Search results for “Gender

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82 articles

Core and activating Symptoms of Depression in Chinese Teachers and Comparison between Different Gender and Stage of Teaching: A Network Analysis Approach

Feb 2026 DOI 10.14302/issn.2474-9273.jbtm-25-5885

Background Depression, increasingly recognized as a critical factor impacting mental health, notably affects various populations, including teachers. This study aimed to delineate the specific characteristics of depressive symptom networks among Chinese teachers, identify the core symptoms of depression within this demographic, and examine the variations in depressive symptom networks across different genders and teaching stages. Method The study encompassed 1,670 teachers. Depressive symptoms were assessed using the Self-Rating Depression Scale (SDS). Central symptoms were identified through centrality indices. Network stability was examined via a case-dropping procedure. Directed Acyclic Graphs (DAG) was used to identify the activating symptoms. Results “Personal devaluation” exhibited the highest and most stable centrality values in the network. “Depressed Affect” and “Emptiness of Life” were identified as the activating symptoms in the network. No significant differences were observed in the network structure and global strength of depression between teachers of different genders. However, significant differences in the network’s global strength were found between junior and senior high school teachers. Conclusion “Personal devaluation” emerged as the core depressive symptoms among teachers in China. “Depressed Affect” and “Emptiness of Life” serve as the gateways that activate the entire teacher depression network. Paying close attention to these symptoms could potentially alleviate the experiences of depression in this demographic.

Recruitment Strategies and Challenges in a Pilot HIV Prevention Study among Cisgender Black Women in Houston, Texas

Dec 2025 DOI 10.14302/issn.2324-7339.jcrhap-25-5715

Recruitment for research studies focused on communicable diseases such as HIV (Human Immunodeficiency Virus) has historically been challenging, particularly among populations who have been underrepresented in media messaging, yet maintain a significant vulnerability to new HIV cases, like Black women. This study examines the recruitment strategies utilized in Aim 2 of pilot study at the University of Texas Health Science Center (UTHealth) in Houston, Texas that was funded by the Ujima Mentoring Program to develop, implement, and evaluate a video log (vlog)-based intervention. The overarching goal of the pilot study was to promote the uptake of pre-exposure prophylaxis (PrEP) among cisgender Black women in Harris County, Texas. Aim 2 involved the creation of a culturally relevant vlog for use in Aim 3, which sought to educate and motivate participants to consider PrEP as an HIV prevention strategy. With the growing role of digital platforms in public health outreach, social media was employed alongside traditional recruitment methods such as flyers and word-of-mouth referrals. Despite an expanded online reach, engagement remained low, and participation rates did not increase proportionally to the number of individuals who viewed recruitment materials. The reluctance to participate was largely attributed to stigma surrounding HIV and concerns about being publicly associated with an HIV prevention study based on participants feedback to the research team. Even the availability of research incentives to encourage participation did not significantly improve recruitment accrual goals, particularly among healthcare providers who experienced limitations with eligibility due to institutional policies. This study underscores the need to better understand the social and cultural barriers that prevent Black women and healthcare providers from engaging in HIV prevention research. While digital recruitment strategies can enhance visibility to a larger audience, they must be supported with trust-building efforts, community partnerships, and culturally competent messaging to encourage meaningful participation. These findings point to the critical need for multi-faceted recruitment strategies that go beyond social media campaigns and actively build trust within communities, ensuring that HIV prevention research and interventions are both accessible and culturally resonant.

ADHD And Care Open Access

Trading on Impulse: The Role of ADHD, Impulsivity, and Gender in Financial Risk and Investment Outcomes

Aug 2025 DOI 10.14302/issn.3066-8042.jac-25-5652

Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.

Women's Mental Health Open Access

Unveiling Gender Disparities in ADHD: A Literature Review on Factors and Impacts of Late Diagnosis in Females (2010-2023)

May 2024

This exploratory study investigates factors and consequences of underdiagnoses or late diagnoses of attention deficit hyperactivity disorder (ADHD) in females favoring males in the referral, diagnosis, and treatment processes resulting in  gender disparities. A literature review in PubMed, PsychINFO, PsychArticles, and PsychiatryOnline from 2010 to 2023 underscores significant implications of delayed ADHD diagnosis in females, hindering timely access, support, and interventions during critical developmental years. Factors associated with underdiagnosis of ADHD among girls include gender differences in symptomology presentation, comorbidity, and gender bias among parents, teachers, and healthcare providers. We highlight the role of ethnicity and cultural factors. This bias prevents girls from receiving necessary ADHD support and treatment, impacting their health, social, and economic outcomes into adulthood. We summarize strategies to urgently address gaps in ADHD research and practice. Raising awareness among communities, healthcare providers, educators, and parents is vital to alleviate these gender disparities. By illuminating factors contributing to delayed diagnoses, the study informs policymakers and stakeholders, facilitating targeted interventions to improve early detection and treatment outcomes for females with ADHD.

Adolescent Girls in Guatemala: Can an Empowerment Program Change Perceptions of Gender Equity, Aspirations, and Communication?

Aug 2021 DOI 10.14302/issn.2641-4538.jphi-21-3927

While Guatemala has made great strides towards gender equality, it remains a country with vast disparities. Gender sensitization and empowerment programs during adolescence when gender attitudes are formed have the potential to diminish gender inequities. The Girl Rising Pilot Program (GR) is a 24-week curriculum designed for adolescent girls living in the Sololá region where 95% of the total population is indigenous and Mayan. The present pilot study evaluated outcomes of the GR Guatemala pilot program. Specifically, the evaluation examined whether there were differences between baseline and follow-up on perceptions of gender equity, aspirations, and communication for adolescent girls who participated in the GR program. A quasi-experimental study design with a one group pre- and post-test was implemented. The pilot evaluation study included all 265 participants at baseline who participated in the GR program. after controlling for significant variables, it was found that the gender equitable attitudes score and communications scale still significantly increased between baseline and follow-up. The results of this evaluation prove that gender sensitization programs play a key role in forming and changing gender attitudes during adolescence, and have the potential to alter their short and long-term attitudes and beliefs.

How do College Students in India Respond to Gender-Based Violence (GBV)?

Jan 2020 DOI 10.14302/issn.2641-4538.jphi-20-3170

Rates of gender-based violence remain high during college in India, a time of adolescent malleability where gender norms, gender perspectives, and responses to violence are open to change. Few gender-based violence interventions focus on college students and even fewer on bystander intervention as a preventative approach - a concept novel to India. This cross-sectional study reached 603 college students in India to examine current gender norms and perspectives, bystander intervention behaviours, and discussion of gender-based violence on campuses. Statistically significant differences were found between male and female college students in all scenarios of bystander intervention response and frequency of discussion of gender-based violence. Multinomial logistic regression analysis showed significant differences in those who had never seen violence or had a positive bystander intervention response, compared to those who responded negatively. Given the findings, targeting college students appears a promising approach to change the narrative of gender-based violence and norms in India.

Adolescents’ Perceptions of Gender Discrimination in India: Do Perceptions Differ for Boys and Girls?

Sep 2019 DOI 10.14302/issn.2641-4538.jphi-19-2995

Despite the gains India has made in recent decades, it remains a country with vast gender inequities. Gender sensitization and empowerment programs aimed at young people, precisely at the time when they are forming their gender attitudes, has the potential to diminish gender inequity in the long-term. This study represents data from 36 qualitative in-depth interviews conducted amongst adolescent boys and girls enrolled in grade 7 in northern India, in schools that serve under-resourced communities. The interviews asked questions related to positive youth development, gender roles, violence, and locus of control. The results of the qualitative analysis provide insights into how adolescents perceive gender discrimination in their families and communnites. The majority of expectations for boys revolved around physical labor, while, for girls, gender roles were primarily focused on stopping education early to get married and take care of the household and children. Many of the responses from both boys and girls on privileges/restrictions were related to daughters not being fully educated while sons often were. Furthermore, when comparing between boys and girls (attributes) and understanding superiority, many participants noted there is a clear preference of boys compared to girls. Girls also had higher proportion of violence codes compared to boys, perhaps because many girls felt they were hit more frequently than boys. The results of this qualitative analysis provide direction for both future research as well as the development of gender sensitization interventions specifically designed for adolescents.

Parental Report of Gender Differences in Sexual Functioning among Adolescents with Down Syndrome: A Jordanian Experience

May 2016 DOI 10.14302/issn.2474-9273.jbtm-15-792

Background: Recently, there has been an increased interest in sexuality among teenagers with Down syndrome (DS). Although DS has been well studied in the western continents, its research is relatively scarce in the Arab region. Aims: This is a cross -sectional study to explore the demographic characteristics and the sexual profile among 23 adolescents with DS who attended the outpatient psychiatric clinic of a tertiary care hospital in Amman, Jordan. Method: A semi-structured interview conducted with the parents of individuals with DS was used to record the socio-demographic profile, self-care skills, socio-sexual skills and sexual behavior. Results: The mean age of the sample was 13.5 years, out of which 69% were males; 26% were sexually oriented and able to identify their gender identity. When questioned about masturbation and self-care skills, a significant statistical difference was observed where girls showed more self-care skills while boys showed more masturbation acts. The p- value was (p = 0.045) for masturbation, p = 0.02 for washing the genitals, p = 0.011 for changing the underwear, and p = 0.001 for hygiene after using the toilet. Conclusion: The present study expands our knowledge about sexual issues in individuals with DS. We found that all adolescents reported adaptation to the physical changes of puberty. However, gender difference on some of the sexuality subscales was observed, mainly in the practice of some self- care, socio-sexual skills and sexual behavior.

Gender Differences in Adherence to Mediterranean Diet and Risk of Atrial Fibrillation.

May 2015 DOI 10.14302/issn.2329-9487.jhc-13-210

Background. Adherence to the Mediterranean Diet (MedD) is associated with a reduction of overall mortality and mortality from cardiovascular diseases and cancer. In a previous study we found a relationship between intake of antioxidant vitamins with diet and risk of atrial fibrillation (AF). The present study focuses on gender differences relative to diet and antioxidant intake in patients (pts) with a first detected episode of AF. Methods. A group of 400 pts, 205 men and 195 women, was investigated. A control group of 400 subjects, age and sex matched, was selected and compared. Nutritional parameters were assessed by a self-administered food frequency validated questionnaire (116 items) completed by an interviewer-administered 24 h diet recall. We previously constructed a MedD adherence score based on a prior scoring system developed for the Greek population. Consumption of cereals, vegetables, legumes, fruit, fish, dairy products, cups of espresso coffee, chocolate snacks, soda drinks and wine was investigated. Results. The MedD Score was higher in women compared to men (28.8 + 2.0 vs 20.1 + 2.5; p<0.001) and was higher in healthy subjects compared to patients with AF (27.9 + 5.6 vs 22.3 + 3.1; p<0.001). In pts with AF the estimated intake of total antioxidants was higher in women (19.9 ± 5.6 vs 11.2 ± 7.4 mmol/d; p<0.001), and women had higher intake of antioxidants from fruit and vegetables. Conclusions. Women showed high adherence to the MedD and higher intake of antioxidants from fruit and vegetables compared to AF men. Men had higher intake of antioxidants from coffee. Women that developed AF were older, with lower adherence to the MedD, and were more sedentary.

Human Psychology Open Access

Honour and Shame as Moral-Emotional Identity Regulation in Diaspora: An Interpretative Phenomenological Analysis of Young British South Asian Women

Apr 2026 DOI 10.14302/issn.2644-1101.jhp-26-6100

Honour and shame are central moral constructs within many South Asian communities, yet their psychological internalisation in diasporic contexts remains underexamined. This qualitative study explored how young British South Asian women (aged 18–25; N = 6) understand and negotiate honour in relation to gender, religion, and identity. Semi-structured interviews were analysed using Interpretative Phenomenological Analysis. Six interrelated themes illustrated honour as a gendered and relational system sustained through anticipatory shame, behavioural surveillance, and sexual double standards. Participants described internalised self-monitoring, bicultural identity tension, and strategic resistance through selective compliance and religious reinterpretation. We propose that honour and shame in minority diaspora contexts function as a moral-emotional identity-regulation system characterised by anticipatory shame, relational accountability, and boundary maintenance under racialisation. This conceptualisation advances acculturation and bicultural identity frameworks by arguing that moral emotion, particularly anticipatory shame, functions as a primary mechanism of cultural internalisation, rather than merely an outcome of value endorsement. The findings further illuminate how moral surveillance shapes identity negotiation and psychological wellbeing, with implications for culturally responsive community and clinical practice.

Rooted Resistance: Women’s Socio-Cultural Roles in Environmental Conservation in a Patriarchal Society in Northern Uganda

Feb 2026 DOI 10.14302/issn.2693-1176.ijgh-25-5735

Background In Northern Uganda’s patriarchal communities, women play vital yet underrecognized roles in environmental conservation. There is limited research examining the socio-cultural roles women play in society in northern Uganda. This study, conducted in Gulu District, examined the socio-cultural functions performed by women in safeguarding natural resources. Methods This study employed an analytical cross-sectional design involving 395 women aged 18–49 in Gulu District, selected for its patriarchal context. Data were collected using structured questionnaires and analyzed with SPSS, applying descriptive and inferential statistics. Key variables included women’s roles in environmental conservation and barriers to participation. Ethical approval and informed consent were obtained to ensure research integrity. Results The study found that women in Gulu District play vital socio-cultural roles in environmental conservation, particularly as custodians of indigenous knowledge (Mean = 4.42), active participants in tree planting (Mean = 4.11), and conservers of ecosystems (Mean = 4.04). However, their involvement in advocacy (Mean = 3.46) and decision-making (Mean = 3.20) was perceived as limited, reflecting the constraints of a patriarchal society. Additionally, evolving gender roles have negatively impacted women’s engagement, with 47.6% citing excessive domestic workload and 44.1% reporting reduced participation in conservation activities. These findings highlight both the significance of women’s contributions and the structural barriers that hinder their full involvement in environmental governance. Conclusion Despite these challenges, women’s contributions remain central to sustainable environmental stewardship. The study recommends targeted sensitization and training programs to promote gender equality and community acceptance of women’s leadership in environmental governance.

Factors Contributing to Domestic Violence Among HIV-Discordant Couples in Kicukiro District, Rwanda

Dec 2025 DOI 10.14302/issn.2641-4538.jphi-25-5613

Background Domestic violence among HIV discordant couples poses significant public health challenges, affecting treatment adherence and HIV transmission risks. This study examined factors contributing to domestic violence among HIV discordant couples in Kicukiro District, Rwanda. Methods A cross-sectional study was conducted among 384 HIV discordant couples from eleven health centers using stratified systematic sampling. Data were collected through structured face-to-face interviews and analyzed using descriptive statistics and bivariate analysis. Results Domestic violence prevalence was 41.1% physical violence, 34.2% sexual coercion, and 52.3% emotional abuse. Key socio-demographic risk factors included female gender (56% vs. 29% males, p<0.001), older age (61% in ≥55 years vs. 32% in 18-24 years, p=0.004), unemployment (55% vs. 34% formal employment, p=0.014), and financial hardship (63% vs. 25% comfortable situations, p=0.002). Behavioral factors included alcohol use (58% vs. 38%, p=0.021), substance abuse (62% vs. 35%, p<0.001), and poor conflict resolution (72% vs. 25%, p<0.001). Contextual factors like hostile HIV disclosure reactions (68% vs. 34%, p<0.001) and HIV-related stigma (60% vs. 35%, p<0.001) significantly increased violence risk. Conclusions Domestic violence among HIV discordant couples is multifactorial, driven by socio-economic, behavioral, and HIV-related factors. Integrated interventions addressing economic empowerment, conflict resolution skills, stigma reduction, and couple-centered counseling are urgently needed.

Exploring the Correlation between Glucose and Apoptosis Levels in Stored Platelets

Aug 2025 DOI 10.14302/issn.3070-1937.ijbt-25-5408

Background and Objectives Platelets are small, anucleate blood cells produced in the bone marrow, primarily involved in blood coagulation. Platelet concentrate is a vital blood product with extensive applications. However, its short lifespan and limited donor availability pose global challenges. This study aimed to follow the trend of platelets 5 during days of storage. Material and Methods We studied on 40 platelet bags and analyzed glucose levels, lactate dehydrogenase (LDH), bacterial culture, and apoptosis using flow cytometry with Annexin V-PI over three consecutive days (first, third, and fifth) post-blood collection. Data were analyzed using SPSS. Results No significant correlations were found between age, blood group, or gender and the variables studied. No bacterial growth was detected. Glucose levels decreased significantly from day 1 (382 mg/dl) to day 5 (298 mg/dl). The average platelet apoptosis increased significantly from 3.65% on day 1 to 9.06% on day 5. Significant correlations were observed between glucose levels and apoptosis on days 3 (p<0.05) and 5 (p<0.01). No correlation found between LDH and apoptosis or necrosis, although a significant relationship between necrosis and apoptosis was noted on day 5 (p=0.003). Conclusion These findings suggest that while demographic factors do not influence the studied variables, the significant decrease in glucose levels correlates with increased platelet apoptosis over time, highlighting potential metabolic interactions that warrant further investigation.   Highlights 1. The study revealed subtle variations in metabolic markers related to donor demographics, particularly gender and age. Understanding these differences can inform targeted donor selection strategies to optimize platelet quality. 2. A significant negative correlation was found between glucose levels and apoptosis rates, indicating that as glucose decreases, platelet viability declines. This relationship highlights the need for careful monitoring of glucose levels during storage to maintain platelet function. 3. Fluctuations in lactate dehydrogenase (LDH) levels were correlated with increasing rates of apoptosis, suggesting that LDH could serve as a valuable biomarker for assessing platelet quality throughout the storage period. This finding could lead to improved storage protocols and enhanced transfusion safety.

Economic Masculinity Support and Well-Being of Married Women in Luwero District, Uganda: A Cross-sectional Study

Aug 2025 DOI 10.14302/issn.2693-1176.ijgh-25-5609

Economic masculinity support is paramount in promoting women’s well-being through numerous ways, including enhancing access to healthcare, education, and financial freedom, hence fostering equitable distribution of household responsibilities. However, studies examining the relationship between economic masculinity support and women’s well-being have not been well established in existing research. This study evaluated the relationship between economic masculinity support and the well-being of married women in Luwero district, Uganda. This Cross-Sectional study was conducted among 382 married women aged 18 to 50 years of age, from selected villages in Luwero district. The outcome variable, well-being, was assessed using the Gender Empowerment Measure (GEM). Data were analyzed using the Pearson correlation coefficient and linear regression to ascertain the relationship between economic masculinity support and the well-being of women. The findings show a moderate positive association between economic masculinity support and women's well-being (r = 0.55, p < 0.0001). Regression analysis indicated that economic masculinity support had a significant predictive influence (β = 0.42, p < 0.01) on women’s well-being, accounting for approximately 30% of the variance in well-being outcomes (Adjusted R² = 0.30). Linking economic masculinity supports improved access to essential resources. These results highlight the crucial role of economic support in enhancing women’s welfare, while also emphasizing the need to address socio-cultural barriers to achieve lasting empowerment. The study underscores the significant role of economic masculinity in promoting married women’s well-being. Transforming economic masculinity into a framework of mutual support is essential for advancing gender equity and safeguarding women’s well-being globally

Assessing the risk of Obstructive Sleep Apnea in Type 2 Diabetes Mellitus patients in India

Nov 2024 DOI 10.14302/issn.2574-4518.jsdr-24-5271

Background/Aim Obstructive Sleep Apnea (OSA) is a prevalent disorder characterized by recurrent respiratory disturbances during sleep. Patients with Type 2 Diabetes Mellitus (T2DM) and obesity exhibit a substantial susceptibility to OSA (23%–86%). People with OSA have a high risk of several comorbidities like insulin resistance, cardiovascular disease, depressed mood and hypertension. Thus, the objective was to comprehensively evaluate the risk of OSA among T2DM patients in India. Materials and Methods A cross-sectional survey was conducted across four cities in India involving 2,000 T2DM patients. The survey gathered data on patient demographics, clinical endpoints, and estimated the risk of OSA using an app which included the STOP BANG questionnaire. Multivariate logistic regression analysis was used to evaluate the association between OSA risk and key variables such as age, gender, BMI, and HbA1c. Result Overall, 63.9% of T2DM patients were identified as high risk and 27.3% were at intermediate risk for OSA development. Results of the multivariate logistic regression demonstrated that patients with high BMI ≥35 had significantly greater odds (OR: 5.70; p<0.00) of developing OSA; males had 2.75 times higher odds (p<0.00) and patients with HbA1c value >8% had higher odds (OR: 1.22; p<0.00) of developing OSA. Conclusion OSA risk and prevalence are significantly higher in T2DM patients than in the general population with a notable escalation in patients who are overweight/obese, older, and have prolonged diabetes duration. Early screening using digitalization with a highly sensitive, cost-efficient, and valid tool like STOP-BANG followed by appropriate intervention for OSA can not only reduce the eventual economic burden but can improve patient outcomes.

A 12-week, Multicenter, Randomized, Double-blind, Placebo-controlled Clinical Trial Evaluating the Efficacy and Safety of DKB-131 in Knee Arthritis

Jun 2024 DOI 10.14302/issn.2379-7835.ijn-24-5117

In this study, the efficacy and safety of DKB-131 (extract of Siraitiagrosvenorii) in adults of both genders presenting mild symptoms of knee arthritis were evaluated in comparison to a placebo. This clinical trial was randomized, double-blind, multicenter, and lasted for 12 weeks. A total of 120 participants with Visual Analogue Scale (VAS) scores of 30 mm or higher in the knee area and Kellgren & Lawrence Grade I or II knee arthritis on X-ray were enrolled, with 60 subjects randomized to receive DKB-131 and 60 subjects receiving placebo. Following 12 weeks of consumption, the change in K-WOMAC total score assessed in the per protocol (PP) set revealed a reduction of 21.86±15.98 points in participants who received DKB-131 (p<0.0001), whereas those in the placebo group exhibited a reduction of 14.92±16.66 points (p<0.0001). This demonstrated a statistically significant difference between the test groups (p=0.0389). Additionally, significant differences were observed between the DKB-131 and placebo groups in the changes in K-WOMAC pain (p=0.0157) and physical function (p=0.0447). For the secondary efficacy endpoint, the change in Visual Analogue Scale (VAS) scores, analyzed in the PP set after 12 weeks of consumption, the test group showed a reduction of 17.82±13.80 mm (p<0.0001), while the control group exhibited a reduction of 11.81±13.99 mm (p<0.0001), indicating a statistically significant difference between the test groups (p=0.0359). Safety evaluations including hematological tests, biochemical tests, and urinalysis revealed no clinically significant differences between the consumption groups. Additionally, vital signs (pulse, blood pressure) and anthropometric measurements (body weight) did not exhibit clinically significant differences between the consumption groups, confirming the safety of DKB-131. We propose that the consumption of DKB-131 is safe for humans and may contribute to joint health. Trial registration (CRIS.NIH.go.Kr): KCT0008527

Mental Health Disparities Among LGBTQ+ Youth and The Strategies to Promote Their Well-Being

Jun 2024 DOI 10.14302/issn.2641-4538.jphi-24-5106

Introduction Compared to their heterosexual counterparts, cisgender LGBTQ+ youth are more likely to experience numerous mental health conditions, for instance, suicidal ideation, stress, and anxiety. This study aimed to explore mental health disparities among LGBTQ+ youth while identifying strategies to promote their well-being. Methodology Incorporating a systematic approach, studies were selected according to the predefined inclusion criteria, ensuring recentness and relevance. Five databases were systematically searched while the PRISMA flowchart was employed for illustrating the systematic selection process. The PEO framework directed the study selection. Thematic analysis was applied to identify themes that were related to the study aim. Results Five themes were emerged including policy changes and legal frameworks, contextual and cultural factors, family and social support, underlying factors of mental health, and healthcare services access. The synthesis of the literature uncovers the multifaceted relationship between cultural and contextual factors and policy changes, social and family support and healthcare services. The study also underlines the importance of implementing an intersectional minority stress model for comprehensively understanding mental health disparities among LGBTQ+ youth. Conclusion The results emphasize the importance of ongoing research in policy alterations, accessibility to healthcare, and creating supportive surroundings to tackle differences in mental health. Recognizing the complexity of these issues, this paper requires an in-depth examination that considers intersecting factors, promotes inclusivity, and involves long-term studies in providing mental health support to enhance the well-being of LGBTQ+ young individuals.

Changes in Cellular Morphology in Bronchoalveolar Lavage Fluid of Children with Mycoplasma Pneumoniae Pneumonia

Apr 2024 DOI 10.14302/issn.2641-4538.jphi-24-5044

Objective To study changes of cell morphology in BALF in children with Mycoplasma pneumoniae pneumonia (MPP). Methods From December 2021 to May 2022, a group of 32 children diagnosed with Acute MPP and admitted for treatment in the Pediatrics Department and PICU of the First Affiliated Hospital of Xinxiang Medical University were selected for our study. These patients underwent bronchoalveolar lavage as part of their clinical assessment. For comparison, we included a control group comprising 10 children who were not infected but had bronchial foreign bodies. We investigated the cellular composition in the bronchoalveolar lavage fluid (BALF) using Wright-Giemsa staining and microscopic evaluation, aiming to understand the relationship between shifts in cell proportions and extra-pulmonary symptoms associated with MPP. Results In this study, a total of 42 cases were enrolled, with 32 cases in the study group and 10 cases in the control group. There were no statistically significant differences in gender, age, height, weight, and BMI between the two groups (p > 0.05). The study group exhibited significantly higher levels of neutrophil percentage (GRA%), CRP, D-dimer, and LDH in blood routine tests compared to the control group (p < 0.05). Furthermore, the proportions of neutrophils (%) and macrophages (%) in BALF were significantly higher in the study group compared to the control group (p< 0.05), while the proportion of lymphocytes (%) in BALF showed no statistically significant difference between the two groups (p> 0.05). Conclusion In the acute phase of MPP in children, BALF is predominantly composed of neutrophils. A lower proportion of lymphocytes in BALF is associated with a higher incidence of extra-pulmonary manifestations and longer hospitalization duration.

Hodgkin's Lymphoma In Low-Income Countries: Experience Of Togo

Mar 2024 DOI 10.14302/issn.2372-6601.jhor-24-4962

While highly curable in developed countries, Hodgkin's lymphoma (HL), remains a significant challenge for resource-limited ones. This study aimed to describe the profile of HL in Togo. This was a retrospective, descriptive study conducted at the Clinical Hematology Department of the Campus University Hospital Center in Lomé, Togo. It focused on patient records diagnosed with HL between January 1, 2006, and December 31, 2022. Various variables such as age, gender, histological type of HL, Ann Arbor stage, prognostic classification, therapeutic protocol used, and patient outcomes were examined. The annual incidence of HL was 1.5 with a mean age of 38.7 years (range 12-63). Lymph node enlargement was the primary clinical sign (100%). Histologically, classical HL was found in 21 patients (87.5%). Staging was conducted for 16 (66.7%) patients, among whom 11 (66.7%) were at an advanced stage, and 6 (37.5%) had an unfavorable prognosis. The ABVD protocol was used in 13 patients (54.2%), receiving between 1 and 6 cycles. One patient achieved complete remission (4.1%), three deceased (12.5%), and 17 (71%) were lost to follow-up. Hodgkin's lymphoma prognosis remains unfavorable with low remission rates in Togo. Improving the technical facilities will ensure better management of this lymphoma.

Investigation of Physical and Mental Fatigue, Perceived Social Support and Quality of Life in Greek Social Workers: The Role of Demographic and Occupational Characteristics

Feb 2024 DOI 10.14302/issn.2641-4538.jphi-24-4928

The present study focuses on the investigation of fatigue, social support and quality of life that characterizes social workers. Furthermore, the study aims to highlight the effect of demographic and occupational characteristics on the above factors. A total of 400 social workers with an average age of 39.05 years took part in the research. Most were women, single, residents of cities of more than 100,000, and health care workers. Participants were asked to answer online questionnaires (FAS for fatigue, MSPSS for social support and GHQ-28 for quality of life). From the analysis of the data, it was found that the level of fatigue of the social workers is at low levels. At the same time, the level of occurrence of negative symptoms is also low, with physical symptoms appearing more often than the rest. Participants receive a high level of support from their environment, and more so from the "significant other" in their life. Finally, it was found that the fatigue, social support and quality of life of social workers is affected by the age of the social workers, the total years of service, gender, marital status, place of residence, employer and position of responsibility.

Women's Mental Health Open Access

Rights of Women with Mental Illness (WWMI): Nigeria in Context

Dec 2023

Introduction This study addresses the critical issue of the rights of Women with Mental Illness (WWMI) in Nigeria, emphasizing the intrinsic link between mental health and human rights. Recognizing the unique challenges faced by women, particularly those with mental health conditions, is essential for achieving global goals related to well-being and gender equality. The aim of the study was to explore the rights of women with mental illness in Nigeria, factors that may be responsible for the difficulty in ensuring that the rights of women with mental illness in Nigeria are protected, and then provide policy suggestions to combat the highlighted challenges. Method A comprehensive literature review was conducted, utilizing databases such as PUBMED, Google Scholar, and African Index Medicus. Key search terms included Women’s rights, Human rights, Mental Health, Nigeria, and UN SDGs. Results The studies selected for the review focused on highlighting the challenges faced in women mental health rights, and identified socioeconomic, traditional and cultural factors as the major challenges to the protection of WWMI. Conclusion The study revealed a complex interplay of societal, cultural, and economic factors contributing to the abuse of rights among WWMI in Nigeria. However, to begin to resolve these challenges, it proposed the need to visibly increase female representation in policy-making, enhance mental health access, and target research efforts. Addressing these issues is crucial for upholding the fundamental human rights of WWMI, ultimately leading to improved mental well-being within society.

Aging and the Pandemic Care Triangle: A View from a Barcelona

Dec 2023 DOI 10.14302/issn.2474-7785.jarh-23-4794

This triangle of care is the result of an ethnographic research conducted with hard pandemic restrictions in Barcelona during 2020. Even if it is based in a bibliography on gender and migration, care and aging, the article is basically empirical. For the interpretation of the debates and discussion groups carried out, we identify here: the elderly person (as we have seen in the interviews in the previous article, Natalia-Ribas Mateos and Herrera 15,“The care debate during the first covid lockout in Barcelona); the caregivers - from family members to hired workers, especially immigrant women- and thirdly, as the third aspect of the triangle, and which remains in this article more blurred, from municipal and health public services. The pandemic highlights the existing systemic inequalities, particularly affecting the elderly, but also migrants and ethnic minorities, people who work in the care sector, and health personnel.

Diseases Open Access

Epidemio-Clinical Profile of Acute Diarrhea in Children From 0 To 5 Years and Prevalence of Rotavirus Before and After the Introduction of the Rotasiil Vaccine in the Democratic Republic of Congo.

Jul 2023 DOI 10.14302/issn.2997-1977.jd-23-4588

Introduction Acute diarrhea remains one of the major health problems in developing countries. According to the WHO, rotavirus contributes to approximately 40% hospitalizations and is the leading cause of severe diarrhea in children 0-5 years old. The objective was to determine the prevalence of rotavirus and the sociodemographic and clinical profile among children with diarrhea in 4 hospitals in the DRC. Methods This study is documentary, retrospective and analytical taking two periods, before and after introduction of the vaccine, i.e. January 2017 to December 2018 and January 2020 to December 2021 in 4 hospitals, i.e. 2 in Kinshasa and 2 in Lubumbashi. Results Total 1872 children, 924 (49.4%) of whom were enrolled before the introduction of the vaccine and 948 (50.6%) after. Only 1737 had performed serology, of which 875 (50.4%) were rotavirus positive and 862 (49.6%) were negative. Positive results, a reduction of 30.6% is noted since the introduction of the vaccine. The predominant age range was 6 to 11 months. The male gender was predominant at 56.7%. Diarrhea was found in 88.5%, vomiting in 73.7% and fever in 73.9%. Before vaccination, the risk was more: 11 times to have diarrhea, 9-10 times the frequency between 3-10 times a day, 9 times vomiting, 2 times fever and 2 times to have a positive result. Conclusion From this study, we note a reduction frequency due to diarrhea unlike previous years, probably attributable to the vaccine.

Disability and prognostic factors of MS severity: An Algerian cohort study

Jul 2023 DOI 10.14302/issn.2470-5020.jnrt-23-4576

Background The evolution of multiple sclerosis (MS) is highly variable. Predicting this evolution at the beginning of the disease will help in the therapeutic management. The objective of this study was to describe the clinical characteristics and to identify early predictors of long-term disability among MS patients in Algeria. Methods We performed a descriptive and retrospective study of 400 MS patients followed over a 4-years period from July 2012 to July 2016 in the neurology department of Mustapha Bacha hospital in Algiers. The following parameters were systematically assessed for each patient: Age at onset, gender, relapses, initial demyelinating event, interval between first and second attack, residual deficit after first attack, onset of the progressive course, time of assignment of the successive scores of irreversible disability and type of disease modifying therapies. Univariate and multivariate Cox models were used to determine factors influencing time to Expanded Disability Status Scale (EDSS) 4 and 6. Results During the follow-up of this cohort of MS patients, a total of 144 (36%) and 83 (20%) patients reached EDSS scores 4 and 6 respectively. The median times from the onset of MS to assignment of a score 4 and 6 was 10 years and 19 years, respectively. Using the MSSS severity score, and after univariate analysis we identified several risk factors predictive of disease severity. These included male sex (P= 0.002), age of onset ≥ 40 years (P= 0.001), pyramidal (P= 0.0001), cerebellar (P= 0.002), and poly-symptomatic (P=0.0001) onset of the disease, incomplete recovery after the first attack (P= 0.0001), a high number of attacks during the first 2 years (P= 0.04) and the progressive form (P=0.001), and all these factors were correlated with a high MSSS score. However, prognostic factors in the multivariate binomial logistic regression analysis were limited to pyramidal onset, incomplete recovery after the first attack, short interval between the first and second attack, and progressive onset. Conclusion On the whole, the early predictive factors of disability in MS among Algerian patients were age of onset over 40 years, pyramidal onset, incomplete recovery after the first attack, short interval between the first and second attack and progressive form at onset. To increase the generalizability of findings, a national MS registry is strongly recommended, as well as long-term follow-up epidemiological studies.

Attitude of Nursing Students towards LGBTIQ Individual and its Associated Factors in Kathmandu Metropolitan City

Apr 2023 DOI 10.14302/issn.2641-4538.jphi-23-4412

Background People may have both negative and positive attitudes about other people, their way of living and those attitudes can be influenced by various factors. LGBTIQ individuals are facing various difficulties and barriers to run their daily life due to different attitudes of people. Attitudes may be different from person to person influenced by their knowledge, acceptance behaviour and understanding. By finding out the associated factors that influences the attitude of people we can change people’s view towards LGBTIQ individuals. Each and every person deserves to be treated equally regardless of their gender, sexual orientation, and preferences. Methods This was a cross-sectional study in which the sample size was 423 and the study population was nursing students. A simple random sampling method was used to select sample for the study. Self-administered questionnaire was used to collect data. The collected data was entered in EPI 3.1 and analyzed using SPSS 25. A descriptive statistic was used to find out the frequency and percentage and analysis (chi-square) was used to find out the association between the dependent and independent variables. A p-value of <0.05 was considered statistically significant. Results Results showed that 87.2% have positive attitudes towards LGBTIQ individuals, and the majority (56.6%) have knowledge about homosexuality. Similarly, more than two-thirds (82.7%) of respondents were not homophobic, and 50.4% showed positive stereotypes about LGBTIQ individuals. Religion (p=0.030), caste (p=0.001) and Family type (p=0.016) were statistically significant with regard to the attitudes of students towards LGBTIQ. Conclusion The majority of students had positive attitudes towards LGBTIQ individuals and few had negative attitudes. Almost half of the respondents had adequate knowledge about homosexuality. The majority of students were not homophobic and few were homophobic. Half had positive stereotypes and about other half had negative stereotypes.

Stemming The Tide Of Hypertension In Women: Optimal Age For Obstetric Debut

Mar 2023 DOI 10.14302/issn.2474-3585.jpmc-23-4442

Objective Women have continued to bear a heavy burden of cardiovascular disease morbidity and mortality with hypertension as the flagship. This is partly because as the modifiable cardiovascular disease risk factors are falling in rate, gender specific risk factors have persisted. One of them is age at first pregnancy and delivery. Methods In order to contribute to this discourse, we secondarily analysed data generated in a previous field study on risk factors for cardiovascular diseases in free living adults in Plateau State, Nigeria. The women were divided into four groups and we looked at blood pressure at the time of study from the perspective of age at first pregnancy. Reults It was found that those who had their first pregnancy in the late teenage years had the lowest mean arterial blood pressure many years down the line; better than those who started child bearing earlier and those who started later. There was also significant within and between group differences in the blood pressures (p = 0.000). Conclusion To stem the tide of female hypertension later in life, child bearing should not start in the early teenage years nor be unnecessarily delayed. Sociocultural conditions that promote early teenage marriage and pregnancy should be discouraged.

Acute Effects of White Button and Shiitake Mushroom Powder Supplementation on Postprandial Lipemia and Glycemia Following a High-Fat Meal

Feb 2023 DOI 10.14302/issn.2379-7835.ijn-23-4430

Background To determine the acute effects on postprandial lipemia and glycemia by supplementing a high-fat meal with either white button (WB) or shiitake (SH) mushroom powder. Methods Nine healthy participants (4-male, 5-female, 23.3±1.3 years, 17.8±6% body fat, 56.2±11.4kg fat free mass) consumed a control hamburger. At one-week intervals, after consumption of a control meal, participants consumed hamburgers in random order, supplemented with 14g of either WB or SH mushroom powder. Peripheral blood for lipids (triglycerides, high-density lipoprotein HDL, low-density lipoprotein LDL), and glucose was obtained at baseline (t=0 hours) and postprandially every two hours for six hours. Data were analyzed using linear mixed effects models. Results Lower LDL levels were observed for both SH and WB burgers compared to the control burger (p=0.0007) over the six-hour period. Mushroom powder content did not alter triglyceride, HDL, or glucose levels. Gender affected triglyceride and HDL levels over the treatment course. Triglyceride levels were higher in males (p=0.0084), and HDL levels were lower in females (p=0.0005). Triglyceride and glucose levels were higher, (p< 0.001 and p< 0.0001 respectively), during the postprandial time course (t=0, 2, 4, 6 hours). Conclusions Supplementing SH or WB mushrooms during a high-fat meal may lower serum LDL levels.

Abdominal Aortic Aneurysms: Epidemiological, Clinical and Echographic Aspects in The Health Structures of Lomé and At The Kara University Hospital (TOGO)

Jan 2023 DOI 10.14302/issn.2329-9487.jhc-22-4362

Objective To describe the epidemiological, clinical and arterial Doppler ultrasound aspects of abdominal aortic aneurysm (AAA). Material and Methods This is a prospective study with descriptive and analytical aims carried out from January 2019 to March 2022 (3 years) at the cardiovascular exploration center (CEC) "Saint-Esprit" of the association of the people's doctors for the research on cardiovascular diseases (AMP-MCV), at the clinic "Le Printemps" and at the University Hospital of Kara. All patients who underwent arterial Doppler ultrasound of the lower limbs for any reason in these centers during the study period were included. Ultrasound scans were performed or confirmed by a physician with a diploma specializing in vascular Doppler ultrasound. Results We retained 32 Doppler ultrasound scans out of 739 performed for AAA with a frequency of 4.38%. The mean age was 73.5± 9.07 years. The sex ratio M/F was 1.4. The cardiovascular medical history (84.38%) found was: hypertension (33.33%), diabetes (18.52%), dyslipidemia (33.33%) and a combination of diabetes and hypertension (14.81%). The circumstances of discovery were: downstream MI ischemia (72%), incidental finding on abdominal ultrasound (15.63%) and De bakey sign (6.25%). The location of the aneurysms was subrenal (84.4%), suprarenal (9.4%) and both (6.2%). AAAs were fusiform (71.9%) and saccular (28.1%). The size of the aneurysms was greater than 5 cm in 78.17% of patients. High blood pressure increases the probability of the occurrence of subrenal AAA while dyslipidemia increases the occurrence of fusiform AAA. Diabetes increases the probability of occurrence of AAA larger than 7cm. AAAs were thrombosed in 75% of patients. There were extensions of the aneurysms to the iliac arteries in 70.59%. Downstream embolic complications represented 46.88%, in the form of occlusions and tight stenoses. Spontaneous mortality was 81.24%. Conclusion Arterial Doppler ultrasonography is a very important tool in the screening, positive and lesion diagnosis of AAA. The risk factors for AAA are: age over 60 years, male gender, hypertension, diabetes and dyslipidemia. Early detection remains essential, because the spontaneous prognosis is poor.

Common Clinical Presentations of GBV Survivors Seen Between 2020-2022 at a GBV Clinic in a Tertiary Care Referral Facility in South East Nigeria

Oct 2022 DOI 10.14302/issn.2381-862X.jwrh-22-4228

Background Gender based violence (GBV) refers to any violence targeted at an individual or group on the basis of their gender. It could occur in different forms with several clinical manifestations. The authors have described several clinical manifestations of GBV in a tertiary health centre, knowledge of which would help in case identification and early clinical management. Methods Retrospective descriptive study of all clients seen at a gbv clinic over a sixteen months period.Data was obtained from case records and clinical presentations were entered into excel. Data analysis was done usingIBM SPSS Statistics for Windows, version 25. The results were presented in frequency tables and graphs Results Of 86 clients studied, 56(65.1%) were of pediatric age (< 18years) while 30(34.9%) were adults with a mean age of 18.33+11.64(range 1-64years).72(82.6%) belonged to the low social class. Physical abuse in the forms of battering, human bite, walking and sitting disturbances, hearing loss possibly from slapping or hitting and red eye possibly from trauma on the eye, constituted 37.6% of the clinical presentations. Other presentations were; sexual abuse in the form of forced sex which constituted 34.9%, while gynaecological / obstetrics presentations in the forms of bleeding per vagina, pregnancy due to forced sex and vaginal pain made up 13.9%. Emotional/psychological abuse was observed in all clients irrespective of their different presenting complaints. Conclusion While various forms of physical abuse were common, emotional abuse was present in all clients but masked probably due to prioritization of physical injuries. Therefore we recommend that all GBV survivors be screened for psycholocal abuse and psychotherapy given.

The Impact of Chest Computed Tomography in A Covid-19 Reference Hospital - First Wave - Distrito Federal - Brazil

Sep 2022 DOI 10.14302/issn.2692-1537.ijcv-22-4328

Objectives To evaluate the diagnostic accuracy of chest CT for the diagnosis of COVID-19 associated with the clinical presentation and in relation to the PCR-RT. Sensitivity, specificity, positive predictive value and negative predictive value, gender, age group and degree of lung involvement will be evaluated. Methods We evaluated 1545 patients with chest CT, delineating the age range and degree of lung involvement, and 306 patients with chest CT and PCR-RT. Results Of the 1545 examinations, 53% were men and 47% were women, there was greater involvement in the 50-59 age group. In the pulmonary study, 55.05% were COVID-19. In the degree of lung involvement 37.70% were mild, 35.76% were moderate, and 26.54% were severe. In the distribution by age, there was a greater involvement between 50-59 years with 56% between moderate (27.6%) and severe (28.0%). Between tomography and PCR-RT, the sensitivity was 68.8%, specificity 59.5%, accuracy 91.3%, with prevalence 31.9%, positive predictive value 44.3% and negative predictive value 80.3%, in females, sensitivity 55.3%, positive predictive value 37.1%, negative predictive value 75.3%, in males, sensitivity 81.6%, positive predictive value 50, 6 and negative predictive value 86.6%.The sensitivities are different between the genders with p of 0.005 and specificity of 0.938, with age effect, starting at 45 years we have a p of 0.057 that decreases to 0.006 at 80 years for sensitivity and specificity. Conclusions The sensitivity and accuracy of CT scan in relation to PCR-RT was significant. Sensitivity increases with prevalence and in the older age group and in men.

From High-Risk Behaviors to Problem-Solving Strategies: Acceptance and Commitment Therapy Effects on Addiction Susceptible Adolescents in Cyberspace

Oct 2021 DOI 10.14302/issn.2643-6655.jcap-21-3922

This study aimed to evaluate acceptance and commitment therapy (ACT) effectiveness in reducing high-risk behaviors and elevating problem-solving strategies in adolescents with addiction susceptibility in cyberspace. This study is longitudinal with quantitative methods of data collection and analysis. The target community in this research was 60 female students randomly selected from a Persian high school in Iran. Participants were randomly divided and placed equally into the experimental and control groups. The participants’ entry criteria were gender, aged from 15 to 18 years, addiction susceptibility, and high-risk behaviors cut-off points. Eight training sessions of ACT were presented in cyberspace for the experimental group between the pre-test and post-test intervals. Data collection instruments were the Iranian youth risk-taking scale, problem-solving strategies, and Iranian adolescents’ addiction susceptibility questionnaires. Participants were followed up after two months. The results using multivariate analysis of among subjects ANOVA showed ACT significantly influenced high-risk behaviors and its’ sub-scales except for the violence (p < .001).Furthermore, ACT affected the problem-solving strategies and its’ sub-scales instead of control, creativity, and confidence (p < .001). According to the findings, ACT decreased high-risk behaviors such as drug abuse, smoking, and unprotected sexual behaviors. These changes might be due to decreased helplessness and avoidance as well as increased acceptance and tendency to solve problems. Instead, problem-solving strategies were improved through ACT cyber treatment.

Human Psychology Open Access

An Investigation of Emotional Intelligence and its Association with Self-Efficacy at Higher Education Level in Pakistan

Aug 2021 DOI 10.14302/issn.2644-1101.jhp-20-3655

The present study examined the effects emotional intelligence on self-Efficacy of tertiary education students. Two scales Schutte Self-Report Emotional Intelligence Scale 44 and Schwarzer & Jerusalem Self Efficacy Scale 47 were used. The pilot study was conducted to assess the reliability of the instrument and main study was conducted to assess the results on sample of the study. A sample of 50 students (25 males, 25 females) were taken from universities of Islamabad and Rawalpindi. Both questionnaire were administered to the sample. The psychometric properties of pilot study were found satisfactory. In second phase main study was conducted which considered of sample of 200 university students (100 males and 100 females). The psychometric properties of main study were also satisfactory. Scores were analysed using SPSS software. Results of demographic variables such as age, birth order, mother education, father education and number of siblings are positively correlated with both scales and sub scales. The results were significant at (p<0.05) of mean differences with gender, education and family system. This survey consists of three hypotheses, which were accepted.

Proportion of WaterBorne Diseases in Children Aged 0 To 5 Years in the Health Area of the Urban Dispensary in Ebolowa - Cameroon

Jul 2021 DOI 10.14302/issn.2641-4538.jphi-21-3897

Background Water-related diseases are water-related disorders of the body. They are a public health problem as they are responsible for 60% of infant mortality in our developing countries. There are few studies in South Cameroon on the subject. Overall Objective of this work was to study the explanatory behavioral factors of waterborne diseases in children aged 0 to 5 years in the health area of the urban dispensary in Ebolowa in Cameroon in 2020. Methodology This was an analytical cross-sectional study comparing two groups of children (group 1: children affected by waterborne diseases group 2: children unaffected by waterborne diseases) within the health area of the Ebolowa urban area. It lasted 21 months and the study period was from 28 December 2020 to 22 January 2021. We included children aged 0 to 5 years present in households where parents/guardians gave their informed consent. Sampling was probabilistic and cluster sampling. Using the Kelsey formula, we obtained a sample of 420 households and 566 children. Data was collected using a questionnaire and stored in the Excel spreadsheet and analyzed with CDC USA's epi info software 7.2.2.6. The calculation p value was done with Stat Calc at the significance threshold of 0.05. Bold The proportion of waterborne diseases was 97% (549/566) among the children aged 0 to 5 years surveyed. The most common reasons for using the health service for children aged 0-5 years were diarrhea 78.62% (IC75.06-81.80), and malaria 78.09% (74.09-81.30). The median age of children suffering from these pathologies was 36 months (24; 60). The gender ratio (Boys/Girls) was 2.06/1. Conclusion We propose to increase the awareness of mothers/guardians on good practices; also, to increase health promotion in the fight against waterborne diseases.

“Happy Village” Concept Helping Villages to Face COVID-19

Jun 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3758

“Health Promoting Village” concept named as “Happy Villages” started in 2007 in Badulla District in Uva Province was a community mobilization process through which village communities have been empowered to look after their community health. The areas included were Early Childhood Care and Development (ECCD), Non-Communicable Diseases (NCD) prevention , Alcohol and drug abuse. Gender Based Violence. The programmed used many interactive tools as “Mood Chart” or “Happiness Calendar” which was giving a visualizing effect. Continuous assessments done from 2009 to 2013 showed that the Health promotion strategies used in the Happy Village concept in the Uva Province can effectively and efficiently be utilized for improvement of nutrition and achievement of milestones in children. From 2017 a National program is launched named “Happy Villages”. During the Covid 19 outbreak health promotion approaches were initiated to change in lay communities successfully. Villagers had actively engaged, collectively acted in responsible manner, and identified measures to prevent COVID-19 transmission in their households, neighbourhood and community. The use of village empowerment had become a fruitful source to face the Covid pandemic in Sri Lanka. Almost 300 “Happy Villages” around the country have made facing the Covid epidemic their chief task. Many innovative ideas and practices in facing Covid 19 pandemic at village level including a visualizing calendar to identify the risk behaviours of the family members as well as the Happiness calendar to identify the family stress levels are among them. Health promotion concept is getting rooted around the country with active participation of the villages with a multisectoral support. Continuous monitoring and evaluation and sharing best practices will show the world the effectiveness of Health Promotion and the ability of empowered people in facing pandemic situations

The Sweet and Sour of the Sugar-Sweetened Beverage Tax

Apr 2021 DOI 10.14302/issn.2379-7835.ijn-21-3780

Obesity is a common and preventable Non-Communicable Disease that is of great importance. Population-based interventions are recognised to have a profound effect on improving health outcomes. One of these approaches includes the adoption of the Sugar-Sweetened Beverage (SSB) Tax. Objectives There were three objectives, 1) explore the associations between gender, age, nationality, and change in SSB consumption, 2) explore SSB consumption during Covid-19 lockdown, and 3) inform policy decision making. Methods A cross-sectional survey in the United Arab Emirates. We performed descriptive analysis and chi-square for independence to test the difference between the expected and the observed frequencies in one or more categories. Results Since the introduction of SSB tax, change in SSB consumption by gender, age or nationality was not statistically significant. Further analysis of the proportion of sugar intake per day was statistically significant (P-value <0.001) by nationality. There was no statistically significant change in SSB consumption by age, gender, or nationality during the Covid-19 lockdown. Further analysis within the group that reported change in SSB consumption suggests a majority (80.5%) reported a reduction in SSB consumption. Conclusions Change in SSB consumption by gender, age or nationality was not statistically significant since the introduction of SSB tax, or during Covid-19 lock-down; thus, we accept the Null Hypothesis. Imposing a levy on frequently consumed SSB or revisiting levy by the gram, volume, or type of added sugar (or in combination) may prove to be more effective in reducing SSB consumption. Further research is needed to determine the extent other demographic factors influence SSB consumption as well as the enablers and barriers associated with SSB consumption. 

Human Psychology Open Access

Power Imbalances Among Intimate Partners in Obio-Akpor Local Government Area

Mar 2021 DOI 10.14302/issn.2644-1101.jhp-21-3753

People tend to believe that power imbalance that women and men experience in an intimate relationship is natural, the way it should be and of course, something that should not be debated. The problem with this argument and/or generalisation is that it usually suggests that hegemonic masculinity should not be interrogated. In Africa, power imbalances are one of the challenges that have limited women in society. This practice is influenced by culture, religion, traditional practices and laws which influence perceptions, and expectations of people in intimate relationships. This study, Power imbalances among intimate partners in Obio-Akpor Local Government Area encapsulate the dynamics of gender power relations that exist in intimate, heterosexual relationships in four communities. This study seeks to examine intimate partners’ perception of decision making, the extent of its social acceptability and relevance of their socio-economic circumstances towards power imbalances. The population for this study was twenty-seven thousand three hundred and fifty-five. Sample size was calculated using the Taro Yamame determination technique which stood at three hundred and ninety-four. The study employed a survey research design which consisted of twenty-two items on a four-point Likert scale of (Agree, Strongly Agree, Disagree, and Strongly Disagree). Simple percentage (%) and frequency table was used to analyze the data. The study found that partners socio-economic circumstances did not reflect a significant degree of influence on power imbalances. This study therefore, recommend for responsive gender equality programmes that support and empower both partners.

Variations in Diameter of the Left Coronary Artery and its Main Branches among Adult Population of Khartoum State, Sudan

Mar 2021 DOI 10.14302/issn.2329-9487.jhc-21-3754

Themain left coronary artery and its branches have wide variability in its morphology regarding caliber, as seen through angiographic imaging. This study aims to determine the diameters of the left coronary artery and its branches among the Sudanese population & to correlate these diameters and the personal and health data. Angiography of 441 patients of both sexes was used in this study. Personal and health information was obtained from the records. We found that the left coronary artery's diameter was between 2.90- 4.90mm, with an average of 3.96mm. The diameter of the left circumflex artery in the range between 1.70- 4.70mm, with an average of 2.73mm, and that of the anterior descending artery in the range between 1.20- 4.70mm, with an average of 2.78mm. We correlated the diameters of the three arteries and the variables of age, gender, BMI, coronary artery disease, smoking habits, and hypertension. Wefound many correlations to be significant. We concluded that the diameters of the left coronary artery and its branches are affected by age, gender, BMI, coronary artery disease, smoking habits, and hypertension.

The Influence of Siblings on Young Children’s Understanding of Fluid Intake

Feb 2021 DOI 10.14302/issn.2379-7835.ijn-21-3709

Background Children need to drink enough water (1.1-1.3 litres) throughout the day to stay hydrated and for health benefits1. Wellbeing and cognitive function benefits have been identified for children who are hydrated2. Yet there is a dearth of research focusing specifically on children’s perceptions of their own fluid intake levels and who helps support them in ensuring they are drinking enough water, this is a novel area to investigate. Previous research3 identified that 44.2% of young children’s fluid intake were influenced the strongest by a family member. This paper will explore in further detail the influence of siblings on children’s fluid intake, in particular older versus younger siblings. Methods 130 children (67 girls and 63 boys, of which 45 had a younger sibling (s) and 85 having an elder sibling(s), from 4 primary schools in the South East of England, were questioned between January and April 2019 using an adapted version of Coppinger and Howells’ (2019)4 questionnaire, on their understanding of fluid intake, how much they perceived they drank and who supported them in prompting them to drink. Physical visual representations were used to aid question comprehension and to ensure the questions were appropriate for young children. The data was analysed using SPSS 24.0 using MANOVAs (P < 0.05) to consider statistical variance in gender and older sibling status. Results The most significant results were linked to elder siblings influence younger siblings in drinking too little fluids within a school day (F=0.530, p<0.05), whilst those without an elder sibling, thought they drank beyond the daily recommended guidelines and reported they drank over 2 litres. This illustrates that children misunderstand fluid intake recommendations regardless of whether they have an elder sibling or not. Children named adults, both parents and teachers as well as elder siblings as the key influencers of them drinking (F=3.67, p<0.05) and the data indicated that girls were more influenced by siblings than boys, whilst twins were not influenced by each other. Conclusion It is concluded that siblings do have an influence on the consumption of water, as siblings act as role models and other siblings follow their habits, therefore the whole family unit is important to ensure that the right fluid intake is consumed. It is recommended that further education, curriculum and community development is needed to continue to support young children’s knowledge and understanding of fluid intake.

Osteoarthritis, COVID-19 Social Isolation-Impacts, and Counter Solutions

Dec 2020 DOI 10.14302/issn.2474-7785.jarh-20-3682

Background to the Issue Many older adults, including those already suffering from chronically painful disabling osteoarthritis of one or more joints remain more susceptible than healthy age and gender matched adults to the COVID-19 corona virus. Aims This report sought to examine what has been published in 2020 on this health condition from the perspective of the variable of widely imposed social isolation strategies designed to mitigate the spread of this highly infectious disease, and to especially keep older community dwelling adults ‘safe’ from infection. Methods Reviewed were all articles published in 2020 in PUBMED from January 1-December 24, 2020 on osteoarthritis and COVID-19 isolation impacts, plus relevant past osteoarthritis and isolation literature among older adults. The focus was on ascertaining how social isolation and distancing strategies might impact current community-dwelling adults diagnosed with osteoarthritis and whether more should be done specifically to mitigate any potentially preventable ‘socially’ induced negative health impact among this group, in spite of the laudable goals of this public health strategy. Results Older adults with osteoarthritis living in the community who are asked to self-isolate, may incur more osteoarthritis pain and disability than would otherwise be encountered if actions taken to counter this possibility are not forthcoming. Advocated over and above basic care approaches are several psychosocial strategies including the role of mobilizing various forms of social support. Conclusion Data indicate a need for concerted thoughtful and immediate attention to offset isolation, fear, and anxiety and depression effects as part of a carefully devised integrated plan of management to reduce excess osteoarthritis disability, as well as excess COVID-19 risk among otherwise free living older adults already compromised by osteoarthritis.

What is the Level of Empathy in Medical Students of University of Ghana Medical School in Accra Ghana?

Dec 2020 DOI 10.14302/issn.2693-1176.ijgh-20-3613

Empathy has been described as a multi-dimensional construct with cognitive and emotional components, both of which are concerned about responsivity to others. It has been touted as a skill essential for medical practice and thus useful to all healthcare professionals. It has been assessed in several countries and among several healthcare cadres however, there is a yawning gap in Ghana about its level in medical students. This study utilised a cross-sectional design to assess empathy using the Multi-Dimensional Emotional Empathy Scale in medical students of the University in Ghana. The scale has an alpha reliability of 0.88. One hundred and eleven students, aged 24 years ±1.5 years completed the study. Overall, there were more males than females. The mean empathy score for the cohort was 101SD 13 and this was adjudged to be low. There was no statistical difference between age, gender and clinical year and empathy in this cohort. The authors recommend that empathy, especially its cognitive aspects, should be taught in medical school curriculum of the University of Ghana Medical School, Accra.

Awareness of Personal Protective Equipment Among Laboratory Workers in Tertiary Health Centre, Ibadan

Oct 2020 DOI 10.14302/issn.2690-4837.ijip-20-3562

Introduction Health care personnel are exposed to a variety of material occupational health hazards while handling biological material and contaminated equipment. The use of appropriate and good qualitypersonal protective equipment in work places cannot be over emphasized. Several years ago, this need was highlighted to several physicians like Sir Thomas Morrison Legye. He identified the role of the employer of labour and those of the employee in reducing workplace hazards and consequently achieving a healthy workplace environment. Objectives This study was to determine level of awareness and utilization of Personal Protective Equipment among Medical Laboratory workers. Methods A questionnaire was structured with two sections and a total of 92 were administered. A pilot study was also carried out before the administration of the questionnaire. The data collected was analyzed on Microsoft excel spreadsheet in duplicate. It was then exported into EPI info version 3.4.1. Data was presented using frequency tables and chi square. Results About 77.3%, 72.9%, and 72.7% were aware of the use of goggle, gloves, and importance of hand washing in preventing exposure to Healthcare associated infections while working on patients’ samples. However, under the socio- demographic characteristics of the respondents and awareness level at P-value < 0.5 the results were 0.02. 0.5, 0.85, 0.92 for education, gender, years in service and age respectively. Hence, there is no significant relationship between respondents’ gender, age and year in service, and level of awareness. Conclusion The hospital management should ensure regular provision and supply of Personal Protective Equipment (PPE) to ensure continual usage. Also, regular training and re-training should be conducted to keep the laboratory workers at briefs with latest innovative and benefits of PPE developments to this end.

Is Social Media Contributing to an Unhealthy Fixation with Health?

Sep 2020

Orthorexia Nervosa (ON) describes a pathological, unhealthy fixation with eating healthy food. This study intends to further understand ON and its possible link to the use of social media, and specifically, to test the prevalence of ON in an opportunity sample with the use of two ON measures – the ORTO-15 and the Tereul Orthorexia Scale (TOS); to use and validate a new ON measure (TOS); to examine the relationship between ON and social media use, with a focus on Instagram users; and to further understand the participants’ interpretations of the possible link between eating patterns and social media use. This study uses a convergent design and a mixed methods approach, which employs both statistical and thematic analysis (TA). Data from 201 participants suggested a high prevalence of ON across the sample, and the results also reinforced the validity of the TOS measure (α = .86). ORTO-15 scores showed significant differences between age groups, genders, and Instagram users and non-Instagram users. The TA generated three overall themes: ‘The Importance of Belonging’, ‘Health as Art’ and ‘Craving’. The high prevalence in the sample may have been a result of the researcher’s recruitment method, and the ON measures may have categorised individuals on non-medically prescribed diets as ‘orthorexic’. Both the quantitative and qualitative results offer evidence to support a possible link between ON and social media use, specifically Instagram. Further research should be done to establish official criteria and measures for ON and the effect of social media on eating patterns.

Zoological Research Open Access

Investigation of Emerging Risk Factors and Isolation of Potential Pathogenic Bacteria from Domestic Dog Stool in Port Harcourt Metropolis, Niger Delta

Sep 2020 DOI 10.14302/issn.2694-2275.jzr-20-3537

This study investigated the potential pathogenic bacteria that are associated with domestic dog stool in Port Harcourt Metropolis. Convenience sampling techniques were used for sample collection outcome. A total of fifty dog stool samples were collected aseptically into a sterile stool container from different locations (Agip Estate, Rumuokoro Community, Government Residential Area, Sand-fill Borokiri, Port Harcourt Township, and Rivers State University lecturers’ quarters) all within Port Harcourt City. Bacteriological analysis was determined using standard microbiological analytical and identification techniques. Statistical analysis was performed using Statistical Package for Social Science version 21 for frequency, percentage, prevalence rate and correlation at 0.01 and 0.05 level of significance. Potential pathogens with associated percentages that were isolated are E coli (20.0%), Klebsiella species (16.0%), Pseudomonas species (4.0%), Proteus species (28.0%), Bacillus species (4.0%), Staphylococcus aureus (14.0%), and unidentified [other Staphylococcus species] (4.0%). However, the research further revealed that Proteus species (28.0%), was the most prevalent pathogen, while Bacillus species (4.0%), Pseudomonas species (4.0%), and Streptococcus species (4.0%), were the least prevalent among pet dogs studied. The correlation analysis showed no significant relationship between isolates with socio-demographic data of pet owner and Pet biodata respectively. From the analysis, correlation coefficient values of .269 and .124 were obtained for Age of Pet Owner and Gender of Owner respectively. It also show a direct correlation but by implication, a very weak, non-significant (p<0.05) relationship existed between the organisms isolated and the variables (Age of Pet Owner and Gender of Pet Owner). However, no relationship exists between isolates and visit to vet Doctor (r-0.038; p>0.05). Furthermore, negative non-significant correlation (p>0.05) was observed for marital status of Pet Owner (r=-.158) and Age of Pet (r=-.023) and isolate. Also, correlation association between isolates and some risk factors using the correlation analysis matrix revealed an indication of an indirect but moderate association between isolates and Caressing (r=-.347, p=0.01). However, other risk factors like vaccination (r=.042), Feeding Pattern(r=.125), Pet Bathing (r=.220) and Eating with pet in same plate (r=.146), did not prove statistical significance at p>0.05. The results from the study strongly suggest that pet dogs carry potential pathogenic organisms in their faecal matter that can serve as a source of infection to the pet owners. It is, therefore, very critical that these pets should be treated and possibly vaccinated frequently, even as their faecal matters should be well disposed to prevent possible zoonotic infectious epidemic outbreak in our global communities.

The Vascular Convolutions-Papillary Endothelial Hyperplasia

Sep 2020 DOI 10.14302/issn.2471-2175.jdrt-20-3511

Intravascular papillary endothelial hyperplasia is an exceptional, benign, inflammatory, vascular neoplasm delineating papillary configuration engendered from reactive proliferation of damaged endothelial cells, while being confined to a thrombus. Initially scripted by Pierre Mason in 1923, the tumefaction was denominated as an intra-luminal lesion within an ulcerated, haemorrhoidal vein and designated as “hemangio-endotheliome’ vegetant’ intravasculaire”(1). The neoplasm is additionally nomenclated as Masson’s tumour,  Masson’s pseudo-angiosarcoma, endovascularite proliferante  thrombopoietique, intravenous atypical vascular proliferation, intravascular angiomatosis, vascular angiomatosis, intravascular endothelial proliferation, reactive papillary endothelial hyperplasia or intravascular papillary endothelial hyperplasia. The papillary neoplasm is associated with deposition of fibrin and thrombotic substances within a painful, ulcerated.

Model Based Research Open Access

Experimental Analysis PVP Coated Silver Nanofluid Properties for Application in Photovoltaic/Thermal (PVT) Collectors

Aug 2020 DOI 10.14302/issn.2643-2811.jmbr-20-3476

Nowadays, supplying energy for the global population has turned into a prominent issue for countries engendering the consumption of huge amounts of fossil fuels which leads to some serious environmental problems. Among the renewable energy technologies, solar collectors can play major role to improve the efficiency, in air conditioning utility systems by minimum pollution. In photovoltaic/thermal (PVT) solar collectors, which are currently considered as the most advanced type to produce electricity and heat simultaneously, working fluid absorbs Energy from photovoltaic (PV) module engendering to decrease temperature of PV module and increase the electricity efficiency and also provide permissible amount of heat for other residential applications. Meanwhile, utilizing nanofluid as the working fluid in collector, regarding that the nanofluid has enhanced thermal properties relative to the base fluid, leads to a higher collector efficiency. In this research, PVP coated silver nanofluid was prepared in three volume concentration being 250, 500 and 1000 ppm by two-step method. To assess the stability of nanofluid the zeta potential is calculated which is obtained -41.6 V. Also, the prominent thermal properties of the nanofluid were analyzed regarding PVT solar collector applications. According to the results, thermal conductivity of the PVP coated silver nanofluid, improves the properties of base fluid, to the extent that thermal conductivity coefficient grows up 50% in some temperatures and increased from 0.594 for base fluid to 1.098 W/mK by escalation of concentration to 1000 ppm. Thus, PVP coated silver nanofluid can be deemed as the vital working fluid to improve the performance of PVT solar collectors.

Factors Influencing Recovery among Children with Moderate Acute Malnutrition Treated at Kirehe District Health Centers

Aug 2020 DOI 10.14302/issn.2641-4538.jphi-20-3437

Acute malnutrition affects nearly 52 million of under five years children globally, 75% of them live in low to middle income countries. The treatment of acute malnutrition using supplement foods could help children recovering and could reduce the risk of sickness. The present study investigated the factors associated with recovery among children with moderate acute malnutrition (MAM) under a follow-up program at health facilities. A prospective study was conducted in 16 health centers of Kirehe District of Rwanda and included 200 children from 6 to 59 months. A semi-structured questionnaire was used for data collection. All children enrolled in the study spent three months in nutrition program at health centers. The results show that after 3 months in the program 77.5% recovered from MAM. Children aged above 36 to 59 months were recovered at 90% whereas children aged from 24-35 months were recovered at 73.5%. Micronutrients and deworming provided at health facility were contributed to the recovery as children who received them were recovered at 89.1% and for those who didn’t were recovery at 72.1%. The findings demonstrated that boys were 16 times more likely to recover from MAM in three months of intervention than girls (AOR=16.19, p<0.001, 95% CI: 5.39- 48.63). Children from moderate income families were 3 more likely to recover than those from very low income families (AOR=2.8, p=0.029, 95% CI: 1.11-7.51). Male gender, receiving micronutrients and deworming from health facilities and family income status were factors associated with MAM recovery status

Impact of Low Birth Weight on Early Vascular Aging and Cardiometabolic Phenotypes in Later Life Among Cameroonian Adults

Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3463

Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.

Climate Migrant Elderly Abuse and Neglect: A Study in Slums of Dhaka, Bangladesh

Apr 2020 DOI 10.14302/issn.2474-7785.jarh-20-3301

Bangladesh many older people spend their life in not only the unwell health but also in poverty which is major risk for the elderly population. This is especially true for older women, who suffer from various difficulties ensuing from prejudices to gender, widowhood and old age. Climate migrants start living in urban slums are in search of better and secure life. But urban slums located mostly in low lying environmentally hazardous area coupled with inadequate facilities like food, shelter, sanitation, health care make their life even worse. Older Women are the vulnerable groups in society in terms of climate change, movement; haphazard growth and unhealthy environment are the target group for this research. This study represents the nature and extent of elderly abuse of climate migrant urban poor women slum dwellers in Dhaka city in Bangladesh context. Besides, this paper also observe the socio-economic status of the study respondents and try to find out the self-stated reasons of elderly abuse. This study conducted both quantitative and qualitative types study on two slums of Dhaka with purposive sample survey, KII and in depth qualitative interview of selected climate migrant slum dwellers while purposive sample size of 50. Decreasing in earning capacity, inability and economic dependency, health hazard, maladjustment, changing social values have a separate role in the connection of older abuse. Planned migration, awareness program implantations against elderly abuse and secured socioeconomic factors are suggested through this paper to lessen exposure to further neglecting of elderly climate migrant women in urban slums.

The Follicular Impaction-Nevus Comedonicus

Apr 2020 DOI 10.14302/issn.2994-6743.ijstd-20-3272

Nevus comedonicus (NC) was initially described by Kofmann in1895 and scripted as a “comedo nevus”. Nevus comedonicus  is cogitated as an exceptional subtype of epidermal nevus engendered from the hair follicle and a lesion predisposition for face and neck. Nevus comedonicus syndrome with constituent nevus comedonicus was initially coined by Engber in 1978. Delayed milestones and deferred neonatal development can ensue with nevus comedonicus or nevus comedonicus syndrome12.

RETRACTED: Assessment of the Risk of Hemochromatosis in Polytransfused Sickle Cell Patients at the Abidjan Transfusion Therapy Unit

Apr 2020 DOI 10.14302/issn.2372-6601.jhor-20-3189

This article has been retracted on 29 January 2021. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2372-6601.jhor-25-5854) In Côte d'Ivoire, sickle cell disease affects 14% of the population. It is responsible for significant morbidity and mortality. Transfusion is a significant element in the management of major sickle cell anemia, which exposes them to post-transfusion hemochromatosis. The biological diagnosis is based on the determination of serum iron and the transferrin saturation coefficient (CST). As the determination of the CST was not available in our exercise context in Côte d'Ivoire, we determined only the ferritinemia. The interest of this work lies in the therapeutic implication linked to the identification of patients at risk of hemochromatosis because chelators are difficult to access for most patients. This was a prospective, descriptive and analytical study, on polytransfused sickle cell patients, followed at the transfusion therapy unit (UTT) of the CNTS of Abidjan, from 2010 to 2018. We included 78 sickle cell patients, all ages and genders who have received at least ten transfusions. The ferritinemia assay was carried out by ELISA. Transfusion exchange, with 59% of cases, was the most used mode of transfusion. The mean ferritinemia was 1719.19 ng / ml. Hyperferritinemia was found in 63% of patients. Most of the patients were on a long-term transfusion program with an average of 27.5 bags of red blood cell concentrates. Thirty-two patients had received at least 20 bags of red blood cell concentrates. We noted 21 patients treated, including 3 with deferoxamine and 18 treated with oral deferasirox. We have identified 33 sickle cell anemia patients at risk for hemochromatosis. The determinants of the risk of hemochromatosis were the high number of blood bags and the method of transfusion.

Assessment of Sex from the Anthropometric Measurements of the Foot in Ogbomosho North Local Government Area

Mar 2020 DOI 10.14302/issn.2577-2279.ijha-20-3254

The aim of this physical anthropometric study is to determine sex by foot measurements. Dismembered human remains are frequently found in cases of mass disasters and criminal mutilation. It is therefore of interest to use foot dimensions for the determination of sex (gender) of an individual in order to assist in establishing personal identity. Another application of anthropometrical measurement is in ergonomics which is the design of working space and the development of industrialized products such as furnishing, cars, tools, shoe designing etc. 500 adult subjects(250 males, 250 females)aged 18-50 years without any foot disability within Ogbomosho North Local Government, Oyo State were randomly selected for the study. The males had an average foot length about 1cm greater than females and foot breadth in males was about 1cm greater as compared to females. Difference in foot length and foot breadth in males and females of the population was highly significant. With the statistical analysis, any foot with length lesser than 26cm and breadth lesser than 11cm can be suggested to be that of a female while any foot with length greater than 26cm and breadth greater than 11cm can be suggested to be that of a male. Therefore, 26cm can be taken as the cut-off point for foot length and 11cm as the cut-off point for foot breadth in this locality.

Occupational and Environmental Health Benefits of Smoking ban not yet Arrived in Austrian Youth

Feb 2020 DOI 10.14302/issn.2690-0904.ijoe-20-3205

The aim was to record the smoking behaviour of 13- to 16-year-old Austrian pupils and to investigate changes in smoking behaviour following amendments of legislation and gender-specific differences. The survey took place in Vienna, Lower Austria, Burgenland, Styria and Carinthia and was conducted at eight different school types. The data was collected by means of a questionnaire in a group setting at the beginning of a school lesson. The completion of the questionnaire was anonymous. 95,1% of the returned questionnaires could be used for this study, yielding data from a total of 1029 young people for analysis. 38.4% of the participants stated that they had at least once consumed tobacco or related products, with girls having tried them more often (41,6%) than boys (34,9%) (p = .028). At the time of the study, 3,3% used tobacco daily and 4,6% several times a week; thus 7,9% smoke regularly. Although friends or family are the most popular type of acquisition for girls and boys, girls buy their tobacco products from vending machines (11,6%) much more frequently than boys (6,0%) (p = .014) and prefer normal cigarettes (p < .001). The results of this study show that while the number of adolescents who smoke daily is decreasing, the number of occasional smokers is increasing. Already 38,4% of the 13 to 16-year olds have had some experience consuming tobacco. Austria must take the measures recommended by the WHO to reduce the smoking prevalence and protect minors from the health damage caused by tobacco smoke.

The Genetic Multiplicity- Multiple Endocrine Neoplasia type I

Feb 2020 DOI 10.14302/issn.2690-4837.ijip-20-3176

Multiple endocrine neoplasia type 1 (MEN1) is a syndrome emerging from characteristic mutations of  MEN1 gene with concurrently enunciated  multiple endocrine and tumours and associated non-endocrine neoplasm. Previously designated as Werner’s syndrome, MEN1 syndrome denominates genomic mutation within  chromosome 11q13 or a  tumour suppressor  gene with a distinctive protein product nomenclated as “menin”. MEN1 syndrome demonstrates an autosomal dominant pattern of disease inheritance where genomic mutations delineate  a comprehensive (100%) disease penetrance. MEN1 gene was initially identified in 1997 upon chromosome 11q13. Although twelve genetic mutations were primarily identified, currently beyond eighteen hundred genomic mutations are scripted12. MEN1 syndrome is comprised of diverse combination of twenty or more endocrine and non-endocrine tumours exemplifying a classic triad of pituitary, parathyroid  and pancreatic  neoplasm. Diverse non endocrine tumours enunciated with MEN1 syndrome are denominated with meningioma, ependymoma or angiofibroma12. Endocrine tumours are discerned on account of excessive hormonal secretion engendered from various neoplasm or on account of neoplastic evolution. Approximately 10% instances can occur due to  a de-novo genomic variant. Offspring of an individual with MEN1 syndrome quantifies a 50% possibility of inheriting the genomic variant. Cogent prenatal diagnosis can be determined in instances where  specific genomic variant of a particular family is known. Physical, psychological and social restrictions are prevalent with MEN1 syndrome. Heterozygotes with MEN1 genetic variant are denominated as carriers and manifest a two- fold possible mortality12. 

The Prevalence of Schistosomasis among People in Almatama locality River Nile State, Sudan

Apr 2019 DOI 10.14302/issn.2324-7339.jcrhap-19-2711

This is cross sectional descriptive community based study to measure the prevalence of Schistosomasis disease, multistage cluster sampling was taken (500person), and the data was collected by the flowing methods, Urine Examination, Stool examination, and Questionnaire, the data was analyzed by using (SPSS) the main result for study Schistosomosis Hematoupium was 15% and Schistosomosis Mansoni was Zero, the prevalence was high in Tibaha Alkhwad administrative unit with 6.0%, Almata with 5.2% and Wedhamid with 3.8%. The study found there was strong relation between Shistosomasis and both genders (male, female) where the prevalence was high among male 10.8%, the study also showed there was strong relationship between Schistosomasis and age groups, The prevalence increases among age group (15 to 25 years )with (5.8%), There was strong significant relation between swimming in stagnant water and getting infected with Schistosomasis, The prevalence increases among people go to swimming in stagnant water with 11.0% (PV =0.0000 significant),

Could Painful Experience in the Neonatal Period Trigger Persistent Anxiety-Like Behavior?

Mar 2019

We used a behavioral test to investigate long-term consequences of neonatal noxious stimulus in the anxiety-like behavior and describe differences between males and females. Male and female Wistar rats were submitted to either tactile (control groups) or noxious stimulus (pain groups) since birth, for 15 days and were followed up to 6 months of life. Experiments were performed on days 15, 30, 90 and 180 after birth. Rats of different groups, ages and genders were exposed only once to the elevated plus-maze (EPM), an apparatus largely used to detect anxiety-related behaviors in rats. For the open arms of the EPM, control animals showed an increase in the number of entries from 15 to 30 days of age followed by a decrease of this number at older ages. The comparison between treatments (control and pain) showed, for males, a reduced number of entries in the open arms in the pain group at 15 and 30 days and the opposite situation at 180 days. No differences were found between pain and control groups in females. Our results are in agreement with the literature that shows sex-dependent changes following chronic stress; stress being anxiolytic in males and anxiogenic in females. We point to the fact that acute painful stimulus in the neonatal period caused persistent changes in anxiety-like behavior in the adult life, independently of previously described intrinsic gender differences on memory, task performance, attention bias or other behaviors.

Parasite Research Open Access

Bancroftian Filariasis Still Endemic in Some Foci in Sohag Governorate, Upper Egypt

Jan 2019 DOI 10.14302/issn.2690-6759.jpar-18-2510

Bancroftian filariasis (BF) is a debilitating disease that has plagued Egypt since the time of the pharaohs. Egypt is the first large endemic country in the world to reach the five-year mark in its national campaign. Now that the mass treatments are completed, a follow-up epidemiological assessment will reveal whether this large-scale, pioneering campaign has been successful in finally eliminating the disease. Hence the aim of the present work was to detect the prevalence of bancoftian filariasis in Tema, El-Maragha, Akhmeem and Girga districts in Sohag Governorate, Upper Egypt. Finger prick thick blood films were randomly collected from 500 clinically suspected individuals representing different sexes and ages suffering from lower limb non-pitting edema and/or inguinal lymphadenitis from May 2015 to February 2017. Three patients (0.6%) were infected with microfilariae of Wuchereria bancrofti while one chronic case was detected with severe chronic elephantiasis that was amicrofilaraemic but was confirmed serologically. Results were discussed in regards of age, gender, occupation, locality and residence. It was concluded that bancroftian filariasis is still endemic in three districts (Tema, El- maragha and Girga). Although in sporadic few cases, the problem should be taken seriously as one microfilaramic patient could be a patent reservoir for spreading of the disease through infecting the prevailing Culex pipiense mosquito intermediate host.

Ophthalmic Science Open Access

Accessibility and Barriers to Uptake of Ophthalmic Services among Rural Communities in the Upper Denkyira West District, Ghana

Jan 2019 DOI 10.14302/issn.2470-0436.jos-19-2602

Vision impairment and blindness remain a challenge in developing countries, especially in rural communities. Notwithstanding, VISION 2020 global initiative seeks to eliminate avoidable blindness by 2020. This community-based cross-sectional study aimed at determining the accessibility of ophthalmic services and barriers to its utilization in rural communities in the Upper Denkyira West District, Ghana. One-hundred and seventy participants from 5 randomly chosen rural communities in the district were included. Participants were interviewed using a structured questionnaire. Socio-demographic information, information regarding accessibility, utilization, and barriers to eye care services were obtained. Descriptive statistics were carried out using SPSS version 23. The Chi-squared test was employed to determine associations. P-values less than 0.05 at a confidence interval of 95% were considered significant. Only 21.8% of participants had had eye examination within the past 3 years, with over half of the examinations undertaken at screening grounds and health centres. Significant associations were found between ophthalmic services utilization and increasing age (p = 0.004), female gender (p = 0.027) and those who had a past history of eye problem(s) (p = 0.0010. The study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Public health education and eye care interventions should prioritize and target rural populations. Key Messages This study found gross inadequate utilization of ophthalmic services mainly due to unavailable ophthalmic services in the rural district. Rural dwellers were thus compelled to resort to harmful eye care practices. Public health education and eye care interventions should prioritize and target rural populations

Vitamin -D Deficiency: A Clinical Problem Searching For Solution.

Sep 2018 DOI 10.14302/issn.2328-0182.japst-18-2281

The role that Vitamin D plays in human health is no more hidden in this modern age where every individual carries the knowledge treasure in the pocket (The internet) but the unjustified deficiency or insufficiency is still a research question waiting for the answer from research community all over the world. Normal levels (30-50 ng/ml) are necessary for the development of teeth and bones in children and bone mineralization in adults. The deficiency or insufficiency causes rickets, arthralgia, arthritis, osteoporosis and Osteomalacia. Study Design: Observational study. Study Setting: Department of Orthopedic LUMHS Jamshoro. Study Duration: from April 2017 to Oct 2017. Sampling: 600 patients were selected through Consecutive sampling. Statistical Analysis: Descriptive statistics like mean, Standard deviation, minimum, and maximum were calculated Using SPSS version 22.Mean of two genders was compared using t-test setting <0.05 as level of significance. Results: Mean serum vitamin –D level was 16.11+10.07ng/ml in men while it was 16.63+11.73 ng/ml in women. 62% of the study population was found deficient (<20ng/ml) while 16.33% were having insufficient levels (<30ng/ml) and only 12% showed normal levels (30-50ng/ml). There was no significant difference between the two genders, p value 0.59 Conclusion: Vitamin –D deficiency is very common in both genders with no significant difference between males and females.

Psychosocial Determinants of Marijuana Utilization among Selected Junior High School Students in the Central Region of Ghana

Aug 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2223

Marijuana utilization among school aged adolescents is major public and mental health concern in Ghana and other developing countries, with the rate of usage soaring high among school going adolescents. The objective of this study was to investigate the prevalence of marijuana utilization among selected Junior High School (JHS) students in the Central Region of Ghana and explore the relative impact of psychosocial factors accounting for its usage. Using a descriptive cross-sectional survey design with the Global School Based Survey GSHS questionnaire, a sample of 1400 school going adolescents students were drawn using multistage sampling procedure. Frequencies, percentages and binary logistic regression results indicated marijuana utilization prevalence of 9% (n = 122). Statistically, gender (OR = 0.52, 95% CI= 0.35 - .765, p = 0.001), religious affiliation (OR = 1.76, 95% CI = 1.0 - 2.95, p = 0.034), socioeconomic background (OR = 0.52, 95% CI = 0.33 - 1.23, p = 0.004) and geographical location (OR = 0.53, 95% CI = 0.31 - .886, p = 0.016) significantly predicted marijuana utilization among school aged adolescents. No statistically significant variations were found in the odds of students’ marijuana usage for age (OR = 1.15, 95% CI = 0.69 - 1.88, p = 0.590), parental communication (OR = 0.83, 95% CI = 0.56 - 1.23, p = 0.348) and academic performance (OR = 1.09, 95% CI = 0.66 -1.80, p = 0.744). Findings suggest that school based research should reflect and perhaps replicate existing prevalence, patterns of marijuana and other drug use through multiple school surveys nationwide. This pathway may provide useful information towards the design, evaluation and implementation of drug prevention cognitive-behavioural interventions and the development of stringent drug regulative standards.  

Neck, Shoulder and Low Back Musculoskeletal Pain in Greek Physical Education University Students: A Series of Three Cross-Sectional Studies

Aug 2018 DOI 10.14302/issn.2474-3585.jpmc-18-2178

Several studies examine the musculoskeletal pain (MSP) in university students sustaining physical load as part of their compulsory learning. However, only two somewhat outdated cross-sectional studies examine the physical education teacher (PET) students. This study aimed to explore the neck, shoulder and low back MSP prevalence in Greek PET students in a series of academic years. The Nordic Musculoskeletal Questionnaire was used to record the past 12-month neck, shoulder and, low back pain, across three academic years (n = 479). The year association to MSP prevalence was examined with the cross-tabulation analysis (using the column proportion test for the year comparison) and, the gender association to MSP prevalence with the χ2 test (SPSS 22.0, p ≤ 0.05). The year association to MSP prevalence was not significant (p > 0.05). The overall prevalence was 67.6%, with multiple pain at 25.7% and, the low back presenting the highest prevalence (40.9%). Women reported a higher prevalence of neck (36%) and low back (47%) pain (p ≤ 0.05). The majority of pain and time loss duration was 1-7 days. The low back required higher medical attention (19.0%) than the neck (9.2%) and the shoulder (12.9%). The recurrent pain was at 30%, with the previous injury/accident rate at 5.8%, 14.4% and 14.6% for the neck, shoulder and low back. Our PET students present an alarming MSP prevalence. Due to their distinct work demands as PE teachers, entering working life with the healthiest possible musculoskeletal system is of critical importance. Thus, university authorities should consider strategies for the prevention of MSP risk.

Assessment of Pupils’ Knowledge and Practices Towards Prevention and Control of Tungiasis Infestation in Ugenya Sub County, Kenya

Jun 2018

Background: Tungiasis is a parasitic tropical disease caused by female Tungapenetranswhich has remained an important public health problem and it affects resource-poor communities causing different health disabilities hence the need for behavior change. Main objective of the study was to determine factors influencing prevention and control of tungiasis infestation among school age children in Ugenya Sub County, Kenya. Methods: A descriptive cross sectional design and utilizing quantitative data collection method. Simple random sampling technique was applied to select the participants. Quantitative data was collected through a pretested structured questionnaire. The data was keyed-into excel and analyzed using SPSS version 23. Results: Study findings indicate that majority of the pupils infested with tungiasis were in classes 5 – 6 at 191(49%). Male participants were 200 (51%), while 185(49%) were female. Gender of pupils (χ2=4.383a, df=1, P<0.005) and household head occupation (χ2=44.729, df = 28, P<0.005) had a statistical significance with tungiasis infestation. Further significance was noted between participants who had ever heard of jiggers (χ2=6.361, df=1, P<0.005), Knowledge on important causes of jiggers (χ2=36.482, df = 9, P<0.005), mode of disease transmission (χ2=17.215, df = 5, P<0.005), signs and symptoms (χ2=4.088, df = 1, P<0.005), seriousness of jiggers in the area (χ2=13.175, df = 1, P<0.005) as well as pupil’s wearing of shoes (χ2=3.934, df = 1, P<0.005) and tungiasis infestation. Conclusions: Study concludes that tungiasis is still a big problem in rural settings and knowledge on tungiasis infestation does not translate to prevention and control in the areas. More emphasis should be given to improving practices touching on personal hygiene and health education to increase awareness both at school and in the households.

Tomboys Revisited: A Retrospective Comparison of Childhood Behavioral Patterns in Lesbians and Transmen

May 2018 DOI 10.14302/issn.2643-6655.jcap-18-2086

In 1979, a study conducted by Ehrhardt et al. retrospectively examined childhood behavioral patterns of 30 adults; 15 identified as lesbian women and 15 identified as transmen. All 30 adults had been assigned female at birth, and, as children, all were regarded as “tomboys.” The study found several key factors that distinguished the two cohorts. The goal of this study was to replicate and extend the 1979 study, utilizing a larger sample size and including a reference group of heterosexual women. Given the major social, technological, medical, and legal paradigm shifts that have occurred over the past four decades, we sought to determine if the previous findings still differentiate the cohorts. In light of the exponential rise in the number of gender diverse and dysphoric youth who request treatment, providing optimal, affirmative care and education is paramount, especially since many of these young people seek social and/or medical transition. Exploration of the early behavioral indices of the diverse trajectories may help to inform best practices for optimal care for these young people and their families.

Assessment of Cardiac Function and Prevalence of Sleep Disordered Breathing using Ambulatory Monitoring with Acoustic Cardiography – Initial Results from SWICOS

Feb 2018 DOI 10.14302/issn.2329-9487.jhc-18-1932

The aim of this study was to assess the use of ambulatory acoustic cardiography during the initial data collection of the longitudinal study of a rural population in Switzerland (n=297, mean age 48.9 ±16.5 years, 57% female). Ambulatory acoustic cardiography non-invasively can assess sleep disordered breathing (SDB) and provides markers of left ventricular systolic and diastolic dysfunction. The percentage of the third heart sound detected during sleep decreased significantly across age groups (age < 40 years, 40-60 years, > 60 years) for both genders (males, p=0.04; females, p=0.02). The percentage of a fourth heart sound detected exhibited an increasing trend for both genders with age suggesting increased diastolic dysfunction with aging. Mean electromechanical activation time (EMAT) during sleep was within the normal range across age groups and both genders (male 93.7 ± 11.6 ms, female 94.6 ± 13.0 ms), and did not vary significantly with age. A large proportion of subjects had a high likelihood of sleep disordered breathing (17.6%). Baseline characteristics categorized by SDB severity indicate increasing age, male gender and being overweight (BMI ≥ 25) to be associated with greater SDB severity. Acoustic cardiography findings categorized by SDB severity reveal increased nocturnal non-dipping heart rate, presence of atrial fibrillation, prolonged QRS duration and QTc interval, increased percentage of fourth heart sound detected, and longer EMAT to be significantly associated with greater SDB severity. Overall, acoustic cardiography detected a very low prevalence of systolic dysfunction, age-related increases in diastolic dysfunction and a moderate prevalence of sleep disordered breathing.

Health Literacy and Older Adults: Fall Prevention and Health Literacy in a Midwestern State

Jan 2018 DOI 10.14302/issn.2474-7785.jarh-17-1911

Falls continue to be a health concern for older adults. Gender and age are key predictors of falls, particularly for those with low health literacy. Data were collected by a State Health Department using the state-led supplemental question option for the Centers for Disease Control and Prevention (CDC) Behavior Risk Factor Surveillance System (BRFSS) survey. Specifically, trend data for respondents were examined by gender, geographic location and health literacy rate. Results indicated the highest mean number falls occurred with men for those within the metropolitan statistical area (MSA) city code, lowest in suburban areas. Females reported to have a higher estimated mean number of falls and injuries than males. For males, the number of falls and injuries tended to decrease with higher health literacy. The findings support the importance of addressing fall prevention for older adults. Long term implications for improving fall prevention and health literacy for older adults include impact on individual outcomes.

Obstructive Sleep Apnea in Individuals with Down Syndrome: A Meta-Analytic Literature Review

Nov 2017 DOI 10.14302/issn.2574-4518.jsdr-17-1754

Objective: Individuals diagnosed with Down syndrome (DS) are predisposed to obstructive sleep apnea (OSA). The aim of this study is to assess the prevalence of OSA and factors associated with OSA in this population. Study Design: Systematic literature review and meta-analysis. Methods: Studies of DS and OSA in the English language through May 2017 were reviewed. Since parental report of symptoms has limited validity related to the diagnosis of OSA, only studies using in laboratory polysomnography to diagnose OSA were included. Results: Twenty three studies examining OSA among 1,469 people with DS were found. Among ten studies using community referred samples, 71.5% of people with DS had OSA, compared to 69.6% in referred community samples suspected of having respiratory events. There was an inverse relationship between apnea hypopnea index (AHI) cutoffs and OSA prevalence as higher cutoffs were associated with somewhat lower prevalence. Examining age groups, adults had a higher prevalence of OSA (90.0%) compared to infants (66.5%) and children between 2-21 years of age (69.9%). Oxygen desaturation and gender did not affect prevalence. Although surgery had less effect on successfully treating OSA among DS individuals compared to those without DS in prior studies, lingual tonsillectomy had the greatest effect (mean AHI decrease of 9.0). Conclusion: OSA appears to occur frequently in children and adults with DS. Untreated, OSA may contribute to health problems and premature death, highlighting the potential importance of identifying OSA among people with DS. Even after traditional surgeries (i.e., adenotonsillectomy, tonsillectomy, adenoidectomy), repeating PSG is highly recommended as residual OSA can persist

Human Psychology Open Access

Prevalence of Psychological Distress in Suriname In Urban and Rural Areas: The Suriname Health Study

Aug 2017 DOI 10.14302/issn.2644-1101.jhp-17-1665

Objective: To describe the presence of mental distress in a representative sample of the Surinamese ethnic groups in the population, across urban and rural areas. Design and Methods: The Kessler Psychological Distress Scale was applied to data from the Suriname Health Study (n=5,434 (15 to 65 years)) designed according to WHO Steps guidelines,to determine prevalences for mental distress in all living areas. Calculations were made in subgroups of sex, age, ethnicity, education, income, marital and employment status. The Odds Ratio (OR) for Sex and Ethnicity was estimated for mild-moderate and severe mental distress. Results: An overall prevalence of 3.8% (95%CI, 3.3-4.4) was observed for severe mental distress, 4.9% (95%CI, 4.4-5.5) for moderate mental distress and 10.8% (95%CI,10.0-11.6) for mild mental distress. The OR for mild-moderate and severe mental distress was 0.7 and 0.5 for men compared to women and higher prevalence of all categories of mental distress were found in women compared to men. Respondents with lower education and lower income showed higher prevalence of all categories of mental distress. Prevalence was also higher among respondents living in urban versus rural coastal areas, among singles versus people living with a partner and in unemployed versus employed. Maroons had higher Odds for mild-moderate and severe mental distress compared to Hindustani. Amerindian and Javanese had lower Odds for mild-moderate mental distress and Creole had lower Odds for Severe mental distress compared to Hindustani. Conclusions: Overall 19.5% of respondents reported mental distress. The main risk factors were female gender, Maroon ethnicity, low level of education and income, living in urban areas, unemployment and being single.

Reversal of Obesity: The Quest for the Optimum Dietary Regimen

Jun 2017 DOI 10.14302/issn.2379-7835.ijn-17-1548

A new approach to weight loss and weight loss maintenance is urgently needed, with the global epidemic of obesity leading to ever higher levels of chronic disease. This new approach should be cheap and simple, it should maintain essential nutrients and not deplete lean mass, should have minimal adverse effects and be carried out safely at home without support from the healthcare profession. This review looked at the forms of caloric restriction (CR) investigated in randomised controlled trials (RCTs) and found that supervised continuous and intermittent CR was more effective than other forms of weight loss over periods from 12 weeks to 2 years and could improve cardiovascular and diabetes risk factors. CR was equally as effective as bariatric surgery, suggesting that it is the post-surgery caloric restriction that has the impact on weight, rather than the surgery itself. Intermittent CR, including alternate day fasting (ADF), was as effective as continuous CR but may show improved compliance and higher lean mass. Unsupervised weight loss maintenance presents a greater problem, since in most weight loss regimens all the weight lost is ultimately regained. Although both continuous and intermittent CR can be effective, it has been found that ADF and a higher protein intake is more likely to maintain the weight loss. These results hold for all age groups and ethnicities and both genders. These findings suggest that intermittent CR, and particularly ADF, may be a viable form of weight loss and maintenance which fulfils all the criteria above. It is therefore recommended that larger RCTs investigate intermittent CR and ADF as a viable and cost effective form of weight loss and weight loss maintenance.

Serum Vitamin D Level in Oral Lichen Planus Patients of North India- A Case-Control Study.

Jun 2017 DOI 10.14302/issn.2471-2175.jdrt-17-1481

Background: Studies have unveiled lower levels of serum vitamin D in autoimmune diseases and the role of vitamin D in inhibition of helper T cells proliferation, stimulation of regulatory T cells, diminishing of B-lymphocyte differentiation and inhibition of immunoglobulin secretion has been discussed in the literature. Oral lichen planus (OLP) is an autoimmune mucocutaneous disorder in which cell mediated immunity plays an important part and so it may also be related to serum vitamin D levels. Aim: To estimate serum vitamin D in oral lichen planus patients of North India, compare it to the controls and to evaluate various factors influencing vitamin D level in OLP cases such as sun exposure, gender, psychosocial factors, meteorological influences, religion and diet. Methods and Material: Venous blood samples of 102 clinically diagnosed oral lichen planus patients and 102 age and sex matched controls were obtained for the study and serum vitamin D levels were estimated using Vitek Immunodiagnostic Assay System, an automated bench-top immuno-analyzer, based on the Enzyme Linked Fluorescent Assay. The data was analyzed using chi-squared test and t-test. Results: Mean vitamin D in OLP cases and controls was 20.40 ng/ml and 32.67 ng/ml respectively. Vitamin D3 deficiency was more in OLP cases (70.6%) as compared to controls (34.3%) and insufficiency was more in controls (35.3%) as compared to OLP cases (16.7%). These differences were statistically significant. Conclusion: Although vitamin D deficiency was found more in OLP cases pointing towards the possible co-relation of vitamin D and OLP, yet insufficiency was seen more commonly in controls which revealed that this important vitamin was lacking in North Indian population. 

Evaluation of Vitamin D Deficiency in Patients with Chronic Liver Disease and Its Clinical Significance

Dec 2016 DOI 10.14302/issn.2379-7835.ijn-16-1381

Introduction: Vitamin D deficiency has been reported highly prevalent in Chronic liver disease (CLD) and there is an emerging interest to explore the relationship of vitamin D deficiency and severity of various types of CLD. Aim: To evaluate vitamin D level in patients with various type of CLD and clinical significance of its deficiency. Materials and Methods: Serum vitamin D levels were measured by ELFA in 100 patients (91 male and 9 female) suffering from CLD. The degree of liver dysfunction was estimated by Child Pugh criteria and Model for End stage Liver Disease (MELD) score. Results: Prevalence of vitamin D deficiency and insufficiency were 43% and 42% respectively among CLD patients. Low levels of vitamin D were associated with leucopenia or leucocytosis indicating increased risk of infection. On Linear regression vitamin D level showed significant negative correlation with Child Pugh score (r = – 0.7382, p<0.0001) and MELD score (r = – 0.6673, p<0.0001). Our study shows low vitamin D level was associated with poor outcome (mean vitamin D level 10.38 ± 2.35 who died vs 23.14 ± 6.68 who survived and discharged). Conclusion: CLD is associated with a significantly low level of vitamin D which was independent to patient’s gender, BMI, residence and education level. The lower level of vitamin D is associated with severity of CLD, mortality and increased risk for infections. Awareness of serum vitamin D level in patients with CLD is important to improve outcome.

Efficacy of a Hypocaloric Mediterranean Diet in Overweight Patients: Factors Predictive of Completion

Dec 2016 DOI 10.14302/issn.2379-7835.ijn-16-1390

Objectives: To evaluate the efficacy of a weight loss programme and the factors that predict successful adherence of the treatment. Methodology: A retrospective chart review of 500 overweight outpatients (427 women, 73 men), mean age 41.7 years (range: 18–81) and mean BMI of 31.44 kg/m2 (range: 25.09–51.33), treated at an obesity specific clinic. A programme involving a hypocaloric Mediterranean diet was prescribed, along with suggestions for leisure exercise and daily activity. The weekly follow-up continued until the weight loss goal was reached (‘completion’ group) or the patient discontinued the programme (‘dropout’ group). Key Results: Those that completed the programme achieved a mean weight loss of 10.6 kg (12.9% percentage loss of initial body weight) and a mean body fat mass loss of 26.8%. Factors predictive of completion were: gender (males higher completion), previous dietary programmes (predictive of dropout), initial percentage of fat mass (higher percentage, lower completion), age (younger age, lower completion) and hypothyroid disease (predictive of dropout). Conclusions: A hypocaloric Mediterranean diet and moderate exercise could help to reduce body weight and body fat in overweight patients. Treatment completion of self-selected and self-paying patients is low, and appear to be more effective for men, persons with a low percentage of fat mass, older age groups and those who have not made other previous diets.

Cervical Medial Branch Blocks For The Diagnosis Of Somatosensory Tinnitus. A Pilot Study.

Dec 2016 DOI 10.14302/issn.2379-8572.joa-16-1369

The purpose was to discover if medial branch blocks (MBBs) of the cervical spine can be used as a diagnostic tool to identify patients with somatosensory tinnitus. MBBs are a diagnostic tool to confirm the diagnosis facet joint pain in patients with neck pain. It is not known, if MBBs are also suitable for testing other symptoms than pain. However, the existence of neural connections between the auditory system and the cervical region can be assumed. Included were 22 consecutive patients presenting with tinnitus, who had received MBBs in a ten years’ period. Patients were tested with a MBB with bupivacaine and triamcinolone. Injections were performed with fluoroscopic visualization using established techniques. The mean follow-up time was 6.2 weeks. Tinnitus was analyzed through the global clinical impression of the patient. Seven patients (31.8 %) experienced a significant improvement of the tinnitus. In one patient a thermal radiofrequency neurotomy was done after positive response to two MBBs. The pain relief and a significant reduction of the tinnitus sustained at the follow-up examination 20 weeks after the denervation. No statistically significant difference was found in age, gender, duration of symptoms, additional neck pain or vertigo, or side or level of the intervention. This pilot study shows the feasibility to identify patients with somatosensory tinnitus with MBBs. Further studies with the primary intention on tinnitus are necessary to prove the significance of MBBs. After a positive response to MBBs, treatment with radiofrequency neurotomy is the rational consequence.

Advances in Sexual and Reproductive Rights of Adolescents in Brazil

Nov 2016 DOI 10.14302/issn.2381-862X.jwrh-16-1294

The paper presents the incorporation of sexual and reproductive rights in the legislation of Brazil, considering the influence of the discussions that involved the United Nations conferences of Cairo and Beijing. Are described and analyzed the Federal Constitution and federal laws, as the Criminal Code and the Code of Child and Adolescent, besides other legal norms of Brazilian executive power bodies, like the Ministry of Health and Ministry of Education, particularly in the areas of health and citizenship. This process allowed the introduction of new health and education practices in public institutions, offered to the entire population -primarily benefiting women and teenage girls and, then, integrating people in situation of sexual diversity -although there are still problems, such as the occurrence of pregnancies and abortions in adolescence and the underreporting of sexual and gender violence. It is concluded that Brazil has incorporated into its laws the precepts of the sexual and reproductive rights more easily due to the proper moment, which coincided with the creation of new legal instruments and the organization of the national state. Nevertheless, it is still necessary translating these legal advances into practical advances in the public policies and policies focused on people’s needs.

Obesity Management Open Access

The Use of Predictive Markers for the Development of a Model to Predict Lowest Quartile Weight Loss following Roux-en-Y Gastric Bypass.

Oct 2016 DOI 10.14302/issn.2574-450X.jom-16-1003

Introduction: The Roux-en-Y Gastric Bypass (RYGB) has been one of the most popular surgeries in the USA for years. While many models have been made to investigate the factors that affect weight loss, these factors are still highly debated. Objective: To create a model that predict performance of RYGB patients. Methods: 110 out of 344 patients who received a RYGB at a single institution between Jan 2010 and April 2014 were included in this study. Data was collected retrospectively. Patients were included if they had greater than 1 year follow up with at least three follow up points and could be modeled with r2>0.95. All patients were one year beyond surgery, while 40 were completely lost to follow up, 104 at 1 month, 138 at 3 months, 188 at 6 months, and 225 at one year. 9 patients were not included because they did not meet the criteria of the study. Patients were divided into quartiles based on percentage excess weight loss (%EWL) at one year. Multivariate analysis was performed to determine the significant factors that influence patients being in the first quartile of weight loss (17-60% %EWL). Results: Only males with a Body Mass Index (BMI) above 44 and females with a BMI above 64 were found to be predictive of patients being in the first quartile. Our model has Positive and Negative predictor values of 66% and 80% respectively with sensitivity and specificity of 29% and 95% respectively. Conclusions: An model to predict %EWL was created, only gender and pre-operative BMI were found to be significant factors. In general females have better outcomes with higher BMI’s than do males. This information should be discussed with patients when deciding a procedure. However, more studies are needed for validation of these results.

Compassion Fatigue and Adopted Coping Strategies of Mental Health Service Providers Working in A Regional Psychiatric Hospital in Nigeria

Sep 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1195

Background: Mental health service providers sometimes suffer burden resulting from their care of mentally ill individuals, and this burden could be modulated by the coping mechanisms they adopt. Objective: This study aimed to investigate the relationships between gender, coping strategy and compassion fatigue of mental health service providers in a mental health facility in Nigeria Method: This was a cross-sectional study which recruited 234 mental health service providers working in a mental health facility in Nigeria, and they completed questionnaires (the Coping Strategy Inventory modified by Addison, Campbell-Jenkins & Sarpong and the Compassion Fatigue subscale of the Professional Quality of Life developed by Stamms. Results: Majority of the mental health service providers surveyed were at risk of compassion fatigue (75.2%), gender did not significantly impact on compassion fatigue (t =-0.111; p>0.05), and coping strategies jointly predicted compassion fatigue (F = 11.927; p<0.05; r=0.417). However, when analyzed separately, only the subgroup of emotional focused engagement coping and emotional focused disengagement coping strategies independently predicted compassion fatigue, (β =0.246, t= 3.3.511, p<0.05) and (β =0.226, t= 3.698, p<0.05) respectively. Conclusion: Mental health service providers have high risk of compassion fatigue and the emotional based coping strategies are associated with this. Measures are suggested to mitigate compassion fatigue among this professionals, to reduce the effect on them and their patients.

Psychological “Risks” of Colonoscopy are Greater Amongst Fecal Immunohistochemical Test Positive Individuals than those with Inflammatory Bowel Disease

Aug 2016 DOI 10.14302/issn.2471-7061.jcrc-14-426

Background: Colorectal cancer (CRC) screening by Fecal Immunohistochemical Testing (FIT) followed by colonoscopy reduces colorectal cancer mortality. Barriers to colonoscopy should be minimised. Objective: To compare psychological “risks” of colonoscopy in FIT positive (FIT+) subjects and those with Inflammatory Bowel Disease (IBD). Method: IBD patients undergoing colonoscopic CRC surveillance were age and gender matched with FIT+ individuals awaiting colonoscopy. Subjects completed Spielberger State and Trait Scales for current levels of anxiety, depression, anger and curiosity, versus long term personality tendencies. Results: 70 IBD respondents were matched with 70 FIT+ respondents, (57% male, mean age 57.6 years). FIT+ subjects demonstrated greater scores for state Anxiety (22.3 vs 20.3 p=0.024), Curiosity (24.3 vs 21.8 p=0.036), Anger (13.7 vs11.5 p=0.037) and Depression (23.8 vs21.2 p=0.002). Conclusion: FIT+ patients experience more anxiety and depression prior to their colonoscopy than IBD patients, which may reduce colonoscopy uptake and is important to address.

Diet and Nutritional Status of the Older Adults in Rural India

Aug 2016 DOI 10.14302/issn.2474-7785.jarh-16-1157

Objectives: World has witnessed a considerable increase in the proportion of elderly population.Aging is associated with decreased physical activity and metabolism and thereby the changes in the nutritional requirements of older adults.The objective of this communication was to assess the nutritional status of rural elderly population in India. Methodology: A community based cross-sectional study; adopting multistage stratified random sampling procedure was carried out by the National Nutrition Monitoring Bureau (NNMB), during 2005-06 among the rural population of nine major states of India. A total of 3871 older adults were covered for anthropometry and of them, a total of 2138 older adults were covered for dietary assessment. Key Results: In general, the consumption of all the foods was below recommended daily intakes (RDI), and the in-adequacy (<70% of RDI) of intake was high with respect to leafy vegetables, milk & milk products, fats & oils and sugar & jaggery. Similarly, the in-adequacy of intakes of micronutrients such as vitamin A, iron, riboflavin and free folic acid was high among both genders. The poor intake of diet was reflected in high prevalence of chronic energy deficiency (CED) among the rural elderly in India. Conclusions: In general,the rural elderly were subsisting on inadequate diets in terms of both quantity and quality. Similarly, the prevalence of CED among elderly is a ‘‘very high’’ public health nutrition problem in India. Therefore, the Government of India should initiate appropriate nutrition intervention measures to improve the overall nutritional status and special nutrition policies to address the health and nutritional problems of the aging population.

Evaluation of the Impact of Clinical, Functional and Social Factors on the Readmission of Patients with Pluripathologies

Apr 2016 DOI 10.14302/issn.2474-7785.jarh-15-699

Purpose Hospital readmission of patients with pluripathologies is frequent and costly. This study describes the impact of patients’ pluripathologies, functional capacity and social complexity on readmissions during a 12-month period following hospital discharge. Methods A prospective cohort study. Monthly monitoring of 111 patients over 12 months in Hospital of Riotinto. The primary endpoint was readmission rate. Predictive variables: age, gender, hospitalizations the year before, illnesses that define the pluripathology, medication prescribed on discharge, social situation (Gijón Scale), functional state (Barthel) and cognitive impairment (Pfeiffer). Results Readmissions accounted for 21.6% of the patients surveyed. Of those readmitted, the mean age was lower than those who did not return to hospital (75.4 vs.79.6) (p=0.031), the average amount of medication prescribed greater (10.5 vs.8.7) (p=0.014), the Barthel score higher (52.5 vs.50.6) and the Gijón value lower (13.8 vs.14.6), but no results was significant. The mean survival time (without readmission) was 310.9 days (95% CI, 289.4-332.5). Category B (chronic renal disease and vasculitis) and F (diabetes with microangiopathy and artery disease) had a lower average survival time (X2=7.02; p=0.008) (X2=7.07; p=0.008). The readmission risk was hazard ratio (HR) = 3.13 (95% CI, 1.37-7.14) for category B, and HR = 3.38 (95% CI, 1.37-8.36) for category F. Conclusions There is a high proportion of readmissions among patients with pluripathologies in the year following discharge from hospital. The greater risk occurs in patients with chronic renal insufficiency and diabetes with microvascular complications. Factors that can be modified are polymedication and the proper control of patients’ diabetes.

Arm Span is an Alternative to Standing Height for Calculation of Body Mass Index (BMI) amongst Older Adults

Mar 2016 DOI 10.14302/issn.2379-7835.ijn-15-903

Objectives: Accurate measurement of height is difficult in older adults because of the reduction in height that occurs during the ageing process. Therefore, several western studies have demonstrated the arm span as an alternative anthropometric measurement to height among older adults, as the length of arm span is less affected by aging. The aim of the study was to use arm span as an alternative to standing height for calculation of body mass index (BMI) amongst older adults. Methodology: A community-based cross sectional study was carried out during 2011-12 among 400 (Men: 180; Women: 220) urban geriatric population (age 60-years and over)of the town of Khammam. Weight, height and arm span were measured with standard procedures. Nutritional status of older adults was calculated by body mass index (BMI) classification using both height and arm span. Key Results: The mean (SD) height and arm span among men were 164.5 cm (6.6) and 175.3cm (7.9), respectively, while among women were 149.5cm (5.8) and 158.7cm (8.6). The mean difference between arm span and height was 10.8cm (10.1,11.4)in men and 9.2cm (8.3,10.0) in women (p<0.001). Similarly, significant (p<0.001) differences were observed between the BMIs derived using both height and arm span among both the genders. Conclusion: The conventional height is not a reliable anthropometric measurement for the assessment of nutritional status of older adults, where the BMI-height model over estimated the nutritional status of older adults compared to the BMI- arm span model. Therefore, arm span is the best alternative to height for calculation of body mass index (BMI) in older adults.

Psychosocial Factors and Comorbidity Associated with Recovery in Bipolar Disorder

Feb 2016 DOI 10.14302/issn.2476-1710.jdt-15-762

Bipolar disorder (BD) is a chronic psychiatric illness impacting patient functioning and quality of life. Medication produces improvement in many patients and remission in some, but there is minimal understanding about why some patients improve and others do not. Our goal was to identify demographic, psychosocial and comorbid variables associated with outcomes in BD. Charts of 121 outpatients treated with medication and supportive psychotherapy were reviewed. Forty four percent attained euthymia for 12 months while 56% did not. Poorer outcome was associated with economic stress, missed appointments, life stress, and presence of pain (p < 0.05). Those employed were more likely to improve (p < 0.02). Patients with BP-II reported more frequent life stressors, headache and use of alcohol (p <0.05) and were less likely to achieve euthymia than BP-I. Gender, education, and co-morbid medical illness did not affect results. Our findings suggest that poorer outcome is related to psychosocial factors. Increased attention to these variables may increase providers’ ability to manage challenging patients with BD.

Efficacy of Focal Photocoagulation to Maintain or Achieve Best Corrected Visual Acuity ≥20/40, in Eyes with Diabetic Macular Edema

Jun 2015 DOI 10.14302/issn.2374-9431.jbd-12-164

Objective: To identify the efficacy of focal photocoagulation to maintain or achieve best corrected visual acuity (BCVA) ≥20/40 in eyes with clinically significant macular edema (CSME) that had a focal angiographic pattern. Material and Methods: Non-experimental, retrospective, longitudinal, descriptive study in type 2 diabetic patients of any gender, who had CSME with focal angiographic pattern, who received focal photocoagulation from January to October 2012, with a register of BCVA before and 3 weeks after photocoagulation. 101 eyes from patients aged 35-74 years (mean 60.1±8.15) were assigned to one of two groups: 1, with BCVA before treatment <20/40 (n=60), and 2, with BCVA ≥20/40 (n=41). The proportion of eyes with BCVA≥20/40 after treatment was identified, in the sample and within each group. Results: In group 1 BCVA improved in 34 eyes (56.7%), did not change in 15 (25%), and worsened in 11 (18.3%); in group 2 BCVA improved in 10 eyes (24.4%), did not change in 18 (43.9%) and worsened in 13 (31.7%). Post treatment BCVA was ≥20/40 in 57 eyes (56.4%, 95% confidence intervals 46.8-66.1%), 21 of them from group 1 (36.8%) and 36 from group 2 (63.2%). Conclusion: Treating CSME with focal photocoagulation was efficacious to maintain BCVA ≥20/40 in 87.8% of eyes with that rank of vision preoperatively, and to achieve BCVA ≥20/40 in 35% of eyes without it. Early detection and treatment of CSME is required to increase the proportion of eyes with BVCA that provides visual independence, preferably when visual function is still good.

One-Third of Patients With Type 2 Diabetes Mellitus Do Not Have Coronary Artery Calcification

Jun 2015 DOI 10.14302/issn.2474-3585.jpmc-14-540

Objective Measuring coronary artery calcification (CAC) enables to optimize cardiovascular risk-stratification also in patients with type 2 diabetes mellitus (T2D), however the prevalence of CAC in randomly selected patients with T2D is uncertain. For this purpose we set out to examine and compare the occurrence of CAC in unselected T2D patients. Design A randomly selected cohort of 1825 individuals, men and women, either 50 or 60 years old, were invited to the screening study. Traditional risk factors were obtained and a non-contrast CT-scan was performed to assess the CAC score. Results A total of 1211 individuals participated, of whom 54 (4%) had T2D while 1157 (96%) were without diabetes. CAC was present in 62% of the patients with T2D versus 44% in those without (p=0.013). Also the prevalence of traditionally risk factors was high in patients with T2D as compared to subjects without T2D. When adjusting for age, gender, smoking, hypertension and hypercholesterolemia in multivariate logistic regression, T2D was not associated with presence of CAC (OR=1.0; 95% confidence interval 0.5 - 2.0, p=0.94). Conclusions One-third of patients with T2D did not have any CAC, and T2D per se was not associated to CAC.

The Lower Prevalence of Chronic Diseases Risk Factors in Vegetarian Brazilians Subjects – CARVOS Study

Feb 2015 DOI 10.14302/issn.2379-7835.ijn-14-461

Objective: To investigate the association of meat consumption with self-reported chronic diseases (heart disease, hypertension, diabetes (type I or type II) and dyslipidemia), according to demographic, social and anthropometric variables. Methods: This was a cross sectional study, conducted at the Heart Institute, University of São Paulo, with 549 adults (≥ 18 years) who answered a questionnaire to select people for The CARVOS Study (Carotid Atherosclerosis, Aortic Stiffness and Risk Factors in Vegetarians and Omnivorous Subjects). The variables analyzed were: age, gender, education level, meat consumption, self-reported coronary heart disease, hypertension, diabetes (type I or type II) and dyslipidemia, smoking and body mass index (BMI) (kg/m2). Study subjects were classified as omnivorous (OMN=consumption of meat or fish four or more times/week) (n=228, 41.5 %), semi-vegetarians (SV=consumption of meat or fish 1-3 times/week) (n=97, 17.7%) and vegetarians (VEG=no consumption of meat or fish) (n=224, 40.8%). The differences between mean values was calculated by T-ANOVA test. To test the association between the variables, chi-square test and multiple logistic regression were used (p<0.05; CI = 95%). Results: There was a greater prevalence of smokers among OM than SV and VEG respectively 56.5%, 14% and 29.4 %, p=0.009, and a higher prevalence of overweight (41.7%) in OMN in comparison with SV (29.2%) and VEG (29.0%), p=0.008. Being OM significantly increased the risk of referring hypertension, regardless of sex and age (OR 2.19; CI 95% 1.08-4.46), and was also associated with dyslipidemia, regardless of body mass index, smoking, sex and age (OR 1.78; CI 95% 1.03-3.08). Conclusion: Higher meat consumption was associated with a greater prevalence of risk factors for hypertension and dyslipidemiachronic diseases.

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