Introduction: A great number of software are currently used to digitalize the patient records in order to optimize the quality of services offered to patients. The objective of this study was to evaluate the effects o...Introduction: A great number of software are currently used to digitalize the patient records in order to optimize the quality of services offered to patients. The objective of this study was to evaluate the effects of Electronic Health Records use in Burundi’s hospitals, taking into account the COVID-19 pandemic context. Methods: This was a quasi-experimental study based on difference in difference method. Ten district hospitals were included in the study, five of them had the Electronic Health Records and five of which did not yet have the Electronic Health Records. The hospital’s control group were chosen using the propensity score matching method. The period before the project’s implementation was 2014 and the period after were 2019 and 2020. Results: After 5 years of the Electronic Health Record’s implementation, the results showed an increase in outpatient consultation (70%), deliveries (more than 100%), caesarean sections (56%) and major surgeries (43%) indicators. The overall quality score of hospitals’ care had a regressive effect of 37% and the income from performance-based funding had an increase by 31%. The indicators which were affected by the context of the COVID-19 pandemic were especially outpatient consultation, caesarian section, income from performance-based funding decreased by 3%, 5% and 20% respectively. Conclusion: The effects of Electronic Health Records use are effective. As the COVID-19 pandemic impacted the hospital’s indicators negatively, the resilient strategies alongside the potential shocks are recommended.展开更多
<strong>Introduction:</strong> Coronavirus disease 2019 (COVID-19) is caused by a viral infection and considered the third coronavirus emerging among human beings over the past two decades. Healthcare Work...<strong>Introduction:</strong> Coronavirus disease 2019 (COVID-19) is caused by a viral infection and considered the third coronavirus emerging among human beings over the past two decades. Healthcare Workers (HCWs) are at high risk of acquiring this serious infection during providing care to patients. Therefore, it’s crucial to assess the knowledge of the HCWs about COVID-19. <strong>Methods:</strong> A multicenter cross-sectional study was conducted on HCWs working at public hospitals and Primary Healthcare (PHC) centers in the Najran region, KSA to evaluate the staff’s knowledge toward COVID-19. The questionnaire consisted of two parts, the first part included the demographic data, and the second part involved questions related to the COVID-19. <strong>Results:</strong> 451 HCWs participated in this study and the median of overall knowledge score was 67%. Most HCWs properly identified symptoms (82.9%), mode of transmission (78.5%), the incubation period (96.4%), the way of preventing the infection (91.5%), the COVID-19 is not same as MERS-CoV (74.3%) and availability of a vaccine against the COVID-19 (82%). However, HCWs were less likely to identify the source of COVID-19 when it was discovered in China (22.5%), the mortality rate (44.6%), and the presence of treatment (32.1%). Overall knowledge score was statistically significantly associated with profession (P = 0.034), educational level (P = 0.033), and availability of the infection control in the workplace (P = 0.006). <strong>Conclusion:</strong> The findings of this study demonstrated an intermediate level of knowledge of HCWs about COVID-19. Intervention programs are urgently needed to raise the knowledge of HCWs about this global public health issue.展开更多
The second wave of COVID-19 pandemic has started globally, right now 220 countries are infected and a total of 71,351,695 confirmed cases and 1,612,372 deaths due to COVID-19 have been reported. Infection Prevention a...The second wave of COVID-19 pandemic has started globally, right now 220 countries are infected and a total of 71,351,695 confirmed cases and 1,612,372 deaths due to COVID-19 have been reported. Infection Prevention and Control (IPC) measures for COVID-19 all have proved vital in decreasing the transmission rates among the communities. <strong>Methodology:</strong> Unmatched Case-Control Study was conducted where cases were defined as “every PCR positive contact (symptomatic or asymptomatic) for any index case” similarly controls were defined as “every PCR negative contact (symptomatic or asymptomatic) for any index case who was home quarantined for 14 days based on suspicion by PDSRU team”. A simple random technique was used and 300 individuals were made part of this study. <strong>Results:</strong> The major findings of this study shows that PCR positive contacts poorly adopted certain COVID-19 IPC measures of interest in their daily life hence got infected. The odds for all the variables of interest were found to be statistically significant among cases as compared to controls like the odds for knowingly and intentionally contacted with a COVID-19 positive case was 13.7 times more among the PCR positive contacts as compare to PCR negative contacts (p = 0.00, C.I = 7.62 - 24.90), similarly, the odds of being a family member of the index COVID-19 case was 7.07 times more among the PCR positive contacts as compared to the PCR negative contacts (p = 0.00, C.I = 3.25 - 15.86). <strong>Conclusion:</strong> Before the development and availability of a vaccine, the only tools that can help prevent the spread of COVID-19 are IPC measures.展开更多
Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since t...Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s. The Ministry of Health and Child Care is relying on screening, which allows early detection of pre-cancerous cells and diagnosis at early stages but many women are not going for the test and no studies have been done to find out why. This study investigated the women’s perception about cervical cancer and its screening using health belief model (HBM) in Bulawayo, where they are two new screening clinics. Methods: We conducted an analytic cross-sectional study. Women from 18 years and above attending health facilities were included in the study. Interviewer administrated questionnaire was used to determine the proportion of screened women and elicit their perception about cervical cancer and its screening. Epi-info version 3.3.2 was used to do bivariate and multivariate analysis. Results: Two hundred women were recruited into the study. The proportion of women who had cervical cancer screening was 52 (26%). Pap smear only had 35 (17.5%) had VIAC only, 13 (6.5%) and Pap smear and VIAC had 4 (2%). Knowledge of cervical cancer and its screening was poor among participants. In multivariate analysis, awareness of cervical cancer screening [adjusted OR 42.05 (95% CI 5.63 - 314.04)] was associated with the uptake of cervical cancer screening and perceiving that having multiple sexual partners[adjusted OR 0.33 (95% CI 0.12 - 0.88)] was independently associated to the uptake of cervical cancer screening. Conclusion: This study demonstrated that lack of awareness of cervical cancer screening is a barrier to the uptake of the screening. Perceiving multiple sexual partners was associated to the uptake of cervical cancer screening. It is therefore necessary to increase awareness in Bulawayo City and educate the community about other risk factors.展开更多
Background: Mothers are dying as a result of abortion associated with preventable unintended pregnancy. The objective of this study was to compare the prevalence of Modern contraceptive use and associated factors amon...Background: Mothers are dying as a result of abortion associated with preventable unintended pregnancy. The objective of this study was to compare the prevalence of Modern contraceptive use and associated factors among Muslim and orthodox Christian women of reproductive age group in Bahir Dar city. Methods: Comparative Cross-sectional study was carried out on 504 participants selected through Simple random sampling technique from the list of households. Data were collected through a pretested interviewer administered questionnaire. The data were analyzed using logistic regression model to determine odds ratio as a measure of strength off association. Result: The prevalence of modern contraceptive use was higher among Orthodox Christian women by 0.28: 95% for the difference (0.19, 0.36). While 63.9% orthodox Christian women were using modern contraceptives only 36.1% of Muslim women were using Modern contraceptive. Age, Religiosity and education level were found to have a statistical association for modern contraceptive use in Both Orthodox Christian and Muslim women (p value < 0.05). Conclusion: The prevalence of modern contraceptive use among Muslim women was found to significantly lower than that in Orthodox Christian. Recommendation: More efforts should be done to increase the number of Modern Contraceptive users, by focusing on awareness creation on Modern contraceptives with special emphasis on Muslims.展开更多
Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the mi...Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric Department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.展开更多
Introduction: Children with surgically repaired esophageal atresia (EA) show esophageal dysmotility. Due to the performance of high-resolution manometry (HRM), three motility alteration patterns have been described, w...Introduction: Children with surgically repaired esophageal atresia (EA) show esophageal dysmotility. Due to the performance of high-resolution manometry (HRM), three motility alteration patterns have been described, which allowed to know the segmental alterations. Objective: To describe the esophageal motility patterns found through HRM in teenagers with EA and to relate these with the associated esophageal pathology and its severity. Materials and Method: Ten teenagers were included with no history of esophageal blockage or dilations in the last six months, who were orally fed and asymptomatic. Through performance of HRM, we found surgical and endoscopic history, as well as of esophageal biopsies and pH monitoring. Results: We found the following patterns: aperistalsis, pressurization and distal contraction. 70% showed distal contraction, and 100% of esophageal endoscopies and biopsies were normal. 57% of the esophageal pH monitoring analyzed was pathologic. In the pressurization and aperistalsis groups, we observed severe esophagitis and requirement of Nissen antireflux procedure in 100% of the cases. Esophageal pH monitoring analyzed was 100% pathologic. Conclusion: We described the esophageal segmental alterations in teenagers with atresia by means of HRM. The distal contraction group showed better development, without severe esophagitis or requirement of antireflux procedure. Therefore, by performing an HRM in teenagers with EA, we could predict the future esophageal behavior, according to the peristaltic pattern, since there are significant differences among the groups in study.展开更多
Cognizant of multifaceted challenge of unwanted pregnancy, Ethiopia strives to increase utiliza-tion of modern family planning across the nation. Therefore, update on the current status of family planning utilization ...Cognizant of multifaceted challenge of unwanted pregnancy, Ethiopia strives to increase utiliza-tion of modern family planning across the nation. Therefore, update on the current status of family planning utilization especially in hard to reach ethnic minorities is critical. The objective of this study was to assess level, and correlates of modern contraceptive utilization in a hard to reach ethnic minorities. A community based study was conducted in Dangur District, Beneshangul Gumuz Regional State July, 2013. A total of 530 married women were included in the study. Structured questionnaire was data collection tool. Data was analysed using SPSS version 20 for windows. Possible association and their strength were measured using odds ratio at 95% CI. Family planning utilization was 18.7% while nearly 27% of study participants had ever used family planning methods. The following variables were predictors of family planning utilization: number of alive children [AOR: 3.31, 95% CI (1.41 - 7.20)], good knowledge [AOR: 2.18, 95% CI (1.35 - 3.52)] and positive attitude [AOR: 1.58, 95% CI (1.03 - 2.50)]. The most outstanding finding of this study was that more than 80% of study participants still believe that many children means high income, and nearly 60% of them believe that family planning utilization decreases confidence among couples. This study witnessed how successful Ethiopia is in addressing reproductive health service inequalities in hard to reach communities. However, misconceptions surrounding family planning, and culture associated desire to have large family size should be addressed in a culture sensitive manner so that this success would further bear fruits.展开更多
<u>Objective</u>: The main aim of the study was to determine whether COVID-19 epidemiological data reported by countries in different hemispheres correlated with the seasons of the year. Since stay-at-home...<u>Objective</u>: The main aim of the study was to determine whether COVID-19 epidemiological data reported by countries in different hemispheres correlated with the seasons of the year. Since stay-at-home orders could be a main factor affecting the time individuals spent outdoors, the progression of COVID-19 in countries that mandated the most stringent lock-downs and stay-at-home orders was compared to countries in the same hemisphere that did not order their citizens to remain at home. <u>Methods</u>: Infections attributed to COVID-19 per million inhabitants, deaths per infections × 100, and deaths per million inhabitants from different countries were analyzed utilizing national reports registered in the Johns’ Hopkins database together with the most recent world population data. The null hypothesis (no difference between countries with and without lock-downs) was tested (two tailed test, p < 0.01) for each paired set of data according to well established statistical analysis. <u>Results</u>: The shift of highest infection rates from countries in the northern-towards countries in the southern-hemisphere during early 2020 and the reverse in December of the same year correlates with the seasonal variation in the flux of germicidal sunlight. Mortality rate for the same virus among different countries did not show a seasonal component. COVID-19 infection mortality rate was considerably lower in developing countries of South America (11 of the largest countries) than in several (at least 8) developed European countries. <u>Discussion</u>: COVID-19 resulted in higher infections during winter than in summer. The finding of a seasonal component, correlating the progression of the pandemic with local solar flux, demonstrates that infectious virus in the environment plays a role in the pandemic since direct person-to-person transmission would afford little time for solar inactivation. Similar epidemiological data amongst “locked” and “unlocked” countries demonstrates that lock-downs and similar confining measures had no effect on the chances of healthy individuals becoming infected with SARS-CoV-2 or dying of COVID-19.展开更多
Obesity is an independent risk factor for chronic diseases such as diabetes, cardiovascular diseases and certain cancers. Early detection of abdominal obesity followed by appropriate interventions will prevent associa...Obesity is an independent risk factor for chronic diseases such as diabetes, cardiovascular diseases and certain cancers. Early detection of abdominal obesity followed by appropriate interventions will prevent associated diseases. The objective was to determine optimal waist circumference (WC) cut-off points predictive of at least one other component of metabolic syndrome in Benin adults. This longitudinal and observational study included at the baseline 541 apparently healthy subjects aged 25 - 60 years randomly selected in the largest city of Cotonou (n = 200), the smaller-size city of Ouidah (n = 171) and rural surroundings of Ouidah (n = 170) in Benin. Components of the metabolic syndrome considered along with abdominal obesity were high blood pressure, high fasting glycaemia, low HDL-cholesterol and high triglycerides as defined by the Joint Interim Statement. After the baseline survey, the subjects were followed-up for four years. Complete data at baseline and four years later were available in 416 subjects. The receiver operating characteristic (ROC) curve for waist circumference to predict at least one other component of the metabolic syndrome was plotted and the Youden index was used to define the optimal cut-offs of WC. At the baseline of the study, the optimal WC cut-off point to predict the presence of at least one other component of the metabolic syndrome was 80 cm for men (sensitivity = 0.62, specificity = 0.65);the area under the ROC curve was 0.67 (IC 95%: 0.61-0.74). In women, the optimal WC cut-off point was 90 cm (sensitivity = 0.54, specificity = 0.80), and the area under the ROC curve was 0.68 (IC 95%: 0.62-0.75). These optimal cut-offs were similar four years later. Optimum WC cut-off points for both men and women in Benin differ from those currently recommended for sub-Saharan Africans. Therefore, waist circumference cut-off points for abdominal obesity need to be reconsidered for these populations.展开更多
Individual causes and community determinants are synergic in maternal death occurrence. This study aimed to identify maternal mortality risk factors in a regional hospital. Material and Methods: This was a retrospecti...Individual causes and community determinants are synergic in maternal death occurrence. This study aimed to identify maternal mortality risk factors in a regional hospital. Material and Methods: This was a retrospective cohort study from data of 1807 hospitalized women. To identify maternal mortality risks factors, mortality hazard ratio (HR CI95%) has been calculated in univariate analysis and Cox proportional hazard model. Results: During hospitalization, 30 maternal deaths occurred. From Cox regression, adjusted mortality HR confirmed that women age older than 35 (HR = 2.5, CI95%: [1.2-5.7] and younger than 19 (HR = 3.02, CI95%: [1.5-6.7]);distance to hospital ≥10 Km (HR = 4.1, CI95%: [1.8-9.4];multiple deliveries (HR = 2.4, CI95%: [1.1-7.3]), less ante natal care (<3 visits) (HR = 3.03, CI95%: [0.97-9.48]);obstetrical maternal mortality directs causes (HR = 2.31, CI95%: [1.7-6.21]) and emergently reference (HR = 3.5, CI95%: [1.8-8.32]) were maternal mortality risk factors. Conclusion: In this regional hospital of low income country, identified maternal mortality factors are related to women socio-economic determinants and quality prenatal or obstetric care access. Interventions to reduce maternal mortality rate should be conducted within both household and women socio-economic status development and in maternal health and obstetric care strengthening.展开更多
A nonlinear mathematical model of vertical transmission of HIV/AIDS is proposed to study the effects of drug resistance in the spread of the disease. The study assumes that treatment leads to the evolution of drug res...A nonlinear mathematical model of vertical transmission of HIV/AIDS is proposed to study the effects of drug resistance in the spread of the disease. The study assumes that treatment leads to the evolution of drug resistance in some pockets of the population. We use traditional methods to determine conditions for existence and stability of disease-free and endemic equilibrium points of the model. The study showed that the burden of the disease may be reduced if the reproduction number is reduced below unity and may persist if the reproduction number is raised above unity. Furthermore, evolution of drug resistance due to treatment may change the cause of the epidemic.展开更多
<strong>Background:</strong> A large percentage of deaths in an epidemic or pandemic can be due to overshoot of population (herd) immunity, either from the initial peak or from planned or unplanned exit fr...<strong>Background:</strong> A large percentage of deaths in an epidemic or pandemic can be due to overshoot of population (herd) immunity, either from the initial peak or from planned or unplanned exit from lockdown or social distancing conditions. <strong>Objectives:</strong> We study partial unlock or reopening interaction with seasonal effects in a managed epidemic to quantify overshoot effects on small and large unlock steps and discover robust strategies for reducing overshoot. <strong>Methods:</strong> We simulate partial unlock of social distancing for epidemics over a range of replication factor, immunity duration and seasonality factor for strategies targeting immunity thresholds using overshoot optimization. <strong>Results:</strong> Seasonality change must be taken into account as one of the steps in an easing sequence, and a two-step unlock, including seasonal effects, minimizes overshoot and deaths. It may cause undershoot, which causes rebounds and assists survival of the pathogen. <strong>Conclusions:</strong> Partial easing levels, even low levels for economic relief while waiting on a vaccine, have population immunity thresholds based on the reduced replication rates and may experience overshoot as well. We further find a two-step strategy remains highly sensitive to variations in case ratio, replication factor, seasonality and timing. We demonstrate a three or more step strategy is more robust, and conclude that the best possible approach minimizes deaths under a range of likely actual conditions which include public response.展开更多
Background: Despite numerous advances in medicine and clinical care, in developing countries, adult undernutrition is overlooked and not considered as a sufficient medical priority. The objective of this study was to ...Background: Despite numerous advances in medicine and clinical care, in developing countries, adult undernutrition is overlooked and not considered as a sufficient medical priority. The objective of this study was to identify the magnitude of adult undernutrition and its associated factors in hospitalized patients. Methods: Cross-sectional study, performed in the university hospital in Bobo-Dioulasso, from August to September 2016, in a sample of 244 adult individuals. Patients were included in the study consecutively to their admission. A structured questionnaire was applied consisting of anthropometric, clinical and dietary data. The patients were evaluated and dichotomized into undernourished and non-undernourished. The rate of undernutrtion was reported using and associated factors were tested using the unadjusted crude Odds ratios (COR) with 95% confidence interval (95% CI) and the Chi-square test. Results: Undernutrition occurred in 32.4% of the sample and at the univariate analysis, the variables associated with undernutrition were: recent and involuntary weight loss (COR = 2.58, 95% CI = 1.45 - 4.59, p Conclusion: Adult undernutrition is common in hospitalized patients. A proper early diagnosis and therapy need to be considered as medical priority of the entire healthcare team that treats adult’s inpatients.展开更多
African-Americans (AAs) maintain a high prevalence of vitamin D insufficiency compared to Caucasians. The relationship between dietary sources of vitamin D and serum 25-hydroxyvitamin D (25(OH)D) among AAs remains poo...African-Americans (AAs) maintain a high prevalence of vitamin D insufficiency compared to Caucasians. The relationship between dietary sources of vitamin D and serum 25-hydroxyvitamin D (25(OH)D) among AAs remains poorly understood. This research examines the dietary determinants of 25(OH)D levels in AAs and Caucasians, controlling for demographic characteristics. 121 Caucasians and 119 AAs participated in a biomarker based study, comparing the correlation of serum 25(OH) D with dietary sources of vitamin D. Diet was assessed by multiple 24-hour (24-hr) recall and Food Frequency Questionnaire (FFQ). Parallel multiple linear and logistic regression models stratified by race were then used to regress 25(OH)D level and sufficiency (25(OH)D > 20 ng/mL) on major dietary sources of vitamin D—multivitamins (MV), milk, and fish—controlling for age, gender, and BMI. Results show that AAs are sensitive to the method of dietary assessment, with multiple 24 hr recall demonstrating highest correlation (0.4) with 25 (OH)D levels. MV’s association with 25(OH)D levels was highest in both groups, 25% higher in AAs vs. Caucasians (8.6 vs. 6.5 ng/mL per 400 IU). Milk’s impact on serum was similar in both groups but fish was only significant among Caucasians. MV consumption significantly increased odds of vitamin D sufficiency in both groups. Given the high prevalence of vitamin D insufficiency and the strong contribution as compared to milk or fish, MV supplementation is recommended. Additionally, future studies aimed at measuring vitamin D intake should consider the use of multiple 24 hr recall instead of a single measure of FFQ or 24 hr recall since the multiple 24 hr recalls have a stronger correlation to serum 25(OH)D.展开更多
We investigated the changes in exercise habits and brachial-ankle pulse wave velocity (baPWV) with lifestyle modification in Japanese. We used data for 105 men (48.2 ± 13.8 years) and 110 women (48.6 ± 12.1 ...We investigated the changes in exercise habits and brachial-ankle pulse wave velocity (baPWV) with lifestyle modification in Japanese. We used data for 105 men (48.2 ± 13.8 years) and 110 women (48.6 ± 12.1 years) without any medications with a 1-year follow up. Subjects were given advice for dietary and lifestyle improvement. At the 1-year follow up, body weight and body mass index (BMI) were significantly decreased in both sexes. Abdominal circumference was significantly decreased in men. In addition, changes in exercise habits were noted in both sexes. In separate analysis in subjects without exercise habits at baseline, the changes in baPWV with exercise habits at follow up was lower than that without exercise habits at follow up in both sexes, but not at a significant level. Lifestyle modification may increase exercise habits, however, it did not evidently change baPWV in this population.展开更多
<strong>Background:</strong> COVID-19 Pandemic is still circulating within the human population and proving to be a deadlier disease with a mortality rate ranging from 0.5% to 7%. Since COVID-19 is a highl...<strong>Background:</strong> COVID-19 Pandemic is still circulating within the human population and proving to be a deadlier disease with a mortality rate ranging from 0.5% to 7%. Since COVID-19 is a highly transmissible disease;there is always a probability for its outward spread towards the general public and community from the hospitals and healthcare facilities where they come to seek treatment. <strong>Methodology:</strong> A prospective cohort study design was used, considering the limited available resources and time—a total of 200 healthcare workers (including doctors, nurses, para-medical staff, janitorial staff, reception staff & pharmacists) working in the OPDs of the two major public sector hospitals of Quetta were made part of this study. The study participants were selected using a simple random sampling technique and selection was made from the daily attendance register. The study participants from “Hospital-A” were first of all educated and trained on various COVID-19 IPC measures later on various COVID-19-IEC materials;written in simple Urdu language, were displayed clearly everywhere in the OPD. Similarly, handwashing stations along with hand sanitizers/soaps and surgical face masks were also made available free of cost for all the study participants of Hospital-A. Moreover the importance and effectiveness of COVID-19 IPC measures were continuously announced in the OPD gallery of Hospital-A, these announcements used simple wording in local languages (<em>i.e.</em>, Urdu, Pashto, Balochi and Brahvi). On the other hand, in the OPD of “Hospital-B”, no such interventions were made. The study participants of both the hospitals were followed for one month and observations like which group showed more on-job noncompliance towards various COVID-19 IPC measures were recorded. The data was recorded on daily basis (from 1<sup>st</sup> May-to-31<sup>st</sup> May 2021) after observing the study participants for compliance towards using face masks, face shields, personal protective gowns, gloves, hand sanitizers, maintaining 6 feet social distancing and implanting triage at his or her OPD counter. Any study participant with daily proper practice of at least face masks, gloves, hand sanitizer and maintaining a 6 feet social distancing SOPs during duty hours at the outdoor patients department was considered to be a compliant individual if even one of these minimum required SOPs has not practiced the study participant, he/she was classified as non-compliant individual. A checklist was used to record these findings for every study participant on daily basis by trained data collectors. Lastly, all the data was analyzed using Microsoft Excel 2007 version. <strong>Results:</strong> The major findings of this study are almost in line with the set objectives, the study results are clearly showing the Risk Ratio (RR) as 0.27, indicating that the intervention group participants were only 27% as likely to develop on-job non-compliance for various COVID-19 IPC measures compare to the non-intervention group. <strong>Discussion & Conclusion:</strong> It is highly recommended that various COVID-19 specific infection prevention and control interventions like COVID-19 IPC trainings, COVID-19 IEC and BCC materials be displayed clearly everywhere in the healthcare facilities especially in the OPD department. Moreover, audio announcements made in simple wording using local languages like Urdu, Pashto, Balochi and Brahvi could really serve as constant reminder tools especially in an OPD department where every next patient in the queue could present with a different infectious bug.展开更多
Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independentl...Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independently. A previous study had established a Fitness Age Score (FAS) based on a theory for biomarker of aging. This study clarified whether the FAS could be used to predict the need for certification of long-term care (CLTC) in independent elderly people. We included 939 independent, community-dwelling-elderly (average age, 74.4 years) whose physical function was measured and for whom the CLTC was tracked for 24 months. The FAS comprised five physical fitness items: Walking time, grip strength, one-leg standing, vertical jump, and functional reach test. Based on the FAS, we calculated the odds ratio (OR) for the CLTC. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) was used for further analysis. We also used the Youden Index (YI), minimum distance method (MD), and two-graph ROC method (TG) to calculate cutoff values (CVs) for screening. We divided subjects into the low and high physical fitness group with CVs. We developed cumulative CLTC curves using the Kaplan-Meier method. Sixteen people could not be tracked for the full 24 months. The measurement of FAS was completed for 798 people, of whom 28 became CLTC. The measurement of FAS was not completed for 125 people, of whom 21 became CLTC. The CLTC OR for people with incomplete FAS was 5.553. The AUC was 0.72 (p < 0.001). The CVs for the FAS were -0.29 for YI (sensitivity, 92.9% and specificity, 40.4%), -1.23 for MD (57.1% and 73.4%), and -0.81 for TG (60.7% and 60.9%). The cumulative CLTC curves according to CVs all showed significant differences (p = 0.000 - 0.020). In conclusion, the FAS can be used to predict CLTC.展开更多
Aims: Establish profiles of young “at risk” of injuries, first, on an overall point of view and, secondly, for some types of injuries (sport, home, road traffic, school and work injuries). Methods: We have taken nea...Aims: Establish profiles of young “at risk” of injuries, first, on an overall point of view and, secondly, for some types of injuries (sport, home, road traffic, school and work injuries). Methods: We have taken nearly 50 variables into consideration: 17 variables for construction of the socioeconomic status, 9 variables for the investigation of symptoms, 11 concerning drugs, 5 for healthy habits, 3 for investigating the violence behavior, 4 concerning the school, 3 for subjective health and finally 3 for social network. We have used the principal component analysis, the multiple correspondence analysis and the weighted-frequency score for reducing the number of them. After these reductions, 15 variables were available for analyses. The relationship between injuries and investigated factors was assessed using the Pearson’s chi-square test. We also calculated odds ratio (OR) with their 95% confidence intervals (95%CI) to estimate the strengths of the associations. To further assess these relationships but also for taking into account the potentials confounding effects of some variables, logistic regression model and multinomial logistic regression model were applied. Results: The whole injury prevalence was equal to 45.6% and among the injured, the proportion of the several types was equal to 33.8% for sport injuries, 32.2% for home injuries, 16.6% for traffic injuries, 11.6% for school injuries and 5.7% for work injuries. We can say that, in light of the variables studied, the “at risk” profile for having reported an injury is being a boy, being younger, having drug experiences, with the violent profile, and declaring several symptoms. There are no consistent and marked deviations in this study from the findings obtained in previous studies. Conclusion: Analyzing injuries in general is interesting but for preventing them it is important to know in which activities children and students are engaged when they are injured.展开更多
Malaria is a public health issue that can cause death. According to the Indonesian Health Profile, in the year 2010, an estimated 45% of Indonesia’s population live in malaria-endemic areas. Pesawaran District is one...Malaria is a public health issue that can cause death. According to the Indonesian Health Profile, in the year 2010, an estimated 45% of Indonesia’s population live in malaria-endemic areas. Pesawaran District is one of the malaria-endemic areas in Lampung province, whose Annual Parasite Incidence in 2010 and 2011 were 2.77 and 4.76 respectively. One of the factors that may inhibit the malaria control is Plasmodium resistance to antimalarial drugs. This study aims to conduct a mapping study and see the prevalence of ACT treatment failure, in Pesawaran District, Lampung Province, Indonesia. Data collection was performed at the Primary Health Centers (PHC) Hanura. A total of 69 samples according to the inclusion and exclusion criteria, the microscopic examination serially for 28 days was done. Microscopic examination performed on D0, D1, D2, D3, D7, D14, D28, and a complaint is found outside the schedule. Coordinates of patient house, determined using GPS. Based on observations, microscopic examination and spatial analysis, the prevalence of ACT treatment failure in patients with falcipaum malaria was 11.59%. The malaria falcifarum patient spread around the coast, that were near vector breeding places. There were five clusters of malaria falciparum patients and one cluster of malaria falciparum patient with treatment failure that were formed. Only one significant cluster of malaria falciparum patient (P = 0.0027, radius 0 km) is found, while the other cluster is not statistically significant. The cluster of malaria falciparum patient with treatment failure was not statistically significant (P = 1.000, radius 0.15 km), but this cluster is located in the area of the suspected vector breeding place. The cluster formation means that people living within a radius of these clusters have a greater risk to get malaria infection.展开更多
文摘Introduction: A great number of software are currently used to digitalize the patient records in order to optimize the quality of services offered to patients. The objective of this study was to evaluate the effects of Electronic Health Records use in Burundi’s hospitals, taking into account the COVID-19 pandemic context. Methods: This was a quasi-experimental study based on difference in difference method. Ten district hospitals were included in the study, five of them had the Electronic Health Records and five of which did not yet have the Electronic Health Records. The hospital’s control group were chosen using the propensity score matching method. The period before the project’s implementation was 2014 and the period after were 2019 and 2020. Results: After 5 years of the Electronic Health Record’s implementation, the results showed an increase in outpatient consultation (70%), deliveries (more than 100%), caesarean sections (56%) and major surgeries (43%) indicators. The overall quality score of hospitals’ care had a regressive effect of 37% and the income from performance-based funding had an increase by 31%. The indicators which were affected by the context of the COVID-19 pandemic were especially outpatient consultation, caesarian section, income from performance-based funding decreased by 3%, 5% and 20% respectively. Conclusion: The effects of Electronic Health Records use are effective. As the COVID-19 pandemic impacted the hospital’s indicators negatively, the resilient strategies alongside the potential shocks are recommended.
文摘<strong>Introduction:</strong> Coronavirus disease 2019 (COVID-19) is caused by a viral infection and considered the third coronavirus emerging among human beings over the past two decades. Healthcare Workers (HCWs) are at high risk of acquiring this serious infection during providing care to patients. Therefore, it’s crucial to assess the knowledge of the HCWs about COVID-19. <strong>Methods:</strong> A multicenter cross-sectional study was conducted on HCWs working at public hospitals and Primary Healthcare (PHC) centers in the Najran region, KSA to evaluate the staff’s knowledge toward COVID-19. The questionnaire consisted of two parts, the first part included the demographic data, and the second part involved questions related to the COVID-19. <strong>Results:</strong> 451 HCWs participated in this study and the median of overall knowledge score was 67%. Most HCWs properly identified symptoms (82.9%), mode of transmission (78.5%), the incubation period (96.4%), the way of preventing the infection (91.5%), the COVID-19 is not same as MERS-CoV (74.3%) and availability of a vaccine against the COVID-19 (82%). However, HCWs were less likely to identify the source of COVID-19 when it was discovered in China (22.5%), the mortality rate (44.6%), and the presence of treatment (32.1%). Overall knowledge score was statistically significantly associated with profession (P = 0.034), educational level (P = 0.033), and availability of the infection control in the workplace (P = 0.006). <strong>Conclusion:</strong> The findings of this study demonstrated an intermediate level of knowledge of HCWs about COVID-19. Intervention programs are urgently needed to raise the knowledge of HCWs about this global public health issue.
文摘The second wave of COVID-19 pandemic has started globally, right now 220 countries are infected and a total of 71,351,695 confirmed cases and 1,612,372 deaths due to COVID-19 have been reported. Infection Prevention and Control (IPC) measures for COVID-19 all have proved vital in decreasing the transmission rates among the communities. <strong>Methodology:</strong> Unmatched Case-Control Study was conducted where cases were defined as “every PCR positive contact (symptomatic or asymptomatic) for any index case” similarly controls were defined as “every PCR negative contact (symptomatic or asymptomatic) for any index case who was home quarantined for 14 days based on suspicion by PDSRU team”. A simple random technique was used and 300 individuals were made part of this study. <strong>Results:</strong> The major findings of this study shows that PCR positive contacts poorly adopted certain COVID-19 IPC measures of interest in their daily life hence got infected. The odds for all the variables of interest were found to be statistically significant among cases as compared to controls like the odds for knowingly and intentionally contacted with a COVID-19 positive case was 13.7 times more among the PCR positive contacts as compare to PCR negative contacts (p = 0.00, C.I = 7.62 - 24.90), similarly, the odds of being a family member of the index COVID-19 case was 7.07 times more among the PCR positive contacts as compared to the PCR negative contacts (p = 0.00, C.I = 3.25 - 15.86). <strong>Conclusion:</strong> Before the development and availability of a vaccine, the only tools that can help prevent the spread of COVID-19 are IPC measures.
文摘Introduction: In Zimbabwe, where cervical cancer is the leading female malignancy, no systematic cervical screening program has been introduced. However, selective or opportunistic screening has been performed since the late 1980s. The Ministry of Health and Child Care is relying on screening, which allows early detection of pre-cancerous cells and diagnosis at early stages but many women are not going for the test and no studies have been done to find out why. This study investigated the women’s perception about cervical cancer and its screening using health belief model (HBM) in Bulawayo, where they are two new screening clinics. Methods: We conducted an analytic cross-sectional study. Women from 18 years and above attending health facilities were included in the study. Interviewer administrated questionnaire was used to determine the proportion of screened women and elicit their perception about cervical cancer and its screening. Epi-info version 3.3.2 was used to do bivariate and multivariate analysis. Results: Two hundred women were recruited into the study. The proportion of women who had cervical cancer screening was 52 (26%). Pap smear only had 35 (17.5%) had VIAC only, 13 (6.5%) and Pap smear and VIAC had 4 (2%). Knowledge of cervical cancer and its screening was poor among participants. In multivariate analysis, awareness of cervical cancer screening [adjusted OR 42.05 (95% CI 5.63 - 314.04)] was associated with the uptake of cervical cancer screening and perceiving that having multiple sexual partners[adjusted OR 0.33 (95% CI 0.12 - 0.88)] was independently associated to the uptake of cervical cancer screening. Conclusion: This study demonstrated that lack of awareness of cervical cancer screening is a barrier to the uptake of the screening. Perceiving multiple sexual partners was associated to the uptake of cervical cancer screening. It is therefore necessary to increase awareness in Bulawayo City and educate the community about other risk factors.
文摘Background: Mothers are dying as a result of abortion associated with preventable unintended pregnancy. The objective of this study was to compare the prevalence of Modern contraceptive use and associated factors among Muslim and orthodox Christian women of reproductive age group in Bahir Dar city. Methods: Comparative Cross-sectional study was carried out on 504 participants selected through Simple random sampling technique from the list of households. Data were collected through a pretested interviewer administered questionnaire. The data were analyzed using logistic regression model to determine odds ratio as a measure of strength off association. Result: The prevalence of modern contraceptive use was higher among Orthodox Christian women by 0.28: 95% for the difference (0.19, 0.36). While 63.9% orthodox Christian women were using modern contraceptives only 36.1% of Muslim women were using Modern contraceptive. Age, Religiosity and education level were found to have a statistical association for modern contraceptive use in Both Orthodox Christian and Muslim women (p value < 0.05). Conclusion: The prevalence of modern contraceptive use among Muslim women was found to significantly lower than that in Orthodox Christian. Recommendation: More efforts should be done to increase the number of Modern Contraceptive users, by focusing on awareness creation on Modern contraceptives with special emphasis on Muslims.
文摘Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric Department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.
文摘Introduction: Children with surgically repaired esophageal atresia (EA) show esophageal dysmotility. Due to the performance of high-resolution manometry (HRM), three motility alteration patterns have been described, which allowed to know the segmental alterations. Objective: To describe the esophageal motility patterns found through HRM in teenagers with EA and to relate these with the associated esophageal pathology and its severity. Materials and Method: Ten teenagers were included with no history of esophageal blockage or dilations in the last six months, who were orally fed and asymptomatic. Through performance of HRM, we found surgical and endoscopic history, as well as of esophageal biopsies and pH monitoring. Results: We found the following patterns: aperistalsis, pressurization and distal contraction. 70% showed distal contraction, and 100% of esophageal endoscopies and biopsies were normal. 57% of the esophageal pH monitoring analyzed was pathologic. In the pressurization and aperistalsis groups, we observed severe esophagitis and requirement of Nissen antireflux procedure in 100% of the cases. Esophageal pH monitoring analyzed was 100% pathologic. Conclusion: We described the esophageal segmental alterations in teenagers with atresia by means of HRM. The distal contraction group showed better development, without severe esophagitis or requirement of antireflux procedure. Therefore, by performing an HRM in teenagers with EA, we could predict the future esophageal behavior, according to the peristaltic pattern, since there are significant differences among the groups in study.
文摘Cognizant of multifaceted challenge of unwanted pregnancy, Ethiopia strives to increase utiliza-tion of modern family planning across the nation. Therefore, update on the current status of family planning utilization especially in hard to reach ethnic minorities is critical. The objective of this study was to assess level, and correlates of modern contraceptive utilization in a hard to reach ethnic minorities. A community based study was conducted in Dangur District, Beneshangul Gumuz Regional State July, 2013. A total of 530 married women were included in the study. Structured questionnaire was data collection tool. Data was analysed using SPSS version 20 for windows. Possible association and their strength were measured using odds ratio at 95% CI. Family planning utilization was 18.7% while nearly 27% of study participants had ever used family planning methods. The following variables were predictors of family planning utilization: number of alive children [AOR: 3.31, 95% CI (1.41 - 7.20)], good knowledge [AOR: 2.18, 95% CI (1.35 - 3.52)] and positive attitude [AOR: 1.58, 95% CI (1.03 - 2.50)]. The most outstanding finding of this study was that more than 80% of study participants still believe that many children means high income, and nearly 60% of them believe that family planning utilization decreases confidence among couples. This study witnessed how successful Ethiopia is in addressing reproductive health service inequalities in hard to reach communities. However, misconceptions surrounding family planning, and culture associated desire to have large family size should be addressed in a culture sensitive manner so that this success would further bear fruits.
文摘<u>Objective</u>: The main aim of the study was to determine whether COVID-19 epidemiological data reported by countries in different hemispheres correlated with the seasons of the year. Since stay-at-home orders could be a main factor affecting the time individuals spent outdoors, the progression of COVID-19 in countries that mandated the most stringent lock-downs and stay-at-home orders was compared to countries in the same hemisphere that did not order their citizens to remain at home. <u>Methods</u>: Infections attributed to COVID-19 per million inhabitants, deaths per infections × 100, and deaths per million inhabitants from different countries were analyzed utilizing national reports registered in the Johns’ Hopkins database together with the most recent world population data. The null hypothesis (no difference between countries with and without lock-downs) was tested (two tailed test, p < 0.01) for each paired set of data according to well established statistical analysis. <u>Results</u>: The shift of highest infection rates from countries in the northern-towards countries in the southern-hemisphere during early 2020 and the reverse in December of the same year correlates with the seasonal variation in the flux of germicidal sunlight. Mortality rate for the same virus among different countries did not show a seasonal component. COVID-19 infection mortality rate was considerably lower in developing countries of South America (11 of the largest countries) than in several (at least 8) developed European countries. <u>Discussion</u>: COVID-19 resulted in higher infections during winter than in summer. The finding of a seasonal component, correlating the progression of the pandemic with local solar flux, demonstrates that infectious virus in the environment plays a role in the pandemic since direct person-to-person transmission would afford little time for solar inactivation. Similar epidemiological data amongst “locked” and “unlocked” countries demonstrates that lock-downs and similar confining measures had no effect on the chances of healthy individuals becoming infected with SARS-CoV-2 or dying of COVID-19.
文摘Obesity is an independent risk factor for chronic diseases such as diabetes, cardiovascular diseases and certain cancers. Early detection of abdominal obesity followed by appropriate interventions will prevent associated diseases. The objective was to determine optimal waist circumference (WC) cut-off points predictive of at least one other component of metabolic syndrome in Benin adults. This longitudinal and observational study included at the baseline 541 apparently healthy subjects aged 25 - 60 years randomly selected in the largest city of Cotonou (n = 200), the smaller-size city of Ouidah (n = 171) and rural surroundings of Ouidah (n = 170) in Benin. Components of the metabolic syndrome considered along with abdominal obesity were high blood pressure, high fasting glycaemia, low HDL-cholesterol and high triglycerides as defined by the Joint Interim Statement. After the baseline survey, the subjects were followed-up for four years. Complete data at baseline and four years later were available in 416 subjects. The receiver operating characteristic (ROC) curve for waist circumference to predict at least one other component of the metabolic syndrome was plotted and the Youden index was used to define the optimal cut-offs of WC. At the baseline of the study, the optimal WC cut-off point to predict the presence of at least one other component of the metabolic syndrome was 80 cm for men (sensitivity = 0.62, specificity = 0.65);the area under the ROC curve was 0.67 (IC 95%: 0.61-0.74). In women, the optimal WC cut-off point was 90 cm (sensitivity = 0.54, specificity = 0.80), and the area under the ROC curve was 0.68 (IC 95%: 0.62-0.75). These optimal cut-offs were similar four years later. Optimum WC cut-off points for both men and women in Benin differ from those currently recommended for sub-Saharan Africans. Therefore, waist circumference cut-off points for abdominal obesity need to be reconsidered for these populations.
文摘Individual causes and community determinants are synergic in maternal death occurrence. This study aimed to identify maternal mortality risk factors in a regional hospital. Material and Methods: This was a retrospective cohort study from data of 1807 hospitalized women. To identify maternal mortality risks factors, mortality hazard ratio (HR CI95%) has been calculated in univariate analysis and Cox proportional hazard model. Results: During hospitalization, 30 maternal deaths occurred. From Cox regression, adjusted mortality HR confirmed that women age older than 35 (HR = 2.5, CI95%: [1.2-5.7] and younger than 19 (HR = 3.02, CI95%: [1.5-6.7]);distance to hospital ≥10 Km (HR = 4.1, CI95%: [1.8-9.4];multiple deliveries (HR = 2.4, CI95%: [1.1-7.3]), less ante natal care (<3 visits) (HR = 3.03, CI95%: [0.97-9.48]);obstetrical maternal mortality directs causes (HR = 2.31, CI95%: [1.7-6.21]) and emergently reference (HR = 3.5, CI95%: [1.8-8.32]) were maternal mortality risk factors. Conclusion: In this regional hospital of low income country, identified maternal mortality factors are related to women socio-economic determinants and quality prenatal or obstetric care access. Interventions to reduce maternal mortality rate should be conducted within both household and women socio-economic status development and in maternal health and obstetric care strengthening.
文摘A nonlinear mathematical model of vertical transmission of HIV/AIDS is proposed to study the effects of drug resistance in the spread of the disease. The study assumes that treatment leads to the evolution of drug resistance in some pockets of the population. We use traditional methods to determine conditions for existence and stability of disease-free and endemic equilibrium points of the model. The study showed that the burden of the disease may be reduced if the reproduction number is reduced below unity and may persist if the reproduction number is raised above unity. Furthermore, evolution of drug resistance due to treatment may change the cause of the epidemic.
文摘<strong>Background:</strong> A large percentage of deaths in an epidemic or pandemic can be due to overshoot of population (herd) immunity, either from the initial peak or from planned or unplanned exit from lockdown or social distancing conditions. <strong>Objectives:</strong> We study partial unlock or reopening interaction with seasonal effects in a managed epidemic to quantify overshoot effects on small and large unlock steps and discover robust strategies for reducing overshoot. <strong>Methods:</strong> We simulate partial unlock of social distancing for epidemics over a range of replication factor, immunity duration and seasonality factor for strategies targeting immunity thresholds using overshoot optimization. <strong>Results:</strong> Seasonality change must be taken into account as one of the steps in an easing sequence, and a two-step unlock, including seasonal effects, minimizes overshoot and deaths. It may cause undershoot, which causes rebounds and assists survival of the pathogen. <strong>Conclusions:</strong> Partial easing levels, even low levels for economic relief while waiting on a vaccine, have population immunity thresholds based on the reduced replication rates and may experience overshoot as well. We further find a two-step strategy remains highly sensitive to variations in case ratio, replication factor, seasonality and timing. We demonstrate a three or more step strategy is more robust, and conclude that the best possible approach minimizes deaths under a range of likely actual conditions which include public response.
文摘Background: Despite numerous advances in medicine and clinical care, in developing countries, adult undernutrition is overlooked and not considered as a sufficient medical priority. The objective of this study was to identify the magnitude of adult undernutrition and its associated factors in hospitalized patients. Methods: Cross-sectional study, performed in the university hospital in Bobo-Dioulasso, from August to September 2016, in a sample of 244 adult individuals. Patients were included in the study consecutively to their admission. A structured questionnaire was applied consisting of anthropometric, clinical and dietary data. The patients were evaluated and dichotomized into undernourished and non-undernourished. The rate of undernutrtion was reported using and associated factors were tested using the unadjusted crude Odds ratios (COR) with 95% confidence interval (95% CI) and the Chi-square test. Results: Undernutrition occurred in 32.4% of the sample and at the univariate analysis, the variables associated with undernutrition were: recent and involuntary weight loss (COR = 2.58, 95% CI = 1.45 - 4.59, p Conclusion: Adult undernutrition is common in hospitalized patients. A proper early diagnosis and therapy need to be considered as medical priority of the entire healthcare team that treats adult’s inpatients.
文摘African-Americans (AAs) maintain a high prevalence of vitamin D insufficiency compared to Caucasians. The relationship between dietary sources of vitamin D and serum 25-hydroxyvitamin D (25(OH)D) among AAs remains poorly understood. This research examines the dietary determinants of 25(OH)D levels in AAs and Caucasians, controlling for demographic characteristics. 121 Caucasians and 119 AAs participated in a biomarker based study, comparing the correlation of serum 25(OH) D with dietary sources of vitamin D. Diet was assessed by multiple 24-hour (24-hr) recall and Food Frequency Questionnaire (FFQ). Parallel multiple linear and logistic regression models stratified by race were then used to regress 25(OH)D level and sufficiency (25(OH)D > 20 ng/mL) on major dietary sources of vitamin D—multivitamins (MV), milk, and fish—controlling for age, gender, and BMI. Results show that AAs are sensitive to the method of dietary assessment, with multiple 24 hr recall demonstrating highest correlation (0.4) with 25 (OH)D levels. MV’s association with 25(OH)D levels was highest in both groups, 25% higher in AAs vs. Caucasians (8.6 vs. 6.5 ng/mL per 400 IU). Milk’s impact on serum was similar in both groups but fish was only significant among Caucasians. MV consumption significantly increased odds of vitamin D sufficiency in both groups. Given the high prevalence of vitamin D insufficiency and the strong contribution as compared to milk or fish, MV supplementation is recommended. Additionally, future studies aimed at measuring vitamin D intake should consider the use of multiple 24 hr recall instead of a single measure of FFQ or 24 hr recall since the multiple 24 hr recalls have a stronger correlation to serum 25(OH)D.
文摘We investigated the changes in exercise habits and brachial-ankle pulse wave velocity (baPWV) with lifestyle modification in Japanese. We used data for 105 men (48.2 ± 13.8 years) and 110 women (48.6 ± 12.1 years) without any medications with a 1-year follow up. Subjects were given advice for dietary and lifestyle improvement. At the 1-year follow up, body weight and body mass index (BMI) were significantly decreased in both sexes. Abdominal circumference was significantly decreased in men. In addition, changes in exercise habits were noted in both sexes. In separate analysis in subjects without exercise habits at baseline, the changes in baPWV with exercise habits at follow up was lower than that without exercise habits at follow up in both sexes, but not at a significant level. Lifestyle modification may increase exercise habits, however, it did not evidently change baPWV in this population.
文摘<strong>Background:</strong> COVID-19 Pandemic is still circulating within the human population and proving to be a deadlier disease with a mortality rate ranging from 0.5% to 7%. Since COVID-19 is a highly transmissible disease;there is always a probability for its outward spread towards the general public and community from the hospitals and healthcare facilities where they come to seek treatment. <strong>Methodology:</strong> A prospective cohort study design was used, considering the limited available resources and time—a total of 200 healthcare workers (including doctors, nurses, para-medical staff, janitorial staff, reception staff & pharmacists) working in the OPDs of the two major public sector hospitals of Quetta were made part of this study. The study participants were selected using a simple random sampling technique and selection was made from the daily attendance register. The study participants from “Hospital-A” were first of all educated and trained on various COVID-19 IPC measures later on various COVID-19-IEC materials;written in simple Urdu language, were displayed clearly everywhere in the OPD. Similarly, handwashing stations along with hand sanitizers/soaps and surgical face masks were also made available free of cost for all the study participants of Hospital-A. Moreover the importance and effectiveness of COVID-19 IPC measures were continuously announced in the OPD gallery of Hospital-A, these announcements used simple wording in local languages (<em>i.e.</em>, Urdu, Pashto, Balochi and Brahvi). On the other hand, in the OPD of “Hospital-B”, no such interventions were made. The study participants of both the hospitals were followed for one month and observations like which group showed more on-job noncompliance towards various COVID-19 IPC measures were recorded. The data was recorded on daily basis (from 1<sup>st</sup> May-to-31<sup>st</sup> May 2021) after observing the study participants for compliance towards using face masks, face shields, personal protective gowns, gloves, hand sanitizers, maintaining 6 feet social distancing and implanting triage at his or her OPD counter. Any study participant with daily proper practice of at least face masks, gloves, hand sanitizer and maintaining a 6 feet social distancing SOPs during duty hours at the outdoor patients department was considered to be a compliant individual if even one of these minimum required SOPs has not practiced the study participant, he/she was classified as non-compliant individual. A checklist was used to record these findings for every study participant on daily basis by trained data collectors. Lastly, all the data was analyzed using Microsoft Excel 2007 version. <strong>Results:</strong> The major findings of this study are almost in line with the set objectives, the study results are clearly showing the Risk Ratio (RR) as 0.27, indicating that the intervention group participants were only 27% as likely to develop on-job non-compliance for various COVID-19 IPC measures compare to the non-intervention group. <strong>Discussion & Conclusion:</strong> It is highly recommended that various COVID-19 specific infection prevention and control interventions like COVID-19 IPC trainings, COVID-19 IEC and BCC materials be displayed clearly everywhere in the healthcare facilities especially in the OPD department. Moreover, audio announcements made in simple wording using local languages like Urdu, Pashto, Balochi and Brahvi could really serve as constant reminder tools especially in an OPD department where every next patient in the queue could present with a different infectious bug.
文摘Long-Term Care Insurance System has been introduced to provide appropriate care for the elderly who needs nursing care in Japan. Physical function is one of most important function for the elderly to live independently. A previous study had established a Fitness Age Score (FAS) based on a theory for biomarker of aging. This study clarified whether the FAS could be used to predict the need for certification of long-term care (CLTC) in independent elderly people. We included 939 independent, community-dwelling-elderly (average age, 74.4 years) whose physical function was measured and for whom the CLTC was tracked for 24 months. The FAS comprised five physical fitness items: Walking time, grip strength, one-leg standing, vertical jump, and functional reach test. Based on the FAS, we calculated the odds ratio (OR) for the CLTC. Receiver operating characteristic (ROC) curves and the area under the curve (AUC) was used for further analysis. We also used the Youden Index (YI), minimum distance method (MD), and two-graph ROC method (TG) to calculate cutoff values (CVs) for screening. We divided subjects into the low and high physical fitness group with CVs. We developed cumulative CLTC curves using the Kaplan-Meier method. Sixteen people could not be tracked for the full 24 months. The measurement of FAS was completed for 798 people, of whom 28 became CLTC. The measurement of FAS was not completed for 125 people, of whom 21 became CLTC. The CLTC OR for people with incomplete FAS was 5.553. The AUC was 0.72 (p < 0.001). The CVs for the FAS were -0.29 for YI (sensitivity, 92.9% and specificity, 40.4%), -1.23 for MD (57.1% and 73.4%), and -0.81 for TG (60.7% and 60.9%). The cumulative CLTC curves according to CVs all showed significant differences (p = 0.000 - 0.020). In conclusion, the FAS can be used to predict CLTC.
文摘Aims: Establish profiles of young “at risk” of injuries, first, on an overall point of view and, secondly, for some types of injuries (sport, home, road traffic, school and work injuries). Methods: We have taken nearly 50 variables into consideration: 17 variables for construction of the socioeconomic status, 9 variables for the investigation of symptoms, 11 concerning drugs, 5 for healthy habits, 3 for investigating the violence behavior, 4 concerning the school, 3 for subjective health and finally 3 for social network. We have used the principal component analysis, the multiple correspondence analysis and the weighted-frequency score for reducing the number of them. After these reductions, 15 variables were available for analyses. The relationship between injuries and investigated factors was assessed using the Pearson’s chi-square test. We also calculated odds ratio (OR) with their 95% confidence intervals (95%CI) to estimate the strengths of the associations. To further assess these relationships but also for taking into account the potentials confounding effects of some variables, logistic regression model and multinomial logistic regression model were applied. Results: The whole injury prevalence was equal to 45.6% and among the injured, the proportion of the several types was equal to 33.8% for sport injuries, 32.2% for home injuries, 16.6% for traffic injuries, 11.6% for school injuries and 5.7% for work injuries. We can say that, in light of the variables studied, the “at risk” profile for having reported an injury is being a boy, being younger, having drug experiences, with the violent profile, and declaring several symptoms. There are no consistent and marked deviations in this study from the findings obtained in previous studies. Conclusion: Analyzing injuries in general is interesting but for preventing them it is important to know in which activities children and students are engaged when they are injured.
文摘Malaria is a public health issue that can cause death. According to the Indonesian Health Profile, in the year 2010, an estimated 45% of Indonesia’s population live in malaria-endemic areas. Pesawaran District is one of the malaria-endemic areas in Lampung province, whose Annual Parasite Incidence in 2010 and 2011 were 2.77 and 4.76 respectively. One of the factors that may inhibit the malaria control is Plasmodium resistance to antimalarial drugs. This study aims to conduct a mapping study and see the prevalence of ACT treatment failure, in Pesawaran District, Lampung Province, Indonesia. Data collection was performed at the Primary Health Centers (PHC) Hanura. A total of 69 samples according to the inclusion and exclusion criteria, the microscopic examination serially for 28 days was done. Microscopic examination performed on D0, D1, D2, D3, D7, D14, D28, and a complaint is found outside the schedule. Coordinates of patient house, determined using GPS. Based on observations, microscopic examination and spatial analysis, the prevalence of ACT treatment failure in patients with falcipaum malaria was 11.59%. The malaria falcifarum patient spread around the coast, that were near vector breeding places. There were five clusters of malaria falciparum patients and one cluster of malaria falciparum patient with treatment failure that were formed. Only one significant cluster of malaria falciparum patient (P = 0.0027, radius 0 km) is found, while the other cluster is not statistically significant. The cluster of malaria falciparum patient with treatment failure was not statistically significant (P = 1.000, radius 0.15 km), but this cluster is located in the area of the suspected vector breeding place. The cluster formation means that people living within a radius of these clusters have a greater risk to get malaria infection.
