BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental...BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.展开更多
Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls ...Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls over 12 months.Methods:A total of 3334 Swedish 70-year-olds were assessed for sarcopenia,as defined by the revised definition of the European Working Group on Sarcopenia in Older People.Assessments were based on low scores for appendicular lean mass(dual-energy X-ray absorptiometry),hand grip strength,and the Timed Up and Go test.For 7 days after baseline,total time and total number of bouts(≥10 min of continuous activity at a given intensity)of activity performed at sedentary,LPA,and MVPA intensities were assessed by accelerometer.Incident falls were self-reported 6 months and 12 months after baseline.Results:Only 1.8%of participants had probable or confirmed sarcopenia.After multivariable adjustment for other levels of activity,only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass,low hand grip strength,and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria(all p<0.05),and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia(odds ratio=0.80,95%confidence interval:0.71-0.91 h/week).Similar associations were identified for total number of bouts,with no evidence of threshold effects for longer duration of bouts of MVPA.A total of 14%of participants reported-1 fall,but neither total time nor bouts of activity was associated with incident falls(all p>0.05).Conclusion:Higher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components,regardless of the length of bouts or amounts of sedentary behavior.展开更多
Background:Soil fungi play crucial roles in ecosystem functions.However,how snow cover change associated with winter warming affects soil fungal communities remains unclear in the Tibetan forest.Methods:We conducted a...Background:Soil fungi play crucial roles in ecosystem functions.However,how snow cover change associated with winter warming affects soil fungal communities remains unclear in the Tibetan forest.Methods:We conducted a snow manipulation experiment to explore immediate and legacy effects of snow exclusion on soil fungal community diversity and composition in a spruce forest on the eastern Tibetan Plateau.Soil fungal communities were performed by the high throughput sequencing of gene-fragments.Results:Ascomycota and Basidiomycota were the two dominant fungal phyla and Archaeorhizomyces,Aspergillus and Amanita were the three most common genera across seasons and snow manipulations.Snow exclusion did not affect the diversity and structure of soil fungal community in both snow-covered and snow-free seasons.However,the relative abundance of some fungal communities was different among seasons.Soil fungal groups were correlated with environmental factors(i.e.,temperature and moisture)and soil biochemical variables(i.e.,ammonium and enzyme).Conclusions:These results suggest that the season-driven variations had stronger impacts on soil fungal community than short-term snow cover change.Such findings may have important implications for soil microbial processes in Tibetan forests experiencing significant decreases in snowfall.展开更多
BACKGROUND:In a tertiary care institute of northern India,the emergency department receives an average of 6-7 patients with poly trauma every day.Of these patients,some come directly and many are referred from other h...BACKGROUND:In a tertiary care institute of northern India,the emergency department receives an average of 6-7 patients with poly trauma every day.Of these patients,some come directly and many are referred from other hospitals from the region.Various problems are faced in the management of patients with poly trauma.This study aimed to elicit various complaints,suggestions and possible solutions in the management of patients with poly trauma.METHODS:A retrospective cross sectional study was done on 210 patients in the emergency OPD for a period of 2 months.All the records of the patients with poly trauma were studied and the problems during their management were measured against 6 predetermined steps(step Ⅰ to step Ⅵ).RESULTS:In the younger generation,males were predominantly the primary victims of poly trauma injury,and road traffic accident was the major etiological factor.Injuries involving more than2 specialties induced many problems during the management of patients with poly trauma.Of 210 patients we studied,32 patients had problems at various steps and maximum problems in step Ⅲ,i.e.co-ordination between various specialties in the management of patients with poly trauma.CONCLUSION:A proper poly trauma management team and a well defined standard operative procedure are the keys to effective management of patients with poly trauma by minimizing the problems encountered.展开更多
Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhu...Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.展开更多
Objective: Relaxation technique is a nonpharmacological treatment applied to increase sleep efficiency and the quality of sleep.Hydrotherapy is one of the relaxation techniques and uses warm water to decrease stress a...Objective: Relaxation technique is a nonpharmacological treatment applied to increase sleep efficiency and the quality of sleep.Hydrotherapy is one of the relaxation techniques and uses warm water to decrease stress and muscle stiffness, as well as to warm the body. The incidence of sleep deficiency among older people in Integrated Community Health Services, Pandak I Bantul, has slightly increased year by year. This research aims to evaluate the effect of hydrotherapy on sleep deprivation among older people.Methods: The research was a quasi-experimental study with a pre-post test design. Purposive sampling was used to enroll 66 older people from the Integrated Community Health Services, Pandak I Bantul, Yogyakarta, Indonesia, as a sample, and we divided them into two groups: 33 people formed the intervention group, and 33 people comprised the control group. The intervention group did hydrotherapy once a day for a total of 7 days. First, they soaked their feet in warm water for 10 minutes. The water temperature was adjusted according to the body temperature, to approximately 40.0℃-43.0℃. Then, the intervention group took a bath using warm water. The level of sleep quality was measured using the Pittsburgh Sleep Quality Index(PSQI) questionnaire. Data analysis was done using the Wilcoxon test.Results: The mean score for sleep quality in the pretest in the intervention group was 9.04(standard deviation [SD]: 2.57) and the score on the posttest was 42(SD: 1.43). The mean score for sleep quality in the intervention group was 4.67, with P=0.05.Meanwhile, the research found that the difference between the pretest and posttest scores for quality of sleep in the control group was 0.42, with P=0.059. Wilcoxon analysis found that in the intervention group, there was a significant difference after intervention using hydrotherapy, with P<0.05. In the control group, there was no significance difference between the pretest and posttest scores,with P> 0.05.Conclusions: According to the results of the present study, it appears that the practice of hydrotherapy is effective in reducing sleep deficiency and hence can be considered an effective method of intervention.展开更多
Introduction:Patients with pain contribute to 60%-70% of emergency department(ED)attendance and the tramadol is among analgesic of choice in ED.However,the use of intravenous tramadol is limited to moderate pain inten...Introduction:Patients with pain contribute to 60%-70% of emergency department(ED)attendance and the tramadol is among analgesic of choice in ED.However,the use of intravenous tramadol is limited to moderate pain intensity because of its weak opiod agonist properties.We conducted a study to examine the effectiveness of intravenous tramadol among patients who suffer from severe traumatic pain.Methodology:In this prospective study,eligible patients received a loading dose of intravenous tramadol(2mg/kg).If visual analogue score(VAS)more than 30 mm after the loading dose,intermittent bolus intravenous tramadol 20mg will be administered every 10 minutes.At 30 minutes of study,rescue medication(i.e.morphine or pethidine)will be provided to those patients with VAS more than 30 mm.VAS score,vital signs and side effects were recorded for every 10 minutesResults:Forty-seven patients who suffered from fracture and soft tissue injury were analysed.The median VAS score on presentation and at 30 minutes was 90 mm 20 mm respectively.The median total dose of IV tramadol received by the patients at 30 minutes was 150 mg(IQR=34.0).There was a significant change in medium pain score at 10,20 and 30 minutes treatment(P<0.001).Vital signs were within normal range throughout the study period.About 66.1% of them had side effects of tramadol.The common side effects were sleepiness(75.0%)and dizziness(56.3%).Conclusion:The intravenous tramadol is a safe and effective analgesia in severe traumatic patients if an initial and intermittent dose is given adequately.展开更多
The aim of this study was to investigate the efficacy of specially designed zori, a Japanese-style sandal, for enhancing walking performance. A total of 89 women aged 59-75 were randomly assigned to either the interve...The aim of this study was to investigate the efficacy of specially designed zori, a Japanese-style sandal, for enhancing walking performance. A total of 89 women aged 59-75 were randomly assigned to either the intervention or control group. The intervention group wore the zori for 6 months while the control group did not. We conducted physical assessments, including The Good Walker’s Index, which consisted of a 10-m walking time measurement, maximal step length, the 40/20-cm step test and tandem gait, and measurement of the toe-gap force (TGF). Additionally, bare foot plantar pressure distribution was measured using a foot-mapping sensor, while gait characteristics were measured using three dimensional sensors. In the intervention group, means for TGF improved significantly between baseline and three months and between baseline and six months, but this improvement was not evident in the control group. In the intervention group, the means for pressure and surface areas of both left and right feet significantly decreased over time compared with the control group. Three-dimensional analysis found that left and right ankle height was enhanced in the intervention group, and their walking speed was improved by the extension of their stride length and an increase in the height of the tiptoe in one cycle. The findings in our study indicate that zori can be useful in improving lower leg function through TGF enhancement and adjustment of the pressure pattern.展开更多
Introduction: Hypertension is a public health problem with a high prevalence in Nigeria. The cost of prescription medications is thought to be a barrier for many patients to access the healthcare they need. This study...Introduction: Hypertension is a public health problem with a high prevalence in Nigeria. The cost of prescription medications is thought to be a barrier for many patients to access the healthcare they need. This study was aimed at identifying associated co-morbid conditions, the prescribing patterns and cost of prescription for the treatment of hypertension in an outpatient clinic at Lagos University Teaching Hospital. Materials and Methods: A cross sectional study was carried out. A total of 147 prescriptions were obtained from the case notes of patients treated at the LUTH outpatient department between February 2012 and August 2012. For each prescription, the number of drugs, the class and combinations of antihypertensives were recorded. The monthly cost of a 30-day anti-hypertensive supply based on the recommended daily dose was calculated. Results: The mean age of the patients was 54(+/-14) years and of the 147 prescriptions, 77(52.4%) was for females and 70(47.6%) was for males. The mean systolic blood pressure was 141.6 mmHg (+/-20.5SD) and mean diastolic blood pressure was 86.5 mmHg (+/-13.3SD). Of the 147 prescriptions, 112(76.2%) were for patients with co-morbidities. The frequency of prescription of the various classes of anti hypertensives are;diuretics 117(79.6%), angiotensin receptor blockers 78(53.1%), angiotensin converting enzyme inhibitors 65(44.2%), calcium channel blockers 65 (44.2%) beta blockers 54(36.7%) and centrally acting agents 12(8.2%). Average cost per month was =N=6611.47 (US$44). There was a statistically significant association between co morbid conditions and high cost of prescriptions with 73.7% of those with diabetes and 63.2% of those with renal disease having cost of prescriptions within the high cost group (p < 0.05). Conclusion: The cost per month is high and it is recommended that hypertension should be addressed as part of an integrated care program. Ingenious ways of health care financing also have to be promoted.展开更多
Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with c...Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with cataract. The objectives of the study were to understand the social, psychological and physical consequences of blindness in families, to understand why some parents with blind children access services and others do not, and to explore factors related to decision making within families that prevent access to health care services. Methodology: A mixed methodology quantitative and qualitative community study of blindness in children conducted in southern Malawi to compare “Doers”: families with blind children from the same communities who had attended cataract surgical services with “Non-doers” versus families with blind children from the same communities who had not attended services. Individual, family, community socio-cultural and economic characteristics and other qualitative data on knowledge, perceptions, and beliefs were recorded and analyzed thematically, based on grounded theory. Results: A total of 53 in-depth interviews of parents;21 in-depth interviews of children;15 focus group discussions with community members;62 children’s clinical eye examinations, and 4 case studies were conducted over the study period. Doer families were likely to have a reliable source of income, have better housing and live closer to health centres than non-doer families. Visual acuity among doers was better than non-doers. Conclusion: This research has highlighted reasons why some families who have children with cataract are likely to be delayed to seek surgical intervention. Comprehensive counseling modules targeting such families need to be developed to increase acceptance and access to children’s cataract surgical services.展开更多
In 2015, about 35 million people died of HIV infection globally, with about 36.7 million infected. Most of the infection occurred in Sub-Saharan Africa. Misconceptions about HIV/AIDS exist mostly in developing countri...In 2015, about 35 million people died of HIV infection globally, with about 36.7 million infected. Most of the infection occurred in Sub-Saharan Africa. Misconceptions about HIV/AIDS exist mostly in developing countries. The research was a cross-sectional study, conducted in Enugu state, Nigeria. Objective was to assess key HIV misconceptions among rural community dwellers. Interviewer administered questionnaire was used, and information was collected from 296 respondents, most of whom were above 50 years of age, married, had no formal education, and were farmers. Correct responses to the misconceptions investigated were: HIV infection found only among sinners (29.7%);HIV can be transmitted by eating from the same plate with an infected person (24.7%);HIV can be transmitted through handshake (29.7%);HIV can be transmitted by touching the urine or faeces of an infected person (24.0%);HIV can be transmitted by hugging or touching an infected person (28.0%);HIV can be cured (19.9%);Praying daily can prevent HIV infection (20.3%);and Worshipping our ancestors can prevent HIV infection (27.0%). Inhabitants of rural communities are more likely to hold misconceptions about HIV. It is recommended that relevant governments in developing countries design interventions aimed at addressing misconceptions about HIV/AIDS.展开更多
Background: Young people are at risk of being victims or perpetrators ofcoerced or forced sexual sex. In predominantly low- and middle-income countries, this contributes significantly to their risk for HIV infection, ...Background: Young people are at risk of being victims or perpetrators ofcoerced or forced sexual sex. In predominantly low- and middle-income countries, this contributes significantly to their risk for HIV infection, unwanted pregnancy, and sexually transmitted diseases. Current trends show that young people sexual identity and preferences affect their sexual and reproductive health. Objective: This study aims to determine prevalence of coerced or forced sexual intercourse, sexual identity and sexual preferences of young people in Oluku Community, Ovia North East, Local Government, Edo State, South Nigeria. Methods: A descriptive cross-sectional study conducted in June, 2013 using multi-stage sampling method. Results: A total of 400 young people participated in this study. The mean age was 17.8 ± 3.9 years. A higher proportion of respondents were of the Bini ethnic group 145 (36.3%). Most respondents were Christians 346 (86.5%) while 33 (8.2%) were Moslems. Majority of the respondents had secondary education 271 (67.8%), most were single 363 (90.8%) and were from families with a monogamous setting 289 (72.3%). The prevalence of forced sex was 12.9%, similarly, condom use during forced sex was 27.8%. More females (15.3%) than males (9.6%) had experienced forced sex;forced sex was common among young people from older age group, monogamous homes, and those living in a flat or self contained. Majority (95.3%) of adolescent’s sexual preference was vaginal, only a few preferred oral (3.3%) and anal sex (1.5%). Religion was associated with sexual preference and identity. The sexual identity of most (98.0%) young person’s was heterosexual (or different sex), while 0.5% were homosexual (or same sex) and 1.5% bisexual (or both). Conclusion and Recommendations: Legislation against forced and coerced sex, rape and other forms of sexual violence should be formulated and implemented.展开更多
As dehydration is related to negative health outcomes in the elderly,including an increased risk of disability and death,prevention may help improve health,functional status,and quality of life.Dehydration diagnosis c...As dehydration is related to negative health outcomes in the elderly,including an increased risk of disability and death,prevention may help improve health,functional status,and quality of life.Dehydration diagnosis can be challenging in the elderly as the traditional physical indications of dehydration may be absent or ambiguous.Numerous etiologies place the elderly at an increased risk.The role of the community health nurse(CHN)derives from the responsibilities attached to her,and the Betty Neuman’s Systems Model of health care with three levels of protection is usually applied to the CHN.In this mini-review,we try to integrate the Betty Neuman’s Systems Model with the results of identified articles.This study includes a literature search of reputable international databases such as SpringerLink,PubMed,Embase,and Wanfang,particularly for the period 2005 to the present.Ten articles that met the qualifying criteria were included in this study.The findings of this study draw a picture of the role of CHN in preventing dehydration across the three levels of prevention as mentioned by Betty Neuman.展开更多
Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CH...Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.展开更多
Studies were carried out to evaluate the effect of distance of sanitary pits on the physicochemical properties of hand-dug well water samples consumed by people living in Akwuke community, Enugu South Local Government...Studies were carried out to evaluate the effect of distance of sanitary pits on the physicochemical properties of hand-dug well water samples consumed by people living in Akwuke community, Enugu South Local Government Area of Enugu State, using standard analytical procedures and instrumentation. The mean range of pH, turbidity, electrical conductivity, total dissolved solids, nitrate and sulphate in the well water samples at the determined sampling distances of 3, 6 and 10 m from the sanitary pits were 5.9 - 7.24, 1.92 - 6.63 NTU, 122.03 - 303.91 μs/cm, 100.00 - 261.90 mg/L, 1.21 - 4.68 mg/L and 28.89 - 49/61 mg/L respectively. The investigated mean physicochemical parameters of the well water samples were generally observed to increase with decrease in the distance of the well water samples from the sanitary pits. The levels of the determined physicochemical parameter of the well water samples at sampling distances of 3, 6, and 10 m respectively from the sanitary pits were statistically significant. The mean pH values of the well water samples at sampling distances of 3 and 6 m respectively from the sanitary pits were below the WHO recommended threshold limits for safe drinking water. Additionally, the mean values of turbidity and total dissolved solids of the well water samples at a sampling distance of 3 m from the sanitary pits were above the WHO permissible limits. The pH, turbidity and total dissolved solids are some of the most important parameters used in assessing the quality of any water source, therefore, the poor physicochemical properties of well water samples at a sampling distance of 3 m from the sanitary pits could put at severe health risk consumption of this water over a prolonged time. Siting well water at a reasonable far distance (above 10 m) for sanitary pits especially in communities with severe water scarcity would definitely help guarantee access to safe drinking water by rural as well as urban dwellers in Nigeria.展开更多
<b>Background: </b>Nigeria<i>,</i> one of the high burden Tuberculosis countries<i>,</i> has developed various intervention strategies to ensuring universal access to quality-assure...<b>Background: </b>Nigeria<i>,</i> one of the high burden Tuberculosis countries<i>,</i> has developed various intervention strategies to ensuring universal access to quality-assured tuberculosis diagnosis and treatment. However<i>,</i> low case detection and unsuccessful treatment outcome still remains a serious challenge in most states. Community Tuberculosis care was born against this background in 2010 as a complementing front to combat the challenges<i>,</i> bringing directly observed treatment short-course strategy beyond the clinic settings to the door steps of patients. This study evaluates the contributions of the intervention to Tuberculosis case detection and treatment outcomes in two states in Nigeria. <b>Materials and Method:</b> A retrospective study with multistage sampling technique was employed to review 23<i>,</i>241 presumptive Tuberculosis cases enrolled for management between 2014-2017. Chi-square (<i>χ</i><sup>2</sup>) test was used for test of association between the independent variables and the main outcomes of the study<i>,</i> with statistical significance set at p-value of 5%. <b>Results</b>: The annual percentage increase for both states was 24.7%<i>,</i> 189.8% and 114.5% in the study group as against 5.2%<i>,</i> 44.6% and 65.6% in control group. Overall<i>,</i> 23.8% were bacteriologically positive (either AFB or Gene-Xpert MTB/Rif) and 1.4% were clinically evaluated to be positive<i>,</i> while 74.8% were bacteriologically negative. Of the total 5861 cases treated<i>,</i> successful treatment rate of the patients in the study group was 88.6% as compared to 76.1% in the control group. The relationship between the referral system from communities where the intervention program was implemented and the case detection/treatment outcome was statistically significant (OR 95% CI = 3.15<i>,</i> 2.95 - 3.35). <b>Conclusion</b>: The community level Tuberculosis intervention led to significantly better case detection and treatment outcome when compared to the conventional approach (p ≤ 0.05). Therefore<i>,</i> full community engagement should be advocated as a major strategy for End Tuberculosis planed by WHO since the patients are found in the community and not in the health facilities.展开更多
Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the freq...Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the frequency and etiologies of urinary tract infections in diabetics hospitalized at the department of medicine of Abass Ndao Hospital. Patients and Methods: This work was a cross-sectional, descriptive, and analytical study conducted from January 01, 2018, to December 31, 2018. It focused on hospitalized diabetic patients with urinary tract infection. Epidemiological, clinical, and evolutionary data of UTI were evaluated. Results: One hundred and twenty-eight (128) diabetic patients had a cytobacteriological urine exam (CUE). 44 of who had a positive CUE (34.4%). The age group [60 - 69] years was the most represented (31.8%). Women predominated (61.4%) with a sex ratio (m/f) of 0.63. Abdominal pain was the most frequent reason for consultation, followed by polydipsia. Fever was recorded in 21 patients (47.7%). Type 2 diabetes was found in most patients (70.5%). Glycemia above 2g/l was found in 34 patients (89.5%). Anemia accounted for more than half of the patients with 29 cases (65.9%). Leukocytosis was noted in 28 patients (63.6%) and a positive CRP in 33 patients (75%). An increase in urea-creatinine was noted in 23 cases (52.3%). The results of the CUE revealed Escherichia coli as predominant (43.2%, n = 19), followed by Candida with 22.7% (n = 10). Antibiotic therapy was given to all patients. The mostly used antibiotic in the treatment of UTI was Cefotaxime 27.3% (n = 12). Older age and female gender were associated with the presence of E. coli. Four (4) deaths were recorded (9%). They were all male over the age of 65. Conclusion: UTI in diabetes is an important cause of morbidity and mortality. The development and implementation of a prevention and management program are essential.展开更多
Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear ...Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.展开更多
Objective:To investigate the epidemiology of injuries and risk factors in Raipur,Chhattisgarh,India.Methods:A community-based cross-sectional study was conducted in 10 selected wards of Raipur.Data were collected from...Objective:To investigate the epidemiology of injuries and risk factors in Raipur,Chhattisgarh,India.Methods:A community-based cross-sectional study was conducted in 10 selected wards of Raipur.Data were collected from injured individuals using a structured questionnaire.Socio-demographic characteristics,injury mechanisms,medical care-seeking behavior,and outcomes were assessed.Results:312 individuals with injuries were included,with 193 men and 119 women.Males were more likely to be injured than females(61.86%v.s.38.14%).Younger adults aged 21-30 were at highest risk(21.5%).The most common injuries were falls(38.8%)and road traffic accidents(34.9%).Injuries occurring on-road are the most frequent,followed by,at home with a highly significant association(P<0.001).Most individuals sought medical care(90.1%),primarily in private facilities(51.3%).Conclusions:This study provides valuable insights into the epidemiology of injuries in Raipur.The findings can inform the development of evidence-based interventions to reduce the burden of injuries and improve the health and well-being of the population.展开更多
Background: Worldwide, Female Genital Mutilation/Cutting (FGM/C) has been practiced for generations. This study examined the practice of FGM/C and identified factors influencing its continuity in Osu, a rural communit...Background: Worldwide, Female Genital Mutilation/Cutting (FGM/C) has been practiced for generations. This study examined the practice of FGM/C and identified factors influencing its continuity in Osu, a rural community in Osun State, Nigeria. Methods: This study employed a mixed method cross-sectional design. The quantitative aspect involved interview of 294 women using a semi-structured questionnaire while the qualitative aspect entailed 16 in-depth interviews using an in-depth interview guide to seek information from selected spouses of the respondent, women leaders, religious leaders and health workers. The study took place between January and June 2023. The quantitative data were subjected to descriptive and inferential statistics while the qualitative data were analyzed using thematic content analysis. Results: Ninety four percent of the women had poor knowledge of the health risks associated with FGM/C practice. About three-third (76.5%) had undergone FGM/C while 77.2% intend to continue FGM/C practice on their daughters. The predictors of continuing FGM/C practice include being married (AOR 2.03, 95% CI 1.12 - 3.65, p = 0.019), none/primary education (AOR 10.02, 95% CI 2.88 - 34.88, p = 0.0001), lower income (AOR 3.17, 95% CI 1.54 - 6.55, p = 0.002) and having undergone FGM/C (AOR 14.65, 95% CI 5.31 - 40.37, p = 0.0001). In-depth interviews revealed that the factors sustaining FGM/C in the community include curbing promiscuity, religious rites, community customs and traditions. Conclusion: Socio-cultural factors continue to sustain FGM/C practice in the community. It is necessary to target married women and other community leaders in the campaign against FGM/C practice.展开更多
文摘BACKGROUND There is a possible link between depression and anxiety about suicidal ideation among parents of children with congenital heart disease(CHD).AIM To document the effects of depression and anxiety on parental suicidal ideation among children with CHD and the associated factors.METHODS This was a cross-sectional study among 50 parents of children with CHD who attended the Cardiac Clinic of University of Nigeria Teaching Hospital Ituku-Ozalla.Information was obtained using the Columbia Suicide Severity Rating Scale and the Hospital Anxiety and Depression Scale.RESULTS A greater percentage of parents whose child had a heart defect had anxiety symptoms(50.0%)than did those whose child had no heart defect(24.0%),and the difference in proportions was statistically significant(χ^(2)=7.250,P=0.007).A greater percentage of parents whose child had a heart defect had suicidal ideation(28.0%)than did those whose child had no heart defect(8.0%),and the difference in proportions was statistically significant(χ^(2)=6.775 P=0.009).A positive correlation was elicited between anxiety and suicide ideation,and this correlation was statistically significant(r=0.748,P<0.001).A positive correlation was elicited between depression and suicidal ideation scores,and this was statistically significant(r=0.617,P<0.001).CONCLUSION There is strong interconnectivity between anxiety and depression with suicidal ideation.There is an urgent need to start screening for the mental health of parents of children with CHD to avert the high propensity of complete suicide.In addition,policy makers may introduce a national clinical practice guideline on the importance of psychotherapy and mental health screening and targeted interventions for parents of children with CHD.
基金supported by the Swedish Research Council(Grant number 2011-2976)DS is supported by an Australian National Health and Medical Research Council(NHMRC)R.D.Wright Biomedical Career Development Fellowship(Grant number GNT1123014).
文摘Purpose:This study was aimed to determine associations of accelerometer-determined time and bouts of sedentary behavior,light physical activity(LPA),and moderate-to-vigorous PA(MVPA)with sarcopenia and incident falls over 12 months.Methods:A total of 3334 Swedish 70-year-olds were assessed for sarcopenia,as defined by the revised definition of the European Working Group on Sarcopenia in Older People.Assessments were based on low scores for appendicular lean mass(dual-energy X-ray absorptiometry),hand grip strength,and the Timed Up and Go test.For 7 days after baseline,total time and total number of bouts(≥10 min of continuous activity at a given intensity)of activity performed at sedentary,LPA,and MVPA intensities were assessed by accelerometer.Incident falls were self-reported 6 months and 12 months after baseline.Results:Only 1.8%of participants had probable or confirmed sarcopenia.After multivariable adjustment for other levels of activity,only greater MVPA time was associated with a decreased likelihood of having low appendicular lean mass,low hand grip strength,and slow Timed Up and Go time as defined by the European Working Group on Sarcopenia in Older People criteria(all p<0.05),and only MVPA time was associated with lower likelihood of probable or confirmed sarcopenia(odds ratio=0.80,95%confidence interval:0.71-0.91 h/week).Similar associations were identified for total number of bouts,with no evidence of threshold effects for longer duration of bouts of MVPA.A total of 14%of participants reported-1 fall,but neither total time nor bouts of activity was associated with incident falls(all p>0.05).Conclusion:Higher amounts of accelerometer-determined MVPA are consistently associated with a decreased likelihood of sarcopenia and its components,regardless of the length of bouts or amounts of sedentary behavior.
基金funded by the National Natural Science Foundation of China(Nos.31700542,32071745,31870602,31800519 and 31901295)Program of Sichuan Excellent Youth Sci-Tech Foundation(No.2020JDJQ0052)the National Key Research and Development Program of China(Nos.2016YFC0502505 and 2017YFC0505003)。
文摘Background:Soil fungi play crucial roles in ecosystem functions.However,how snow cover change associated with winter warming affects soil fungal communities remains unclear in the Tibetan forest.Methods:We conducted a snow manipulation experiment to explore immediate and legacy effects of snow exclusion on soil fungal community diversity and composition in a spruce forest on the eastern Tibetan Plateau.Soil fungal communities were performed by the high throughput sequencing of gene-fragments.Results:Ascomycota and Basidiomycota were the two dominant fungal phyla and Archaeorhizomyces,Aspergillus and Amanita were the three most common genera across seasons and snow manipulations.Snow exclusion did not affect the diversity and structure of soil fungal community in both snow-covered and snow-free seasons.However,the relative abundance of some fungal communities was different among seasons.Soil fungal groups were correlated with environmental factors(i.e.,temperature and moisture)and soil biochemical variables(i.e.,ammonium and enzyme).Conclusions:These results suggest that the season-driven variations had stronger impacts on soil fungal community than short-term snow cover change.Such findings may have important implications for soil microbial processes in Tibetan forests experiencing significant decreases in snowfall.
文摘BACKGROUND:In a tertiary care institute of northern India,the emergency department receives an average of 6-7 patients with poly trauma every day.Of these patients,some come directly and many are referred from other hospitals from the region.Various problems are faced in the management of patients with poly trauma.This study aimed to elicit various complaints,suggestions and possible solutions in the management of patients with poly trauma.METHODS:A retrospective cross sectional study was done on 210 patients in the emergency OPD for a period of 2 months.All the records of the patients with poly trauma were studied and the problems during their management were measured against 6 predetermined steps(step Ⅰ to step Ⅵ).RESULTS:In the younger generation,males were predominantly the primary victims of poly trauma injury,and road traffic accident was the major etiological factor.Injuries involving more than2 specialties induced many problems during the management of patients with poly trauma.Of 210 patients we studied,32 patients had problems at various steps and maximum problems in step Ⅲ,i.e.co-ordination between various specialties in the management of patients with poly trauma.CONCLUSION:A proper poly trauma management team and a well defined standard operative procedure are the keys to effective management of patients with poly trauma by minimizing the problems encountered.
文摘Objective:To assess the factors associated with knowledge,attitude and behavior of contraception use among urban slum population in Chennai.Methods:A cross-sectional study was conducted in the urban slum of Anakaputhur,Chennai.Married couples between ages of 19-49 years and living in slum areas were taken up for the study by simple random sampling.Pregnant women,postnatal and postmenopausal women were excluded from the study.Data collection was done using a pretested structured questionnaire focusing on details regarding contraception knowledge,attitude,and practices.Data analysis was done using IBM SPSS version 22.Analytical test like Chi square and odds ratio(OR)were used to identify association between knowledge,attitude,and behavior of contraception with the associated variables and enter method of logistic regression analysis was done.Results:Out of the 360 respondents,228 were females,with a mean age of(34±5)years.Approximately 43%demonstrated adequate knowledge of contraception use,and 91%were aware of at least one contraceptive method.Notably,72%exhibited a positive attitude towards contraceptive use.Nevertheless,43%(155 individuals)did not utilize any contraceptive method.Among contraceptive users,intrauterine devices were the most commonly adopted,followed by barrier methods and female sterilization.There was significant association between knowledge of contraception and education(aOR 7.29,95%CI 2.93-18.10,P<0.05),age(aOR 2.04,95%CI 1.19-3.50,P<0.05)and socioeconomic class(aOR 3.66,95%CI 1.71-7.85,P<0.05;aOR 3.97,95%CI 2.12-7.49,P<0.05).Regarding attitude towards contraception use,education(aOR 8.54,95%CI 2.35-31.03,P<0.05),sex(aOR 0.15,95%CI 0.06-0.37,P<0.05),age(aOR 0.53,95%CI 0.28-0.99,P<0.05),socio-economic class(aOR 4.42,95%CI 1.97-9.92,P<0.05;aOR 9.83,95%CI 3.63-26.58,P<0.05)and number of children(aOR 10.04,95%CI 4.26-23.66,P<0.05)were the variables that had a significant association.Conclusions:These findings underscore the imperative for enhanced dissemination of health education pertaining to contraception use within the slum population.The health sectors of the area and other stakeholders need to make sure to extend penetration of family planning related services to the urban slum population.
基金supported by the Center of Research and Community Services(PPPM),Stikes Jenderal Achmad Yani,Yogyakarta(No.SPK/039/STIKES/VI/2016)
文摘Objective: Relaxation technique is a nonpharmacological treatment applied to increase sleep efficiency and the quality of sleep.Hydrotherapy is one of the relaxation techniques and uses warm water to decrease stress and muscle stiffness, as well as to warm the body. The incidence of sleep deficiency among older people in Integrated Community Health Services, Pandak I Bantul, has slightly increased year by year. This research aims to evaluate the effect of hydrotherapy on sleep deprivation among older people.Methods: The research was a quasi-experimental study with a pre-post test design. Purposive sampling was used to enroll 66 older people from the Integrated Community Health Services, Pandak I Bantul, Yogyakarta, Indonesia, as a sample, and we divided them into two groups: 33 people formed the intervention group, and 33 people comprised the control group. The intervention group did hydrotherapy once a day for a total of 7 days. First, they soaked their feet in warm water for 10 minutes. The water temperature was adjusted according to the body temperature, to approximately 40.0℃-43.0℃. Then, the intervention group took a bath using warm water. The level of sleep quality was measured using the Pittsburgh Sleep Quality Index(PSQI) questionnaire. Data analysis was done using the Wilcoxon test.Results: The mean score for sleep quality in the pretest in the intervention group was 9.04(standard deviation [SD]: 2.57) and the score on the posttest was 42(SD: 1.43). The mean score for sleep quality in the intervention group was 4.67, with P=0.05.Meanwhile, the research found that the difference between the pretest and posttest scores for quality of sleep in the control group was 0.42, with P=0.059. Wilcoxon analysis found that in the intervention group, there was a significant difference after intervention using hydrotherapy, with P<0.05. In the control group, there was no significance difference between the pretest and posttest scores,with P> 0.05.Conclusions: According to the results of the present study, it appears that the practice of hydrotherapy is effective in reducing sleep deficiency and hence can be considered an effective method of intervention.
文摘Introduction:Patients with pain contribute to 60%-70% of emergency department(ED)attendance and the tramadol is among analgesic of choice in ED.However,the use of intravenous tramadol is limited to moderate pain intensity because of its weak opiod agonist properties.We conducted a study to examine the effectiveness of intravenous tramadol among patients who suffer from severe traumatic pain.Methodology:In this prospective study,eligible patients received a loading dose of intravenous tramadol(2mg/kg).If visual analogue score(VAS)more than 30 mm after the loading dose,intermittent bolus intravenous tramadol 20mg will be administered every 10 minutes.At 30 minutes of study,rescue medication(i.e.morphine or pethidine)will be provided to those patients with VAS more than 30 mm.VAS score,vital signs and side effects were recorded for every 10 minutesResults:Forty-seven patients who suffered from fracture and soft tissue injury were analysed.The median VAS score on presentation and at 30 minutes was 90 mm 20 mm respectively.The median total dose of IV tramadol received by the patients at 30 minutes was 150 mg(IQR=34.0).There was a significant change in medium pain score at 10,20 and 30 minutes treatment(P<0.001).Vital signs were within normal range throughout the study period.About 66.1% of them had side effects of tramadol.The common side effects were sleepiness(75.0%)and dizziness(56.3%).Conclusion:The intravenous tramadol is a safe and effective analgesia in severe traumatic patients if an initial and intermittent dose is given adequately.
文摘The aim of this study was to investigate the efficacy of specially designed zori, a Japanese-style sandal, for enhancing walking performance. A total of 89 women aged 59-75 were randomly assigned to either the intervention or control group. The intervention group wore the zori for 6 months while the control group did not. We conducted physical assessments, including The Good Walker’s Index, which consisted of a 10-m walking time measurement, maximal step length, the 40/20-cm step test and tandem gait, and measurement of the toe-gap force (TGF). Additionally, bare foot plantar pressure distribution was measured using a foot-mapping sensor, while gait characteristics were measured using three dimensional sensors. In the intervention group, means for TGF improved significantly between baseline and three months and between baseline and six months, but this improvement was not evident in the control group. In the intervention group, the means for pressure and surface areas of both left and right feet significantly decreased over time compared with the control group. Three-dimensional analysis found that left and right ankle height was enhanced in the intervention group, and their walking speed was improved by the extension of their stride length and an increase in the height of the tiptoe in one cycle. The findings in our study indicate that zori can be useful in improving lower leg function through TGF enhancement and adjustment of the pressure pattern.
文摘Introduction: Hypertension is a public health problem with a high prevalence in Nigeria. The cost of prescription medications is thought to be a barrier for many patients to access the healthcare they need. This study was aimed at identifying associated co-morbid conditions, the prescribing patterns and cost of prescription for the treatment of hypertension in an outpatient clinic at Lagos University Teaching Hospital. Materials and Methods: A cross sectional study was carried out. A total of 147 prescriptions were obtained from the case notes of patients treated at the LUTH outpatient department between February 2012 and August 2012. For each prescription, the number of drugs, the class and combinations of antihypertensives were recorded. The monthly cost of a 30-day anti-hypertensive supply based on the recommended daily dose was calculated. Results: The mean age of the patients was 54(+/-14) years and of the 147 prescriptions, 77(52.4%) was for females and 70(47.6%) was for males. The mean systolic blood pressure was 141.6 mmHg (+/-20.5SD) and mean diastolic blood pressure was 86.5 mmHg (+/-13.3SD). Of the 147 prescriptions, 112(76.2%) were for patients with co-morbidities. The frequency of prescription of the various classes of anti hypertensives are;diuretics 117(79.6%), angiotensin receptor blockers 78(53.1%), angiotensin converting enzyme inhibitors 65(44.2%), calcium channel blockers 65 (44.2%) beta blockers 54(36.7%) and centrally acting agents 12(8.2%). Average cost per month was =N=6611.47 (US$44). There was a statistically significant association between co morbid conditions and high cost of prescriptions with 73.7% of those with diabetes and 63.2% of those with renal disease having cost of prescriptions within the high cost group (p < 0.05). Conclusion: The cost per month is high and it is recommended that hypertension should be addressed as part of an integrated care program. Ingenious ways of health care financing also have to be promoted.
文摘Background: Late presentation to the hospital and poor post-operative follow-up after cataract surgery are associated with complications which compromise visual recovery and perpetuate disability among children with cataract. The objectives of the study were to understand the social, psychological and physical consequences of blindness in families, to understand why some parents with blind children access services and others do not, and to explore factors related to decision making within families that prevent access to health care services. Methodology: A mixed methodology quantitative and qualitative community study of blindness in children conducted in southern Malawi to compare “Doers”: families with blind children from the same communities who had attended cataract surgical services with “Non-doers” versus families with blind children from the same communities who had not attended services. Individual, family, community socio-cultural and economic characteristics and other qualitative data on knowledge, perceptions, and beliefs were recorded and analyzed thematically, based on grounded theory. Results: A total of 53 in-depth interviews of parents;21 in-depth interviews of children;15 focus group discussions with community members;62 children’s clinical eye examinations, and 4 case studies were conducted over the study period. Doer families were likely to have a reliable source of income, have better housing and live closer to health centres than non-doer families. Visual acuity among doers was better than non-doers. Conclusion: This research has highlighted reasons why some families who have children with cataract are likely to be delayed to seek surgical intervention. Comprehensive counseling modules targeting such families need to be developed to increase acceptance and access to children’s cataract surgical services.
文摘In 2015, about 35 million people died of HIV infection globally, with about 36.7 million infected. Most of the infection occurred in Sub-Saharan Africa. Misconceptions about HIV/AIDS exist mostly in developing countries. The research was a cross-sectional study, conducted in Enugu state, Nigeria. Objective was to assess key HIV misconceptions among rural community dwellers. Interviewer administered questionnaire was used, and information was collected from 296 respondents, most of whom were above 50 years of age, married, had no formal education, and were farmers. Correct responses to the misconceptions investigated were: HIV infection found only among sinners (29.7%);HIV can be transmitted by eating from the same plate with an infected person (24.7%);HIV can be transmitted through handshake (29.7%);HIV can be transmitted by touching the urine or faeces of an infected person (24.0%);HIV can be transmitted by hugging or touching an infected person (28.0%);HIV can be cured (19.9%);Praying daily can prevent HIV infection (20.3%);and Worshipping our ancestors can prevent HIV infection (27.0%). Inhabitants of rural communities are more likely to hold misconceptions about HIV. It is recommended that relevant governments in developing countries design interventions aimed at addressing misconceptions about HIV/AIDS.
文摘Background: Young people are at risk of being victims or perpetrators ofcoerced or forced sexual sex. In predominantly low- and middle-income countries, this contributes significantly to their risk for HIV infection, unwanted pregnancy, and sexually transmitted diseases. Current trends show that young people sexual identity and preferences affect their sexual and reproductive health. Objective: This study aims to determine prevalence of coerced or forced sexual intercourse, sexual identity and sexual preferences of young people in Oluku Community, Ovia North East, Local Government, Edo State, South Nigeria. Methods: A descriptive cross-sectional study conducted in June, 2013 using multi-stage sampling method. Results: A total of 400 young people participated in this study. The mean age was 17.8 ± 3.9 years. A higher proportion of respondents were of the Bini ethnic group 145 (36.3%). Most respondents were Christians 346 (86.5%) while 33 (8.2%) were Moslems. Majority of the respondents had secondary education 271 (67.8%), most were single 363 (90.8%) and were from families with a monogamous setting 289 (72.3%). The prevalence of forced sex was 12.9%, similarly, condom use during forced sex was 27.8%. More females (15.3%) than males (9.6%) had experienced forced sex;forced sex was common among young people from older age group, monogamous homes, and those living in a flat or self contained. Majority (95.3%) of adolescent’s sexual preference was vaginal, only a few preferred oral (3.3%) and anal sex (1.5%). Religion was associated with sexual preference and identity. The sexual identity of most (98.0%) young person’s was heterosexual (or different sex), while 0.5% were homosexual (or same sex) and 1.5% bisexual (or both). Conclusion and Recommendations: Legislation against forced and coerced sex, rape and other forms of sexual violence should be formulated and implemented.
文摘As dehydration is related to negative health outcomes in the elderly,including an increased risk of disability and death,prevention may help improve health,functional status,and quality of life.Dehydration diagnosis can be challenging in the elderly as the traditional physical indications of dehydration may be absent or ambiguous.Numerous etiologies place the elderly at an increased risk.The role of the community health nurse(CHN)derives from the responsibilities attached to her,and the Betty Neuman’s Systems Model of health care with three levels of protection is usually applied to the CHN.In this mini-review,we try to integrate the Betty Neuman’s Systems Model with the results of identified articles.This study includes a literature search of reputable international databases such as SpringerLink,PubMed,Embase,and Wanfang,particularly for the period 2005 to the present.Ten articles that met the qualifying criteria were included in this study.The findings of this study draw a picture of the role of CHN in preventing dehydration across the three levels of prevention as mentioned by Betty Neuman.
基金supported by the University of Jember for funding IDB grand research No.2589/UN25.3.1/LT/2020。
文摘Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.
文摘Studies were carried out to evaluate the effect of distance of sanitary pits on the physicochemical properties of hand-dug well water samples consumed by people living in Akwuke community, Enugu South Local Government Area of Enugu State, using standard analytical procedures and instrumentation. The mean range of pH, turbidity, electrical conductivity, total dissolved solids, nitrate and sulphate in the well water samples at the determined sampling distances of 3, 6 and 10 m from the sanitary pits were 5.9 - 7.24, 1.92 - 6.63 NTU, 122.03 - 303.91 μs/cm, 100.00 - 261.90 mg/L, 1.21 - 4.68 mg/L and 28.89 - 49/61 mg/L respectively. The investigated mean physicochemical parameters of the well water samples were generally observed to increase with decrease in the distance of the well water samples from the sanitary pits. The levels of the determined physicochemical parameter of the well water samples at sampling distances of 3, 6, and 10 m respectively from the sanitary pits were statistically significant. The mean pH values of the well water samples at sampling distances of 3 and 6 m respectively from the sanitary pits were below the WHO recommended threshold limits for safe drinking water. Additionally, the mean values of turbidity and total dissolved solids of the well water samples at a sampling distance of 3 m from the sanitary pits were above the WHO permissible limits. The pH, turbidity and total dissolved solids are some of the most important parameters used in assessing the quality of any water source, therefore, the poor physicochemical properties of well water samples at a sampling distance of 3 m from the sanitary pits could put at severe health risk consumption of this water over a prolonged time. Siting well water at a reasonable far distance (above 10 m) for sanitary pits especially in communities with severe water scarcity would definitely help guarantee access to safe drinking water by rural as well as urban dwellers in Nigeria.
文摘<b>Background: </b>Nigeria<i>,</i> one of the high burden Tuberculosis countries<i>,</i> has developed various intervention strategies to ensuring universal access to quality-assured tuberculosis diagnosis and treatment. However<i>,</i> low case detection and unsuccessful treatment outcome still remains a serious challenge in most states. Community Tuberculosis care was born against this background in 2010 as a complementing front to combat the challenges<i>,</i> bringing directly observed treatment short-course strategy beyond the clinic settings to the door steps of patients. This study evaluates the contributions of the intervention to Tuberculosis case detection and treatment outcomes in two states in Nigeria. <b>Materials and Method:</b> A retrospective study with multistage sampling technique was employed to review 23<i>,</i>241 presumptive Tuberculosis cases enrolled for management between 2014-2017. Chi-square (<i>χ</i><sup>2</sup>) test was used for test of association between the independent variables and the main outcomes of the study<i>,</i> with statistical significance set at p-value of 5%. <b>Results</b>: The annual percentage increase for both states was 24.7%<i>,</i> 189.8% and 114.5% in the study group as against 5.2%<i>,</i> 44.6% and 65.6% in control group. Overall<i>,</i> 23.8% were bacteriologically positive (either AFB or Gene-Xpert MTB/Rif) and 1.4% were clinically evaluated to be positive<i>,</i> while 74.8% were bacteriologically negative. Of the total 5861 cases treated<i>,</i> successful treatment rate of the patients in the study group was 88.6% as compared to 76.1% in the control group. The relationship between the referral system from communities where the intervention program was implemented and the case detection/treatment outcome was statistically significant (OR 95% CI = 3.15<i>,</i> 2.95 - 3.35). <b>Conclusion</b>: The community level Tuberculosis intervention led to significantly better case detection and treatment outcome when compared to the conventional approach (p ≤ 0.05). Therefore<i>,</i> full community engagement should be advocated as a major strategy for End Tuberculosis planed by WHO since the patients are found in the community and not in the health facilities.
文摘Introduction: Urinary tract infection (UTI) is a major public health problem because of its morbidity and mortality. It occurs with increased frequency during diabetes. The objective of this work was to study the frequency and etiologies of urinary tract infections in diabetics hospitalized at the department of medicine of Abass Ndao Hospital. Patients and Methods: This work was a cross-sectional, descriptive, and analytical study conducted from January 01, 2018, to December 31, 2018. It focused on hospitalized diabetic patients with urinary tract infection. Epidemiological, clinical, and evolutionary data of UTI were evaluated. Results: One hundred and twenty-eight (128) diabetic patients had a cytobacteriological urine exam (CUE). 44 of who had a positive CUE (34.4%). The age group [60 - 69] years was the most represented (31.8%). Women predominated (61.4%) with a sex ratio (m/f) of 0.63. Abdominal pain was the most frequent reason for consultation, followed by polydipsia. Fever was recorded in 21 patients (47.7%). Type 2 diabetes was found in most patients (70.5%). Glycemia above 2g/l was found in 34 patients (89.5%). Anemia accounted for more than half of the patients with 29 cases (65.9%). Leukocytosis was noted in 28 patients (63.6%) and a positive CRP in 33 patients (75%). An increase in urea-creatinine was noted in 23 cases (52.3%). The results of the CUE revealed Escherichia coli as predominant (43.2%, n = 19), followed by Candida with 22.7% (n = 10). Antibiotic therapy was given to all patients. The mostly used antibiotic in the treatment of UTI was Cefotaxime 27.3% (n = 12). Older age and female gender were associated with the presence of E. coli. Four (4) deaths were recorded (9%). They were all male over the age of 65. Conclusion: UTI in diabetes is an important cause of morbidity and mortality. The development and implementation of a prevention and management program are essential.
文摘Objective: We studied the feasibility of using Alcohol, Smoking, and Substance Involvement Screening Test (ASSIST) linked with Brief Intervention (ALBI) in treating Substance Use Disorder in Nigeria. There is a clear gap in meeting the needs for treatment and care for people with drug use disorders in Nigeria with many users reporting a self-perceived need for treatment and about 40% of them wanting to receive drug treatment but were unable to access such services. Methods: ASSIST questionnaire was used to gather baseline data, and ALBI along with Motivational Interviewing (MI) was used to intervene for 6 weeks following which ASSIST score was repeated and compared with baseline. Results: Majority of the participants were aged 21 - 30 years, mostly males with (61.3%) lacking steady jobs. Lifetime prevalence of any drug use was (88.2%). Three months prevalence was nicotine (72.0%), alcohol (66.7%), cannabis (47.3%), opioids (11.8%) among others. The ASSIST scores were mostly on the severe ranges. ASSIST result after six weeks showed marked reduction. The Mean Difference (MD) in the ASSIST scores after intervention was significant for tobacco, opioids, alcohol, and cannabis. The Cohen’s D effect size was large for tobacco (1.08), alcohol (0.92) and cannabis (0.73) but low for other substances. Conclusion: ALBI along with MI was helpful in combating the menace of substance use.
文摘Objective:To investigate the epidemiology of injuries and risk factors in Raipur,Chhattisgarh,India.Methods:A community-based cross-sectional study was conducted in 10 selected wards of Raipur.Data were collected from injured individuals using a structured questionnaire.Socio-demographic characteristics,injury mechanisms,medical care-seeking behavior,and outcomes were assessed.Results:312 individuals with injuries were included,with 193 men and 119 women.Males were more likely to be injured than females(61.86%v.s.38.14%).Younger adults aged 21-30 were at highest risk(21.5%).The most common injuries were falls(38.8%)and road traffic accidents(34.9%).Injuries occurring on-road are the most frequent,followed by,at home with a highly significant association(P<0.001).Most individuals sought medical care(90.1%),primarily in private facilities(51.3%).Conclusions:This study provides valuable insights into the epidemiology of injuries in Raipur.The findings can inform the development of evidence-based interventions to reduce the burden of injuries and improve the health and well-being of the population.
文摘Background: Worldwide, Female Genital Mutilation/Cutting (FGM/C) has been practiced for generations. This study examined the practice of FGM/C and identified factors influencing its continuity in Osu, a rural community in Osun State, Nigeria. Methods: This study employed a mixed method cross-sectional design. The quantitative aspect involved interview of 294 women using a semi-structured questionnaire while the qualitative aspect entailed 16 in-depth interviews using an in-depth interview guide to seek information from selected spouses of the respondent, women leaders, religious leaders and health workers. The study took place between January and June 2023. The quantitative data were subjected to descriptive and inferential statistics while the qualitative data were analyzed using thematic content analysis. Results: Ninety four percent of the women had poor knowledge of the health risks associated with FGM/C practice. About three-third (76.5%) had undergone FGM/C while 77.2% intend to continue FGM/C practice on their daughters. The predictors of continuing FGM/C practice include being married (AOR 2.03, 95% CI 1.12 - 3.65, p = 0.019), none/primary education (AOR 10.02, 95% CI 2.88 - 34.88, p = 0.0001), lower income (AOR 3.17, 95% CI 1.54 - 6.55, p = 0.002) and having undergone FGM/C (AOR 14.65, 95% CI 5.31 - 40.37, p = 0.0001). In-depth interviews revealed that the factors sustaining FGM/C in the community include curbing promiscuity, religious rites, community customs and traditions. Conclusion: Socio-cultural factors continue to sustain FGM/C practice in the community. It is necessary to target married women and other community leaders in the campaign against FGM/C practice.
