Exploring the meaning of care among lived experiences of patients with blindness:an interpretive phenomenological study

Objective:To explore the meaning of care experienced by people with blindness in hospitals.Methods:Interpretive phenomenology along with the 6-step method of van Manen was used to conduct the study.Using purposeful sampling,15 people with legal blindness were interviewed.Thematic analysis was used to isolate the meaning of care.Results:Five themes emerged:(a)nurses in the eyes of patients with blindness;(b)negligence in the caring moments;(c)being cared for in ambiguity;(d)Uncoordinated care;and(e)Psychological discomfor t.These sub-themes were condensed into an overarching theme titled as“marginalized patients inside the stereotypical healthcare system.”Conclusions:Lived experiences of patients with blindness revealed that hospitals provide stereotypic or inappropriate care for this minority group in society.Health professionals par ticularly nurses should be skilled to provide person-centered and coordinated care for patients with blindness.

The Role of Library and Information Science Education in the Development of Community Health Information Services for People Living with HIV/AIDS: Perspectives of Directors and Managers of Public Libraries

This article identifies the role of library and information science (LIS) education in the development of community health information services for people living with HIV/AIDS (PLWHA). Preliminary findings are presented from semi- structured qualitative interviews that were conducted with eleven directors and managers of local branches in the Knox County Public Library (KCPL) System that is located in the East Tennessee region in the United States. Select feedback reported by research participants is summarized in the article about strategies in LIS education that can help local public librarians and others in their efforts to become more responsive information providers to PLWHA. Research findings help better understand the issues and concerns regarding the development of digital and non-digital health information services for PLWHA in local public library institutions.

Study on Water Consumption Coefficient of People's Living and Its Regional Disparity in the North of China

By employing the information-reshufflingmethod that integrates census data, precipitation dataand inquiry data of water consumption, this paperdiscusses 5 (water consumption coefficient of people’sliving) in allusion to different precipitation zones anddifferent periods of time. The study shows that 5-(water consumption coefficient of urban people’sliving), 5. (water consumption coefficient of ruralpeople’s living) and increase with time passing, andthe increasing extent of 5 is 1.84, 2.62, 2.84 and 2.68times respectively from the west to the east, whichresults from the total quantity of water resources andthe speed of urbanization. 5- and 5. of eachprecipitation zone increased with 5- increasing morequickly than 5., and the difference between the twoalso increased when time passed. In the past fifty years(1950-2000), the increasing extent of 5- was 1.71,2.96, 2.41 and 2.33 times respectively from the westto the east, in which 200-400mm precipitation zoneincreased more than others. Meanwhile the increasingextent of 5. is 1.55, 1.60, 1.53 and 1.64 timesrespectively from the west to the east with eachprecipitation zone increasing similarly. The change of5-is due to the speed of urbanization and the stabilityof water resources. This study provides basis forcalculating the water demand of people’s living andrevealing the impact of water demand of people’s livingon ecological drought in different zones.

Assessment of the Level of Knowledge, Attitude, and Practice with Regard to Care of People Living with HIV/AIDS among Nursing and Midwifery Students in Fako, Cameroon

Due to the chronic shortage of health personnel, nurses and midwives now play a fundamental role in the care and treatment of people living with HIV/ AIDS (PLHIV) in Cameroon. This study was therefore designed to assess the level of knowledge, attitude and practice with regard to care of PLHIV among nursing and midwifery students in Fako division of Cameroon. A survey was performed between May and July 2015, among 227 nursing and midwifery students (in their second to final year of study), selected from 8 government accredited training institutions in Fako division of Cameroon. An anonymous self-administered semi-structured questionnaire was used to collect data. The Pearson’s chi-square test, univariate and multivariate logistic regression analyses adjusting for possible confounders were all performed as part of the statistical analyses. The cutoff of statistical significance was set at p ≤ 0.05. Nursing and midwifery students had a moderate level of HIV/AIDS knowledge (average score of 7.02 on a scale of 11). Attitude towards PLHIV was generally positive (68.7%) but there were some misconceptions and prejudice about PLHIV, with considerable stigmatization (31.3%), unwillingness to share a room with someone infected with HIV (27.7%), and unwillingness to work on PLHIV (23.8%). Good HIV/AIDS knowledge was observed to be the sole independent predictor (p = 0.004) of positive attitude towards PLHIV. Fur-thermore the confidence of the respondents regarding care of PLHIV was generally moderate. Our results suggest the need for the development of a more appropriate education program in nursing and midwifery institutions in Fako division to reduce the discrepancies between the general knowledge, attitude and practice regarding care of PLHIV.

Determination of a Cut-Off Point of a Scale for Achievement Motive in Geriatrics That Predicts the Frequency of Undertaking Instrumental Activities of Daily Living in Community-Dwelling Elderly People

Background: Among elderly people, rehabilitation is important for reducing the risk of falls and hospitalization and to maintain an independent life for longer. Motivation is a factor for elderly people to lead an active daily life and leave home more frequently. Purpose: The purposes of this study were to determine the optimal cut-off point in the Scale for Achievement Motive in Geriatrics (SAMG) that could identify individuals as inactive or active, based on the Frenchay Activities Index (FAI), and to compare characteristics between active and inactive groups classified by the cut-off point. Methods: A cross-sectional study of 285 community-dwelling elderly people measured SAMG and FAI and physical function. Receiver operating characteristic (ROC) analysis was used to calculate the area under the curve (AUC) that was the optimal cut-off point for the SAMG total score, with the associated sensitivity and 1-specificity when compared with the FAI results. Demographic parameters and physical function were compared between two groups defined by cut-off point. Results: The AUC was 0.78, the optimal cut-off for SAMG total score for indicating inactivity was ≤48, the sensitivity was 77.98% and the 1-specificity was 75.00%. The group with SAMG score >48 was characterized by a significantly higher proportion of women, fewer people sharing a house, and participation in more hobbies. Discussion: A cut-off point of 48 in the SAMG could be a predictive index of motivation toward goals for individuals with inactive daily activities. The group with score higher than the cut-off was characterized by more women, fewer people living together, and more hobbies than the group with lower scores.

National trend of heart failure and other cardiovascular diseases in people living with human immunodeficiency virus

BACKGROUND As people living with human immunodeficiency virus(HIV)(PLWH)enjoy longer life expectancy with highly effective antiretroviral therapy,they are encountering challenging cardiovascular health risks.AIM To retrospectively examine the increasing burden of cardiovascular diseases in PLWH over the past decade.METHODS All hospitalizations for heart failure(HF),ischemic heart disease(IHD),and cerebrovascular disease(CeVD)in PLWH were identified using the International Classification of Diseases,Ninth Revision,Clinical Modification(ICD-9-CM)and ICD-10-CM codes in the National Inpatient Sample from 2008 to 2018.Outcomes included number of hospitalizations,in-hospital mortality,length of stay,and total hospital charge.Trend of the outcomes from 2008 to 2018 were analyzed using Cochran-Armitage_(trend)test and simple linear regression.RESULTS The number of hospitalizations for HF in PLWH increased from 4212 in 2008 to 6700 in 2018(P_(trend)<0.01).Similar increasing_(trend)was seen with those for IHD and CeVD over the decade(P_(trend)<0.01).A decreasing_(trend)of in-hospital mortality was observed in all hospitalizations of PLWH(P_(trend)<0.01)and CeVD in PLWH(P_(trend)<0.01),but not in those for HF(P_(trend)=0.67)and IHD(P_(trend)=0.13).The_(trend)of length of stay was decreasing in all hospitalizations of PLWH(P_(trend)<0.01),but increasing in those for HF in PLWH(P_(trend)<0.01).An increasing_(trend)of total hospital charge was observed in hospitalizations for HF,IHD,and CeVD(P_(trend)<0.01).CONCLUSION The burden of cardiovascular diseases has significantly increased in hospitalizations of PLWH from 2008 to 2018.Continued efforts are needed to address the additional cardiovascular risks in this vulnerable population.

Epidemiology of Lower Extremity Artery Disease in People Living with HIV Followed at the Departmental University Hospital Center Ouémé-Plateau in 2019

Introduction: Lower extremity artery disease (LEAD) is a serious cardiovascular disease. People living with the human immunodeficiency virus (HIV) are at risk. The aim of the study was to determine the prevalence of LEAD and identify the associated factors among people living with HIV who were followed at the departmental university hospital Ouémé-Plateau in Benin. Methods: This was a cross-sectional study. It included all HIV-infected people who were monitored at the department of medicine of the target hospital during the study period and met the inclusion criteria (followed for at least three months, aged at least 25 years, and having given their written consent to participate). Data were collected during an individual interview, followed by the measurement of parameters. The ankle brachial index ≤ 0.9 was used for the diagnosis of LEAD. Associated factors were searched through a multivariable logistic regression. Results: The prevalence of LEAD was 34.2% among 222 respondents having a mean age was 42.9 ± 10.8 years and a female predominance (77.5%). No significant association was found between the presence of LEAD and sociodemographic factors. The presence of LEAD was significantly associated with hypertension and antiretroviral therapy. Hypertensive patients had a higher risk of LEAD compared to non-hypertensive patients (OR = 1.98, 95% CI [1.04-3.83], p = 0.037). Those who were receiving second-line therapy also had a higher risk of LEAD compared to those on first-line therapy (OR = 2.95, 95% CI [1.14-7.60], p = 0.025). Conclusion: This study showed a high prevalence of LEAD especially among hypertensive patients and those who were receiving second-line antiretroviral therapy. LEAD diagnosis and management should be included in the routine care of people living with HIV in Benin.

The Prevalence of Drug-Resistant Tuberculosis among People Living with HIV (PLHIV) in Abia State

Tuberculosis (TB) is a chronic disease caused by mycobacterium tuberculosis and transmitted from person to person, through inhalation of droplet nuclei aerosolized by coughing of an infected person. It reached epidemic proportions in Europe and North America during the 18th and 19th centuries. The incubation period is 2 - 6 weeks and the control has been complicated with emergence of HIV and drug-resistant TB. In 1993, World Health Organization (WHO) declared TB a global emergency. However, despite the concerted effort of National TB control programs, adoption and implementation of Stop TB strategy, TB has remained a major public health challenge with high mortality rate, especially in developing countries. Methodology: This is a descriptive study, evaluated using the positivist/quantitative approach. The study was conducted at FederalMedical Centre Umuahia, a tertiary specialist hospital with comprehensive TB/HIV treatment services. All the presumptive drug-resistant TB cases and symptomatic PLHIV were screened for HIV and their sputum specimens were tested for tuberculosis using the Gene xpert and the Ziehl- Neelsen technique for detecting Acid Fast bacilli. A pretested structured questionnaire was used tocollect the demographic data and other essential data from the presumptive TB and laboratory registers such as total number of TB presumptive cases registered HIV status, AFB status and rifampicin status within the study period. Result: A total of 493 presumptive TB cases were screened in the study, 49.9% were HIV positive while 50.05% were HIV negative. More so, 77.85% of thescreened cases were AFB negative and 22.15% were AFB positive. Moreover, 11% of the TB/HIV co-infected patients were rifampicin positive. Interestingly among the 493 cases screened with gene xpert machine, 3.6% were rifampicin positive. Furthermore, 3.6% of the HIV negative cases were rifampicin positive while 1.6% of the HIV positive cases were rifampicin positive. Discussion: The data depict lower rifampicin resistance among HIV positive cases than HIV negative cases. The implication for public health professionals is to intensify equitable and unbiased search for resistant TB cases among smear negative and positive cases.

Advances in Health Promotion for People with Disabilities and the Laws of Brazil

Brazilian laws guarantee the protection to the rights of the citizenship of people with disabilities and their participation in various social sectors which influence health promotion. One aimed at reflecting about the health promotion actions contemplated in Brazilian laws directed to people with physical, hearing and visual disabilities. Through the website of the National Secretariat for the Promotion of the Rights of People with Disabilities, one selected 14 laws whose content was articulated to the Health Promotion Charts in the process of discussion. The laws had as their main objective, the accessibility of people with disabilities to urban spaces, health, income, education, transportation and leisure, i.e. to public services that are essential for the establishment of health. It is concluded that there was a progress in the elaboration of laws that guarantee the rights and integration of this population. However, it is observed that the non-compliance of the laws makes the promotion of health impossible.

The Right to Development of Chinese Ethnic Minorities Promoted in Accordance with the Idea of Putting People First

I. The Idea of Putting People First and the Right to Development from the Contemporary Perspective of Human Rights

Ethical Dilemma Factor in Regarding Physical Restraints to Elderly of Female Nurses with the Living Together Experience

Purpose: The aim of this study was to illuminate the connotation of “dilemma” regarding the use of physical restraint on elderly patients as represented by female nurses working in general wards at community hospitals who also live with elderly adults at home. Method: The study used the questionnaire method with an independently prepared questionnaire. Participants: The objective of the study was explained to the persons in charge of nursing in the selected 17 hospitals, and 1929. Finally, this study of participants were 524 female nurses working in general 54 wards (excluding the emergency wards of psychiatry, pediatrics, obstetrics, outpatients, operating rooms, and intensive care units) at community hospitals who also live with elderly adults at home. Results and conclusions: Cronbach’s overall coefficient for the 20 items of dilemma was high (0.78) and the factor analysis extracted four dilemma factors as having a characteristic value of 1 (Kaiser-Meyer-Olkin measure value = 0.81) with a cumulative contribution ratio of 64.5%. The high Cronbach’s for these items (0.86, 0.88, 0.87 and 0.81) confirmed the internal consistencies. With respect to the dilemma where nurses working in general wards at community hospitals who also live with elderly adults at home are faced with the physical restraint of elderly persons, four factors in the clarification of the dilemma were extracted: accomplishment of medical-treatment and accident prevention, characteristic features in nursing for elderly patients with dementia, healthcare professional relationship in nursing for elderly patients with dementia, and priorities on the accident prevention for elderly patients with dementia. Therefore, the construction of four systems to cope with these dilemmas is suggested. These systems would enable practising nurses to: (i) institution of policies to encourage discussion between nurses and other medical staff to reach consensus on treatment;(ii) allocating elderly care specialists to wards to promote alternatives to restraints;(iii) establishment of safety standards to define nurses’ responsibilities;and (iv) institution of continuous ethical education for nurses.

Associations of PNPLA3 and LEP genetic polymorphisms with metabolic-associated fatty liver disease in Thai people living with human immunodeficiency virus

BACKGROUND The prevalence of metabolic-associated fatty liver disease(MAFLD)is a growing public health issue in people living with human immunodeficiency virus(PLWH).However,the pathophysiology of MAFLD is still unknown,and the role of genetic variables is only now becoming evident.AIM To evaluate the associations of gene-polymorphism-related MAFLD in PLWH.METHODS The study employed transient elastography with a controlled attenuation parameter≥248 dB/m to identify MAFLD in patients from a Super Tertiary Hospital in central Thailand.Candidate single-nucleotide polymorphisms(SNPs)were genotyped using TaqMan®MGB probe 5'nuclease assays for seven MAFLD-related genes.Statistical analyses included SNP frequency analysis,Fisher's Exact and Chi-square tests,odds ratio calculations,and multivariable logistic regression.RESULTS The G-allele carriers of PNPLA3(rs738409)exhibited a two-fold rise in MAFLD,increasing by 2.5 times in MAFLD with human immunodeficiency virus infection.The clinical features and genetic patterns imply that LEP rs7799039 A-allele carriers had a nine times(P=0.001)more significant chance of developing aberrant triglyceride among PLWH.CONCLUSION The current study shows an association between PNPLA3 rs738409 and LEP rs7799039 with MAFLD in PLWH.

Assessing the relationship between health literacy intervention and hypertension self-management:A 7-year systematic review from January 2016 to December 2022

Hypertension(HTN)is one of the most common chronic diseases affecting over 30%of the adult population globally,with a growing incidence rate.This review assesses the relationship between health literacy(HL)intervention and hypertension(HTN)self-management among people with HTN.The study design was a systematic review of empirical research articles using a well-defined strategy.Online journals were accessed through databases such as PubMed,CINAHL,Google Scholar,ProQuest,Global Health,WHOLIS,Embase,and EbscoHost,spanning from January 2016 to December 2022 as the scope of the study.Articles selected for inclusion were those published in English during the specified time frame and adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and Sample,Phenomenon of Interest,Design,Evaluation,Research Type framework for systematic review,focusing on criteria related to the sample,the phenomenon of interest,study design,evaluation,and research type.Out of 180 studies initially identified in the database search,20 studies were ultimately included in the review.The findings were reported based on these five emerging themes:Relationship between HL and HTN self-management;Effect of HL intervention on HTN self-management;Factors predicting self-care behaviors among HTN patients with low HL;Effect of HL and self-management efficacy on health-related quality of life(HRQoL);and level of self-care practices.This review highlights a relationship between HL,self-efficacy,self-care,and HRQoL,underscoring the necessity for further well-designed intervention studies focused on enhancing HL in individuals with HTN in Nigeria to enhance their quality of life.

Dietary fat intake of Japanese male children and its associated factors: Results of the 1995 National Nutrition Survey in Japan

Aim: To clarify the factors associated with reported dietary fat intake by Japanese male children. Methods: This study is based on the data of a nationally representative cross-sectional study in Japan. Three hundred and seventy-seven male children (age, 6 - 11 years) whose households were sampled in the 1995 Comprehensive Survey of Living Conditions of the People on Health and Welfare, and the 1995 National Nutrition Survey and whose parents were identified through record linkage between the 2 survey data sets were enrolled. Results: The final dataset in this study consisted of 377 boys with 329 of their parents. Fifty-two boys were found to be overweight (13.8%). The reported dietary fat intake was higher among the overweight boys than among the non-overweight boys. Maternal obesity was significantly associated with obesity in male children. Boys who frequently consumed foods from the “fats and lipids” group and the “meat” groups, and children from nuclear families rather than 3- generation families reported high dietary fat intake. In addition, parental fat intake was also significantly associated with fat intake of male children. Conclusions: Child and parental dietary habits along with the household status should be considered when implementing nutritional education programmes to control dietary fat intake and reduce the obesity risks of male children.

Assessing the Relationship between Caregivers Burden and Availability of Support for Family Caregivers’ of HIV/AIDS Patients in Calabar, South East Nigeria

Purpose: This study examined the level of burden and the extent of support on family caregivers of people living with AIDS (PLWHA) in Calabar, South East Nigeria. Methods: A mixed method with cross sectional approach was used. Purposive sampling technique guided the recruitment process and data collection methods included, semi-structured questionnaires and focusing group discussion. 260 respondents participated in the study. The quantitative data were mined with the aid of SPSS and the qualitative data were analysed with the aid of NVivo8 using thematic analysis. Results: Results indicated high level of burden with limited support to caregivers. A Chi-square value of 25.1 was obtained at P < 0.05, suggesting a significant relationship between availability of support and caregivers burden. This relationship was supported by the themes of physical, social, emotional and financial burden for the caregivers. Similarly, information on coping skills, emotional support, financial assistance and help with caregiving themes emerged for social support. Conclusion: In Nigeria, the burden of caring for HIV/AIDS patients has a remarkable impact on family caregivers. This calls for the development of policies that can systematically address the needs of family caregivers in order to ameliorate the negative consequences of caregiving for PLWHA.

The Impact of HIV Spending on Health Outcomes in Thailand

Background: The Sustainable Development Goals commitment to Ending HIV/AIDS by 2030 requires sustained adequate investment. This study sought to examine the association between HIV/AIDS spending and outcomes in Thailand between 2008 and 2019. Methods: A quantitative secondary data analysis with time-series was conducted using a retrospective dataset of HIV spending and some selected outcomes including the number of people living with HIV (PLHIV), incidence and prevalence of HIV/AIDS, the prevention of mother-to-child transmission (PMTCT) and AIDS-related deaths. Data were obtained from a diverse set of sources. Descriptive statistics and univariate regression model were used to analyze HIV expenditure and outcomes. Results: HIV spending per PLHIV rose by two folds from $347 in 2008 to more than $600 in 2019, mostly financed by domestic sources. This increase of domestic resources per PLHIV was significantly associated with better HIV-related outcomes especially in the reduction of PLHIV and AIDS-related deaths through increased number of people receiving antiretroviral therapy (ART). However, the spending per PLHIV varied across the three public health insurance schemes. Comparison of HIV expenditure and health outcomes across upper-middle-income countries shows Thailand is not highly ranked in terms of spending efficiency despite having made good progress. Conclusion: Domestic financing for HIV programs is indispensable for achieving the goal of ending AIDS. Despite significant improvement in HIV-related outcomes, challenges remain in achieving the 90-90-90 goal. The redesigning of payment methods should be considered to increase the efficiency of HIV financing. Other factors related to strengthening the health system should not be overlooked.

A People's Gala to Promote Mutual Under standing between China and Other Countries——2012 Understanding and Cooperation Dialogue held by CAFIU

正The Understanding and Cooperation Dialogue, Sponsored by the Chinese Association for International Understanding (CAFIU) and the China Foundation for Peace and Development (CFPD), and Co-organized by the Chinese People' s Association for Peace and

For People's Right to Safety Of Lives and Health——On development of health-related human rights in China

Medical and health work constitutes the prerequisite to protection of the people's right to safety of lives and health. Over the past decades, the Chinese Government has spared no effort in this regard and, as a result, the Chinese people's health has significantly improved. In the nationwide fight against the SARS (severe acute respiratory syndrome) epidemic in the first half of 2003, the Government placed the health of the Chinese people and the safety of their lives above everything else. With a huge input of human, financial and material resources, the country won a decisive victory over the epidemic. Following is the full text of an interview by Human Rights with Gao Qiang, executive vice-minister of the Ministry of Health, on China's medical and health work and how it is related to protection of human rights.