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This methods article presents a neonatal pericardial effusion training model using ultrasound. It details materials, construction, and training objectives to support procedural competence.
Knee joint osteoarthritis, a chronic condition resulting in considerable disability, particularly in later life, not only impacts life quality significantly and severely, but is also strongly associated with the persistence of intractable pain, depression, helplessness, and a high falls injury risk. This narrative overview synthesizes the knowledge base regarding painful knee osteoarthritis and what is known about Tai Chi exercise participation in the context of reducing knee joint disability and its associated risk of one or more injurious falls, as well as pain and depression. To this end, all relevant articles published in the English language on the topic were sought. While most reports rely on Eastern observations, rather than Western medicine studies, collectively, these data reveal that Tai Chi practiced widely in Asia for many centuries may have an enormous positive impact on reducing distress and increasing function and autonomy among older adults living in the community and diagnosed as having knee osteoarthritis. They specifically suggest the increasing numbers of older adults diagnosed as having knee osteoarthritis can safely practice selected Tai Chi exercises with the expectation that consistent applications will enhance mobility, reduce pain and depression, plus instability and possible injurious falls, while reducing fatigue, even if surgery is forthcoming.
Background and Purpose Public health problems are caused by the emergence of environmental pollution and infectious diseases, which have caused concern around the world. The public health threat affects the relationship between people. Population growth and associated pressures increase difficulties associated with effective means of maintaining public health. The diseases transmitted from human and livestock communication, water pollution, air pollution, and environmental pollutants urge us to find new solutions to address these problems. Understanding the environmental and environmental health is a prerequisite for protecting public health. In Iran, like other countries in the world, the issue of environmental protection and its compliance with the first program of economic, social and cultural development of the Islamic Republic has begun and expanded in the future. In this regard, new perspectives are being introduced that will bring about dramatic changes at various levels of planning, processes and specialized sectors such as civil, industrial and educational sectors. The training of engineers in this regard can play a very important role in refining the attitudes of young engineers and using these bases in their specialized activities. One of the important tasks of universities is to provide a suitable platform for such training. In this regard, it is essential that the major industrial universities of the country develop various programs in this field. Materials and Methods The present study is a review of the type of validity that is performed through search of authoritative scientific databases such as PubMed and Scopus, Google scholar, PubMed using the key words of building safety and health, HSE, and prevention methods are the latest information. Results Implementing the principles of HSE in various construction, industrial and other projects requires time, because any change that is considered in the system requires a change of attitude, which in turn requires time to adapt and adapt to the new conditions. The conditions for the projects in this research are their current conditions, and the next research, after a while, can determine the percentage of project progress in terms of HSE. Conclusion In order to comply with the principle of HSE cases, there is a need for training. These trainings should be executed at different levels and levels of contracting and monitoring so that the level of awareness of the risks involved in the development of civil operations between the personnel reaches a common frontier.
Purpose This paper assess the impact of COVID-19 pandemic on Education, Staff development and Training in Africa. Online Research Methodology/Approach The data use in this paper was generated from online survey questionnaire, in which the participants were asked about certain questions in which covid-19 affect their social-economic situation. The questionnaire was design to help Africa to understand covid-19 impacts on their social and economic live. Results The results of this study reveal that coronavirus pandemic affected Africa in a number of ways; 1) 52.2 percent of the respondents said they should open school now in Africa, while 47.8 percent fear they should not open schools 2) 81 percent said before educational institution are closed there is public or official announcement that institutions must be closed due to pandemic—may be 3 months, ……,,…,, one week it depends on the severity of how covid-19 is spreading across the regions in Africa, 10.7 percent of the respondent said it may be and only 8.3 percent said it is not official announced.3) 65.4 percent of the respondents said government implemented an education response for continue of learning in Africa while educational institutions are closed 4) 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government, while 50 percent said television, radio, or podcast broadcast and 17.9 percent said assigning reading and exercises for home study. 5) 45.3 percent out of 100 percent said use of online or digital learning platform are the proportion of children affected by education institution closure. 38.7 percent said the proportion of children affect are the one that concentrate of using television, radio or podcast broadcasts to get academic content. 14.7 percent of the respondents are the proportion of the children affected by educational institute closure if they are assigning reading and exercises for home study. 6) 52.6 percent of the respondents from non-government organization, private schools said use of online or digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes, while 61.5 percent said use of online/digital learning platform is the method for continuity of learning is currently available for children affected by closures of educational institutes provided by government. The same thing government said as well. Similar respondents from government as do the non-government or private schools and 35.9 percent respondent said television, radio and podcast broadcast are method for continuity of learning is currently available for children affected by closures of educational institutes-provided by non-governmental organization, private schools etc, whereas 50 percent of the respondents said assigning reading and exercises for home study is the method for continuity of learning is currently available for children affected by closures of educational institutes-provided by government.7) 48.1 percent of the respondents said for the impact of covid-19 pandemic on staff development and training that their enterprise or organization partially suspended operation due to the pandemic and 34.2 percent of the responded said they completely suspended operation because of coronavirus pandemic and 16.5 percent said no closures on in operation for staff development and training because of pandemic. 8)According to the results of this question of the online survey, 49.3 percent said the challenges their enterprise face in delivery staff training programmes and activities using online learning or offline learning during covid-19 was due to infrastructure issues such the problem associated with internet and the like. The survey of the study also confirmed that 32.9 percent twice said limited digital skills of trainers and cost of staff training was a major setback to train staff in their enterprise or organization or department or establishment while 30.1 percent said it is due to limited digital literacy of users are the main challenges face by their department in order to train staff. Policy Implications The implication of the results from this online survey is that it has serious impacts on education closure and staff development and training. As educations are closed due to covid-19 pandemic, it will affect already problems of human capital that are hampering the development of Africa. Due to covid-19 pandemic, the achievement of sustainable development goals on quality education will be seriously halted. The government and the ministry in Africa should work hand in hand to solve the problems of children affected by schools closure after the pandemic by either additional hours or provide more study hours for schools to catch-up with what happened during the pandemic, the study noted. Originality/value The impact of covid-19 on education, staff development and training.
An anterior cruciate ligament (ACL) injury is an important cause of rest in athletes. In most cases, ACL injuries do not require external contact and they are associated with biomechanical risk factors that increase ACL tension. The increase of the hip flexion angle (HF) is included within these. The ACL requires cooperation of the periarticular musculature of the knee, muscle groups, hip stabilizers and CORE muscles; consequently, fatigue caused by exercise would alter the balance and put this ligament at risk. The objective of the study is to determine the angular behavior for HF before and after a physical load (a standardized training) in children between 11 and 12 years old. A non-randomized clinical study was carried out. The sample consisted of 50 soccer school students born between 11 and 12 years old. The angular behavior of HF was compared before and after performing a training session. The angular behavior was measured through the Drop Jump test (DJ), with data obtained by inertial sensors. After the exercise, there was a significant increase in HF. It was concluded that the angular behavior of HF increases significantly in both extremities after training and that preventive measures must be applied for neuromuscular control of the hip.
Introduction Cognitive and physical (especially aerobic) training have been reported to enhance cognition in the elderly. The goal of this study was to compare the effectiveness of two types of training, namely combined cognitive-and-physical training and cognitive training alone, for cognition and in particular for executive function and working memory. Material and Method Healthy older adults (aged 65–86 years) were included in cognitive-and-physical - CAP (n=16) - or cognitive - COG (n=16) - training groups or in a passive control group – CONT (n=16). The training took place in 60-minute sessions conducted twice a week for 8 weeks. Cognitive functions were assessed before and immediately after the interventions and at a 1-month follow-up. Results In the short-term, the CAP and COG groups showed a transfer on updating, unlike the CONT group. In the long-term, although the gains achieved by both CAP and COG persisted, the benefit observed in the COG group was greater than that in the CAP group. Conclusion Our data suggest that there may be a complementarity between cognitive and physical training effects at the level of short-term transfer, given that physical training was able to boost cognitive training. Moreover, regarding transfer, physical training may help improve performance on untrained tasks. However, as far as the long-term persistence of the benefits of training is concerned, the results tend to indicate the superiority of cognitive training.
Two groups of young pigeons were trained and flight parameters profiled over a flight path of approximately 90 km and a number of measures were developed to analyse their flight performances. An aerodynamic model of avian flight was fitted to the data to assess its value in predicting flight performances. Both groups, although trained and flown independent of each other, had very similar profiles through time. Race speeds home peaked between weeks 5 - 8 of training and averaged 15.0 (2.0) m/s for Group 1 and 15.6 (2.7) m/s for Group 2. Flight performance in early stages of training in this study seemed to be affected by previous health conditions but once training progressed beyond 5 weeks, young pigeons appeared to fly at a constant preferred speed.
Background and Objective: Cognitive stimulation training was effective in reducing risk of cognitive decline and dementia in patients with mild cognitive impairment. The present study aimed to explore factors that contribute to regular participation and practice cognitive stimulation training for elderly patients with mild cognitive impairment. Materials and Methods: Data were collected through individual face-to-face interviews with 25 elderly subjects with mild cognitive impairment, and analyzed using interpretive description method. Results: Five core themes emerged from the analysis of data: (i) program with four subthemes of “interesting session, ” “effective teaching materials,” “suitable duration and frequency” and “small group activities;” (ii) group facilitators with three subthemes of “good explanation,” “always facilitate” and “friendly personality;” (iii) homework assignments with two subthemes of “suitable content” and “can adapt in daily living;” (iv) family members with two subthemes of “supporting” and “sharing;” (v) before and after class notification. Conclusion: Increasing awareness of holistic factors including in clinic and at home should be emphasized in planning cognitive stimulation training. Having an effective program and facilitators and collaboration from family member were the keys of successful training.
Hypertension is a major modifiable risk factor for cardiovascular disease, responsible for approximately 31% of global mortality. The aim of this study was to examine the hypertensive responses and determine the peak rate pressure product, calculated by multiplying systolic blood pressure and heart rate, during isometric handgrip exercise. Rate pressure product is a surrogate measure of myocardial oxygen consumption. Hypertensive responses utilising rate pressure product during isometric handgrip exercise have not previously been reported. A randomized trial was conducted with 60 normotensive and 60 pre-hypertensive participants who attended once for an acute session of isometric handgrip exercise. Participants were randomized into groups exercising at 5%, 10% or 30% of their maximum voluntary contraction. Training was conducted using 4x2min isometric handgrip exercises each separated by a 3min rest period. There were no significant differences between peak systolic and diastolic blood pressure, mean arterial pressure, heart rate and rate pressure product across the four bouts of isometric handgrip exercise in all groups, all p>.05. Peak increases in rate pressure product were significantly higher than baseline at all intensities assessed; all normotensive groups p<.02, all pre-hypertensive groups p≤.001. Increases were relative to baseline blood pressure status and intensity of isometric handgrip exercise, with no significant differences between normotensive and pre-hypertensive groups. Rate pressure product responses to isometric handgrip exercise indicate that it may be a safe alternative for people unable to perform recommended levels of aerobic exercise for blood pressure management.
Basic Life Support in Obstetrics (BLSO®) is a novel, simulation-based, emergency obstetrics training program for health care workers who perform deliveries infrequently, such as paramedics and nurses. Advanced Life Support in Obstetrics (ALSO®) is intended for regular maternity care providers such as physicians and certified nurse midwives. This paper describes a pre/post study of 111 learners in two ALSO and two BLSO courses taught in Addis Ababa, Bonga, and Jimma, Ethiopia in October, 2012. The study objective was to assess the effectiveness of ALSO and BLSO training programs to improve Ethiopian health care workers’ confidence in managing common obstetrical problems. A previously-validated survey tool was given immediately pre- and post-course and six months post-course. The survey tool included demographic questions and Likert scales to self-assess comfort managing 13 common obstetric emergencies including postpartum hemorrhage, maternal resuscitation, and preeclampsia. Ninety-seven ALSO and BLSO learners completed pre- and immediate post-training questionnaires. Nineteen ALSO learners completed the 6 month post-training questionnaire. Immediately post-course, participants in ALSO and BLSO courses reported increased comfort in all 13 areas assessed. ALSO participants had increased comfort at 6 months in all areas except breech delivery. Participation in a novel emergency obstetrics training program increases Ethiopian health workers’ self-assessed confidence in addressing common obstetrical emergencies. This increase in confidence persists in most topic areas for at least six months. This paper describes the first formal evaluation of BLSO and contributes to the growing body of evidence regarding the value of ALSO training in a low- and middle-income country.
Background: Medullary Thyroid Cancer (MTC) is a rare malignancy, accounting for less than 3% of all thyroid cancers and causes significant morbidity and mortality. MTC is often due to an underlying mutation of the RET proto-oncogene, which can result in additional endocrinopathies that must be screened for pre-operatively. The project aim was to determine if surgical training background influenced patient pre-operative evaluation for MTC. Methods: A retrospective review was performed of patients undergoing thyroidectomy for MTC at a single academic institution. Patients were analyzed based on who performed the initial operative procedure, a surgeon with specific endocrine surgery training or a surgeon without. Results: From 1994 to 2011, 37 patients with MTC were identified. Thirty percent were managed by an endocrine surgeon and 70% by a non-endocrine surgeon. A complete thyroid work-up was done for all the patients managed by an endocrine surgeon vs. 38.5% of the non-endocrine surgeon patients (p<0.01). Appropriate preoperative endocrine screening was performed in 91% of the endocrine surgeon patients vs. 50% of the non-endocrine surgeon patients (p= 0.03). RET mutation genetic testing was done for all endocrine surgeon patients vs. 85% of non-endocrine surgeon patients (p= 0.30). Conclusion: Endocrine trained surgeons recognize and appropriately manage the complexity of MTC and associated endocrinopathies, more often than surgeons without an endocrine surgery background. This may result in optimized management of these patients.
Introduction The risk of exposure to M. tuberculosis among healthcare workers (HCW) remains a public health concern worldwide. During the COVID-19 pandemic, the Biomedical Research and Training Institute supported the Zimbabwe Ministry of Health and Child Care in strengthening infection prevention and control (IPC) practices in healthcare facilities (HCF), integrating tuberculosis (TB) infection control (TBIC) into the intervention strategy. We describe the impact of this intervention on TBIC practices and HCW screening outcomes. Methods The strategy, implemented from June 2021–September 2022, included IPC mentorship training, competency assessments, and use of a standardized risk assessment tool for progress monitoring. For the training purposes, the project developed eight practical problem-solving IPC modules including an occupational health component. Trained mentors conducted bi-monthly site support visits (SSV), used a checklist to track compliance, and assessed competencies of HCW at the targeted facilities. Facility-based risk assessments were conducted three times during the project implementation. Results During the intervention, 1,865 HCW from 105 facilities were trained. Availability and use of personal protective equipment improved by 49% and 42%, respectively. The proportion of HCF with designated areas for sputum collection increased by 43%. The proportion of HCF that screened HCW for TB increased by 42% with 3,761 HCW screened during the project period. Fourteen were diagnosed with TB and referred for care, resulting in 372 new cases per 100,000. Conclusion The implemented strategy of training, mentorship, and regular SSV strengthened TBIC measures, improved TB screening practices and case finding among HCW. Improving and maintaining practices is critical for effective TBIC.
Background In Northern Uganda’s patriarchal communities, women play vital yet underrecognized roles in environmental conservation. There is limited research examining the socio-cultural roles women play in society in northern Uganda. This study, conducted in Gulu District, examined the socio-cultural functions performed by women in safeguarding natural resources. Methods This study employed an analytical cross-sectional design involving 395 women aged 18–49 in Gulu District, selected for its patriarchal context. Data were collected using structured questionnaires and analyzed with SPSS, applying descriptive and inferential statistics. Key variables included women’s roles in environmental conservation and barriers to participation. Ethical approval and informed consent were obtained to ensure research integrity. Results The study found that women in Gulu District play vital socio-cultural roles in environmental conservation, particularly as custodians of indigenous knowledge (Mean = 4.42), active participants in tree planting (Mean = 4.11), and conservers of ecosystems (Mean = 4.04). However, their involvement in advocacy (Mean = 3.46) and decision-making (Mean = 3.20) was perceived as limited, reflecting the constraints of a patriarchal society. Additionally, evolving gender roles have negatively impacted women’s engagement, with 47.6% citing excessive domestic workload and 44.1% reporting reduced participation in conservation activities. These findings highlight both the significance of women’s contributions and the structural barriers that hinder their full involvement in environmental governance. Conclusion Despite these challenges, women’s contributions remain central to sustainable environmental stewardship. The study recommends targeted sensitization and training programs to promote gender equality and community acceptance of women’s leadership in environmental governance.
This article offers a literature review and theoretical synthesis and application of existential therapy and the contextual model. It reviews the contextual factors that may be predictive of positive therapy outcomes in general, identifies distinct types of existential therapy, highlights core commonalities in these existential branches, and explores how the main aims of the existential therapy approach may be foundational in facilitating improved mental health treatment outcomes and well-being. The author asserts that presence-both intrapersonal and interpersonal are at the heart of the contextual factors, along with flexibility, and meaning-making. This assertion has implications for therapist education, development, training, and supervision.
Social work has its roots in the efforts of early twentieth-century charity organizations to reduce human suffering. This movement among charity workers of the era was founded in the search for theoretical knowledge that would illuminate effective treatment options for social ills and ultimately transform the provision of charity into social work. Coinciding with the birth of social work was the development of psychoanalysis (PA) as a tool for theorizing and treating mental illness. For many decades training in PA theory was common within social work graduate programs and many clinical social workers practice today psychotherapy informed by PA principles. However, clinical social workers were long excluded from enrolling in and graduating from psychoanalytic training institutes, a requirement for being able to say that one is a psychoanalyst and provides psychoanalysis. In 1985, a legal ruling asserted that psychologists and other qualified mental health professionals could not be excluded from enrollment in PA training programs. Since that watershed decision, although many social workers have gone on to enroll and graduate as psychoanalysts, the process whereby one can pursue this training path is unfamiliar to most social workers. We describe the current PA training landscape and describe the process on how a LCSW can become a legitimate psychoanalyst.
Frequency neurofeedback (FNF) is a biofeedback method that targets frequencies between 1 and 50 Hz. The efficacy of FNF with autism has been labeled ‘probably efficacious’ in literature reviews in the last decade, despite new research pointing towards a higher standard. The aim of this review was to analyze key features of these studies, with a goal of determining the efficacy standard of FNF on autism and establishing a research direction. Electronic databases and literature reviews were used to collect a total of ten randomized and/or matched controlled trials. FNF reaches a Level 4 efficacy standard, with an impact on a broad range of factors including core autistic traits, social communication, emotional regulation, cognitive flexibility, executive function, behaviors of concern, attention, metabolic or thermal activity, and EEG e.g. decreased absolute power, mu rhythm, coherence and hyperconnectivity. Current evidence generalizes to male children, up to 18 years, with a low-average or higher intellectual functioning, with autism as the only diagnosis. A meta-analysis suggests a large superior effect when compared to wait list controls. Current research does not meet the higher efficacy standards outlined by Arns et al. (2020). Small samples plague most studies, and the maintenance of improvements post-training are yet to be assessed adequately. Eight recommendations are made.
The rising need for structured and efficient blood transfusion services in low-resource settings has driven the adoption of collaborative blood transfusion management systems (CBTMS). This study explores the functionality and impact of the Cornerstone University Blood Management System version 1.0 (CUBMS vs 1.0) in Cameroon. This study was an exploratory research design which used a system interface analysis, comparative case reviews from four countries, and literature synthesis, to reveal that CUBMS improves accessibility, data management, inventory control, emergency responsiveness, and community engagement. Despite infrastructural challenges in rural regions, the system can enhance efficiency, transparency, and safety in blood services. The success of CBTMS in Cameroon is linked to digital infrastructure, training, and culturally relevant community engagement. The Ministry of Public Health of Cameroon should prioritize the nationwide implementation of CBTMS, ensuring consistency in digital health tools.
Physiological performance may be limited by reduced systemic glucose availability to working muscles. Continuous glucose monitors (CGM) measure interstitial glucose every 1-15 minutes, offering a practical way to assess glucose during sporting activity. However, empirical research has predominantly focused on endurance-based sports, whereas glucose responses during professional competitive football matches remain unknown. This study evaluated the feasibility and utility of CGM in professional football. Eight professional, male outfield footballers from the English third tier participated in the study. Participants completed a 14-day food diary control period, followed by a 28-day observation period wearing CGM devices during six matches and sixteen training sessions. CGM devices remained in situ for 98% of training sessions and matches. Mean glucose concentrations were 6.5 ± 1.2 mmol/L during training sessions, 7.5 ± 2.1 mmol/L during match play, and 5.4 ± 0.3 mmol/L overnight. No significant differences were found between glucose concentrations during match play (p = 0.060) or training (p = 0.510), compared to overnight fasted glucose concentrations. There was also no difference between training and match-play glucose concentrations (p = 0.788). Glucose concentrations were highly individualised, with one player displaying minimal change throughout match play (-0.2 mmol/L) whereas another experienced increases of up to 5.8 mmol/L. Non-nutritional factors appeared to influence glucose concentrations; participants (n=3) who used nicotine pouches displayed an transient increase in blood glucose in the 10-55 minutes after administration. This study concludes that CGM use in professional football is feasible for assessing individual glucose responses to training and match-play.
Physical therapists (PTs) experience stress and burnout due to high job and productivity demands. Exercise can assist in decreasing stress and burnout, but finding the time to exercise can be difficult. This study examined the effects of a 28-day, 7-minute, high intensity interval training (HIIT) workout on PT’s stress and burnout levels. In this quasi-experimental pretest-posttest design, the Perceived Stress Scale, Maslach Burnout Inventory, grip strength, Functional Reach Test, and VO2max measures were administered on day 1 and day 28. Between the data collection period, participants completed a daily, 7-minute HIIT workout. A series of paired sample t-tests were computed to compare the pre- and post-HIIT raw values. Significant improvements were found in all comparisons post-HIIT (p< .001). Therefore, it was concluded that 7-minutes of HIIT can assist PTs in reducing stress and burnout levels. Employers should consider implementing a workplace wellness program to benefit their employees.
A letter to the editor comments on animal research ethics, post‑service roles in humanitarian response, and public health preparedness. It advocates clear oversight, training, and accountability frameworks for paramilitary substitutes in HA/DR.
Background Antibiotics are the most prescribed medications worldwide. Global consumption rose by 65% in 76 low and middle-income countries between the years 2000 and 2015. According to the World Health Organization, improper administration of antibiotics occurs in over 60% of people with upper respiratory tract infections. Inadvertent antibiotic use has been identified as a contributor to antimicrobial resistance. Outpatient antibiotic use accounts for around 80-90% of all antibiotic use in patients. Clinical officers are non-physician healthcare workers who have received less training, have a more restricted scope of practice than physicians. Clinical officers are key service providers in this country especially at the primary healthcare level. Objective The study assessed the factors that influence antibiotic prescribing for upper respiratory tract infections by clinical officers. Method A prospective study was carried out at 20 public hospitals in Kiambu County, on 36 clinical officers and 600 patient prescriptions. The parameters measured were patient factors, prescriber factors, institutional factors and how they affected the antibiotic prescribing practices by either being rational or irrational. Rational prescribing was identified as prescribing the right drug, at the right frequency, in the right duration, right dose for the right indication. Prescriptions were considered irrational if they did not satisfy any of the rational indices. Data was collected via a questionnaire from the clinical officers while WHO prescription checklist was used to collect data from patient encounters. Data was analyzed using Statistical Package for Social Sciences version 22.0 (SPSS v22.0) with P-value, Confidence Interval and Odds Ratio. Results A total of 600 patient encounters were recorded and 79.8% of the 479 encounters had an antibiotic prescription for URTI, 91% of the antibiotics prescribed were the right dose, 98% had the right frequency, 75% had the right duration, and only 23% had the right indication. Patients above 65 years were more likely to receive an antibiotic prescription OR 3.98 CI 0.91,17.41 P=0.17 compared to children under 12 years old. Males were more likely to receive an antibiotic, but this was not significant OR 1.06 CI 0.70, 1.59 P=0.79. A total of 28 (4.6%) patients had fever, and all received antibiotics. A total of 36 clinical officers were sampled and only 5 (13.8%) were found to have rational prescriptions (P=0.63), prescriber age (P=0.92), prescriber level of education (P=0.99) and prescriber work experience (P=0.22) were not associated with antibiotic prescription. As per institutional factors, availability of antibiotics (P=0.026) and availability of prescription guidelines (P=0.012) were associated with rational prescription of antibiotics. Conclusion The study indicated that there was a high antibiotic prescription rate deviating from the WHO standard. It demonstrated that most antibiotic prescriptions were irrational.
This editorial aims to propose and delineate that disciplined open-air exercise can slow down aging in humans. The aging process may be slowed down by outdoor physical training (e.g., mountaineering, climbing, running, swimming, walking, jogging) mainly because of fresh air inhalation and psychological calmness. However, for outdoor exercise to be a healthy asset, it should be performed in unpolluted and uncontaminated environments. Advanced public education policies must be developed to persuade people to maximize their outdoor physical activities. This is to ensure achieving peace and serenity for both body and psych. Integrated social activities may also be encouraged with open-air exercise. As such, stress in the third millennium can be pragmatically attenuated and managed. As a result of slower aging process, human life quality may improve worldwide.
Access to sexual and reproductive healthcare for sexual minority women is essential to fulfilling their human rights. This qualitative study was conducted in Rivers State, Nigeria, with fifteen participants as key informants. The study addressed the barriers to the sexual and reproductive healthcare needs of lesbians, bisexual women and sex workers in Port Harcourt metropolis. To address these barriers, the study answered the research questions on what access barriers prevent lesbians, bi-women, and sex workers from adequate utilization of sexual and reproductive healthcare services and common mental health issues sexual minority women experience. The study found that the barriers that prevent sexual minority women from accessing sexual and reproductive healthcare services include limited sexual and reproductive health information on available services offered by the health facilities, prejudice from healthcare providers and lack of social acceptance. Common mental health issues experienced as a result of these limitations are self-doubt over sexual orientation, trauma from threats, and parental pressure over marriage. To mitigate these barriers, the study recommends training healthcare providers on inclusive sexual and reproductive healthcare and to eliminate stigma and discrimination to improve access. Additionally, an improvement in laws and increased agency of sexual minority women to minimize negative mental health experiences. Finally, it also recommends creating a social group for sexual minority women to share experiences, support each other and learn about their sexual and reproductive healthcare will minimise barriers.
The present study aimed to provide baseline information of fish culture status (obstacles) of Omdurman, Khartoum and Khartoum north in the Khartoum state in Sudan due to there is little or lack of information in this field. 30 owners of farm were questioned from Omdurman, Khartoum and Khartoum north, 10 farms for each location; Descriptive analysis was done for analyzing the raw data of the study by using Excel Microsoft Software 2007. Social data showed that male farm owners group was dominant in third sites 100%. Age groups of fishermen ranged between 20 to 60 years; where age group 31- 40 Khartoum north, age group 41- 50 was dominant in O mdurman and age group 51-60 year was dominant in Khartoum. Six educational categories were recorded where University education was dominant in the three locations 50%, 50% and 70% respectively; whereas, postgraduate was the second in the tow location: O mdurman and Khartoum 20% and the secondary education were the third in Khartoum 30%. all farm owners were married 100% in three sites; As regards to the farm owners other activities results showed that most of them were practicing other activities (farmers, business owner, officers and workers). Category of farmer was dominant 90% secondly business owner and officer 70% and 50% respectively. Data showed that the problems (Varanus niloticus, birds, marketing, fees and thefts) was dominant in three locations had the highest percentage 90%, 80%, 60%, 30% and 10% respectively. and according to production cost in three locations arranged: (feeds, workers, fingerlings, water and technical supervision) 50, and 70% and 40%, 50% and 70% and 30%, 40% and 50% and 10, 20 and 40% and 10, 20 and 30% respectively. Category of feeds dominant followed by workers and fingerlings, the best Method to obtain of information, the results showed that Bulletins was dominant in three sites 80%, 30% and 90%; whereas, field visits in three location was the second 60%, 90% and 0%, Radio programs in three location was the third 60%, 10% and 60% and the lowest percentage; Seminars and television 40%, 50% and 40%, and 30%, 0% and 0%. For the best location to obtain information results revealed that the General Director of Fisheries Ministry of Agriculture, Animal Resources and Irrigation - Khartoum State was dominant in the three locations 90%, 80% and 90%, whereas, Universities in three location was the second 40%, 20% and 0%, and the lowest percentage Central Research of fisheries 40%, 0% and 0%, and Internet 10%, 20% and30%. Also result showed most of the farm owners in three sites all them need to training courses in deferent programmers (Fish extinction, Fish feeding, Fish production and Fish marketing) according to this percentages 60%, 30% and 50%, and 30%, 10% and 50%, and 10%, 10% and 30%, and 10%, 0% and 20% respectively.
Nutrition during pregnancy is of utmost important to ensure positive pregnancy outcomes after delivery. This study examined the utilization of nutrition services provided at health facilities to pregnant women. A cross sectional study design, involving 105 pregnant women and 5 RCH providers from 2 health facilities was used. Structured questionnaires, and structured observations were used in data collection. SPSS software version 25 was used in data analysis. Results showed that, RCH providers had inadequate nutrition knowledge due to limited nutrition courses during nursing training and on job trainings/seminars. All RCH providers advised that, nutrition knowledge is important to pregnant women hence they were responsible for its delivery. In adequate staff and lack of teaching materials contributed to the poor delivery of quality nutrition education to all pregnant women as it was observed that there is variations in nutrition information given to women. More than a half of all pregnant women (63%) started their ANC clinic during their first trimester where they received all nutrition services including education on importance of nutrition during pregnancy which helped them to be aware of the relationship between diet maternal nutrition and birth outcomes (63.8%). Most common food group that has been consumed more by pregnant women was grains, roots and tubers and plantains, while also there was high consumption of fruits and vegetables by all women as they are being more emphasized during routine clinics to prevent anemia. Also, there are some barriers that were identified by the service providers which makes their work difficult such as inadequate teaching materials like brochures, posters and jobs aids, also shortage of staff was found to be the core cause of services being provided occasionally as it is the RCH nurse who provide the education and counselling as there is no any nutritionist hired by government at the facility. Regional and district nutrition officers should coordinate and conduct on job training to health providers on issues related to nutrition in order to update their nutrition knowledge and facilitate clear, accurate and more evidence based nutrition information delivered.
Nutrition during pregnancy is of utmost important to ensure positive pregnancy outcomes after delivery. This study examined the utilization of nutrition services provided at health facilities to pregnant women. A cross sectional study design, involving 105 pregnant women and 5 RCH providers from 2 health facilities was used. Structured questionnaires, and structured observations were used in data collection. SPSS software version 25 was used in data analysis. Results showed that, RCH providers had inadequate nutrition knowledge due to limited nutrition courses during nursing training and on job trainings/seminars. All RCH providers advised that, nutrition knowledge is important to pregnant women hence they were responsible for its delivery. In adequate staff and lack of teaching materials contributed to the poor delivery of quality nutrition education to all pregnant women as it was observed that there is variations in nutrition information given to women. More than a half of all pregnant women (63%) started their ANC clinic during their first trimester where they received all nutrition services including education on importance of nutrition during pregnancy which helped them to be aware of the relationship between diet maternal nutrition and birth outcomes (63.8%). Most common food group that has been consumed more by pregnant women was grains, roots and tubers and plantains, while also there was high consumption of fruits and vegetables by all women as they are being more emphasized during routine clinics to prevent anemia. Also, there are some barriers that were identified by the service providers which makes their work difficult such as inadequate teaching materials like brochures, posters and jobs aids, also shortage of staff was found to be the core cause of services being provided occasionally as it is the RCH nurse who provide the education and counselling as there is no any nutritionist hired by government at the facility. Regional and district nutrition officers should coordinate and conduct on job training to health providers on issues related to nutrition in order to update their nutrition knowledge and facilitate clear, accurate and more evidence based nutrition information delivered.
Small island states, such as Malta face numerous, unique challenges in relation to agricultural sustainability, with solutions amenable to larger states being unfit given the particular characteristics of the island. These include the poor soil conditions, the limited water resources, the aging farmer population, farming being mainly part-time, and most farmers having no formal training. Currently farmers practice intensive agriculture to achieve higher crop productivity at lower production costs by relying heavily on agri-chemicals and over-extracting groundwater. This destroys the Maltese natural environment and urges for the development and implementation of sustainable agriculture practices, whereby traditional farming is supplemented with sustainable alternatives such that local agriculture remains productive in the long-term while safeguarding the local environment. Here we outline some of the critical issues that urgently need to be addressed and potential ways forward in relation to soil, water and biodiversity, implementing permaculture principles in small-scale, practical actions in order to improve the sustainability of local agricultural through a combination of scientific evidence, agricultural technology and traditional practices.
Oral ulceration is a common disorder of the oral mucosa with individuals regularly presenting to primary care practitioners seeking advice and treatment. Diagnosis of oral ulceration remains a challenge for clinicians due to the overlap in clinical presentations and the diverse aetiological processes that can be involved in their development. A recent study evaluating general medical practitioners’ attitudes towards oral examination identified problems in clinicians’ confidence in differentiating between benign and malignant ulcers, with a lack of knowledge and training being cited as contributing factors. This article aims to provide an overview of the diagnosis and management of oral ulceration, providing a framework to guide clinical decision-making in a primary care setting.
The Gas Turbine operation was investigated with a view to evolving a system designed to provide a realistic imitation of the controls and operation of a Gas Turbine, used for training purposes. Operator Training Simulator has been widely adopted by many industries being a computer simulation which attempts to model a real-life plant so that it can be studied. A well trained and skilled operator is key in increasing power plant safety and productivity. Therefore, enabling quality training for operators is becoming more important as they need to handle increased load of information and duties whereas the lack of training is a major reason for inadequate performance. By changing variables in the simulator, predictions are made about the behaviour of the engine. It is a tool to virtually investigate the behaviour of the system while in operation. This work becomes indispensable because it is prohibitively expensive or simply too dangerous to allow trainees use the real equipment in a power plant. The Gas Turbine operation’s simulator is born from Object Oriented Programming, employing key programming languages. The simulator design focused on specific tasks in the operation of the Gas Turbine which include; startup, synchronization and monitoring of vital parameters like vibration, temperature, pressure, and angle of the Inlet Guide Vane. The statuses of various valves, pumps and motors as well as the Performance of actuators and the response of concatenated components are also being tracked. The simulator was found to effectively mimic a real plant life. With this simulator, trainee operators in Gas Turbine can spend time learning valuable lessons in a "safe" virtual environment yet living a lifelike experience. This will go a long way in minimizing operators’ error in GT power plants, thereby curtailing power outages and conserving power plant components.
The major a biotic stresses affecting chickpea production are high and low temperature, drought and salinity. Heat stress is a major a biotic stress factor, constraining chickpea production worldwide. This study was conducted to identifying chickpea genotypes combining heat tolerance and high yield potential and to study correlation among the heat tolerance indices. The genotypes were tested under different field-growing conditions, normal sown (non – heat stress) and late sown (heat stress) at two locations, Merowe and Gezira during winter season 2018/2019. The trials were laid out in alpha lattice design with three replications. Eight heat tolerance indices, which were most frequently used in plant breeding including, geometric mean productivity (GMP), yield index (YI), mean productivity (MP), stress susceptibility index (SSI), stress tolerance index (STI), tolerance index (TOL), sensitivity heat index (SHI) and relative heat index (RHI) were calculated based on seed yield under heat stress (Ys) and non – heat stress (Yp) conditions. Under both environments, the results from combined analysis of variance showed that there were highly significant differences among the genotypes for all traits studies. There were highly significant differences observed among the tested chickpea genotypes response to heat stress. Seed yield in stress (Ys) condition was positive and highly significant correlated with geometric mean productivity, yield index, stress tolerance index and relative heat index. The Ys was negative and highly significant correlated with stress susceptibility index and sensitivity heat index. Seed yield in non-stress (Yp) condition was positive and significant correlated with geometric mean productivity, yield index, stress tolerance index and tolerance index. The results of this research showed that the six indices, GMP, YI, SSI, STI, SHI and RHI can be used as optimal indicators for screening heat tolerant chickpea genotypes. Nine genotypes including four released improved varieties (Shiekh Mohamed, Wad Hamid, Salwa and Hwata) and five genotypes (no. 11, 4, 26, 30 and 34) are most stable chickpea genotypes for heat tolerance and can be further used in breeding program. These genotypes can be used in the chickpea national breeding program to develop varieties with improved heat tolerance in Sudan. Genotype no. 11 (FLIP 08-59 C) was release by Sudan national variety release committee for commercial production under the name Elbarkal in September 2022 to will be grown in Gezira, River Nile and Northern States of Sudan.
Tactile information plays an important role in human manipulation of objects; however, prosthetic limb placement or teleoperation requires the manipulation of alternative bodies in the absence of tactile sensations. To provide an alternative to tactile sensation, this study proposes and assesses a continuous feedback scheme with temporally coded vibration. This scheme was designed to provide discrete intended tactile information in response to changing object-controlled situations by repetitively presenting time-coded vibration patterns. The effects of the proposed scheme on an object with acatch-and-hold task in virtual reality were confirmed. Compared to the control feedback scheme that provides vibration only when the balance of the virtual grip force and object position is changed, the proposed feedback scheme has a better effect in terms of the success rate of holding on to the object with an appropriate holding force during the task. The effect is larger, especially in the invisible task condition, suggesting that the increased amount of information with coded vibration patterns can be used without any special training, especially without visual information. Considering the existing studies that show the effect of a feedback scheme in response to motion events, the continuous feedback scheme proposed in this study may be more suitable for movements that require sequential coordination and passive responses than stimulation methods based on motion events. This feedback scheme has potential applications not only in tele-technology but also in healthcare, such as rehabilitation.
Introduction Physical, psychological, and emotional growth are among the changes that define the adolescent stage. As compared to other age groups, adolescents are more vulnerable to sexual and reproductive health issues. Parents can become protective and influencing factors for their children to prevent risky sexual behavior. This study aims to assess adolescent-parent communication on sexual and reproductive health and its associated factors. Methods A descriptive cross-sectional study was conducted among 212 adolescents aged 15–19 in higher secondary schools of Tokha Municipality. A self-administered structured modified questionnaire to assess the communication used the Weighted Topics Measure of Family Sexual Communication (WTM) tool with a simple random sampling technique of data collection. We performed descriptive statistical analysis and chi-square tests to analyze data and assess the association between variables. Data quality was assured through careful questionnaire design, pretesting, and training. Results The study found that about 75.9% of adolescents had communicated on SRH topics with their parents. Only 56.1%, 50.1%, 55.2%, and 50.5% of adolescents communicated about choosing a life partner, menstruation, physical and psychological changes during adolescence, and the physical growth and development of reproductive organs, respectively, while topics like using birth controls, when to start having sex, pregnancy, how to handle sexual pressure from a partner, STI and HIV/AIDs, about condoms, and abortion had never communicated by 61.3%, 86.6%, 69.3%, 85.8%, 72.2%, 78.8%, and 82.5% of adolescents, respectively. Adolescent-parent communication on sexual and reproductive health was significantly associated with the level of knowledge regarding sexual and reproductive health (X2 = 5.809, p = 0.01, df = 1). Similarly, there was a significant association with the perceived parenting style (X2 =3.932, p =0.04, df =1), living arrangements (X2 =6.376, p=0.01, df =1), and adolescent-parent communication. Conclusion It concluded that adolescent-parent communication on SRH issues is not satisfactory. Creating an adolescent-friendly environment at home and conducting awareness programs with the help of the local government of the respective schools would help to increase adolescent-parent communication.
The study evaluated the users' opinions on data quality and related characteristics in ten public-health institutions of Nyarugenge district. A study used a cross-sectional design, data was collected through quantitative (n=150) methodology while qualitative data was obtained using interviews (n=20) and focus group talks (n=3). A checklist was utilized to examine the completeness, accuracy, and timeliness of data quality aspects. Collected quantitative data was analyzed through logistic regression by SPSS to examine the association of variables, while qualitative data was analyzed using the summative content analysis (SCA) to summarize the key themes. A 95 percent confidence level, Odds Ratio (AOR) were used to establish the strength of correlation among study variables, while a p-value of less than (p<0.05) was utilized to identify the variables which were statistically significant associated to HMIS data quality. The study finding showed that the majority (53.0%) was female while, 33 years was an average age, the majority of health practitioner (52.7%) had an A1 diploma. Approximately 90.6% of respondents have a positive perceptions on the system usage. Limited ability and a lack of relevant technology equipment such as computers and the internet have been cited as the challenges while using the system. Factors such as training AOR:2.62(95% CI:1.45, supervision AOR:1.81(95% CI:1.02, AOR:2.50(95% CI:0.85 for education background, works-experience AOR:1.60(95% CI:090 are factors associated with data quality. Maintaining, supportive supervision, regular training and refresher courses should be regularly offered to public health professionals to improve their knowledge in order to maximize the use of health information.
This study investigated the healthcare provider’s knowledge and attitudes towards induced abortion in Rwanda. A total of 152 healthcare providers from six public hospitals in Kigali city participated in this study. Questionnaires were used to record data on demographics, level of knowledge and attitudes towards abortion law then be cleaned, coded and entered into Excel sheet. Then all data were exported into SPSS version 22 for final cleaning and analysis. The study findings revealed that 54.6% were female, 56.0% were single, and 73% participants said that they attended formal training on abortion care. The study findings revealed that 23.70% healthcare providers had poor knowledge towards legal abortion law, and 57.20% had positive attitude with regards to induced abortion law. The findings revealed that religion and formal training on abortion care were among the factors which were strongly influencing attitudes of health care providers towards induced abortion where protestants were unlikely to have positive attitude with regards to induced abortion (AOR=0.277; 95% CI=0.027-0.377; P=<0.001) compared to participants belonged to catholic religion and participants who were not trained were unlikely to have positive attitude with regards to induced abortion (AOR=0.696; 95% CI=0.056-0.721; P=0.048) compared to trained respondents. It concludes that marital status, category of caregiver, religion, formal training on abortion and level of knowledge were the main risk factors of level of attitude towards induced abortion. More training about induced abortion are highly needed among health care providers to increase related knowledge as well as to eliminate negative attitude towards induced abortion.
Background The COVID-19 pandemic has had significant impact on healthcare worldwide. Surgeons are at increased occupational risk of contracting COVID-19. The impact of the disease on surgical practice will continue to evolve. We assessed the impact of the disease on surgical practice and training in Nigeria. Method Survey questionnaire was designed, transcribed to Google form and electronically circulated online to surgeons practicing in Nigeria. Surgeons from various subspecialties from the six regions in Nigeria were included. Survey questions pertaining to pre-COVID-19 era surgical practices, impact on current practice and changes occurring in health facilities during this COVID-19 pandemic. Responses were collated and analyzed statistically. Results One hundred and nine (109) surgeons completed the survey, of which 2.8% were women. Majority (68.8%) of the respondents are in the consultant cadre, majority (86.2%) are working in public hospital, 88.1% running their SOPD, 81.7% have isolation wards in their centers, 66.1% have dedicated team for COVID-19 management. Only 48.6% of the frontline health workers have access to personal protective equipment (PPE), and 33.9% had formal training on the use of PPE. Only 11.0% were satisfied with level of preparation of the management. Elective cases were done only in 45% of respondents. 103(94.4 %) confirmed that the numbers of elective cases are less than pre Covid-19 period. Emergency cases were carried out by 93.6% of respondents. Only 1.8% of respondents carried out screening tests for their patients before embarking on emergency surgery. Conclusion COVID-19 has led to reduction in surgical outpatients, significant reduction in elective surgeries in Nigeria. Adequate PPE needs to be provided, there should be guidelines for safety for future. There should be adequate preparation should there be any pandemic in the near future.
COVID-19 epidemic, described as a community health emergency by the World Health Organization, began in December 2019. COVID-19 is a source of deep vein thrombosis (DVT) because of hypercoagulation, blood stasis, and endothelium injury complications. This study reports a 26-year-old pregnant woman with coronavirus hospitalized with a left ovarian vein (LOV) thrombosis at Sultangazi- Haseki Training and Research Hospital in Istanbul. Risk classification for DVT disease is of crucial importance for the forecast of coronavirus.
This study aimed to assess factors influencing knowledge and practices of hospital cleaners towards hepatitis B prevention. This was a hospital-based cross-sectional study conducted at in Northern Province of Rwanda. A pretested self-administered questionnaire was used to gather data from study participants. A total of 134 cleaners were recruited in the study. Data were entered using Kobo collect toolbox and exported to Microsoft office excel for data cleaning and to entered in SPSS version 21 for analysis. Descriptive and logistic regression analysis was done and the significance level was 5%. More than a half of respondents were female (51.5%), and had primary level of education (54.5%). Results showed that only 9.7% of respondents had a high level of knowledge about HBV and only 2.2% had good practices on HBV practices. The odds of having high level of knowledge towards HBV prevention was 2.3 times (AOR=2.3, 95%CI: (1.1-27.3); p=0.045) among respondents with high school compared to those with no educational level. Respondents with work experience of 5-7 years were 1.5 times to have high level of knowledge towards HBV prevention than those with work experience of less than one year. Being aged between 20-30 years was associated with 2.5 times more likely to have good practices on HBV prevention than respondents aged less than 20 years. The odds of having good practice towards HBV had found to increase with work experience (AOR=2.3; 95%CI: (1.29-4.3); p=0.014). Considerable proportion of participants lacks the requisite knowledge of post-exposure treatment and prevention of HBV. Training programs on HBV infection, including PEP are highly recommended.
This study aimed to evaluate acceptance and commitment therapy (ACT) effectiveness in reducing high-risk behaviors and elevating problem-solving strategies in adolescents with addiction susceptibility in cyberspace. This study is longitudinal with quantitative methods of data collection and analysis. The target community in this research was 60 female students randomly selected from a Persian high school in Iran. Participants were randomly divided and placed equally into the experimental and control groups. The participants’ entry criteria were gender, aged from 15 to 18 years, addiction susceptibility, and high-risk behaviors cut-off points. Eight training sessions of ACT were presented in cyberspace for the experimental group between the pre-test and post-test intervals. Data collection instruments were the Iranian youth risk-taking scale, problem-solving strategies, and Iranian adolescents’ addiction susceptibility questionnaires. Participants were followed up after two months. The results using multivariate analysis of among subjects ANOVA showed ACT significantly influenced high-risk behaviors and its’ sub-scales except for the violence (p < .001).Furthermore, ACT affected the problem-solving strategies and its’ sub-scales instead of control, creativity, and confidence (p < .001). According to the findings, ACT decreased high-risk behaviors such as drug abuse, smoking, and unprotected sexual behaviors. These changes might be due to decreased helplessness and avoidance as well as increased acceptance and tendency to solve problems. Instead, problem-solving strategies were improved through ACT cyber treatment.
Background The rapid and ongoing spread of antimicrobial-resistant organisms threatens the ability to successfully prevent, control, or treat a growing number of infectious diseases in developed and developing countries. This study was designed to convey more insight on the profile of antimicrobial resistance and the capacity of laboratories conducting antimicrobial susceptibility testing in Cameroon. Methods A multicentre cross-sectional study was conducted from October 2019 to March 2020 in the Deido Health District. Laboratories that carry out culture and sensitivity testing within the Deido Health District were identified and assessed to determine their capacity as well as the quality of results from microbiological investigations. Information on antimicrobial susceptibility of various isolates was collected using tablet phones in which the study questionnaires had been incorporated. Results Gaps identified in antimicrobial susceptibility testing that cut across laboratories included; insufficient standard operating procedures, inadequate records on personnel training and competency assessment, lack of safety equipment such as biosafety cabinet, stock out and non-participation in external quality assurance program. The turnaround time for antimicrobial susceptibility testing ranged from 3 – 7 days. Out of the 1797 samples cultured, 437(24.3%) had at least one isolate. A total of 15 different isolates were identified with Candida albicans being the most frequent 178 (40.7%), followed by Escherichia coli 80(18.3%). Among the 15 classes of antimicrobial drugs used in this study, the overall resistance of the isolates showed that five classes had class median resistance above 40% (Cephalosporins, Penicillins, Beta-lactam, Macrolides, and Polyenes). Conclusion This study has shown the need to develop a coordinated national approach to fight antimicrobial resistance. Scaling-up of antimicrobial susceptibility testing will, therefore, require strengthening the microbiology units of laboratory systems as well as ensuring the use of laboratory data for decision making.
Aim Community-based psychosocial support centers for cancer patients and their relatives (CBPSCs), developed in the Netherlands, offer easily accessible contacts with fellow patients and support by trained volunteers. We studied the characteristics of visitors of CBPSCs, which palliative support they need and receive, and how satisfied they are with this support. Methods The role of 20 CBPSCs was explored in semi-structured interviews among 34 visitors with regard to their contacts with CBPSCs on palliative care (study 1). Additionally, in 25 CBPSCs, 701 visitors filled out a web-based questionnaire about their experiences with the palliative care (study 2). Within this second study, 25 coordinators of CBPSCs also answered questions about the palliative care (study 3). Results The cancer patients and proxies stressed the view that palliative support should be a part of the support by CBPSCs. This belief was confirmed by the coordinators. Not only attention to the reduction of symptoms, but also emotional support and information supply should be offered when recovery is no longer possible. Talking about death and dying may be worrying for some visitors in a better condition. Education of the volunteers is needed, taking into account the conditions in the CBPSCs e.g., the already existing experience with the palliative care in the CBPSCs and participation in regional networks. Practical Implications Further development of the attention given to palliative support, training and research in that field is needed.
Background Breast cancer is one of the most common types of cancer affecting women globally. It has shown increasing morbidity and mortality rates over the past years. Several screening methods ranging from simple breast self-examination to a highly sensitive test procedures for early detection and treatment are available, but uptake is a challenge. Lack of a national screening programme in the country makes available regional screening programme unsuccessful. This study aims to assess the factors affecting the uptake of breast cancer screening programme among female staff in a tertiary hospital, Southwest Nigeria. Method This descriptive cross-sectional study involves 375 participants selected by a stratified random sampling technique, with proportional allocation to population size and the use of a semi-structured questionnaire. Respondents were questioned on their basic knowledge of breast cancer symptoms, risk factors and treatment, over a score of 50 and above, were set as the cut-off mark to determine good knowledge of breast cancer. Patients attitudes towards breast cancer screening as well as factors affecting uptake were also measured. Descriptive statistical analysis was done using SPSS-20 while the predictors of the uptake of screening were determined using logistic regression at p ≤ 0.05. Results There were 360 respondents, comprising of 13.3% clinical and 86.7% non-clinical female staff within the age bracket of 20 to 58 years (38.2±0.42 years). Out of the respondents, 97.8% have heard about breast cancer but only 52.3% had been screened while 65.5% had “Good knowledge” of breast cancer. Positive attitude to breast cancer screening was displayed in 52.5% while over 90% claimed to be practicing breast self-examination. Only 36.1% of respondents above 40 years old have had mammography done. Most frequent barriers to screening uptake include cost, poor accessibility to screening facilities, shyness (unfamiliar screener), unavailability of female doctors, careless attitude, fear of cancer and other more pressing family problems. Using logistic Regression at p ≤ 0.05, females with a negative attitude, young unmarried (less than 30years) and lack of easy accessibility to screening facilities were significant factors affecting uptake of breast cancer screening services. Conclusion Due to knowledge-uptake gap of breast cancer screening revealed in this study. It is therefore obvious from these findings that a concerted effort is needed to actively remove these barriers by repeated education, training and re-training strategies among health workers and to improve their uptake and level of advocacy and campaign for breast cancer screening among their patients and clients.
After entering the new century, people are facing a new external environment. Recently human society is coming into knowledge economy era, and the industrial structure has deeply been adjusted. Today, the past teaching method of imparting knowledge and getting people to accept education, or exam-oriented teaching ideas have been unable to keep up with the needs of the development of the Times. In the future, the key point of education is to promote people to understand the knowledge, and grasp rules between things. Based on this, it is particularly necessary for the talents cultivation to adopt a new idea of training. The paper takes the major in mathematics as an example, designs two classes of new teaching methods CT&CL and BOOF with the diversified assessment to cultivate students’ innovative thinking, providing a reference for the other students. The two classes of new teaching methods and the diversified assessment are worthy of further spreading and exercising during the coronavirus disease 2019 epidemic.
Background A well-functioning drug supply management is the corner stone for any meaningful health service. However, Pharmaceutical supply systems in many developing countries have severe problems, including inefficient selection, procurement and use of drugs. The magnitude and extent of the problem is huge and chronic in the Ethiopian health care system for a long time. Objective To evaluate auditable pharmaceutical transaction service process in Seka primary hospital, Jimma zone south west Ethiopia. Evaluation Methodology Case study design involving both quantitative and qualitative methods was conducted in Seka primary hospital. The focus of this evaluation was on the process of Auditable pharmaceutical transaction service. The evaluation was focused on process part of the program with dimensions; availability, compliance and client satisfaction in the dimension of accommodation. Resource inventory, document review; key informant interviews and observations were conducted. Client satisfaction was assessed through exit interview; with sample size of 326. The qualitative data was analyzed manually using thematic analysis and quantitative data were analyzed by using SPSS version 23 software. Results In Seka primary hospital, percentage availability of the 32 selected Key medicinewas 10.7(82.0%) and there were no expired drugs found on their shelves. The availability of 17 of the required 20(85%) professionals was adequate according the Auditable pharmaceutical transaction service. The average lead time was found to be less than five days. The average counselling and dispensing time were 5:43 minutes and 1:17 minutes, respectively. The average number of drugs per prescription was 2.0. The 1154(97.9%) of drugs prescribed by generic name and 1175(99.7%) of prescribed drugs on Essential Drug List indicates prescribers ‘adherence to facility specific List. Conclusion This evaluation revealed that (based on the pre-set judgment criteria) the achievement of the Auditable pharmaceutical transaction service in Seka primary Hospital was GOOD 82.6 % (achieved 355.2 of 430 weight given), i.e. even though it is Good achievement ,there are areas that needs improvement. Areas for improvement identified were: Pre- and in-service training for all health workers involved in store room and dispensary to improve on the medium counselling time, poor record keeping and the extremely poor labelingof drugs which this all improve the overall client satisfaction.
Introduction Health care personnel are exposed to a variety of material occupational health hazards while handling biological material and contaminated equipment. The use of appropriate and good qualitypersonal protective equipment in work places cannot be over emphasized. Several years ago, this need was highlighted to several physicians like Sir Thomas Morrison Legye. He identified the role of the employer of labour and those of the employee in reducing workplace hazards and consequently achieving a healthy workplace environment. Objectives This study was to determine level of awareness and utilization of Personal Protective Equipment among Medical Laboratory workers. Methods A questionnaire was structured with two sections and a total of 92 were administered. A pilot study was also carried out before the administration of the questionnaire. The data collected was analyzed on Microsoft excel spreadsheet in duplicate. It was then exported into EPI info version 3.4.1. Data was presented using frequency tables and chi square. Results About 77.3%, 72.9%, and 72.7% were aware of the use of goggle, gloves, and importance of hand washing in preventing exposure to Healthcare associated infections while working on patients’ samples. However, under the socio- demographic characteristics of the respondents and awareness level at P-value < 0.5 the results were 0.02. 0.5, 0.85, 0.92 for education, gender, years in service and age respectively. Hence, there is no significant relationship between respondents’ gender, age and year in service, and level of awareness. Conclusion The hospital management should ensure regular provision and supply of Personal Protective Equipment (PPE) to ensure continual usage. Also, regular training and re-training should be conducted to keep the laboratory workers at briefs with latest innovative and benefits of PPE developments to this end.
Background Pregnancy and parturition are events of considerable significance in the life cycle of women. Though it is supposed that the quality of care during labor, birth, and postpartum period plays a great role for adverse outcomes of birth, various reports claimed that cesarean delivery carries a higher maternal and fetal morbidity and mortality compared to vaginal delivery. Therefore, this study assessed the Rate, Maternal and Fetal Outcome of Cesarean delivery performed by IESO at Shenen Gibe General Hospital, Jimma south west Ethiopia. Integrated Emergency surgical officer is a health professional qualified and authorized to perform emergency obstetrical-gynecological and emergency general surgical procedures. The training has started in 2010 in 3 universities and 10 affiliated sites with intake of 43 students. The MSc program in integrated emergency surgery is intended to achieve one of the millennium development goals (MDG): reducing the overwhelming maternal mortality ratio and perinatal mortality rate at the local and national level. (1) Methods Hospital based two-year retrospective descriptive cross-sectional study design was employed and data collected from November to December 2019 in shenen Gibe General Hospital ,Jimma south west Ethiopia. A total of 185 mothers who delivered by cesarean delivery from December 2017 to December 2018 and complete data were included in the study. Data were extracted using structured data collection format and cleaned, and entered into Epi data software version 3.1 and exported into SPSS version 26 for further descriptive analysis. Result Among 2115 deliveries in the two years of retrospective data, a total of 186 mothers were delivered by cesarean section, giving cesarean delivery rate 8.8 %. The leading indication for cesarean delivery was fetal distress (24.2%). Among the total cesarean delivery, 22 neonates were died, giving the proportion of neonate mortality rate 16.8%. One mothers were died following cesarean delivery, giving maternal mortality rate following cesarean delivery 12 per 1000 live births. The leading cause for maternal mortality was hemorrhagic shock Conclusion However, cesarean delivery rate in this study was within the WHO recommended range, the health outcome of mothers and neonates’ following cesarean delivery was not acceptable. The neonatal and maternal mortality following cesarean delivery was 16.8% and12 per 1000 live births respectively. The main cause of neonatal death was birth asphyxia.
This research paper focuses on rainfall variations in Tamil Nadu, India using Wavelet, Linear regression and Artificial Neural Networks model from 2004 to 2017. As the rainfall is the key factor in understanding climate change, the seasonal datasets from 2004-2017 of Tamil Nadu state has been taken for study. The salient feature of this study is the application of Neural Networks and wavelet analysis. It reveals that the rainfall variations are ambiguous that it does not maintain a constant pattern. Wavelet coefficients of multiresolution spectrogram reveals that the intensity of rainfall in each year. Linear regression model divulge the pattern of rainfall followed in every season and the results show that except winter season all other season suffers deficient rainfall. The deficiency of rainfall may be due to different parameters like ElNino or LaNina pattern or global warming. Results showed that all seasons except winter does not maintain consistency in the rainfall variability. Winter season provides the positive slope values of 4.7 and 0.6 for January and February respectively. Moreover Artificial Neural Networks training provides prominent results of Regression value 0.98 which is comparably high with other seasons taken for study.
A commentary on remote education challenges during COVID‑19 in Brazil. It covers equity, infrastructure, teacher training, and student engagement, proposing pragmatic steps to support learning continuity.
The question that this paper answer is whether the Illinois Reporter’s Privilege should protect an online blogger. The definitions of the terms “reporter,” “news medium,” and “source” quoted from 735 ILCS 5/8-902, followed by several examples. Second, a brief history of journalism is presented, where it is demonstrated that for hundreds of years, journalists and publishers alike engaged in their profession with little formal training, but rather with a sincere desire to convey the facts and the truth to their peers. Second, the essay outlines how Illinois and federal courts have employed the privilege in case law. In answering the question, the work examines whether WikiLeaks qualifies under the Illinois Reporter’s Privilege. The position taken is that the answer is yes. The idea is that if WikiLeaks qualifies under the privilege, then other online blogs also qualify. The opinion of the author is that the law is sufficient as it stands. There is no need to change its wording. Finally, some loose ends are discussed before reiterating the conclusion that the Illinois Reporters’ should not be changed.
Objective This study conducted to assess health care practitioners’ knowledge and perceptions of hand hygiene among health professional working in clinical settings in Khartoum State - Sudan. with the specific objective of determining the association between their stance on hand hygiene and the general demographic characteristics of these health-care professionals. Methodology This is a cross-sectional study conducted between July and November 2017 using a modified form of WHO questionnaire for knowledge and perception that was included 22 items was sent online to health care workers via social media. The data obtained entered and analyzed by SPSS version 24. Chi-square and test of independence were used as a test of significance. A p-value of < 0.05 was considered statistically significant for all purposes. Result 437 hospital staff were responded to the questionnaire. (99.3%) was found to have good knowledge. 197(45.2%) had good perception and 239(54.8%) had fair perception. Formal hand hygiene training was found to have no association with knowledge levels of hand hygiene, but the fair perception was higher in the respondents who didn’t receive formal training. Conclusion The present study highlights the hand hygiene knowledge and perception. Most health care workers were found to have good knowledge, and the majority was found to have a fair perception. Formal hand hygiene training courses were found to have no association with knowledge but it may be reflected in practice. The importance of training sessions regarding hand hygiene was noticed in the perception level.
Background Since receiving unexplained pneumonia patients at the Jinyintan Hospital in Wuhan, China in December 2019, the new coronavirus (COVID-19) has rapidly spread in Wuhan, China and spread to the entire China and some neighboring countries. We establish the dynamics model of infectious diseases and time series model to predict the trend and short-term prediction of the transmission of COVID-19, which will be conducive to the intervention and prevention of COVID-19 by departments at all levels in mainland China and buy more time for clinical trials. Methods Based on the transmission mechanism of COVID-19 in the population and the implemented prevention and control measures, we establish the dynamic models of the six chambers, and establish the time series models based on different mathematical formulas according to the variation law of the original data. Findings The results based on time series analysis and kinetic model analysis show that the cumulative diagnosis of pneumonia of COVID-19 in mainland China can reach 36,343 after one week (February 8, 2020), and the number of basic regenerations can reach 4.01. The cumulative number of confirmed diagnoses will reach a peak of 87,701 on March 15, 2020; the number of basic regenerations in Wuhan will reach 4.3, and the cumulative number of confirmed cases in Wuhan will reach peak at 76,982 on March 20. Whether in Mainland China or Wuhan, both the infection rate and the basic regeneration number of COVID-19 continue to decline, and the results of the sensitivity analysis show that the time it takes for a suspected population to be diagnosed as a confirmed population can have a significant impact on the peak size and duration of the cumulative number of diagnoses. Increased mortality leads to additional cases of pneumonia, while increased cure rates are not sensitive to the cumulative number of confirmed cases. Interpretation Chinese governments at various levels have intervened in many ways to control the epidemic. According to the results of the model analysis, we believe that the emergency intervention measures adopted in the early stage of the epidemic, such as blocking Wuhan, restricting the flow of people in Hubei province, and increasing the support to Wuhan, had a crucial restraining effect on the original spread of the epidemic. It is a very effective prevention and treatment method to continue to increase investment in various medical resources to ensure that suspected patients can be diagnosed and treated in a timely manner. Based on the results of the sensitivity analysis, we believe that enhanced treatment of the bodies of deceased patients can be effective in ensuring that the bodies themselves and the process do not result in additional viral infections, and once the pneumonia patients with the COVID-19 are cured, the antibodies left in their bodies may prevent them from reinfection COVID-19 for a longer period of time.
The skeletal muscle mass varies by race. Dietary habits over generations are a factor that influences the skeletal muscle mass, as well as genetic factors. Therefore, we investigated the effects of diets with different macronutrient contents on exercise-induced muscle hypertrophy in rats. Male 4-week-old Sprague–Dawley rats were randomly divided into three groups: a normal-diet (N), high-protein diet (HP) and high-fat diet (HF) group. The food intake was manipulated to gain comparable body weight across the three groups. All rats were performed a climbing exercise training for 8 weeks. The final body weight and weight of the liver, kidneys and adipose tissues did not significantly differ among the groups. The flexor hallucis longus was significantly higher in the HF group than in the HP group. The total lipid content in the muscle was significantly higher in the HF group than in the N group, while it did not differ significantly between the HF and HP groups. There were no marked differences in the water or protein content in the muscle among the groups. The plasma amino acid concentration was significantly or tended to be lower in the HP group than in the HF or N group, except for the branched-chain amino acid concentration, which tended to be higher after ingesting the HP diet than other diets. These findings suggest that consuming an HP diet is not likely to facilitate exercise-induced muscle hypertrophy, partly due to the plasma amino acid imbalance induced by habitual HP diet consumption.
Background Globally, about 10 to 25% of the volume of bio-medical waste from hospitals and healthcare institutions presents a serious health risks to patients, healthcare personnel, and anybody who comes in contact with it. The waste management practices in Rwanda healthcare facilities are poor and need improvement. Objectives To assess the knowledge and practices regarding bio-medical waste management among healthcare personnel at Kabgayi district hospital in Southern Province of Rwanda. Materials and Methods A cross-sectional study design was conducted. A total of 200 healthcare personnel were selected randomly out of 400 target population including doctors, nurses, social workers, and cleaners. Structured questionnaire was used to collect data. Descriptive analysis using frequency and proportions were used. Chi-Square test was used to determine the association between the variables and level of significance was set at p ≤ 0.05. Results The study found that about half (49.0%) of healthcare personnel had good knowledge about waste management. We found that the majority of healthcare personel 133(66.5%) had poor practices towards bio-medical waste management. The factors associated with good practice were better knowledge on bio-medical waste management (p=0.013) and older age group (p=0.001). Conclusion/Recommendations The level of in both knowledge and practice towards bio-medical waste management among healthcare personnel was low. Continuing education and training programmes and short courses on bio-medical waste management should be carried out to improve the knowledge and practices towards bio-medical waste management among healthcare personnel.
Background Adolescents is the transition from childhood to adulthood .Which is a time of opportunity, but also one of risk. In Ethiopia, sexual and reproductive health problems of adolescents are increasing from time to time related to many parents not feeling happy to discuss sexual matters in addition to early sexual commencement among adolescents. Objective This study was intended to assess parent-adolescent communication on sexual and reproductive health matters and associated factors among secondary and preparatory school students in Robe Town, Bale Zone, South East Ethiopia, 2017. Methods Institution based cross sectional study was conducted among 394 secondary and preparatory school students in Robe town from April 10-25, 2017. Simple random sampling technique was used. Data was obtained through the use of a self administered questionnaire and supplemented by focus group discussion with parents. Data was entered using Epi Data 3.1 and analyzed by SPSS 20. Descriptive statistics and logistic regression analyses were done. Data quality was assured through careful questionnaire design, pretest and training. Results One hundred eighty six (47%) of the study participants had discussed at least two SRH issues with their parents. Grade eleven students were about nearly five times more likely discussed on sexual and reproductive matters with their parent compared with grade nine students (AOR: 4.88, 95% CI: 1.76, 13.54). Those living with relatives were 3.13 times less likely discussed as compared to those students are living with both parents (AOR: 0.32, 95%CI: (0.12, 0.80) and the odds of discussion on SRH matters is 2 times higher among females compared with their counterpart (AOR=2.02, 95% CI: 1.25, 3.26). Conclusions Communication on sexual and reproductive health matters between adolescent and parent was low. Majority of student preferred to discuss with their peers than parent. Being ashamed, parents lack of communication skill and parent knowledge on SRH issues were the major reasons mentioned by the students for not discussing about SRH matters with their parents. Therefore; comprehensive family life education needs to be initiated for the students and parents. Sexual information exchange between peers needs to be strengthened.
Background The Anterior Cruciate Ligament (ACL) injury is uncommon, but constitutes an important percentage of the lesions requiring more than 8 weeks of recovery in sports. Most ACL injuries do not require external contact and are associated with biomechanical risk factors that stress this ligament ACL: like an increase in knee valgus angle (KV) and hip flexion (HF) and a decreased in knee flexion (KF). The ACL requires muscle cooperation to resist the load; however, when there is fatigue, the protective capacity of the musculature would decrease. The objective of the study is to analyze the angular behavior before and after a physical load for HF in children of 14-15 years old. Hypothesis The physical load applied in a single training session is enough to change some biomechanical risk factors of ACL injury. Study Design Experimental study Level of Evidence 2b Methods The sample consisted of 50 students from different soccer schools between 14-15 years old. We analyzed the hip angular behavior of hip flexion before and after a training session. The angles where obtained from inertioal sensor while the students performed a Drop Jump test from a 30 centimeters drawer. Results Statistically significant differences were found in the differences between pre physical load HF / post-load HF (p = 0.00053), right pre physical load HF / right post- load HF (p = 0.0086) and left post- load (p = 0.0248206). Conclusions It was concluded that the angular behavior of HF increases significantly in both post-training limbs, after performing a physical load. Clinical Relevance This study analyzed the importance of using prevention injury programs since early stages, and give importance to the eccentric role of hamstring, gluteus and core exercises.
Introduction In France 33% of patients didn’t take care of hepatitis C because there were no diagnosed. Drug injection was main contamination route of hepatitis C virus (HCV) in France. French guidelines were to treat all inmates and drug users, even fibrosis level. Access of HCV screening, care and treatment in drugs users, prisoners and homeless was low in France. They were considered as difficult to treat populations. All these patients need specific support. Hepatitis Mobile Team (HMT) was created in July 2013 to increase screening care and treatment of hepatitis B and C patients. HMT was composed of hepatologist, nurses, social workers and health care worker. Objective increase outreach screening care treatment access and cure of our target population. Patients and methods Target population was drugs users, prisoners, homeless, precarious people, migrants and psychiatric patients. We proposed part or all of our services to our 42 medical and social partners: HCV HBV screening by DBS (dried blood test); outside DBS and FIBROSCAN in converted van; Outreach open center; Drug users information and prevention, Free blood tests in primary care;, Staff training; Social screening and diagnosis; Mobile liver stiffness Fibroscan in site; Advanced on-site specialist consultation; Easy access to pre-treatment commission; Low cost mobile phones for patients; Individual psycho-educative intervention sessions; Collective educative workshops; Peer to peer educational program; Specific one day hospitalizations. All services were free for patients and for partners. Results from 2013 July to 2018 December, we did 8382 DBS for 5382 people (3053 HCV DBS) and 2302 Fibroscan*. HCV new positive rate was 21.3%. Our HCV active file was 651patients included these 24.8% new patients screened by DBS; 98% realized HCV genotype, HCV viral load and FIBROSCAN. DAA treatment was proposed to 96%; 95% started treatment, 4% were lost follow up or refused treatment. After treatment, there was 7 relapse and 3 reinfections by drug injection and cured rate of 94%. Sociological evaluation showed that 4 program qualities for patients: free access, closeness (outside hospital), speed (of the results) and availability (of nurse and social workers). Conclusions: Specific follow-up of drugs users and other HCV high-risk patients including screening, early detection, diagnosis and treatment increase rate of treated and cured patients, with low rate of relapse and reinfections.
Human immunodeficiency viruses causes HIV infection in humans belongs to two species of Lentivirus. It damages the cells of immune system which leads to weak immune system and the ability to fight from infections and diseases. This study was conducted to investigate the prevalence rate of HIV infection among pregnant women of different age groups attending Ajiko medical clinic, Damaturu, Nigeria. The prevalence rate was maximum (12.5%) in 36-45 age group and minimum (5%) in 26-35 age group but their was no HIV infection in 15-25 age group. The overall prevalence rate among pregnant women was 4%. General knowledge , training and campaigns of HIV prevention need to be tailored towards older women of age group 36-45 because of high prevalence rate.
Entry into the world of work is an important moment for people with disabilities and for their professional inclusion. Using a case study, This research presents the project of school/work alternation carried out with a student with intellectual disability within a supermarket during the frequency of the last year in a higher institute in northern Italy. This study intends to describe the process and highlight the strategies used in this experience. The paper ends with an analysis of the factors that can favour a positive experience and which can be a starting-point for other, similar experiences. This experience shows that, with adequate training, people with intellectual disabilities can be protagonists of an experience that favors their well-being and social inclusion.
Objective The purpose of this study was to evaluate the feasibility of a home-based educational skill building program to support exclusive breastfeeding for mothers in the early postpartum period. Specific aims were to: (1) evaluate the effectiveness of the study’s recruitment strategy, comparing the use of an intermediary with a direct approach, (2) examine intervention fidelity, (3) examine program adherence, and (4) assess the acceptability of the intervention to participants. Design and Sample A mixed methods within-group, three-occasion descriptive design, delivered to 14 dyads of breastfeeding mothers and their full-term singleton infants. Intervention The program was implemented during three, 60-90 minute educational training sessions in the home, delivered at 6, 13, and 27 days postpartum. Results Mothers who adhered to the intervention protocol correctly attributed their infant’s crying behavior to factors other than the adequacy of the mother’s milk supply. All participants were recruited through direct approach. The program was delivered as planned with high fidelity, a high retention rate, and with a high rate of acceptability. Conclusions A fully scripted, at-home, nurse-delivered educational skill building program can be delivered with efficiency to breastfeeding mothers with full-term singleton infants; intervention fidelity, retention, and acceptability were high.
Swimming is a human activity that relies heavily on individual physiological capabilities. In fact, the swimming general performance equation, proposed several years ago by di Prampero 1, highlighted the energy expenditure, the propulsive efficiency and the hydrodynamic drag as its main determinants. Therefore, coaches and exercise physiologists have been proposing a number of testing protocols aiming to diagnose the swimmers physiological training status. However, most of these protocols are invasive, time consuming and costly (e.g. the oxygen uptake assessment and the blood lactate concentrations determination). In addition, some of these tests have some constraints, as the use of a cumbersome breathing valve for respiratory data collection (cf. 2) and the selection of an averaged value of blood lactate concentrations as an non individualized index of endurance performance 34.
Objective: Soccer has a reduced overall recovery time. If these situations are not properly controlled they can cause the athlete chronic fatigue, an increase in delayed-onset muscle soreness (DOMS) and thus result in a decrease in athletic performance. There are several therapies that have attempted to improve athletic performance, decrease the percentage of injuries and results in soccer. Training and recovery instances are opportunities to find ways to address this issue. Understanding the physiology of recovery is essential to accelerate some processes, with the aim of shortening the times. Subjects: Cryotherapy could improve functional performance tests and decrease pain in soccer players. Our work design is an experimental prospective study. Method: Twenty subjects (10 experimental subjects and 10 control group subjects), between the ages of 17 and 23, who are members of a university men's soccer team, participated in the study. The following variables were controlled: power; the number of jumps, the average height of a jump in a 30-second continuous jump test, and DOMS perception through visual analog scale (VAS). Both groups shall be subjected to a more active recovery as well as elongation carried out by the coaching staff. In addition to this, the experimental group shall also be subjected to ice baths (42-47 °F) for three minutes. Results: We found significant statistical differences in the number of jumps and the power of the same in the control group, thus obtaining improvements. No significant differences were observed in either group for the average jump height and percentage yield variables. In the assessment of DOMS significant differences were observed, with a lower perception of DOMS seen in the experimental group. Conclusion: Ice baths provide favorable results in some aspects of the 30-second continuous jump test, decreasing the perception of leg pain and fatigue, and therefore they can be considered a valid alternative in the management of these athletes.
Objective: This study aimed to assess the knowledge and attitude levels of pediatricians in terms of the pertussis vaccine. Materials and Methods: A survey study was carried out to evaluate the knowledge and attitude levels of pediatricians working in Istanbul in terms of the pertussis vaccine between May 1, 2015 and July 1, 2015. Results: A total of 104 pediatricians who comprised of 53 male and 51 female physicians, participated in this study. It was found that 35.6% of them at low-level, 51% at middle-level and 13.5% at a high-level of knowledge. The knowledge-level scores of the pediatricians who had children were significantly higher than those of pediatricians who had not a child on pertussis vaccine. Moreover, the knowledge-level scores of the specialist doctors in terms of the pertussis vaccine were significantly higher than those of the assistant doctors. It was significant that pediatricians who had children suffering from chronic diseases had greater knowledge-level scores in terms of the pertussis vaccine than those who had children without any disease. Conclusion: The knowledge and awareness of physicians in terms of the pertussis vaccine should be increased with in-service trainings, as the surveyors presented an insufficient knowledge level.
Physiological changes in musculature allow widespread movements in human body. Correspondingly, varying in muscle prototypes characterise direct different training paradigms in therapeutics practice or can governs athletic performances. Mode of muscle contraction type are isometric, concentric or eccentric. Great examples of concentric exercise are walking- up-hill, stair ascent and lifting a dumbbell in bicep curl or pushing a bar up. Examples of eccentric muscle actions are walking - down-hill, satire decent and, isokinetic arm and leg extensions. During isometric muscle contraction the length of muscle does not change while muscle exert force .This type of movement can be seen while a person performs a maximal voluntary contractions (MVCs).Eccentric exercises increasing the concentric and isometric contraction as well. Performing the eccentric muscle contraction in daily life enhance quality of life and lifespan due to increasing muscle strength with low cost of energy consuming and thus it can apply in variety of domains. A simple walking task such as downhill - walking (i.e. 30 min) can provide the aforementioned conditions.
Objective: Use "The 11 +" warm-up program in female players of the National Chilean Sub-17 Football team in order to analyze morpho – physiological variables. The implementation of this training program will generate morpho – physiological changes between players exposed. Federation International Football Association (FIFA) created a training program known as the "11+", designed to amend morpho-functional parameters such as lower extremity alignment, strength, intra, and inter muscular coordination and balance, among others. Subjects: Information indicates that injuries are a serious cause of concern for the soccer clubs and therefore, it is necessary to introduce the prevention programs. Methods: 20 female players of the National Chilean Sub-17 Soccer Team, from 14 to 17 years, who trained from March 2017 to January 2018. The “The 11+” warm-up program was considering an independent variable and thigh circumference, jumping ability, speed and balance are considered dependent variables. We use The STATA 11.1 SE (Statistics / Data Analysis) program for the statistical. Results: After implementing the “The 11+” program, significant changes (p < 0.05) were observed in the morphological variables of thigh circumference and functional speed. Concerning the functional variables of jump and balance, favorable but not statistically significant. Conclusions: Application of the "The 11 +" warm-up program for 3 months in addition to proper training, generated morpho – physiological changes associated with an increase in thigh circumference and an improvement in speed. The practical utility is to improve morpho-physiological characteristics of players in a competitive area and thereby to improve the utility of athletic performance indirectly.
This study reviews the agricultural development perspective in the light of a rapid space technology development. In other words, precision agriculture as part of geoinformatics. The aim is to quantify whether the adopted technology can improve the efficiency of agricultural fields management and production to attain food security. Therefore, views of targeted groups from different States of Sudan were investigated, using stratified sampling method. Where quantitative statistics (descriptive/inductive techniques) was applied. About 800 questionnaires were distributed. The outcomes of data analysis reflected that the majority of interviewed groups 357 (82.1%) do not know the principles and application of integrated technology in the field of agricultural management. 85.3% of respondents know nothing about computer program related to precision agriculture. The majority of the respondents (84.6 %), did not get courses on precision agriculture during the under graduate study. The result also revealed that only 11.8% of the respondents use modern techniques in land preparation, 16.1 % in soil analysis, 12.5 % in the field of seed technology, and 11.4% in crop harvesting. However, 53.9% of the respondents reported that their Departments did not care about training on agricultural precision. Nevertheless, 24.3 % of the respondents got trained on precision agriculture through personal efforts, while about 19% got trained by their respective Departments. In regard to education, 16% of the respondents got trained on precision agriculture at undergraduate and only 9% after graduation. The study concludes that despite the rapid technological development, agriculture in Sudan remained lagging, and the productivity is below the expectation. It recommends that the Ministries of Agriculture in different States in Sudan should take the issue of introduction of new technology seriously to boost the agricultural development to attain food security.
Introduction: In an educational organization, because of its important function in human resources development and training in the community, respecting the values, spirituality, leadership, and management strengthening, based on spirituality and good citizenship behavior and commitment have greater importance. Aim: This study examined the relation between spiritual intelligence with organizational citizenship behavior and organizational commitment of secondary school teachers. Methods: The research method was correlational and its population included all teachers in education districts 2 and 5 in 2015 from which 358 teachers were selected by using Cochran formula and simple random sampling method as a sample. To collect data, three questionnaire: the King Spiritual Intelligence questionnaire (2007) and Padasakof et al. citizenship behavior questionnaire (2000) and organizational commitment questionnaire of Meyer (2001)were used .The reliability of the tools obtained by Cronbakh Formula 0/85,0/84, 0/7 respectively. For statistical analysis, the descriptive statistics (average, percentage, Standard deviation) and inferential statistical tests (Kolmogorov - Smirnov test, Pearson correlation coefficient test and stepwise regression analysis) were used. Conclusion: The results showed that none of the components of citizenship behavior has a significant relation with a critical thought component of spiritual intelligence. Regarding the personal meaning making component of spiritual intelligence, only the components of sportsmanship and social customs have a significant relation, and other components have no significant association. All components of citizenship behavior are significantly associated with a transcendental consciousness component of spiritual intelligence and have no significant relation with self-awareness extends component. None of the organizational commitment components have a significant relation to the critical thinking component and high awareness of spiritual intelligence and only the emotional commitment of the organizational commitment component have a significant relation with the personal meaning making of spiritual intelligence, as well as with the expansion of consciousness component.
Background: Ideally, disclosure of HIV status to infected children and adolescents should involve both health care workers and parents/caregivers. Most studies on disclosure in children have focus mainly on parents/caregivers with little information on health care workers. We conduct this study to evaluate the practice, perception of the healthcare workers in our health facility on disclosure to infected children and adolescents. It is envisaged that such information will help in the design of better strategies on disclosure in our environment. Methods: A cross sectional hospital based study was conducted among health care workers at the special treatment clinic, and heart to heart unit of the University of Abuja Teaching Hospital, Gwagwalada from January to March 2017 for the above objective. A structured questionnaire was used to collect information on disclosure among the healthcare workers, which include among others: their bio-data, knowledge, perception, and practice on disclosure in the two service areas of the hospital. Results: Of the 80 health care workers interviewed, 60(75.0%) were females, 11(13.8%) were doctors, 9(11.3%) nurses, 17(21.3%) monitoring/evaluation/record clerks, and 16(20.0%) were either voluntary counseling and testing counselors or adherence counselors. Their mean age and duration in service in the two areas were 39.70±7.10 and 7.93±4.99 years respectively. Over half 48(60.0%) of the health care workers were unaware of the hospital having guideline on disclosure, 64(80.0%) have not been trained, and 68(85.0%) does not know any key information on disclosure. While all 80(100%) felt that disclosure was a good practice for better adherence, only 16(20.0%) had actually disclosed, with 6(37.5%) not seeking any formal permission from parent/caregivers before disclosing. Ages 8-16 years was recommended by 60(75%) as the appropriate age to disclose, however 28(35.0%) recommended age 14-16 years. Over half of the respondents 58(72.5%) admitted that disclosure should be a shared responsibility between themselves and the caregivers, most however perceive their role as only preparing the parents/caregivers for disclosure, and providing ongoing counseling to both the parents/caregivers and the children and adolescents. Lack of training on disclosure, and none availability of guideline in the health institution were major setback on the ability of the healthcare providers to fully participate in disclosure process. Conclusion: While healthcare providers support the idea of disclosing at mid and late adolescent, their perceived role was that of support and provision of ongoing counseling. Lack of training and none availability of disclosure guideline affects their perceived role. There is need to train and retrain healthcare workers on disclosure guideline, and making such guideline available in the health facilities.
Objective: The aim of the present study is to determine the efficiency of third year ophthalmology residents from a tertiary hospital in performing preliminary retinal examination to identify eyes at risk retinopathy of prematurity on the basis of retinal fundus findings up to International Classification of Retinopathy of Prematurity (ICROP) Zone II. Methods: This is a single-center, cross-sectional, prospective comparative research conducted from June to October 2015 at a tertiary training hospital in the Philippines. All infants referred for retinopathy of prematurity screening within the study period where included. The presence of retinal vessel dilatation and tortuosity were identified by third year ophthalmology residents using indirect funduscopy. The residents’ fundus findings were then compared to that of a retina consultant who is proficient in the diagnosis and management of retinopathy of prematurity (ROP). The Kappa index was used to rate inter-observer agreement. The correlation between ROP risk factors and the presence of abnormal retinal vessels were assessed using odd ratio computations. Fisher’s exact test was used to determine the correlation between retinopathy of prematurity and the presence of retinal dilatation and tortuosity. The McNemar’s test was also applied to determine significant differences in the retinal findings of the consultant and ophthalmology residents. Results: A total of 82 eyes of 41 premature infants were evaluated to determine if retinal findings observed by ophthalmology residents were comparable to that of a retina consultant. Odds ratios show that age of gestation, birth weight, and history of blood transfusion are significantly associated with the presence of retinopathy of prematurity. Retinal vessel tortuosity and dilatation are also more common among infants diagnosed with retinopathy of prematurity. There was no significant difference between the retinal vascular findings of the retina consultant and the third year ophthalmology resident in terms of identifying retinal vessel dilatation and tortuosity (P < 0.05). Conclusion: After sufficient and in-depth ophthalmology training, third year ophthalmologists, who will be general ophthalmologists in the future, can reliably identify eyes at risk for severe retinopathy of prematurity on the basis of retinal vascular dilatation and/or tortuosity.
The continuous waves of refugees from Africa and the Middle East to Europe present major inter¬cultural challenges to European health professionals and to society at large. A recent workshop in Sicily brought together local physicians, nurses, psychologists and managers of governmental agencies, along with representatives from Lebanon, Israel, Iraq, Iran, Sudan, Tunisia, Jordan and the European Society of Medical Oncology (ESMO) to develop training programs aimed at formulating dialogue between regional professionals and refugees. A major barrier refugees face is a lack of verbal and cultural communication, which hinders their smooth absorption into the new society. Cultural mediators who speak Arabic and Italian and understand the refugees' faith, tradition and beliefs are vital to successfully build bridges of trust between caregivers and refugees. Most asylum seekers experience anxiety, fear, and depression upon arrival in Europe. To achieve trust, all workshop participants agreed to develop a palliative care model that would best suit the unique circumstances now facing some Mediterranean countries and assist in overcoming the suffering of refugees during their initial stay in Europe. Such a model would include bio-psychosocial elements, essential for a culturally sensitive approach and based on core ethical principles.
This perspective connects green economy transitions with occupational health and safety. It outlines potential hazards, workforce training needs, and prevention policies to ensure safe, sustainable jobs.
Integration of music therapy into medical treatment facilities is very uneven in different countries. Scientific evidence of successful examples and sharing of good practices between countries is essential for the further development of music therapy and the improvement of the quality of complex medical services. The goal of this study was to analyse the situation of music therapy implementation into the health services in Lithuania. Analysis of historical background, legislation and overview on music therapy training has been made. Music therapy in Lithuania has gone through more than thirty years of development. Acqaintance and acceptance of music therapy as a relevant and fruitful component to the complexity of the existing medical services was long but successful process. Overview of current initiatives and achievements of the implementation of music therapy into clinical practice and research has shown promissing positive results in developmental pediatrics, psychiatry, special education, neurology, neonatology, oncology, somatic and preventive medicine, rehabilitation. The Music Therapy Master program in Lithuania is being implemented. Possibilities to use music therapy as an inovative service and resourse in various medical settings are in the process of the rapid growth. Collaboration involving music therapists in interdisciplinary teams would help to achieve a comprehensive, versatile patient-centered and health-centered complex service.
Background: Point-of-care diagnostic tests (POCTs) are increasingly used in both developing and developed countries. They allow same day testing and treatment at remote locations where no laboratory support is available. Quality control measures, which are routinely used in laboratories, have not been widely implemented for POCTs. This aimed to assess the integrity of the entire laboratory testing process, and aims to educate and improve performance in quality of HIV rapid testing. Methods: A health facility based cross section study was conducted from April to June 2016.Randomly selected health facilities were participated in the external quality assessment. Onsite evaluation and panel test were used to collect data using structured checklists and formats. Data was entered and analyzed using SPSS version 16. Results: Between April to June 2016, a total of 60 health facilities (145 testing points) from governmental health facilities (hospitals and health centers) were participated in the study. Among the participated testing points 41% have no designated area, 40% have no clean water for hand washing and 51% have no national test algorithm. The average performance of testing points was varies from 89.6% to 99.1% (Laboratory 99.1%, ANC 90.4%, TB clinic 91.4% and VCT 89.6%). In a multivariable logistic regression model, didn’t follow national testing algorithm to report client test results have statistical significance. Conclusions: High quality test results underpin accurate diagnosis and appropriate treatment for patients. But in the study area the score of proficiency testing result and coverage of training is slightly low comparing to other findings. Therefore following national testing algorithm to report client test results, training and monitoring are critical points to improve the proficiency testing score of testing points.
Background The prevalence of obesity and type 2 diabetes is escalating at an alarming rate in many developed as well as developing countries. Irisin is a novel muscle and adipose drived chemokine that is, proteolytically processed from the product of the FNDC5 (fibronectin type ш domain containing 5) gene. The purpose of this study is to examine the effect of three kind of training on irisin in sedentary obese women. METHODSː33 obese women (medium age: 37.99 ± 3.7 year, height: 1.55 ± 0.03 meter, BMI: 34.6 ± 5.07 kg/m2) participated in the study, on three groups, including endurance, resistance and concurrent. Results After 8 weeks exercise we did not find significant differences in fasting glucose, insulin, HOMA-IR and irisin between the groups (P>0.05), but glucose and insulin in resistance groups and irisin in all groups had significant changes (P<0.05). Conclusions In summery in this study in contrast to hypothesis there were no difference between groups of training. It can be hypothesise that the increase of irisin in obese people is one of the preventing ways against of obesity's side effects. Exercise could improve the signaling pathways and consume the fat accumulations, therefore at the end of exercise duration, irisin decreased.
The socio-cultural context of illness has become a major research area, and it has made significant contributions to our understanding of the socio-cultural dimensions of illness. In this article, we briefly trace the roots of a socio-cultural approach to illness, and we present some of the key findings of socio-cultural organized under main themes. Adherence to antiretroviral therapy drugs in the treatment of HIV infection is complicated because of many psychosocial factors. The aim of the study was to investigate the psychosocial factors involved in non-compliance with ART among people infected with HIV in Alert Hospital in Ethiopia. To achieve its objective, the study utilized a qualitative method to gather direct, inductive and wealthy information from the participants. The study covered interviews with twenty participants. The participants were selected using purposive sampling technique. The collected data was categorized and analyzed thematically based on the research objective. The results of the study indicated that the major psychological and social factors such as stigma and discrimination, social support, substance abuse, subjective norms, belief system and perceived behavioral control, and various cultural factors may uniquely contribute to deeper and potential barriers to ART adherence. Evaluating changes in the level of knowledge health workers trained in adherence measurements and concerned bodies work for providing relevant and updated information about ART issues for the followers in a convincing way. Therefore, the study has concluded that health workers in all facilities that provide ART would be trained in adherence counseling through formal training.
Second-generation antipsychotics have relatively recently become available in long-acting intramuscular formulations (LAIs) and have been receiving a substantial amount of pharmaceutical industry promotion on the grounds that they improve treatment adherence in patients with psychotic illness. LAIs do have some drawbacks, however, which is the topic area covered by this review. A Global Scholar search of the nursing and medical literature reveals several factors that can negatively impinge on the clinical efficacy of LAIs: 1. The extent of training of injection personnel 2. The quality of surveillance of patient symptoms and side effects 3. The skilled use of the full range of injection techniques 4. The extent of drug accumulation over time 5. The potential loss of drug dose flexibility 6. The impact of exercise and temperature on drug distribution 7. The burden of the medication routine and the social burdens of LAIs 8. The safety of LAIs during pregnancy 9. The perceived coerciveness of LAIs 10. Issues of overdose and polypharmacy 11. Issues of cost 12. The important issue of responsibility for self-management of illness. Although the evidence is clinical and anecdotal, LAIs appear to work well for many patients, but their drawbacks are not negligible. Clinicians need to weigh individual risks and benefits when making treatment decisions.
Objective. To describe the attitudes and behavior of registered nurses in their professional interaction toward unlicensed assistive personnel (UAPs) and to identify areas to develop policy for an effective nursing development and workforce planning. Background: One of the challenges health care systems have been addressing is the integration of the UAPs into the nursing care delivery systems. Study Design: Aphenomenological study involving registered nurses, staff and managerial positions. Data were collected using an in-depth semi-structured interview. Findings: Nurses report an increased task management workload which may lead to a decline in the quality of nursing care. Structural factors that are related to nurses and to UAPs were mentioned as affecting the quality of their professional and collaborative interaction. Conclusions: Training nurses to work with UAPs while developing their communication and managerial skills may improve the quality of care and increase their level of satisfaction.
Background: Unemployment is a chronic stressor which is associated with higher levels of impaired physical and mental wellbeing, e.g. reduced heart rate variability (HRV) and decline in self-esteem and self-efficacy. The present study investigated the effectivity of a HRV-biofeedback-training in increasing HRV and general self-efficacy. Method: A total of n = 22 unemployed individuals with adjustment disorder participated in this study (14 females, mean ages 42.53 ± 8.88 years). All participants performed randomized the “stress tests” for heart rate (HR) and HRV assessment: timed breathing, d2-attention-stress-test and math-test drawn from the Trier Social Stress Test (TSST). Four sessions HRV-biofeedback à 20 min within 2 weeks were administered. HR and HRV were assessed before and after biofeedback training. ECG preprocessing and analysis were performed with the Stressball software program (BioSign GmbH, Ottenhofen, Germany). The RMSSD time domain measure was calculated as HRV index. Clinical outcome measures were the ADNM total score and the general self-efficacy scale (GSE). Results: Participants were well matched in terms of demographic and clinical characteristics. ANOVA didn’t demonstrate significant time x group interaction effects neither for HRV parameters (HR, RMSSD) nor for psychological parameters (ADNM, GSE). Conclusion: Our findings do not indicate that HRV-biofeedback can increase HRV nor general self-efficacy in unemployed subjects with adjustment disorder. Implications for future studies are discussed.
We describe seasonal influenza-like illness (ILI) outbreaks in long-term care facilities in the Health Service Executive (HSE) East area of Ireland in the 2013/2014 influenza season, risk factors associated with outbreak duration and attack rates, and management challenges. Separate questionnaires were distributed to 28 facilities who reported an outbreak and to public health specialists leading outbreak management, with a 79% response rate. Mean outbreak duration (21 vs 17 days; p=0.046) was longer in facilities with staff vaccination rates of <40%. Facilities with a high attack rate (≥50%) were less likely to have an outbreak plan (p=0.03). Smaller facilities (under 50 residents) had a higher attack rate (50% vs 23%, p=0.003) even when controlled for staff vaccination rate (p=0.01). Prior to the outbreak, resident vaccination rates were high (82%, above the World Health Organization target of 75%) but staff vaccination rates were low (39%). Reported challenges to ILI outbreak management in long term care facilities included visitor restrictions, staff education issues, outbreak notification delays and lack of outbreak lead in facilities. Targeted public health-assisted planning, training and response, comprising of staff vaccination, education, written policies, with early notification and prompt response would facilitate a more co-ordinated approach to the management of outbreaks, and reduction in infection rates and consequent morbidity.
Objectives The aim of this study was to compare the functional outcomes (including swallowing, respiration and phonation) of supraglottic horizontal laryngectomy (SGHL) and supracricoid partial laryngectomy (SCPL). Methods The clinical and pathological data were evaluated for 36 previously untreated patients who were diagnosed with laryngeal carcinoma and underwent SGHL or SCPL at the Department of Otorhinolaryngology-Istanbul Training and Research Hospital from 2010 to 2016. Removal of the nasogastric tube, decannulation and hospitalisation times were recorded in both groups and postoperative complications were noted. Results The SGHL group contained 15 patients and the SCPL group contained 21 patients (14 cases of cricohyoidoepiglottopexy (CHEP) and 7 cases of cricohyoidopexy (CHP)). The mean age of the subjects was 57.4 years in the SGHL group, and 59.7 in the SCPL group. Patients in the SGHL group were decannulated after 65.2 days, whereas the average decannulation time was 72.6 days in the SCPL group. This difference in decannulation time between the groups was not statistically significant (p>0.05). The mean hospitalisation time was 23 days, with no statistically significant difference between the groups (>0.05). The nasogastric tube was removed from the patients after 37.9 days in the SGHL group and after 35.8 days in the SCPL group. No statistically significant difference was determined in the time to start feeding between the groups (p>0.05). Surgical wound infection, the occurrence of pharyngo-cutaneous fistulas and rupture of the pexy sutures were complications. Conclusion Functional outcomes of SCPL were similar to those of patients who underwent SGHL. The preservation of the hyoid bone is the most important consideration for preserving the swallowing function.
Although inaccurate, non-reproducible blood pressure values can result from non-standardized assessments, recommended approaches to standardize blood pressure measurement are often not followed in research studies. An expert consensus of national and international health and scientific organizations developed recommended minimum standards for assessing blood pressure in research subjects where: 1) blood pressure or hypertension is a major endpoint, or 2) blood pressure is likely a major mediator of the research outcome. Minimum research standards are presented for training of observers, technical aspects of assessing blood pressure, and equipment for both adults and children. The standards are based on prior recommendations some of which did not conform to current evidence based methods. All new research should require adherence to these minimum standards on the patient populations described above. Readers need to use caution in interpreting studies if the standards are not met in the defined populations.
A popular scale for assessing knowledge about Alzheimer’s disease is the Alzheimer’s Disease Knowledge Scale (ADKS). The aim of the study was to investigate the effect of adding ‘don’t know’ to the original ‘true’ or ‘false’ response option. It was assumed that this modification would provide insight into the reasons underlying incorrect responses and could distinguish between misconceptions and knowledge gaps. To investigate this, carers (care home carers and informal carers) and members of the general population were recruited. The results showed that percentage correct responses was lower than previously reported, suggesting potential inflation of knowledge by guesses without the ‘don’t know’ option. Moreover, care-home workers were more likely to select the incorrect response than ‘don’t know’ compared to informal carers for several items related to the earlier stages of AD, suggesting a higher level of misconceptions around this topic and highlighting potential training needs for care home carers.
Background To quantify the underlying rhythmic patterns observed in surface electromyography (SEMG) in patients with Parkinson’s Disease (PD), to compare rhythmicity of PD gait with normal gait, and to compare overground walking to treadmill gait. Methods Eight individuals with idiopathic PD, and ten individuals with no history of neurological disorders participated. SEMG was recorded from the vastus lateralis, tibialis anterior, lateral gastrocnemius and biceps femoris muscles bilaterally. Each participant performed two trials of overground walking and two trials of treadmill walking at a self-selected comfortable walking speed. SEMG was analyzed using a non-linear statistical model that identified underlying recurrent locomotor patterns, which estimated the relative contribution of central pattern generators to the observed muscle activation signals. An index of rhythmicity was determined from the statistic, R2. Results The rhythmicity of PD gait was significantly higher than that of normal gait (p = .0458). There was also a significant difference between the rhythmicity of overground walking and treadmill walking (p = .0097). Conclusions Individuals with PD appear to walk with muscle activation patterns that are more rhythmic than normal. This suggests that there is more stride-to-stride consistency, and there are fewer postural adjustments and responses to perturbations. We also found that treadmill gait was more rhythmic than overground walking. These findings, although preliminary, challenge the paradigm and current approach to gait retraining of patients with PD.
The low level of women autonomy and the key pre disposing factors affecting household decision makings among many population groups in Ethiopia is not well understood among scholars, and is less investigated. This study examined the status and the micro level factors associated with women autonomy in Sidama, the most populous zone in Southern Ethiopia. A simple random sampling technique (using the available complete listing of households) was used to select the 231 sample households from one of the districts of the zone. Sidama zone was selected due to its historically strong customs of patriarchal family system. Quantitative and qualitative data were obtained using structured questionnaire and focus group discussions. Household, women and husband characteristics were used as explanatory variables while women autonomy index, developed from a set of questions, served as the dependent variable. The study revealed that women’s decision makings on core household and personal issues were very low in the study population. The predicted probability, using Ordinary Least Square Regression shows that women’s education, alcohol intake by husbands, household size and land size were the main determinants of autonomy in decision makings in the study area. The study recommended that concerned bodies should capitalize on educating women and girls through both formal and informal learning platforms, promote income generation activities through entrepreneurship, increased access to property and economic assets, training, microfinance and markets.
The prevalence of young adults endorsing depressive symptomatology is thought to peak during late adolescence. While there has been a wealth of research assessing the relationship between decline of the prefrontal cortex and how this process impacts depression and therapy in older adults, very little is known about the relationship on the younger end of the continuum. The current study sought to explore whether there is also a significant relationship between executive functioning and depression in younger adults. In addition, different types of executive dysfunction were assessed to better understand the possible implications for therapy in younger adults with depressive symptomatology. Data from 1,730 college-aged participants were collected on measures of depression (Center for Epidemiological Studies-Depression, CES-D) and executive dysfunction (Dysexecutive Questionnaire, DEX). In addition, three factors of the DEX were assessed; Executive cognition (EC), emotional/ behavioral control (EMO), and metacognition (MC). Correlations between CES-D scores and the full DEX survey were statistically significant (R = .45, p < .001) as were correlations between CES-D scores and scores on each individual factor (p< .001). A multiple linear regression was run to demonstrate the predictive value of each individual DEX factor as a function of CES-D scores (p < .001). Results suggested that there was a clear relationship between depressive symptoms and executive dysfunction and that all factors of the DEX appeared to be affected by depressive symptoms in this population. The implications of these results for therapy, particularly the use of problem-solving therapy or complimentary executive functioning training are discussed.
Objective: We compared preoperative data of physical examination, CT and diffusion MRI findings of temporal bone with our intraoperative observations. We investigated the diagnostic efficiency of single-shot spin echo echoplanar diffusion MRI (SS SE EPI) on primary cholesteatoma. Methods: 33 patients with chronic otitis media who had been admitted to Otolaryngology Department of Haydarpasa Numune Training and Research Hospital between June 2010 and September 2011 were involved in this study. All patients did undergo otoscopic and audiometric examination. After imaging of temporal bone by CT and diffusion MRI, patients were operated and intraoperative observations were recorded. Patients with intraoperatively approved cholesteatoma were defined as group 1 and those without cholesteatoma were defined as group 2. Perioperative and preoperative findings of physical examination, CT and MRI of all patients were compared one by one. Results: Positive physical examination findings have been superior to MRI and CT, having a sensitivity of 96%, specifity of 87.5%, positive predictive value of 96% and negative predictive value of 87.5%. In terms of effectiveness of MRI in diagnosing intraoperative cholesteatoma, we had a sensitivity of 80%, specifity of 50%, positive predictive value of 83.3% and negative predictive value of 44.4%. These values are also lower than previously reported results. Conclusion: When we had preoperative suspection of cholesteatoma on physical examination and diffusion MRI, in addition with bone tissue erosion on CT, we found that physical examination is superior to MRI and CT in terms of capability of diagnosing the disease.
The risk levels of chronic diseases are increasing among Asian migrants in Western countries compared to their origin-country counterparts. This study evaluates the impact of an 8-week nutrition and lifestyle intervention on cardio-metabolic risk factors in Korean migrants living in Melbourne, Australia. Thirty participants aged 32-62 years completed the program. Self-reported food intake and physical activity, anthropometric and blood pressure measurements, and biomarkers of cardio-metabolic risk were assessed. An initial training session and four consequent nutrition advice sessions were provided for all participants. There was a significant reduction in the waist and hip circumferences. Positive changes were also observed in plasma lipid profiles, calcium intake and frequency of physical activities. These findings demonstrate that a culturally appropriate nutrition and lifestyle intervention can be successfully delivered to reduce the cardio-metabolic risk factors and improve the health and wellbeing of Korean adult migrants.
Diabetes mellitus type 2 (DMT2) is a complex polygenic disorder. DMT2 is a result of insulin resistance and destruction of pancreatic β-cell or dysfunction. Therefore, glucose builds up in the bloodstream, leading to nerve damage, blindness, organ failures and sometimes death. Recently, some recently discovered genes play a key role in regulating the sensitivity to insulin. Scientists have long known that the disease often runs in families, and other genetic links. Human genetic discoveries will keep improving our knowledge about diabetes for many years to come. Varieties of prospective diabetic researches were developed to diagnose and control DMT2. Researchers spent thousands of millions of dollars to address DMT2. Pioneers of advanced biotechnology developed bioinformatics tools that changed the course of research about the role of metabolomics in DMT2. It will facilitate the identification of possible causes of DMT2 in genome studies. The present article aimed at reviewing the research studies per training to metabolomics and bioinformatics in genome studies in relation to DMT2.
Background: Health practitioners of different disciplines (physicians, paramedic personnel, pharmacists) should possess adequate ICT (Information and Communication Technology) skills and practical competence on these technologies. Pharmacy practice requires a relevant flow of information, collection and handling of which could be facilitated by ICT. The correct use of ICT requires a proper knowledge by professionals offering a public service. The purpose of this paper was to assess basic informatics background and computer uses in pharmacists practicing in Italy, with the aim to identify educational interventions for increasing their informatics abilities. Methods: A questionnaire was proposed to pharmacists working in Italian community pharmacies. The survey was articulated into 35 questions concerning computer basic knowledge, ICT facilities, computer skills, habits, and uses in pharmacy practice. Results: The questionnaire was completed by ~45% (No. 224) of responders, the 96.9% of which used computer. Only 7.8% of interviewed people employed e-mail to communicate with health authorities and less than 2% used it to be in contact with physicians or other health professionals. Less than 40% used ICT for training courses. The results revealed a relevant percentage (90.8%) of self-learners to computer use, while only 9.2% was trained by specific courses. Conclusion: Basic knowledge of community pharmacists on ICT technological infrastructure is quite low. Although pharmacists play an essential role in health services, they have apparently limited computer skills. This suggests the need of educational and training efforts for enlarging computer and ICT resources competent use in daily pharmacy practice.
Continuous-time glucose monitoring (CGM) effectively improves glucose control, as oppose to infrequent glucose measurements (i.e. using Lancet Meters), by providing frequent blood glucose concentration (BGC) to better associate this variation with changes in behavior. Currently, the most widely used CGM devices rely on a sensor that is inserted invasively under the skin. Because of the invasive nature and also the replacement cost of sensors, the primary users of current CGM devices are insulin dependent people (type 1 and some type 2 diabetics). Most non-insulin dependent diabetics use only lancet glucose measurements. The ultimate goal of this research is the development of CGM technology that overcomes these limitations (i.e. invasive sensors and their cost) in an effort to increase CGM applications among non-insulin dependent people. To meet this objective, this preliminary work has developed a methodology to mathematically infer BGC from measurements of non-invasive input variables which can be thought of as a “virtual” or “soft” sensor approach. In this work virtual sensors are developed and evaluated on 20 subjects using four BGC measurements per day and eight input variables representing meals, activity, stress, and clock time. Up to four weeks of data are collected for each subject. One evaluation consists of 3 days of training and up to 25 days of testing data. The second one consists of one week of training, one week of validation, and 2 weeks of testing data. The third one consists two weeks of training, one week of validation and one week of testing data. Model acceptability is determined on an individual basis based on the fitted correlation to CGM testing data. For 3 day, 1 week, and 2 weeks training studies, 35%, 55% and 65% of the subjects, respectively, met the Acceptability Criteria that we established based on the concept of usefulness.
Retention of sufficient numbers of participants in longitudinal research studies is a serious methodological concern, as retention influences the validity of the research findings. An assessment of participant retention or attending all study visits was made quarterly during a 12 month follow-up of an HIV incident cohort in Kisumu, Kenya. The study objectives were to determine 1) the proportion of participants attending all study visits and 2) demographic and behavioral factors associated with missing ≥ 1 visit. The Kisumu Incidence Cohort Study (KICoS) was initiated in January 2007 (N=831). Detailed contact information was collected from each participant to enhance retention. Bivariate and multivariable analyses were used to determine factors associated with missing ≥ 1 visit. Overall retention was 90%. Of those enrolled, 46.4% were females. The adjusted odds of missing ≥ 1 study visit were greater for participants who were female (AOR=2.85; CI=1.90-4.28) and who had technical training (AOR=2.51; CI=1.20-5.25) or college/university education (AOR=1.89; CI=1.10-3.24) compared to having no or only primary education. Retention was high in this HIV prevention cohort study. However, studies could benefit by tailoring retention strategies for women. Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the views of their respective institutions.
HIV infected children who started antiretroviral therapy (ART) in public health facilities in South Africa have survived to older age and disclosure has become an essential part of their care. Available data on HIV disclosure to children were collected much earlier in the provision of ART in South Africa. The aim of the study was to (a) determine the characteristics of caregivers of pediatric HIV patients in Gauteng, South Africa, (b) estimate the prevalence and timing of HIV disclosure among these patients, and (c) assess the factors associated with disclosure status. A cross-sectional study was conducted among 286 caregivers of paediatric ART children aged 4–17 in two centres in Gauteng, South Africa. Bivariate and multivariate logistic regression analyses were carried out. The highest proportion of care givers were biological mothers (n=140, 49.3%). The mean age of the children was 8.5 years, (range 4-17 years). More than a third (n=99, 34%) were disclosed their HIV status, and the mean age at disclosure was 9.3 years, (SD = 2.7). Child’s age older than 10 years (OR =1.63; 95% CI: 1.44–1.85), having a nonbiological caregiver (OR=1.75; 95% CI: 1.06-2.89), caregiver educational level (OR =0.64; 95% CI: 0.47–0.87), and caregiver’s age older than 60 years (OR=1.02; 95% CI: 1.01-1.04), were significantly associated with HIV disclosure to infected children. The relatively higher prevalence of disclosure is attributed to increasing access to paediatric ART. Training healthcare providers to support caregivers in disclosure will increase the rate of disclosure to HIV infected children receiving ART in public health facilities.