Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An ob...Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An observational descriptive prospective study involves Filipino patients, aged 19 years and older, with dyslipidemia. The Dutch Lipid Network (DLN) Criteria was used to diagnose FH. Prevalence data and categorical variables were expressed as percentages, while continuous variables were reported as mean and standard deviations. Results: 529 patients were included in the study. 302 were females, and 227 were males. 180 (34%) scored Unlikely, 100 (19%) scored Probable, 185 (35%) scored Possible, and 64 (12%) were classified under Definite Familial Hypercholesterolemia. Most of the patients diagnosed with definite FH did not have diabetes, cerebrovascular disease (CVD), and coronary artery disease (CAD). The diagnosis was not affected by gender, BMI, smoking, and alcohol consumption. Hypertension was significantly correlated to the diagnosis of FH, as most of them were already hypertensive at diagnosis. It was noted that hypertension, diabetes, CVD, and CAD were seen at an earlier age among patients with definite FH. Conclusion: The prevalence of heterozygous FH at 12% among dyslipidemia patients and 1.3% among the general population was described for the first time in our region. This result should raise the awareness of our healthcare providers that FH, which is a major risk factor for premature CAD and CVD, exists, and early detection and management are important.展开更多
Rehabilitation for patients with chronic physical conditions,such as stroke,spinal cord injury,and fibromyalgia,is predominantly focused on physical recovery,often neglecting the affective and social dimensions crucia...Rehabilitation for patients with chronic physical conditions,such as stroke,spinal cord injury,and fibromyalgia,is predominantly focused on physical recovery,often neglecting the affective and social dimensions crucial for comprehensive health outcomes.This oversight contributes to a significant mental health burden,with up to40%of rehabilitating patients experiencing depression or anxiety.This perspective article reviews evidence from social and affective neuroscience to highlight the urgent need to integrate well-being as a central component of rehabilitation.We propose a holistic rehabilitation model that includes psychological,affective,and social interventions alongside physical therapies.This model draws on existing studies demonstrating that emotional resilience and social support are key predictors of successful rehabilitation outcomes.Patients with strong social and affective well-being are more likely to adhere to treatment protocols and achieve better physical recovery.Conversely,neglecting these dimensions can exacerbate mental health conditions,leading to what we identify as a"second wave"of health crises—mental health conditions triggered by chronic physical ailments.By adopting this holistic approach,healthcare systems can improve immediate rehabilitation outcomes,prevent the long-term escalation of mental health issues,and reduce the overall burden on global mental health services,ultimately enhancing the quality of life for patients worldwide.展开更多
Objective: Adolescent reproduction health (ARH) differs greatly based on religions, religious norms, culture, and ethnicities in the Indonesian context. The value of local wisdom was considered too binding, traditiona...Objective: Adolescent reproduction health (ARH) differs greatly based on religions, religious norms, culture, and ethnicities in the Indonesian context. The value of local wisdom was considered too binding, traditional, and outdated, particularly on ARH in agricultural areas. The purpose of the study was to identify the problems, challenges, and needs, specifically for ARH, in the agricultural area of Indonesia. Methods: A qualitative study was performed among 41 communities, including 28 village officials (VOs), 9 community health volunteers (CHVs), and 9 adolescents. The data were collected through in-depth interviews and FGD. An thematic analysis was used to describe the phenomena. Results: This research obtained results regarding ARH in terms of communication patterns, daily behavior, reproductive practices, and hygiene of adolescent reproductive organs, especially in agricultural areas. Conclusions: The differences in the perspective of ARH are influenced by environment, parental roles, religion, ethnicity, and knowledge.展开更多
Chronic obstructive pulmonary disease(COPD)is a complex condition marked by considerable interindividual heterogeneity.Comorbidities exacerbate this variability,worsening disease severity and reducing health-related q...Chronic obstructive pulmonary disease(COPD)is a complex condition marked by considerable interindividual heterogeneity.Comorbidities exacerbate this variability,worsening disease severity and reducing health-related quality of life(HRQoL).Despite the high prevalence of COPD in China,COPD patient clusters remain poorly characterized.This study aimed to identify and validate clusters of Chinese patients with COPD,characterized primarily by comorbidity profiles,using cluster analysis.This cross-sectional,multicenter cohort study used data from the Chinese Enjoying Breathing Program(2020–2023).HRQoL was measured using the EuroQol five dimension(EQ-5D).Dimension reduction was performed via multiple correspondence analysis on 31 variables,including indicators of 27 comorbidities and four sociodemographic or health-related characteristics.Unsupervised machine learning algorithms,K-means++,and hierarchical clustering identified distinct clusters.Robustness was assessed using random forest classification.Logistic regression evaluated the association between cluster membership and EQ-5D outcomes.Among 11145 patients,59.4%had comorbidities.Four clusters emerged:young male smokers,biomass-exposed females,respiratory comorbidity,and elderly multimorbid.The last two clusters had notably lower HRQoL.Cluster analysis identified four clinically meaningful COPD patient clusters based on comorbidities and risk profiles,each with distinct HRQoL outcomes.These findings support targeted public health interventions and integrated care strategies for COPD management.展开更多
Dear Editor,Idiopathic orbital inflammation(IOI),also known as orbital inflammatory pseudotumor,is a relatively common orbital disorder[1].Its pathogenesis remains unclear,often regarded as a nonspecific immune-mediat...Dear Editor,Idiopathic orbital inflammation(IOI),also known as orbital inflammatory pseudotumor,is a relatively common orbital disorder[1].Its pathogenesis remains unclear,often regarded as a nonspecific immune-mediated response[2].IOI presents with symptoms such as pain,photophobia,proptosis,eyelid swelling,edema,conjunctival congestion,and diplopia,with possible vision loss occurring in some cases.Based on the soft tissue structures involved,IOI can be classified into subtypes such as myositis,optic neuritis,dacryoadenitis,diffuse orbital inflammation,and orbital inflammatory masses[2].展开更多
BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite imp...BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.展开更多
Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,an...Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,and social exclusion factors as key psychosocial variables predicting bullying behavior in adolescents.Methods:In a cross-sectional study conducted with 349 high school students in Hakkari,Türkiye.Data were collected using the Olweus Bullying Scale,the Parental Acceptance-Rejection Scale,the Social Exclusion Scale,and the Three-Dimensional Attachment Styles Scale.Independent samples t-tests,one-way ANOVAs,Pearson correlations,and hierarchical regression analyses were performed.Results:Research findings reveal that peer bullying varies significantly according to gender,class level,parents’educational level,and socio-economic status.Furthermore,our findings indicate that social exclusion(β=0.506,p<0.01)and avoidant attachment(β=0.162,p<0.01)positively predict peer bullying,while secure attachment(β=−0.205,p<0.01),maternal(β=−0.385,p<0.01)and paternal(β=−0.217,p<0.01)acceptance/rejection negatively predict bullying.The final regression model explains approximately 55%of the variance in bullying.Conclusion:Our findings indicate that social exclusion,parental acceptance/rejection,and secure or avoidant attachment patterns may be associated with bullying behaviour in adolescents.These findings emphasise the necessity of family-and peer-focused interventions to combat bullying.展开更多
In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing...In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.展开更多
Reward-based decision-making has been found to activate several brain areas, including the ven- trolateral prefronta~ lobe, orbitofrontal cortex, anterior cingulate cortex, ventral striatum, and mesolimbic dopaminergi...Reward-based decision-making has been found to activate several brain areas, including the ven- trolateral prefronta~ lobe, orbitofrontal cortex, anterior cingulate cortex, ventral striatum, and mesolimbic dopaminergic system. In this study, we observed brain areas activated under three de- grees of uncertainty in a reward-based decision-making task （certain, risky, and ambiguous）. The tasks were presented using a brain function audiovisual stimulation system. We conducted brain scans of 15 healthy volunteers using a 3.0T magnetic resonance scanner. We used SPM8 to ana- lyze the location and intensity of activation during the reward-based decision-making task, with re- spect to the three conditions. We found that the orbitofrontal cortex was activated in the certain reward condition, while the prefrontal cortex, precentral gyrus, occipital visual cortex, inferior parietal lobe, cerebellar posterior lobe, middle temporal gyrus, inferior temporal gyrus, limbic lobe, and midbrain were activated during the ＇risk＇ condition. The prefrontal cortex, temporal pole, inferior temporal gyrus, occipital visual cortex, and cerebellar posterior lobe were activated during am- biguous decision-making. The ventrolateral prefrontal lobe, frontal pole of the prefrontal lobe, orbi- tofrontal cortex, precentral gyrus, inferior temporal gyrus, fusiform gyrus, supramarginal gyrus, infe- rior parietal Iobule, and cerebellar posterior lobe exhibited greater activation in the ＇risk＇ than in the ＇certain＇ condition （P 〈 0.05）. The frontal pole and dorsolateral region of the prefrontal lobe, as well as the cerebellar posterior lobe, showed significantly greater activation in the ＇ambiguous＇ condition compared to the ＇risk＇ condition （P 〈 0.05）. The prefrontal lobe, occipital lobe, parietal lobe, temporal lobe, limbic lobe, midbrain, and posterior lobe of the cerebellum were activated during deci- sion-making about uncertain rewards. Thus, we observed different levels and regions of activation for different types of reward processing during decision-making. Specifically, when the degree of reward uncertainty increased, the number of activated brain areas increased, including greater ac- tivation of brain areas associated with loss.展开更多
BACKGROUND The use of induction immunosuppression agents has improved kidney transplant outcomes,but selecting the optimal agent remains a point of debate.AIM To compare the long-term outcomes of kidney transplant rec...BACKGROUND The use of induction immunosuppression agents has improved kidney transplant outcomes,but selecting the optimal agent remains a point of debate.AIM To compare the long-term outcomes of kidney transplant recipients receiving alemtuzumab vs basiliximab induction,focusing on graft function,acute rejection,infection,malignancy,post-transplant glomerulonephritis,and survival,using a propensity score matched cohort design.METHODS Kidney transplant recipients who received alemtuzumab or basiliximab induction from 2014 to 2019 across two nephrology centres in Northwest England were evaluated.Propensity score matching at a 1:1.5 ratio ensured comparability between cohorts.Baseline characteristics,immunosuppression regimens,and outcomes were analyzed.Linear,binary logistic and Cox proportional hazard regression models.RESULTS A total of 436 recipients were included,with a median follow-up of 5.2 years.The matched cohort(n=262)had a mean age of 51.1±13.5 years;39%were female and 92%were white.There was no significant difference in the cumulative incidence of acute rejection[odds ratio(OR)=2.10;95%CI:0.9-4.9;P=0.110].Compared with basiliximab,alemtuzumab was associated with lower estimated glomerular filtration rate at 12 months(-6.6 mL/minute/1.73 m2;95%CI:-10.5 to-2.7;P<0.001)and higher risks of cytomegalovirus viremia(OR=3.2;95%CI:1.6-6.5;P<0.001),BK viremia(OR=2.4;95%CI:1.1-5.5;P=0.02),post-transplant malignancy(OR=6.2;95%CI:1.6-29.9;P=0.013),and death-censored graft loss(hazard ratio=3.6;95%CI:1.2-11.4;P=0.03).No significant differences were observed in post-transplant glomerulonephritis or recipient mortality.CONCLUSION In this propensity score-matched analysis,alemtuzumab induction was associated with lower graft function at 12 months and higher risks of viral infection,post-transplant malignancy,and graft loss compared with basiliximab.These findings highlight the need for further studies to confirm the long-term safety and effectiveness of alemtuzumab in kidney transplantation.展开更多
Air is the ocean we breathe. Air supplies us with oxygen which is essential for our bodies to live. 99.9% air is nitrogen, oxygen, water vapor and inert gases. Human activities can release substances into the air, som...Air is the ocean we breathe. Air supplies us with oxygen which is essential for our bodies to live. 99.9% air is nitrogen, oxygen, water vapor and inert gases. Human activities can release substances into the air, some of which can cause problems for humans, plants and animals. There are several main types of pollution and well-known effects of pollution which are commonly discussed. These include smog, acid rain, the greenhouse effect, and ＂holes＂ in the ozone layer. Each of these problems has serious implications for our health and well-being as well as for the whole environment. The age and health condition are more important also at the response opposite the pollution of air. During the last decade in our country such as result of freely population movement, development and growth of their industrial activities, growth of vehicle number, collapse of roadway infrastructure etc., an increase of air quality pollution is evident. In this study, we exhibited the causers, such as increasing of number of the old cars, which is an important factor of the air pollution and, at the same time, we exhibited the pollution indicators of the air quality, such as PM I 0, total dust, dust levels outdoors and indoors, which are in the high levels. These factors indicated on human health. We have observed the health indicators, especially lung diseases such as bronchial asthma with higher percentage, chronic bronchitis and lung cancer. There was consistency in the finding that relates the acute increases in urban air pollution and the short-term health effects or patients suffering from chronic obstructive pulmonary diseases.展开更多
Background: India being the country with largest adolescent population in the world, needs a special focus on the health services as the status of an adolescent determines the health status in his/her adulthood. Some ...Background: India being the country with largest adolescent population in the world, needs a special focus on the health services as the status of an adolescent determines the health status in his/her adulthood. Some of the major issues faced by the adolescents include: mental health problems, early pregnancy and childbirth, (HIV/STI) and other infectious diseases, violence, injuries and malnutrition. The present study aims to understand the effectiveness of peer-led intervention on knowledge, attitude and practices related to sexual reproductive and mental health issues in adolescents among participants and non-participants. The study was carried out to improve the health-seeking behaviour of adolescents on sexual reproductive and mental health issues in low resource setting across four states in India. Methods: The study adopted a cross-sectional survey which was conducted on 400 adolescents from each of the four districts namely Bangalore, Khagaria-Bihar, Khed-Pune and Sahinganj-Jharkhand. A comparative analysis was conducted between the participants and the non-participants of the intervention to understand the effectiveness of the intervention on the KAP related to sexual reproductive and mental health of adolescents. Results: The study shows that the participants from Karnataka and Maharashtra had better knowledge in emergency contraception, HIV awareness, use of contraceptives and consumption of IFA’s than the non-participants;both the participants and the non-participants showed a positive behaviour in help-seeking in case of psychological challenges. Conclusion: The peer-led approach was found to be an effective strategy for learning, sharing and monitoring adolescent sexual reproductive and mental health.展开更多
Objective:This study aims to identify the knowledge,attitude,and behavior of students using eight indicators of Clean and Healthy Living Behavior(CHLB)in relation to the health education and grade levels in Islamic Bo...Objective:This study aims to identify the knowledge,attitude,and behavior of students using eight indicators of Clean and Healthy Living Behavior(CHLB)in relation to the health education and grade levels in Islamic Boarding Schools(IBS)in Jember regency,East Java Province,Indonesia.Methods:A cross-sectional school-based survey design was used.About 114 students(mean age of 13.17 years old)selected through a multi-stage random sampling completed a selfadministered questionnaire to measure the eight indicators of CHLB,such as washing hands with running water and soap,eating healthy snacks,using clean and healthy latrines,exercising regularly and measurably,eradicating mosquito larvae,not smoking at school,weighing and height measurement every 6 months,and disposing garbage properly.The data analyses included descriptive and comparative analyses of the difference in knowledge,attitude,and behavior toward CHLB by health education and grade level.Results:About 66.7% students received health education.Significant knowledge in CHLB in relation to health education and grade was observed(P<.05),including in-depth knowledge of exercises,measurable weight and height,smoking,and healthy latrines.Meanwhile,no significant difference was observed between the attitude toward CHLB and health education in different grade levels.Furthermore,CHLB was associated with health education,including habitual exercise and using of clean and healthy latrines.展开更多
Until very recently, treatment for chronic hepatitis C virus(HCV) infection has been based on the combination of two non-viral specific drugs: pegylated interferon-α and ribavirin, which is effective in, overall, abo...Until very recently, treatment for chronic hepatitis C virus(HCV) infection has been based on the combination of two non-viral specific drugs: pegylated interferon-α and ribavirin, which is effective in, overall, about 40%-50% of cases. To improve the response to treatment, novel drugs have been designed to specifically block viral proteins. Multiple compounds are under development, and the approval for clinical use of the first of such direct-acting antivirals in 2011(Telaprevir and Boceprevir), represents a milestone in HCV treatment. HCV therapeutics is entering a new expanding era, and a highly-effective cure is envisioned for the first timesince the discovery of the virus in 1989. However, any antiviral treatment may be limited by the capacity of the virus to overcome the selective pressure of new drugs, generating antiviral resistance. Here, we try to provide a basic overview of new treatments, HCV resistance to new antivirals and some considerations derived from a Public Health perspective, using HCV resistance to protease and polymerase inhibitors as examples.展开更多
Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review stu...Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological agents of human infectious diseases in order to compile data on the main wild animals and etiological agents involved in zoonotic outbreaks. A systematic review was carried out using PRISMA guidelines, using the PubMed, Scopus and SciELO platforms as data banks. The descriptors used were "zoonosis", "human infectious diseases" and "wild animals". The results show that wild animals(mainly bats, birds and primates) play an important role in the dissemination of etiological agents(mainly viruses, as a new coronavirus called 2019 Novel Coronavirus) in extensive geographic regions. Moreover, these wild animal organisms can act as the site for essential biotic synergy among several pathogenic microorganisms, promoting a higher rate of adaptation, mutation and even genetic recombination, with consequent stimulation of new strains and subtypes, inducing new infectious agents with unknown virulent potential. In conclusion, the monitoring of these diseases and adequate preparation for possible epidemics and pandemics are fundamental conditions for the mitigation of their future impact. The zoonotic threat of these etiological agents and the impact on public health can be enormous as shown by the ongoing epidemic of 2019 novel coronavirus(2019-nCoV) infections.展开更多
The purpose of this study was to determine health-promoting behaviours of university nursing students in Jordan. This descriptive cross-sectional study used convenient sampling technique to recruit 167 undergraduate n...The purpose of this study was to determine health-promoting behaviours of university nursing students in Jordan. This descriptive cross-sectional study used convenient sampling technique to recruit 167 undergraduate nursing students in Jordan. Data were collected by using an Arabic version of Health-Promoting Lifestyle Profile II. The study results revealed that the mean item score for total Health-Promoting Lifestyle Profile II was (127.24 ± 21.03). The students obtained highest scores in spiritual growth (25.04 ± 4.70) and lowest in physical activity subscales (16.27 ± 5.21). Significant difference was found between Health-Promoting Lifestyle Profile II subscales (stress management, health responsibility, and interpersonal relations) and students’ age and gender.展开更多
This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of soci...This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunity of the community to prevent transmission of disease pathogen to cause a disease. Community Health Practitioners are the frontline Primary Health Care Professionals charged with the responsibility of implementation of immunization programmes in Nigeria and therefore contributing significantly to the prevention and control of targeted vaccine preventable diseases in Nigeria Health System. Our findings on factors militating against Community Health Practitioners’ Roles in National Development as elicited in this paper may form basis for empirical studies to determine the level of significance of each of these factors. In conclusion, it is when the Community Health parameters are adequately addressed that we can ensure sustainable National Development and we can say we have succeeded in our various strategic agenda of government at whatever level that makes up the complex whole. This brings to fore, the importance of the roles of Community Health Practitioners in health care delivery to National Development in the context of our country, Nigeria.展开更多
Hepatitis B virus(HBV) is the most efficiently transmissible of the bloodborne viruses that are important in healthcare settings. Healthcare workers(HCWs)are at risk for exposure to HBV from infected patients and, if ...Hepatitis B virus(HBV) is the most efficiently transmissible of the bloodborne viruses that are important in healthcare settings. Healthcare workers(HCWs)are at risk for exposure to HBV from infected patients and, if infected, are similarly at risk of transmitting HBV to patients. Published cases of HBV transmission from HCW to patient are relatively rare, having decreased in frequency following the introduction of standard(universal) precautions, adoption of enhanced percutaneous injury precautions such as double-gloving in surgery, and routine HBV vaccination of HCWs. Here we review published cases of HCW-to-patient transmission of HBV, details of which have helped to guide the creation of formal guidelines for the management of HBV-infected HCWs. We also compare the published guidelines for the management of HBV-infected HCWs from various governing bodies, focusing on their differences with regard to vaccination requirements, viral load limits, frequency of monitoring, and restrictions on practice. Importantly, while there are differences among the recommendations from governing bodies, no guidelines uniformly restrict HBV-infected HCWs from performing invasive or exposure-prone procedures.展开更多
The Urban Heat Island Effect（UHI）has now become a commonly observed phenomenon worldwide.Indeed,it has become a significant environmental effect of urbanisation.In Malaysia,research results showed that UHI effects a...The Urban Heat Island Effect（UHI）has now become a commonly observed phenomenon worldwide.Indeed,it has become a significant environmental effect of urbanisation.In Malaysia,research results showed that UHI effects are very evident in several cities such as Kuala Lumpur and Putrajaya.UHI effect has long been observed to cause temperature of cities.展开更多
As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for u...As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.展开更多
文摘Objectives: It is to determine the prevalence of familial hypercholesterolemia (FH) among adult Filipino patients with dyslipidemia at Universidad de Santa Isabel Health Services Department in one year. Methods: An observational descriptive prospective study involves Filipino patients, aged 19 years and older, with dyslipidemia. The Dutch Lipid Network (DLN) Criteria was used to diagnose FH. Prevalence data and categorical variables were expressed as percentages, while continuous variables were reported as mean and standard deviations. Results: 529 patients were included in the study. 302 were females, and 227 were males. 180 (34%) scored Unlikely, 100 (19%) scored Probable, 185 (35%) scored Possible, and 64 (12%) were classified under Definite Familial Hypercholesterolemia. Most of the patients diagnosed with definite FH did not have diabetes, cerebrovascular disease (CVD), and coronary artery disease (CAD). The diagnosis was not affected by gender, BMI, smoking, and alcohol consumption. Hypertension was significantly correlated to the diagnosis of FH, as most of them were already hypertensive at diagnosis. It was noted that hypertension, diabetes, CVD, and CAD were seen at an earlier age among patients with definite FH. Conclusion: The prevalence of heterozygous FH at 12% among dyslipidemia patients and 1.3% among the general population was described for the first time in our region. This result should raise the awareness of our healthcare providers that FH, which is a major risk factor for premature CAD and CVD, exists, and early detection and management are important.
文摘Rehabilitation for patients with chronic physical conditions,such as stroke,spinal cord injury,and fibromyalgia,is predominantly focused on physical recovery,often neglecting the affective and social dimensions crucial for comprehensive health outcomes.This oversight contributes to a significant mental health burden,with up to40%of rehabilitating patients experiencing depression or anxiety.This perspective article reviews evidence from social and affective neuroscience to highlight the urgent need to integrate well-being as a central component of rehabilitation.We propose a holistic rehabilitation model that includes psychological,affective,and social interventions alongside physical therapies.This model draws on existing studies demonstrating that emotional resilience and social support are key predictors of successful rehabilitation outcomes.Patients with strong social and affective well-being are more likely to adhere to treatment protocols and achieve better physical recovery.Conversely,neglecting these dimensions can exacerbate mental health conditions,leading to what we identify as a"second wave"of health crises—mental health conditions triggered by chronic physical ailments.By adopting this holistic approach,healthcare systems can improve immediate rehabilitation outcomes,prevent the long-term escalation of mental health issues,and reduce the overall burden on global mental health services,ultimately enhancing the quality of life for patients worldwide.
基金supported by Kementerian RisetTeknologi dan Pendidikan Tinggi (Ministry of Research,Technology&Higher Education (RISTEKDIKTI) for funding International Collaboration Hibah Kerjasama International LP2M Universitas Jember 2021
文摘Objective: Adolescent reproduction health (ARH) differs greatly based on religions, religious norms, culture, and ethnicities in the Indonesian context. The value of local wisdom was considered too binding, traditional, and outdated, particularly on ARH in agricultural areas. The purpose of the study was to identify the problems, challenges, and needs, specifically for ARH, in the agricultural area of Indonesia. Methods: A qualitative study was performed among 41 communities, including 28 village officials (VOs), 9 community health volunteers (CHVs), and 9 adolescents. The data were collected through in-depth interviews and FGD. An thematic analysis was used to describe the phenomena. Results: This research obtained results regarding ARH in terms of communication patterns, daily behavior, reproductive practices, and hygiene of adolescent reproductive organs, especially in agricultural areas. Conclusions: The differences in the perspective of ARH are influenced by environment, parental roles, religion, ethnicity, and knowledge.
基金supported by the Ministry of Science and Tech-nology of the People’s Republic of China(2023ZD0506000)the CAMS Innovation Fund for Medical Sciences(ClFMS,2023-I2M-2-001)the Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2022-ZHCH330-01).The statements made and views expressed are solely the responsibility of the authors.
文摘Chronic obstructive pulmonary disease(COPD)is a complex condition marked by considerable interindividual heterogeneity.Comorbidities exacerbate this variability,worsening disease severity and reducing health-related quality of life(HRQoL).Despite the high prevalence of COPD in China,COPD patient clusters remain poorly characterized.This study aimed to identify and validate clusters of Chinese patients with COPD,characterized primarily by comorbidity profiles,using cluster analysis.This cross-sectional,multicenter cohort study used data from the Chinese Enjoying Breathing Program(2020–2023).HRQoL was measured using the EuroQol five dimension(EQ-5D).Dimension reduction was performed via multiple correspondence analysis on 31 variables,including indicators of 27 comorbidities and four sociodemographic or health-related characteristics.Unsupervised machine learning algorithms,K-means++,and hierarchical clustering identified distinct clusters.Robustness was assessed using random forest classification.Logistic regression evaluated the association between cluster membership and EQ-5D outcomes.Among 11145 patients,59.4%had comorbidities.Four clusters emerged:young male smokers,biomass-exposed females,respiratory comorbidity,and elderly multimorbid.The last two clusters had notably lower HRQoL.Cluster analysis identified four clinically meaningful COPD patient clusters based on comorbidities and risk profiles,each with distinct HRQoL outcomes.These findings support targeted public health interventions and integrated care strategies for COPD management.
基金Supported by the National Natural Science Foundation of China(No.82388101,No.81930024)the Science and Technology Commission of Shanghai(No.22YS1400400,No.20DZ2270800).
文摘Dear Editor,Idiopathic orbital inflammation(IOI),also known as orbital inflammatory pseudotumor,is a relatively common orbital disorder[1].Its pathogenesis remains unclear,often regarded as a nonspecific immune-mediated response[2].IOI presents with symptoms such as pain,photophobia,proptosis,eyelid swelling,edema,conjunctival congestion,and diplopia,with possible vision loss occurring in some cases.Based on the soft tissue structures involved,IOI can be classified into subtypes such as myositis,optic neuritis,dacryoadenitis,diffuse orbital inflammation,and orbital inflammatory masses[2].
文摘BACKGROUND Post-transplant tertiary hyperparathyroidism(PT-tHPT)is a well-recognized complication following kidney transplantation,characterized by persistent excessive secretion of parathyroid hormone(PTH)despite improved renal function.It is potentially associated with an increased risk of cardiovascular events,renal osteodystrophy,pathologic fractures,graft loss,and mortality.AIM To evaluate the incidence,risk factors,and outcomes of PT-tHPT amongst kidney transplant recipients.METHODS A total of 887 transplant recipients who underwent transplantation between 2000 and 2020 were evaluated.Univariable and multivariable logistic regression was performed to determine the predictors of tertiary hyperparathyroidism.Graft and recipient outcomes were assessed using multivariable Cox regression.A separate multivariable Cox regression was performed to determine the effect of treatment strategies on outcomes.RESULTS PT-tHPT,defined as elevated PTH(>65 ng/L)and persistent hypercalcemia(>2.60 mmol/L),was diagnosed in 14%of recipients.Risk factors for PT-tHPT included older age[odds ratio(OR)=1.36,P<0.001],Asian ethnicity(OR=0.33,P=0.006),total ischemia time(OR=1.03,P=0.048 per hour),pre-transplant serum calcium(OR=1.38,P<0.001)per decile increase,pre-transplant PTH level(OR=1.31,P<0.001)per decile increase,longer dialysis duration(OR=1.12,P=0.002)per year,history of acute rejection(OR=2.37,P=0.012),and slope of estimated glomerular filtration rate change(OR=0.91,P=0.001).There were a 3.4-fold higher risk of death-censored graft loss and a 1.9-fold greater risk of recipient death with PT-tHPT.The three treatment strategies of conservative management,calcimimetic and parathyroidectomy did not significantly change the graft or patient outcome.CONCLUSION Pretransplant elevated calcium and PTH levels,older age and dialysis duration are associated with PT-tHPT.While PT-tHPT significantly affects graft and recipient survival,the treatment strategies did not affect survival.
文摘Background:Bullying during adolescence is shaped by numerous psychosocial factors such as family dynamics,attachment,and peer relationships.This study aims to examine parental acceptance-rejection,attachment styles,and social exclusion factors as key psychosocial variables predicting bullying behavior in adolescents.Methods:In a cross-sectional study conducted with 349 high school students in Hakkari,Türkiye.Data were collected using the Olweus Bullying Scale,the Parental Acceptance-Rejection Scale,the Social Exclusion Scale,and the Three-Dimensional Attachment Styles Scale.Independent samples t-tests,one-way ANOVAs,Pearson correlations,and hierarchical regression analyses were performed.Results:Research findings reveal that peer bullying varies significantly according to gender,class level,parents’educational level,and socio-economic status.Furthermore,our findings indicate that social exclusion(β=0.506,p<0.01)and avoidant attachment(β=0.162,p<0.01)positively predict peer bullying,while secure attachment(β=−0.205,p<0.01),maternal(β=−0.385,p<0.01)and paternal(β=−0.217,p<0.01)acceptance/rejection negatively predict bullying.The final regression model explains approximately 55%of the variance in bullying.Conclusion:Our findings indicate that social exclusion,parental acceptance/rejection,and secure or avoidant attachment patterns may be associated with bullying behaviour in adolescents.These findings emphasise the necessity of family-and peer-focused interventions to combat bullying.
基金supported by the Research Funds of the Center for Big Data and Population Health of IHM(grant number JKS2022015)the Key Scientific Research Fund of the Anhui Provincial Education Department(grant number2023AH050610)the Anhui Natural Science Foundation(grant number 1808085QH252)。
文摘In 2021,approximately 537 million people suffered from diabetes mellitus(DM)globally,and this figure will increase to approximately 783 million within the next quarter-century.The increasing burden of DM is a pressing global public health issue.Therefore,the early identification of high-risk groups and implementation of effective intervention measures is imperative.
基金supported by the Science and Technology Development Project of Shandong Province,China,No.2011YD18045the Natural Science Foundation of Shandong Province,China,No.ZR2012HM049+3 种基金the Health Care Foundation Program of Shandong Province,China,No.2007BZ19the Foundation Program of Technology Bureau of Qingdao,ChinaNo.Kzd-0309-1-1-33-nsh
文摘Reward-based decision-making has been found to activate several brain areas, including the ven- trolateral prefronta~ lobe, orbitofrontal cortex, anterior cingulate cortex, ventral striatum, and mesolimbic dopaminergic system. In this study, we observed brain areas activated under three de- grees of uncertainty in a reward-based decision-making task （certain, risky, and ambiguous）. The tasks were presented using a brain function audiovisual stimulation system. We conducted brain scans of 15 healthy volunteers using a 3.0T magnetic resonance scanner. We used SPM8 to ana- lyze the location and intensity of activation during the reward-based decision-making task, with re- spect to the three conditions. We found that the orbitofrontal cortex was activated in the certain reward condition, while the prefrontal cortex, precentral gyrus, occipital visual cortex, inferior parietal lobe, cerebellar posterior lobe, middle temporal gyrus, inferior temporal gyrus, limbic lobe, and midbrain were activated during the ＇risk＇ condition. The prefrontal cortex, temporal pole, inferior temporal gyrus, occipital visual cortex, and cerebellar posterior lobe were activated during am- biguous decision-making. The ventrolateral prefrontal lobe, frontal pole of the prefrontal lobe, orbi- tofrontal cortex, precentral gyrus, inferior temporal gyrus, fusiform gyrus, supramarginal gyrus, infe- rior parietal Iobule, and cerebellar posterior lobe exhibited greater activation in the ＇risk＇ than in the ＇certain＇ condition （P 〈 0.05）. The frontal pole and dorsolateral region of the prefrontal lobe, as well as the cerebellar posterior lobe, showed significantly greater activation in the ＇ambiguous＇ condition compared to the ＇risk＇ condition （P 〈 0.05）. The prefrontal lobe, occipital lobe, parietal lobe, temporal lobe, limbic lobe, midbrain, and posterior lobe of the cerebellum were activated during deci- sion-making about uncertain rewards. Thus, we observed different levels and regions of activation for different types of reward processing during decision-making. Specifically, when the degree of reward uncertainty increased, the number of activated brain areas increased, including greater ac- tivation of brain areas associated with loss.
文摘BACKGROUND The use of induction immunosuppression agents has improved kidney transplant outcomes,but selecting the optimal agent remains a point of debate.AIM To compare the long-term outcomes of kidney transplant recipients receiving alemtuzumab vs basiliximab induction,focusing on graft function,acute rejection,infection,malignancy,post-transplant glomerulonephritis,and survival,using a propensity score matched cohort design.METHODS Kidney transplant recipients who received alemtuzumab or basiliximab induction from 2014 to 2019 across two nephrology centres in Northwest England were evaluated.Propensity score matching at a 1:1.5 ratio ensured comparability between cohorts.Baseline characteristics,immunosuppression regimens,and outcomes were analyzed.Linear,binary logistic and Cox proportional hazard regression models.RESULTS A total of 436 recipients were included,with a median follow-up of 5.2 years.The matched cohort(n=262)had a mean age of 51.1±13.5 years;39%were female and 92%were white.There was no significant difference in the cumulative incidence of acute rejection[odds ratio(OR)=2.10;95%CI:0.9-4.9;P=0.110].Compared with basiliximab,alemtuzumab was associated with lower estimated glomerular filtration rate at 12 months(-6.6 mL/minute/1.73 m2;95%CI:-10.5 to-2.7;P<0.001)and higher risks of cytomegalovirus viremia(OR=3.2;95%CI:1.6-6.5;P<0.001),BK viremia(OR=2.4;95%CI:1.1-5.5;P=0.02),post-transplant malignancy(OR=6.2;95%CI:1.6-29.9;P=0.013),and death-censored graft loss(hazard ratio=3.6;95%CI:1.2-11.4;P=0.03).No significant differences were observed in post-transplant glomerulonephritis or recipient mortality.CONCLUSION In this propensity score-matched analysis,alemtuzumab induction was associated with lower graft function at 12 months and higher risks of viral infection,post-transplant malignancy,and graft loss compared with basiliximab.These findings highlight the need for further studies to confirm the long-term safety and effectiveness of alemtuzumab in kidney transplantation.
文摘Air is the ocean we breathe. Air supplies us with oxygen which is essential for our bodies to live. 99.9% air is nitrogen, oxygen, water vapor and inert gases. Human activities can release substances into the air, some of which can cause problems for humans, plants and animals. There are several main types of pollution and well-known effects of pollution which are commonly discussed. These include smog, acid rain, the greenhouse effect, and ＂holes＂ in the ozone layer. Each of these problems has serious implications for our health and well-being as well as for the whole environment. The age and health condition are more important also at the response opposite the pollution of air. During the last decade in our country such as result of freely population movement, development and growth of their industrial activities, growth of vehicle number, collapse of roadway infrastructure etc., an increase of air quality pollution is evident. In this study, we exhibited the causers, such as increasing of number of the old cars, which is an important factor of the air pollution and, at the same time, we exhibited the pollution indicators of the air quality, such as PM I 0, total dust, dust levels outdoors and indoors, which are in the high levels. These factors indicated on human health. We have observed the health indicators, especially lung diseases such as bronchial asthma with higher percentage, chronic bronchitis and lung cancer. There was consistency in the finding that relates the acute increases in urban air pollution and the short-term health effects or patients suffering from chronic obstructive pulmonary diseases.
文摘Background: India being the country with largest adolescent population in the world, needs a special focus on the health services as the status of an adolescent determines the health status in his/her adulthood. Some of the major issues faced by the adolescents include: mental health problems, early pregnancy and childbirth, (HIV/STI) and other infectious diseases, violence, injuries and malnutrition. The present study aims to understand the effectiveness of peer-led intervention on knowledge, attitude and practices related to sexual reproductive and mental health issues in adolescents among participants and non-participants. The study was carried out to improve the health-seeking behaviour of adolescents on sexual reproductive and mental health issues in low resource setting across four states in India. Methods: The study adopted a cross-sectional survey which was conducted on 400 adolescents from each of the four districts namely Bangalore, Khagaria-Bihar, Khed-Pune and Sahinganj-Jharkhand. A comparative analysis was conducted between the participants and the non-participants of the intervention to understand the effectiveness of the intervention on the KAP related to sexual reproductive and mental health of adolescents. Results: The study shows that the participants from Karnataka and Maharashtra had better knowledge in emergency contraception, HIV awareness, use of contraceptives and consumption of IFA’s than the non-participants;both the participants and the non-participants showed a positive behaviour in help-seeking in case of psychological challenges. Conclusion: The peer-led approach was found to be an effective strategy for learning, sharing and monitoring adolescent sexual reproductive and mental health.
基金received financial support for the research from KEMENRISTEK-DIKTI as at the grand of research Ipteks Bagi Masyarakat(IbM).
文摘Objective:This study aims to identify the knowledge,attitude,and behavior of students using eight indicators of Clean and Healthy Living Behavior(CHLB)in relation to the health education and grade levels in Islamic Boarding Schools(IBS)in Jember regency,East Java Province,Indonesia.Methods:A cross-sectional school-based survey design was used.About 114 students(mean age of 13.17 years old)selected through a multi-stage random sampling completed a selfadministered questionnaire to measure the eight indicators of CHLB,such as washing hands with running water and soap,eating healthy snacks,using clean and healthy latrines,exercising regularly and measurably,eradicating mosquito larvae,not smoking at school,weighing and height measurement every 6 months,and disposing garbage properly.The data analyses included descriptive and comparative analyses of the difference in knowledge,attitude,and behavior toward CHLB by health education and grade level.Results:About 66.7% students received health education.Significant knowledge in CHLB in relation to health education and grade was observed(P<.05),including in-depth knowledge of exercises,measurable weight and height,smoking,and healthy latrines.Meanwhile,no significant difference was observed between the attitude toward CHLB and health education in different grade levels.Furthermore,CHLB was associated with health education,including habitual exercise and using of clean and healthy latrines.
基金Supported by The Fondo de Investigación Sanitaria,Instituto de Salud Carlos III,Spanish Ministry of Economy,Directorate of Science(PI10/00512 and CIBER-ESP)supported by the Fondo de Investigación Sanitaria,Instituto de Salud Carlos III,Spain
文摘Until very recently, treatment for chronic hepatitis C virus(HCV) infection has been based on the combination of two non-viral specific drugs: pegylated interferon-α and ribavirin, which is effective in, overall, about 40%-50% of cases. To improve the response to treatment, novel drugs have been designed to specifically block viral proteins. Multiple compounds are under development, and the approval for clinical use of the first of such direct-acting antivirals in 2011(Telaprevir and Boceprevir), represents a milestone in HCV treatment. HCV therapeutics is entering a new expanding era, and a highly-effective cure is envisioned for the first timesince the discovery of the virus in 1989. However, any antiviral treatment may be limited by the capacity of the virus to overcome the selective pressure of new drugs, generating antiviral resistance. Here, we try to provide a basic overview of new treatments, HCV resistance to new antivirals and some considerations derived from a Public Health perspective, using HCV resistance to protease and polymerase inhibitors as examples.
基金support received from the Faculdade Dinamica do Vale do Piranga(FADIP),Conselho Nacional de Desenvolvimento Científico e Tecnológico(CNPq)and Fundacao de Amparo a Pesquisa do Estado de Minas Gerais(FAPEMIG).
文摘Infectious diseases continue to impose unpredictable burdens on global health and economies, a subject that requires constant research and updates. In this sense, the objective of the present article was to review studies on the role of wild animals as reservoirs and/or dispersers of etiological agents of human infectious diseases in order to compile data on the main wild animals and etiological agents involved in zoonotic outbreaks. A systematic review was carried out using PRISMA guidelines, using the PubMed, Scopus and SciELO platforms as data banks. The descriptors used were "zoonosis", "human infectious diseases" and "wild animals". The results show that wild animals(mainly bats, birds and primates) play an important role in the dissemination of etiological agents(mainly viruses, as a new coronavirus called 2019 Novel Coronavirus) in extensive geographic regions. Moreover, these wild animal organisms can act as the site for essential biotic synergy among several pathogenic microorganisms, promoting a higher rate of adaptation, mutation and even genetic recombination, with consequent stimulation of new strains and subtypes, inducing new infectious agents with unknown virulent potential. In conclusion, the monitoring of these diseases and adequate preparation for possible epidemics and pandemics are fundamental conditions for the mitigation of their future impact. The zoonotic threat of these etiological agents and the impact on public health can be enormous as shown by the ongoing epidemic of 2019 novel coronavirus(2019-nCoV) infections.
文摘The purpose of this study was to determine health-promoting behaviours of university nursing students in Jordan. This descriptive cross-sectional study used convenient sampling technique to recruit 167 undergraduate nursing students in Jordan. Data were collected by using an Arabic version of Health-Promoting Lifestyle Profile II. The study results revealed that the mean item score for total Health-Promoting Lifestyle Profile II was (127.24 ± 21.03). The students obtained highest scores in spiritual growth (25.04 ± 4.70) and lowest in physical activity subscales (16.27 ± 5.21). Significant difference was found between Health-Promoting Lifestyle Profile II subscales (stress management, health responsibility, and interpersonal relations) and students’ age and gender.
文摘This is a review paper that brings to focus, concepts of Community Health Practice that connect Community Health Practitioners’ Roles to National development in view of its composite index improvement measure of social welfare services provision among others for the citizens of a country over time, with particular emphasis on medical care component of such index aimed at reduction in diseases and poverty in the population. The objective of the review work is to determine the extent to which Community Health Practice, particularly by Community Health Practitioners is capable of ensuring National Development in democratic governance or otherwise, in the context of our country, Nigeria. The methodology applied was traditional review of published literatures concerning the subject and findings of operational research of programme implemented by Community Health Practitioners at the Primary Health Care facilities and household level in the communities. This paper emphasizes on Primary Health Care services delivery contribution to National Development, since it is the level where Community Health Practitioners are mainly commissioned to render their services. Home-Based Care Strategy for Integrated Maternal, Newborn and Child Health piloted in three (3) local government areas (Ahoada West, Etche and Oyigbo) in Rivers State, Nigeria, in 2012 and implemented by Community Health Practitioners, aimed at reducing maternal, newborn and child morbidity and mortality by 20% by 2015 in line with the United Nations (UN) Millennium Development Goals 4 and 5, had been shown to achieve an average of 26% improvement in utilization of maternal and newborn health services, an average of 27% overall reduction in maternal malnutrition status, an average of 14% overall improvement in under 5 years malnutrition status among others in 2013 on comparing with baseline indicators. Nigeria also attained 80% coverage in routine immunization in most vaccine preventable diseases except Tetanus Toxiod (TT) 2 (54%) in 2013 to achieve herd immunity of the community to prevent transmission of disease pathogen to cause a disease. Community Health Practitioners are the frontline Primary Health Care Professionals charged with the responsibility of implementation of immunization programmes in Nigeria and therefore contributing significantly to the prevention and control of targeted vaccine preventable diseases in Nigeria Health System. Our findings on factors militating against Community Health Practitioners’ Roles in National Development as elicited in this paper may form basis for empirical studies to determine the level of significance of each of these factors. In conclusion, it is when the Community Health parameters are adequately addressed that we can ensure sustainable National Development and we can say we have succeeded in our various strategic agenda of government at whatever level that makes up the complex whole. This brings to fore, the importance of the roles of Community Health Practitioners in health care delivery to National Development in the context of our country, Nigeria.
基金Supported by National Institutes of Health Infectious Diseases Training Grant No.5T32AI007046-37
文摘Hepatitis B virus(HBV) is the most efficiently transmissible of the bloodborne viruses that are important in healthcare settings. Healthcare workers(HCWs)are at risk for exposure to HBV from infected patients and, if infected, are similarly at risk of transmitting HBV to patients. Published cases of HBV transmission from HCW to patient are relatively rare, having decreased in frequency following the introduction of standard(universal) precautions, adoption of enhanced percutaneous injury precautions such as double-gloving in surgery, and routine HBV vaccination of HCWs. Here we review published cases of HCW-to-patient transmission of HBV, details of which have helped to guide the creation of formal guidelines for the management of HBV-infected HCWs. We also compare the published guidelines for the management of HBV-infected HCWs from various governing bodies, focusing on their differences with regard to vaccination requirements, viral load limits, frequency of monitoring, and restrictions on practice. Importantly, while there are differences among the recommendations from governing bodies, no guidelines uniformly restrict HBV-infected HCWs from performing invasive or exposure-prone procedures.
基金funded by Grand Challenge-SUS(Sustainability Science)Grants GC002C-15SUS and GC002A-15SUS
文摘The Urban Heat Island Effect（UHI）has now become a commonly observed phenomenon worldwide.Indeed,it has become a significant environmental effect of urbanisation.In Malaysia,research results showed that UHI effects are very evident in several cities such as Kuala Lumpur and Putrajaya.UHI effect has long been observed to cause temperature of cities.
文摘As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.
