Search results for: vascular health

Authors: Dilara Usta, Fatos Korkmaz

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Background: Individuals who utilise health services maintain relationships with health professionals, insurers and institutions. The nature of these relationships requires service receivers to have trust in the service providers because maintaining health services without reciprocal trust is very difficult. Therefore, individual evaluations of trust within the scope of health services have become increasingly important. Objective: To investigate patients’ trust in the health-care system and their relevant socio-demographical characteristics. Methods: This research was conducted using a descriptive design which included 493 literate patients aged 18-65 years who were hospitalised for a minimum of two days at public university and training&research hospitals in Ankara, Turkey. Patients’ trust in health-care professionals, insurers, and institutions were investigated. Data were collected using a demographic questionnaire and the Multidimensional Trust in Health-Care Systems Scale between September 2015 and April 2016. Results: The participants’ mean age was 47.7±13.1; 70% had a moderate income and 69% had a prior hospitalisation and 63.5% of the patients were satisfied with the health-care services. The mean Multidimensional Trust in Health-Care Systems Scale score for the sample was 61.5±8.3; the provider subscale had a mean of 38.1±5, the insurers subscale had a mean of 12.9±3.7, and institutions subscale had a mean of 10.6±1.9. Conclusion: Patients’ level of trust in the health-care system was above average and the trust level of the patients with higher educational and socio-economic levels was lower compared to the other patients. Health-care professionals should raise awareness about the significance of trust in the health-care system.

Keywords: delivery of health care, health care system, nursing, patients, trust

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Authors: Sunita Patel

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Cardiovascular diseases are the leading cause of morbidity as well as mortality in India. Objective of this study is to examine CVDs prevalence and identify their behavioral and cultural risk factors with the help of SAGE-2007 data conducted on 6th states in India. Findings reveal that 18.3% of people diagnosed with CVDs in India. Higher disease occurs in an increasing rate between ages of 30-39 having OR 2.45 (CI: 1.66-3.63) and 70+ age OR 7.45 (CI: 4.82-11.49) times higher compare to 18-29 age group respectively. Wealth quintile higher CVD occurs as 3rd in 60% (CI: 1.16-2.21) and in richest 5th quintile 58% (CI: 1.13-2.21) contrast to lowest quintile. Relative risk depicted that 22.4% in moderate and 44% in vigorous activity have less chance of diseases compare to who performed no work and those who consumed alcohol. Results reveal that policy prospect should be recommended and that it would be beneficial for awareness of people and their future.

Keywords: behavioral risk, cultural risk, cardio-vascular diseases, wealth quintile

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Authors: Shao-Ju Chien, Yi-Chien Wu, Ting-Ying Huang, Li-Tsen Li, You-Jin Chen, Cheng-Nan Chen

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Homocysteine and pro-inflammatory mediators such as cyclooxygenase-2 (COX-2) have been linked to vascular dysfunction and risks of cardiovascular diseases. Fulvic acid (FA) is class of compounds of humic substances and possesses various pharmacological properties. However, the effect of FA on inflammatory responses of the monocytes remains unclear. We investigated the regulatory effect of FA on homocysteine-induced COX-2 expression in human monocytes. Peripheral blood monocytes and U937 cells were kept as controls or pre-treated with FA, and then stimulated with homocysteine. The results show that pretreating monocytes with FA inhibited the homocysteine-induced COX-2 expression in a dose-dependent manner. The inhibitor for nuclear factor-kB (NF-kB) attenuated homocysteine-induced COX-2 expression. Our findings provide a molecular mechanism by which FA inhibit homocysteine-induced COX-2 expression in monocytes, and a basis for using FA in pharmaceutical therapy against inflammation.

Keywords: homocysteine, monocytes, cyclooxygenase-2, fulvic acid, anti-inflammation

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Authors: Arun Karoriya, Mrinal Agrawal

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Health is one of the basic requirements of human being. And today India is facing a major degradation of health at every age group. As society evolves and flourishes, there are different types of rules, norms, standards which are required to control the conduct of the human being for its well-being and growth. Right to health is one of those aspects that can be counted, discovered and examined under the purview of constitutional provisions of India. The condition of health is at downfall despite the fact that there are several policies framed by the government. There is an urgent call for rigid public health laws to ensure safe and disease free society. The effectiveness of health law has to be examined by keeping in mind that it is hampering growth and economy and society establishment. Health in any society is a main social aspect as it plays a major role for economic development. The multidimensional approach to determine it is by discussing i) rational selection and use of medicines ii) sustainable adequate financing iii) affordable prices iv)reliable health and supply systems.

Keywords: degradation, flourish, multidimensional, policies

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Authors: Lubowa Samuel

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Health information systems, often known as HIS, are critical components of the healthcare system to improve health policies and promote global health development. In a broader sense, HIS as a system integrates data collecting, processing, reporting, and making use of various types of data to improve healthcare efficacy and efficiency through better management at all levels of healthcare delivery. The aim of this study is to assess the adoption of health information systems (HIS) in a resource-constrained country drawing from the Unified Theory of Acceptance and Use of Technology 2 (UTAUT2) model. The results indicate that the user's perception of the technology and the poor information technology infrastructures contribute a lot to the low adoption of HIS in resource-constrained countries.

Keywords: health information systems, resource-constrained countries, health information systems

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Authors: Alikeju F. Maji

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The role of girl child education on reproductive health of any nation cannot be over emphasized. Today this has become a global concern because of the awareness that girl child education has direct proven impact on reproductive health and sustainable development of a national. Thus, this paper attempts to re-emphasize and re-awaken the mind of humanity on the undisputable importance of girl-child education as a tool for improving reproductive health in Nigeria. The paper further examine that despite government’s effort in attaining education for all by the year 2015, the numbers of girls attending schools remain abysmally low in Nigeria. The paper noted that if the trend persists, personal health of women and their contribution to national development will reduce. The paper recommends that women in Nigeria should be availed with good educational opportunities to enhance their improved reproductive health, and greater participating in national development.

Keywords: girl-child education, reproductive health, sustainable development, personal health

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Authors: N. Slepickova Kasalkova, P. Slepicka, L. Bacakova, V. Svorcik

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Tissue engineering includes combination of materials and techniques used for the improvement, repair or replacement of the tissue. Scaffolds, permanent or temporally material, are used as support for the creation of the "new cell structures". For this important component (scaffold), a variety of materials can be used. The advantage of some polymeric materials is their cytocompatibility and possibility of biodegradation. Poly(L-lactic acid) (PLLA) is a biodegradable,  semi-crystalline thermoplastic polymer. PLLA can be fully degraded into H₂O and CO₂. In this experiment, the effect of the surface modification of biodegradable polymer (performed by plasma treatment) on the various cell types was studied. The surface parameters and changes of the physicochemical properties of modified PLLA substrates were studied by different methods. Surface wettability was determined by goniometry, surface morphology and roughness study were performed with atomic force microscopy and chemical composition was determined using photoelectron spectroscopy. The physicochemical properties were studied in relation to cytocompatibility of human osteoblast (MG 63 cells), rat vascular smooth muscle cells (VSMC), and human stem cells (ASC) of the adipose tissue in vitro. A fluorescence microscopy was chosen to study and compare cell-material interaction. Important parameters of the cytocompatibility like adhesion, proliferation, viability, shape, spreading of the cells were evaluated. It was found that the modification leads to the change of the surface wettability depending on the time of modification. Short time of exposition (10-120 s) can reduce the wettability of the aged samples, exposition longer than 150 s causes to increase of contact angle of the aged PLLA. The surface morphology is significantly influenced by duration of modification, too. The plasma treatment involves the formation of the crystallites, whose number increases with increasing time of modification. On the basis of physicochemical properties evaluation, the cells were cultivated on the selected samples. Cell-material interactions are strongly affected by material chemical structure and surface morphology. It was proved that the plasma treatment of PLLA has a positive effect on the adhesion, spreading, homogeneity of distribution and viability of all cultivated cells. This effect was even more apparent for the VSMCs and ASCs which homogeneously covered almost the whole surface of the substrate after 7 days of cultivation. The viability of these cells was high (more than 98% for VSMCs, 89-96% for ASCs). This experiment is one part of the basic research, which aims to easily create scaffolds for tissue engineering with subsequent use of stem cells and their subsequent "reorientation" towards the bone cells or smooth muscle cells.

Keywords: poly(L-lactic acid), plasma treatment, surface characterization, cytocompatibility, human osteoblast, rat vascular smooth muscle cells, human stem cells

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Authors: T. Holecki, J. Wozniak-Holecka, K. Sobczyk

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Development, implementation, and evaluation of the effects of health policy programs, resulting from the identified health needs and health status of residents, is the own task of all local government units in Poland. This is due to the obligation to provide access to healthcare services to all residents and the implementation of tasks in the field of health promotion based on specific legal acts. Until the end of 2016 local governments financed health policy programs only with their own funds. Currently, there are additional resources available from the public health insurance subsidising up to 80% of health policy programs costs in cities with a population under 5 thousand people and up to 40% in bigger cities. Changes in legal provisions do not translate automatically to increased involvement of local government units in the implementation of public health tasks. The main objective of the study was to assess the actual impact of the new legal regulation on financing local health policy programs on the engagement of local administration in this area of public health activity. To achieve this aim, we analyzed difference in the number of local governments developing and implementing health policy programs before and after the new law came into force. The aim of the study was also to estimate the level of expenditures incurred by self-government units and the National Health Fund to cover the costs of health policy programs. In the first stage of the project, legal acts concerning the subject of research and financial data published by the National Health Fund were analyzed. The material for the second, main stage of the study was the detailed financial data obtained from the National Health Fund and data obtained from local government units. The results present the situation in Poland in territorial terms, divided into 16 voivodships.

Keywords: health care system, health policy programs, local self-governments, public health

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Authors: Weiran An, Junyou Shi

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Health management has become one of the design goals in the research and development of new generation avionics systems, and is an important complement and development for the testability and fault diagnosis technology. Currently, the research and application for avionics system health dividing and diagnosis technology is still at the starting stage, lack of related technologies and methods reserve. In this paper, based on the health three-state dividing of avionics products, state lateral transfer coupling modeling and diagnosis reasoning method considering sub-health are researched. With the study of typical case application, the feasibility and correctness of the method and the software are verified.

Keywords: sub-health, diagnosis reasoning, three-valued coupled logic, extended dependency model, avionics

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Authors: L. Lindsay, S. A. Coleman, D. Kerr, B. J. Taylor, A. Moorhead

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Cognitive decline and frailty is apparent in older adults leading to an increased likelihood of the risk of falling. Currently health care professionals have to make professional decisions regarding such risks, and hence make difficult decisions regarding the future welfare of the ageing population. This study uses health data from The Irish Longitudinal Study on Ageing (TILDA), focusing on adults over the age of 50 years, in order to analyse health risk factors and predict the likelihood of falls. This prediction is based on the use of machine learning algorithms whereby health risk factors are used as inputs to predict the likelihood of falling. Initial results show that health risk factors such as long-term health issues contribute to the number of falls. The identification of such health risk factors has the potential to inform health and social care professionals, older people and their family members in order to mitigate daily living risks.

Keywords: classification, falls, health risk factors, machine learning, older adults

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Authors: Margaret S. Wright

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Background/Significance: During many recent public health emergencies/disasters, public health nursing data has been missing or delayed, potentially impacting the decision-making and response. Data used as evidence for decision-making in response, planning, and mitigation has been erratic and slow, decreasing the ability to respond. Methodology: Applying best practices in data management and data use in public health settings, and guided by the concepts outlined in ‘Disaster Standards of Care’ models leads to the development of recommendations for a model of best practices in data management and use in public health disasters/emergencies by public health nurses. As the ‘patient’ in public health disasters/emergencies is the community (local, regional or national), guidelines for patient documentation are incorporated in the recommendations. Findings: Using model public health nurses could better plan how to prepare for, respond to, and mitigate disasters in their communities, and better participate in decision-making in all three phases bringing public health nursing data to the discussion as part of the evidence base for decision-making.

Keywords: data management, decision making, disaster planning documentation, public health nursing

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Authors: Samuel Reisman

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Background: Comparative rankings are increasingly used to evaluate health care systems. These rankings combine discrete attribute rankings into a composite overall ranking. Health care equity is a component of overall rankings, but excelling in other categories can counterbalance low inequity grades. Highly ranked inequitable health care would commend systems that disregard human rights. We simulated the ranking of a maximally inequitable health care system using a published, influential ranking methodology. Methods: We used The Commonwealth Fund’s ranking of eleven health care systems to simulate the rank of a maximally inequitable system. Eighty performance indicators were simulated, assuming maximal ineptitude in equity benchmarks. Maximal rankings in all non-equity subcategories were assumed. Subsequent stepwise simulations lowered all non-equity rank positions by one. Results: The maximally non-equitable health care system ranked first overall. Three subsequent stepwise simulations, lowering non-equity rankings by one, each resulted in an overall ranking within the top three. Discussion: Our results demonstrate that grossly inequitable health care systems can rank highly in comparative health care system rankings. These findings challenge the validity of ranking methodologies that subsume equity under broader benchmarks. We advocate limiting maximum overall rankings of health care systems to their individual equity rankings. Such limits are logical given the insignificance of health care system improvements to those lacking adequate health care.

Keywords: global health, health equity, healthcare systems, international health

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Authors: Catherine Bernard

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The maldistribution of clinicians within countries is well documented. It is a common theme throughout the world that rural areas often struggle to recruit and retain health workers resulting in inadequate healthcare for many. This paper will concentrate on the responsibilities that medical schools may have in addressing this shortage of rural health workers. Recommendations are made with regards to targeted rural student admissions, rurally-based medical schools, rural clinical rotations and a curriculum orientated towards rural health issues. The evidence gathered suggests that individual factors are positive in encouraging health workers to practice in rural locations. However, there is strength in numbers, and combining all the recommendations will likely result in a synergistic effect, thereby increasing numbers of rural health workers and achieving accessible healthcare for those living in rural populations.

Keywords: medical education, medical education design, public health, rural health

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Authors: Yifan Lu, Ying Cui, Ying Zhu, Edward S. Lu, Rebecca Zeng, Rohan Bajaj, Raviv Katz, Rongrong Le, Jay C. Wang, John B. Miller

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Purpose: Retinal artery occlusion (RAO) is an ophthalmic emergency that can lead to poor visual outcome and is associated with an increased risk of cerebral stroke and cardiovascular events. Fluorescein angiography (FA) is the traditional diagnostic tool for RAO; however, wide-field swept-source optical coherence tomography angiography (WF SS-OCTA), as a nascent imaging technology, is able to provide quick and non-invasive angiographic information with a wide field of view. In this study, we looked for associations between OCT-A vascular metrics and visual acuity in patients with prior diagnosis of RAO. Methods: Patients with diagnoses of central retinal artery occlusion (CRAO) or branched retinal artery occlusion (BRAO) were included. A 6mm x 6mm Angio and a 15mm x 15mm AngioPlex Montage OCT-A image were obtained for both eyes in each patient using the Zeiss Plex Elite 9000 WF SS-OCTA device. Each 6mm x 6mm image was divided into nine Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The average measurement of the central foveal subfield, inner ring, and outer ring was calculated for each parameter. Non-perfusion area (NPA) was manually measured using 15mm x 15mm Montage images. A linear regression model was utilized to identify a correlation between the imaging metrics and visual acuity. A P-value less than 0.05 was considered to be statistically significant. Results: Twenty-five subjects were included in the study. For RAO eyes, there was a statistically significant negative correlation between vision and retinal thickness as well as superficial capillary plexus vessel density (SCP VD). A negative correlation was found between vision and deep capillary plexus vessel density (DCP VD) without statistical significance. There was a positive correlation between vision and choroidal thickness as well as choroidal volume without statistical significance. No statistically significant correlation was found between vision and the above metrics in contralateral eyes. For NPA measurements, no significant correlation was found between vision and NPA. Conclusions: This is the first study to our best knowledge to investigate the utility of WF SS-OCTA in RAO and to demonstrate correlations between various retinal vascular imaging metrics and visual outcomes. Further investigations should explore the associations between these imaging findings and cardiovascular risk as RAO patients are at elevated risk for symptomatic stroke. The results of this study provide a basis to understand the structural changes involved in visual outcomes in RAO. Furthermore, they may help guide management of RAO and prevention of cerebral stroke and cardiovascular accidents in patients with RAO.

Keywords: OCTA, swept-source OCT, retinal artery occlusion, Zeiss Plex Elite

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Authors: Sung Un Kim, Ivana Martinović, Snježana Stanarević Katavić

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As more and more youth use mobile devices, such as tablets and smartphones, for information seeking in their everyday lives, the purpose of this study is to understand the behaviors of youth seeking health information on mobile devices. The specific objective of this study is to examine 1) for what health issues youth use mobile devices, 2) for what reasons youth use mobile devices to obtain health information, 3) in what ways youth use mobile devices for health information, and 4) the features of health applications that youth find useful. The researchers devised a questionnaire for this study. Four hundred eight students from two high schools, located in Osijek, Croatia, participated by answering the questionnaire (281 girls and 127 boys). The collected data were analyzed using descriptive statistics and content analysis. The results show that among all participants, about 85 percent (n = 344) reported having used mobile devices for health information. The most frequent health topic for which they had been using mobile devices is physical activity (n = 273), followed by eating issues and nutrition (n = 224), mental health (n = 160), sexual health (n = 157), alcohol, drugs, and tobacco (n = 125), safety (n = 96) and particular diseases (n = 62). They use mobile devices to obtain health information due to the ease of use (n = 342), the ease of sharing health information (n = 281), portability (n = 215), timeliness (n = 162), and the ease of tracking/recording/monitoring health status (n = 147). Of those who have used mobile devices for health information, three-quarters (n = 261) use mobile devices to search health information, while 32.8% (n =113) use applications and 31.7% (n =109) browse information. Those who have used applications for health information (n = 113) consider the alert feature (n=107) as the most useful, followed by the tracking/recording/monitoring feature (n =92), the customized information feature (n = 86), the video feature (n = 58), and the sharing feature (n =39). It is notable that although health applications have been actively developed and studied, a majority of the participants search for or browse information on mobile devices, instead of using applications. The researchers will discuss reasons that some of them did not use mobile devices to obtain health information, students’ concerns about using health applications, and features that they wish to have in health applications.

Keywords: Croatia, health information, information seeking behaviors, mobile devices, youth

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Authors: Muhammad Rafiq, Lamae Zulfiqar, Nazish Idrees Chaudhary

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A growing number of research focuses on healthy and unhealthy eating behaviors and their impact on health. It was intended to study the Islamic point of view on eating behavior, its impact on mental health and preventative strategies in the light of the Quran and Sunnah. Different articles and Islamic sayings related to eating behaviors and mental health were reviewed in detail. It was also revealed scientifically and through Islamic point of view that appropriate quantity, quality and timings of food have positive effects on mental health. Therefore, a 3Rs model of eating behaviors has been proposed.

Keywords: food intake, mental health, quality of food, quantity of food

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Authors: Jie Ji, Jing Xu, Yuehong Zhuang, Xiangqing Kang, Ying Qian, Ping Zhou, Di Xue

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Background: In 2014, there were 28,341 health professionals in Pudong new area of Shanghai and the number per 1000 population was 5.199, 55.55% higher than that in 2006. But it was always less than the average number of health professionals per 1000 population in Shanghai from 2006 to 2014. Therefore, allocation planning for the health professionals in Pudong new area has become a high priority task in order to meet the future demands of health care. In this study, we constructed an objective-based system dynamics model to forecast the number of health professionals in Pudong new area of Shanghai in 2020. Methods: We collected the data from health statistics reports and previous survey of human resources in Pudong new area of Shanghai. Nine experts, who were from health administrative departments, public hospitals and community health service centers, were consulted to estimate the current and future status of nine variables used in the system dynamics model. Based on the objective of the number of health professionals per 1000 population (8.0) in Shanghai for 2020, the system dynamics model for health professionals in Pudong new area of Shanghai was constructed to forecast the number of health professionals needed in Pudong new area in 2020. Results: The system dynamics model for health professionals in Pudong new area of Shanghai was constructed. The model forecasted that there will be 37,330 health professionals (6.433 per 1000 population) in 2020. If the success rate of health professional recruitment changed from 20% to 70%, the number of health professionals per 1000 population would be changed from 5.269 to 6.919. If this rate changed from 20% to 70% and the success rate of building new beds changed from 5% to 30% at the same time, the number of health professionals per 1000 population would be changed from 5.269 to 6.923. Conclusions: The system dynamics model could be used to simulate and forecast the health professionals. But, if there were no significant changes in health policies and management system, the number of health professionals per 1000 population would not reach the objectives in Pudong new area in 2020.

Keywords: allocation planning, forecast, health professional, system dynamics

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Authors: Shishir Kumar, Chhaya Gangwal, Seema Raj

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Public health informatics (PHI) which has seen successful implementation in the developed world, become the buzzword in the developing countries in providing improved healthcare with enhanced access. In rural areas especially, where a huge gap exists between demand and supply of healthcare facilities, PHI is being seen as a major solution. There are factors such as growing network infrastructure and the technological adoption by the health fraternity which provide support to these claims. Public health informatics has opportunities in healthcare by providing opportunities to diagnose patients, provide intra-operative assistance and consultation from a remote site. It also has certain barriers in the awareness, adaptation, network infrastructure, funding and policy related areas. There are certain medico-legal aspects involving all the stakeholders which need to be standardized to enable a working system. This paper aims to analyze the potential and challenges of public health informatics services in rural communities.

Keywords: PHI, e-health, public health, health informatics

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Authors: Sean Yao Zu Kong, Khong Yik Chew

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Introduction: We described a case report of the successful use of advanced surgical techniques in a patient with recurrent breast cancer who underwent a wide resection including the hemi-sternum, clavicle, multiple ribs, and a lobe of the lung due to tumor involvement. This extensive resection exposed critical structures, requiring a creative approach to reconstruction. To address this complex chest wall reconstruction, a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap were successfully utilized. The use of a free vascularized bone flap allowed for rapid osteointegration and resistance against osteoradionecrosis after adjuvant radiation, while a four-zone tram flap allowed for reconstruction of both the chest wall and breast mound. Although limited recipient vessels made free flaps challenging, the free fibula flap served as both a bony reconstruction and vascular conduit, supercharged with the distal peroneal artery and veins of the peroneal artery from the fibula graft. Our approach highlights the potential of advanced surgical techniques to improve outcomes in complex cases of chest wall reconstruction in patients with recurrent breast cancer, which is becoming increasingly relevant as breast cancer incidence rates increases. Case presentation: This report describes a successful reconstruction of a patient with recurrent breast cancer who required extensive resection, including the anterior chest wall, clavicle, and sternoclavicular joint. Challenges arose due to the loss of accessory muscles and the non-rigid rib cage, which could lead to compromised ventilation and instability. A free fibula osteocutaneous flap and a four-zone TRAM flap with vascular supercharging were utilized to achieve long-term stability and function. The patient has since fully recovered, and during the review, both flaps remained viable, and chest mound reconstruction was satisfactory. A planned nipple/areolar reconstruction was offered pending the patient’s decision after adjuvant radiotherapy. Conclusion: In conclusion, this case report highlights the successful use of innovative surgical techniques in addressing a complex case of recurrent breast cancer requiring extensive resection and radical reconstruction. Our approach, utilized a combination of a free fibula flap and a 4-zone rectus abdominis musculocutaneous flap, demonstrates the potential for advanced techniques in chest wall reconstruction to minimize complications and ensure long-term stability and function. As the incidence of breast cancer continues to rise, it is crucial that healthcare professionals explore and utilize innovative techniques to improve patient outcomes and quality of life.

Keywords: free fibula flap, rectus abdominis musculocutaneous flap, post-adjuvant radiotherapy, reconstructive surgery, malignancy

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Authors: Hansraj Bookun, Rachel Xuan, Angela Tan, Kejia Wang, Animesh Singla, David Kim, Christopher Loupos, Jim Iliopoulos

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Introduction: Complex endovascular aortic aneursymal repairs with fenestrated and branched endografts require customised devices to exclude the pathology while reducing morbidity and mortality, which was historically associated with open repair of complex aneurysms. Such endovascular procedures have predominantly been performed in a large volume dedicated tertiary centres. We present here our nine year multidisciplinary experience with this technology in an Australian tertiary centre. Method: This was a cross-sectional, single-centre observational study of 670 patients who had undergone complex endovascular aortic aneurysmal repairs with conventional endografts, fenestrated endografts, and iliac-branched devices from January 2010 to July 2019. Descriptive statistics were used to characterise our sample with regards to demographic and perioperative variables. Homogeneity of the sample was tested using multivariant regression, which did not identify any statistically significant confounding variables. Results: 670 patients of mean age 74, were included (592 males) and the comorbid burden was as follows: ischemic heart disease (55%), diabetes (18%), hypertension (90%), stage four or greater kidney impairment (8%) and current or ex-smoking (78%). The main indications for surgery were elective aneurysms (86%), symptomatic aneurysms (5%), and rupture aneurysms (5%). 106 patients (16%) underwent fenestrated or branched endograft repairs. The mean length of stay was 7.6 days. 2 patients experienced reactionary bleeds, 11 patients had access wound complications (6 lymph fistulae, 5 haematoms), 11 patients had cardiac complications (5 arrhythmias, 3 acute myocadial infarctions, 3 exacerbation of congestive cardiac failure), 10 patients had respiratory complications, 8 patients had renal impairment, 4 patients had gastrointestinal complications, 2 patients suffered from paraplegia, 1 major stroke, 1 minor stroke, and 1 acute brain syndrome. There were 4 vascular occlusions requiring further arterial surgery, 4 type I endoleaks, 4 type II endoleaks, 3 episodes of thromboembolism, and 2 patients who required further arterial operations in the setting of patient vessels. There were 9 unplanned returns to the theatre. Discussion: Our numbers of 10 years suggest that we are not a dedicated high volume centre focusing on aortic repairs. However, we have achieved significantly low complication rates. This can be attributed to our multidisciplinary approach with the intraoperative involvement of skilled interventional radiologists and vascular surgeons as well as postoperative protocols with particular attention to spinal cord protection. Additionally, we have a ratified perioperative pathway that involves multidisciplinary team discussions of patient-related factors and lesion-centered characteristics, which allows for holistic, patient-centered care.

Keywords: aneurysm, aortic, endovascular, fenestrated

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Authors: Nuray Gökçek Karaca, Berrin Gökçek

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Employers occupational safety and health training obligations are regulated in 89/391/EEC Framework Directive and also in 6331 numbered Occupational Health and Safety Law in Turkey. The main objective of this research is to determine and evaluate the employers’ occupational health and safety training obligations in Framework Directive in comparison with the 6331 numbered Occupational Health and Safety Law and to examine training principles in Turkey. For this purpose, employers’ occupational health and safety training obligations examined in Framework Directive and Occupational Health and Safety Law. This study carried out through comparative scanning model and literature model. The research data were collected through European Agency and ministry legislations. As a result, employers’ occupational health and safety training obligations in the 6331 numbered Occupational Health and Safety Law are compatible with the 89/391/EEC numbered Framework Directive and training principles are determined by in different ways like the trained workers, training issues, training period, training time, and trainers. In this study, employers’ training obligations are evaluated in detail.

Keywords: directive, occupational health and safety, training, work accidences

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Authors: Ildikó Balatoni, Nikolett Kosztin

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In this study the importance of maintaining the mental and physical health of employees was examined from the perspective of the employers. To this end companies in Hajdú-Bihar county of Hungary that are within in the TOP 100 based on their net revenue were interviewed. Economic sectors that were represented the most in this survey were processing, services, trade, agriculture, and construction. We examined whether or not companies provided any benefits to their employees concerning health awareness. Among respondents those who offered various services of medical specialists and/or discounted gym or swim passes in addition to compulsory medical examinations were hard to find, however more employers organize health and sports days. Nevertheless, a significant albeit very shallow positive correlation were found between the number of offered benefits vs. total gross income and vs. number of employees (r2=0.2555, p<0.001 and r2=0.1196 and p<0.05, respectively). In conclusion, while workplace health promotion is necessary it requires a change in employers’attitudes.

Keywords: corporate health promotion, employees, employers, health

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Authors: Sara Herrero Jaén, José María Santamaría García, María Lourdes Jiménez Rodríguez, Jorge Luis Gómez González, Adriana Cercas Duque, Alexandra González Aguna

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Background: Health concept has evolved throughout history. The health level is determined by the own individual perception. It is a dynamic process over time so that you can see variations from one moment to the next. In this way, knowing the health of the patients you care for, will facilitate decision making in the treatment of care. Objective: To design a technological tool that calculates the people health level in a sequential way over time. Material and Methods: Deductive methodology through text analysis, extraction and logical knowledge formalization and education with expert group. Studying time: September 2015- actually. Results: A computational tool for the use of health personnel has been designed. It has 11 variables. Each variable can be given a value from 1 to 5, with 1 being the minimum value and 5 being the maximum value. By adding the result of the 11 variables we obtain a magnitude in a certain time, the health level of the person. The health calculator allows to represent people health level at a time, establishing temporal cuts being useful to determine the evolution of the individual over time. Conclusion: The Information and Communication Technologies (ICT) allow training and help in various disciplinary areas. It is important to highlight their relevance in the field of health. Based on the health formalization, care acts can be directed towards some of the propositional elements of the concept above. The care acts will modify the people health level. The health calculator allows the prioritization and prediction of different strategies of health care in hospital units.

Keywords: calculator, care, eHealth, health

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Authors: Karina Guimaraes, Lilian Santos

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This study has the purpose of planning and instituting monitoring actions as a way of knowing the scenario of assistance to the patient with stoma, treated in the public health network in Brazil, from January to November of the year 2016, from the elaboration of a technical document containing the survey of the number of procedures offered and the value of the ostomy services, accredited in the Unified Health System-SUS. The purpose of this document is to improve the quality of these services in the efficient management of available financial resources, making it indispensable for the creation of strategies for the implementation and implementation of care services for people with stomata as a strategic tool in the promotion, prevention, qualification and efficiency in health care.

Keywords: health economic, management, ostomy, unified health system

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Authors: Suzan Odabasi

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Suicide attempts and mental health problems among immigrants have been increasing and have become important public health concerns during the last century. Immigrants may face more difficulties in society because of social conflict, language barriers, inadequate social support, socioeconomic problems, and delay in accessing help. The limited number of research has shown that: first-generation migrants may be at higher risk of mental disorders and a higher prevalence of suicide attempts. The main aim of the proposed work is to identify to what degree each of these pressures is causing higher suicides currently observed. In addition, a comparison will be conducted between females and males and also rural and urban areas for which recent data are available. Specifically, this study investigates how accessing mental health services, the uninsured population rate, socioeconomic factors, and being an immigrant affect Turkish immigrants’ mental health and suicide attempts.

Keywords: access to healthcare, immigration, health economics, mental health economics

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Authors: Hamid Vahidkia

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The International Health Regulations (IHR), the sole worldwide regulations for managing infectious diseases, have remained largely unchanged since their initial release in 1951. The WHO is currently involved in updating the IHR. This article evaluates WHO's updated IHR draft and suggests enhancements to enhance global health, such as a strong focus on the organization's fundamental public health goals, activities, and crucial services; wide-reaching coverage for various health risks; establishing global monitoring through official and unofficial data networks; setting benchmarks for national public health systems, evaluating results, and ensuring accountability from countries; safeguarding human rights by implementing evidence-based guidelines and just processes; and promoting good governance by embracing fairness, impartiality, and openness. The World Health Organization needs to guarantee that countries follow health regulations and provide ample economic and technical support to less privileged nations. A crucial concern for the global community is how independent nations can collaborate to ensure that global health benefits all individuals, regardless of their economic status.

Keywords: IHR, law, health, international, WHO

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Authors: Petcharat Kerdonfag, Supunnee Thrakul

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School health services through regular screening of school students’ health status have been the main responsibility for community or school health nurses. The purposes of these retrospective study were to assess and compare health problems between government and private primary school students in the central region of Thailand. The data were collected from the school health records in October at the end of the first semester in the academic year 2018. Two thousand and fifty primary school health records from government and private primary schools were gathered to assess health problems regarding anthropometric measurements, physical examination/personal hygiene, and clinical findings for this study. Descriptive statistics and Chi-square were used to be analyzed. The results revealed that health problems of all the school students remained high magnitude. The five top ranks for prevalence rate of health problems were dental caries (36.6%), visual acuity problem (27.7%), over-nutrition (16.8%), head lice (12.8%), and under-nutrition (6.8%), respectively. However, when compared between government and private schools among five health problems; dental caries (55.0% vs 19.9%), visual acuity problem (23.1% vs 31.9%), over-nutrition (20.2% vs 13.8%), head lice (26.5% vs 0.3%), and under-nutrition (10.6% vs 3.4%) with Chi-square analysis, there were significantly different (p < .001). The problem of visual acuity seems to be more serious in private schools while other health problems tend to be more critical in government schools. The findings have suggested that parents who have children in the private primary schools should pay more attention to visual health defects whereas parents with children in the government school should pay more vigilance regards to hygiene and health behavior problems.

Keywords: community health nursing, school health service, health status, primary school children

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Authors: Jessica Hemberg, Anna K. Forsman, Johanna Nordmyr

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With a considerable increase in the aging population in the Nordic countries there is a call for a deeper understanding of healthy aging and its underlying mechanisms. The aim of this study is to uncover health and well-being for older adults according to their own views and understand what role the existential dimension play? The study uses a hermeneutical approach. Material was collected through focus group interviews with 18 older adults. The texts were interpreted through hermeneutical reading. The underlying mechanisms of health among older adults are described, illustrating the key prerequisites for health as being in the present. This implies ‘living on the continuums of life and death’ and in this field of forces also ‘living on the continuum of the past and the future’. Important aspects for being in the present was balancing ambivalent emotions, considering existential issues, and being in connectedness. Health for older adults may be understood in the light of the metaphor of taking it one day at a time. Being in the present was emphasized as a health potential for older adults highlighting the existential health dimension. From a societal point of view, this implies that health promotion should focus on highlighting the importance of the existential dimension of health since it holds health-promoting potentials for older adults. Optimal health for older adults requires awareness of one’s attitude to life through being in the present as a basis for a positive and healthy outlook on life.

Keywords: focus group interviews, hermeneutics, life experiences, older adults

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Authors: Alya Al Ghufli, Kelaithim Al Tunaiji, Sara Al Ali, Khalid Samara

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It is well known that health care systems encompass a variety of key knowledge sources that need to be integrated and shared amongst all types of users to attain higher-levels of motivation and productivity. The development of Health Integrated Systems (HIS) is often seen as a crucial step in strengthening the integration of knowledge to help serve the information needs of health care users. As an emergent economy, the United Arab Emirates (UAE) is regarded as a new arrival in the area of health information systems. As a new nation, there may be several challenges in terms of organisational climate and the sufficient skills and knowledge activities for effective use of HIS. In this regard, the lack of coordination, attitudes and practice of health-related systems can eventually result in unnecessary data and generally poor use of the system. This paper includes results from a qualitative preliminary study carried out from a case study investigation in a single large primary health care organisation in the United Arab Emirates (UAE) comprising various health care users. The study explored health care user’s perceptions about health integration and the impact it has on their practice. The main sources of information were semi-structured interviews and non-obtrusive observations. The authors conclude by presenting various recommendations for the development of HIS and knowledge activities and areas for further study.

Keywords: health integrated systems, knowledge sharing, knowledge activities, health information systems

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Authors: Hatem Abdel Moniem Ahmed, Ragaa Mohamed Abdel Maaboud, Heba A. Mubarak

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A commercially available Stone Hair Dye (SHD) was spread in Upper Egypt and used for dying woman's hair. Paraphenyl-diamine (PPD) is the main component of SHD and reported as a toxic substance. This work aims to study the systemic effects induced in experimental animals as a result of dermal application of SHD. 21 rats were divided into three groups, and doses of SHD and PPD were applied according to body weight (25 mg/100 g body weight) for 90 days. The results revealed that insignificant decrease in RBC count and Hb level, but there were significant increases in the WBC count, AST, ALT, GPT, and total protein while creatinine level was insignificantly increased. Hepatocytes showed a lot of degenerative changes in the form of vacuolated cytoplasm and irregular deeply stained nuclei with vascular congestion and lymphocytic infiltration, while renal affection indicated the occurrence of atrophy of glomerular capillaries, hyperplasia, and widening of bowman space.

Keywords: PPD, SHD, rats and histology, biochemistry and hematology

Procedia PDF Downloads 451