The purpose of this project is to examine why the mental health of employees should be prioritized in the workplace. Most employees have likely experienced a visible illness or injury at some point during their career...The purpose of this project is to examine why the mental health of employees should be prioritized in the workplace. Most employees have likely experienced a visible illness or injury at some point during their careers. It is easier to identify these physical ailments that may adversely affect an employee’s performance at work, such as a broken leg or the common cold. However, there are conditions that are much less visible that negatively impact employees every day, and mental health is one of them. A person’s mental health is a significant factor in their work life that should not be ignored. While it may be difficult to recognize when someone is struggling with depression, anxiety, or another form of mental illness on the surface, employers should not automatically assume their entire staff is okay. As a result of the COVID-19 pandemic coupled with an increase in civil unrest in society, employers must reevaluate the way they conduct business, starting with the treatment of their employees. To aid employers with prioritizing mental health at work, this paper’s objectives are to address the stigma associated with mental health issues/illness, develop recommendations for inclusive work environments, increase an employer’s investment in mental health, reduce employee turnover, and normalize respect in the workplace. The findings are discussed, and recommendations are provided. Employers who intentionally prioritize and invest in their employees’ mental health will significantly reduce the costs associated with attracting and recruiting new staff due to high turnover rates. Additionally, their reputation as a preferred employer will increase.展开更多
Introduction: Pregnancy is a critical period during which environmental factors such as nutrition can affect the optimal development of the fetus. This study aims to evaluate the knowledge, attitudes, and practices in...Introduction: Pregnancy is a critical period during which environmental factors such as nutrition can affect the optimal development of the fetus. This study aims to evaluate the knowledge, attitudes, and practices in food and nutrition among pregnant women in antenatal consultation at Menontin Hospital in 2021. Methods: This was a cross-sectional, descriptive study including 96 pregnant women at Menontin Hospital in Cotonou. Variables including socio-anthropological data, level of knowledge of nutritional requirements and their consequences on malnutrition, and description of physical activity practices were collected using a questionnaire and data on pregnant women’s dietary practices, macronutrient consumption, and fruit and vegetable consumption were documented using a food frequency questionnaire. Results: The majority of pregnant women (88%) were unaware of their nutrient needs during pregnancy. Only 49.6% of them took at least three meals and two snacks a day, and 45% practiced less than 30 minutes of physical activity per day. The consumption of carbohydrates, proteins, and lipids were respectively in the proportions of 36.5%, 50%, and 38.5%. It was also found that 48% of pregnant women did not consume fruits and vegetables daily. Conclusion: The pregnant women followed in the Mènontin area hospital had a low level of knowledge in terms of food and nutrition during pregnancy. Consequently, their attitudes and practices were unfavorable to good nutrition for both the mother and the child.展开更多
Background: Little is known about what the experience of “taking antipsychotics” means in a patient’s life. Therefore, this study aims to identify what it means for patients with schizophrenia living in the communi...Background: Little is known about what the experience of “taking antipsychotics” means in a patient’s life. Therefore, this study aims to identify what it means for patients with schizophrenia living in the community to remain on medication. Methods: The participants were five residents of communities, who had been discharged from a psychiatric hospital, but were currently visiting a private psychiatric hospital. In this study, we used participants’ narratives as data and analyzed them according to the procedures described in “An Application of Phenomenological Method in Psychology” (Giorgi, 1975), and “Practice of analyzing materials describing experiences” (Giorgi, 2004). Results: The study results are as follows. 1) The drug may be effective, but Subject (below, S) still wants to take it as little as possible. Meanwhile, S has people who care about S and a person who S can rely on nearby, to manage S’s life. The people above tell S to take medicine, and S takes it. 2) S does not know what kind of medication S is consuming, but recently S has been having a hard time walking;S has people who care for S’s foot and look after S. S thinks taking medicine is for living. 3) S feel some drugs is ineffective. However, S met some people S could trust who passionately recommended the medication to S. S started being careful in remembering to take it. 4) S does not think drugs are necessary for S, but S can interact with people and spend S’s days. S has people who accept S as S is. S continues living in the community while taking medicine that a doctor offers. 5) S was skeptical about the drugs. However, S has a person S can trust, who recommended a way to take the medication in a way that S does not feel overwhelmed. S thinks that it may be a good idea to take it. Conclusions: Based on the analysis of the narratives of each of the five participants, the essential structure was read from the perspective of a third party regarding participants’ medication adherence. A generalized reading of the structure common to the above five essential structures reveals a structure that includes the following three opportunities: 1) Patients realize the importance of people;2) They sometimes entrust themselves to people or follow people’s opinions when taking actions;3) They have come to terms with their initial negative feelings about antipsychotic drugs, subsequently continuing to take antipsychotic drugs. This suggests that the following are important attitudes of supporters of patients with schizophrenia who continue to live in the community: To accept what is happening to the patients, to talk to them with encouragement and compassion, and to be there for them. It is also important for supporters to make patients feel comfortable in opening up while the patients reside in the community and to support patients in making decisions.展开更多
<strong>Background: </strong>Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregula...<strong>Background: </strong>Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enzyme-2 (ACE2) expression, facilitating SARS-CoV2 entry to the lungs. Several retrospective clinical studies, however, found no such effect. Here, we explore how the use of ACEIs and ARBs links to COVID-19 across all countries of the world.<strong> Methods:</strong> Data on the availability of ACEIs and ARBs for 200 countries and on the number of cases and number of deaths per country by 28 December 2020 were extracted from WHO and Worldometer website, respectively. Data on life expectancy at age 65 years as a measure of ageing were from WHO and on Gross Domestic Product Per Capita (GDP PPP) and the percentage of urbanization were from the World Bank. Excel and SPSS v 26 software were used for statistical analyses.<strong> Results:</strong> In linear regression and logistic conditional regression analysis, GDP correlates with COVID-19 prevalence (rho = 0.66, p > 0.001) and deaths from COVID-19 (rho = 0.55, p < 0.001) while urbanization and life expectancy do not when GDP influence is controlled for. After statistically removing the effects of GDP on the prevalence and mortality from COVID-19, we found that countries without ACEI and ARB availability had lower COVID-19 cases and deaths (p < 0.02). <strong>Conclusions:</strong> Our study based on the global data contradicts findings of most published clinical studies at regional levels. We found that GDP positively correlates with prevalence of and mortality related to COVID-19. ACEI and ARB use increases COVID-19 infectivity and mortality.展开更多
Appropriate adherence to World Health Organisation (WHO) pain management guidelines is vital in palliative care centres as it promotes the comfort of patients who are experiencing pain and it improves their quality of...Appropriate adherence to World Health Organisation (WHO) pain management guidelines is vital in palliative care centres as it promotes the comfort of patients who are experiencing pain and it improves their quality of life. WHO (1996) highlighted the use of the WHO analgesic ladder guideline. This “analgesic ladder” proposes that after proper assessment with an appropriate pain assessment tool, patients in mild pain should be given non-opioids plus or minus adjuvants (including anticonvulsants and steroids);patients in moderate pain should be given weak opioids plus or minus non-opioids plus or minus adjuvants;and patients in severe pain should be given strong opioids plus or minus non-opioids plus or minus adjuvants as per the WHO pain ladder. The audit project was focused on assessing the palliative care practitioners’ (PCPs) adherence to WHO guidelines in managing their patients’ pain at Cancer Diseases Hospital (CDH). 15 participants were involved in the study and the data collection method used was a cross-sectional study in which the auditor observed PCPs, with an observation checklist comparing practice with WHO analgesic ladder guidelines. The result revealed that most of the PCPs were not meeting 80% of the standard set in the specific objectives for the audit. 7 (47%) PCPs were scoring the pain level before analgesia administration, whereas 8 (53%) PCPs were not scoring the pain level before analgesia administration. On the other hand, 47% (7 PCPs) were adhering to the WHO ladder of pain management, but 53% (8 PCPs) were not adhering to the WHO ladder of pain management. Therefore, effective adherence to the WHO analgesic ladder practice is still lacking in the PCPs at CDH. The percentage of PCPs who were not scoring the pain and not adhering to the WHO pain ladder guidelines was high, which is 8 (53%). Therefore, a re-audit is recommended to find out if levels of adherence have improved or not.展开更多
Background: Ebola Virus Disease (EVD) presents with a high global mortality and is known to be a highly infectious disease with devastating and gendered effects on the social fabric, yet most of the science has focuse...Background: Ebola Virus Disease (EVD) presents with a high global mortality and is known to be a highly infectious disease with devastating and gendered effects on the social fabric, yet most of the science has focused on the disease’s biology. However, little has been documented with regard to the gender and social aspects of Ebola Virus Disease (EVD) in two sub counties (Kikyo and Bundibugyo Town Council) in Bundibugyo District in Western Uganda. The study was set to examine the gender differences in the level of knowledge, attitudes and perceptions about EVD. Methods: The study employed a cross-sectional design using both quantitative and qualitative data collection methods. A structured questionnaire was administered to 254 respondents, 50% of whom were women. Simple random sampling was used to select the participants. Questionnaire data were analysed using SPSS at univariate and bivariate levels. Qualitative methods such as key informant interviews (with 6 participants) and Focus Group Discussions (three, one with men alone, another with women alone and the last one with both men and women) were also used to collect additional information from participants. Results: The findings indicated that socio-demographically, the majority (35%) of the respondents were aged between 20 and 29 years, 53% of whom were females. More women (about 56%) compared to men (44%) attained secondary education while more men (about 51% versus 49% of the women) reported that they were married. In terms of religion, the majority of the survey participants were Catholics (59% females and 49% males). With regard to communities’ knowledge about EVD, there was no significant relationship between men and women in terms of prior knowledge about EVD, risk factors and control measures. However, slightly more males (about 51%) than females (49%) had heard about EVD and more males (about 52%) than females (48%) admitted that they were at risk of contracting the disease. On the control measures, slightly more females than males (about 53% vs. 47% respectively) proposed avoiding contact with infected persons. The results further revealed that more males (about 51%) than females (49%) were willing to relate with EVD survivors, and this was due to the latter’s fear of contracting the disease. The major devastating effects of EVD that were reported included loss of lives, disruption of peoples movements, isolation of people, disruption of children’s school activities, stigma and discrimination of survivors. More females (about 52%) than males (about 48%) reported that EVD survivors were discriminated during the EVD outbreak in Bundibugyo District. Conclusions: This study has shown that whereas both men and women demonstrate average knowledge about EVD, there is need for more training and sensitization targeting women who have delusions about the severity of the disease, its risk factors, stigma and the integration of survivors in the affected communities. Communities also need to be sensitized about the gender roles that increase both the burden of EVD and the risk of men and women contracting the disease. This will lead to more culturally sensitive responses to EVD outbreaks in future.展开更多
In an era where the health-damaging effects of wheat flour (gluten) are increasingly recognized, rice flour has become an important alternative for many people, yet its psychophysiological effects remain largely unkno...In an era where the health-damaging effects of wheat flour (gluten) are increasingly recognized, rice flour has become an important alternative for many people, yet its psychophysiological effects remain largely unknown. Here, we report the potential beneficial effects of rice flour for sleep disturbances in stressed mice. Four-week-old male ddY mice were reared in social isolation for 4 weeks. The control group was reared in a social group. Rice flour was given orally in food to isolated mice at a dose of 2.5 w/w% and 5.0 w/w% for 4 weeks from the start of isolation rearing. MF food was given to the control group. Pentobarbital-induced (40 mg/kg, i.p.) time to sleep induction and righting reflex was measured to determine the effects of rice flour on sleep behavior. Blood samples were obtained after the experiments, and serum corticosterone was measured. Sections from the prefrontal cortex and the brainstem were isolated to measure serotonin, dopamine and interleukin (IL)-6 concentrations. We found that the administration of rice flour dose-dependently improved time to sleep and reduced sleep time in socially isolated mice. Blood corticosterone concentrations, which increased after isolation stress, were decreased after the administration of rice flour. Serotonin and dopamine concentrations in the prefrontal cortex which decreased after isolation stress improved after the administration of rice flour. Brainstem IL-6 concentrations increased after isolation stress, but decreased dose-dependently after rice flour administration. Our results suggest that rice flour reverses sleep disturbances in mice induced by social isolation.展开更多
Dropout from medical attendance is a well-recognized issue among patients with human immunodeficiency virus (HIV) infection. We interviewed 23 HIV-positive patients and used text mining methods to analyse the risk fac...Dropout from medical attendance is a well-recognized issue among patients with human immunodeficiency virus (HIV) infection. We interviewed 23 HIV-positive patients and used text mining methods to analyse the risk factors for dropout. Fifteen patients continued medical attendance and eight patients dropped out of medical attendance. Categories were extracted from the interview data of the patients who continued medical attendance (i.e., the continuity group) and the patients who dropped out of medical care (i.e., the discontinuity group). Categories of the continuity group included needing to take a day off for medical attendance, scheduling each appointment, writing down medical appointments, being grateful for the medical care, and 12 additional categories. Categories of discontinuity group included forgetting the dates of medical appointments, not needing to get a day off for medical attendance, allowing aid for medical care to expire, and 10 additional categories. The discontinuity group had poorer schedule management than the continuity group, which caused them to forget their next medical appointments and delay the renewal of aid for medical care. Thus, medical staff may be able to prevent dropouts by ensuring that patients record the dates of their medical appointments.展开更多
Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle ...Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle to reducing maternal and infant mortality. To support the Ministry of Health and Social Action in the implementation of its Strategic Plan for Reproductive Health (2012-2015), the NGO Micronutriment Initiative has developed a project based on community-based maternal and neonatal health services (CBMNHS) in the Kolda region. The general objective of this study is to collect the perceptions of the actors on the Community-Based Maternal and Neonatal Health Services project in the Kolda and Sedhiou regions. Method: This was a qualitative study consisting of an evaluation of the activities carried out within the framework of the CBMNHS project at the level of the intervention zone. The study focused on support groups, community actors, post nurses and implementers of the intervention. Sampling was comprehensive for community actors and nurse heads. Focus groups and in-depth individual interviews were used to assess the perceptions of women and support groups, as well as to better understand the dynamics of the intervention. The content analysis was performed to exploit the qualitative data. Results: All local and national health authorities interviewed are unanimous about the relevance of the project. The project’s strategies are essentially community-oriented. Thus, a large number of committees have been set up. A total of 1258 support groups were set up during the project, distributed as follows: 260 grandmother groups (Grandmothers Strategy);266 groups of pregnant women (Pregnant Women’s Solidarity Circles);248 Care Group;468 community watch and alert circles and 16 Future Fathers’ Groups (Future Fathers’ Solidarity Circles). These committees aimed to involve women of reproductive age, mothers, mothers-in-law and fathers. More than 70% of women surveyed agree that support groups have improved their knowledge of maternal health, nutrition, and children’s health. Groups also improved their attendance at health facilities, which is a major asset of the project. Conclusion: The analysis of the perception of the different actors of the CBMNHS project shows that the project is well conducted in the area of intervention that is the region of Kolda. However, the central question of the success of sustainability is the existence of a withdrawal plan. Indeed, this plan must be studied from the very beginning and must be adapted to the local context. As a result, support groups are urged to become more involved in reproductive health activities, especially those related to the exclusive breastfeeding, and to continue to provide all forms of support (financial and moral) to women of reproductive age for reproductive health carrying out reproductive health activities for better access to services.展开更多
Objective: Although there are adult vaccination schemes in our country, there are serious deficiencies in the way that doctors direct the patients to this vaccination, but also patients have to make and demand these v...Objective: Although there are adult vaccination schemes in our country, there are serious deficiencies in the way that doctors direct the patients to this vaccination, but also patients have to make and demand these vaccinations. The aim of our study is to identify the shortcomings in this area and draw a roadmap for what arrangements should be made in terms of physicians and patients in order to increase adult immunization rates in primary care. Method: We conducted a two-phase, multicentered, descriptive clinical trial between October and December 2017. The first phase of the trial was carried out with patients from 3 Family Health Centers in Antalya, Istanbul and Osmaniye. Patients to be interviewed were selected voluntarily among Family Health Center’s applicants. The second phase of the trial was carried out with health workers, who were participated to trial from 26 different provinces of Turkey. In the process, a questionnaire of 19 questions was applied to primary health care workers by the internet. Results: 490 patients were included in the study. There was a significant difference between gender, age, education level and guideline follow-up and vaccination status of patients [p Conclusion: As a result of the studies including our study about adult vaccination, only 10% - 20% of the targeted groups in adults can be vaccinated. However, just like in childhood during adulthood, vaccinations protect individuals from diseases and provide economic benefits. Firstly, the knowledge level of physicians on adult immunization should be updated with in-service trainings, they should first be convinced to vaccinate because they are in risk group and then they should be recommended vaccination to patient to increase the vaccination rates.展开更多
Background: According to the diversification of the health needs and the expansion of health disparities, public health nurses need to improve their practical capabilities, starting from basic education in graduate an...Background: According to the diversification of the health needs and the expansion of health disparities, public health nurses need to improve their practical capabilities, starting from basic education in graduate and undergraduate courses. And Reflective Practice with using reflective journal is one way of improving practical capabilities. The purpose of this study was to investigate the relationship between the volume of reflective journal and the quality of progress in the reflective cycle. Methods: The participants in this study were 20 junior students majoring in public health nursing (hereinafter “PHN students”) at a university in the Chugoku area, Japan. We asked the participants to answer the questions on Reflective Practice Skills (RPS) composed of six criteria corresponding to the six questions of Gibbs on the reflective cycle before and after they started writing RJ. The volume of reflective writing was measured by the number of characters written by the PHN students in RJ of the reflective practice for three months. The study plan was approved by the Ethics Committee for Nursing Study, Okayama University. Results: Although the average total RPS score showed a change of about 3 points as a result of the 3-month RJ writing exercise, no correlation was observed between the RPS score and the RJ writing volume (r = 0.175). However, we did observe a moderately positive correlation between the RPS score and the RJ writing volume with regard to Items 5 and 6 (r = 0.475 and r = 0.444, respectively). Conclusion: This study indicated that detailed RJ writing helps to complete the reflective cycle all the way to theorization and action planning, and that the volume of writing may serve as a criterion for qualitative evaluation.展开更多
It is well known that massage therapists often develop a number of health problems relatively early on in their career. A preliminary study showed that grounding massage therapists during their work may alleviate some...It is well known that massage therapists often develop a number of health problems relatively early on in their career. A preliminary study showed that grounding massage therapists during their work may alleviate some of the health problems they encounter. A doubled-blind randomized controlled trial was designed to examine the effects of working and sleeping grounded for 4 weeks on massage therapists’ blood viscosity, stress (through HRV), inflammation (IFN-γ, IL-6, TNF-α, and hsCRP) and oxidative stress (MPO and MDA) biomarkers. The results show stress reduction as measured by heart rate, respir-atory rate and hear rate variability (HRV) and a lowering effect on blood viscosity that lasted for at least one week after ungrounding, with systolic blood viscosity becoming significantly lower at the end of the study. Inflammation markers (IFN-γ, TNF-α, and hsCRP) increased rapidly, within one week, after ungrounding. The findings suggest that grounding is beneficial for massage therapists in multiple domains relevant to health and wellbeing.展开更多
Objective: To explore the importance of CBL in pathophysiology teaching. Methods: 218 undergraduate clinical medicine students in 2015 grade were divided into CBL group and control group, and each group had 109 studen...Objective: To explore the importance of CBL in pathophysiology teaching. Methods: 218 undergraduate clinical medicine students in 2015 grade were divided into CBL group and control group, and each group had 109 students. The CBL group was taught by CBL, while the control group was taught by routine teaching mode. The teaching effects was evaluated by questionnaire survey and stage test. Results: The CBL group was superior to the control group in learning interest, logical thinking, knowledge system construction, comprehensive use of knowledge to solve problems. Conclusion: CBL teaching enhanced students’ understanding of knowledge significantly, and also enhanced their clinical thinking and problem analysis ability.展开更多
Background: Chronic kidney disease (CKD) is a pre-condition for end-stage kidney disease (ESKD) undergoing hemodialysis, as well as a risk factor for cardiovascular disease. Therefore, it is vital that CKD prevention ...Background: Chronic kidney disease (CKD) is a pre-condition for end-stage kidney disease (ESKD) undergoing hemodialysis, as well as a risk factor for cardiovascular disease. Therefore, it is vital that CKD prevention measures be established. In particular, socioeconomic status (SES), as represented by income, contributes to non-communicable diseases like CKD. The purpose of this study was to examine the independent association between CKD and individual SES in Japan, with consideration of other metabolic risks. Methods: In the present study, we analyzed the 2011 National Health and Nutrition Survey by the Ministry of Health, Labor, and Welfare. Specifically, we analyzed 3,557 people out of 8,762 whose serum creatinine was measured. Logistic regression analysis was used to calculate the odds ratio (OR) of CKD by income distinction, after adjustment for age and metabolic risks (obesity, diabetes mellitus, dyslipidemia, and hypertension), which were assessed at the medical examination. Results: CKD was found in 385 participants (10.8%) and was associated with greater age, obesity, higher levels of low-density lipoprotein cholesterol, triglyceride, and glycated hemoglobin, and lower levels of hemoglobin and high-density lipoprotein cholesterol. The adjusted model indicated a significant association between lower income and CKD: the OR of the low income group (<2 million yen) was 1.33 (95% confidence interval: 1.01 - 1.78) in comparison with the high income group. Conclusions: The results of the present study indicate a substantial relationship between individual lower income status and CKD in Japan, where healthcare is easy to access. To prevent ESKD and cardiovascular diseases, early detection of CKD and its metabolic risks is necessary, especially among the socioeconomically vulnerable population.展开更多
Background: Avoiding primary C-section is the safest and most effective way of decreasing C-section rates. We analyzed circumstances and decisions made among pregnant women without history of C-section and cephalic si...Background: Avoiding primary C-section is the safest and most effective way of decreasing C-section rates. We analyzed circumstances and decisions made among pregnant women without history of C-section and cephalic single fetus (group B), who ended up having a Cesarean birth, to identify opportunities that may optimize the decisions about delivery. Methodology: We evaluated the clinical histories of pregnant women from group B who completed their pregnancies in the Hospital Universitario de Santander (Bucaramanga, Colombia) during 2013. We evaluated the decision moments from admission until birth, including the registry of the reasons for having a C-section, compliance of all the criteria to support the decision and its appropriateness, and how adequate were the procedures done during the induction or augmentation of labor. Results: We evaluated 1320 histories;666 (55.7%) ended by C-Section. In 59.8% of the histories, we identified at least one decision that could have been addressed differently to optimize the delivery type and, potentially, avoid ending in a Cesarean birth. The most frequent opportunities arise due to a lack of clarity in the record of the reason for performing the C-section (70.1%), and inadequate use of labor induction in the patients that had to end their gestation (38.5%). Conclusion: In the Hospital Universitario de Santander during 2013, despite observing a meaningful subregistry of the indication to perform a C-section, we found that in one out of every two patients there are opportunities of improvement in the registry and attention to reduce the high incidence of C-sections in the institution. This analysis allowed us to create a checklist to fill out before making the final decision of performing a Cesarean birth.展开更多
Background: The ability of managers of small-scale enterprises (SSEs) to prioritize health, working conditions, and their own physical fitness is an important issue for workplace health promotion in Norway and Sweden,...Background: The ability of managers of small-scale enterprises (SSEs) to prioritize health, working conditions, and their own physical fitness is an important issue for workplace health promotion in Norway and Sweden, where most owner-manager positions are in SSEs. Aim: To assess the physical fitness status of SSE managers compared to a norm population and to study changes in physical fitness status, self-reported physical activity, and sickness outcomes after workplace health interventions. Methods: The study allocated SSE managers to either an intervention or a reference group. The intervention, over twelve months, consisted of motivational input related to lifestyle and physical activity through tests and feedback, individual support, and courses on health and psychosocial working conditions. The participants (N = 28) completed health screening checks, questionnaires and testing before and after the intervention. Results: SSE managers in the study had positive outcomes for BMI levels and strength compared to the norm population, while percentage of fat for both men and women indicated poor results. There were no further improvements in the intervention group after comparison with the reference group. Separately, both groups seemed to improve strength and body composition. Conclusion: Workplace health interventions with essentially motivational components may increase SSE managers’ attention to physical fitness, but appear to have limited effects on objective and subjective physical fitness outcomes.展开更多
Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medica...Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.展开更多
Gallstones are common and costly in the world. This disease also have high health burden with high mortality. Currently, Laparoscopic Cholecystectomy has become a gold standard for surgical treatment of symptomatic ga...Gallstones are common and costly in the world. This disease also have high health burden with high mortality. Currently, Laparoscopic Cholecystectomy has become a gold standard for surgical treatment of symptomatic gallstones. Pain is usually the first concern after surgery. Postoperative pain decreases with time but it is severe enough to interfere with daily activities of patients. Pain after the surgery is also affected by many factors. This cross-sectional study aimed to 1) assess pain intensity and interference pain with daily activities;2) describe the association between pain intensity and interference with daily activities of patients;3) explore factors that influence post-operative pain after Laparoscopic Cholecystectomy. Data were collected by 50 patients who were undergoing Laparoscopic Cholecystectomy completed questionnaire including the Visual Analogue Scale (VAS) and the Brief Pain Inventory (BPI). Data were analyzed based on three aims. As this is the first time that this type of study is conducted in Vietnam, it is expected that the results will contribute significantly to local knowledge and should add to global perspectives. From understanding the factors that affect severity of pain, this study is expected to design nursing intervention strategies to improve daily activities among patients undergoing LC.展开更多
As low cost and highly portable sensors, inertial measurements units (IMU) have become increas-ingly used in gait analysis, embodying an efficient alternative to motion capture systems. Mean-while, being able to compu...As low cost and highly portable sensors, inertial measurements units (IMU) have become increas-ingly used in gait analysis, embodying an efficient alternative to motion capture systems. Mean-while, being able to compute reliably accurate spatial gait parameters using few sensors remains a relatively complex problematic. Providing a clinical oriented solution, our study presents a gy-rometer and accelerometer based algorithm for stride length estimation. Compared to most of the numerous existing works where only an averaged stride length is computed from several IMU, or where the use of the magnetometer is incompatible with everyday use, our challenge here has been to extract each individual stride length in an easy-to-use algorithm requiring only one inertial sensor attached to the subject shank. Our results were validated on healthy subjects and patients suffering from Parkinson’s disease (PD). Estimated stride lengths were compared to GAITRite? walkway system data: the mean error over all the strides was less than 6% for healthy group and 10.3% for PD group. This method provides a reliable portable solution for monitoring the in-stantaneous stride length and opens the way to promising applications.展开更多
Objectives: Identification of the level of knowledge on ergonomics principles, and application of these by dentistry students to investigate whether painful symptomatology was experienced. An-other objective is the ex...Objectives: Identification of the level of knowledge on ergonomics principles, and application of these by dentistry students to investigate whether painful symptomatology was experienced. An-other objective is the expansion of discussions on occupational health in academic settings. Study Design and Settings: Dentistry students of the Federal University of Rio Grande do Norte, Brazil (n = 148) were surveyed using the Nordic Musculoskeletal Questionnaire to determine the severity of musculoskeletal symptoms experienced. Data were analyzed through EpiInfo 7.0 to measure central trends and variability 5for quantitative variables, absolute and relative frequencies for categorical variables, and significance between groups (confidence intervals and chisquare). Association analysis (Pearson) was also carried out. Results: Ergonomic measures were not reported by students. Within the musculoskeletal symptoms described, females were the most affected, independent of academic level. Conclusions: Positive correlations were verified between all categories and all anatomic regions (e.g., neck, lower back, wrists, hands, and shoulders). Data suggest progressive worsening of symptoms, which will eventually result in leaves of absence.展开更多
文摘The purpose of this project is to examine why the mental health of employees should be prioritized in the workplace. Most employees have likely experienced a visible illness or injury at some point during their careers. It is easier to identify these physical ailments that may adversely affect an employee’s performance at work, such as a broken leg or the common cold. However, there are conditions that are much less visible that negatively impact employees every day, and mental health is one of them. A person’s mental health is a significant factor in their work life that should not be ignored. While it may be difficult to recognize when someone is struggling with depression, anxiety, or another form of mental illness on the surface, employers should not automatically assume their entire staff is okay. As a result of the COVID-19 pandemic coupled with an increase in civil unrest in society, employers must reevaluate the way they conduct business, starting with the treatment of their employees. To aid employers with prioritizing mental health at work, this paper’s objectives are to address the stigma associated with mental health issues/illness, develop recommendations for inclusive work environments, increase an employer’s investment in mental health, reduce employee turnover, and normalize respect in the workplace. The findings are discussed, and recommendations are provided. Employers who intentionally prioritize and invest in their employees’ mental health will significantly reduce the costs associated with attracting and recruiting new staff due to high turnover rates. Additionally, their reputation as a preferred employer will increase.
文摘Introduction: Pregnancy is a critical period during which environmental factors such as nutrition can affect the optimal development of the fetus. This study aims to evaluate the knowledge, attitudes, and practices in food and nutrition among pregnant women in antenatal consultation at Menontin Hospital in 2021. Methods: This was a cross-sectional, descriptive study including 96 pregnant women at Menontin Hospital in Cotonou. Variables including socio-anthropological data, level of knowledge of nutritional requirements and their consequences on malnutrition, and description of physical activity practices were collected using a questionnaire and data on pregnant women’s dietary practices, macronutrient consumption, and fruit and vegetable consumption were documented using a food frequency questionnaire. Results: The majority of pregnant women (88%) were unaware of their nutrient needs during pregnancy. Only 49.6% of them took at least three meals and two snacks a day, and 45% practiced less than 30 minutes of physical activity per day. The consumption of carbohydrates, proteins, and lipids were respectively in the proportions of 36.5%, 50%, and 38.5%. It was also found that 48% of pregnant women did not consume fruits and vegetables daily. Conclusion: The pregnant women followed in the Mènontin area hospital had a low level of knowledge in terms of food and nutrition during pregnancy. Consequently, their attitudes and practices were unfavorable to good nutrition for both the mother and the child.
文摘Background: Little is known about what the experience of “taking antipsychotics” means in a patient’s life. Therefore, this study aims to identify what it means for patients with schizophrenia living in the community to remain on medication. Methods: The participants were five residents of communities, who had been discharged from a psychiatric hospital, but were currently visiting a private psychiatric hospital. In this study, we used participants’ narratives as data and analyzed them according to the procedures described in “An Application of Phenomenological Method in Psychology” (Giorgi, 1975), and “Practice of analyzing materials describing experiences” (Giorgi, 2004). Results: The study results are as follows. 1) The drug may be effective, but Subject (below, S) still wants to take it as little as possible. Meanwhile, S has people who care about S and a person who S can rely on nearby, to manage S’s life. The people above tell S to take medicine, and S takes it. 2) S does not know what kind of medication S is consuming, but recently S has been having a hard time walking;S has people who care for S’s foot and look after S. S thinks taking medicine is for living. 3) S feel some drugs is ineffective. However, S met some people S could trust who passionately recommended the medication to S. S started being careful in remembering to take it. 4) S does not think drugs are necessary for S, but S can interact with people and spend S’s days. S has people who accept S as S is. S continues living in the community while taking medicine that a doctor offers. 5) S was skeptical about the drugs. However, S has a person S can trust, who recommended a way to take the medication in a way that S does not feel overwhelmed. S thinks that it may be a good idea to take it. Conclusions: Based on the analysis of the narratives of each of the five participants, the essential structure was read from the perspective of a third party regarding participants’ medication adherence. A generalized reading of the structure common to the above five essential structures reveals a structure that includes the following three opportunities: 1) Patients realize the importance of people;2) They sometimes entrust themselves to people or follow people’s opinions when taking actions;3) They have come to terms with their initial negative feelings about antipsychotic drugs, subsequently continuing to take antipsychotic drugs. This suggests that the following are important attitudes of supporters of patients with schizophrenia who continue to live in the community: To accept what is happening to the patients, to talk to them with encouragement and compassion, and to be there for them. It is also important for supporters to make patients feel comfortable in opening up while the patients reside in the community and to support patients in making decisions.
文摘<strong>Background: </strong>Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enzyme-2 (ACE2) expression, facilitating SARS-CoV2 entry to the lungs. Several retrospective clinical studies, however, found no such effect. Here, we explore how the use of ACEIs and ARBs links to COVID-19 across all countries of the world.<strong> Methods:</strong> Data on the availability of ACEIs and ARBs for 200 countries and on the number of cases and number of deaths per country by 28 December 2020 were extracted from WHO and Worldometer website, respectively. Data on life expectancy at age 65 years as a measure of ageing were from WHO and on Gross Domestic Product Per Capita (GDP PPP) and the percentage of urbanization were from the World Bank. Excel and SPSS v 26 software were used for statistical analyses.<strong> Results:</strong> In linear regression and logistic conditional regression analysis, GDP correlates with COVID-19 prevalence (rho = 0.66, p > 0.001) and deaths from COVID-19 (rho = 0.55, p < 0.001) while urbanization and life expectancy do not when GDP influence is controlled for. After statistically removing the effects of GDP on the prevalence and mortality from COVID-19, we found that countries without ACEI and ARB availability had lower COVID-19 cases and deaths (p < 0.02). <strong>Conclusions:</strong> Our study based on the global data contradicts findings of most published clinical studies at regional levels. We found that GDP positively correlates with prevalence of and mortality related to COVID-19. ACEI and ARB use increases COVID-19 infectivity and mortality.
文摘Appropriate adherence to World Health Organisation (WHO) pain management guidelines is vital in palliative care centres as it promotes the comfort of patients who are experiencing pain and it improves their quality of life. WHO (1996) highlighted the use of the WHO analgesic ladder guideline. This “analgesic ladder” proposes that after proper assessment with an appropriate pain assessment tool, patients in mild pain should be given non-opioids plus or minus adjuvants (including anticonvulsants and steroids);patients in moderate pain should be given weak opioids plus or minus non-opioids plus or minus adjuvants;and patients in severe pain should be given strong opioids plus or minus non-opioids plus or minus adjuvants as per the WHO pain ladder. The audit project was focused on assessing the palliative care practitioners’ (PCPs) adherence to WHO guidelines in managing their patients’ pain at Cancer Diseases Hospital (CDH). 15 participants were involved in the study and the data collection method used was a cross-sectional study in which the auditor observed PCPs, with an observation checklist comparing practice with WHO analgesic ladder guidelines. The result revealed that most of the PCPs were not meeting 80% of the standard set in the specific objectives for the audit. 7 (47%) PCPs were scoring the pain level before analgesia administration, whereas 8 (53%) PCPs were not scoring the pain level before analgesia administration. On the other hand, 47% (7 PCPs) were adhering to the WHO ladder of pain management, but 53% (8 PCPs) were not adhering to the WHO ladder of pain management. Therefore, effective adherence to the WHO analgesic ladder practice is still lacking in the PCPs at CDH. The percentage of PCPs who were not scoring the pain and not adhering to the WHO pain ladder guidelines was high, which is 8 (53%). Therefore, a re-audit is recommended to find out if levels of adherence have improved or not.
文摘Background: Ebola Virus Disease (EVD) presents with a high global mortality and is known to be a highly infectious disease with devastating and gendered effects on the social fabric, yet most of the science has focused on the disease’s biology. However, little has been documented with regard to the gender and social aspects of Ebola Virus Disease (EVD) in two sub counties (Kikyo and Bundibugyo Town Council) in Bundibugyo District in Western Uganda. The study was set to examine the gender differences in the level of knowledge, attitudes and perceptions about EVD. Methods: The study employed a cross-sectional design using both quantitative and qualitative data collection methods. A structured questionnaire was administered to 254 respondents, 50% of whom were women. Simple random sampling was used to select the participants. Questionnaire data were analysed using SPSS at univariate and bivariate levels. Qualitative methods such as key informant interviews (with 6 participants) and Focus Group Discussions (three, one with men alone, another with women alone and the last one with both men and women) were also used to collect additional information from participants. Results: The findings indicated that socio-demographically, the majority (35%) of the respondents were aged between 20 and 29 years, 53% of whom were females. More women (about 56%) compared to men (44%) attained secondary education while more men (about 51% versus 49% of the women) reported that they were married. In terms of religion, the majority of the survey participants were Catholics (59% females and 49% males). With regard to communities’ knowledge about EVD, there was no significant relationship between men and women in terms of prior knowledge about EVD, risk factors and control measures. However, slightly more males (about 51%) than females (49%) had heard about EVD and more males (about 52%) than females (48%) admitted that they were at risk of contracting the disease. On the control measures, slightly more females than males (about 53% vs. 47% respectively) proposed avoiding contact with infected persons. The results further revealed that more males (about 51%) than females (49%) were willing to relate with EVD survivors, and this was due to the latter’s fear of contracting the disease. The major devastating effects of EVD that were reported included loss of lives, disruption of peoples movements, isolation of people, disruption of children’s school activities, stigma and discrimination of survivors. More females (about 52%) than males (about 48%) reported that EVD survivors were discriminated during the EVD outbreak in Bundibugyo District. Conclusions: This study has shown that whereas both men and women demonstrate average knowledge about EVD, there is need for more training and sensitization targeting women who have delusions about the severity of the disease, its risk factors, stigma and the integration of survivors in the affected communities. Communities also need to be sensitized about the gender roles that increase both the burden of EVD and the risk of men and women contracting the disease. This will lead to more culturally sensitive responses to EVD outbreaks in future.
文摘In an era where the health-damaging effects of wheat flour (gluten) are increasingly recognized, rice flour has become an important alternative for many people, yet its psychophysiological effects remain largely unknown. Here, we report the potential beneficial effects of rice flour for sleep disturbances in stressed mice. Four-week-old male ddY mice were reared in social isolation for 4 weeks. The control group was reared in a social group. Rice flour was given orally in food to isolated mice at a dose of 2.5 w/w% and 5.0 w/w% for 4 weeks from the start of isolation rearing. MF food was given to the control group. Pentobarbital-induced (40 mg/kg, i.p.) time to sleep induction and righting reflex was measured to determine the effects of rice flour on sleep behavior. Blood samples were obtained after the experiments, and serum corticosterone was measured. Sections from the prefrontal cortex and the brainstem were isolated to measure serotonin, dopamine and interleukin (IL)-6 concentrations. We found that the administration of rice flour dose-dependently improved time to sleep and reduced sleep time in socially isolated mice. Blood corticosterone concentrations, which increased after isolation stress, were decreased after the administration of rice flour. Serotonin and dopamine concentrations in the prefrontal cortex which decreased after isolation stress improved after the administration of rice flour. Brainstem IL-6 concentrations increased after isolation stress, but decreased dose-dependently after rice flour administration. Our results suggest that rice flour reverses sleep disturbances in mice induced by social isolation.
文摘Dropout from medical attendance is a well-recognized issue among patients with human immunodeficiency virus (HIV) infection. We interviewed 23 HIV-positive patients and used text mining methods to analyse the risk factors for dropout. Fifteen patients continued medical attendance and eight patients dropped out of medical attendance. Categories were extracted from the interview data of the patients who continued medical attendance (i.e., the continuity group) and the patients who dropped out of medical care (i.e., the discontinuity group). Categories of the continuity group included needing to take a day off for medical attendance, scheduling each appointment, writing down medical appointments, being grateful for the medical care, and 12 additional categories. Categories of discontinuity group included forgetting the dates of medical appointments, not needing to get a day off for medical attendance, allowing aid for medical care to expire, and 10 additional categories. The discontinuity group had poorer schedule management than the continuity group, which caused them to forget their next medical appointments and delay the renewal of aid for medical care. Thus, medical staff may be able to prevent dropouts by ensuring that patients record the dates of their medical appointments.
文摘Introduction: The health of mothers and children remains a major concern in developing countries. Infant and maternal mortality rates, although declining, are still high. Access to health services is a major obstacle to reducing maternal and infant mortality. To support the Ministry of Health and Social Action in the implementation of its Strategic Plan for Reproductive Health (2012-2015), the NGO Micronutriment Initiative has developed a project based on community-based maternal and neonatal health services (CBMNHS) in the Kolda region. The general objective of this study is to collect the perceptions of the actors on the Community-Based Maternal and Neonatal Health Services project in the Kolda and Sedhiou regions. Method: This was a qualitative study consisting of an evaluation of the activities carried out within the framework of the CBMNHS project at the level of the intervention zone. The study focused on support groups, community actors, post nurses and implementers of the intervention. Sampling was comprehensive for community actors and nurse heads. Focus groups and in-depth individual interviews were used to assess the perceptions of women and support groups, as well as to better understand the dynamics of the intervention. The content analysis was performed to exploit the qualitative data. Results: All local and national health authorities interviewed are unanimous about the relevance of the project. The project’s strategies are essentially community-oriented. Thus, a large number of committees have been set up. A total of 1258 support groups were set up during the project, distributed as follows: 260 grandmother groups (Grandmothers Strategy);266 groups of pregnant women (Pregnant Women’s Solidarity Circles);248 Care Group;468 community watch and alert circles and 16 Future Fathers’ Groups (Future Fathers’ Solidarity Circles). These committees aimed to involve women of reproductive age, mothers, mothers-in-law and fathers. More than 70% of women surveyed agree that support groups have improved their knowledge of maternal health, nutrition, and children’s health. Groups also improved their attendance at health facilities, which is a major asset of the project. Conclusion: The analysis of the perception of the different actors of the CBMNHS project shows that the project is well conducted in the area of intervention that is the region of Kolda. However, the central question of the success of sustainability is the existence of a withdrawal plan. Indeed, this plan must be studied from the very beginning and must be adapted to the local context. As a result, support groups are urged to become more involved in reproductive health activities, especially those related to the exclusive breastfeeding, and to continue to provide all forms of support (financial and moral) to women of reproductive age for reproductive health carrying out reproductive health activities for better access to services.
文摘Objective: Although there are adult vaccination schemes in our country, there are serious deficiencies in the way that doctors direct the patients to this vaccination, but also patients have to make and demand these vaccinations. The aim of our study is to identify the shortcomings in this area and draw a roadmap for what arrangements should be made in terms of physicians and patients in order to increase adult immunization rates in primary care. Method: We conducted a two-phase, multicentered, descriptive clinical trial between October and December 2017. The first phase of the trial was carried out with patients from 3 Family Health Centers in Antalya, Istanbul and Osmaniye. Patients to be interviewed were selected voluntarily among Family Health Center’s applicants. The second phase of the trial was carried out with health workers, who were participated to trial from 26 different provinces of Turkey. In the process, a questionnaire of 19 questions was applied to primary health care workers by the internet. Results: 490 patients were included in the study. There was a significant difference between gender, age, education level and guideline follow-up and vaccination status of patients [p Conclusion: As a result of the studies including our study about adult vaccination, only 10% - 20% of the targeted groups in adults can be vaccinated. However, just like in childhood during adulthood, vaccinations protect individuals from diseases and provide economic benefits. Firstly, the knowledge level of physicians on adult immunization should be updated with in-service trainings, they should first be convinced to vaccinate because they are in risk group and then they should be recommended vaccination to patient to increase the vaccination rates.
文摘Background: According to the diversification of the health needs and the expansion of health disparities, public health nurses need to improve their practical capabilities, starting from basic education in graduate and undergraduate courses. And Reflective Practice with using reflective journal is one way of improving practical capabilities. The purpose of this study was to investigate the relationship between the volume of reflective journal and the quality of progress in the reflective cycle. Methods: The participants in this study were 20 junior students majoring in public health nursing (hereinafter “PHN students”) at a university in the Chugoku area, Japan. We asked the participants to answer the questions on Reflective Practice Skills (RPS) composed of six criteria corresponding to the six questions of Gibbs on the reflective cycle before and after they started writing RJ. The volume of reflective writing was measured by the number of characters written by the PHN students in RJ of the reflective practice for three months. The study plan was approved by the Ethics Committee for Nursing Study, Okayama University. Results: Although the average total RPS score showed a change of about 3 points as a result of the 3-month RJ writing exercise, no correlation was observed between the RPS score and the RJ writing volume (r = 0.175). However, we did observe a moderately positive correlation between the RPS score and the RJ writing volume with regard to Items 5 and 6 (r = 0.475 and r = 0.444, respectively). Conclusion: This study indicated that detailed RJ writing helps to complete the reflective cycle all the way to theorization and action planning, and that the volume of writing may serve as a criterion for qualitative evaluation.
文摘It is well known that massage therapists often develop a number of health problems relatively early on in their career. A preliminary study showed that grounding massage therapists during their work may alleviate some of the health problems they encounter. A doubled-blind randomized controlled trial was designed to examine the effects of working and sleeping grounded for 4 weeks on massage therapists’ blood viscosity, stress (through HRV), inflammation (IFN-γ, IL-6, TNF-α, and hsCRP) and oxidative stress (MPO and MDA) biomarkers. The results show stress reduction as measured by heart rate, respir-atory rate and hear rate variability (HRV) and a lowering effect on blood viscosity that lasted for at least one week after ungrounding, with systolic blood viscosity becoming significantly lower at the end of the study. Inflammation markers (IFN-γ, TNF-α, and hsCRP) increased rapidly, within one week, after ungrounding. The findings suggest that grounding is beneficial for massage therapists in multiple domains relevant to health and wellbeing.
文摘Objective: To explore the importance of CBL in pathophysiology teaching. Methods: 218 undergraduate clinical medicine students in 2015 grade were divided into CBL group and control group, and each group had 109 students. The CBL group was taught by CBL, while the control group was taught by routine teaching mode. The teaching effects was evaluated by questionnaire survey and stage test. Results: The CBL group was superior to the control group in learning interest, logical thinking, knowledge system construction, comprehensive use of knowledge to solve problems. Conclusion: CBL teaching enhanced students’ understanding of knowledge significantly, and also enhanced their clinical thinking and problem analysis ability.
文摘Background: Chronic kidney disease (CKD) is a pre-condition for end-stage kidney disease (ESKD) undergoing hemodialysis, as well as a risk factor for cardiovascular disease. Therefore, it is vital that CKD prevention measures be established. In particular, socioeconomic status (SES), as represented by income, contributes to non-communicable diseases like CKD. The purpose of this study was to examine the independent association between CKD and individual SES in Japan, with consideration of other metabolic risks. Methods: In the present study, we analyzed the 2011 National Health and Nutrition Survey by the Ministry of Health, Labor, and Welfare. Specifically, we analyzed 3,557 people out of 8,762 whose serum creatinine was measured. Logistic regression analysis was used to calculate the odds ratio (OR) of CKD by income distinction, after adjustment for age and metabolic risks (obesity, diabetes mellitus, dyslipidemia, and hypertension), which were assessed at the medical examination. Results: CKD was found in 385 participants (10.8%) and was associated with greater age, obesity, higher levels of low-density lipoprotein cholesterol, triglyceride, and glycated hemoglobin, and lower levels of hemoglobin and high-density lipoprotein cholesterol. The adjusted model indicated a significant association between lower income and CKD: the OR of the low income group (<2 million yen) was 1.33 (95% confidence interval: 1.01 - 1.78) in comparison with the high income group. Conclusions: The results of the present study indicate a substantial relationship between individual lower income status and CKD in Japan, where healthcare is easy to access. To prevent ESKD and cardiovascular diseases, early detection of CKD and its metabolic risks is necessary, especially among the socioeconomically vulnerable population.
文摘Background: Avoiding primary C-section is the safest and most effective way of decreasing C-section rates. We analyzed circumstances and decisions made among pregnant women without history of C-section and cephalic single fetus (group B), who ended up having a Cesarean birth, to identify opportunities that may optimize the decisions about delivery. Methodology: We evaluated the clinical histories of pregnant women from group B who completed their pregnancies in the Hospital Universitario de Santander (Bucaramanga, Colombia) during 2013. We evaluated the decision moments from admission until birth, including the registry of the reasons for having a C-section, compliance of all the criteria to support the decision and its appropriateness, and how adequate were the procedures done during the induction or augmentation of labor. Results: We evaluated 1320 histories;666 (55.7%) ended by C-Section. In 59.8% of the histories, we identified at least one decision that could have been addressed differently to optimize the delivery type and, potentially, avoid ending in a Cesarean birth. The most frequent opportunities arise due to a lack of clarity in the record of the reason for performing the C-section (70.1%), and inadequate use of labor induction in the patients that had to end their gestation (38.5%). Conclusion: In the Hospital Universitario de Santander during 2013, despite observing a meaningful subregistry of the indication to perform a C-section, we found that in one out of every two patients there are opportunities of improvement in the registry and attention to reduce the high incidence of C-sections in the institution. This analysis allowed us to create a checklist to fill out before making the final decision of performing a Cesarean birth.
文摘Background: The ability of managers of small-scale enterprises (SSEs) to prioritize health, working conditions, and their own physical fitness is an important issue for workplace health promotion in Norway and Sweden, where most owner-manager positions are in SSEs. Aim: To assess the physical fitness status of SSE managers compared to a norm population and to study changes in physical fitness status, self-reported physical activity, and sickness outcomes after workplace health interventions. Methods: The study allocated SSE managers to either an intervention or a reference group. The intervention, over twelve months, consisted of motivational input related to lifestyle and physical activity through tests and feedback, individual support, and courses on health and psychosocial working conditions. The participants (N = 28) completed health screening checks, questionnaires and testing before and after the intervention. Results: SSE managers in the study had positive outcomes for BMI levels and strength compared to the norm population, while percentage of fat for both men and women indicated poor results. There were no further improvements in the intervention group after comparison with the reference group. Separately, both groups seemed to improve strength and body composition. Conclusion: Workplace health interventions with essentially motivational components may increase SSE managers’ attention to physical fitness, but appear to have limited effects on objective and subjective physical fitness outcomes.
文摘Shared Explanatory Models (EM) of High Blood Pressure (HBP)/Hypertension (HTN) were explored using systematic data collection and analysis methods from cognitive anthropology. Older adults who were members of a Medicare HMO in Los Angeles were asked to list all the illnesses experienced by older adults that they could recall, and those listing HBP or HTN were asked to further list and discuss its symptoms, causes, treatments and prevention. Responses were tape recorded, transcribed, and analyzed to develop a systematic “sentence completion by card sort” follow-up procedure. Consensus Analysis (CA) of the systematically collected data identified shared EM for HBP/HTN. The model presented here is similar to models of HBP/HTN described by researchers working with patients from different regions and different ethnic groups, suggesting that there is a widely shared lay or popular model for this disease. Stress, lifestyle (diet, exercise, weight, and substance use), heredity and aging are thought to be the major causes of HBP/HTN. Physicians are thought to be the appropriate source of care, as HTN/HBP is serious, life threatening, and potentially disabling. The study of cultural understandings and shared EM of disease has direct relevance for clinical practice and public health education. For a disease such as HTN/HBP, knowing where and how such explanations differ systematically between patients and clinicians, and what impact this may have on patterns of adherence to prescribed treatment is a crucial area of concern.
文摘Gallstones are common and costly in the world. This disease also have high health burden with high mortality. Currently, Laparoscopic Cholecystectomy has become a gold standard for surgical treatment of symptomatic gallstones. Pain is usually the first concern after surgery. Postoperative pain decreases with time but it is severe enough to interfere with daily activities of patients. Pain after the surgery is also affected by many factors. This cross-sectional study aimed to 1) assess pain intensity and interference pain with daily activities;2) describe the association between pain intensity and interference with daily activities of patients;3) explore factors that influence post-operative pain after Laparoscopic Cholecystectomy. Data were collected by 50 patients who were undergoing Laparoscopic Cholecystectomy completed questionnaire including the Visual Analogue Scale (VAS) and the Brief Pain Inventory (BPI). Data were analyzed based on three aims. As this is the first time that this type of study is conducted in Vietnam, it is expected that the results will contribute significantly to local knowledge and should add to global perspectives. From understanding the factors that affect severity of pain, this study is expected to design nursing intervention strategies to improve daily activities among patients undergoing LC.
基金supported by an INRIA internal financial support:ADT SENSBIO and a Montpellier Hospital internal financial support(AOI PARKDEMAR CHU Montpellier).
文摘As low cost and highly portable sensors, inertial measurements units (IMU) have become increas-ingly used in gait analysis, embodying an efficient alternative to motion capture systems. Mean-while, being able to compute reliably accurate spatial gait parameters using few sensors remains a relatively complex problematic. Providing a clinical oriented solution, our study presents a gy-rometer and accelerometer based algorithm for stride length estimation. Compared to most of the numerous existing works where only an averaged stride length is computed from several IMU, or where the use of the magnetometer is incompatible with everyday use, our challenge here has been to extract each individual stride length in an easy-to-use algorithm requiring only one inertial sensor attached to the subject shank. Our results were validated on healthy subjects and patients suffering from Parkinson’s disease (PD). Estimated stride lengths were compared to GAITRite? walkway system data: the mean error over all the strides was less than 6% for healthy group and 10.3% for PD group. This method provides a reliable portable solution for monitoring the in-stantaneous stride length and opens the way to promising applications.
文摘Objectives: Identification of the level of knowledge on ergonomics principles, and application of these by dentistry students to investigate whether painful symptomatology was experienced. An-other objective is the expansion of discussions on occupational health in academic settings. Study Design and Settings: Dentistry students of the Federal University of Rio Grande do Norte, Brazil (n = 148) were surveyed using the Nordic Musculoskeletal Questionnaire to determine the severity of musculoskeletal symptoms experienced. Data were analyzed through EpiInfo 7.0 to measure central trends and variability 5for quantitative variables, absolute and relative frequencies for categorical variables, and significance between groups (confidence intervals and chisquare). Association analysis (Pearson) was also carried out. Results: Ergonomic measures were not reported by students. Within the musculoskeletal symptoms described, females were the most affected, independent of academic level. Conclusions: Positive correlations were verified between all categories and all anatomic regions (e.g., neck, lower back, wrists, hands, and shoulders). Data suggest progressive worsening of symptoms, which will eventually result in leaves of absence.