Compliance of Physicians with Standard Precautions of Handling Patients with Infectious Respiratory Disease

Background: Standard precautions (SPs) are the minimum infection prevention practices that aim to protect Health care workers (HCWs) including physicians and prevent them from transmitting the infections to their patients. Purpose: To assess the level of compliance of physicians with standard precautions of handling patients with infectious respiratory disease. Method: A cross sectional questionnaire-based study was conducted in two tertiary level hospitals named M Abdur Rahim Medical College and Hospital, Dinajpur, Bangladesh and Rajshahi Medical College and Hospital, Rajshahi, Bangladesh to assess the level of compliance of physicians with standard precautions. Purposive sampling technique was applied as per inclusion criteria and data was collected by face to face interview from 285 physicians. Statistical analysis of the results was done by SPSS and a p value less than 0.05 was considered as significant. Result: The study revealed that maximum physicians (76.5%) handling patients with infectious respiratory disease had a moderate level of compliance with standard precautions. 78.6% of the physicians had moderate level of awareness about standard precautions. Only 20.35% of the physicians had training on infection control. 94.4% of the respondents didn’t know the component of standard precaution and most of the physicians were not aware of the sequence of wearing and removing the different components of PPEs. Conclusion: The study result implies that with increased awareness, the compliance of the physicians with standard precautions increased. The main reasons of non-compliance with standard precautions were found to be lack of resources, lack of regular training and excess workload.

Health Training Needs at Primary Care Level Health Facilities in Rural Western Uganda

Introduction: Continual education is recognized worldwide as a tool for the professional development of health care practitioners. It is however effective when the training targets the appropriate needs of the target beneficiaries. This study was therefore aimed at identifying priority training needs of Primary Care Level health professionals in rural Western Uganda. Methods: This was a descriptive cross-sectional survey among 35 rural community health facilities represented by their managers in rural Western Uganda. Participants were invited to Mbarara University of Science and Technology and responded to a self-administered questionnaire and also participated in qualitative group discussions guided by Facilitators from the Community Based Education and Research Services unit within the Community Health Department of Mbarara University of Science and Technology. Priority health training needs were determined based on the computed weighted scores. Results: The majority of managers of rural primary care level health facilities were medical officers by the level of training (51.43%) and male by gender (68.57%). Priority health training needs identified were child health and maternal health with total weighted scores of 12.0 and 10.9 respectively. Qualitatively, emerging themes included;leadership and management, and supervisory roles during student field attachments. Conclusion: Priority health training needs at rural Primary Care level health facilities were child health, maternal health, leadership and management, and supervisory skills. There is dire need to train rural primary care level, health professionals. In-service training based on identified needs should be offered by MUST in partnership with regional stakeholders. This is likely to enhance the quality of services provided by rural primary care level health facilities.

Is increased water consumption among older adults associated with improvements in glucose homeostasis?

Obesity and impaired glucose homeostasis in older adults place these individuals at risk for diabetes. Dehydration, glucose homeostasis, and insulin resistance are related;while aging and dehydration are associated with decreased glucose tolerance, weight loss can improve glycemia. For older adults following hypocaloric diets, additional water consumption may lead to greater weight loss. Further more, research suggests an association between insulin resistance and the body water retention hormone, arginine vasopressin (AVP). Analysis of the association between plasma copeptin (an AVP derivative) and fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) may provide further insight into the relationship between dehydration and diabetes risk. Our objective was to investigate the possibility that increased water consumption among older adults (n = 29, BMI = 31 ± 1 kg/m2, age = 62 ± 1 years) could improve glucose homeostasis beyond that observed with weight loss, as well as associations between plasma copeptin and diabetes risk. This retrospective analysis utilized data from a previous investigation, in which obese/overweight older adults were assigned to one of two groups: 1) Water: consume 500 ml of water prior to three daily meals over a 12-week hypocaloric diet intervention, or 2) Non-water: hypocaloric diet alone. In the present analysis, fasting plasma glucose and insulin, HOMA-IR, and plasma copeptin were evaluated, and compared to urinary specific gravity (USG), drinking water consumption, and body weight. Analyses performed using group assignment, volume of drinking water consumed or among a subgroup pair-matched for weight loss and sex did not reveal significant differences between groups. However in the full sample, plasma insulin concentration was associated with USG (r = 0.512,

Pattern of mental health service use and risk of injury: A longitudinal study

Objective: The aim of this study is to investigate the association between mental health treatment patterns and risk of injuries among a Western Australian male birth cohort. Method: A population-based birth-cohort of males born between 1980 and 1984 in Western Australia was followed up using linked health data. Results: Participants with mental health conditions were at an increased risk of injury. Those with a continuous mental health treatment pattern without interruption or window periods had lower risk of injury compared to those with treatment interruption or window periods. The adjusted incidence rate ratios (95% confidence interval) for injury among participants: 1) without a mental condition, 2) with a previous mental condition, 3) with a mental condition in the last four years and without interruption in their mental health treatment, and 4) with a mental condition in the last four years with interruptions in mental health service, were 0.38 (0.35 - 0.40), 0.77 (0.71 - 083), 1.0 (reference group) and 2.06 (1.72 - 2.47) respectively. Conclusion: Increasing resources for mental health services and enabling sufficient continuous mental health services and follow-up may reduce the risk of injury among populations with mental health conditions.

Infection Prevention Strategy in General Hospital under Regular Epidemic Prevention and Control

New coronavirus pneumonia spread rapidly all over the world in the first half of 2020, which is a new respiratory disease with strong infectiousness. At present, the epidemic situation in China has been effectively controlled, but the global epidemic situation remains grim, and the National Health Commission has instructed that the prevention and control of new coronavirus pneumonia should become normalized. As outposts for surveillance of public health events, hospitals are an important front in the fight against the epidemic. Therefore, it is very crucial to construct infection prevention and control system actively to contain the outbreak. This paper analyzes and summarizes the normal prevention and control management strategy of Infection Control Branch Management (hereinafter referred to as Hospital Infection-Control Dept) in a certain designated comprehensive third-grade hospital in Guangdong Province and transforms the prevention and control means in emergency state into measures for sustainable development, which also provides basis and reference for Hospital Infection-Control Dept of medical institutions to formulate prevention and control guidelines.

The Evolution of Disability during the Last Years in Romania and EU Member States

Purpose: People with disabilities represent a major objective, a global public health issue. This disadvantaged category needs protection and integration into society by implementing an improved legislative framework. The effectiveness of the policy making, consolidating the benefit programs and enhancing equity of the social insurance system represent the key of The Governments strategy. Methods: The paper highlights comparable data and research related to disability and social insurance system from Romania and other Member States of the European Union. Internationally, a proper measurement of disability may lead to a successful removal of barriers which increase the vulnerability of people with disability. Results: According to official data, in Romania the number of disabled people decreased gradually one year to another (in the last 5 years). In the EU Member States, musculoskeletal disorders leading to disability were one of the most common compared to Romania where it ranked last. From the point of view of the share in the total number of people with disabilities, according to the degree of disability, both in the EU Member States and in Romania, the number of moderately disabled people was double, respectively triple compared to the number of those with severe disability. Conclusion: The Romania Government promotes social-professional integration of people with disabilities, being responsible for the guidance, vocational counselling and employment. In accordance with our law, “any person with disabilities, fit and included in the labor market in Romania is entitled to a reasonable accommodation of the workplace.”

Determinants of alcohol drinking and its association with sexual practices among high school students in Addis Ababa, Ethiopia: Cross sectional study

Introduction: Alcohol drinking and risky sexual practices have become serious public health problem among teenagers and young adults globally, including many developing countries. The available reports are sparse, especially there is a lack of recent and representative data for high school students in developing countries including Ethiopia. The aim of this study was to estimate the prevalence, identify determinants, and examine the association of alcohol drinking with sexual practices among high school students in Addis Ababa, capital city of Ethiopia. Methods: School based cross sectional study was conducted from November to December 2010. Multivariate logistic regression analysis was used to determine the association between students’ background characteristics and alcohol use, and alcohol use and sexual practices. Results: Among 2551 students surveyed, lifetime and current (past month) alcohol drinking was reported by 1166 (45.7%) and 676 (26.5%) students, respectively. Having sexual intercourse at least once in their lifetime was reported by 412 (16.2%) with151 (5.9%) of them being sexually active during a month prior to the survey. Having multiple sexual partners (52.5%), drinking alcohol before sexual intercourse (26.4%), and having sexual intercourse without the use of condom (47.3%) were also common among sexually active students. In adjusted logistic regression model, age (18 and 19 and older), living with 2 parents, getting pocket money, having alcohol drinking friends and attending general secondary school (grade 9-10) were positive predictors of current alcohol drinking. Nergative predictors of current alcohol drinking were being Protestant Christian and living with relatives or siblings. Conclusion: Alcohol drinking before sexual intercourse was a major problem among high school students in Addis Ababa, Ethiopia. Male gender, older age and higher school grade, friends influence, religious affiliation, living with parents and getting pocket money were significant predictors of current alcohol drinking. Educating about substance use and risky sexual behaviors, engaging students in extracurricular activities and restrict access to alcohol to high school students may help in solution of these problems on a local scale.

Comparison of breakfast consumption in rural and urban among Inner Mongolia Medical University students

Objective: The aim of current study was to investigate breakfast consumption between rural and urban among Inner Mongolia Medical University students, China. Method: From December 2010 to January 2011, a cross-sectional survey was conducted among medical students in the Inner Mongolia Medical University using a self-administered questionnaire. X2 was used to identify the differences between rural and urban. Result: The prevalence of breakfast consumption was 70.95%. The prevalence of breakfast in rural was higher than that in urban (72.09% vs. 69.78%). Breakfast consumption prevalence among male students in rural was higher 7.4% than those of students in urban. Students in Mongolian ethnic in rural were more likely to eat breakfast than Mongolian students in urban. The prevalence of breakfast decreases with grade increase both urban and rural. Students with good physical condition were more likely to eat breakfast compared with students with poor physical condition. Conclusion: The prevalence of regular breakfast consumption in rural was higher than that in urban. However, the prevalence of eating breakfast declined faster in rural than that in urban. Our study findings could help health care professionals develop targeted interventions designed to increase breakfast consumption.

Cross-cultural psychometric assessment of the parent-teen sexual risk communication (PTSRC-III) scale in Jamaica

Background: HIV/AIDS represents a serious health threat in Jamaica. Adolescent and young adult females are at particularly high risk. US studies have shown that parent-teen sexual communication may significantly influence the sexual risk-related beliefs and behaviors. However, no studies have examined parent-teen sexual communication in Jamaica or the wider Caribbean. Objective: The study aims to describe patterns of parent-teen sexual communication between Jamaican mothers and adolescent daughters and assess the psychometric properties of the Parent-Teen Sexual Risk Communication (PTSRC-III) scale when used with this population. Method: Data were collected as part of a larger randomized controlled trial study. A total of 330 urban Jamaican adolescent girls, ages 13 - 17, and their mothers or female guardians completed the 8-item PTSRC-III scale at baseline and 3-month follow-up. Results: Mothers’ and daughters’ scores covered the full range of possible scores. Internal reliability of the PTSRC-III scale was excellent (α = 0.92 and 0.93 for mothers and daughters, respectively). There was evidence of consistency over time (r = 0.57, p r = 0.27, p r = 0.427, p r = 0.146, p = 0.008). A two-factor structure was identified, although the second factor showed a lower eigen-value than was found in previous US studies. The loading pattern and explanation of variance were very similar to the factor 2 described in the initial psychometric testing of the PTSRC-III instrument. Discussion: Patterns of sexual communication and the psychometrics of the scale when used in Jamaica were consistent with US results, and provided evidence of the cross-cultural reliability and validity of the PTSRC-III scale.

What determines walking of older people in their neighborhood?

Based on literature review and five focus groups, a model was analyzed describing individual, social environmental and physical environmental (perceived) determinants of walking by older people. Aim was to test whether these determinants were significantly associated with the duration of walking by older people (N = 567, 50 - 80 years) in a middle-sized Dutch town. Walking time was best predicted by attitude towards walking (partial correlation in model (partial r) 0.18;p r 0.12, p r 0.21 p r - 0.14, p r 0.28 p < 0.01). The model explained 20% of the total variance in walking time. Conclusion is that individual and social determinants predicted the most variance in walking time and that perceived environmental determinants played only a minor role. Health promotion actions may benefit from these insights.

Evaluation of the Effectiveness of Workplace Health Promotion Programs from 2000 to 2020: Literature Review

Introduction. Recognition of best practices in workplace health promotion is an important task that significantly affects the expansion of those programs. Once the program has been developed, its effectiveness becomes the most critical point of evaluation to guarantee achievements in the improvement of workers’ health. Objectives. To identify the practices for evaluating the effectiveness of workplace health promotion programs. Material and Methods: A search was performed on MEDLINE through PubMed with the MeSH: “Occupational Health”, “Health Promotion” and “Program Evaluation”, from the year 2000 to the year 2020 for studies with the following designs: Meta-analyses, Systematic reviews, Randomized Clinical Trials and Clinical Trials. Results: The most common topic of workplace health promotion programs (WHP) was increasing physical activity and avoiding a sedentary lifestyle, followed by stress management and finally smoking cessation and musculoskeletal disorders. The post-intervention measurements were most often done at 6 months and 12. The most commonly used indicators were the number of steps, weight, BMI, % body fat, waist circumference, blood pressure, sedentary time, level of physical activity and time of moderate-vigorous physical activity, daily energy output, life purpose, life satisfaction, mood and stress level. Conclusions: Although a great variability was observed in the evaluation of WHP programs, there were also common aspects. These results will help with designing WHP programs and defining evidence-based evaluation of their effectiveness. It is important to remember that WHP programs must be customized, taking into consideration the needs of each organization’s workforce.

Development of Japanese Version of Smartphone Dependence Scale

We designed a Japanese version of the Smartphone Dependence Scale (J-SDS) for university students, and assessed its validity and reliability. For development of this scale, we initially selected 43 preliminary items based on previous studies of Internet and mobile phone dependence. Each response was scored using a Likert scale (0, 1, 2, 3), with higher scores indicating greater dependence. After administering the preliminary scale to 149 university students, the final 29 items were selected according to exploratory factor analysis. The final scale consisted of 5 factors: 1) craving and withdrawal, 2) overuse and tolerance, 3) virtual life orientation, 4) disturbance of concentration in class, and 5) physical symptoms. Reliability coefficient (Cronbach’s alpha) values for the 5 factors and total J-SDS were 0.87, 0.87, 0.76, 0.77, 0.69, and 0.92, respectively. We then summed the Likert scores for each item to provide a quantitative overall smartphone dependence score, with higher scores indicating greater dependence. The J-SDS score became significantly higher with longer hours of smartphone use (p < 0.001). Our results suggest that the J-SDS is a reliable and valid scale for screening university students who may be at risk of developing smartphone dependence.

Ethical and Regulatory Issues with Residual Newborn Screening Dried Bloodspots

After newborn screening is completed, most states retain leftover dried bloodspots. These dried bloodspots are stored for varying lengths of time among different state newborn screening programs. Dried bloodspots are a unique and valuable resource for the development of new newborn screening tests, quality assurance and biomedical research. Recent changes to the 2014 Newborn Screening Reauthorization Saves Lives Act require explicit parental consent for the retention and use of dried bloodspots in federally funded research. This has raised several ethical and regulatory issues and highlighted the challenges of respecting individual autonomy and public health goals. This article provides an overview of these issues and discusses methods for obtaining parental consent. These issues may be applicable to consent for the storage and use of biospecimens among other settings according to proposed changes to the Common Rule.

Comparison of characteristics among Korean American male smokers between survey and cessation studies

This study compared characteristics of Korean American men in two studies: a telephone survey with a random sample of Korean American men who reported daily smoking versus a smoking cessation clinical trial with a convenience sample of Korean American men who reported smoking at least 10 cigarettes a day. Guided by the Theory of Planned Behavior (TPB), both studies attempted to explain how much its theoretical variables (attitudes, perceived social norms, and self-efficacy) would explain quit intentions in Korean American men. Participants in the cessation study were less likely to have health insurance coverage (χ2 [2, 271] = 138.31, p = 0.001) than those in the survey study. The cessation group was more likely to smoke in indoor offices (χ2 [1, 231] = 18.09, p = 0.003) and had higher nicotine dependence than the survey group (t269 = 3.32, p = 0.001) but these differences became insignificant when only those who smoked 10 or more cigarettes were compared. Participants in the cessation study had more positive attitudes towards quitting (t267 = 4.99, p < 0.001), stronger perceived social norms favoring quitting (t269 = 5.63, p t268 = 9.86, p < 0.001) at baseline than those in the survey study. Korean American men are more likely to have a quit intention and make a quit attempt when they have more positive and fewer negative attitudes towards quitting and perceive stronger social norms favoring quitting. To motivate Korean American men to quit smoking, clinicians should underscore the immediate health benefits of quitting, promote quitting with cessation aids to reduce perceived risks of quitting in anticipation of withdrawal symptoms, and encourage family members to relate firm anti-smoking messages.

Persistence in health behaviors among Medicare beneficiaries

We examined persistence in seven common preventive health practices for a nationally representative sample of Medicare beneficiaries over 4-year observation periods. Six panels from the 1997-2005 Medicare Current Beneficiary Survey (MCBS) were used resulting in 13,913 unique individuals with ages ranging from below 65 (disabled) to over 80 years old. Persistence in behavior was defined as the proportion of the observation period beneficiaries participated in each activity. We estimated behavioral persistence as a function of baseline demographic, socioeconomic, and health characteristics using multivariate regression analysis. Beneficiaries were most persistent in smoking abstinence (81% reported not smoking) and least persistent with routine exercise (47% reporting none). From multivariate regression results, there was greater persistence among beneficiaries who were married when compared to those living alone (p 300% FPL compared to <100% FPL all p < 0.01). Increasing age (greater than 80 compared to 65 - 69) was associated with increased compliance in influenza vaccination and smoking cessation (p < 0.01) while negatively associated with weekly exercise and cancer screenings (p < 0.01). Medicare beneficiaries are inconsistently persistent with common preventive health practices.

Maternal and foetal risk factors of cerebral palsy among Iraqi children. A case control study

Background: The importance of studying cerebral palsy comes from the fact that, this disorder imposes huge burden families psychologically, emotionally, financially and socially. Moreover, it imposes a major burden on the National Health System because it is simply a chronic disorder, which needs a continuous care and multiple financial resources. At the same time, it needs collaborative efforts and team work between many parties and organizations for a good management and rehabilitation. In Iraq, risk factors of cerebral palsy have not been explored before. Our study objective was to measure the association between, maternal factors, foetal and early neonatal factors, and occurrence of cerebral palsy among Iraqi children. Postnatal risk factors of cerebral palsy were excluded in our study. Methods: We did a retrospective case-control study in Baghdad-Iraq. The place of study was The Central hospital of Children of Baghdad. Cases and controls were fully investtigated (retrospectively) for the risk factors of cerebral palsy using a self-administered questionnaire. The sample size was 300. Number of cases in our study was 100 while the number of controls in our study was 200. Results and conclusion: 84% of the mothers of Cerebral Palsy children were employed compared to 49% of the mothers of normal children who were employed (P value 0.00). After using a multiple logistic regression model, the final adjusted odd ratios included 6 variables which were, employment of mother (OR 8.05, 95% CI 0.98 - 6.62), Primigravida(OR 0.24, 95% CI 0.10 - 0.60), gender of the child(OR 0.15, 95% CI 0.04 - 0.51 ), asphyxia (OR 10.58, 95% CI 3.59 - 31.21), hypoglycemia (OR 40.99, 95% CI 6.93 - 242.27) and hypocalcaemia (OR 27.91, 95% CI 2.04 - 380.96). Our study came to a conclusion that neonatal asphyxia, hypoglycemia and hypocalcaemia were still the major risk factors for cerebral palsy In Iraq.

Prevalence of Viral Hepatitis B among Women of Childbearing Age in the Kara Region of Togo in 2022

Introduction: The hepatitis B virus (HBV) is one of the major causes of morbidity and mortality in the world. Few up-to-date data on this disease are available in developing countries, including Togo. The aim of this study was to estimate the prevalence of hepatitis B among women of childbearing age in the Kara region of Togo. Methods: A cross-sectional study was carried out from 23 to 25 September 2022 during a fairground campaign. Data were collected using a standardised questionnaire. HBV screening was performed using “SD-BIOLINE HBsAg WB” rapid immunochromatographic tests. HBV prevalence was reported with its 95% confidence interval (CI). Regression analyses were performed to identify factors associated with HBV infection. Results: A total of 327 women were enrolled, with a median age of 34 years and an interquartile range of [25 - 43]. Nearly half (49.5%) of the women had had their first sexual intercourse before the age of 18 and 2.1% had at least 2 sexual partners at the time of the survey. The majority (91.7%) had not used a condom the last time they had sex. The prevalence of hepatitis B was 10.4% (95% CI: 7.5 - 14.2]). In multivariable analysis, having had sexual intercourse for the first time after the age of 18 (ORa = 0.17;95% CI [0.06 - 0.43];p Conclusion: The results of this study underline the importance of monitoring the prevalence of hepatitis B in women of childbearing age, and of implementing targeted prevention and screening measures to eliminate mother-to-child transmission of HBV.

Analysis on Long-Term Care and Influencing Factors of Empty-Nest Differently Abled Elderly People in China —Based on the Data from the Chinese Longitudinal Healthy Longevity Survey

Purpose: This study aimed to understand the actual needs of empty-nest differently abled elderly people and analyze their long-term care status including the factors affecting choice of care mode so adequate resources can be allocated to meet their healthcare needs. Methods: An empty-nest group was compared with a non-empty-nest group based on data from the 2014 Chinese Longitudinal Healthy Longevity Survey. Individual characteristics, family characteristics, and sociological factors were considered as independent variables, and long-term care model was the dependent variable in the three binary logistic regression method. Results: Age, gender, marriage, and disability were the most important factors influencing the choice of long-term care mode, including the willingness of the differently abled elderly. Family care can no longer meet the needs of the severely disabled elderly. Long-term care for such elderly people should be undertaken by professional and specialized social institutions. Conclusion: Multi-level services should be provided according to the elderly peoples’ needs, and the skill and expertise of professional personnel of care institutions should be strengthened. The government should deploy fund-raising initiatives, actively use the power of non-governmental organizations, and strive to resolve the financial issues faced by the empty-nested elderly people with disability.

Seropositivity for Hepatitis B Virus, Vaccination Status and Response to Vaccine in a Cohort of Dental Students

Background: The development of a vaccine against hepatitis B virus (HBV) has been a major achievement in terms of prevention of HBV infection. To evaluate the immunological status against HBV of dental-profession students, we analysed the long-term immunogenicity and effectiveness of HBV vaccination in Italian dental students with different work seniorities, determining the influence of epidemiological variables on the immune response. Methods: This study, carried out from January 2014 to April 2016, involved 361 under- and post-graduate dental students attending the Second University of Naples. HBV serum markers were determined and multivariate logistic regression analysis was used to identify factors associated with the level of long-term immunogenicity. Results: Of the 361 subjects evaluated, 15 (4.2%) declared no history of vaccination. All vaccinated subjects were HBsAg/anti-HBc negative, with 86 (24.9%) having an anti-HBs titre <10 IU/L. The latter were younger, more likely to be attending undergraduate dental school, and more likely to have been vaccinated in infancy. Conclusion: The findings of this study suggest that assessment of HBV serum markers in workers potentially exposed to hospital infections is useful to identify small numbers of unvaccinated subjects or vaccinated subjects with low antibody titre, all of whom should be referred for a booster series of vaccinations.

Precocious puberty: Pathology, related risks, and support strategies

Children are currently starting pubertal development much earlier than 20 to 30 years ago. Data from the National Health and Nutrition Examination Survey (NHANES III) conducted from 1988-1994 revealed that the median age for breast development in white girls was approximately 9.7 years and 8 years in African-American girls versus 10.9 years ago. More recent data, however, indicate that some children are starting pubertal development even earlier (age 7 or 8 in girls or age 9 in boys). Very early pubertal development is identified as precocious puberty, a phenomenon that brings great concern to others besides parents: the child, their peers, school nurses, teachers and counselors. This paper discusses precocious pubertal development, possible causes or relationships, related risks, treatment and helping strategies.