Search results for: asylum medicine
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1530

Search results for: asylum medicine

1410 Regime under Trade Related Intellectual Property Rights Agreement 1994 and Its Impacts on Health in Pakistan: A Case Study of Pharmaceutical Patents

Authors: Muhammad Danyal Khan

Abstract:

The standards of patentability are drawing a great impact upon medicine industry of Pakistan which is indirectly troubling the right to health of ordinary citizen. Globalization of intellectual property laws is directly impacting access to medicine for population in Pakistan. Pakistan has enacted Patent Ordinance 2000 to develop the standards of Patent laws in consonance with international commitments. Moreover, Pakistan is signatory to UN Millennium Development Goals (2000-2015), and three of them directly put stress upon the health standards. This article will provide a critical brief about implications of TRIPS Agreement on standards of health in Pakistan and will also propose a futuristic approach for the pharmaceutical industry. This paper will define the paradox of globalization and national preparedness on pharmaceutical patents utilizing industry statistics and case laws from Pakistan. Moreover, this work will contribute towards debate on access to medicine at legislative and interpretative levels that will further help development of equilibrium between pharmaceutical patents and right to health.

Keywords: TRIPS (Trade Related Intellectual Property Rights), patents, compulsory licensing, patent, lifesaving drugs, WTO, infringement

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1409 Socio-Demographic and Clinical Characteristics and Use of Herbal Medicine among Patients Seeking Consultation for Knee Osteoarthritis at Secondary Healthcare Facilities in Oman

Authors: Thuraya Ahmed Al Shidhani, Yahya Al Farsi, Alya Al Husni, Samir Al Adawi

Abstract:

Background: Knee osteoarthritis (knee OA) represents a major public health burden worldwide, particularly among older adults. However, little has been documented from Arabian Gulf countries, which have left an information gap. Objective: This study describes the socio-demographic, clinical risk factors, and use of herbal medicine among men and women seeking consultation for knee OA at two secondary healthcare facilities in Muscat, Oman. Methods: A cross-sectional study was conducted among 213 Omani adults with knee OA attending a referral polyclinic in Muscat, Oman, over 12 months from January to December. Socio-demographic data were collected from the participants who are seeking consultation for knee OA. Results: Among the 213 study participants, 171 were females and 42 males. The females were comparatively older than the males, had lower education and lower-income, and more overweight. The majority of the participants were normal weight or underweight. About one-third of participants reported OA in other joints as well. Most participants recalled that they had knee OA for less than a year. About 12% reported a history of trauma. The majority (63%) concurrently had other chronic illnesses, and 33% reported having at least one complication. About 22% were using herbal medicines. About 77% are using herbal local applications in form of powder and creams. Conclusion: This study, to our knowledge, is the first to explore socio-demographic characteristics, clinical risk factors and use of herbal medicine among sufferers of knee OA in Oman. Knee OA tended to occur among our participants at younger ages than reported elsewhere, while obesity appeared orthogonal to the severity of knee OA. Women were more affected than men. About one quarter of Omani patients are using herbal medicine. More studies are needed to understand the causal factors and development of knee OA in Oman. Targeted health education and rehabilitation programs are needed, particularly among Omani women, to improve their physical quality of life.

Keywords: knee joint, osteoarthritis, herbal medicine, Oman

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1408 Escaping Domestic Violence in Time of Conflict: The Ways Female Refugees Decide to Flee

Authors: Zofia Wlodarczyk

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I study the experiences of domestic violence survivors who flee their countries of origin in times of political conflict using insight and evidence from forty-five biographical interviews with female Chechen refugees and twelve refugee resettlement professionals in Poland. Both refugees and women are often described as having less agency—that is, they lack the power to decide to migrate – refugees less than economic migrants and women less than men. In this paper, I focus on how female refugees who have been victims of domestic violence make decisions about leaving their countries of origin during times of political conflict. I use several existing migration theories to trace how the migration experience of these women is shaped by dynamics at different levels of society: the macro level, the meso level and the micro level. At the macro level of analysis, I find that political conflict can be both a source of and an escape from domestic violence. Ongoing conflict can strengthen the patriarchal cultural norms, increase violence and constrain women’s choices when it comes to marriage. However, political conflict can also destabilize families and make pathways for women to escape. At the meso level I demonstrate that other political migrants and institutions that emerge due to politically triggered migration can guide those fleeing domestic violence. Finally, at the micro level, I show that family dynamics often force domestic abuse survivors to make their decision to escape alone or with the support of only the most trusted female relatives. Taken together, my analyses show that we cannot look solely at one level of society when describing decision-making processes of women fleeing domestic violence. Conflict-related micro, meso and macro forces interact with and influence each other: on the one hand, strengthening an abusive trap, and on the other hand, opening a door to escape. This study builds upon several theoretical and empirical debates. First, it expands theories of migration by incorporating both refugee and gender perspectives. Few social scientists have used the migration theory framework to discuss the unique circumstances of refugee flows. Those who have mainly focus on “political” migrants, a designation that frequently fails to account for gender, does not incorporate individuals fleeing gender-based violence, including domestic-violence victims. The study also enriches migration scholarship, typically focused on the US and Western-European context, with research from Eastern Europe and Caucasus. Moreover, it contributes to the literature on the changing roles of gender in the context of migration. I argue that understanding how gender roles and hierarchies influence the pre-migration stage of female refugees is crucial, as it may have implications for policy-making efforts in host countries that recognize the asylum claims of those fleeing domestic violence. This study also engages in debates about asylum and refugee law. Domestic violence is normatively and often legally considered an individual-level problem whereas political persecution is recognized as a structural or societal level issue. My study challenges these notions by showing how the migration triggered by domestic violence is closely intertwined with politically motivated refuge.

Keywords: AGENCY, DOMESTIC VIOLENCE, FEMALE REFUGEES, POLITICAL REFUGE, SOCIAL NETWORKS

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1407 Phytochemical Investigation of Berries of the Embelia schimperi Plant

Authors: Tariku Nefo Duke

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Embelia is a genus of climbing shrubs in the family Myrsinaceae. Embelia schimperi is as important in traditional medicine as the other species in the genus. The plant has been much known as a local medicine for the treatment of tapeworms. In this project, extraction, phytochemical screening tests, isolation, and characterization of berries of the Embelia schimperi plant have been conducted. The chemical investigations of methanol and ethyl acetate (1:1) ratio extracts of the berries lead to the isolation of three new compounds. The compounds were identified to be alkaloids coded as AD, AN, and AG. Structural elucidations of the isolated compounds were accomplished using spectroscopic methods (IR, UV, ¹H NMR, ¹³C NMR, DEPT and 2D NMR, HPLC, and LC-MS). The alkaloid coded as (AN) has a wide MIC range of 6.31-25.46 mg/mL against all tested bacteria strains.

Keywords: Embelia schimper, HPLC, alkaloids, 2D NMR, MIC

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1406 A Study on the Annual Doses Received by the Workers of Some Medical Practices

Authors: Eltayeb Hamad Elneel Yousif

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This paper describes occupational radiation doses of workers in non-destructive testing (NDT) and some medical practices during the year 2007. The annual doses received by the workers of a public hospital are presented in this report. The Department is facilitated with HARSHAW Reader model 6600 and assigned the rule of personal monitoring to contribute in controlling and reducing the doses received by radiation workers. TLD cards with two TLD chips type LiF: Mg, Ti (TLD-100) were calibrated to measure the personal dose equivalent Hp(10). Around 150 medical radiation workers were monitored throughout the year. Each worker received a single TLD card worn on the chest above lead apron and returned for laboratory reading every two months. The average annual doses received by the workers of radiotherapy, nuclear medicine and diagnostic radiology were evaluated. The annual doses for individual radiation workers ranged between 0.55-4.42 mSv, 0.48-1.86 mSv, and 0.48-0.91 mSv for the workers of radiotherapy, nuclear medicine and diagnostic radiology, respectively. The mean dose per worker was 1.29±1, 1.03±0.4, and 0.69±0.2 mSv, respectively. The results showed compliance with international dose limits. Our results reconfirm the importance of personal dosimetry service in assuring the radiation protection of medical staff in developing countries.

Keywords: radiation medicine, non-destructive testing, TLD, public hospital

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1405 Communication Barriers and Challenges for Accessing Autism Care: Conventional Versus Alternative Medicine

Authors: M. D. Antoine

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Despite the widespread use of complementary and alternative medicine (CAM) for autistic children, little is known about the communication flow between the different parties involved in autism care (e.g., parents/caregivers, conventional providers, alternative practitioners). This study aimed to describe how communication occurs through the first year following an autism spectrum disorder (ASD) diagnosis to identify challenges and potential barriers to communication within the healthcare system in Ottawa, Canada. From an ecological perspective, we collected qualitative data through 12 semi-structured interviews with six parents/caregivers, three conventional providers (e.g., family doctor, neurodevelopmental pediatrician, psychologist), and three alternative practitioners (e.g., naturopath, occupational therapist, speech and language pathologist) operating in Ottawa. We interpreted the data using thematic analysis. Findings revealed communication challenges between the parents/caregivers and conventional providers while they experience better communication flow with fewer challenges in alternative care settings. However, parents/caregivers are the only links between the health professionals of both streams. From the five contexts examined: organizational, interpersonal, media, cultural, and political-legal, we found four themes (provider knowledge, care integration, flexible care, and time constraints) underlining specific barriers to communication flow between the parties involved in the care of autistic children. The increasing interest in alternative medicine is forcing changes in the healthcare system. Communications occur outside the norms making openings for better communication and information-sharing increasingly essential. Within the identified themes in the current study, the necessity for better communication between all parties involved in the care of autistic children is evident. More ASD and CAM-related training for providers would support effective parent/caregiver-provider communication. The findings of the current study contribute to a better understanding of the role of communication in the care management of autism, which has implications for effective autism care.

Keywords: alternative medicine, autism care management, autism spectrum disorder, conventional medicine, parent-provider communication

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1404 Soul-Body Relationship in Medieval Islamic Thought – Analysis of Avicenna’s Psychology and Medicine with Implication to Mental Health

Authors: Yula Milshteyn

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The present study focuses on the science of the “Soul” in Islamic Medieval Psychology.The main objective of the current essay is to analyze the concept of the “soul” in relation to “mental” disorders, in the philosophical psychology and medicinal treatise of Ibn Sina, a Muslim Persian physician-philosopher (known as Avicenna in the Western world) (981-1037 CE). The examination will concentrate on the nature of the soul, and the relationship of the soul to the body, as well as the manifestation of health and sickness in soul and body, The analysis draws on Avicenna’s Psychology (Kitab al-Najat or The Book of Salvation), Remarks and Admonitions (Al-isharat wa al-tanbihat), and the medical treatise – The Canon of Medicine (al-Qānūn fī al-Ṭibb). Avicenna’s psychology of the soul is primarily based on Aristotelian and Neo-platonic paradigms. For Avicenna, soul is a metaphysical, independent substance, which in modern terms implies independence of human consciousness from the material body. The soul however, is linked to the body and controls all its’ faculties or functions. It is suggested that in the specific case study of schizophrenia, it is a disorder pertained to both, soul and body and can be characterized as a multi-faceted neurobiological, physiological, psychological and metaphysical spiritual phenomenon.

Keywords: Avicenna, canon of the medicine, mental disorders, psychology, schizophrenia, soul-body

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1403 Predictive Factors of Prognosis in Acute Stroke Patients Receiving Traditional Chinese Medicine Therapy: A Retrospective Study

Authors: Shaoyi Lu

Abstract:

Background: Traditional Chinese medicine has been used to treat stroke, which is a major cause of morbidity and mortality. There is, however, no clear agreement about the optimal timing, population, efficacy, and predictive prognosis factors of traditional Chinese medicine supplemental therapy. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend. Key words: traditional Chinese medicine, acupuncture, Stroke, NIH stroke scale, Barthel index, predictive factor. Method: In this study, we used a retrospective analysis with data collection from stroke patients in Stroke Registry In Chang Gung Healthcare System (SRICHS). Stroke patients who received traditional Chinese medicine consultation in neurology ward of Keelung Chang Gung Memorial Hospital from Jan 2010 to Dec 2014 were enrolled. Clinical profiles including the neurologic deficit, activities of daily living and other basic characteristics were analyzed. Through propensity score matching, we compared the NIHSS and Barthel index before and after the hospitalization, and applied with subgroup analysis, and adjusted by multivariate regression method. Results: Totally 115 stroke patients were enrolled with experiment group in 23 and control group in 92. The most important factor for prognosis prediction were the scores of National Institutes of Health Stroke Scale and Barthel index right before the hospitalization. Traditional Chinese medicine intervention had no statistically significant influence on the neurological deficit of acute stroke patients, and mild negative influence on daily activity performance of acute hemorrhagic stroke patient. Conclusion: Efficacy of traditional Chinese medicine as a supplemental therapy for acute stroke patients was controversial. The reason for this phenomenon might be complex and require more research to comprehend.

Keywords: traditional Chinese medicine, complementary and alternative medicine, stroke, acupuncture

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1402 Treatment of NMSC with Traditional Medicine Method

Authors: Aferdita Stroka Koka, Laver Stroka, Juna Musa, Samanda Celaj

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Non-melanoma skin cancers (NMSCs) are the most common human malignancies. About 5.4 million basal and squamous cell skin cancers are diagnosed each year in the US and new cases continue to grow. About eight out of ten of these are basal cell cancers. Squamous cell cancers occur less often. NMSC usually are treatable, but treatment is expensive and can leave scars. In 2019, 167 patients of both sexes suffering from NMSC were treated by traditional medicine. Patients who have been diagnosed with Basal Cell Carcinoma were 122 cases, Squamous Cell Carcinoma 32 cases and both of them 13 cases. Of these,122 cases were ulcerated lesions and 45 unulcerated lesions. All patients were treated with the herbal solution called NILS, which contains extracts of some Albanian plants such as Allium sativum, Jugulans regia and Laurus nobilis. The treatment is done locally, on the surface of the tumor, applying the solution until the tumor mass is destroyed and, after that, giving the necessary time to the wound to make the regeneration that coincides with the complete healing of the wound. We have prepared a collection of photos for each case. Since the first sessions, a shrinkage and reduction of the tumor mass were evident, up to the total disappearance of the lesion at the end of treatment. The normal period of treatment lasted 1 to 2 weeks, depending on the size of the tumor, then take care of it until the closure of the wound, taking the whole process from 1 to 3 months. In 7 patients, the lesion failed to be dominated by treatment and they underwent standard treatment with radiotherapy or surgery, while in 10 patients, the lesion recurred and was treated again. The aim of this survey was to put in evidence the good results obtained by treatment of NMSC with Albanian traditional medicine methods.

Keywords: local treatment, nils, NMSC, traditional medicine

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1401 Being Reticent for Healing – Singularity and Non-Verbalization in Indigenous Medical Practices in Sri Lanka

Authors: Ayami Umemura

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The purpose of this paper is to examine the meaning of verbalization in clinical practice using the keywords silence and singularity. A patient's experience of illness and treatment is singular, irreplaceable, and irreproducible and ultimately cannot be compared with that of others. In his book Difference and Repetition, Gilles Deleuze positioned irreplaceable singularity as the opposite concept of particularity as a generalizable and substitutable property and matched the former with universality. He also said that singularity could not be represented because of its irreplaceable nature. Representation or verbalization is a procedure that converts an irreplaceable, idiosyncratic reality into something that can be substituted. Considering the act of verbalizing medical diagnosis based on this, it can be said that diagnosis is the practice of decontextualizing and generalizing the suffering embedded in the patient's irreplaceable life history as a disease. This paper examines the above with the key concept of the practice of "non-verbalization" in traditional medical practices in Sri Lanka. In the practice of Sri Lankan traditional medicine and the inheritance of medical knowledge and care techniques, there is a tendency to avoid verbalizing specific matters or stating them aloud. Specifically, the following should be avoided. The healer informs the patient of the name of the disease, mentions the name of the herb used in front of the patient, explains the patient's condition to the healer, and referring the names of poisonous animals, such as poisonous snakes that have been damaged. And so on. Furthermore, when passing on medical knowledge and skills, it is also possible to avoid verbalizing knowledge of medicinal herbs and medical treatment methods and explaining them verbally. In addition to the local belief that the soul of language in Sri Lanka is deeply involved in this background, Sri Lankan traditional medicine has a unique view of the human body and personality that is rooted in the singularity that appears in the relationship with the movement of celestial bodies and the supernatural realm. It can be pointed out that it is premised on the view. In other words, the “silence” in Sri Lankan indigenous medicine is the reason for emphasizing specificity. Furthermore, we can say that "non-verbalization" is a practice aimed at healing. Based on these discussions, this paper will focus on the unique relationships between practitioners and patients that become invisible due to verbalization, which is overlooked by clinical medicine, where informed consent, ensuring transparency, and audit culture is dominant. We will examine the experience of treatment and aim to relativize clinical medicine, which is based on audit cultures.

Keywords: audit cultures, indigenous medicine, singularity, verbalization

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1400 Dialogues of Medical Places and Health Care in Oporto City (20th Century)

Authors: Monique Palma, Isabel Amaral

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This paper aims at mapping medical places in Oporto in the twentieth century in order to bring the urban history of medicine and healthcare in Portugal to a large audience, using Oporto as a case study. This analysis is consistent with the SDS's 2030 goals for policy guidance for heritage and development actors. As a result, it is critical to begin this research in order to place on the political agenda the preservation of Portuguese culture's history, memory, and heritage, particularly the medical culture, which is one of the most important drivers of civilizational development. To understand the evolution of medical care in urban history, we will conduct archive research (manuals, treatises, reports, periodic journals, newspapers, etc.) and interviews with key actors from medical institutions and medical museums. The findings of this study will be used to develop medical itineraries for inclusion in touristic agendas in Portugal and abroad, to include Portuguese medicine in global roadmaps, and to promote the preservation of the most iconic places of health care and medical heritage, as well as tools to promote social cohesion, dialogue among people, and "sense of place" globally.

Keywords: medical itineraries, history of medicine, urban history, Oporto

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1399 Antioxidant Activity of Selected Medicinal Plants Used in Folk Medicine in Libya

Authors: Salmin Alshalmani, Ghazall M Benhusein, Ebtisam Alhadi Absomaha, Marwa I. Meshri, Hamdoon A. Mohammed, Jamal Mezogi

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Eight wild medicinal plants used by Libyan and growing in Al-Jebel Al-Akhdar, Libya were suspected to estimate the antioxidant activity using 2,2-Diphenyl-1-Picrylhydrazyl stable free radical (DPPH). Incidences of purple colour reduction of the DPPH by testing extracts in addition to quercetin and vitamin C as positive controls reflect its ability to scavenge free radicals. All testing plants extract showed noticeable strength as antioxidant regarding its abilities to scavenge DPPH with an especial regards to Sarcopoterium spinosum.

Keywords: antioxidant, scavenging activity, folk medicine, methanol extracts

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1398 Diagnosis of Avian Pathology in the East of Algeria

Authors: Khenenou Tarek, Benzaoui Hassina, Melizi Mohamed

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The diagnosis requires a background of current knowledge in the field and also complementary means in which the laboratory occupies the central place for a better investigation. A correct diagnosis allows to establish the most appropriate treatment as soon as possible and avoids both the economic losses associated with mortality and growth retardation often observed in poultry furthermore it may reduce the high cost of treatment. Epedemiologic survey, hematologic and histopathologic study’s are three aspects of diagnosis heavily used in both human and veterinary pathology and the advanced researches in human medicine would be exploited to be applied in veterinary medicine with given modification .Whereas, the diagnostic methods in the east of Algeria are limited to the clinical signs and necropsy finding. Therefore, the diagnosis is based simply on the success or the failure of the therapeutic methods (therapeutic diagnosis).

Keywords: chicken, diagnosis, hematology, histopathology

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1397 Lower Risk of Ischemic Stroke in Hormone Therapy Users with Use of Chinese Herbal Medicine

Authors: Shu-Hui Wen, Wei-Chuan Chang, Hsien-Chang Wu

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Background: Little is known about the benefits and risks of use of Chinese herbal medicine (CHM) in conditions related to hormone therapy (HT) use on the risk of ischemic stroke (IS). The aim of this study is to explore the risk of IS in menopausal women treated with HT and CHM. Materials and methods: A total of 32,441 menopausal women without surgical menopause aged 40- 65 years were selected from 2003 to 2010 using the 2-million random samples of the National Health Insurance Research Database in Taiwan. According to the medication usage of HT and CHM, we divided the current and recent users into two groups: an HT use-only group (n = 4,989) and an HT/CHM group (n = 9,265). Propensity-score matching samples (4,079 pairs) were further created to deal with confounding by indication. The adjusted hazard ratios (HR) of IS during HT or CHM treatment were estimated by the robust Cox proportional hazards model. Results: The incidence rate of IS in the HT/CHM group was significantly lower than in the HT group (4.5 vs. 12.8 per 1000 person-year, p < 0.001). Multivariate analysis results indicated that additional CHM use was significant with a lower risk of IS (HR = 0.3; 95% confidence interval, 0.21-0.43). Further subgroup analyses and sensitivity analyses had similar findings. Conclusion: We found that combined use of HT and CHM was associated with a lower risk for IS than HT use only. Further study is needed to examine possible mechanism underlying this association.

Keywords: Chinese herbal medicine, hormone therapy, ischemic stroke, menopause

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1396 Review of Health Disparities in Migrants Attending the Emergency Department with Acute Mental Health Presentations

Authors: Jacqueline Eleonora Ek, Michael Spiteri, Chris Giordimaina, Pierre Agius

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Background: Malta is known for being a key player as a frontline country with regard to irregular immigration from Africa to Europe. Every year the island experiences an influx of migrants as boat movement across the Mediterranean continues to be a humanitarian challenge. Irregular immigration and applying for asylum is both a lengthy and mentally demanding process. Those doing so are often faced with multiple challenges, which can adversely affect their mental health. Between January and August 2020, Malta disembarked 2 162 people rescued at sea, 463 of them between July & August. Given the small size of the Maltese islands, this regulation places a disproportionately large burden on the country, creating a backlog in the processing of asylum applications resulting in increased time periods of detention. These delays reverberate throughout multiple management pathways resulting in prolonged periods of detention and challenging access to health services. Objectives: To better understand the spatial dimensions of this humanitarian crisis, this study aims to assess disparities in the acute medical management of migrants presenting to the emergency department (ED) with acute mental health presentations as compared to that of local and non-local residents. Method: In this retrospective study, 17795 consecutive ED attendances were reviewed to look for acute mental health presentations. These were further evaluated to assess discrepancies in transportation routes to hospital, nature of presenting complaint, effects of language barriers, use of CT brain, treatment given at ED, availability of psychiatric reviews, and final admission/discharge plans. Results: Of the ED attendances, 92.3% were local residents, and 7.7% were non-locals. Of the non-locals, 13.8% were migrants, and 86.2% were other-non-locals. Acute mental health presentations were seen in 1% of local residents; this increased to 20.6% in migrants. 56.4% of migrants attended with deliberate self-harm; this was lower in local residents, 28.9%. Contrastingly, in local residents, the most common presenting complaint was suicidal thought/ low mood 37.3%, the incidence was similar in migrants at 33.3%. The main differences included 12.8% of migrants presenting with refused oral intake while only 0.6% of local residents presented with the same complaints. 7.7% of migrants presented with a reduced level of consciousness, no local residents presented with this same issue. Physicians documented a language barrier in 74.4% of migrants. 25.6% were noted to be completely uncommunicative. Further investigations included the use of a CT scan in 12% of local residents and in 35.9% of migrants. The most common treatment administered to migrants was supportive fluids 15.4%, the most common in local residents was benzodiazepines 15.1%. Voluntary psychiatric admissions were seen in 33.3% of migrants and 24.7% of locals. Involuntary admissions were seen in 23% of migrants and 13.3% of locals. Conclusion: Results showed multiple disparities in health management. A meeting was held between entities responsible for migrant health in Malta, including the emergency department, primary health care, migrant detention services, and Malta Red Cross. Currently, national quality-improvement initiatives are underway to form new pathways to improve patient-centered care. These include an interpreter unit, centralized handover sheets, and a dedicated migrant health service.

Keywords: emergency department, communication, health, migration

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1395 Silica Nanofibres – Promising Material for Regenerative Medicine

Authors: Miroslava Rysová, Zdena Syrová, Tomáš Zajíc, Petr Exnar

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Currently, attention of tissue engineers has been attracted to novel nanofibrous materials having advanced properties and ability to mimic extracellular matrix (ECM) by structure which makes them interesting candidates for application in regenerative medicine as scaffolding and/or drug delivering material. Throughout the last decade, more than 200 synthetic and natural polymers have been successfully electrospun leading to the formation of nanofibres with a wide range of chemical, mechanical and degradation properties. In this family, inorganic nanofibres represent very specific group offering an opportunity to manufacture inert to body, well degradable and in properties tunable material. Aim of this work, was to reveal unique properties of silica (SiO2, CAS 7631-86-9) nanofibres and their potential in field of regenerative medicine. Silica nanofibres were prepared by sol-gel method from tetraethyl orthosilicate (TEOS, CAS 78-10-4) as a precursor and subsequently manufactured by needleless electrospinning on NanospiderTM device. Silica nanofibres thermally stabilized under 200°C were confirmed to be fully biodegradable and soluble in several simulated body fluids. In vitro cytotoxicity tests of eluate (ES ISO 10993-5:1999) and in direct contact (ES ISO 10993-5:2009) showed no toxicity - e.g. cell viabilities reached values exceeding 80%. Those results were obtained equally from two different cell lines (Vero, 3T3). Non-toxicity of silaca nanofibres´ eluate was additionally confirmed in real time by testing on xCelligence (ACEA Biosciences, Inc.) device. Both cell types also showed good adhesion to material. To conclude, all mentioned results lead to resumption that silica nanofibres have a potential as material for regenerative medicine which opens door to further research.

Keywords: cytotoxicity, electrospinning, nanofibres, silica, tissue engineering

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1394 Action Plans to Prevent Negative Attitudes Towards Gay and Lesbian Parents: A Systemic Analysis of Health-Care Interventions in Belgium

Authors: Therese Scali

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Over the years, the European Union has continued to extend its action on lesbian, gay men, bisexual and transgender (LGBT) rights to a range of areas including access to justice, asylum, freedom of expression and assembly, parenting, and mutual recognition of civil status within the EU. The European Parliament has been a driving force behind such action adopting a range of resolutions calling for continued progress in this field. In particular, Belgium has been one of the first countries to legalize same-sex parenting and to create a general framework for action against negative attitudes towards gay and lesbian parents. The present paper aims at highlighting public healthcare workers’ attitudes towards different types of same-sex headed families in Belgium, and the content of their interventions in schools. Results revealed that attitudes can go from supportive to unsupportive, and participants do not show the same degree of support towards the different types of same-sex parenting. This contribution highlights work’s implication for public policy by understanding the resources and challenges that health-care professionals face in their work.

Keywords: attitudes, gay and lesbian parents, health-care workers, homophobia, prevention

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1393 NanoCelle®: A Nano Delivery Platform to Enhance Medicine

Authors: Sean Hall

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Nanosystems for drug delivery are not new; as medicines evolve, so too does the desire to deliver a more targeted, patient-compliant medicine. Though, historically the widespread use of nanosystems for drug delivery has been fouled by non-replicability, scalability, toxicity issues, and economics. Examples include steps of manufacture and thus cost to manufacture, toxicity for nanoparticle scaffolding, autoimmune response, and considerable technical expertise for small non-commercial yields. This, unfortunately, demonstrates the not-so-obvious chasm between science and drug formulation for regulatory approval. Regardless there is a general and global desire to improve the delivery of medicines, reduce potential side effect profiles, promote increased patient compliance, and increase and/or speed public access to medicine availability. In this paper, the author will discuss NanoCelle®, a nano-delivery platform that specifically addresses degradation and solubility issues that expands from fundamental micellar preparations. NanoCelle® has been deployed in several Australian listed medicines and is in use of several drug candidates across small molecules, with research endeavors now extending into large molecules. The author will discuss several research initiatives as they relate to NanoCelle® to demonstrate similarities seen in various drug substances; these examples will include both in vitro and in vivo work.

Keywords: NanoCelle®, micellar, degradation, solubility, toxicity

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1392 Perceptions of Pregnant Women on the Transitional Use of Traditional Medicine in the Transitional District Western Uganda

Authors: Demmiele Matu Kiiza, Constantine Steven Labongo Loum, Julaina Obika Asinasi

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Background: The use of traditional medicine in Uganda forms the preliminary therapeutic approaches among many people. Traditional medicines have been used in Uganda for many years, not only for the management of pregnancy-related complications but also for the management of other physical and psychological illnesses. Traditional medicines are always considered the first line of treatment by a considerable number of people. This study, therefore, sought to explore the lived experiences of pregnant women by assessing their perceptions of the transitional use of traditional medicine. Methods: Ethnography was used to capture data from an emic perspective. The ethnographic approach involved visiting a few selected pregnant women to observe and participate in the identification of traditional medicines. The ethnographic fieldwork was carried out within a period of three months. In-depth interviews were carried out and audio recorded and later transcribed verbatim. Data was thereafter analyzed thematically. The thematic analysis involved identifying statements made by research participants by transcribing audio and reading through field notes, coding was done, and themes were generated according to commonly mentioned experiences of using traditional medicine. Results: The findings revealed that women performed a ritual of ‘cutting the cord’ by making a small horizontal incision on the belly across the linea Nigra (also known as a pregnancy line) at around six months of pregnancy to avoid producing a baby with an umbilical cord tied around the baby’s neck. They also used crushed egg shells, crushed snail shells and herbs such as pawpaw roots, Entarahompo (crassocephalum vitelline), Ekyoganyanja (Erlangea tomentose), to manage Omushohokye (a term used by the study participants to refer to a situation where women pass out too much water when giving birth, producing a child with mold and oozing out of a milky liquid through the breasts before giving births); prepare for safe delivery and also to manage pregnancy-related complications. The study recommends the implementation of a traditional medicine use policy using a bottom-up approach. Designing and implementing of culturally sensitive maternal healthcare intervention programs and involving village health teams and the elderly in health education.

Keywords: traditional medicine, pregnant women, uganda, perceptions

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1391 Phytochemical and Proximate Composition Analysis of Aspillia kotschyi

Authors: A. U. Adamu, E. D Paul, C. E. Gimba, I. G. Ndukwe

Abstract:

The phytochemical and proximate composition of Aspillia kotschyi belonging to Compositae family which is commonly used as medicinal plant in Nigeria was determined on both the Methanolic and Petroleum sprit extract of the plant. The Methanolic extract of the plant revealed the presence of carbohydrates, cardiac glyscosides, flavonoids, triterpene, and alkaloids. The Petroleum sprit extract showed the presence of only carbohydrates and alkaloid. Proximate composition analysis shows moisture content of 5.7%, total ash of 4.03%, crude protein 10.94%, fibre 9.06%, fat value 0.83%, and nitrogen free extract of 70.19%. The results of this study suggest some merit in the popular use of Aspillia kotschi in herbal medicine.

Keywords: Aspillia kotschyi, herbal medicine, phytochemical, proximate composition

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1390 Review and Analyze on the Journal of Sport Science

Authors: Zhan Dong, Qiu Jianrong, Li Qinghui, Zhang Lei

Abstract:

The quantity and quality of the papers published on sport science from 2001 to 2013 had been counted and analysed and compared with the papers published on the journal from 1990 to 2000. The result showed that: 1. In the sports medicine field, the proportion of basic/application was abnormal. Basic research was far more than the application research. The papers on researching of imitating altitude training was the main part. Gene research made great progress.The research on sport injury and medical supervision were lower and lower. Research on sports prescription had made much progress, especially in the patients of heart infarction. 2. In building up people’s health field, the research on the old people had been more and more compared with the 10 years before, but it was not enough. 3. In the field of sports psychology, the research on disable people had been more compared with the 10 years before. Solved the problem of the sportmen before the game. 4. In the field of sports biomechanics, it showed that methods had made great progress compared with the 10 years before. Sport biomechanics combined with sports medicine, helped the sportsmen in good condition in the game. 5. In the exercise training field, the experts pay more attention to the outstanding sportsmen, and the researches emphasized that biology knowledge is the main basic for them to the research.

Keywords: sport medicine, sport injury, medical supervision

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1389 Feasibility of Leukemia Cancer Treatment (K562) by Atmospheric Pressure Plasma Jet

Authors: Mashayekh Amir Shahriar, Akhlaghi Morteza, Rajaee Hajar, Khani Mohammad Reza, Shokri Babak

Abstract:

A new and novel approach in medicine is the use of cold plasma for various applications such as sterilization blood coagulation and cancer cell treatment. In this paper a pin-to-hole plasma jet suitable for biological applications is investigated, characterized and the possibility and feasibility of cancer cell treatment is evaluated. The characterization includes power consumption via Lissajous method, thermal behavior of plasma using Infra-red camera as a novel method, Optical Emission Spectroscopy (OES) to determine the species that are generated. Treatment of leukemia cancer cells is also implemented and MTT assay is used to evaluate viability.

Keywords: Atmospheric Pressure Plasma Jet (APPJ), Plasma Medicine, Cancer cell treatment, leukemia, Optical Emission

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1388 Holistic Approach Illustrating the Use of Complementary and Alternative Medicine in Pain and Stress Management for Spinal Cord Injury

Authors: Priyanka Kalra

Abstract:

Background: Complementary and alternative medicine (CAM) includes various practices like Ayurveda, Yoga & Meditation Acupressure Acupuncture and Reiki. These practices are frequently used by patients with spinal cord injury (SCI). They have shown effectiveness in the management of pain and stress consequently improving overall quality of life post injury. Objective: The goals of the present case series were to evaluate the feasibility of 1) Using of Ayurvedic herbal oil massages in shoulder pain management, 2) Using yoga & meditation on managing the stress in spinal cord injury. Methodology: 15 SCI cases with muscular pain around shoulder were treated with Ayurvedic herbal oil massage for 10 days in CAM Department. Each session consisted of 30 min oil massage followed by 10 min hot towel fomentation. The patients continued regular therapy medications along with CAM. Another 15 SCI cases were treated with yoga and meditation for 15 days 30 min yoga (20 min Asana+ 10 min Pranayam + 15 min Meditation) in isolated yoga room of CAM department. Results: On the VAS scale the patients reported a reduction in their pain score by 70 %. On the PSS scale, the patients reported a reduction in their stress score by 80 %. Conclusion: These case series may encourage more people to explore CAM therapies.

Keywords: spinal cord injury, Ayurveda, complementary and alternative medicine, yoga, meditation

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1387 Pharmacoacupuncture Therapy for Dizziness in Traditional Korean Medicine: A Systematic Review

Authors: Jiwon Oh, Hyunjoo Oh, Seungwon Shin, Junghee Yoo, Euiju Lee

Abstract:

Background and Aims: This systematic review aimed at briefly exploring how effective pharmacoacupuncture therapy for dizziness is. Methods: We searched publications in Medline, EMBASE, Cochrane Library, KoreaMed, China National Knowledge Infrastructure (CNKI), Cinii, DBpia, KSI, Kiss, KMbase, NDSL and RISS. We included randomized controlled trials and well-designed non-randomized controlled trials that compared the effects of only pharmacoacupuncture or pharmacoacupuncture and usual therapies with any controls for dizziness. Results: The risk of bias was assessed using the Cochrane tool. Three studies have been included with eligibility criteria. The prevalence of "unclear" ratings in the risk assessment results is predominantly due to the included studies reporting their findings inadequately. This review found evidence that pharmacoacupuncture therapy was effective as an add-on therapy to acupoint therapy physiotherapy and had additional benefits in increasing CER for cervical vertigo. Also, it was recommended that pharmacoacupuncture therapy was effective as an add-on therapy to Western medicine and had additional benefits in increasing CER for vasovagal syncope. Conclusions: Pharmacoacupuncture therapy had additional benefits as an add-on therapy for cervical vertigo and vasovagal syncope. However, further studies are required to overcome the limitations of the lack of study qualities.

Keywords: pharmacoacupuncture therapy, dizziness, systematic review, traditional Korean medicine

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1386 Combining the Production of Radiopharmaceuticals with the Department of Radionuclide Diagnostics

Authors: Umedov Mekhroz, Griaznova Svetlana

Abstract:

In connection with the growth of oncological diseases, the design of centers for diagnostics and the production of radiopharmaceuticals is the most relevant area of healthcare facilities. The design of new nuclear medicine centers should be carried out from the standpoint of solving the following tasks: the availability of medical care, functionality, environmental friendliness, sustainable development, improving the safety of drugs, the use of which requires special care, reducing the rate of environmental pollution, ensuring comfortable conditions for the internal microclimate, adaptability. The purpose of this article is to substantiate architectural and planning solutions, formulate recommendations and principles for the design of nuclear medicine centers and determine the connections between the production and medical functions of a building. The advantages of combining the production of radiopharmaceuticals and the department of medical care: less radiation activity is accumulated, the cost of the final product is lower, and there is no need to hire a transport company with a special license for transportation. A medical imaging department is a structural unit of a medical institution in which diagnostic procedures are carried out in order to gain an idea of the internal structure of various organs of the body for clinical analysis. Depending on the needs of a particular institution, the department may include various rooms that provide medical imaging using radiography, ultrasound diagnostics, and the phenomenon of nuclear magnetic resonance. The production of radiopharmaceuticals is an object intended for the production of a pharmaceutical substance containing a radionuclide and intended for introduction into the human body or laboratory animal for the purpose of diagnosis, evaluation of the effectiveness of treatment, or for biomedical research. The research methodology includes the following subjects: study and generalization of international experience in scientific research, literature, standards, teaching aids, and design materials on the topic of research; An integrated approach to the study of existing international experience of PET / CT scan centers and the production of radiopharmaceuticals; Elaboration of graphical analysis and diagrams based on the system analysis of the processed information; Identification of methods and principles of functional zoning of nuclear medicine centers. The result of the research is the identification of the design principles of nuclear medicine centers with the functions of the production of radiopharmaceuticals and the department of medical imaging. This research will be applied to the design and construction of healthcare facilities in the field of nuclear medicine.

Keywords: architectural planning solutions, functional zoning, nuclear medicine, PET/CT scan, production of radiopharmaceuticals, radiotherapy

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1385 Practice Based Approach to the Development of Family Medicine Residents’ Educational Environment

Authors: Lazzat M. Zhamaliyeva, Nurgul A. Abenova, Gauhar S. Dilmagambetova, Ziyash Zh. Tanbetova, Moldir B. Ahmetzhanova, Tatyana P. Ostretcova, Aliya A. Yegemberdiyeva

Abstract:

Introduction: There are many reasons for the weak training of family doctors in Kazakhstan: the unified national educational program is not focused on competencies, the role of a general practitioner (GP) is not clear, poor funding for the health care and education system, outdated teaching and assessment methods, inefficient management. We highlight two issues in particular. Firstly, academic teachers of family medicine (FM) in Kazakhstan do not practice as family doctors; most of them are narrow specialists (pediatricians, therapists, surgeons, etc.); they usually hold one-time consultations; clinical mentors from practical healthcare (non-academic teachers) do not have the teaching competences, and the vast majority of them are also narrow specialists. Secondly, clinical sites (polyclinics) are unprepared for general practice and do not follow the principles of family medicine; residents do not like to be in primary health care (PHC) settings due to the chaos that is happening there, as well as due to the lack of the necessary equipment for mastering and consolidating practical skills. Aim: We present the concept of the family physicians’ training office (FPTO), which is being created as a friendly learning environment for young general practitioners and for the involvement of academic teachers of family medicine in the practical work and innovative development of PHC. Methodology: In developing the conceptual framework and identifying practical activities, we drew on literature and expert input, and interviews. Results: The goal of the FPTO is to create a favorable educational and clinical environment for the development of the FM residents’ competencies, in which the residents with academic teachers and clinical mentors could understand and accept the principles of family medicine, improve clinical knowledge and skills, and gain experience in improving the quality of their practice in scientific basis. Three main areas of office activity are providing primary care to the patients, improving educational services for FM residents and other medical workers, and promoting research in PHC and innovations. The office arranges for residents to see outpatients at least 50% of the time, and teachers of FM departments at least 1/4 of their working time conduct general medical appointments next to residents. Taking into account the educational and scientific workload, the number of attached population for one GP does not exceed 500 persons. The equipment of the office allows FPTO workers to perform invasive and other manipulations without being sent to other clinics. In the office, training for residents is focused on their needs and aimed at achieving the required level of competence. International methodologies and assessment tools are adapted to local conditions and evaluated for their effectiveness and acceptability. Residents and their faculty actively conduct research in the field of family medicine. Conclusions: We propose to change the learning environment in order to create teams of like-minded people, to unite residents and teachers even more for the development of family medicine. The offices will also invest resources in developing and maintaining young doctors' interest in family medicine.

Keywords: educational environment, family medicine residents, family physicians’ training office, primary care research

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1384 Obstruction to Treatments Meeting International Standards for Lyme and Relapsing Fever Borreliosis Patients

Authors: J. Luché-Thayer, C. Perronne, C. Meseko

Abstract:

We reviewed how certain institutional policies and practices, as well as questionable research, are creating obstacles to care and informed consent for Lyme and relapsing fever Borreliosis patients. The interference is denying access to treatments that meet the internationally accepted standards as set by the Institute of Medicine. This obstruction to care contributes to significant human suffering, disability and negative economic effect across many nations and in many regions of the world. We note how evidence based medicine emphasizes the importance of clinical experience and patient-centered care and how these patients benefit significantly when their rights to choose among treatment options are upheld.  

Keywords: conflicts of interest, obstacles to healthcare accessibility, patient-centered care, the right to informed consent

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1383 Ethnobotanical Study on the Usage of Toxic Plants in Traditional Medicine in the City Center of Tlemcen, Algeria

Authors: Nassima Elyebdri, Asma Boumediou, Soumia Addoun

Abstract:

Traditional medicine has been part of the Algerian culture for decades. In particular, the city of Tlemcen still retains practices based on phytotherapy to the present day, as this kind of medicine fulfills the needs of its followers among the local population. The toxic plants contain diverse natural substances which supplied a lot of medicine in the pharmaceutical industry. In order to explore new medicinal sources among toxic plants, an ethnobotanical study was carried out on the use of these plants by the population, at Emir Abdelkader Square of the city of Tlemcen, a rather busy place with a high number of traditional health practitioners and herbalists. This is a descriptive and transversal study aimed at estimating the frequency of using toxic plants among the studied population, for a period of 4 months. The information was collected, using self-anonymous questionnaires, and analyzed by the IBM SPSS Statistics software used for statistical analysis. A sample of 200 people, including 120 women and 80 men, were interviewed. The mean age was 41 ± 16 years. Among those questioned, 83.5% used plants; 8% of them used toxic plants and 35% used plants that can be toxic under certain conditions. Some improvements were observed in 88% of the cases where toxic plants were used. 80 medicinal plants, belonging to 36 botanical families, were listed, identified and classified. The most frequent indications for these plants were for respiratory diseases in 64.7% of cases, and for digestive disorders in 51.5% of cases. 11% of these plants are toxic, 26% could be toxic under certain conditions. Among toxics plants, the most common ones are Berberis vulgaris with 5.4%, indicated in the treatment of uterine fibroids and thyroid, Rhamnus alaternus with 4.8% for hepatic jaundice, Nerium oleander with 3% for hemorrhoids, Ruta chalepensis with 1.2%, indicated for digestive disorders and dysmenorrhea, and Viscum album with 1.2%, indicated for respiratory diseases. The most common plants that could be toxic are Mentha pulegium (15.6%), Eucalyptus globulus (11.4%), and Pimpinella anisum (10.2%). This study revealed interesting results on the use of toxic plants, which are likely to serve as a basis for further ethno-pharmacological investigations in order to get new drug sources.

Keywords: ethnobotany, phytotherapy, Tlemcen, toxic plants

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1382 Extent of Knowledge, Preparedness and Perception on Telemedicine among Family Medicine Resident Physicians in Different Training Institutions in Cebu City, PH during COVID-19 Pandemic

Authors: Kristine Joy Y. Sumanga, Clarissa Mae D. Derecho

Abstract:

Telemedicine is providing health care services using electronic means at a distance, including the diagnosis, treatment, and prevention of diseases as well as the research and evaluation and education of health care providers. The role of telemedicine in this time of the COVID-19 pandemic is vital, especially in the practice of medicine. General Objective: To determine the extent of knowledge, preparedness and perception of telemedicine among Family Medicine Resident Physicians in different training institutions in Cebu City during the Coronavirus Disease 19 pandemic. Methods: A descriptive, cross-sectional survey research study was conducted in four hospital training institutions in Cebu City. A total of 41 respondents gave their consent and were given the online survey questionnaire pertaining to the extent of knowledge, preparedness and perceptions on telemedicine, including respondents’ demographic data and problems encountered in Telemedicine. Results: Out of the 41 respondents, 56.10% were young adults (26 to 30 years old), mostly females (70.73%), single (68.29%), first-year residents (43.90%), employed at a government hospital (70.73%) and are in the traditional residency pathway (82.93%). On relevant experience, 82.93% experienced telemedicine during residency, with 100% on follow-up consultations, and 95% were consulted due to infections. Respondents’ extent of knowledge was average, while the extent of preparedness and perception were great. Problems with low connectivity (80.48%) were noted by most of the respondents. Conclusion: Resident physicians moderately understood the information about telemedicine but with a great extent of preparedness and perception. They are always prepared for telemedicine modality because they are fully aware of its existence and need in the delivery of health care services among their patients at the time of the pandemic. Challenges to low connectivity and handling patients’ data privacy were the major concerns met by the resident physicians in the use of telemedicine.

Keywords: telemedicine, knowledge, preparedness, perception, family medicine, residents, COVID 19

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1381 A Phenomenological Analysis of LBTQI+ Women’s Identification and Disidentification Processes through Walking Interviews in Montreal

Authors: Tara Chanady

Abstract:

Through 21 walking interviews with women from various backgrounds and positionalities, this study examines issues of identity politics in Montreal’s sociocultural space. The research looks at the social, political and economical implications of claiming or refusing identifications amongst women of sexual diversity (e.g. defining as lesbian, queer, bi, pan, fluid or not wanting to identity). The results are analysed from a phenomenological perspective, paying attention to the participants personal interpretations and perspectives, as well as contextualising the interviews in time and space. Using intersectional insights, this study pays attention to varying social positions, including immigration status (newly immigrated, rural to city immigration, Montreal-born, seeking asylum), age (20 to 80), gender (cis, trans and intersex women), relationship style (monogamous and polyamorous) and class. Preliminary findings include a generational shift in issues (e.g. community politics within lesbian communities in the 1980s), varying perspectives on the need of exclusive and safe spaces, shifts in issues of racism and transphobia and identifying points of tensions within conceptualisations of queer and lesbian positionalities.

Keywords: identifications, lesbian, queer, sexual orientation

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