Search results for: clinical health psychology

Authors: Euan Donley

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Emergency Departments (EDs) are heavily burdened as presentation rates continue to rise. To improve patient flow National Emergency Access Targets (NEAT) were introduced. NEAT implements timelines for ED presentations, such as discharging patients within four hours of arrival. Mental health patients use EDs more than the general population and are generally more complex in their presentations. The aim of this study is to examine the impact of NEAT on psychiatric risk assessment of mental health patients in the ED. Seventy-eight mental health clinicians from 7 Victoria, Australia, hospital EDs participated in a mixed method analysis via anonymous online survey. NEAT was considered helpful as mental health patients were seen quicker, were less likely to abscond, could improve teamwork amongst ED staff, and in some cases administrative processes were better streamlined. However, clinicians felt that NEAT was also responsible for less time with patients and relatives’, resulted in rushed assessments, placed undue pressure on mental health clinicians, was not conducive to training, and the emphasis on time was the wrong focus for patient treatment. The profile of a patient typically likely to be treated within NEAT timelines showed a perfect storm of luck and compliance. If a patient was sober, medically stable, referred early, did not require much collateral information and did not have distressed relatives, NEAT was more likely to be met. Organisationally participants reported no organisational change or training to meet NEAT. Poor mental health staffing, multiple ED presentations and a shortage of mental health beds also hamper meeting NEAT. Findings suggest participants were supportive of NEAT in principle, but a demanding workload and organisational barriers meant NEAT had an overall negative effect on psychiatric risk assessment of mental health patients in ED.

Keywords: assessment, emergency, risk, psychiatric

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Authors: Tatiana Butkova, Nikolai Kibrik, Kristina Malsagova, Alexander Izotov, Alexander Stepanov, Anna Kaysheva

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Relevance. The genetic risk of developing schizophrenia is determined by two factors: single nucleotide polymorphisms and gene copy number variations. The search for serological markers for early diagnosis of schizophrenia is driven by the fact that the first five years of the disease are accompanied by significant biological, psychological, and social changes. It is during this period that pathological processes are most amenable to correction. The aim of this study was to analyze single nucleotide polymorphisms (SNPs) that are hypothesized to potentially influence the onset and development of the endogenous process. Materials and Methods It was analyzed 73 single nucleotide polymorphism variants. The study included 48 patients undergoing inpatient treatment at "Psychiatric Clinical Hospital No. 1" in Moscow, comprising 23 females and 25 males. Inclusion criteria: - Patients aged 18 and above. - Diagnosis according to ICD-10: F20.0, F20.2, F20.8, F21.8, F25.1, F25.2. - Voluntary informed consent from patients. Exclusion criteria included: - The presence of concurrent somatic or neurological pathology, neuroinfections, epilepsy, organic central nervous system damage of any etiology, and regular use of medication. - Substance abuse and alcohol dependence. - Women who were pregnant or breastfeeding. Clinical and psychopathological assessment was complemented by psychometric evaluation using the PANSS scale at the beginning and end of treatment. The duration of observation during therapy was 4-6 weeks. Total DNA extraction was performed using QIAamp DNA. Blood samples were processed on Illumina HiScan and genotyped for 652,297 markers on the Infinium Global Chips Screening Array-24v2.0 using the IMPUTE2 program with parameters Ne=20,000 and k=90. Additional filtration was performed based on INFO>0.5 and genotype probability>0.5. Quality control of the obtained DNA was conducted using agarose gel electrophoresis, with each tested sample having a volume of 100 µL. Results. It was observed that several SNPs exhibited gender dependence. We identified groups of single nucleotide polymorphisms with a membership of 80% or more in either the female or male gender. These SNPs included rs2661319, rs2842030, rs4606, rs11868035, rs518147, rs5993883, and rs6269.Another noteworthy finding was the limited combination of SNPs sufficient to manifest clinical symptoms leading to hospitalization. Among all 48 patients, each of whom was analyzed for deviations in 73 SNPs, it was discovered that the combination of involved SNPs in the manifestation of pronounced clinical symptoms of schizophrenia was 19±3 out of 73 possible. In study, the frequency of occurrence of single nucleotide polymorphisms also varied. The most frequently observed SNPs were rs4849127 (in 90% of cases), rs1150226 (86%), rs1414334 (75%), rs10170310 (73%), rs2857657, and rs4436578 (71%). Conclusion. Thus, the results of this study provide additional evidence that these genes may be associated with the development of schizophrenia spectrum disorders. However, it's impossible cannot rule out the hypothesis that these polymorphisms may be in linkage disequilibrium with other functionally significant polymorphisms that may actually be involved in schizophrenia spectrum disorders. It has been shown that missense SNPs by themselves are likely not causative of the disease but are in strong linkage disequilibrium with non-functional SNPs that may indeed contribute to disease predisposition.

Keywords: gene polymorphisms, genotyping, single nucleotide polymorphisms, schizophrenia.

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Authors: Ioannis Iglezakis, Theodoros D. Trokanas, Panagiota Kiortsi

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This paper aims to explore major legal issues arising from the collection and processing of Health Big Data in the light of the new European secondary legislation for the protection of personal data of natural persons, placing emphasis on the General Data Protection Regulation 679/2016. Whether Big Health Data can be characterised as ‘personal data’ or not is really the crux of the matter. The legal ambiguity is compounded by the fact that, even though the processing of Big Health Data is premised on the de-identification of the data subject, the possibility of a combination of Big Health Data with other data circulating freely on the web or from other data files cannot be excluded. Another key point is that the application of some provisions of GPDR to Big Health Data may both absolve the data controller of his legal obligations and deprive the data subject of his rights (e.g., the right to be informed), ultimately undermining the fundamental right to the protection of personal data of natural persons. Moreover, data subject’s rights (e.g., the right not to be subject to a decision based solely on automated processing) are heavily impacted by the use of AI, algorithms, and technologies that reclaim health data for further use, resulting in sometimes ambiguous results that have a substantial impact on individuals. On the other hand, as the COVID-19 pandemic has revealed, Big Data analytics can offer crucial sources of information. In this respect, this paper identifies and systematises the legal provisions concerned, offering interpretative solutions that tackle dangers concerning data subject’s rights while embracing the opportunities that Big Health Data has to offer. In addition, particular attention is attached to the scope of ‘consent’ as a legal basis in the collection and processing of Big Health Data, as the application of data analytics in Big Health Data signals the construction of new data and subject’s profiles. Finally, the paper addresses the knotty problem of role assignment (i.e., distinguishing between controller and processor/joint controllers and joint processors) in an era of extensive Big Health data sharing. The findings are the fruit of a current research project conducted by a three-member research team at the Faculty of Law of the Aristotle University of Thessaloniki and funded by the Greek Ministry of Education and Religious Affairs.

Keywords: big health data, data subject rights, GDPR, pandemic

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Authors: Yujun Liu, Maosheng Ran

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Background: Chinese rural-to-urban migrant workers’ mental health problems raise attentions from different social sectors. However, situation of present mental health services provided to this population has not been discovered. This study attempts to describe the current mental health service situation, identify the gaps and give the future directions based on the quantitative data. Methods: Questionnaire surveys were conducted among 2017 rural-to-urban migrant workers in 13 cities and 100 social work service organizations in 5 cities in 2014. Data was collected by face-to-face structured interview by trained interviewers. Findings: Migrant workers’ mental health status was not good. Compared to the severity of mental distress, mental health service for this population was lacking and insufficient, which accounted for only 14.4% of all services in our sample. And the group work and case work were the most frequently-used methods. By estimating a series of regression models, we revealed that life experiences and working conditions were significantly associated with migrant workers’ mental health status. Therefore, the macro social work practices aimed at this whole group were advocated to promote their mental wellbeing. That is, practitioners should not only focus on the improvement of migrant workers’ emotion management capacity, but also pay attention to raise awareness and improve their living and working condition; not only concentrate on the solving of individuals’ dilemma, but also promote gradual reformation of present labor regime and hukou system in China.

Keywords: Chinese rural-to-urban migrant workers, macro social work practice, mental health service needs, mental health status

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Authors: Sarwat Sultan, Muhammad Saleem, Frasat Kanwal

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Adolescence is a transition period of life that brings physical and psychological changes and always results in several challenges for an adolescent. An adolescent must learn life skills for a healthy transition from adolescence period to adulthood. Therefore this study was planned to examine the effects of life skill education on adolescents' mental health and academic benefits. A random sample of 720 school students aged between 13-17 years was categorized into two groups; experimental (n=360) and control (n=360). Life skill education was given to the students of the intervention group with repeated assessments of mental health and academic benefits at pre-intervention (T1) and post-intervention (T2) for both groups. Both groups were compared on scores of mental health and academic benefits across two times T1 and T2 by employing a mixed between-within-subjects analysis of variance. Findings showed the main effect of time suggesting the largest changes in mental health and academic benefits over time. Interaction effects between time and both groups were also found significant indicating the largest changes across time between both groups. Results of between-group comparisons showed significant values for Wilks’ Lambda and partial eta squared for students of the intervention group who scored higher on mental health and academic benefits after receiving life skills training than the students of the control group. Results of the present study determined the efficacy of life skill education and have implications for both teachers and psychotherapists to improve the students’ mental health and academic performance.

Keywords: academic benefits, life skills, mental health, adolescents

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Authors: Lea Stein, Sabine Rösner, Alessandra Lo Giudice, Beate Ditzen, Tewes Wischmann

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For many couples bearing children is a consistent life goal; however, it cannot always be fulfilled. Undergoing infertility treatment does not guarantee pregnancies and live births. Couples have to deal with miscarriages and sometimes even discontinue infertility treatment. Significant medical predictors for the outcome of infertility treatment have yet to be fully identified. To further our understanding, a cross-sectional five-year follow-up survey was undertaken, in which 95 women and 82 men that have been treated at the Women’s Hospital of Heidelberg University participated. Binary logistic regressions, parametric and non-parametric methods were used for our sample to determine the relevance of biological (infertility diagnoses, maternal and paternal age) and lifestyle factors (smoking, drinking, over- and underweight) on the outcome of infertility treatment (clinical pregnancy, live birth, miscarriage, dropout rate). During infertility treatment, 72.6% of couples became pregnant and 69.5% were able to give birth. Suffering from miscarriages 27.5% of couples and 20.5% decided to discontinue an unsuccessful fertility treatment. The binary logistic regression models for clinical pregnancies, live births and dropouts were statistically significant for the maternal age, whereas the paternal age in addition to maternal and paternal BMI, smoking, infertility diagnoses and infections, showed no significant predicting effect on any of the outcome variables. The results confirm an effect of maternal age on infertility treatment, whereas the relevance of other medical predictors remains unclear. Further investigations should be considered to increase our knowledge of medical predictors.

Keywords: advanced maternal age, assisted reproductive technology, female factor, male factor, medical predictors, infertility treatment, reproductive medicine

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Authors: Lok Bahadur Shrestha, Narayan Raj Bhattarai, Basudha Khanal

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Introduction: Coagulase-negative staphylococci (CoNS) are the normal commensal of human skin and mucous membranes. The study was carried out to study the prevalence of CoNS among clinical isolates, to characterize them up to species level and to compare the three conventional methods for detection of biofilm formation. Objectives: to characterize the clinically significant coagulase-negative staphylococci up to species level, to compare the three phenotypic methods for the detection of biofilm formation and to study the antimicrobial susceptibility pattern of the isolates. Methods: CoNS isolates were obtained from various clinical samples during the period of 1 year. Characterization up to species level was done using biochemical test and study of biofilm formation was done by tube adherence, congo red agar, and tissue culture plate method. Results: Among 71 CoNS isolates, seven species were identified. S. epidermidis was the most common species followed by S. saprophyticus, S. haemolyticus. Antimicrobial susceptibility pattern of CoNS documented resistance of 90% to ampicillin. Resistance to cefoxitin and ceftriaxone was observed in 55% of the isolates. We detected biofilm formation in 71.8% of isolates. The sensitivity of tube adherence method was 82% while that of congo red agar method was 78%. Conclusion: Among 71 CoNS isolated, S. epidermidis was the most common isolates followed by S. saprophyticus and S. haemolyticus. Biofilm formation was detected in 71.8% of the isolates. All of the methods were effective at detecting biofilm-producing CoNS strains. Biofilm former strains are more resistant to antibiotics as compared to biofilm non-formers.

Keywords: CoNS, congo red agar, bloodstream infections, foreign body-related infections, tissue culture plate

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Authors: Mathilde Blondon, Salla Aicha Dieng, Catherine Pfister

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In a paradoxical way, teenagers nowadays seem to use suicidal attempts to elaborate on their trauma abuses and regain some kind of control in their lives. As their behavior becomes life-threatening, the hospital offers a variety of expertise to address their need, with Child Protective Services also joining in, to a point when teenagers could have a feeling of losing control of their lives, which results in them making more suicidal attempts. Our goal here is to walk with these foster teenagers long enough to step therapy up first, then as their mental health is restored enough to step the therapy down in a way that is secure and will give them their life back. This would prevent them from making suicidal attempts to get a feeling of control over their life. We’ll present a clinical case of a 14-year-old girl named Sofia, who was suffering from parental deprivation, an identity disorder, and severe depression disorder. Our intervention took place in January 2024, after Sofia had undergone four hospitalizations, including a two-month period in a specialized clinic. In a stepping-up effort, a substantial setting has been built around Sofia. She was coming three days a week to therapeutic activities at the Child Psychiatry Day Hospital, she had one psychotherapy session a week at the Medical-Psychological Center, and she was meeting with the Adolescent Psychiatrist on a regular basis. However, her suicidal attempts frequency continued to increase to the point when she couldn’t stay more than four days outside the hospital unit without harming herself and being brought back to the Emergency Unit. We were all stuck in some kind of medical deadlock, writing to clinics that had no room for her while social workers were calling foster homes that wouldn’t even accept her either. At some point, a clinical decision was made by the psychiatrist to stop what appeared to be a global movement of traumatic repetition, which involved Sofia’s family, the medical team and the social workers as one. This decision to step therapy down created a surprise and put an end to the cycle. It provided a new path, a new solution where Sofia could securely settle without being unfaithful to her family. Her suicidal attempts stopped for four weeks. She had one relapse, then didn’t make another attempt so far. There is a fine line between too little and too much, a pathway with the right amount of care and support. We believe it is not a steady line but rather a path up and down the hill. It’s about building up this moment when medication and mental processes have improved the subject’s condition enough to allow the medical team to step therapy down and give more control back to the subject. These needed variations used to come from a change of hospital or medical team. Stepped care avoids any breaking of bonds and appears to be decisive in stopping teenagers’ suicidal attempts.

Keywords: child protection, adolescent psychiatry, teenager suicidal attempt, foster teenagers, parental deprivation, stepped care

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Authors: Kamal Ameis

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This study aims to further improve our understanding of the underlying mechanism of local injury that occurs after manual acupuncture needle manipulation, and that initiates the muscle regeneration process, which is essential for muscle maintenance and adaptation. Skeletal muscle is maintained by resident stem cells called muscle satellite cells. These cells are normally in quiescent state, but following muscle injury, they re-enter the cell cycle and execute a myogenic program resulting in muscle fiber regeneration. Our previous work in young rats demonstrated that acupuncture treatment induced injury that activated resident satellite (stem) cells, which leads to muscle regeneration. Skeletal muscle regeneration is an adaptive response to injury that requires a tightly orchestrated event between signaling pathways activated by growth factor and intrinsic regulatory program controlled by myogenic transcription factor. We identified several gene expressions uniquely important for muscle regeneration in response to acupuncture treatment at different time course using different biological techniques, including Immunocytochemistry, western blotting, and Real Time PCR. This study uses a novel but non-invasive model of injury induced by manual acupuncture to further our current understanding of regenerative mechanism of muscle stem cells. From a clinical perspective, this model of injury induced by manual acupuncture may be easily translatable into a clinical tool that can be used as an alternative to physical exercise for patients challenged by bed rest or forced inactivity. Finally, the knowledge gained from this research could be useful for studies of the local effects of various modalities of induced injury, such as the traditional method of healing by cupping (hijamah), which may enhanced muscle stem cells and muscle fiber regeneration.

Keywords: acupuncture, injury, regeneration, muscle stem cells

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Authors: Menouni Aziza, Chbihi Kaoutar, El Jaafari Samir

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There is strong evidence connecting epidemics with the disruption of the human-animal-environment interaction. Despite the fact that several cases of emerging and endemic zoonotic diseases indifferent parts of Africa have been documented, there is limited data regarding which specific interventions are effective in preventing and managing the associated risks using a One Health approach. The aim of this study is to better understand perceptions and ongoing research related to interventions in Africa through the implementation of suitable projects and policies. A bibliometric review of the scientific literature on one health studies with a focus on African countries was conducted, followed by a qualitative survey among stakeholders involved in fields related to One Health research or management in the Africa, including veterinary experts, public health professionals, environmentalists and policy makers, to learn about determinants of their perceptions, as well as barriers to and promoters of successful interventions and governance. The project was concluded with an international workshop in March 2023, where a broad range of topics relevant to One Health were discussed. 94% of the respondents were aware of the importance of the One Health approach and strongly endorse it within their respective countries. The top reported barriers to One Health development in Africa included paucity of data, weak linkages and institutional communication between the different departments and the lack of funding. Key areas of improvement identified were the impact evaluation of current initiatives, awareness raising campaigns among citizens targeted at behavioral changes, capacity building of relevant professionals and stakeholders, as well as the implementation of adequate policies and enforcement of national and continental regulations, allowing for better coordination on the African level. All One Health sectors in Africa require strong governance and leadership, as well as inter-ministerial, inter-sectoral, and interdisciplinary cooperation.

Keywords: one health, perceptions, governance, Africa

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Authors: Elyria Kemp, Kelly Cowart, My Bui

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According to the National Institute of Mental Health, an estimated 31.9% of adolescents have had an anxiety disorder. Several environmental factors may help to contribute to high levels of anxiety and depression in young people (i.e., Generation Z, Millennials). However, as young people negotiate life on social media, they may begin to evaluate themselves using excessively high standards and adopt self-perfectionism tendencies. Broadly defined, self-perfectionism involves very critical evaluations of the self. Perfectionism may also come from others and may manifest as socially prescribed perfectionism, and young adults are reporting higher levels of socially prescribed perfectionism than previous generations. This rising perfectionism is also associated with anxiety, greater physiological reactivity, and a sense of social disconnection. However, theories from psychology suggest that improvement in emotion regulation can contribute to enhanced psychological and emotional well-being. Emotion regulation refers to the ways people manage how and when they experience and express their emotions. Cognitive reappraisal and expressive suppression are common emotion regulation strategies. Cognitive reappraisal involves changing the meaning of a stimulus that involves construing a potentially emotion-eliciting situation in a way that changes its emotional impact. By contrast, expressive suppression involves inhibiting the behavioral expression of emotion. The purpose of this research is to examine the efficacy of social marketing initiatives which promote emotion regulation strategies to help young adults regulate their emotions. In Study 1 a single factor (emotional regulation strategy: a cognitive reappraisal, expressive, control) between-subjects design was conducted using an online, non-student consumer panel (n=96). Sixty-eight percent of participants were male, and 32% were female. Study participants belonged to the Millennial and Gen Z cohort, ranging in age from 22 to 35 (M=27). Participants were first told to spend at least three minutes writing about a public speaking appearance which made them anxious. The purpose of this exercise was to induce anxiety. Next, participants viewed one of three advertisements (randomly assigned) which promoted an emotion regulation strategy—cognitive reappraisal, expressive suppression, or an advertisement non-emotional in nature. After being exposed to one of the ads, participants responded to a measure composed of two items to access their emotional state and the efficacy of the messages in fostering emotion management. Findings indicated that individuals in the cognitive reappraisal condition (M=3.91) exhibited the most positive feelings and more effective emotion regulation than the expressive suppression (M=3.39) and control conditions (M=3.72, F(1,92) = 3.3, p<.05). Results from this research can be used by institutions (e.g., schools) in taking a leadership role in attacking anxiety and other mental health issues. Social stigmas regarding mental health can be removed and a more proactive stance can be taken in promoting healthy coping behaviors and strategies to manage negative emotions.

Keywords: emotion regulation, anxiety, social marketing, generation z

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Authors: Tacho Rubby Kong

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Community health workers’ performances are known to influence members’ behaviours and practices while translating policies into service delivery. However, little remains known about the extent to which this remains true within interventions aimed at addressing malaria burden in low-resource settings like Cameroon. The objective of this study was to examine the health workers’ performance and their influence on the adoption of strategies to address the malaria burden at a subnational level health system in Cameroon. A qualitative exploratory design was adopted on a purposively selected sample of 18 key informants. The study was conducted in Konye health district among sub-national health systems, managers, health facility in-charges, and frontline community health workers. Data was collected using semi-structured interview guides in a face-to-face interview with respondents. The analysis adopted a thematic approach utilising journals, credible authors, and peer review articles for data management. Participants acknowledged that workplace networks were influential during the implementation of policies to address malaria. The influence exerted was in form of linkage with other services, caution, and advice regarding strict adherence to policy recommendations, perhaps reflective of the level of trust in providers’ ability to adhere to policy provisions. At the district health management level and among non-state actors, support in perceived areas of weak performance in policy implementation was observed. In addition, timely initiation of contact and subsequent referral was another aspect where community health workers exerted influence while translating policies to address the malaria burden. While the level of support from among network peers was observed to influence community health workers’ adoption and implementation of strategies to address the malaria burden, different mechanisms triggered subsequent response and level of adherence to recommended policy aspects. Drawing from the elicited responses, it was infer that community health workers’ performance influence the direction and extent of success in policy implementation to address the malaria burden at the subnational level.

Keywords: subnational, community, malaria, strategy

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Authors: Fasanmi Samuel Sunday, Awosusi Omojola

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The aim of the present study was to investigate the effect of abusive supervision, interactional justice and supportive workplace supervision burnout among health workers in Makurdi, Benue State, Nigeria. Three hundred and twenty (320) health workers were sampled within Makurdi metropolis, Benue State, Nigeria. Standardized questionnaire on abusive supervision scale, interactional justice scale, supportive workplace supervision scale and employee burnout scale were used in the study. The research was a 2x2x2 factorial design. Four hypotheses were generated and were tested using Analysis of Variance (ANOVA). Scheffe’s post-hoc analysis was used to know the direction of the findings. Results revealed that there was a significant main effect of perceived abusive supervision on employee burnout among health workers. Also, there was a significant main effect of interactional justice on employee burnout among health workers. It was also found out that there was a significant interaction effect of supportive workplace supervision, interactional justice, and abusive supervision on employee burnout among health workers. Results were discussed in line with hypotheses; and recommendations on how to reduce employee burnout were suggested.

Keywords: employee burnout, abusive supervision, interactional justice, supportive workplace supervision

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Authors: T. Ferreira, A. Kulkarni, C. Bretscher, K. Richter, M. Ehrlich, A. Marchini

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H-1 protoparvovirus (H-1PV) is a virus with inherent oncolytic and oncosuppressive activities while remaining non-pathogenic in humans. H-1PV was the first oncolytic parvovirus to undergo clinical testing. Results from trials in patients with glioblastoma or pancreatic carcinoma showed an excellent safety profile and first signs of efficacy. H-1PV infection is vastly dependent on cellular factors, from cell attachment and entry to viral replication and egress. Hence, we believe that the characterisation of the parvovirus life cycle would ultimately help further improve H-1PV clinical outcome. In the present study, we explored the entry pathway of H-1PV in cervical HeLa and glioma NCH125 cancer cell lines. Electron and confocal microscopy showed viral particles associated with clathrin-coated pits and vesicles, providing the first evidence that H-1PV cell entry occurs through clathrin-mediated endocytosis. Accordingly, we observed that by blocking clathrin-mediated endocytosis with hypertonic sucrose, chlorpromazine, or pitstop 2, H-1PV transduction was markedly decreased. Accordingly, siRNA-mediated knockdown of AP2M1, which retains a crucial role in clathrin-mediated endocytosis, verified the reliance of H-1PV on this route to enter HeLa and NCH125 cancer cells. By contrast, we found no evidence of viral entry through caveolae-mediated endocytosis. Indeed, pre-treatment of cells with nystatin or methyl-β-cyclodextrin, both inhibitors of caveolae-mediated endocytosis, did not affect viral transduction levels. Unexpectedly, siRNA-mediated knockdown of caveolin-1, the main driver of caveolae-mediated endocytosis, increased H-1PV transduction, suggesting caveolin-1 is a negative modulator of H-1PV infection. We also show that H-1PV entry is dependent on dynamin, a protein responsible for mediating the scission of vesicle neck and promoting further internalisation. Furthermore, since dynamin inhibition almost completely abolished H-1PV infection, makes it unlikely that H-1PV uses macropinocytosis as an alternative pathway to enter cells. After viral internalisation, H-1PV passes through early to late endosomes as observed by confocal microscopy. Inside these endocytic compartments, the acidic environment proved to be crucial for a productive infection. Inhibition of acidification of pH dramatically reduced H-1PV transduction. Besides, a fraction of H-1PV particles was observed inside LAMP1-positive lysosomes, most likely following a non-infectious route. To the author's best knowledge, this is the first study to characterise the cell entry pathways of H-1PV. Along these lines, this work will further contribute to understand H-1PV oncolytic properties as well as to improve its clinical potential in cancer virotherapy.

Keywords: clathrin-mediated endocytosis, H-1 parvovirus, oncolytic virus, virus entry

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Authors: Maimona A. E. Elimam, Suhair Rehan, Miskelyemen A. Elmekki, Mogahid M. Elhassan

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Staphylococcus aureus (Staph. aureus), a major cause of potentially life-threatening infections acquired in healthcare and community settings, has developed resistance to most classes of antimicrobial agents as determined by the dramatic increase. The present study aimed to determine the prevalence of MRSA, and VRSA in patients with different clinical manifestations in Khartoum state. The study population (n, 426) were males and females with different age categories, suffering either from wound infections (105), ear infections (121), or UTI (101), in addition to nasal carriers of medical staff (100). Cultures, Gram staining, and other biochemical tests were performed for conventional identification. Modified Kirby-Bauer disk diffusion method was applied and DNA was extracted from MRSA and VRSA isolates and PCR was then performed for amplification of arc, mecA, VanA, and VanB genes. The results confirmed the existence of Staph. aureus in 49/426 (11.5%) cases among which MRSA were isolated from 34/49 (69.4%) when modified Kirby-Bauer disk diffusion method was applied. Ten out of these 34 MRSA were confirmed as VRSA by cultures on BHI agar containing 6μg/ml vancomycin according to NCCLS criteria. PCR revealed that out of the 34 MRSA isolates, 26 were mecA positive (76.5%) while 8 (23.5%) were arcC positive. No vanA or VanB genes were detected. Molecular method confirmed the results for MRSA through the presence of either arcC or mecA genes while it failed to approve the occurrence of VRSA since neither VanA or VanB genes were detected. Thus, VRSA may be attributed to other factors.

Keywords: antibiotic resistance, Staphylococcus aureus, VRSA, MRSA, Khartoum, Sudan

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Authors: Lev Bertovsky

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The purpose of this study was to determine the reasons for the formation of false testimony from witnesses and make recommendations on the recognition of such cases. During the studies, which were based on the achievements of professionals in the field of psychology, as well as personal investigative practice, the stages of perception of the information were studied, as well as the process of its reclaim from the memory and transmission to the communicator upon request. Based on the principles of the human brain, kinds of conscientious witness mistakes were systematized. Proposals were formulated for the optimization of investigative actions in cases where the witnesses make an honest mistake with respect to the effects previously observed by them.

Keywords: criminology, eyewitness testimony, honest mistake, information, investigator, investigation, questioning

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Authors: Lucia Mavudzi

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Socioeconomic and demographic factors influence male attendance of antenatal care (ANC) activities which are beneficial in improving maternal health and birth outcome. When a male, as the head of the family is expected to solely make decisions of how finances are managed, when and where health services are sought, it impacts on the woman’s health seeking behavior. Using the data from the Zimbabwe Demographic and Health Survey 2010-2011 this paper seeks to assess the prevalence of male ANC attendance in Zimbabwe and factors that influence male ANC attendance. We hypothesized that socioeconomic and demographic factors do not influence male ANC attendance. To achieve the objectives of this paper, descriptive analysis was used to describe the characteristics of men and the Binomial logistic modelling was used to assess the relationship between male ANC attendance and selected socioeconomic and demographic factors. Male ANC attendance was used as the dependent variable, and the independent variables are age, marital status, place of residence, wealth, education, religion and employment. A high percentage of males did not attend ANC with their pregnant partners. Religion, education, and place of residence were found to be significantly associated with male ANC attendance. There was no evidence to show that there was a difference in male ANC attendance by employment, marital status, and age. Findings from this paper are relevant to public health. They will be used to develop strategies and intervention programs to improve pregnant women’s attendance of ANC attendance by involving men in maternal health.

Keywords: antenatal care, male participation, maternal health, socio-economic and demographic factors

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Authors: Arwa Alnowaiser, Hala Shoukri

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The ‘FreeAITherapist’ is an artificial intelligence application that uses the power of AI to offer advice and mental health counseling to its users through its chatbot services. The AI therapist is designed to understand users' issues, concerns, and problems and respond appropriately; it provides empathy and guidance and uses evidence-based therapeutic techniques. With its user-friendly platform, it ensures accessibility for individuals in need, regardless of their geographical location. This website was created in direct response to the growing demand for mental health support, aiming to provide a cost-effective and confidential solution. Through promising confidentiality, it considers user privacy and data security. The ‘FreeAITherapist’ strives to bridge the gap in mental health services, offering a reliable resource for individuals seeking guidance and counseling to improve their overall well-being.

Keywords: artificial intelligence, mental health, AI therapist, website, counseling

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Authors: Abram Zoltan

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Over the past hundred years, human activities, particularly the burning of fossil fuels, have released enough carbon dioxide and other greenhouse gases to dissipate additional heat into the lower atmosphere and affect the global climate. Climate change affects many social and environmental determinants of health: clean air, safe drinking water, and adequate food. Our aim is to draw attention to the effects of climate change on the health and health care system. Improving climate awareness and the knowledge related to climate change's health impacts are essential among medical students and practicing medical doctors. Therefore, in their everyday practice, they also need some assistance and up-to-date knowledge of how climate change can endanger human health and deal with these novel health problems. Our activity, based on the cooperation of more universities, aims to develop new curriculum outlines and learning materials on climate change's health impacts for medical schools. Special attention is intended to pay to the possible preventative measures against these impacts. For all of this, the project plans to create new curriculum outlines and learning materials for medical students, elaborate methodological guidelines and create training materials for medical doctors' postgraduate learning programs. The target groups of the project are medical students, educational staff of medical schools and universities, practicing medical doctors with special attention to the general practitioners and family doctors. We had searched various surveys, domestic and international studies about the effects of climate change and statistical estimation of the possible consequences. The health effects of climate change can be measured only approximately by considering only a fraction of the potential health effects and assuming continued economic growth and health progress. We can estimate that climate change is expected to cause about 250,000 more deaths. We conclude that climate change is one of the most serious problems of the 21st century, affecting all populations. In the short- to medium-term, the health effects of climate change will be determined mainly by human vulnerability. In the longer term, the effects depend increasingly on the extent to which transformational action is taken now to reduce emissions. We can contribute to reducing environmental pollution by raising awareness and by educating the population.

Keywords: climate change, health impacts, medical students, education

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Authors: Kobus-Cisowska Joanna, Flaczyk Ewa, Gramza-Michalowska Anna, Kmiecik Dominik, Przeor Monika, Marcinkowska Agata, Korczak Józef

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The object of this study was to develop recipes and technology of production of functional bread with morus alba fruit addition. There were prepared four samples of functional breads and the control sample also. Bread recipe was designed for supporting the treatment of anemia, diabetes, obesity and cardiovascular diseases. Samples of bread were baked with mixes directly after preparation and after three months' storage, each time preparing the water and methanol extracts. The sensory analysis and nutritional value were estimated. The antioxidant activity were estimated used tests such as the ability to scavenge free radical DPPH, the ability to scavenge the ABTS cation, chelating properties and the total content of polyphenols. The study results showed that the prepared sample of functional breads were characterized by a high nutritional value with high concentration of biologically active compounds which showed antioxidant activity. In addition, the profile sensory of bread samples was highly rated. However, to determine whether they can be considered as a new product preset pro-health properties require additional nutritional studies - clinical trials.

Keywords: functional food, breads, white mulberry, bioactive components

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Authors: Roseline Oghogho Osaseri, Osaseri E. I.

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Lassa fever is an epidemic hemorrhagic fever caused by the Lassa virus, an extremely virulent arena virus. This highly fatal disorder kills 10% to 50% of its victims, but those who survive its early stages usually recover and acquire immunity to secondary attacks. One of the major challenges in giving proper treatment is lack of fast and accurate diagnosis of the disease due to multiplicity of symptoms associated with the disease which could be similar to other clinical conditions and makes it difficult to diagnose early. This paper proposed an Adaptive Neuro Fuzzy Inference System (ANFIS) for the prediction of Lass Fever. In the design of the diagnostic system, four main attributes were considered as the input parameters and one output parameter for the system. The input parameters are Temperature on admission (TA), White Blood Count (WBC), Proteinuria (P) and Abdominal Pain (AP). Sixty-one percent of the datasets were used in training the system while fifty-nine used in testing. Experimental results from this study gave a reliable and accurate prediction of Lassa fever when compared with clinically confirmed cases. In this study, we have proposed Lassa fever diagnostic system to aid surgeons and medical healthcare practictionals in health care facilities who do not have ready access to Polymerase Chain Reaction (PCR) diagnosis to predict possible Lassa fever infection.

Keywords: anfis, lassa fever, medical diagnosis, soft computing

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Authors: Elaine Wong Yee-Sing

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Older adults are at high risk of chronic health conditions in Singapore. A closer examination at all facets of their aging process has revealed that they may not be necessary aging well. This demands for an increasing healthcare services brought to their home environment due to limited mobility and in the interest of time management. The home environment is an ideal setting to implement self-directed health promoting activities at their convenience and enable family’s support and motivation. This research protocol aims to explore their healthcare concerns, and creation of age appropriate interventions targeted to improve their chronic disease biomarkers. Convenience sampling of 130 families residing in private housing within five major districts in Singapore will be selected to participate in the health intervention. Statistical Package for Social Science 25 will be used to examine the pre and post screening results of their lipid, glycaemia and anthropometric outcomes. Using focus interviews, data results will be translated and transcribed to investigate on enablers, barriers and improvement on these services. Both qualitative and quantitative research outcomes are crucial to examine the impact of these services for these older adults living in private housing as they are not exposed to government subsidized community health programs. It is hypothesized that provision of relevant yet engaging health programs at their homes may mitigate the rising burden of chronic health conditions and result in successful aging outcomes among older Singaporeans.

Keywords: chronic diseases, health program, older adults, residential homes

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Authors: Kadhim Alabady

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Purpose: Mental health problems affect women and men equally, but some are more common among women. To Provide a baseline of the current picture of major mental health challenges among women in Dubai. which can then be used to measure the impact of interventions or service development. Method: We have used mixed methods evaluation approaches. This was used to increase the validity of findings by using a variety of data collection techniques. We have integrated qualitative and quantitative methods in this piece of work. Conducting the two approaches is to explore issues that might not be highlighted enough through one method. Results: The key findings are: The prevalence of people who suffer from different types of mental disorders remains largely unknown, many women are unwilling to seek professional help because of lack of awareness or the stigma attached to it. -It is estimated there were around 2,928–4,392 mothers in Dubai (2014) suffering from postnatal depression of which 858–1,287, early intervention can be effective. -The system for managing health care for women with mental illness is fragmented and contains gaps and duplications. -It is estimated 1,029 girl aged 13–19 years affected with anorexia nervosa and there would be an estimated 1,029 girl aged 13–19 years affected with anorexia nervosa. Recommendations: -Work is required with primary health care in order to identify women with undiagnosed mental illnesses. Further work is undertaken within primary health care to assess disease registries with the aim of helping GP practices to improve their disease registers. -It is important to conduct local psychiatric morbidity surveys in Dubai to obtain data and assess the prevalence of essential mental health symptoms and conditions that are not routinely collected to get a clear sense of what is needed and to assist decision and policy making in getting a complete picture on what services are required. -Emergency Mental Health Care – there is a need for a crisis response team to respond to emergencies in the community. -Continuum of care – a significant gap in the services for women once they diagnosed with mental disorder.

Keywords: mental health, depression, schizophrenia, women

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Authors: Daniel Walker, Adam Qureshi, David Marchant, Alex Bahrami Balani

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The present study aimed to assess the impact of concussion and physical pain on depression and health-related quality of life. Depressive symptoms were assessed using the Center for Epidemiological Studies' Depression Scale, and scores of health-related quality of life were measured by health-related quality of life short form-12. Data analysis of 67 participants (concussed 32 vs. 35 non-concussed) revealed that (i) 52% were displaying depressive symptoms (concussed 30% vs. non-concussed 22%) (ii) concussion had a significant effect on depressive symptoms when controlling for pain but no effect on the quality of life scores when controlling the same variable (iii) pain had a significant effect on depressive symptoms and quality of life. With this, both concussion and physical pain seem to have a negative impact on mental health; however, individuals may only recognise a reduction in quality of life with increased physical pain, hence a deterioration in mental well-being could be disregarded as a factor of health-related quality of life.

Keywords: depression, quality of life, concussion, physical pain

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Authors: Ashana Gupta

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Aim: In the UK, Botulinum Toxin (botox) is authorised for treating chronic myofascial pain secondary to masseter muscle hypertrophy (Fedorowicz et al. 2013). This audit aimed to ensure the Maxillofacial Unit is meeting the trust guidelines for the safe storage and disposal of botox. Method: The trust upholds a strict policy for botox handling. The audit was designed to optimise several elements including Staff awareness of regulations around botox handling A questionnaire was designed to test knowledge of advised storage temperatures, reporting of adverse events, disposal procedures and regulatory authorities. Steps taken to safely delivertoxin and eliminate unused toxin. A checklist was completed. These include marks for storagetemperature, identification checks, disposal of sharps, deactivation of toxin, and disposal. Results: All staff correctly stated storage requirements for toxin. 75% staff (n=8) were unsure about reporting and regulations. Whilst all staff knew how to dispose of vials, 0% staff showed awareness for the crucial step of deactivating toxin. All checklists (n=20) scored 100% for adequate storage, ID checks, and toxin disposal. However, there were no steps taken to deactivate toxin in any cases. Staff training took place with revision to clinical protocols. In line with Trust guidelines, an additional clinical step has been introduced including use of 0.5% sodium hypochlorite to deactivate botox. Conclusion: Deactivation is crucial to ensure residual toxin is not misused. There are cases of stolen botox within South-Tees Hospital (Woodcock, 2014). This audit was successful in increasing compliance to safe handling and disposal of botox by 100% and ensured our hospitalmeets Trust guidance.

Keywords: botulinum toxin, aesthetics, handling, disposal

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Authors: Ephrem Mebratu Dagnew, Mohammed Biset Ayalew, Gizework Alemnew Mekonnen, Alehegn Bishaw Geremew, Ousman Abubeker Abdela

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Objective: To assess the prevalence of drug-related problems and associated factors among adult psychiatric inpatients. Method: Hospital-based multicenter cross-sectional observational study was conducted from April to July 2021 at five randomly selected hospitals in North-west Ethiopia. A total of 325 consecutively sampled patients participated in the study. Clinical pharmacists assessed the DRPs based on clinical judgment supported by updated evidence-based diseases guidelines. A Medscape drug-interactions checker was used to check drug-drug interactions. The results were summarized using descriptive statistics, including frequency, mean, and standard deviation. Odds ratio (OR) with 95% confidence interval were also computed for each variable for the corresponding P-value. The value of P ≤ 0.05 was considered statistically significant. Result : From the total of 325 study participants, more than half of them (52.9%) were females and the mean age ± (standard deviation) was 30.8±11.3 years. At least one drug-related problem was recorded from 60.9%, 95% CI (55.7-65.8) of study participants with a mean of 0.6±0.49 per patient. Need additional drug therapy was the most common DRP (22.8%), followed by non-adherence to medicine (20.6%) and adverse drug reactions (11%), respectively. Factors independently associated with drug-related problems were rural residence [AOR=1.96,95%CI:1.01-2.84, P-value=0.046], self-employed [AOR=6.0 ,95% CI: 1.0-36.9, P-value=0.035] and alcohol drinkers [AOR=6.40,95%CI:1.12-37.5, p-value=0.034]. Conclusion: The prevalence of drug-related problems among adult psychiatric patients admitted to psychiatric wards was high. Healthcare providers give more attention to tackling these problems. Being a rural residence, self-employed, and Alcohol drinkers were associated with drug-related problems.

Keywords: psychiatric patients, drug-relatedproblems, multicenter, Ethiopia

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Authors: Tya M. Arthur

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Purpose: BIPOC (Black, Indigenous, and People of Color) adolescents face racism and discrimination at a young age. These early experiences have short- and long-term impacts on their health and overall well-being. The purpose of this study was to determine the relationships between perceived racial discrimination at school and health risk behaviors and experiences of BIPOC adolescents. Methods: Data from the 2021 Adolescent Behaviors and Experiences Survey (ABES) were analyzed. All demographic data were summarized using frequencies and chi-squared tests. A univariate and multivariate logistic regression model was used to test the relationship between perceived racial discrimination and selected health risk factors. All analyses were conducted using STATA SE 18. Results: A total of 42.2% of the BIPOC adolescents in the study indicated being treated unfairly at school due to their race. The majority of those who reported being discriminated against were Black/African American or Multiple Race-Hispanic. Asian adolescents were almost 5 times more likely to face racial discrimination at school compared to their American Indian/Alaska Native counterparts (OR = 4.86, 95% CI [2.69-8.77], p < 0.001). Other risk predictors of racial discrimination included being female (OR = 1.38, 95% CI [1.13-1.68], p = 0.002) and feeling disconnected at school (OR = 1.76, 95% CI [1.30-2.38], p < 0.001). After adjustment for health risk behaviors and experiences, BIPOC adolescents were still more likely to face racial discrimination with even higher odds. Conclusions: The results of this study highlight the depth of racial discrimination faced by BIPOC adolescents at school. Greater attention should be placed on racial discrimination as a social determinant of health and a public health crisis.

Keywords: racial discrimination, adolescents, heath risk factors, BIPOC

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Authors: Shabnam Sarwar, Franck Lacoeuille, Nadia Withofs, Roland Hustinx

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After the development of a potential surrogate of MAA, and its successful application for the diagnosis of pulmonary embolism in artificially embolized rats’ lungs, this microparticulate system were radiolabelled with gallium-68 to synthesize 68Ga-SBMP with high radiochemical purity >99%. As a prerequisite step of clinical trials, 68Ga- labelled starch based microparticles (SBMP) were analysed for their in-vivo behavior in small animals. The purpose of the presented work includes the ex-vivo biodistribution studies of 68Ga-SBMP in order to assess the activity uptake in target organs with respect to time, excretion pathways of the radiopharmaceutical, %ID/g in major organs, T/NT ratios, in-vivo stability of the radiotracer and subsequently the microparticles in the target organs. Radiolabelling of starch based microparticles was performed by incubating it with 68Ga generator eluate (430±26 MBq) at room temperature and pressure without using any harsh reaction condition. For Ex-vivo biodistribution studies healthy White Wistar rats weighing between 345-460 g were injected intravenously 68Ga-SBMP 20±8 MBq, containing about 2,00,000-6,00,000 SBMP particles in a volume of 700µL. The rats were euthanized at predefined time intervals (5min, 30min, 60min and 120min) and their organ parts were cut, washed, and put in the pre-weighed tubes and measured for radioactivity counts through automatic Gamma counter. The 68Ga-SBMP produced >99% RCP just after 10-20 min incubation through a simple and robust procedure. Biodistribution of 68Ga-SBMP showed that initially just after 5 min post injection major uptake was observed in the lungs following by blood, heart, liver, kidneys, bladder, urine, spleen, stomach, small intestine, colon, skin and skeleton, thymus and at last the smallest activity was found in brain. Radioactivity counts stayed stable in lungs with gradual decrease with the passage of time, and after 2h post injection, almost half of the activity were seen in lungs. This is a sufficient time to perform PET/CT lungs scanning in humans while activity in the liver, spleen, gut and urinary system decreased with time. The results showed that urinary system is the excretion pathways instead of hepatobiliary excretion. There was a high value of T/NT ratios which suggest fine tune images for PET/CT lung perfusion studies henceforth further pre-clinical studies and then clinical trials should be planned in order to utilize this potential lung perfusion agent.

Keywords: starch based microparticles, gallium-68, biodistribution, target organs, excretion pathways

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Authors: Joyce Chieh Hsin Lo

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In the forthcoming paper, we aim to comprehensively investigate the relation between floor movement and the health condition. We embark on an extensive exploration of the innovative Movement Flow system, a contemporary paradigm that is reshaping the landscape of physical fitness and well-being. Our primary aim is to dissect the profound potential of this groundbreaking approach, not only as a means to enhance our physical fitness but also as a transformative tool for nurturing mental health. Within the scope of this comprehensive analysis, we will delve into the multifaceted aspects of Movement Flow, highlighting its versatility and adaptability to various individuals' needs and objectives.

Keywords: prehab, floor movement, proprioception, movement flow

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Authors: Dini Riandini

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The research is aimed to find out the causes and effect of Andrea’s lifestyle changes and the other factors that contribute to Andrea’s lifestyle changes which influence Andrea’s behavior and personality in The Devil Wears Prada novel. The method of this research is descriptive qualitative method. Theory of Anderson (1999) about social psychology is used to figure out Andrea’s lifestyle changes. Lifestyle changes are influenced by social and environment in which people live. Andrea changes her lifestyle from simple to luxurious because of society and environment in which she lives. Social interaction creates humans’ lifestyles which influence their personality and behavior.

Keywords: lifestyle, lifestyle changes, personality, behaviour

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