Despite the fact that the sale of tobacco to minors is illegal in Ontario, youth are still able to purchase tobacco. This study aims to determine the geographic variations of underage tobacco sales at the neighborhood...Despite the fact that the sale of tobacco to minors is illegal in Ontario, youth are still able to purchase tobacco. This study aims to determine the geographic variations of underage tobacco sales at the neighborhood level within the Windsor-Essex County Health Unit. Data were collected on all inspections of tobacco retail stores from 2007 to 2011 in the Windsor-Essex County Health Unit. Data were split into season 1 (September-February) and season 2 (March-August) to assess a possible seasonal effect. Relative risks were calculated for each dissemination area (DA) by modeling the risks in a hierarchical Bayesian fashion, incorporating appropriate random effects terms for both spatially correlated and uncorrelated random errors with adjustments for neighborhood income. The association between violation rate and proximity to a school was assessed through a buffer analysis. Elliptical analysis detected a significant cluster of high risk DAs in season 1 in Windsor (p-value = 0.022) but no significant cluster in season 2. Some DAs exhibited higher relative risks of tobacco sales to minors, however after adjusting the model for neighborhood income no excess risk was observed. The results of the buffer analysis showed that in season 1 there was a significantly higher probability (p-value = 0.045) of tobacco vendors located closer to schools to sell tobacco to minors. This analysis demonstrates the utility of a systematic approach to identifying neighborhoods with higher risks of tobacco sales to minors. The insights provided by this exploratory, ecologic study are valuable for program planning and directing tobacco enforcement efforts to high risk areas.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
Adolescence is a crucial time period with especial vulnerability for development of mental health problems.Growing interest is focusing on the determinants of positive mental health in order to find the key concepts t...Adolescence is a crucial time period with especial vulnerability for development of mental health problems.Growing interest is focusing on the determinants of positive mental health in order to find the key concepts that could be influenced in the promotion of mental well-being of adolescents.In this study we aim to explore the relations between self-esteem,character strengths and experience of social inclusion as determinants of adolescents’positive mental health controlled for selected sociodemographic background factors.The study population(n=195)consisted of comprehensive school students who filled in an electronic questionnaire of adolescent’s mental well-being in Fall 2019.The questionnaire included measures of Warwick-Edinburgh Mental Well-being Scale(WEMWBS),VIA Youth-measure 96,Rosenberg Self-Esteem Scale and Experience of Social Inclusion Scale.The methods included group comparisons and General Linear Model computed by SPSS 24.0.The strongest association was found between positive mental health and self-esteem(β=0.789,p<0.001),followed by character strengths of hope and kindness and experience of social inclusion.Interestingly,family’s socioeconomic factors did not associate significantly with positive mental health in the final statistical model.In terms of our results,it seems that self-esteem,character strengths and experience of social inclusion might have stronger association with adolescents’mental well-being than family’s socioeconomic determinants.Therefore,it should be discussed whether psychological determinants overcome the individual effect of poor socioeconomic status as factors that influence positive mental health.Further studies are needed to establish these results more firmly.展开更多
AIM:To determine the prevalence and associations of non-retinopathy ocular conditions among older Australian adults with diabetes.METHODS:Multistage random-cluster sampling was used to select 3098 non-indigenous Austr...AIM:To determine the prevalence and associations of non-retinopathy ocular conditions among older Australian adults with diabetes.METHODS:Multistage random-cluster sampling was used to select 3098 non-indigenous Australians aged 50 y or older(46.4%male)and 1738 indigenous Australians aged 40 y or older(41.1%male)from all levels of geographic remoteness in Australia.Participants underwent a standardised questionnaire to ascertain diabetes history,and a clinical examination to identify eye disease.We determined the prevalence of uncorrected refractive error,visually significant cataract,cataract surgery,age-related macular degeneration,glaucoma,ocular hypertension,retinal vein occlusion and epiretinal membrane among those with and without self-reported diabetes.RESULTS:Participants with self-reported diabetes had a higher prevalence of cataract surgery than those without diabetes(28.8%vs 16.9%,OR 1.78,95%CI:1.35-2.34 among non-indigenous Australians,and 11.3%vs 5.2%,OR 1.62,95%CI:1.22-2.14 among indigenous Australians).Diabetic retinopathy(DR)increased the odds of cataract surgery among self-reported diabetic indigenous and nonindigenous Australians(OR 1.89,P=0.004 and OR 2.33,P<0.001 respectively).Having diabetes for≥20 y and having vision-threatening DR increased the odds of cataract surgery among indigenous Australians with diabetes(OR 3.73,P=0.001 and 7.58,P<0.001,respectively).CONCLUSION:Most non-retinopathy ocular conditions are not associated with self-reported diabetes.However,to account for Australia’s worsening diabetes epidemic,interventions to reduce the impact of diabetes-related blindness should include increased cataract surgery services.展开更多
Background: Groundwater is an important source of water. Since the control and removal of pollution are expensive, it is essential to identify the possible sources of contamination and to correctly classify groundwate...Background: Groundwater is an important source of water. Since the control and removal of pollution are expensive, it is essential to identify the possible sources of contamination and to correctly classify groundwater on the basis of its intrinsic and integrated vulnerability. Objectives: To group ground water chemical ions and heavy metals parameters into similar groups. Method: The investigation made use of standard analytical procedures. All sampling, conservation, transportation and analysis followed standard procedures described in APHA (2012). To prevent degradation of the organic substances, all obtained samples were transferred to the laboratory, while kept in an icebox. Results: Sampling records from the same area are generally assigned to the same cluster during hierarchical cluster analysis (HCA). The cluster diagram shows the grouping of the heavy metal in the study area during wet and dry seasons. It reveals that 5 distinct clusters were identified for wet season and 4 clusters were identified during dry season. Also, it reveals that 5 distinct clusters were identified for wet season and for dry season, 4 distinct clusters were identified. Conclusion: The findings of this study are significant for policymakers and agencies in terms of dealing with the issues identified to enhance sustainable livelihood practices in the oil rich Niger Delta region of Nigeria. Therefore, decision-makers should take proper initiatives to get local people aware of the endangered zones before use, as drinking water is key to good health. Similarly, multinational oil companies will find it useful in their quest for viable social corporate responsibility and remediation plans in their respective host communities. The method proved to be a useful and objective tool for environmental planning.展开更多
Background: Hazardous alcohol consumption and associated harms are high among young uni- versity students. The university environment is conducive to excessive alcohol consumption with studies finding young university...Background: Hazardous alcohol consumption and associated harms are high among young uni- versity students. The university environment is conducive to excessive alcohol consumption with studies finding young university students to drink alcohol at higher levels than their non-university peers. Methods: A random sample of 18 - 24-year-old undergraduate, internal university students completed a survey (n = 2465) to investigate differences in self-reported personal, second-hand and witnessed alcohol-related harms, alcohol expectancies, pre-loading, and friends’ alcohol consumption between low risk and hazardous drinkers. Univariate and multivariate analyses are reported. Results: Almost 40% of students who had consumed alcohol in the past year reported drinking at hazardous levels. Univariate analyses found students who reported hazardous drinking reported significantly higher scores relating to experienced, second-hand, witnessed and academic problems compared to low risk drinkers. Hazardous drinkers were also more likely to pre-load, to drink at higher levels when pre-loading, have more friends who drank alcohol, have more friends who drank at hazardous levels and to score higher on alcohol expectancies. However both low risk and hazardous drinkers experienced a range of harms due to their own drinking including hangover (71.2%), unprotected sex (19.3%), regretted sex (16.8%) and drink-driving (17%). Looking after an intoxicated student (34.3%) and witnessing someone pass out (37.5%) were issues for all drinkers. Experienced alcohol related harms, academic problems, alcohol expectancies, close friends’ level of alcohol consumption, pre-loading in the last four weeks and level of consumption when pre-loading were predictors of hazardous drinking (p < 0.001). Conclusion: Young undergraduate university students are at risk of a range of academic, social, emotional and physical harms associated with their own and other students’ alcohol consumption. There is a need for integrated programs to address university drinking culture and effect positive changes.展开更多
The world＇s population is ageing rapidly, which will have substantial consequences. According to WHO： ＂Process of optimizing opportunities for health, participation and security in order to enhance quality of life ...The world＇s population is ageing rapidly, which will have substantial consequences. According to WHO： ＂Process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age＂. The aim of this work is to make a literature review on key measures that contribute to healthy ageing. A search was conducted in the following databases： PubMed, Cochrane, National Guideline Clearinghouse, Trip Database, Guideline finders, NICE and WHO database, written in English and published in the last ten years. The following MeSH words were used： ＂healthy ageing＂. The search was conducted from July first till end of December 2015. Based on the articles searched there are many measures with potential to achieve gains in healthy ageing such as prevention of falls; vaccination; regular physical activity, eating fruits and vegetables daily, drinking alcohol moderately; never smoking; prevention of social isolation and social exclusion; prevention of elder maltreatment; public support for informal care giving and create strategies to ensure the quality of care for older people. Getting older can come with a variety of health challenges. In the daily practice of family doctor there are many effective interventions that can improve health and wellbeing in elderly people.展开更多
This study evaluated transfer of maternal lysozyme and immunoglobulin (IgM) against Lactococcus garviea, the causative agent of lactococcosis to eggs and larvae in rainbow trout. Changes in circulating lysozyme and Ig...This study evaluated transfer of maternal lysozyme and immunoglobulin (IgM) against Lactococcus garviea, the causative agent of lactococcosis to eggs and larvae in rainbow trout. Changes in circulating lysozyme and IgM during development of eggs and larvae were measured by a method based on the ability of lysozyme to lyse the bacterium Micrococcus lysodeikticus and enzyme-linked immunosorbent assay (ELISA) respectively. For doing this, twelve broodstocks were injected weekly with 2.5 mg·kg-1 letrozole (an endocrine disrupter component) two months before spawning season and vaccinated intraperitoneally (i.p) with a bacterin (inactivated L. garviae) one month before spawning. Twelve broodstocks for vaccination and twelve female rainbow trouts as control group were also immiunised (i.p) with the bacterin and injected (i.p) with PBS respectively. Results showed that at day 8 after hatching, lysozyme and IgM levels during pre-larval stages decreased gradually, as yolks were absorbed. Lysozyme and IgM levels were significantly higher in the letrozole injected immiunised parents 30 days after immunisation as well as their larvae compared to the control group (p L. garviae) (one month before spawning) in maternal transfer of lysozyme and IgM levels to eggs and larvae.展开更多
The paper studied the imperatives of health psychologists in the control and management of HIV/ AIDS. HIV/AIDS is a relatively new disease, but has caused more deaths than any other disease in human history, and there...The paper studied the imperatives of health psychologists in the control and management of HIV/ AIDS. HIV/AIDS is a relatively new disease, but has caused more deaths than any other disease in human history, and there is no known cure yet. Even though, HIV/AIDS is a death sentence, experts agreed that early detection, and early commencement of treatment may prolong the life of the patients, and that early detection may prevent or reduce the transmission of the virus. Early detection, commencement of treatment, and compliance with medical advice are the responsibilities of the health psychologist. This paper therefore, concludes that health psychologist is indispensable in effective control, and management of HIV/AIDS, and so recommends that awareness be created on the roles of health psychologists in this regard, through health education.展开更多
<strong>Background:</strong> Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the I...<strong>Background:</strong> Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. <strong>Methods:</strong> We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. <strong>Results:</strong> The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). <strong>Conclusion:</strong> The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.展开更多
Objective: Biodanza seems able to improve well-being and personal abilities and to prevent stress. This study’s aim was to explore the experiences of the professional caregivers who participated in the Biodanza sessi...Objective: Biodanza seems able to improve well-being and personal abilities and to prevent stress. This study’s aim was to explore the experiences of the professional caregivers who participated in the Biodanza sessions. Materials and methods: The study which was carried out could be defined as a hermeneutic phenomenological study. In-depth and face-to-face interviews, as well as audio recording of professional caregivers who attended 24 sessions of Biodanza (12 sessions with only the professional caregivers and 12 sessions with patients with Alzheimer’s disease), were used as methods to carry out the study. Subsequently, the interviews were transcripted and the narrative data were analyzed using the Giorgi method. Results: 6 Units of Meaning emerged (major topics) from the study: Feelings before the beginning of the sessions and during the Biodanza;Emotions during the sessions of Biodanza;The influence that the Biodanza experience had in the workplace;The impact of the Biodanza experience on personal life;The professional care givers’ perceptions about the benefits of Biodanza on the patients;Organizational aspects for participation in the sessions of Biodanza. At first, Biodanza may cause embarrassment and initiating a kind of contact with each other may be difficult. Subsequently, positive emotions (such as energy and tranquility) arise in those who take part in Biodanza session. On the workplace, the subjects start having a better relationship with the colleagues who have also participated in the Biodanza sessions. They also feel less stressed during work and in private life as well. They feel like they’re able to love and appreciate life more. Based on the caregivers’ opinion, the patients also benefit from the Biodanza sessions. It’s important to pay attention to the organization of the Biodanza sessions, in order not to cause discomfort to the operators during their daily work. Conclusions: The professional caregivers believe that Biodanza is helpful both on a personal level and in improving the relationship between people within the workgroup. The professional caregivers see improvements in the patients in regard to movement and deambulation, concentration, and aggression.展开更多
Introduction and Aim: Vitamin K acupuncture point injection is an effective and safe menstrual pain treatment derived from Traditional Chinese Medicine, commonly used in some Chinese hospitals. This case series invest...Introduction and Aim: Vitamin K acupuncture point injection is an effective and safe menstrual pain treatment derived from Traditional Chinese Medicine, commonly used in some Chinese hospitals. This case series investigated the effectiveness and safety of vitamin K acupuncture point injection on menstrual pain in patients with severe primary dysmenorrhea at a regional public health clinic at Bologna, Italy. Methods: From September 2006 to July 2010, 24 women were enrolled and treated during their first day of menstrual pain with an injection of 1 ml of solution containing 5 mg of vitamin K1 in an acupuncture point San Yin Jiao/Spleen 6 (SP6) bilaterally on the inside of each lower leg above the ankle. Results: Treatment was well tolerated and no major adverse events were reported. Pain relief was observed starting from 2 minutes after treatment and within 30 minutes. All treated women but one (96%) reported a substantial pain reduction (p 0.001). During the six post-treatment follow-up cycles, a trend toward a reduction of menstrual distress evaluated by the Cox Pain Intensity and Duration Scales was documented. Women reported fewer daily life restrictions and consumption of fewer analgesic tablets when compared to what they reported at the pre-treatment cycle. Conclusions: The results of this case series indicate that in primary dysmenorrhea a single vitamin K1 injection in the SP6 acupuncture point has an immediate pain-relieving effect and may ameliorate menstrual pain intensity and duration in post-treatment follow-up cycles.展开更多
Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interes...Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.展开更多
Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric...Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric related conditions. Objectives: It aimed to determine rate, characters, morbidity and mortality of septic obstetric cases at Omdurman New Hospital. Methods: It was a descriptive, prospective, analytic, cross-sectional hospital based total coverage study;conducted at Omdurman New Hospital (ONH), Khartoum-Sudan. Results: Sever sepsis and septic shock rate 1.16 (13/1124 = 1.16%) of hospital pregnancy complication admission. Hyperthermia, Tachycardia and hypotension are the main presenting clinical findings and uterine infection is the main focus of sepsis. The mean average Intensive Care Unit (ICU) stay is 6.3-day. Organs dysfunctions are the main morbidity and mortality is reported in five cases. Conclusion: Sever sepsis and septic shock contributes in maternal morbidity and mortality. Safe obstetric care prevents maternal sepsis and improves the outcome. Management of sever sepsis and septic shock remains a challenge in obstetric medicine.展开更多
Background: Incidence of obesity in children is increasing worldwide. Healthy eating and exercise are the major components of a healthy life style in the community. Objective: we aim to assess the knowledge of healthy...Background: Incidence of obesity in children is increasing worldwide. Healthy eating and exercise are the major components of a healthy life style in the community. Objective: we aim to assess the knowledge of healthy eating and exercise in children?of varying weight?and to explore the correlation between knowledge and bodyweight. Method: School children are invited to fill in a 2 questions quiz about healthy life style.?BMI is calculated and children are classified into obese, overweight, normal and underweight. Answers are scored and results compared for different categories of the BMI. Results: 445 children participated. Age range (mean) was 7 - 13 (10) years. 67 were obese, 59 overweight, 237 normal weight and 34 were underweight. In the food question, 22%, 20%, 23% 15% of obese, overweight, underweight and normal weight children respectively gave wrong answers compared to 17.5%, 15% and 14.7%, 13.3% for the exercise question. Neither of the results was statistically significant. Boys are more knowledgeable about exercise than girls (P = 0.03). Conclusion: There is no difference in the level of knowledge about healthy eating and exercise among children with varying body weights. Tackling children behavior and attitude towards food and exercise is as important as improving their knowledge.展开更多
Purpose: To assess the prevalence of DSM-IV anorexia nervosa criteria, anorexia nervosa and subthreshold subgroups, and their incidence between the ages of 12 and 17 years using Cole’s international thinness cut-offs...Purpose: To assess the prevalence of DSM-IV anorexia nervosa criteria, anorexia nervosa and subthreshold subgroups, and their incidence between the ages of 12 and 17 years using Cole’s international thinness cut-offs, and to characterize these anorexic adolescents by parental socioeconomic status and whether or not they reported receiving treatment. Method: In all, a representative sample of 39,542 French adolescents (19,658 girls and 19,884 boys) was recruited in a cross-sectional study in 2008. Anorexia nervosa DSM-IV diagnosis was determined by a self-administered questionnaire. Results: Among females, 0.5% (n = 105) met criteria for anorexia nervosa between the ages of 12 and 17 years, whereas among males, the prevalence was 0.03% (n = 6). In females, the prevalence of sub-threshold anorexia nervosa was found to be between 1.2% (n = 216) and 3.3% (n = 618);more than 75% were of the restrictive subtype. The highest incidence of anorexia nervosa was at 16 years. There was also a greater prevalence of sub-threshold anorexia nervosa subgroups among subjects with high parental socioeconomic status. More than half of the female adolescents who met the anorexia nervosa criteria reported receiving treatment for their disorder, versus 23% to 40% of the adolescents in the sub-threshold subgroups (P sample of adolescents. Using Cole’s international thinness cut-off could improve international comparability among studies. Adolescents from the higher socioeconomic categories were more likely to be anorexic.展开更多
Background The coronavirus disease 2019(COVID-19)pandemic has had a profound and prolonged impact on healthcare services and healthcare workers.Aims The Australian COVID-19 Frontline Healthcare Workers Study aimed to ...Background The coronavirus disease 2019(COVID-19)pandemic has had a profound and prolonged impact on healthcare services and healthcare workers.Aims The Australian COVID-19 Frontline Healthcare Workers Study aimed to investigate the severity and prevalence of mental health issues,as well as the social,workplace and financial disruptions experienced by Australian healthcare workers during the COVID-19 pandemic.Methods A nationwide,voluntary,anonymous,single timepoint,online survey was conducted between 27 August and 23 October 2020.Individuals self-identifying as frontline healthcare workers in secondary or primary care were invited to participate.Participants were recruited through health organisations,professional associations or colleges,universities,government contacts and national media.Demographics,home and work situation,health and psychological well-being data were collected.Results A total of 9518 survey responses were received;of the 9518 participants,7846(82.4%)participants reported complete data.With regard to age,4110(52.4%)participants were younger than 40 years;6344(80.9%)participants were women.Participants were nurses(n=3088,39.4%),doctors(n=2436,31.1%),allied health staff(n=1314,16.7%)or in other roles(n=523,6.7%).In addition,1250(15.9%)participants worked in primary care.Objectively measured mental health symptoms were common:mild to severe anxiety(n=4694,59.8%),moderate to severe burnout(n=5458,70.9%)and mild to severe depression(n=4495,57.3%).Participants were highly resilient(mean(SD)=3.2(0.66)).Predictors for worse outcomes on all scales included female gender;younger age;pre-existing psychiatric condition;experiencing relationship problems;nursing,allied health or other roles;frontline area;being worried about being blamed by colleagues and working with patients with COVID-19.Conclusions The COVID-19 pandemic is associated with significant mental health symptoms in frontline healthcare workers.Crisis preparedness together with policies and practices addressing psychological well-being are needed.展开更多
文摘Despite the fact that the sale of tobacco to minors is illegal in Ontario, youth are still able to purchase tobacco. This study aims to determine the geographic variations of underage tobacco sales at the neighborhood level within the Windsor-Essex County Health Unit. Data were collected on all inspections of tobacco retail stores from 2007 to 2011 in the Windsor-Essex County Health Unit. Data were split into season 1 (September-February) and season 2 (March-August) to assess a possible seasonal effect. Relative risks were calculated for each dissemination area (DA) by modeling the risks in a hierarchical Bayesian fashion, incorporating appropriate random effects terms for both spatially correlated and uncorrelated random errors with adjustments for neighborhood income. The association between violation rate and proximity to a school was assessed through a buffer analysis. Elliptical analysis detected a significant cluster of high risk DAs in season 1 in Windsor (p-value = 0.022) but no significant cluster in season 2. Some DAs exhibited higher relative risks of tobacco sales to minors, however after adjusting the model for neighborhood income no excess risk was observed. The results of the buffer analysis showed that in season 1 there was a significantly higher probability (p-value = 0.045) of tobacco vendors located closer to schools to sell tobacco to minors. This analysis demonstrates the utility of a systematic approach to identifying neighborhoods with higher risks of tobacco sales to minors. The insights provided by this exploratory, ecologic study are valuable for program planning and directing tobacco enforcement efforts to high risk areas.
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.
文摘Adolescence is a crucial time period with especial vulnerability for development of mental health problems.Growing interest is focusing on the determinants of positive mental health in order to find the key concepts that could be influenced in the promotion of mental well-being of adolescents.In this study we aim to explore the relations between self-esteem,character strengths and experience of social inclusion as determinants of adolescents’positive mental health controlled for selected sociodemographic background factors.The study population(n=195)consisted of comprehensive school students who filled in an electronic questionnaire of adolescent’s mental well-being in Fall 2019.The questionnaire included measures of Warwick-Edinburgh Mental Well-being Scale(WEMWBS),VIA Youth-measure 96,Rosenberg Self-Esteem Scale and Experience of Social Inclusion Scale.The methods included group comparisons and General Linear Model computed by SPSS 24.0.The strongest association was found between positive mental health and self-esteem(β=0.789,p<0.001),followed by character strengths of hope and kindness and experience of social inclusion.Interestingly,family’s socioeconomic factors did not associate significantly with positive mental health in the final statistical model.In terms of our results,it seems that self-esteem,character strengths and experience of social inclusion might have stronger association with adolescents’mental well-being than family’s socioeconomic determinants.Therefore,it should be discussed whether psychological determinants overcome the individual effect of poor socioeconomic status as factors that influence positive mental health.Further studies are needed to establish these results more firmly.
基金Supported by Department of Health of the Australian Government,Novartis Australia and the Peggy and Leslie Cranbourne FoundationThe Principal Investigator,Dr Mohamed Dirani,is supported by an NHMRC Career Development Fellowship(No.1090466)supported by an Australian Postgraduate Award scholarship。
文摘AIM:To determine the prevalence and associations of non-retinopathy ocular conditions among older Australian adults with diabetes.METHODS:Multistage random-cluster sampling was used to select 3098 non-indigenous Australians aged 50 y or older(46.4%male)and 1738 indigenous Australians aged 40 y or older(41.1%male)from all levels of geographic remoteness in Australia.Participants underwent a standardised questionnaire to ascertain diabetes history,and a clinical examination to identify eye disease.We determined the prevalence of uncorrected refractive error,visually significant cataract,cataract surgery,age-related macular degeneration,glaucoma,ocular hypertension,retinal vein occlusion and epiretinal membrane among those with and without self-reported diabetes.RESULTS:Participants with self-reported diabetes had a higher prevalence of cataract surgery than those without diabetes(28.8%vs 16.9%,OR 1.78,95%CI:1.35-2.34 among non-indigenous Australians,and 11.3%vs 5.2%,OR 1.62,95%CI:1.22-2.14 among indigenous Australians).Diabetic retinopathy(DR)increased the odds of cataract surgery among self-reported diabetic indigenous and nonindigenous Australians(OR 1.89,P=0.004 and OR 2.33,P<0.001 respectively).Having diabetes for≥20 y and having vision-threatening DR increased the odds of cataract surgery among indigenous Australians with diabetes(OR 3.73,P=0.001 and 7.58,P<0.001,respectively).CONCLUSION:Most non-retinopathy ocular conditions are not associated with self-reported diabetes.However,to account for Australia’s worsening diabetes epidemic,interventions to reduce the impact of diabetes-related blindness should include increased cataract surgery services.
文摘Background: Groundwater is an important source of water. Since the control and removal of pollution are expensive, it is essential to identify the possible sources of contamination and to correctly classify groundwater on the basis of its intrinsic and integrated vulnerability. Objectives: To group ground water chemical ions and heavy metals parameters into similar groups. Method: The investigation made use of standard analytical procedures. All sampling, conservation, transportation and analysis followed standard procedures described in APHA (2012). To prevent degradation of the organic substances, all obtained samples were transferred to the laboratory, while kept in an icebox. Results: Sampling records from the same area are generally assigned to the same cluster during hierarchical cluster analysis (HCA). The cluster diagram shows the grouping of the heavy metal in the study area during wet and dry seasons. It reveals that 5 distinct clusters were identified for wet season and 4 clusters were identified during dry season. Also, it reveals that 5 distinct clusters were identified for wet season and for dry season, 4 distinct clusters were identified. Conclusion: The findings of this study are significant for policymakers and agencies in terms of dealing with the issues identified to enhance sustainable livelihood practices in the oil rich Niger Delta region of Nigeria. Therefore, decision-makers should take proper initiatives to get local people aware of the endangered zones before use, as drinking water is key to good health. Similarly, multinational oil companies will find it useful in their quest for viable social corporate responsibility and remediation plans in their respective host communities. The method proved to be a useful and objective tool for environmental planning.
文摘Background: Hazardous alcohol consumption and associated harms are high among young uni- versity students. The university environment is conducive to excessive alcohol consumption with studies finding young university students to drink alcohol at higher levels than their non-university peers. Methods: A random sample of 18 - 24-year-old undergraduate, internal university students completed a survey (n = 2465) to investigate differences in self-reported personal, second-hand and witnessed alcohol-related harms, alcohol expectancies, pre-loading, and friends’ alcohol consumption between low risk and hazardous drinkers. Univariate and multivariate analyses are reported. Results: Almost 40% of students who had consumed alcohol in the past year reported drinking at hazardous levels. Univariate analyses found students who reported hazardous drinking reported significantly higher scores relating to experienced, second-hand, witnessed and academic problems compared to low risk drinkers. Hazardous drinkers were also more likely to pre-load, to drink at higher levels when pre-loading, have more friends who drank alcohol, have more friends who drank at hazardous levels and to score higher on alcohol expectancies. However both low risk and hazardous drinkers experienced a range of harms due to their own drinking including hangover (71.2%), unprotected sex (19.3%), regretted sex (16.8%) and drink-driving (17%). Looking after an intoxicated student (34.3%) and witnessing someone pass out (37.5%) were issues for all drinkers. Experienced alcohol related harms, academic problems, alcohol expectancies, close friends’ level of alcohol consumption, pre-loading in the last four weeks and level of consumption when pre-loading were predictors of hazardous drinking (p < 0.001). Conclusion: Young undergraduate university students are at risk of a range of academic, social, emotional and physical harms associated with their own and other students’ alcohol consumption. There is a need for integrated programs to address university drinking culture and effect positive changes.
文摘The world＇s population is ageing rapidly, which will have substantial consequences. According to WHO： ＂Process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age＂. The aim of this work is to make a literature review on key measures that contribute to healthy ageing. A search was conducted in the following databases： PubMed, Cochrane, National Guideline Clearinghouse, Trip Database, Guideline finders, NICE and WHO database, written in English and published in the last ten years. The following MeSH words were used： ＂healthy ageing＂. The search was conducted from July first till end of December 2015. Based on the articles searched there are many measures with potential to achieve gains in healthy ageing such as prevention of falls; vaccination; regular physical activity, eating fruits and vegetables daily, drinking alcohol moderately; never smoking; prevention of social isolation and social exclusion; prevention of elder maltreatment; public support for informal care giving and create strategies to ensure the quality of care for older people. Getting older can come with a variety of health challenges. In the daily practice of family doctor there are many effective interventions that can improve health and wellbeing in elderly people.
文摘This study evaluated transfer of maternal lysozyme and immunoglobulin (IgM) against Lactococcus garviea, the causative agent of lactococcosis to eggs and larvae in rainbow trout. Changes in circulating lysozyme and IgM during development of eggs and larvae were measured by a method based on the ability of lysozyme to lyse the bacterium Micrococcus lysodeikticus and enzyme-linked immunosorbent assay (ELISA) respectively. For doing this, twelve broodstocks were injected weekly with 2.5 mg·kg-1 letrozole (an endocrine disrupter component) two months before spawning season and vaccinated intraperitoneally (i.p) with a bacterin (inactivated L. garviae) one month before spawning. Twelve broodstocks for vaccination and twelve female rainbow trouts as control group were also immiunised (i.p) with the bacterin and injected (i.p) with PBS respectively. Results showed that at day 8 after hatching, lysozyme and IgM levels during pre-larval stages decreased gradually, as yolks were absorbed. Lysozyme and IgM levels were significantly higher in the letrozole injected immiunised parents 30 days after immunisation as well as their larvae compared to the control group (p L. garviae) (one month before spawning) in maternal transfer of lysozyme and IgM levels to eggs and larvae.
文摘The paper studied the imperatives of health psychologists in the control and management of HIV/ AIDS. HIV/AIDS is a relatively new disease, but has caused more deaths than any other disease in human history, and there is no known cure yet. Even though, HIV/AIDS is a death sentence, experts agreed that early detection, and early commencement of treatment may prolong the life of the patients, and that early detection may prevent or reduce the transmission of the virus. Early detection, commencement of treatment, and compliance with medical advice are the responsibilities of the health psychologist. This paper therefore, concludes that health psychologist is indispensable in effective control, and management of HIV/AIDS, and so recommends that awareness be created on the roles of health psychologists in this regard, through health education.
文摘<strong>Background:</strong> Zimbabwe started HIV case-based surveillance in April 2017. Rapid testing for HIV recent infection was introduced into routine HIV and testing services in 2019 along with the Impilo Electronic Health Record System. For the period January-June 2020, only 1 out of 13 health facilities in Mutare district reported seven newly diagnosed HIV patients through the electronic health record system compared to 483 in the District Health Information System (DHIS-2) recorded from paper-based registers. We evaluated the case-based surveillance system attributes, usefulness and reasons for under-reporting from January-December 2020. <strong>Methods:</strong> We conducted a descriptive cross-sectional study using updated Centres for Disease Control guidelines for evaluating public health surveillance systems. Questionnaires were administered to 36 health workers involved in HIV testing services. Facility checklists were used to collect data on knowledge, system attributes and usefulness of the system. Completed HIV case-based surveillance forms were assessed for completeness. Epi Info Version 7 was used to generate frequencies, means and proportions. <strong>Results:</strong> The reasons for under-reporting of patients in the electronic health record system were lack of reporting guidelines 26/36 (72%), limited coordination between technical staff and health facilities 24/36 (67%) and limited competency on the Electronic health record system 22/36 (61%). Timeliness, completeness, and validity were 88%, 82% and 100% respectively. The stability of the system was affected by the lack of standard operating procedures during system interruptions. Overall representativeness was 45% despite increasing from 3/226 (1%) to 224/303 (73%) between Quarter-1 and Quarter-4 of 2020. Acceptability was 100% due to reduced paperwork and the ability to generate simple reports. The information generated was used to identify new infection hotspots 28/36 (78%). <strong>Conclusion:</strong> The HIV cases based surveillance system was timely, acceptable with good data quality. Representativeness was poor due to limited competency on the electronic health record system. As a result, health workers received further training.
文摘Objective: Biodanza seems able to improve well-being and personal abilities and to prevent stress. This study’s aim was to explore the experiences of the professional caregivers who participated in the Biodanza sessions. Materials and methods: The study which was carried out could be defined as a hermeneutic phenomenological study. In-depth and face-to-face interviews, as well as audio recording of professional caregivers who attended 24 sessions of Biodanza (12 sessions with only the professional caregivers and 12 sessions with patients with Alzheimer’s disease), were used as methods to carry out the study. Subsequently, the interviews were transcripted and the narrative data were analyzed using the Giorgi method. Results: 6 Units of Meaning emerged (major topics) from the study: Feelings before the beginning of the sessions and during the Biodanza;Emotions during the sessions of Biodanza;The influence that the Biodanza experience had in the workplace;The impact of the Biodanza experience on personal life;The professional care givers’ perceptions about the benefits of Biodanza on the patients;Organizational aspects for participation in the sessions of Biodanza. At first, Biodanza may cause embarrassment and initiating a kind of contact with each other may be difficult. Subsequently, positive emotions (such as energy and tranquility) arise in those who take part in Biodanza session. On the workplace, the subjects start having a better relationship with the colleagues who have also participated in the Biodanza sessions. They also feel less stressed during work and in private life as well. They feel like they’re able to love and appreciate life more. Based on the caregivers’ opinion, the patients also benefit from the Biodanza sessions. It’s important to pay attention to the organization of the Biodanza sessions, in order not to cause discomfort to the operators during their daily work. Conclusions: The professional caregivers believe that Biodanza is helpful both on a personal level and in improving the relationship between people within the workgroup. The professional caregivers see improvements in the patients in regard to movement and deambulation, concentration, and aggression.
文摘Introduction and Aim: Vitamin K acupuncture point injection is an effective and safe menstrual pain treatment derived from Traditional Chinese Medicine, commonly used in some Chinese hospitals. This case series investigated the effectiveness and safety of vitamin K acupuncture point injection on menstrual pain in patients with severe primary dysmenorrhea at a regional public health clinic at Bologna, Italy. Methods: From September 2006 to July 2010, 24 women were enrolled and treated during their first day of menstrual pain with an injection of 1 ml of solution containing 5 mg of vitamin K1 in an acupuncture point San Yin Jiao/Spleen 6 (SP6) bilaterally on the inside of each lower leg above the ankle. Results: Treatment was well tolerated and no major adverse events were reported. Pain relief was observed starting from 2 minutes after treatment and within 30 minutes. All treated women but one (96%) reported a substantial pain reduction (p 0.001). During the six post-treatment follow-up cycles, a trend toward a reduction of menstrual distress evaluated by the Cox Pain Intensity and Duration Scales was documented. Women reported fewer daily life restrictions and consumption of fewer analgesic tablets when compared to what they reported at the pre-treatment cycle. Conclusions: The results of this case series indicate that in primary dysmenorrhea a single vitamin K1 injection in the SP6 acupuncture point has an immediate pain-relieving effect and may ameliorate menstrual pain intensity and duration in post-treatment follow-up cycles.
文摘Introduction: Maternal mortality, which is estimated at 614 deaths per 100,000 births in Côte d’Ivoire, is associated with a low national contraceptive prevalence rate of 13.9%. In this study, we are interested in the contraceptive experiences of women who attend health centers to estimate their rate of contraceptive use and to assess the factors involved in the use of modern contraceptive methods among women of childbearing age who are exposed to the risk of pregnancy. Method: A descriptive cross-sectional study was conducted from December 2018 to September 2019 among 423 women, who attended two health centers in Abidjan. A bivariate analysis identified factors associated with contraceptive use by these women. A descriptive analysis determined the means for the quantitative variables and the frequencies and percentages of qualitative variables. Interpretation of results was based on significance (α = 5%, 95% CI). Results: Contraceptive prevalence was 37%. There was a significant relationship between contraceptive use and the socio-demographic and reproductive characteristics of women (p Conclusion: Women who were over 35 years age, uneducated, primary school graduates, housewives, unemployed, in the informal sector, Muslims, nulliparous, and lacking information and decision-making power were less likely to use modern contraceptive methods. They are the target population for strategic interventions to improve contraceptive prevalence.
文摘Introduction: Sever sepsis and septic shock contributes to maternal morbidity and mortality. The etiology of sever sepsis and septic shock during pregnancy and postpartum result from obstetric related or non-obstetric related conditions. Objectives: It aimed to determine rate, characters, morbidity and mortality of septic obstetric cases at Omdurman New Hospital. Methods: It was a descriptive, prospective, analytic, cross-sectional hospital based total coverage study;conducted at Omdurman New Hospital (ONH), Khartoum-Sudan. Results: Sever sepsis and septic shock rate 1.16 (13/1124 = 1.16%) of hospital pregnancy complication admission. Hyperthermia, Tachycardia and hypotension are the main presenting clinical findings and uterine infection is the main focus of sepsis. The mean average Intensive Care Unit (ICU) stay is 6.3-day. Organs dysfunctions are the main morbidity and mortality is reported in five cases. Conclusion: Sever sepsis and septic shock contributes in maternal morbidity and mortality. Safe obstetric care prevents maternal sepsis and improves the outcome. Management of sever sepsis and septic shock remains a challenge in obstetric medicine.
文摘Background: Incidence of obesity in children is increasing worldwide. Healthy eating and exercise are the major components of a healthy life style in the community. Objective: we aim to assess the knowledge of healthy eating and exercise in children?of varying weight?and to explore the correlation between knowledge and bodyweight. Method: School children are invited to fill in a 2 questions quiz about healthy life style.?BMI is calculated and children are classified into obese, overweight, normal and underweight. Answers are scored and results compared for different categories of the BMI. Results: 445 children participated. Age range (mean) was 7 - 13 (10) years. 67 were obese, 59 overweight, 237 normal weight and 34 were underweight. In the food question, 22%, 20%, 23% 15% of obese, overweight, underweight and normal weight children respectively gave wrong answers compared to 17.5%, 15% and 14.7%, 13.3% for the exercise question. Neither of the results was statistically significant. Boys are more knowledgeable about exercise than girls (P = 0.03). Conclusion: There is no difference in the level of knowledge about healthy eating and exercise among children with varying body weights. Tackling children behavior and attitude towards food and exercise is as important as improving their knowledge.
文摘Purpose: To assess the prevalence of DSM-IV anorexia nervosa criteria, anorexia nervosa and subthreshold subgroups, and their incidence between the ages of 12 and 17 years using Cole’s international thinness cut-offs, and to characterize these anorexic adolescents by parental socioeconomic status and whether or not they reported receiving treatment. Method: In all, a representative sample of 39,542 French adolescents (19,658 girls and 19,884 boys) was recruited in a cross-sectional study in 2008. Anorexia nervosa DSM-IV diagnosis was determined by a self-administered questionnaire. Results: Among females, 0.5% (n = 105) met criteria for anorexia nervosa between the ages of 12 and 17 years, whereas among males, the prevalence was 0.03% (n = 6). In females, the prevalence of sub-threshold anorexia nervosa was found to be between 1.2% (n = 216) and 3.3% (n = 618);more than 75% were of the restrictive subtype. The highest incidence of anorexia nervosa was at 16 years. There was also a greater prevalence of sub-threshold anorexia nervosa subgroups among subjects with high parental socioeconomic status. More than half of the female adolescents who met the anorexia nervosa criteria reported receiving treatment for their disorder, versus 23% to 40% of the adolescents in the sub-threshold subgroups (P sample of adolescents. Using Cole’s international thinness cut-off could improve international comparability among studies. Adolescents from the higher socioeconomic categories were more likely to be anorexic.
基金The Royal Melbourne Hospital Foundation and the Lord Mayor’s Charitable Foundation kindly provided financial support for this study.
文摘Background The coronavirus disease 2019(COVID-19)pandemic has had a profound and prolonged impact on healthcare services and healthcare workers.Aims The Australian COVID-19 Frontline Healthcare Workers Study aimed to investigate the severity and prevalence of mental health issues,as well as the social,workplace and financial disruptions experienced by Australian healthcare workers during the COVID-19 pandemic.Methods A nationwide,voluntary,anonymous,single timepoint,online survey was conducted between 27 August and 23 October 2020.Individuals self-identifying as frontline healthcare workers in secondary or primary care were invited to participate.Participants were recruited through health organisations,professional associations or colleges,universities,government contacts and national media.Demographics,home and work situation,health and psychological well-being data were collected.Results A total of 9518 survey responses were received;of the 9518 participants,7846(82.4%)participants reported complete data.With regard to age,4110(52.4%)participants were younger than 40 years;6344(80.9%)participants were women.Participants were nurses(n=3088,39.4%),doctors(n=2436,31.1%),allied health staff(n=1314,16.7%)or in other roles(n=523,6.7%).In addition,1250(15.9%)participants worked in primary care.Objectively measured mental health symptoms were common:mild to severe anxiety(n=4694,59.8%),moderate to severe burnout(n=5458,70.9%)and mild to severe depression(n=4495,57.3%).Participants were highly resilient(mean(SD)=3.2(0.66)).Predictors for worse outcomes on all scales included female gender;younger age;pre-existing psychiatric condition;experiencing relationship problems;nursing,allied health or other roles;frontline area;being worried about being blamed by colleagues and working with patients with COVID-19.Conclusions The COVID-19 pandemic is associated with significant mental health symptoms in frontline healthcare workers.Crisis preparedness together with policies and practices addressing psychological well-being are needed.
