be treated at earlier stage. Although various CFD approaches have been tried to establish some prediction frameworks, they are sensitive to uncertainty in both image segmentation and boundary conditions. Tedious pre-processing and demanding calibration procedures requirement further compound the issue, thus hampering their clinical applicability. Using the latest physics informed deep learning methods to establish an accurate and cost-effective predictor framework are amongst the main goals for a better Type A aortic dissection treatment. Methods: Via training a novel physics-informed deep residual network, with non-invasive 4D MRI displacement vectors as inputs, the trained model can cost-effectively calculate all these biomarkers: aortic blood pressure, WSS, and OSI, which are used to predict potential type A aortic dissection to avoid the high mortality events down the road. Results: The proposed deep learning method has been successfully trained and tested with both synthetic 3D aneurysm dataset and a clinical dataset in the aortic dissection context using Google colab environment. In both cases, the model has generated aortic blood pressure, WSS, and OSI results matching the expected patient’s health status. Conclusion: The proposed novel physics-informed deep residual network shows great potential to create a cost-effective, non-invasive predictor framework. Additional physics-based de-noising algorithm will be added to make the model more robust to clinical data noises. Further studies will be conducted in collaboration with big institutions such as Cleveland Clinic with more clinical samples to further improve the model’s clinical applicability.

Keywords: type-a aortic dissection, deep residual networks, blood flow modeling, data-driven modeling, non-invasive diagnostics, deep learning, artificial intelligence.

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Authors: Jasna Čanadanović-Brunet, Lidija Jevrić, Gordana Ćetković, Vesna Tumbas Šaponjac, Jelena Vulić, Slađana Stajčić

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Wheat contains high amount of nutrients such as dietary fiber, resistant starch, vitamins, minerals and microconstituents, which are building blocks of body tissues, but also help in the prevention of diseases such as cardiovascular disease, cancer and diabetes. Sprouting enhances the nutritional value of whole wheat through biosynthesis of tocopherols, polyphenols and other valuable phytochemicals. Since the nutritional and sensory benefits of germination have been extensively documented, using of sprouted grains in food formulations is becoming a trend in healthy foods. The present work addressed the possibility of using freeze-dried sprouted wheat powder, obtained from spelt-wheat cv. ‘Nirvana’ (Triticum spelta L.) and winter wheat cv. ‘Simonida’ (Triticum aestivum L. ssp. vulgare var. lutescens), as a source of phytochemicals, to improve the functional status of the consumer. The phytochemicals' content (total polyphenols, flavonoids, chlorophylls and carotenoids) and biological activities (antioxidant activity on DPPH radicals and antiinflammatory activity) of sprouted wheat powders were assessed spectrophotometrically. The content of flavonoids (216.52 mg RE/100 g), carotenoids (22.84 mg β-carotene/100 g) and chlorophylls (131.23 mg/100 g), as well as antiinflammatory activity (EC50=3.70 mg/ml) was found to be higher in sprouted spelt-wheat powder, while total polyphenols (607.21 mg GAE/100 g) and antioxidant activity on DDPPH radicals (EC50=0.27 mmol TE/100 g) was found to be higher in sprouted winter wheat powders. Simulation of gastro-intestinal digestion of sprouted wheat powders clearly shows that intestinal digestion caused a higher release of polyphenols than gastric digestion for both samples, which indicates their higher bioavailability in the colon. The results of the current study have shown that wheat sprouts can provide a high content of phytochemicals and considerable bioactivities. Moreover, data reported show that they contain a unique pattern of bioactive molecules, which make these cereal sprouts attractive functional foods for a health-promoting diet.

Keywords: wheat, sprouts, phytochemicals, bioactivity

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Authors: Jordan Chamarande, Lisiane Cunat, Corentine Alauzet, Catherine Cailliez-Grimal

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Gut microbiota (GM) is now considered a new organ mainly due to the microorganism’s specific biochemical interaction with its host. Although mechanisms underlying host-microbiota interactions are not fully described, it is now well-defined that cell surface molecules and structures of the GM play a key role in such relation. The study of surface structures of GM members is also fundamental for their role in the establishment of species in the versatile and competitive environment of the digestive tract and as a potential virulence factor. Among these structures are capsular polysaccharides (CPS), fimbriae, pili and lipopolysaccharides (LPS), all well-described for their central role in microorganism colonization and communication with host epithelium. The health-promoting Parabacteroides distasonis, which is part of the core microbiome, has recently received a lot of attention, showing beneficial properties for its host and as a new potential biotherapeutic product. However, to the best of the authors’ knowledge, the cell surface molecules and structures of P. distasonis that allow its maintain within the GM are not identified. Moreover, although P. distasonis is strongly recognized as intestinal commensal species with benefits for its host, it has also been recognized as an opportunistic pathogen. In this study, we reported gene clusters potentially involved in the synthesis of the capsule, fimbriae-like and pili-like cell surface structures in 26 P. distasonis genomes and applied the new RfbA-Typing classification in order to better understand and characterize the beneficial/pathogenic behaviour related to P. distasonis strains. In context, 2 different types of fimbriae, 3 of pilus and up to 14 capsular polysaccharide loci, have been identified over the 26 genomes studied. Moreover, the addition of data to the rfbA-Type classification modified the outcome by rearranging rfbA genes and adding a fifth group to the classification. In conclusion, the strain variability in terms of external proteinaceous structure could explain the inter-strain differences previously observed in P. distasonis adhesion capacities and its potential pathogenicity.

Keywords: gut microbiota, Parabacteroides distasonis, capsular polysaccharide, fimbriae, pilus, O-antigen, pathogenicity, probiotic, comparative genomics

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Authors: Leonore Robieux, Franck Zenasni, Marc Pocard, Clarisse Eveno

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Empirical data in health psychology studies show the necessity to consider the doctor-patient communication and its positive impact on outcomes such as patients’ satisfaction, treatment adherence, physical and psychological wellbeing. In this line, the present research aims to define the role and determinants of an effective doctor–patient communication during the treatment of patients with serious illness (peritoneal carcinomatosis). We carried out a prospective longitudinal study including patients treated for peritoneal carcinomatosis of various origins. From November 2016, to date, data were collected using validated questionnaires at two times of evaluation: one month before the surgery (T0) and one month after (T1). Thus, patients reported their (a) anxiety and depression levels, (b) standardized and individualized quality of life and (c) how they perceived communication, attitude and empathy of the surgeon. 105 volunteer patients (Mean age = 58.18 years, SD = 10.24, 62.2% female) participated to the study. PC arose from rare diseases (14%), colorectal (38%), eso-gastric (24%) and ovarian (8%) cancer. Three groups are defined according to the severity of their pathology and the treatment offered to them: (1) important surgical treatment with the goal of healing (53%), (2) repeated palliative surgical treatment (17%), and (3) the patients recused for surgical treatment, only palliative approach (30%). Results are presented according to Baron and Kenny recommendations. The regressions analyses show that only depression and anxiety are sensitive to the communication and empathy of surgeon. The main results show that a good communication and high level of empathy at T0 and T1 limit depression and anxiety of the patients in T1. Results also indicate that the severity of the disease modulates this positive impact of communication: better is the communication the less are the level of depression and anxiety of the patients. This effect is higher for patients treated for the more severe disease. These results confirm that, even in the case severe disease a good communication between patient and physician remains a significant factor in promoting the well-being of patients. More specific training need to be developed to promote empathic care.

Keywords: clinical empathy, determinants, healthcare, psychological wellbeing

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Authors: Chaudhary Itisha, Shankar Manu

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Patient satisfaction represents a crucial aspect in the evaluation of health care services. Preoperative teaching provides the patient with pertinent information concerning the surgical process and the intended surgical procedure as well as anticipated patient behavior (anxiety, fear), expected sensation, and the probable outcomes. Although patient education is part of Accreditation protocols, it is not uniform at most places. The aim of this study was to try to assess the benefit of preoperative patient education on selected post-operative outcome parameters; mainly, post-operative pain scores, requirement of additional analgesia, return to activity of daily living and overall patient satisfaction, and try to standardize few education protocols. Dependent variables were measured before and after the treatment on a study population of 302 volunteers. Educational intervention was provided by the Investigator in the preoperative period to the study group through personal counseling. An information booklet contained detailed information was also provided. Statistical Analysis was done using Chi square test, Mann Whitney u test and Fischer Exact Test on a total of 302 subjects. P value <0.05 was considered as level of statistical significance and p<0.01 was considered as highly significant. This study suggested that patients who are given a structured, individualized and elaborate preoperative education and counseling have a better ability to cope up with postoperative pain in the immediate post-operative period. However, there was not much difference when the patients have had almost complete recovery. There was no difference in the requirement of additional analgesia among the two groups. There is a positive effect of preoperative counseling on expected return to the activities of daily living and normal work schedule. However, no effect was observed on the activities in the immediate post-operative period. There is no difference in the overall satisfaction score among the two groups of patients. Thus this study concludes that there is a positive benefit as suggested by the results for pre-operative patient education. Although the difference in various parameters studied might not be significant over a long term basis, they definitely point towards the benefits of preoperative patient education. 

Keywords: patient education, post-operative pain, postoperative outcomes, patient satisfaction

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Authors: Carmen Pena-Díaz

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Linguistic and cultural difficulties regarding the access and use of public services, as well as facilitating communication at all levels, are problems which have not yet been tackled by authorities in Spain. In fact, linguistic and cultural issues are often not recognised as an integral part of migratory movements or social integration. While professionals of interlinguistic and intercultural communication (translators, interpreters, mediators) know that language and culture are key components to achieve immigrant integration and consolidate a truly multilingual society, policymakers at local, national, or supranational levels do not always seem aware of the risks and costs of not providing interpreting and translation services, particularly those affecting the health of users. Regarding the services currently used to cover the communication-related needs between the non-Spanish speaking population and healthcare professionals, evidence proves that there are no effective provisions for communication problems at present in Spanish hospitals. An example that suggests the poor management of the situation in relation to the migrants’ access to public healthcare is the fact that relying on a family member (often a minor) in medical consultations is one of the main practices that affects communication. At present, most medical professionals will explain that in their consultations with migrants who do not speak Spanish, they ask them to bring along a family member or friend who speaks Spanish. In fact, an abundant body of literature describes situations in which family members, children, friends, or anyone who speaks or understands a language helps to break language barriers in hospitals, not only in Spain. It is not difficult to see the problems this may cause, from ethical issues to comprehension problems and misunderstandings. This paper will present the results of Narrative Inquiry from a sample of eight clinicians about their perceptions and experiences using child language brokers in their appointments with non-Spanish speaking families. The main aim is to collect information about child language brokering as recalled and perceived by clinicians who present CLB as a routine practice and express their concerns and worries about using children to convey negative news to their parents or family members.

Keywords: child language brokering, community interpreting, healthcare, PSIT

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Authors: Cherif Y., Ghariani R., Derbal S., Farhati S., Ben Dahmen F., Abdallah M.

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Introduction: Tuberculosis (TBC) is a frequent infection and is still a major public health problem in Tunisia. The aim of this work is to focus on diagnostic and therapeutic characteristics of TBC in patients referred to our internal medicine department. Patients and Methods: The study was retrospective and descriptive of a cohort of consecutive cases treated from January 2016 to December 2019, collecting patients with latent or patent TBC. Twenty-eight medical records of adults diagnosed with TBC were reviewed. Results: Twenty-eight patients, including 18 women and 10 men, were diagnosed with TBC. Their mean age is 48 years (range: 22-78 years). Five patients have a medical history of diabetes mellitus, 1 patient was followed for systemic lupus erythematosus treated with corticosteroids and immunosuppressant drugs, and another was treated with corticosteroids for Mac Duffy syndrome. The TBC is latent in 12 cases and patent in 16 cases. The most common symptoms were fever and weight loss and were found in 10 cases, a cough in 2 cases, sputum in 3 cases, lymph nodes in 4 cases, erythema nodosum in 2 cases, and neurological signs in 3 cases. Lymphopenia is noticed in 3 cases and a biological inflammatory syndrome in 18 of the cases. The purified protein derivate reaction was positive in 17 cases, anergic in 3 cases, negative in 5 cases, and not done in 3 cases. The acid-fast bacilli stain culture was strongly positive in one patient. The histopathological study was conclusive in 11 patients and showed granulomatosis with caseous necrosis. TBC was pulmonary in 7 patients, lymph node in 7 cases, peritoneal in 7 cases, digestive in 1 case, neuromeningeal in 3 cases, and thyroïd in 1 case. Seven patients had multifocal TBC. All the patients received anti-tuberculosis treatment with a mean duration of 8 months with no failure or relapse with an average follow-up time of 10.58 months. Conclusion: Diagnosis and management of TBC remain essential to avoid serious complications. The survey is necessary to ensure timely detection and treatment of infected adults to decrease its incidence. The best treatment remains preventive through vaccination and improving social and economic conditions.

Keywords: tuberculosis, infection, autoimmune disease, granulomatosis

Procedia PDF Downloads 181

Authors: A. Bajek, J. Skopinska-Wisniewska, A. Rynkiewicz, A. Jundzill, M. Bodnar, A. Marszalek, T. Drewa

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Traumatic injury and age-related degenerative diseases associated with cartilage are major health problems worldwide. The articular cartilage is comprised of a relatively small number of cells, which have a relatively slow rate of turnover. Therefore, damaged articular cartilage has a limited capacity for self-repair. New clinical methods have been designed to achieve better repair of injured cartilage. However, there is no treatment that enables full restoration of it. The aim of this study was to evaluate how collagen gel with bone marrow mesenchymal stem cells (MSCs) and collagen gel alone will influence on the hip cartilage repair after injury. Collagen type I was isolated from rats’ tails and cross-linked with N-hydroxysuccinimide in 24-hour process. MSCs were isolated from rats’ bone marrow. The experiments were conducted according to the guidelines for animal experiments of Ethics Committee. Fifteen 8-week-old Wistar rats were used in this study. All animals received hip joint surgery with a total of 30 created cartilage defects. Then, animals were randomly divided into three groups and filled, respectively, with collagen gel (group 1), collagen gel cultured with MSCs (group II) or left untreated as a control (control group). Immunohistochemy and radiological evaluation was carried out 11 weeks post implantation. It has been proved that the surface of the matrix is non-toxic, and its porosity promotes cell adhesion and growth. However, the in vivo regeneration process was poor. We observed the low integration rate of biomaterial. Immunohistochemical evaluation of cartilage after 11 weeks of treatment showed low II and high X collagen expression in two tested groups in comparison to the control one, in which we observed the high II collagen expression. What is more, after radiological analysis, we observed the best regeneration process in control group. The biomaterial construct and mesenchymal stem cells, as well as the use of the biomaterial itself was not sufficient to regenerate the hip cartilage surfaces. These results suggest that the collagen gel based biomaterials, even with MSCs, are not satisfactory in repar of hip cartilage defect. However, additional evaluation is needed to confirm these results.

Keywords: collafen gel, MSCs, cartilage repair, hip cartilage

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Authors: Shannon Hearney, Jeffrey Hoch

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While all cancers are costly to treat, pancreatic cancer is a notoriously costly and deadly form of cancer. Across the world there are a variety of treatment centers ranging from small clinics to large, high-volume hospitals as well as differing structures of payment and access. It has been noted that centers that treat a high volume of pancreatic cancer patients have higher quality of care, it is unclear if that care is cost-effective. In the US there is no clear consensus on the cost-effectiveness of high-volume centers for the surgical care of pancreatic cancer. Other European countries, like Finland and Italy have shown that high-volume centers have lower mortality rates and can have lower costs, there however, is still a gap in knowledge about these centers cost-effectiveness globally. This paper seeks to review the current literature in Europe and the US to gain a better understanding of the state of high-volume pancreatic surgical centers cost-effectiveness while considering the contextual differences in health system structure. A review of major reference databases such as Medline, Embase and PubMed will be conducted for cost-effectiveness studies on the surgical treatment of pancreatic cancer at high-volume centers. Possible MeSH terms to be included, but not limited to, are: “pancreatic cancer”, “cost analysis”, “cost-effectiveness”, “economic evaluation”, “pancreatic neoplasms”, “surgical”, “Europe” “socialized medicine”, “privatized medicine”, “for-profit”, and “high-volume”. Studies must also have been available in the English language. This review will encompass European scientific literature, as well as those in the US. Based on our preliminary findings, we anticipate high-volume hospitals to provide better care at greater costs. We anticipate that high-volume hospitals may be cost-effective in different contexts depending on the national structure of a healthcare system. Countries with more centralized and socialized healthcare may yield results that are more cost-effective. High-volume centers may differ in their cost-effectiveness of the surgical care of pancreatic cancer internationally especially when comparing those in the United States to others throughout Europe.

Keywords: cost-effectiveness analysis, economic evaluation, pancreatic cancer, scientific literature review

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Authors: Istvan Csarnovics, Attila Bonyar, Miklos Veres, Laszlo Himics, Attila Csik, Judit Kaman, Julia Burunkova, Geza Szanto, Laszlo Balazs, Sandor Kokenyesi

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In this work, the performance of gold nanoparticles were investigated for stimulation of photosensitive materials for photonic applications. It was widely used for surface plasmon resonance experiments, not in the last place because of the manifestation of optical resonances in the visible spectral region. The localized surface plasmon resonance is rather easily observed in nanometer-sized metallic structures and widely used for measurements, sensing, in semiconductor devices and even in optical data storage. Firstly, gold nanoparticles on silica glass substrate satisfy the conditions for surface plasmon resonance in the green-red spectral range, where the chalcogenide glasses have the highest sensitivity. The gold nanostructures influence and enhance the optical, structural and volume changes and promote the exciton generation in gold nanoparticles/chalcogenide layer structure. The experimental results support the importance of localized electric fields in the photo-induced transformation of chalcogenide glasses as well as suggest new approaches to improve the performance of these optical recording media. Results may be utilized for direct, micrometre- or submicron size geometrical and optical pattern formation and used also for further development of the explanations of these effects in chalcogenide glasses. Besides of that, gold nanoparticles could be added to the organic light-sensitive material. The acrylate-based materials are frequently used for optical, holographic recording of optoelectronic elements due to photo-stimulated structural transformations. The holographic recording process and photo-polymerization effect could be enhanced by the localized plasmon field of the created gold nanostructures. Finally, gold nanoparticles widely used for electrochemical and optical sensor applications. Although these NPs can be synthesized in several ways, perhaps one of the simplest methods is the thermal annealing of pre-deposited thin films on glass or silicon surfaces. With this method, the parameters of the annealing process (time, temperature) and the pre-deposited thin film thickness influence and define the resulting size and distribution of the NPs on the surface. Localized surface plasmon resonance (LSPR) is a very sensitive optical phenomenon and can be utilized for a large variety of sensing purposes (chemical sensors, gas sensors, biosensors, etc.). Surface-enhanced Raman spectroscopy (SERS) is an analytical method which can significantly increase the yield of Raman scattering of target molecules adsorbed on the surface of metallic nanoparticles. The sensitivity of LSPR and SERS based devices is strongly depending on the used material and also on the size and geometry of the metallic nanoparticles. By controlling these parameters the plasmon absorption band can be tuned and the sensitivity can be optimized. The technological parameters of the generated gold nanoparticles were investigated and influence on the SERS and on the LSPR sensitivity was established. The LSPR sensitivity were simulated for gold nanocubes and nanospheres with MNPBEM Matlab toolbox. It was found that the enhancement factor (which characterize the increase in the peak shift for multi-particle arrangements compared to single-particle models) depends on the size of the nanoparticles and on the distance between the particles. This work was supported by GINOP- 2.3.2-15-2016-00041 project, which is co-financed by the European Union and European Social Fund. Istvan Csarnovics is grateful for the support through the New National Excellence Program of the Ministry of Human Capacities, supported by the ÚNKP-17-4 Attila Bonyár and Miklós Veres are grateful for the support of the János Bolyai Research Scholarship of the Hungarian Academy of Sciences.

Keywords: light sensitive nanocomposites, metallic nanoparticles, photonic application, plasmonic nanostructures

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Authors: Belal Rahhal, Isra Taha, Insaf Najajreh, Waleed Basha, Hamzeh Alzabadeh, Ahed Zyoud

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Phytochemical Investigation and Diuretic Activity of the Palestinian Crataegus aronia in Mice using an Aqueous Extract Division of Physiology, Pharmacology and Toxicology Faculty of Medicine and Health Sciences An- Najah National University Nablus- Palestine Belal Rahhal, Isra Taha, Insaf Najajreh, Waleed Basha, Hamzeh Alzabadeh and Ahed Zyoud Purpose: Throughout history, various natural materials were used as remedies for treatment of various diseases, and recently a vastly growing and renewed interest in herbal medicine is witnessed globally. In Palestinian folk medicine, Crataegus aronia is used as a diuretic and for treatment of hypertension. This study aimed to assess the preliminary phytochemical properties and the diuretic effect of the aqueous extracts of this plant in mice after its intraperitonial administration. Methods: It is an experimental trial applied on mice (n=8, Male, CD-1, weight range: [25-30 gram]), which are divided into two groups (4 in each). The first group administered with the plant extract (500 mg/kg) , and the second with normal saline as negative control group. Then urine output and electrolyte contents were quantified up to 6 hours for the three groups and then compared to the control one. Results: Preliminary phytochemical screening reveals the presence of tannins, alkaloids and flavoniods as major phytoconstituents in aqueous extract. Significant diuresis was noted in those received the aqueous extract of Crataegus aronia (p < 0.05) compared to controls. Moreover, aqueous extract had an acidic pH and a mild increase in the electrolyte excretion (Na, K). Conclusions: Our results revealed that Crataegus aronia aqueous extract has a potential diuretic effect. Further studies are needed to evaluate this diuretic effect in the relief of diseases characterized by volume overload. Keywords: C. aronia, furosemide, diuresis, mice, medicinal plants.

Keywords: medicinal plants, diuretic activity, mice, C. aronia, , furosemide, , Phytochemical Investigation

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Authors: Helena Bolini, Erick Esmerino, Adriano Cruz, Juliana Paixao

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The currently concern for health has increased demand for low-calorie ingredients and functional foods as probiotics. Understand the reasons that infer on food choice, besides a challenging task, it is important step for development and/or reformulation of existing food products. The use of appropriate multivariate statistical techniques, such as External Preference Map (PrefMap), associated with regression by Partial Least Squares (PLS) can help in determining those factors. Thus, this study aimed to determine, through PLS regression analysis, the sensory attributes considered drivers of liking in probiotic petit suisse cheeses, strawberry flavor, sweetened with different sweeteners. Five samples in same equivalent sweetness: PROB1 (Sucralose 0.0243%), PROB2 (Stevia 0.1520%), PROB3 (Aspartame 0.0877%), PROB4 (Neotame 0.0025%) and PROB5 (Sucrose 15.2%) determined by just-about-right and magnitude estimation methods, and three commercial samples COM1, COM2 and COM3, were studied. Analysis was done over data coming from QDA, performed by 12 expert (highly trained assessors) on 20 descriptor terms, correlated with data from assessment of overall liking in acceptance test, carried out by 125 consumers, on all samples. Sequentially, results were submitted to PLS regression using XLSTAT software from Byossistemes. As shown in results, it was possible determine, that three sensory descriptor terms might be considered drivers of liking of probiotic petit suisse cheese samples added with sweeteners (p<0.05). The milk flavor was noticed as a sensory characteristic with positive impact on acceptance, while descriptors bitter taste and sweet aftertaste were perceived as descriptor terms with negative impact on acceptance of petit suisse probiotic cheeses. It was possible conclude that PLS regression analysis is a practical and useful tool in determining drivers of liking of probiotic petit suisse cheeses sweetened with artificial and natural sweeteners, allowing food industry to understand and improve their formulations maximizing the acceptability of their products.

Keywords: acceptance, consumer, quantitative descriptive analysis, sweetener

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Authors: Jiyoung Kim, Chae Weon Chung

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Labor pain is one of the most common concerns of pregnant women, thus women are in need of possible options they could take to control the pain. So, this study aimed to explore maternal perception of epidural anesthesia and to compare the childbirth outcomes according to the use of epidural anesthesia. For this descriptive study, women who were over 36 weeks of pregnancy were recruited from an out-patient obstetric clinic in a public hospital in Seoul. Women were included in the study if agreed to participate, were pregnant singleton, without pregnancy complication, and expecting a natural birth. Data collection was done twice, the first one at the prenatal care visit and the second one at an in-patient ward on 2nd day postpartum. The instrument of the beliefs about epidural anesthesia, one item of asking intention to use epidural anesthesia, demographics, and obstetrical characteristics were incorporated into a questionnaire. One nurse researcher performed data collection with the structured questionnaire after the approval of the institutional review board. At the initial data collection 133 women were included, while 117 were retained at the second point after excluded 13 women due to the occurrence of complications. Analyses were done by chi-square, t-test, and ANOVA using the SPSS program. Women were aged 32.5 years old, 22.2% were over 35 years old. The average gestational age was 38.5 weeks, and 67.5% were nulliparous. Out of 38 multiparous women, 20 women (52.6%) had received epidural anesthesia in the previous delivery. At the initial interview, 62.6% (n=73) of women wanted to receive epidural anesthesia while 22.4% answered not decided and 15.4% did not want to take the procedure. However, there were changes in proportions between women’s intention to take it and actual procedures done, particularly, two-thirds of women (n=26) who had been undecided were found to receive epidural anesthesia during labor. There was a significant difference in the perception of epidural anesthesia measured before delivery between women who received and not received it (t=3.68, p < .001). Delivery outcomes were statistically different between the two groups in delivery mode (chi-square=8.64, p=.01), O₂ supply during labor (chi-square =5.01, p=.03), duration of 2nd stage of labor (t=3.70, p < .001), and arterial cord blood pH (t=2.64, p=.01). Interestingly, there was no difference in labor pain perceived between women with and without epidural anesthesia. Considering the preference and use of epidural anesthesia, health professionals need to assess coping ability of women undergoing delivery and to provide accurate information about pain control to support their decision making and eventually to enhance delivery outcomes for mothers and neonates.

Keywords: epidural anesthesia, delivery outcomes, labor pain, perception

Procedia PDF Downloads 151

Authors: Nyimas Annissa Mutiara Andini

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There are 325,000 children younger than age 15 in the U.S. have epilepsy. In Indonesia, 40% of 3,5 millions cases of epilepsy happens in children. The most common type of epilepsy, which affects 6 out of 10 people with the disorder, is called idiopathic epilepsy and which has no identifiable cause. One of the most commonly used medications in the treatment of this childhood epilepsy is sodium valproate. Administration of sodium valproat in children has a problem to fail. Nearly 60% of pediatric patients known were mildly, moderately, or severely non-adherent with therapy during the first six months of treatment. Many parents or caregiver took far less medication than prescribed, and the treatment-adherence pattern for the majority of patients was established during the first month of treatment. 42% of the patients were almost always given their medications as prescribed but 13% had very poor adherence even in the early weeks and months of treatment. About 7% of patients initially gave the medication correctly 90% of the time, but adherence dropped to around 20% within six months of starting treatment. Over the six months of observation, the total missing of administration is about four out of 14 doses in any given week. This fail can cause the epilepsy to relapse. Whereas, current reported epilepsy disorder were significantly more likely than those never diagnosed to experience depression (8% vs 2%), anxiety (17% vs 3%), attention-deficit/hyperactivity disorder (23% vs 6%), developmental delay (51% vs 3%), autism/autism spectrum disorder (16% vs 1%), and headaches (14% vs 5%) (all P< 0.05). They had a greater risk of limitation in the ability to do things (relative risk: 9.22; 95% CI: 7.56–11.24), repeating a school grade (relative risk: 2.59; CI: 1.52–4.40), and potentially having unmet medical and mental health needs. In the other side, technology can help to make our life easier. One of the technology, that we can use is a mobile application. A mobile app is a software program we can download and access directly using our phone. Indonesians are highly mobile centric. They use, on average, 6.7 applications over a 30 day period. This paper is aimed to describe an application that could help to control a sodium valproat administration in children; we call it as D-Epi app. D-Epi app is a downloadable application that can help parents or caregiver alert by a timer-related application to warn whether it is the time to administer the sodium valproat. It works not only as a standard alarm, but also inform important information about the drug and emergency stuffs to do to children with epilepsy. This application could help parents and caregiver to take care a child with epilepsy in Indonesia.

Keywords: application, children, D-Epi, epilepsy

Procedia PDF Downloads 275

Authors: Junjira Mahaboon, Anongnard Boonpak, Nattakarn Worrasan, Busma Kama, Mujalin Saikliang, Siripor Dankachatarn

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Rubber wood processing is one of the most important industries in southern Thailand. The process has several safety hazards for example unsafe wood cutting machine guarding, wood dust, noise, and heavy lifting. However, workers’ occupational health and safety measures to promote their behaviors are still limited. This quasi-experimental research was to determine factors affecting workers’ safety behaviors using theory of planned behavior after implementing job safety intervention program. The purposes were to (1) determine factors affecting workers’ behaviors and (2) to evaluate effectiveness of the intervention program. The sample of study was 66 workers from a rubber wood processing factory. Factors in the Theory of Planned Behavior model (TPB) were measured before and after the intervention. The factors of TPB included attitude towards behavior, subjective norm, perceived behavioral control, intention, and behavior. Firstly, Job Safety Analysis (JSA) was conducted and Safety Standard Operation Procedures (SSOP) were established. The questionnaire was also used to collect workers’ characteristics and TPB factors. Then, job safety intervention program to promote workers’ behavior according to SSOP were implemented for a four month period. The program included SSOP training, personal protective equipment use, and safety promotional campaign. After that, the TPB factors were again collected. Paired sample t-test and independent t-test were used to analyze the data. The result revealed that attitude towards behavior and intention increased significantly after the intervention at p<0.05. These factors also significantly determined the workers’ safety behavior according to SSOP at p<0.05. However, subjective norm, and perceived behavioral control were not significantly changed nor related to safety behaviors. In conclusion, attitude towards behavior and workers’ intention should be promoted to encourage workers’ safety behaviors. SSOP intervention program e.g. short meeting, safety training, and promotional campaign should be continuously implemented in a routine basis to improve workers’ behavior.

Keywords: job safety analysis, rubber wood processing workers, safety standard operation procedure, theory of planned behavior

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Authors: Dativa Maria Aliddeki, Fred Monje, Godfrey Nsereko, Benon Kwesiga, Daniel Kadobera, Alex Riolexus Ario

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Background: Cholera is a severe gastrointestinal disease caused by Vibrio cholera. It has caused several pandemics. On 26 February 2018, a suspected cholera outbreak, with one death, occurred in School X in Hoima Municipality, western Uganda. We investigated to identify the scope and mode of transmission of the outbreak, and recommend evidence-based control measures. Methods: We defined a suspected case as onset of diarrhea, vomiting, or abdominal pain in a student or staff of School X or their family members during 14 February–10 March. A confirmed case was a suspected case with V. cholerae cultured from stool. We reviewed medical records at Hoima Hospital and searched for cases at School X. We conducted descriptive epidemiologic analysis and hypothesis-generating interviews of 15 case-patients. In a retrospective cohort study, we compared attack rates between exposed and unexposed persons. Results: We identified 15 cases among 75 students and staff of School X and their family members (attack rate=20%), with onset from 25-28 February. One patient died (case-fatality rate=6.6%). The epidemic curve indicated a point-source exposure. On 24 February, a student brought fried fish from her home in a fishing village, where a cholera outbreak was ongoing. Of the 21 persons who ate the fish, 57% developed cholera, compared with 5.6% of 54 persons who did not eat (RR=10; 95% CI=3.2-33). None of 4 persons who recooked the fish before eating, compared with 71% of 17 who did not recook it, developed cholera (RR=0.0, 95%CIFisher exact=0.0-0.95). Of 12 stool specimens cultured, 6 yielded V. cholerae. Conclusion: This cholera outbreak was caused by eating fried fish, which might have been contaminated with V. cholerae in a village with an ongoing outbreak. Lack of thorough cooking of the fish might have facilitated the outbreak. We recommended thoroughly cooking fish before consumption.

Keywords: cholera, disease outbreak, foodborne, global health security, Uganda

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Authors: Benjamin Osei-Tutu, Henrietta Awewole Kolson

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Background: Acute gastroenteritis is one of the frequently reported Out-Patient Department (OPD) cases. However, the causative pathogens of these cases are rarely identified at the OPD due to delay in laboratory results or failure to obtain specimens before antibiotics is administered. Method: A retrospective review of surveillance data from the Adentan Municipality, Accra, Ghana that were recorded in the National foodborne disease surveillance system of Ghana, was conducted with the main aim of describing the epidemiology and food practice of cases reported from the Adentan Municipality. The study involved a retrospective review of surveillance data kept on patients who visited health facilities that are involved in foodborne disease surveillance in Ghana, from January 2015 to December 2016. Results: A total of 375 cases were reviewed and these were classified as viral hepatitis (hepatitis A and E), cholera (Vibrio cholerae), dysentery (Shigella sp.), typhoid fever (Salmonella sp.) or gastroenteritis. Cases recorded were all suspected case and the average cases recorded per week was 3. Typhoid fever and dysentery were the two main clinically diagnosed foodborne illnesses. The highest number of cases were observed during the late dry season (Feb to April), which marks the end of the dry season and the beginning of the rainy season. Relatively high number of cases was also observed during the late wet seasons (Jul to Oct) when the rainfall is the heaviest. Home-made food and street vended food were the major sources of suspected etiological food, recording 49.01% and 34.87% of the cases respectively. Conclusion: Majority of cases recorded were classified as gastroenteritis due to the absence of laboratory confirmation. Few cases were classified as typhoid fever and dysentery based on clinical symptoms presented. Patients reporting with foodborne diseases were found to consume home meal and street vended foods as their predominant source of food.

Keywords: accra, etiologic food, food poisoning, gastroenteritis, illness, surveillance

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Authors: Obadire F. O., Obadire, S. O., Adeoti R. F., Pirgozliev V.

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An experiment was conducted to determine the efficacy of utilizing African black plum seed nut (ABPNBD) meal on hematological and biochemical indices of broiler chicken ration formulated to substitute wheat offal. A total of 150- 1day-old, male Agrited birds were reared for 28 days of the experiment. The birds were assigned to five dietary treatments, with ten birds per treatment replicated 3 times. Experimental diets were formulated by supplementing the milled African black plum nut at (0, 5, 10, 12.5, and 15%) inclusion levels in the starter broiler’s ratio designated as T1 (control diet containing no ABPBD), Treatments (T2, 3,4 and 5) contained ABPNBD at 5, 10, 12.5, and 15%, respectively, in a completely randomized design. The hematological and biochemical indices of the birds were determined. The result revealed that all hematological parameters measured were significant (P <0.05) except for WBC. Increasing inclusion levels of ABPNBD decreased the PCV, HB, and RBC of the birds across the treatment groups. Birds fed 12.5 and 15% ABPNBD diets recorded the least of the parameters. The result of the serum biochemical indices showed significant (P < 0.05) influence for all parameters measured except for alanine transaminase (ALT), (AST), and creatinine. The total protein (TP), albumin, globulin, and glucose values were reduced across the treatment group as ABPNBD inclusion increased. Birds fed above 10% ABPNBD recorded the lowest value of TP, albumin, globulin, and glucose when compared with birds on a control diet and other treatments. The uric acid ranged from 3.85 to 2 .13 mmol/L, while creatinine ranged from 62.00 to 53.50 mmol/l. AST ranged between 8.50 u/l (5%) to 7.90 u/l (10%). ALT ranged between 7.50 u/l (12.5%) to 5.50 u/l (5 and 10%). In conclusion, dietary inclusion of African black plum up to 10% has no detrimental effect on the health of the starter chickens. Meanwhile, inclusion above 10% revealed a negative effect on some blood parameters measured. Therefore, African black plum should be supplemented with probable probiotics or subjected to different processing methods if to be used at a 15% inclusion level for optimal results.

Keywords: African black plum seed, starter broiler chickens, hematological and serum biochemical indices, (Vitex doniana)

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Authors: Yunjia Yang, Yakun Yan, Peng Li, Gordon Xu, Timothy Mahony, Neena Mitter, Karishma Mody

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Sheep flystrike is one of the most economically important diseases affecting the Australian sheep and wool industry (>356M/annually). Currently, control of Lucillia cuprina relies almost exclusively on chemicals controls and the parasite has developed resistance to nearly all control chemicals used in the past. It is therefore critical to develop an alternative solution for the sustainable control and management of flystrike. RNA interference (RNAi) technologies have been successfully explored in multiple animal industries for developing parasites controls. This research project aims to develop a RNAi based biological control for sheep blowfly. Double-stranded RNA (dsRNA) has already proven successful against viruses, fungi and insects. However, the environmental instability of dsRNA is a major bottleneck with a protection window only lasting 5-7 days. Bentonite polymer (BenPol) technology can overcome this problem, as it can be tuned for controlled release of the dsRNA in the gut challenging pH environment of the blowfly larvae, prolonging its exposure time to and uptake by target cells. We have investigated four different BenPol carriers for their dsRNA loading capabilities of which three of them were able to afford dsRNA stability under multiple temperatures (4°C, 22°C, 40°C, 55°C) in the sheep serum. Based on stability results, we further tested dsRNA from potential targeted genes loaded with BenPol carrier in larvae feeding assay, and get three knockdowns. Our results, establish that the dsRNA when loaded on BenPol particles is stable unlike naked dsRNA which is rapidly degraded in the sheep serum. A stable nanoparticles delivery system that can protect and increase the inherent stability of the dsRNA molecules at higher temperatures in a complex biological fluid like serum, offers a great deal of promise for the future use of this approach for enhancing animal protection.

Keywords: RNA interference, Lucillia cuprina, polymer carriers, polymer stability

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