Search results for: typical disease
Commenced in January 2007
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Edition: International
Paper Count: 596

Search results for: typical disease

26 Chikungunya Protease Domain–High Throughput Virtual Screening

Authors: Surender Singh Jadav, Venkatesan Jayaprakash, Arijit Basu, Barij Nayan Sinha

Abstract:

Chikungunya virus (CHICKV) is an arboviruses belonging to family Tagoviridae and is transmitted to human through by mosquito (Aedes aegypti and Aedes albopictus) bite. A large outbreak of chikungunya has been reported in India between 2006 and 2007, along with several other countries from South-East Asia and for the first time in Europe. It was for the first time that the CHICKV outbreak has been reported with mortality from Reunion Island and increased mortality from Asian countries. CHICKV affects all age groups, and currently there are no specific drugs or vaccine to cure the disease. The need of antiviral agents for the treatment of CHICKV infection and the success of virtual screening against many therapeutically valuable targets led us to carry out the structure based drug design against Chikungunya nSP2 protease (PDB: 3TRK). Highthroughput virtual screening of publicly available databases, ZINC12 and BindingDB, has been carried out using the Openeye tools and Schrodinger LLC software packages. Openeye Filter program has been used to filter the database and the filtered outputs were docked using HTVS protocol implemented in GLIDE package of Schrodinger LLC. The top HITS were further used for enriching the similar molecules from the database through vROCS; a shape based screening protocol implemented in Openeye. The approach adopted has provided different scaffolds as HITS against CHICKV protease. Three scaffolds: Indole, Pyrazole and Sulphone derivatives were selected based on the docking score and synthetic feasibility. Derivatives of Pyrazole were synthesized and submitted for antiviral screening against CHICKV.

Keywords: Chikungunya, nsP2 protease, ADME filter, HTVS, Docking, Active site.

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25 Determination of in Vitro Susceptibility of the Typhoid Pathogens to Synergistic Action of Euphorbia Hirta, Euphorbia Heterophylla and Phyllanthus Niruri for Possible Development of Effective Anti-Typhoid Drugs

Authors: Abalaka, M. E., Daniyan, S. Y., Adeyemo, S. O.

Abstract:

Studies were carried out to determine the in vitro susceptibility of the typhoid pathogens to combined action of Euphorbia hirta, Euphorbia heterophylla and Phyllanthus niruri. Clinical isolates of the typhoid bacilli were subjected to susceptibility testing using agar diffusion technique and the minimum inhibitory concentration (MIC) determined with tube dilution technique. These isolates, when challenged with doses of the extracts from the three medicinal plants showed zones of inhibition as wide as 26±0.2mm, 22±0.1mm and 18±0.0mm respectively. The minimum inhibitory concentration (MIC) revealed organisms inhibited at varying concentrations of extracts: E. hirta (S. typhi 0.250mg/ml, S. paratyphi A 0.125mg/ml, S. paratyphi B 0.185mg/ml and S. paratyphi C 0.225mg/ml), E. heterophylla (S. typhi 0.280mg/ml, S. paratyphi A 0.150mg/ml, S. paratyphi B 0.200mg/ml and S. paratyphi C 0.250mg/ml) and P. niruri (S. typhi 0.150mg/ml, S. paratyphi A 0.100mg/ml, S. paratyphi B 0.115mg/ml and S. paratyphi C 0.125mg/ml). The results of the synergy between the three plants in the ration of 1:1:1 showed very low MICs for the test pathogens as follows S. typhi 0.025mg/ml, S. paratyphi A 0.080mg/ml, S. paratyphi B 0.015mg/ml and S. paratyphi C 0.10mg/ml with the diameter zone of inhibition (DZI) ranging from 35±0.2mm, 28±0.4mm, 20±0.1mm and 32±0.3mm respectively. The secondary metabolites were identified using simple methods and HPLC. Organic components such as anthroquinones, different alkaloids, tannins, 6-ethoxy-1,2,3,4-tetrahydro-2,2,4-trimethyl and steroids were identified. The prevalence of Salmonellae, a deadly infectious disease, is still very high in parts of Nigeria. The synergistic action of these three plants is very high. It is concluded that pharmaceutical companies should take advantage of these findings to develop new anti-typhoid drugs from these plants.

Keywords: A Prevalence, Susceptibility, Synergistic, Typhoid pathogens.

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24 Statistical Optimization of Adsorption of a Harmful Dye from Aqueous Solution

Authors: M. Arun, A. Kannan

Abstract:

Textile industries cater to varied customer preferences and contribute substantially to the economy. However, these textile industries also produce a considerable amount of effluents. Prominent among these are the azo dyes which impart considerable color and toxicity even at low concentrations. Azo dyes are also used as coloring agents in food and pharmaceutical industry. Despite their applications, azo dyes are also notorious pollutants and carcinogens. Popular techniques like photo-degradation, biodegradation and the use of oxidizing agents are not applicable for all kinds of dyes, as most of them are stable to these techniques. Chemical coagulation produces a large amount of toxic sludge which is undesirable and is also ineffective towards a number of dyes. Most of the azo dyes are stable to UV-visible light irradiation and may even resist aerobic degradation. Adsorption has been the most preferred technique owing to its less cost, high capacity and process efficiency and the possibility of regenerating and recycling the adsorbent. Adsorption is also most preferred because it may produce high quality of the treated effluent and it is able to remove different kinds of dyes. However, the adsorption process is influenced by many variables whose inter-dependence makes it difficult to identify optimum conditions. The variables include stirring speed, temperature, initial concentration and adsorbent dosage. Further, the internal diffusional resistance inside the adsorbent particle leads to slow uptake of the solute within the adsorbent. Hence, it is necessary to identify optimum conditions that lead to high capacity and uptake rate of these pollutants. In this work, commercially available activated carbon was chosen as the adsorbent owing to its high surface area. A typical azo dye found in textile effluent waters, viz. the monoazo Acid Orange 10 dye (CAS: 1936-15-8) has been chosen as the representative pollutant. Adsorption studies were mainly focused at obtaining equilibrium and kinetic data for the batch adsorption process at different process conditions. Studies were conducted at different stirring speed, temperature, adsorbent dosage and initial dye concentration settings. The Full Factorial Design was the chosen statistical design framework for carrying out the experiments and identifying the important factors and their interactions. The optimum conditions identified from the experimental model were validated with actual experiments at the recommended settings. The equilibrium and kinetic data obtained were fitted to different models and the model parameters were estimated. This gives more details about the nature of adsorption taking place. Critical data required to design batch adsorption systems for removal of Acid Orange 10 dye and identification of factors that critically influence the separation efficiency are the key outcomes from this research.

Keywords: Acid Orange 10, Activated carbon, Optimum conditions, Statistical design.

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23 Seismic Response of Reinforced Concrete Buildings: Field Challenges and Simplified Code Formulas

Authors: Michel Soto Chalhoub

Abstract:

Building code-related literature provides recommendations on normalizing approaches to the calculation of the dynamic properties of structures. Most building codes make a distinction among types of structural systems, construction material, and configuration through a numerical coefficient in the expression for the fundamental period. The period is then used in normalized response spectra to compute base shear. The typical parameter used in simplified code formulas for the fundamental period is overall building height raised to a power determined from analytical and experimental results. However, reinforced concrete buildings which constitute the majority of built space in less developed countries pose additional challenges to the ones built with homogeneous material such as steel, or with concrete under stricter quality control. In the present paper, the particularities of reinforced concrete buildings are explored and related to current methods of equivalent static analysis. A comparative study is presented between the Uniform Building Code, commonly used for buildings within and outside the USA, and data from the Middle East used to model 151 reinforced concrete buildings of varying number of bays, number of floors, overall building height, and individual story height. The fundamental period was calculated using eigenvalue matrix computation. The results were also used in a separate regression analysis where the computed period serves as dependent variable, while five building properties serve as independent variables. The statistical analysis shed light on important parameters that simplified code formulas need to account for including individual story height, overall building height, floor plan, number of bays, and concrete properties. Such inclusions are important for reinforced concrete buildings of special conditions due to the level of concrete damage, aging, or materials quality control during construction. Overall results of the present analysis show that simplified code formulas for fundamental period and base shear may be applied but they require revisions to account for multiple parameters. The conclusion above is confirmed by the analytical model where fundamental periods were computed using numerical techniques and eigenvalue solutions. This recommendation is particularly relevant to code upgrades in less developed countries where it is customary to adopt, and mildly adapt international codes. We also note the necessity of further research using empirical data from buildings in Lebanon that were subjected to severe damage due to impulse loading or accelerated aging. However, we excluded this study from the present paper and left it for future research as it has its own peculiarities and requires a different type of analysis.

Keywords: Seismic behavior, reinforced concrete, simplified code formulas, equivalent static analysis, base shear, response spectra.

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22 Validation on 3D Surface Roughness Algorithm for Measuring Roughness of Psoriasis Lesion

Authors: M.H. Ahmad Fadzil, Esa Prakasa, Hurriyatul Fitriyah, Hermawan Nugroho, Azura Mohd Affandi, S.H. Hussein

Abstract:

Psoriasis is a widespread skin disease affecting up to 2% population with plaque psoriasis accounting to about 80%. It can be identified as a red lesion and for the higher severity the lesion is usually covered with rough scale. Psoriasis Area Severity Index (PASI) scoring is the gold standard method for measuring psoriasis severity. Scaliness is one of PASI parameter that needs to be quantified in PASI scoring. Surface roughness of lesion can be used as a scaliness feature, since existing scale on lesion surface makes the lesion rougher. The dermatologist usually assesses the severity through their tactile sense, therefore direct contact between doctor and patient is required. The problem is the doctor may not assess the lesion objectively. In this paper, a digital image analysis technique is developed to objectively determine the scaliness of the psoriasis lesion and provide the PASI scaliness score. Psoriasis lesion is modelled by a rough surface. The rough surface is created by superimposing a smooth average (curve) surface with a triangular waveform. For roughness determination, a polynomial surface fitting is used to estimate average surface followed by a subtraction between rough and average surface to give elevation surface (surface deviations). Roughness index is calculated by using average roughness equation to the height map matrix. The roughness algorithm has been tested to 444 lesion models. From roughness validation result, only 6 models can not be accepted (percentage error is greater than 10%). These errors occur due the scanned image quality. Roughness algorithm is validated for roughness measurement on abrasive papers at flat surface. The Pearson-s correlation coefficient of grade value (G) of abrasive paper and Ra is -0.9488, its shows there is a strong relation between G and Ra. The algorithm needs to be improved by surface filtering, especially to overcome a problem with noisy data.

Keywords: psoriasis, roughness algorithm, polynomial surfacefitting.

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21 Multiple Organ Manifestation in Neonatal Lupus Erythematous (Report of Two Cases)

Authors: Lubis A., Widayanti R., Hikmah Z., Endaryanto A., Harsono A., Harianto A., Etika R., Handayani D. K., Sampurna M.

Abstract:

Neonatal lupus erythematous (NLE) is a rare disease marked by clinical characteristic and specific maternal autoantibody. Many cutaneous, cardiac, liver, and hematological manifestations could happen with affect of one organ or multiple. In this case, both babies were premature, low birth weight (LBW), small for gestational age (SGA) and born through caesarean section from a systemic lupus erythematous (SLE) mother. In the first case, we found a baby girl with dyspnea and grunting. Chest X ray showed respiratory distress syndrome (RDS) great I and echocardiography showed small atrial septal defect (ASD) and ventricular septal defect (VSD). She also developed anemia, thrombocytopenia, elevated C-reactive protein, hypoalbuminemia, increasing coagulation factors, hyperbilirubinemia, and positive blood culture of Klebsiella pneumonia. Anti-Ro/SSA and Anti-nRNP/sm were positive. Intravenous fluid, antibiotic, transfusion of blood, thrombocyte concentrate, and fresh frozen plasma were given. The second baby, male presented with necrotic tissue on the left ear and skin rashes, erythematous macula, athropic scarring, hyperpigmentation on all of his body with various size and facial haemorrhage. He also suffered from thrombocytopenia, mild elevated transaminase enzyme, hyperbilirubinemia, anti-Ro/SSA was positive. Intravenous fluid, methyprednisolone, intravenous immunoglobulin (IVIG), blood, and thrombocyte concentrate transfution were given. Two cases of neonatal lupus erythematous had been presented. Diagnosis based on clinical presentation and maternal auto antibody on neonate. Organ involvement in NLE can occur as single or multiple manifestations.

Keywords: Neonatus lupus erythematous, maternal autoantibody, clinical characteristic.

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20 Identification of Complex Sense-antisense Gene's Module on 17q11.2 Associated with Breast Cancer Aggressiveness and Patient's Survival

Authors: O. Grinchuk, E. Motakis, V. Kuznetsov

Abstract:

Sense-antisense gene pair (SAGP) is a pair of two oppositely transcribed genes sharing a common region on a chromosome. In the mammalian genomes, SAGPs can be organized in more complex sense-antisense gene architectures (CSAGA) in which at least one gene could share loci with two or more antisense partners. Many dozens of CSAGAs can be found in the human genome. However, CSAGAs have not been systematically identified and characterized in context of their role in human diseases including cancers. In this work we characterize the structural-functional properties of a cluster of 5 genes –TMEM97, IFT20, TNFAIP1, POLDIP2 and TMEM199, termed TNFAIP1 / POLDIP2 module. This cluster is organized as CSAGA in cytoband 17q11.2. Affymetrix U133A&B expression data of two large cohorts (410 atients, in total) of breast cancer patients and patient survival data were used. For the both studied cohorts, we demonstrate (i) strong and reproducible transcriptional co-regulatory patterns of genes of TNFAIP1/POLDIP2 module in breast cancer cell subtypes and (ii) significant associations of TNFAIP1/POLDIP2 CSAGA with amplification of the CSAGA region in breast cancer, (ii) cancer aggressiveness (e.g. genetic grades) and (iv) disease free patient-s survival. Moreover, gene pairs of this module demonstrate strong synergetic effect in the prognosis of time of breast cancer relapse. We suggest that TNFAIP1/ POLDIP2 cluster can be considered as a novel type of structural-functional gene modules in the human genome.

Keywords: Sense-antisense gene pair, complex genome architecture, TMEM97, IFT20, TNFAIP1, POLDIP2, TMEM199, 17q11.2, breast cancer, transcription regulation, survival analysis, prognosis.

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19 Effect of Dietary Supplementation of Different Levels of Black Seed (Nigella Sativa L.) on Growth Performance, Immunological, Hematological and Carcass Parameters of Broiler Chicks

Authors: R. S. Shewita, A. E. Taha

Abstract:

This experiment was conducted to investigate the effect of dietary supplementation of different levels of black seed (Nigella sativa L.) on the performance and immune response of broiler chicks. A total 240 day-old broiler chicks were used and randomly allotted equally into six experimental groups designated as 1, 2, 3, 4, 5 and 6 having black seed at the rate of 0, 2, 4, 6, 8 and 10 g /kg diet respectively. The study was lasted for 42 days. Average body weight, weight gain, relative growth rate, feed conversion, antibody titer against Newcastle disease, phagocytic activity and phagocytic index, some blood parameters(GOT, GPT, Glucose, Cholesterol, Triglyceride, Total protein, Albumen, WBCs, RBCs, Hb and PCV), dressing percentage, weight of different body organs, abdominal fat weight, were determined. It was found that, N. Sativa significantly improved final body weight, total body gain and feed conversion ratio of groups 2 and 3 when compared with the control group. Higher levels of N. Sativa did not improve growth performance of the chicks. Non significant differences were observed for antibody titer against Newcastle virus, WBCs count, serum GOT, glucose level, dressing %, relative liver, spleen, heart and head percentages. Lymphoid organs (Bursa and Thymus) improved significantly with increasing N. Sativa level in all supplemented groups. Serum cholesterol, triglyceride and visible fat % significantly decreased with Nigella sativa supplementation while serum GPT level significantly increased with nigella sativa supplementation.

Keywords: Nigella Sativa, broiler, growth, carcass traits, serum, blood

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18 Ports and Airports: Gateways to Vector-Borne Diseases in Portugal Mainland

Authors: Maria C. Proença, Maria T. Rebelo, Maria J. Alves, Sofia Cunha

Abstract:

Vector-borne diseases are transmitted to humans by mosquitos, sandflies, bugs, ticks, and other vectors. Some are re-transmitted between vectors, if the infected human has a new contact when his levels of infection are high. The vector is infected for lifetime and can transmit infectious diseases not only between humans but also from animals to humans. Some vector borne diseases are very disabling and globally account for more than one million deaths worldwide. The mosquitoes from the complex Culex pipiens sl. are the most abundant in Portugal, and we dispose in this moment of a data set from the surveillance program that has been carried on since 2006 across the country. All mosquitos’ species are included, but the large coverage of Culex pipiens sl. and its importance for public health make this vector an interesting candidate to assess risk of disease amplification. This work focus on ports and airports identified as key areas of high density of vectors. Mosquitoes being ectothermic organisms, the main factor for vector survival and pathogen development is temperature. Minima and maxima local air temperatures for each area of interest are averaged by month from data gathered on a daily basis at the national network of meteorological stations, and interpolated in a geographic information system (GIS). The range of temperatures ideal for several pathogens are known and this work shows how to use it with the meteorological data in each port and airport facility, to focus an efficient implementation of countermeasures and reduce simultaneously risk transmission and mitigation costs. The results show an increased alert with decreasing latitude, which corresponds to higher minimum and maximum temperatures and a lower amplitude range of the daily temperature.

Keywords: Human health, risk assessment, risk management, vector-borne diseases.

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17 TNFRSF11B Gene Polymorphisms A163G and G11811C in Prediction of Osteoporosis Risk

Authors: Boroňová I., Bernasovská J., Kľoc J., Tomková Z., Petrejčíková E., Gabriková D., Mačeková S.

Abstract:

Osteoporosis is a complex health disease characterized by low bone mineral density, which is determined by an interaction of genetics with metabolic and environmental factors. Current research in genetics of osteoporosis is focused on identification of responsible genes and polymorphisms. TNFRSF11B gene plays a key role in bone remodeling. The aim of this study was to investigate the genotype and allele distribution of A163G (rs3102735) osteoprotegerin gene promoter and G1181C (rs2073618) osteoprotegerin first exon polymorphisms in the group of 180 unrelated postmenopausal women with diagnosed osteoporosis and 180 normal controls. Genomic DNA was isolated from peripheral blood leukocytes using standard methodology. Genotyping for presence of different polymorphisms was performed using the Custom Taqman®SNP Genotyping assays. Hardy-Weinberg equilibrium was tested for each SNP in the groups of participants using the chi-square (χ2) test. The distribution of investigated genotypes in the group of patients with osteoporosis were as follows: AA (66.7%), AG (32.2%), GG (1.1%) for A163G polymorphism; GG (19.4%), CG (44.4%), CC (36.1%) for G1181C polymorphism. The distribution of genotypes in normal controls were follows: AA (71.1%), AG (26.1%), GG (2.8%) for A163G polymorphism; GG (22.2%), CG (48.9%), CC (28.9%) for G1181C polymorphism. In A163G polymorphism the variant G allele was more common among patients with osteoporosis: 17.2% versus 15.8% in normal controls. Also, in G1181C polymorphism the phenomenon of more frequent occurrence of C allele in the group of patients with osteoporosis was observed (58.3% versus 53.3%). Genotype and allele distributions showed no significant differences (A163G: χ2=0.270, p=0.605; χ2=0.250, p=0.616; G1181C: χ2= 1.730, p=0.188; χ2=1.820, p=0.177). Our results represents an initial study, further studies of more numerous file and associations studies will be carried out. Knowing the distribution of genotypes is important for assessing the impact of these polymorphisms on various parameters associated with osteoporosis. Screening for identification of “at-risk” women likely to develop osteoporosis and initiating subsequent early intervention appears to be most effective strategy to substantially reduce the risks of osteoporosis.

Keywords: Osteoporosis, Real-time PCR method, SNP polymorphisms.

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16 In vitro and in vivo Anticholinesterase Activity of the Volatile Oil of the Aerial Parts of Ocimum basilicum L. and O. africanum Lour. Growing in Egypt

Authors: M. G. Tadros, S. M. Ezzat, M. M. Salama, M. A. Farag

Abstract:

In this study, the in vitro anticholinesterase activity of
the volatile oils of both O. basilicum and O. africanum was
investigated and both samples showed significant activity. The major
constituents of the two oils were isolated using several column
chromatographies. Linalool, 1,8-cineol and eugenol were isolated
from the volatile oil of O. basilicum and camphor was isolated from
the volatile oil of O. africanum. The anticholinesterase activities of
the isolated compounds were also evaluated where 1,8-cineol showed
the highest inhibitory activity followed by camphor. To confirm these
activities, learning and memory enhancing effects were tested in
mice. Memory impairment was induced by scopolamine, a
cholinergic muscarinic receptor antagonist. Anti-amnesic effects of
both volatile oils and their terpenoids were investigated by the
passive avoidance task in mice. We also examined their effects on
brain acetylcholinesterase activity. Results showed that scopolamineinduced
cognitive dysfunction was significantly attenuated by
administration of the volatile oils and their terpenoids, eugenol and
camphor, in the passive avoidance task and inhibited brain
acetylcholinesterase activity. These results suggest that O. basilicum
and O. africanum volatile oils can be good candidates for further
studies on Alzheimer’s disease via their acetylcholinesterase
inhibitory actions.

Keywords: Acetylcholinesterase, Ocimum africanum, Ocimum basilicum, passive avoidance.

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15 Challenges of Irrigation Water Supply in Croplands of Arid Regions and their Environmental Consequences – A Case Study in the Dez and Moghan Command Areas of Iran

Authors: Lobat Taghavi, Najaf Hedayat

Abstract:

Renewable water resources are crucial production variables in arid and semi-arid regions where intensive agriculture is practiced to meet ever-increasing demand for food and fiber. This is crucial for the Dez and Moghan command areas where water delivery problems and adverse environmental issues are widespread. This paper aims to identify major problems areas using on-farm surveys of 200 farmers, agricultural extensionists and water suppliers which was complemented by secondary data and field observations during 2010- 2011 cultivating season. The SPSS package was used to analyze and synthesis data. Results indicated inappropriate canal operations in both schemes, though there was no unanimity about the underlying causes. Inequitable and inflexible distribution was found to be rooted in deficient hydraulic structures particularly in the main and secondary canals. The inadequacy and inflexibility of water scheduling regime was the underlying causes of recurring pest and disease spread which often led to the decline of crop yield and quality, although these were not disputed, the water suppliers were not prepared to link with the deficiencies in the operation of the main and secondary canals. They rather attributed these to the prevailing salinity; alkalinity, water table fluctuations and leaching of the valuable agro-chemical inputs from the plants- route zone with farreaching consequences. Examples of these include the pollution of ground and surface resources due to over-irrigation at the farm level which falls under the growers- own responsibility. Poor irrigation efficiency and adverse environmental problems were attributed to deficient and outdated farming practices that were in turn rooted in poor extension programs and irrational water charges.

Keywords: water delivery, inequity, inflexibility, conflicts, environmental impact, Dez and Moghan

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14 Heart Rate Variability Analysis for Early Stage Prediction of Sudden Cardiac Death

Authors: Reeta Devi, Hitender Kumar Tyagi, Dinesh Kumar

Abstract:

In present scenario, cardiovascular problems are growing challenge for researchers and physiologists. As heart disease have no geographic, gender or socioeconomic specific reasons; detecting cardiac irregularities at early stage followed by quick and correct treatment is very important. Electrocardiogram is the finest tool for continuous monitoring of heart activity. Heart rate variability (HRV) is used to measure naturally occurring oscillations between consecutive cardiac cycles. Analysis of this variability is carried out using time domain, frequency domain and non-linear parameters. This paper presents HRV analysis of the online dataset for normal sinus rhythm (taken as healthy subject) and sudden cardiac death (SCD subject) using all three methods computing values for parameters like standard deviation of node to node intervals (SDNN), square root of mean of the sequences of difference between adjacent RR intervals (RMSSD), mean of R to R intervals (mean RR) in time domain, very low-frequency (VLF), low-frequency (LF), high frequency (HF) and ratio of low to high frequency (LF/HF ratio) in frequency domain and Poincare plot for non linear analysis. To differentiate HRV of healthy subject from subject died with SCD, k –nearest neighbor (k-NN) classifier has been used because of its high accuracy. Results show highly reduced values for all stated parameters for SCD subjects as compared to healthy ones. As the dataset used for SCD patients is recording of their ECG signal one hour prior to their death, it is therefore, verified with an accuracy of 95% that proposed algorithm can identify mortality risk of a patient one hour before its death. The identification of a patient’s mortality risk at such an early stage may prevent him/her meeting sudden death if in-time and right treatment is given by the doctor.

Keywords: Early stage prediction, heart rate variability, linear and non linear analysis, sudden cardiac death.

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13 Morphology and Risk Factors for Blunt Aortic Trauma in Car Accidents - An Autopsy Study

Authors: Ticijana Prijon, Branko Ermenc

Abstract:

Background: Blunt aortic trauma (BAT) includes various morphological changes that occur during deceleration, acceleration and/or body compression in traffic accidents. The various forms of BAT, from limited laceration of the intima to complete transection of the aorta, depends on the force acting on the vessel wall and the tolerance of the aorta to injury. The force depends on the change in velocity, the dynamics of the accident and of the seating position in the car. Tolerance to aortic injury depends on the anatomy, histological structure and pathomorphological alterations due to aging or disease of the aortic wall. An overview of the literature and medical documentation reveals that different terms are used to describe certain forms of BAT, which can lead to misinterpretation of findings or diagnoses. We therefore, propose a classification that would enable uniform systematic screening of all forms of BAT. We have classified BAT into three morphologycal types: TYPE I (intramural), TYPE II (transmural) and TYPE III (multiple) aortic ruptures with appropriate subtypes. Methods: All car accident casualties examined at the Institute of Forensic Medicine from 2001 to 2009 were included in this retrospective study. Autopsy reports were used to determine the occurrence of each morphological type of BAT in deceased drivers, front seat passengers and other passengers in cars and to define the morphology of BAT in relation to the accident dynamics and the age of the fatalities. Results: A total of 391 fatalities in car accidents were included in the study. TYPE I, TYPE II and TYPE III BAT were observed in 10,9%, 55,6% and 33,5%, respectively. The incidence of BAT in drivers, front seat and other passengers was 36,7%, 43,1% and 28,6%, respectively. In frontal collisions, the incidence of BAT was 32,7%, in lateral collisions 54,2%, and in other traffic accidents 29,3%. The average age of fatalities with BAT was 42,8 years and of those without BAT 39,1 years. Conclusion: Identification and early recognition of the risk factors of BAT following a traffic accident is crucial for successful treatment of patients with BAT. Front seat passengers over 50 years of age who have been injured in a lateral collision are the most at risk of BAT.

Keywords: Aorta, blunt trauma, car accidents, morphology, risk factors.

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12 Effects of Four Dietary Oils on Cholesterol and Fatty Acid Composition of Egg Yolk in Layers

Authors: A. F. Agboola, B. R. O. Omidiwura, A. Oyeyemi, E. A. Iyayi, A. S. Adelani

Abstract:

Dietary cholesterol has elicited the most public interest as it relates with coronary heart disease. Thus, humans have been paying more attention to health, thereby reducing consumption of cholesterol enriched food. Egg is considered as one of the major sources of human dietary cholesterol. However, an alternative way to reduce the potential cholesterolemic effect of eggs is to modify the fatty acid composition of the yolk. The effect of palm oil (PO), soybean oil (SO), sesame seed oil (SSO) and fish oil (FO) supplementation in the diets of layers on egg yolk fatty acid, cholesterol, egg production and egg quality parameters were evaluated in a 42-day feeding trial. One hundred and five Isa Brown laying hens of 34 weeks of age were randomly distributed into seven groups of five replicates and three birds per replicate in a completely randomized design. Seven corn-soybean basal diets (BD) were formulated: BD+No oil (T1), BD+1.5% PO (T2), BD+1.5% SO (T3), BD+1.5% SSO (T4), BD+1.5% FO (T5), BD+0.75% SO+0.75% FO (T6) and BD+0.75% SSO+0.75% FO (T7). Five eggs were randomly sampled at day 42 from each replicate to assay for the cholesterol, fatty acid profile of egg yolk and egg quality assessment. Results showed that there were no significant (P>0.05) differences observed in production performance, egg cholesterol and egg quality parameters except for yolk height, albumen height, yolk index, egg shape index, haugh unit, and yolk colour. There were no significant differences (P>0.05) observed in total cholesterol, high density lipoprotein and low density lipoprotein levels of egg yolk across the treatments. However, diets had effect (P<0.05) on TAG (triacylglycerol) and VLDL (very low density lipoprotein) of the egg yolk. The highest TAG (603.78 mg/dl) and VLDL values (120.76 mg/dl) were recorded in eggs of hens on T4 (1.5% sesame seed oil) and was similar to those on T3 (1.5% soybean oil), T5 (1.5% fish oil) and T6 (0.75% soybean oil + 0.75% fish oil). However, results revealed a significant (P<0.05) variations on eggs’ summation of polyunsaturated fatty acid (PUFA). In conclusion, it is suggested that dietary oils could be included in layers’ diets to produce designer eggs low in cholesterol and high in PUFA especially omega-3 fatty acids.

Keywords: Dietary oils, Egg cholesterol, Egg fatty acid profile, Egg quality parameters.

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11 A Perspective Study of Asthma and its Control in Assam (India)

Authors: S. Vijayakumar, M. Sasikala, T. S. Mohammed Saleem, Gurusharan, K. Gauthaman

Abstract:

The main objective of our study is to collect data about the profile of the asthmatic patients in Assam and thereby have a comprehensive knowledge of the factors influencing the asthmatic patients of the state and their medication pattern. We developed a search strategy to find any publication about the community based survey asthma related and used. These to search the MEDLINE (1996 to current literature) CINAHL DOAJ pubmed databases using the key phrases, Asthma, Respiratory disorders, Drug therapy of Asthma, database decision support system and asthma. The appropriate literature was printed out from the online source and library (Journal) source. The study was conducted through a set of structured and non-structured questionnaires targeted on the asthmatic patients belonging to the rural and urban areas of Assam, during the month of Dec 2006 to July 2007, 138 cases were studied in Gauwathi Medical College & Hospital located in Bhangagarh, Assam in India. The demographic characteristics a factor in 138 patients with asthma with allergic rhinitis (cases) gives the detail profile of asthmatic patient-s distribution of Assam as classified on the basis of age and sex. It is evident from the study that male populations (66%) are more prone to asthma as compared to the females (34%).Another striking features that emerged from this survey is the maximum prevalence of asthma in the age group of 20- 30 years followed by infants belonging to the age group of 7 (0.05%) 0-10years among both male and female populations of Assam. The high incidence of asthma in the age group of 20-30 years may probably be due to the allergy arising out of sudden exposure to dust and pollen which the children face while playing and going to the school. The rural females in the age group of 30-40 years are more prone to asthma than urban females in the same age group may be due to sex differentiation among the tribal population of the state. Pharmacists should educate the asthmatics how to use inhalers considering growing menace of asthma in the state. Safer drugs should be produced in the form of aerosol so that easy administration by the asthmatic patients and physicians of the state is possible for curing asthma. The health centers should be more equipped with the medicines to cure asthma in the state like Assam.

Keywords: Asthma, Respiratory disease, Smoker.

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10 Deterioration of Groundwater in Arid Environments: What Impact in Oasis Dynamics? Case Study of Tafilalet, Morocco

Authors: W. EL Khoumsi, A. Hammani, M. Kuper, A. Bouaziz

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Oases are complex and fragile agro-ecosystems. They have always existed in environments characterized by an arid climate, scarcity of rainfall, high temperatures and high evaporation. These palms have grown up despite the severity of the physical characteristics thanks to the water's existence and irrigation practice. The oases are generally spread along non-perennial rivers (wadis), shallow water table or deep artesian groundwater. However, the sustainability of oasis system is threatened by water scarcity and declining of water table levels particularly in arid areas. Located in the southern east area of Morocco, Tafilalet plain encompasses one of the largest palm groves in the kingdom. In recent years, this area has become increasingly threatened by water shortage and has seen a sharp deterioration under the effect of several combined anthropogenic and climatic factors. The Bayoud disease, successive years of drought, Hassan Addakhil dam construction etc are all factors that have affected both water and phoenicicole heritage of the area. The objective of this study is to understand the interaction between qualitative and quantitative degradation of groundwater resources, and the palm grove dynamics, while reviewing the assumption that groundwater resources contribute in a direct way to the conservation of this oasis agroecosystem. A historical analysis tracing both the oasis dynamics and the groundwater evolution has been established. Data were collected from satellite images, surveys with different actors (farmers, Regional Office for Agricultural Development, Basin agency...). They were complemented by a synthesis of numerous technical reports in the area. The results showed that within 40 years, the thickness of the groundwater table has dropped in 50 %. Along with this, there has been a downsizing of date palm by 50 %. Areas with higher groundwater level were the least affected by the downsizing. So we can say that the shallow groundwater contribute significantly and directly to the water supply of date palm through its root system, and largely ensures the oasis ecosystem sustainability.

Keywords: Oasis dynamics, Arid environments, Groundwater deterioration, Date palm.

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9 Brazilian Constitution and the Fundamental Right to Sanitation

Authors: Michely Vargas Delpupo, José Geraldo Romanello Bueno

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The right to basic sanitation, was elevated to the category of fundamental right by the Constitution of 1988 to protect the ecologically balanced environment, ensuring social rights to health and adequate housing and put the dignity of the human person as the foundation of the Brazilian Democratic State. Before their essentiality to humans, this article seeks to understand why universal access to basic sanitation is a goal so difficult to achieve in Brazil. Therefore, this research uses the deductive and analytical method. Given the nature of the research literature, research techniques were centered in specialized books on the subject, journals, theses and dissertations, laws, relevant law case and raising social indicators relating to the theme. The relevance of the topic stems, among other things, the fact that sanitation services are essential for a dignified life, i.e., everyone is entitled to the maintenance of the necessary existence conditions are satisfied. However, the effectiveness of this right is undermined in society, since Brazil has huge deficit in sanitation services, denying thus a worthy life to most of the population. Thus, it can be seen that the provision of water and sewage services in Brazil is still characterized by a large imbalance, since the municipalities with lower population index have greater disability in the sanitation service. The truth is that the precariousness of water and sewage services in Brazil is still very concentrated in the North and Northeast regions, limiting the effective implementation of the Law 11.445/2007 in the country. Therefore, there is urgent need for a positive service by the State in the provision of sanitation services in order to prevent and control disease, improve quality of life and productivity of individuals, besides preventing contamination of water resources. More than just social and economic necessity, there is a government duty to implement such services. In this sense, given the current scenario, to achieve universal access to basic sanitation imposes many hurdles. These are mainly in the field of properly formulated and implemented public policies, i.e., it requires an excellent institutional organization, management services, strategic planning, social control, in order to provide answers to complex challenges.

Keywords: Fundamental rights, sanitation, universal access.

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8 Magnitude and Determinants of Overweight and Obesity among High School Adolescents in Addis Ababa, Ethiopia

Authors: Mulugeta Shegaze, Mekitie Wondafrash, Alemayehu A. Alemayehu, Shikur Mohammed, Zewdu Shewangezaw, Mukerem Abdo, Gebresilasea Gendisha

Abstract:

Background: The 2004 World Health Assembly called for specific actions to halt the overweight and obesity epidemic that is currently penetrating urban populations in the developing world. Adolescents require particular attention due to their vulnerability to develop obesity and the fact that adolescent weight tracks strongly into adulthood. However, there is scarcity of information on the modifiable risk factors to be targeted for primary intervention among urban adolescents in Ethiopia. This study was aimed at determining the magnitude and risk factors of overweight and obesity among high school adolescents in Addis Ababa. Methods: An institution-based cross-sectional study was conducted in February and March 2014 on 456 randomly selected adolescents from 20 high schools in Addis Ababa city.  Demographic data and other risk factors of overweight and obesity were collected using self-administered structured questionnaire, whereas anthropometric measurements of weight and height were taken using calibrated equipment and standardized techniques. The WHO STEPS instrument for chronic disease risk was applied to assess dietary habit and physical activity. Overweight and obesity status was determined based on BMI-for-age percentiles of WHO 2007 reference population. Results: The prevalence rates of overweight, obesity, and overall overweight/ obesity among high school adolescents in Addis Ababa were 9.7% (95%CI = 6.9-12.4%), 4.2% (95%CI = 2.3-6.0%), and 13.9% (95%CI = 10.6-17.1%), respectively. Overweight/obesity prevalence was highest among female adolescents, in private schools, and in the higher wealth category. In multivariable regression model, being female [AOR(95%CI) = 5.4(2.5,12.1)], being from private school [AOR(95%CI) = 3.0(1.4,6.2)], having >3 regular meals [AOR(95%CI) = 4.0(1.3,13.0)], consumption of sweet foods [AOR(95%CI) = 5.0(2.4,10.3)] and spending >3 hours/day sitting [AOR(95%CI) = 3.5(1.7,7.2)] were found to increase overweight/ obesity risk, whereas high Total Physical Activity level [AOR(95%CI) = 0.21(0.08,0.57)] and better nutrition knowledge [AOR(95%CI) = 0.160.07,0.37)] were found protective. Conclusions: More than one in ten of the high school adolescents were affected by overweight/obesity with dietary habit and physical activity are important modifiable risk factors. Well-tailored nutrition education program targeting lifestyle change should be initiated with more emphasis to female adolescents and students in private schools.

Keywords: Adolescents, NCDs, overweight, obesity.

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7 Antioxidative, Anticholinesterase and Anti-Neuroinflammatory Properties of Malaysian Brown and Green Seaweeds

Authors: Siti Aisya Gany, Swee Ching Tan, Sook Yee Gan

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Diminished antioxidant defense or increased production of reactive oxygen species in the biological system can result in oxidative stress which may lead to various neurodegenerative diseases including Alzheimer’s disease (AD). Microglial activation also contributes to the progression of AD by producing several proinflammatory cytokines, nitric oxide (NO) and prostaglandin E2 (PGE2). Oxidative stress and inflammation have been reported to be possible pathophysiological mechanisms underlying AD. In addition, the cholinergic hypothesis postulates that memory impairment in patient with AD is also associated with the deficit of cholinergic function in the brain. Although a number of drugs have been approved for the treatment of AD, most of these synthetic drugs have diverse side effects and yield relatively modest benefits. Marine algae have great potential in pharmaceutical and biomedical applications as they are valuable sources of bioactive properties such as anticoagulation, antimicrobial, antioxidative, anticancer and anti-inflammatory. Hence, this study aimed to provide an overview of the properties of Malaysian seaweeds (Padina australis, Sargassum polycystum and Caulerpa racemosa) in inhibiting oxidative stress, neuroinflammation and cholinesterase enzymes. These seaweeds significantly exhibited potent DPPH and moderate superoxide anion radical scavenging ability (P<0.05). Hexane and methanol extracts of S. polycystum exhibited the most potent radical scavenging ability with IC50 values of 0.157±0.004mg/ml and 0.849±0.02mg/ml for DPPH and ABTS assays, respectively. Hexane extract of C. racemosa gave the strongest superoxide radical inhibitory effect (IC50 of 0.386±0.01mg/ml). Most seaweed extracts significantly inhibited the production of cytokine (IL-6, IL-1 β, TNFα) and NO in a concentration-dependent manner without causing significant cytotoxicity to the lipopolysaccharide (LPS)-stimulated microglia cells (P<0.05). All extracts suppressed cytokine and NO level by more than 50% at the concentration of 0.4mg/ml. In addition, C. racemosa and S. polycystum also showed anti-acetylcholinesterase activities with the IC50 values ranging from 0.086-0.115 mg/ml. Moreover, C. racemosa and P. australis were also found to be active against butyrylcholinesterase with IC50 values ranging from 0.118- 0.287 mg/ml.

Keywords: Anticholinesterase, antioxidative, neuroinflammation, seaweeds.

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6 Physicians’ Knowledge and Perception of Gene Profiling in Malaysia

Authors: Farahnaz Amini, Woo Yun Kin, Lazwani Kolandaiveloo

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Availability of different genetic tests after completion of Human Genome Project increases the physicians’ responsibility to keep themselves update on the potential implementation of these genetic tests in their daily practice. However, due to numbers of barriers, still many of physicians are not either aware of these tests or are not willing to offer or refer their patients for genetic tests. This study was conducted an anonymous, cross-sectional, mailed-based survey to develop a primary data of Malaysian physicians’ level of knowledge and perception of gene profiling. Questionnaire had 29 questions. Total scores on selected questions were used to assess the level of knowledge. The highest possible score was 11. Descriptive statistics, one way ANOVA and chi-squared test was used for statistical analysis. Sixty three completed questionnaires were returned by 27 general practitioners (GPs) and 36 medical specialists. Responders’ age ranges from 24 to 55 years old (mean 30.2 ± 6.4). About 40% of the participants rated themselves as having poor level of knowledge in genetics in general whilst 60% believed that they have fair level of knowledge; however, almost half (46%) of the respondents felt that they were not knowledgeable about available genetic tests. A majority (94%) of the responders were not aware of any lab or company which is offering gene profiling services in Malaysia. Only 4% of participants were aware of using gene profiling for detection of dosage of some drugs. Respondents perceived greater utility of gene profiling for breast cancer (38%) compared to the colorectal familial cancer (3%). The score of knowledge ranged from 2 to 8 (mean 4.38 ± 1.67). Non- significant differences between score of knowledge of GPs and specialists were observed, with score of 4.19 and 4.58 respectively. There was no significant association between any demographic factors and level of knowledge. However, those who graduated between years 2001 to 2005 had higher level of knowledge. Overall, 83% of participants showed relatively high level of perception on value of gene profiling to detect patient’s risk of disease. However, low perception was observed for both statements of using gene profiling for general population in order to alter their lifestyle (25%) as well as having the full sequence of a patient genome for the purpose of determining a patient’s best match for treatment (18%). The lack of clinical guidelines, limited provider knowledge and awareness, lack of time and resources to educate patients, lack of evidence-based clinical information and cost of tests were the most barriers of ordering gene profiling mentioned by physicians. In conclusion Malaysian physicians who participate in this study had mediocre level of knowledge and awareness in gene profiling. The low exposure to the genetic questions and problems might be a key predictor of lack of awareness and knowledge on available genetic tests. Educational and training workshop might be useful in helping Malaysian physicians incorporate genetic profiling into practice for eligible patients.

Keywords: Gene Profiling, Knowledge, Malaysia, Physician.

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5 Effect of Euphorbia Pulcherrima Leaf and Inflorescence Extract on Various Cytomorphological Parameters of Aspergillus fumigatus

Authors: Arti Goel, Kanika Sharma

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Microorganisms can be removed, inhibited or killed by physical agents, physical processes or chemical agents but they have their inherent disadvantages such as increased resistance against antibiotics etc. Since, plants have endless ability to synthesize aromatic substances which act as the master agents for plant defense mechanisms against microorganisms, insects and herbivores. Thus, secondary metabolites or phytochemicals obtained from plants can be used as agents of disease control nowadays. In the present study effect of different concentrations of acetone fraction of leaves and alcohol fraction of inflorescence of Euphorbia pulcherrima on various cytomorphological parameters i.e. cell number, mycelium width, conidial size, conidiophore size etc. of Aspergillus fumigatus has been studied. Change in mycelium/ hyphal cell width, conidium size, conidiophore size etc. was measured with the help of a previously calibrated oculometer. To study effect on morphology, fungal mycelium along with conidiophore and conidia were stained with cotton blue and mounted in lactophenol and observed microscopically. Inhibitory action of the acetone extract of Euphorbia pulcherrima leaf on growth of Aspergillus fumigatus was investigated. Control containing extract free medium supported profuse growth of the fungus. Although decrease in growth was observed even at 3.95μg/ml but significant inhibition of growth was started at7.81μg/ml concentration of the extract. Complete inhibition was observed at 15.62μg/ml and above. Microscopic examination revealed that at 3.95, 7.81 and 15.62μg/ml extract concentration hyphal cell width was found to be increased from 1.44μm in control to 3.86, 5.24 and 8.98 μm respectively giving a beaded appearance to the mycelium. Vesicle size was reduced from 24.78x20.08μm (control) to 11.34x10.06μm at 3.95μg/ml concentration. At 7.81 and 15.62μg/ml concentration no phialides and sterigmata were observed. Inhibitory action of the alcohol extract of inflorescence on the growth of Aspergillus fumigatus was also studied. Control containing extract free medium supported profuse growth of the fungus. Although decrease in growth was observed even at 3.95μg/ml but complete inhibition was observed at 62.5μg/ml and above. Microscopic examination revealed that hyphal cell width of Aspergillus fumigatus was found to be increased from 1.67μm in control to 5.84μm at MIC i.e. at 62.5μg/ml. Vesicle size was reduced from 44.76x 24.22μm (control) to 11.36x 6.80μm at 15.62μg/ml concentrations. At 31.25 μg/ml and 62.5μg/ml concentration no phialides and sterigmata was found. Spore germination was completely found to be inhibited at 3.95μg/ml concentration. Similarly 92.87% reduction in vesicle size was observed at 15.62μg/ml concentration. It is evident from the results that plant extracts inhibit fungal growth and this inhibition is concentration dependent. 

Keywords: Antimicrobial Activity, Aspergillus fumigatus, cytomorphology, Euphorbia pulcherrima.

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4 Study on Metabolic and Mineral Balance, Oxidative Stress and Cardiovascular Risk Factors in Type 2 Diabetic Patients on Different Therapy

Authors: E. Nemes-Nagy, E. Fogarasi, M. Croitoru, A. Nyárádi, K. Komlódi, S. Pál, A. Kovács, O. Kopácsy, R. Tripon, Z. Fazakas, C. Uzun, Z. Simon-Szabó, V. Balogh-Sămărghițan, E. Ernő Nagy, M. Szabó, M. Tilinca

Abstract:

Intense oxidative stress, increased glycated hemoglobin and mineral imbalance represent risk factors for complications in diabetic patients. Cardiovascular complications are most common in these patients, including nephropathy. This study was conducted in 2015 at the Procardia Laboratory in Tîrgu Mureș, Romania on 40 type 2 diabetic adults. Routine biochemical tests were performed on the Konleab 20XTi analyzer (serum glucose, total cholesterol, LDL and HDL cholesterol, triglyceride, creatinine, urea). We also measured serum uric acid, magnesium and calcium concentration by photometric procedures, potassium, sodium and chloride by ion selective electrode, and chromium by atomic absorption spectrometry in a group of patients. Glycated hemoglobin (HbA1c) dosage was made by reflectometry. Urine analysis was performed using the HandUReader equipment. The level of oxidative stress was measured by serum malondialdehyde dosage using the thiobarbituric acid reactive substances method. MDRD (Modification of Diet in Renal Disease) formula was applied for calculation of creatinine-derived glomerular filtration rate. GraphPad InStat software was used for statistical analysis of the data. The diabetic subject included in the study presented high MDA concentrations, showing intense oxidative stress. Calcium was deficient in 5% of the patients, chromium deficiency was present in 28%. The atherogenic cholesterol fraction was elevated in 13% of the patients. Positive correlation was found between creatinine and MDRD-creatinine values (p<0.0001), 68% of the patients presented increased creatinine values. The majority of the diabetic patients had good control of their diabetes, having optimal HbA1c values, 35% of them presented fasting serum glucose over 120 mg/dl and 18% had glucosuria. Intense oxidative stress and mineral deficiencies can increase the risk of cardiovascular complications in diabetic patients in spite of their good metabolic balance. More than two third of the patients present biochemical signs of nephropathy, cystatin C dosage and microalbuminuria could reveal better the kidney disorder, but glomerular filtration rate calculation formulas are also useful for evaluation of renal function.

Keywords: Cardiovascular risk, malondialdehyde, metabolic balance, minerals, type 2 diabetes.

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3 Exploring Communities of Practice through Public Health Walks for Nurse Education

Authors: Jacqueline P. Davies

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Introduction: Student nurses must develop skills in observation, communication and reflection as well as public health knowledge from their first year of training. This paper will explain a method developed for students to collect their own findings about public health in urban areas. These areas are both rich in the history of old public health that informs the content of many traditional public health walks, but are also locations where new public health concerns about chronic disease are concentrated. The learning method explained in this paper enables students to collect their own data and write original work as first year students. Examples of their findings will be given. Methodology: In small groups, health care students are instructed to walk in neighbourhoods near to the hospitals they will soon attend as apprentice nurses. On their walks, they wander slowly, engage in conversations, and enter places open to the public. As they drift, they observe with all five senses in the real three dimensional world to collect data for their reflective accounts of old and new public health. They are encouraged to stop for refreshments and taste, as well as look, hear, smell, and touch while on their walk. They reflect as a group and later develop an individual reflective account in which they write up their deep reflections about what they observed on their walk. In preparation for their walk, they are encouraged to look at studies of quality of Life and other neighbourhood statistics as well as undertaking a risk assessment for their walk. Findings: Reflecting on their walks, students apply theoretical concepts around social determinants of health and health inequalities to develop their understanding of communities in the neighbourhoods visited. They write about the treasured historical architecture made of stone, bronze and marble which have outlived those who built them; but also how the streets are used now. The students develop their observations into thematic analyses such as: what we drink as illustrated by the empty coke can tossed into a now disused drinking fountain; the shift in home-life balance illustrated by streets where families once lived over the shop which are now walked by commuters weaving around each other as they talk on their mobile phones; and security on the street, with CCTV cameras placed at regular intervals, signs warning trespasses and barbed wire; but little evidence of local people watching the street. Conclusion: In evaluations of their first year, students have reported the health walk as one of their best experiences. The innovative approach was commended by the UK governing body of nurse education and it received a quality award from the nurse education funding body. This approach to education allows students to develop skills in the real world and write original work.

Keywords: Education, innovation. nursing, urban.

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2 Training During Emergency Response to Build Resiliency in Water, Sanitation, and Hygiene

Authors: Lee Boudreau, Ash Kumar Khaitu, Laura A. S. MacDonald

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In April 2015, a magnitude 7.8 earthquake struck Nepal, killing, injuring, and displacing thousands of people. The earthquake also damaged water and sanitation service networks, leading to a high risk of diarrheal disease and the associated negative health impacts. In response to the disaster, the Environment and Public Health Organization (ENPHO), a Kathmandu-based non-governmental organization, worked with the Centre for Affordable Water and Sanitation Technology (CAWST), a Canadian education, training and consulting organization, to develop two training programs to educate volunteers on water, sanitation, and hygiene (WASH) needs. The first training program was intended for acute response, with the second focusing on longer term recovery. A key focus was to equip the volunteers with the knowledge and skills to formulate useful WASH advice in the unanticipated circumstances they would encounter when working in affected areas. Within the first two weeks of the disaster, a two-day acute response training was developed, which focused on enabling volunteers to educate those affected by the disaster about local WASH issues, their link to health, and their increased importance immediately following emergency situations. Between March and October 2015, a total of 19 training events took place, with over 470 volunteers trained. The trained volunteers distributed hygiene kits and liquid chlorine for household water treatment. They also facilitated health messaging and WASH awareness activities in affected communities. A three-day recovery phase training was also developed and has been delivered to volunteers in Nepal since October 2015. This training focused on WASH issues during the recovery and reconstruction phases. The interventions and recommendations in the recovery phase training focus on long-term WASH solutions, and so form a link between emergency relief strategies and long-term development goals. ENPHO has trained 226 volunteers during the recovery phase, with training ongoing as of April 2016. In the aftermath of the earthquake, ENPHO found that its existing pool of volunteers were more than willing to help those in their communities who were more in need. By training these and new volunteers, ENPHO was able to reach many more communities in the immediate aftermath of the disaster; together they reached 11 of the 14 earthquake-affected districts. The collaboration between ENPHO and CAWST in developing the training materials was a highly collaborative and iterative process, which enabled the training materials to be developed within a short response time. By training volunteers on basic WASH topics during both the immediate response and the recovery phase, ENPHO and CAWST have been able to link immediate emergency relief to long-term developmental goals. While the recovery phase training continues in Nepal, CAWST is planning to decontextualize the training used in both phases so that it can be applied to other emergency situations in the future. The training materials will become part of the open content materials available on CAWST’s WASH Resources website.

Keywords: Water and sanitation, emergency response, education and training, building resilience.

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1 A Study on the Relation among Primary Care Professionals Serving the Disadvantaged Community, Socioeconomic Status, and Adverse Health Outcome

Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, Jr., James Tyus, Dexter Samuels

Abstract:

During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the United States. The elevated death and disease rates among former slaves were attributable to lack of quality healthcare. To address the paucity of healthcare services, Meharry Medical College, an institution with the mission of educating minority professionals and serving the underserved population, was established in 1876. Purpose: The social ecological framework and partial least squares (PLS) path modeling were used to quantify the impact of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Thus, the study results could demonstrate the accomplishment of the College’s mission of training primary care professionals to serve in underserved areas. Methods: Various statistical methods were used to analyze alumni data from 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates in the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t-test was performed to detect the significant mean differences of respective clustering and criterion variables. Chi-square test was used to test if the proportions of primary care and non-primary care specialists are consistent with those of medical and dental graduates practicing in the designated community clusters. Finally, the PLS path model was constructed to explore the construct validity of analytic model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving the disadvantaged community. Results: Approximately 83% (3,192/3,864) of Meharry Medical College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. Independent t-test confirmed the content validity of the cluster analysis model. Also, the PLS path modeling demonstrated that alumni served as primary care professionals in communities with significantly lower socioeconomic status and higher adverse health outcome (p < .001). The PLS path modeling exhibited the meaningful interrelation between primary care professionals practicing communities and surrounding environments (socioeconomic statues and adverse health outcome), which yielded model reliability, validity, and applicability. Conclusion: This study applied social ecological theory and analytic modeling approaches to assess the attainment of Meharry Medical College’s mission of training primary care professionals to serve in underserved areas, particularly in communities with low socioeconomic status and high rates of adverse health outcomes. In summary, the majority of medical and dental graduates from Meharry Medical College provided primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcome, which demonstrated that Meharry Medical College has fulfilled its mission. The high reliability, validity, and applicability of this model imply that it could be replicated for comparable universities and colleges elsewhere.

Keywords: Disadvantaged Community, K-means Cluster Analysis, PLS Path Modeling, Primary care.

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