Health Sciences

The treatment of headache is commonly delivered in an outpatient environment. There are patients who are refractive to outpatient treatment, and in whom inpatient care may be appropriate. Factors that determine the optimal setting, methods, and results of such treatment have come under increasing scrutiny secondary to the cost of inpatient care. The US Headache Guidelines Consortium project, in conjunction with From the Diamond Headache Clinic, Chicago and

Background: Indonesia has more than 125 million workers, and Indonesian regulations ordered medical check-ups for all employees. Despite abundant workers' health data in industries and health providers, national data is still limited. This study aimed to investigate the health profile of Indonesian workers. Method: We analyzed the health data of 12031 workers examined in a national-wide health provider between 2015 and 2016. The data included smoking habits, body mass index, blood pressure, hemoglobin, blood lipid, blood sugar, blood creatinine, ECG, spirometry, and audiometry test. The analysis focused on the proportions of diseases among workers and the proportion of diseases according to gender and age. Results: The proportion of male workers was 78.8%, and the average age was 36.9. The highest percentage of workers was from DKI Jakarta. The top five clinical findings were obesity (46.7%), dyslipidemias (44.5%), dental caries (21.7%), hearing loss (17.6%), and lung function problems (17.6%). Almost in all findings, the proportion of diseases in males was higher than in females except for anemia and bacteriuria. The proportion of kidney function problems, myocardial ischemic/infarct, hepatitis B carrier, diabetes mellitus, anemia, hyperuricemia, hypertension, lung function problem, hearing impairment, dyslipidemia, and obesity were higher in older workers. In general, this study can provide an overview of the health profile of Indonesian workers and can be a reference for the development of worker health programs. Individual programs can be given based on gender and age to maintain workers' health and prevent further deterioration.

Pulmonary tuberculosis (TB) is an infection caused by mycobacterium tuberculosis. This bacteria infects the lungs. Sufferers usually experience symptoms of old cough to bloody cough, decreased appetite, weight loss. This study aims to determine the effect of Etawa milk feeding on weight gain in pulmonary TB patients at the Tanjung Rejo Health Center. This research uses research design with a quasiexperimental approach and design one group pre and posttest design with group control. This research was conducted from January 30 to February 13, 2019. This study's population was pulmonary TB patients using The Side Purposive technique and the number of up to 30 people. Results of lung TB patients majority pre-milk Etawa lung TB patients weight 45 kg as much as eight people (26.7%) the majority of post milk Etawa lung TB patients weight 48 kg as much as eight people (26.7%) obtained a significant value p-value (0.018) < (0.05) there is an influence of Etawa milk feeding on weight g...

Mexico, in recent decades, has developed several programs to eradicate the problem of infant malnutrition <5 years, primarily among those living in rural and indigenous areas. However, there is insufficient evidence on these programs’ impact on child health and nutrition. Objective: to describe the nutritional changes of two generations of brothers and sisters living in rural communities of Chiapas and who are Oportunidades beneficiaries. Methods: cross-sectional study. It was determined: underweight, stunting, wasting and overweight plus obesity. Older brothers and sisters were evaluated in 2002-2003, for 2010-2011 younger brothers and sisters were evaluated, both groups were <5 years of age at the time of data collection. Results: malnutrition, in its three types is a problem. 43.4% of brothers and sisters evaluated in 2010-2011 showed stunting, underweight prevalence declined from 18% to 13.2%, wasting (low weight for height) increased from 8.1% to 10.4%. Overweight and obe...

Sentence completion norms are a valuable resource for researchers interested in the study of the effects of context in word recognition processes and language comprehension. This study presents completion norms for 278 sentences-final words in Spanish for Mexican children. These norms were obtained through the cloze method in a sample of 420 students (226 boys and 194 girls) 9 to 12 years old, from fourth to sixth grades of elementary public schools located in Estado de México. Children's task was to read each one of the sentences and completed them with one closing word. According to children's responses, cloze probability of each closing word was calculated for each sentence context. Although the set of sentences included different contextual constraints, subject's responses showed a greater number of sentences with high cloze probability. This corpus can be used in research on language comprehension (both oral and written) in children.

The implementation of physical education (PE) has the potentially will not run optimally because it is implemented through distance learning. PE teachers have a heavy responsibility in implementing distance learning. This study aims to determine the differences in the responsibilities of PE teachers in urban and suburban areas of the Special Region of Yogyakarta. The method used is experimental pre-test and post-test. The study population was PE teachers in urban and suburban areas who carried out distance learning (n = 60). The instrument used is a modification of the Tool for Assessing Responsibility-Based Education (TARE), consisting of 28 questions about teacher responsibilities. Primary data collection by questionnaire and secondary data collection by literature study. The results of the data independence t-test analysis showed that the significance value was .000 < .01 (confidence interval = 99%), the results of the paired sample t-test data analysis showed that the significance value was .000 < .01. Thus the results of the study indicate that the responsibility of teachers in urban areas is higher than that of teachers in suburban areas. The attitude of teacher responsibility is considered as one of the feasible and effective pedagogical approaches for the distance learning.

Introduction: Maternal factor V Leiden status is associated with fetal loss. Due to the uncertain etiology of the disorder and the lack of established criteria for more precise risk stratification, prophylactic anticoagulation during pregnancy is a subject of intense debate. We have recently developed a mouse model of pregnancy disorder in factor V Leiden mothers, establishing a causeeffect relation for the epidemiologic association. We exploit this model to identify risk modifiers of fetal loss in factor V Leiden mothers and to characterize disease pathogenesis. Methods: Genetic and histological approaches were used to clarify disease pathogenesis. Placental perfusion was assessed by intravenous FITC-dextran injections. Platelet depleting antibodies were used to examine the role of maternal platelets in fetal loss. Results: We show that: (1) Fetal defects in thrombomodulin and endothelial protein C receptor genes precipitate pregnancy loss in factor V Leiden mothers; the same mutations in the factor V Leiden animal are compatible with normal functioning of other vascular compartments. (2) Heterozygous deficiency of tissue factor pathway inhibitor is inconsequential with respect to fetal loss. (3) Fetal loss is caused by disruption of placental morphogenesis at the stage of labyrinth layer formation, and occurs in the absence of overt thrombosis or perfusion defects. (4) Platelet depletion or genetic elimination of the thrombin receptor Par4 from the mother allows normal placentation and prevents fetal loss. Conclusions: Our results identify fetal gene defects in the thrombomodulin-protein C pathway as risk modifiers of fetal loss in factor V Leiden mothers; show the existence of vascular bed-specific pathogenic mechanisms in the placenta; and identify platelets and the thrombin receptor Par4 as critical mediators of fetal loss, likely involving a pathogenic mechanism independent of occlusive thrombosis. This model provides an opportunity to test the efficacy of anti-thrombotic and antiplatelet treatments.

Objective-To assess whether the risk of vulvodynia is associated with previous use of oral contraceptives (OCs). Setting-Four counties in south-east Michigan, USA. Population-A population-based sample of women, aged 18 years and older, enrolled using random-digit dialling. Methods-Enrolled women completed surveys that included information on demographic characteristics, health status, current symptoms, past and present OC use, and a validated screen for vulvodynia. The temporal relationship between OC use and subsequent symptoms of vulvodynia was assessed using Cox regression, with OC exposure modelled as a time-varying covariate. Main outcome measure-Vulvodynia, as determined by validated screen. Results-Women aged <50 years who provided data on OC use, completed all questions required for the vulvodynia screen, and had first sexual intercourse prior to the onset of vulvodynia symptoms were eligible (n = 906). Of these, 71.2% (n = 645) had used OCs. The vulvodynia screen was positive in 8.2% (n = 74) for current vulvodynia and in 20.8% (n = 188) for past vulvodynia. Although crude cross-tabulation suggested that women with current or past vulvodynia were less likely to have been exposed to OCs prior to the onset of pain (60.7%), compared with those without this disorder (69.3%), the Cox regression analysis identified no

The quality of nursing is one of the most important factors in healthcare. Fatigue and burnout are common complaintsamong nurses, due to which they may become less productive and make more professional mistakes. The aim of this study isto find burnout and fatigue and their correlation among nurses practicing in Latvia. Research was performed using Maslach’sBurnout Inventory (MBI) assessed emotional exhaustion, de-personalisation and the lack of personal achievement. Tomeasure fatigue, the Checklist Individual Strength (CIS) Questionnaire Study was used; the sample included 190 registeredand practicing nurses working both in the medical and surgical units in hospitals. The respondents were aged 23–74 years.Burnout and fatigue were measured and correlations were calculated. The data showed that there are significant correlationsbetween the MBI and CIS subscales. The results indicate that fatigue and burnout are common and are strongly associated inthe nursing population in Latvia....

Intussusception in adolescents is usually idiopathic in nature. A 17-year-old woman with diffuse large B cell lymphoma presented with signs of intestinal obstruction after initiation of induction chemotherapy. On evaluation, the patient was diagnosed to have ileoileal intussusception with intestinal lymphangiectasia as the lead point. Intestinal lymphangiectasia as a rare cause for intussusception and its relationship with lymphoma is discussed in this case report.

These studies examined the effects of cocaine on thalamic neurons that respond maximally either to noxious or to innocuous somatic stimulation. Cocaine attenuated high intensity electrically-evoked nociceptive responses of all 25 units studied in the parafascicular and central lateral nuclei of the medial thalamus. A dose of 1 mg/kg intraveneously (i.v.) suppressed medial thalamic unit discharge evoked by both noxious somatic stimulation (49.4 + 8.7% of control response) and spinal cord stimulation (76.2 + 6.6% of control response). The effect of cocaine on unit responses to noxious somatic stimulation was dose-related in the range of 0.3-3.5 mg/kg i.v. and was attenuated by eticlopride, a D-2 selective dopamine receptor antagonist. Morphine also suppressed noxious somatic evoked responses of medial thalamic units in a dose-dependent manner. Units in the lateral (ventrobasal) thalamus (n = 4) that responded only to innocuous stimuli were not affected by cocaine at doses up to 3.5 mg/kg i.v. Ibotenic acid lesions in the parafascicular nucleus of the medial thalamus attenuated the analgesic effect of cocaine in the formalin test. These results suggest that both cocaine and the parafascicular nucleus interact with dopaminergic mechanisms that attenuate nociceptive spinal projections to the medial thalamus.

The role of dopaminergic descending supraspinal processes in mediating the antinociccptive action of cocaine was studied in the rat using a combination of extracellular neuronal recording and behavioral techniques. Neurons in the superficial laminae (I-II) of the spinal dorsal horn with receptive fields on the tail were recorded in anesthetized rats using insulated metal microelectrodes. Stimulation of the receptive field with either high intensity transcutaneous electrical pulses or with an infrared CO 2 laser beam produced a biphasic increase in dorsal horn unit discharge. Conduction velocity estimates indicated that the early discharge corresponded to activity in A~ whereas the late response corresponded to activity in C afferent fibers. Cumulative doses of cocaine (0.1-3.1 mg/kg i.v.) inhibited the late response to either electrical or laser stimulation in a dose-related manner. The early response to laser, but not electrical, stimulation was also suppressed by cocaine. Neurons in the spinal dorsal horn with receptive fields on the ipsilateral hindpaw were activated by natural noxious (pinch) or innocuous (tap) somatic stimulation. Cocaine selectively suppressed nociceptively evoked dorsal horn unit discharge. This antinociceptive effect was dose-related (0.3-3.1 mg/kg, i.v.) and antagonized by eticlopride (0.05-0.1 mg/kg, i.v.), a selective D2 dopamine receptor blocker. The same doses of cocaine failed to inhibit the responses of dorsal horn neurons to low threshold innocuous stimulation. Complete thoracic spinal cord transection eliminated the antinociceptive effect of cocaine on dorsal horn neurons and also eliminated the cocaine-induced attenuation of the tail-flick reflex. These data demonstrate that cocaine selectively inhibits nociceptive spinal reflexes and the nociceptive responses of dorsal horn neurons primarily by means of a D2 dopaminergic receptor mechanism. This antinociceptive effect of cocaine is independent of its local anesthetic activity and requires the integrity of the thoracic spinal cord, suggesting that the drug potentiates or activates supraspinal dopaminergic projections to the dorsal horn.

Medical science has entered an era of rapid evolution, fundamentally altering how complex and long-term illnesses are explored and addressed. Breakthroughs in genetics, digital health tools, and targeted therapies have widened the scope of what researchers can investigate. With these advances comes a heightened obligation to examine new ideas carefully before they influence patient care. Every emerging treatment carries potential alongside unanswered questions. The healthcare community therefore, operates within a constant tension between discovery and responsibility. Understanding this balance allows readers to interpret medical progress with greater clarity and perspective. Caution within healthcare should not be mistaken for reluctance to advance. Instead, it reflects a deliberate system designed to test evidence thoroughly and ethically. Regulatory standards exist to ensure that new medical approaches are examined transparently and responsibly. Researchers are required to validate safety, consistency, and scientific merit throughout development. While this process may appear slow, it underscores the seriousness of introducing change into human health. Public attention often highlights innovation while overlooking these protective measures. A more complete view recognizes that progress depends on both exploration and restraint.

Background: Miners and the people living close to mining sites are exposed to elevated levels of ionizing radiation with or without their knowledge. This study was designed to evaluate the outdoor background radiation levels in some selected mining locations and major activity areas of Ebonyi State, South-Eastern, Nigeria and their radiological impacts. Materials and Methods: The levels of background radiation in these mining areas were estimated using a well calibrated International Medicom CRM-100 Digital Radiation Monitor (survey meter). A cross-sectional survey was adopted for this study. Based on standard method, the radiation monitor was held at a distance of 1.0 meters above the ground and three readings taken at each location and the mean recorded. The radiation dose rates were calculated. A descriptive statistic and inferential statistic were used to summarize the data using statistical package for social Sciences SPSS version 21. Results: The mean dose rate for all the min...

Research is a key component of evidence-based medical imaging and good knowledge and attitude towards research is important in implementing the paradigm shift from traditional model of practice to evidence-based practice. The aim of the study was to assess the research awareness of Nigerian radiographers. Two hundred and fifty 20-item self-completion questionnaires were sent to 250 fifty radiographers. The questionnaires were sent by post to the selected radiographers to collect data about their awareness and attitudes towards research. The radiographers were those in the academia and those in clinical practice. Two hundred and two questionnaires were filled out and returned within a period of 2 months (80.80% response rate). Data were analyzed using statistical package for social sciences (SPSS) version 14.0. Statistical tests were two-tailed with D &lt; 0.05 to indicate statistical significance. The respondents were mainly, 92.1% (n=186) in clinical practice. Only 9.4% (n=19) poss...

Sportsperson required a proper balanced diet to full fill the daily need of nutrients. Absence of nutrients and their presence in lesser amounts in the sportsperson diet affects the performance of sportsperson. Many researchers found that the diet rich in nutrients and intake of sports drinks enhance the sportsperson performance. Sports drinks are to prompt fast fluid absorption and speed up rehydration and promote recovery after the exercise. Macronutrients plays an important role in our diet, carbohydrates gives energy supply for cell functions, fat also providing energy for workout, and principle elements of cell membranes and facilitation of the absorption of fat-soluble vitamins. Protein helps rebuild and repair muscle after exercise and also a source of energy during exercise, particularly when carbohydrate reserves are very low.

Health Information Seeking Behaviour (HISB) refers to the action individuals take to fulfil their healthrelated information needs. In today's information-rich world, understanding HISB has become crucial for developing effective strategies in information-seeking and health management. For university students, efficient HISB can alleviate health-related anxiety, enhance risk management, promote self-care, and empower informed decision-making, all of which can positively impact academic performance. The findings unveiled intriguing patterns in information source preferences, with 46.2% of students turning to the Internet as their primary source, 41% relying on interpersonal networks, and 13% consulting healthcare professionals. Notably, no students reported using mass media platforms for health information. Gender, year of study, degree program, physical activity, health literacy, self-efficacy, and perceived severity of health problems exhibited significant associations with the choice of information sources. For instance, male students preferred the Internet, while female students leaned towards consulting healthcare professionals and interpersonal networks. Second-year students primarily used the internet, while finalyear students sought advice from family and friends. Those who work-activity turned to healthcare professionals, whereas sports-activity favoured the internet. Furthermore, students with low work activity showed reduced odds of using the internet. Interestingly, sports activity had a significant impact only among internet information seekers. Students with moderate health literacy were more inclined to consult family and friends. This comprehensive study provides valuable insights into the factors affecting HISB among university students, offering a nuanced understanding of their information-seeking behaviour. These findings have implications for health education and interventions promoting informed and responsible health-related decision-making among young adults.

The aim of the study was to evaluate intraocular pressure (IOP) control, potential benefits, and associated complications in advanced cases of glaucoma (visual acuity of &lt;6/60) after trabeculectomy. Although many studies of trabeculectomy in glaucoma patients have been done, very few in such advanced cases. The study was done on 60 cases of advanced primary open-angle glaucoma (POAG). Trabeculectomy was done and IOP control was assessed. Pre-operative workup included a detailed history, slit lamp biomicroscopy, Goldmann applanation tonometry, gonioscopy using Goldmann 2 mirror lens, and detailed fundus examination with the 78D lens. All the patients were to undergo optical coherence tomography and Humphrey automated perimetry. Out of 60 patients with POAG, 48 were males and 12 were females with a ratio of 4:1. Of all the 60 cases, 36 had a visual acuity of 20/200, 16 had a visual acuity of hand movements, and eight patients had a visual acuity of perception of light. The mean pre...

With new advancement in treatment of the acute severely burned patients leads to an increase in number of patients posted for series of reconstructive surgery to treat post burn sequel. Post burn contraction (PBC) neck not only restrict the movement of neck but also leads to restriction in mouth opening , respiratory difficulty, alteration in position of trachea and distortion of cervical spine. Repair of PBC neck taken as a priority as it will help the airway management in subsequent procedure. The oro-facial and anterior neck contracture makes prediction of difficult airway in burn patients challenging, also functional anomalies and comorbid condition like sub mucous fibrosis can be easily missed. Here we are presenting a case of a patient having sub mucous fibrosis with accidental electrical burns involving face, neck, anterior chest wall and both upper limb. The combination of sub mucous fibrosis with PBC neck leading to fix flexion deformity is a unique challenge for airway man...

Women with both human immunodeficiency virus and sickle cell disease face distinct reproductive hurdles stemming from intertwined biological, pharmacologic, and psychosocial influences. Each condition separately affects fertility due to immune dysregulation, persistent inflammation, hormonal interference, and blood vessel issues, while their simultaneous presence intensifies these impacts. This narrative review examines the intricate connections between HIV and SCD in women, highlighting processes that influence ovarian function, fertility preservation, safe conception, and maternal-fetal results. Literature related to the topic was compiled from PubMed, Scopus, Web of Science, and Google Scholar, concentrating on research about fertility, reproductive endocrinology, management of hematologic and infectious diseases, and the effects of antiretroviral therapy and hydroxyurea. Global standards from the World Health Organization and the Centers for Disease Control and Prevention were included to frame clinical recommendations. HIV and SCD intersect via mechanisms such as oxidative stress, endothelial dysfunction, gonadal suppression, and chronic inflammation, resulting in reduced ovarian reserve, menstrual irregularities, and subfertility. Pharmacologic treatments, although crucial, may have cumulative gonadotoxic impacts, underscoring the necessity for fertility preservation methods. Multidisciplinary approaches that incorporate hematologic stabilization, optimization of ART, reproductive counseling, and strict adherence to PMTCT guidelines enhance reproductive results and lower the risk of vertical transmission. The convergence of HIV and SCD creates complex reproductive issues that necessitate personalized, evidence-based care. Timely preconception counseling, comprehensive clinical care, and focus on psychosocial elements are essential for maintaining fertility and safeguarding maternal and fetal health. Additional studies are necessary to clarify the lasting impacts of ART and hydroxyurea on ovarian reserve and pregnancy results.

Dengue has emerged as one of the most severe and rapidly escalating public health threats in Bangladesh, refl ecting both localized vulnerabilities and broader global transmission dynamics. This study aims to examine the key environmental, climatic, and socioeconomic drivers underlying the country's unprecedented dengue surge since 2018, with particular emphasis on post-COVID trends. The central research questions are: (i) how climate variability and urban environmental changes are reshaping dengue transmission in Bangladesh, (ii) which often-overlooked structural factors are intensifying the severity of outbreaks, (iii) how these local dynamics refl ect emerging global risks, and (iv) how global risk management practices can be effectively implemented in the Bangladeshi context. Using a comprehensive narrative review of national surveillance data obtained from offi cial sources, peer-reviewed literature, meteorological records, and validated public reports, the study synthesizes evidence on temperature rise, altered rainfall patterns, humidity, unplanned urban growth, population density, sanitation failures, construction activity, pollution, insecticide resistance, and declining green cover. Findings indicate that dengue transmission in Bangladesh is driven by a convergence of climate stressors and human-made environmental conditions, particularly clogged drainage systems, unmanaged plastic waste, water storage practices, and high-rise construction sites that facilitate Aedes mosquito breeding. The study concludes that Bangladesh's dengue crisis represents an early warning of a wider global emergency. Addressing it requires integrated climateresponsive surveillance, urban planning reforms, strengthened vector control, and coordinated public health action grounded in a One Health approach.

Introduction: Anemia is when the blood's hemoglobin (Hb) level is less than usual. Anemia is a nutritional problem that is prevalent throughout the world. Anemia occurs not only in developing countries but also in developed countries. Anemia can occur anywhere and can happen to anyone. The impact of anemia on adolescent girls in the short term is to disrupt growth and development, reduce physical ability and work activity, reduce learning concentration, and hurt the digestive tract, central nervous system, cardiovascular system, and immunity. Material and Methods: This research is a literature review. Articles according to the theme were selected from 2018-2023 from electronic databases such as Science Direct, PubMed, and Google Scholar. We used the PRISMA method for the analysis of the literature review. Results: From 217 selected articles, 16 eligible studies were thoroughly reviewed, and only 10 could be analyzed. The results of the ten articles examined that many factors affect adherence to taking Fe tablets, namely knowledge that dominates in the matter. With the help of their parents, families, and teachers, the students exhibited a promising level of compliance with taking iron tablets, which is anticipated to lower the prevalence of anemia among teenage girls.

Background: Many critically ill patients in intensive care units (ICUs) suffer from threatening or manifest organ failure which puts them at risk of death. Respiratory insufficiency is the most common organ failure. These patient's ability to change body position is reduced due to sedation and disease which makes the patient dependent to the ICU nurse responsible for the patients change of body position to avoid complications. Hypoxemic patients can be positioned in a prone position in addition to mechanical ventilation to improve oxygen saturation, reducing mortality. The position is related to a risk of complications. With the increased use of prone positioning of late there is a need for new knowledge about related complications so that these can be addressed preventively and thereby increase patient safety. Aim: To identify and summarize the research of the past ten years regarding patient-related complications associated with prone positioning of patients with critical illness. Design and method: A systematic literature review of relevant scientific journal articles was performed. Data was analyzed using content analysis. Results: 18 quantitative articles including 1580 critically ill patients in prone position were analyzed. The analysis resulted in four categories, The body surface, Breathing related complications, Hemodynamic instability and Abdominal complications, with ten subcategories. Patients were affected by several different complications, the three most common were pressure ulcers, ventilatory complications and ventilator associated pneumonia. A total of 993 separate complications occurred among the 1580 critically ill patients in prone position. Conclusion: Critically ill patients are at risk of several different complications when being cared for, or having been cared for, in prone position. The identified complications affect different body parts but pressure ulcers in the skin and complications related to the respiration are the most common.

In the fall of 2004 and again in spring of 2007, the journal Health Affairs asked my colleague, Professor Janet Golden of Rutgers University, and me to write some historical perspectives on children's health policy in the United States and how that history had shaped our present. It was, to put it crudely, an intriguing gig because Health Affairs is not only the leading journal of health policy wonks across the nation, it is also read by every Congressperson-or his or her staff members-who is concerned with health issues. So here was a chance, we thought, to, at least, speak truth to power. Many of the historically informed and entirely impassioned conclusions we made would not be a surprise to an audience comprised of the University of Michigan's School of Social Work. They were: 1. Focus on the environment that makes children sick rather than on sick children. 2. Attack the biggest health problems, not just the most interesting ones. 3. Children's health and welfare professionals need to go where the children are! 4. We do not exactly repeat the past, but that doesn't give us permission to ignore it either. In all candor, we hardly expected many to pay all that much attention to our cliometric analysis; as a historian I am used to being ignored or, at best, tolerated as a literary form of window dressing when major events come up that need a "bit of historical context" or, in the case of anniversaries and celebrations, some background to demonstrate how far we have progressed. In some sense, however, the Fauri Lecture is a much better bully pulpit not only because it is delivered to a body of distinguished social workers and social theorists who are "on the ground," so to speak, in our struggle for social justice for all Americans, regardless of race, creed, or age, but also because it affords me the opportunity to try to convince you about the remarkable value of historical insight. I may be called biased, but I believe that historians have a great deal to offer to those struggling with policy dilemmas-not only because they have a nuanced and contextualized view of how the dilemmas began and evolved, but also because a study of the past reveals many useful models and good ideas that still deserve to be acted upon. Or as the late President Harry Truman once opined, "There is nothing new in the world, except the history you don't know." This is particularly true in the case of U.S. child health and welfare policy.

salud enfermedad y estructura social UNA CONTRIBUCION PARA SU ESTUDIO RESUMEN: E l autor h w una breve revision sobre las idees mas recientes acerca da las relacionas e n t m e l p r n c n o salud-enfermedad y la estructura social. Propone u n m oddo, sp~rciciondiuble, para el estudio emplrico de dichas relaciores. E l modelo propcvrsto ?! mar r o m o ceruteristicas. el objeto da n t u d i o qua plantea. esto es. 111 gewbn cohctivo de marbilidad, tuiacisnindolo con l o s distintos niveles di1 la estructura social. Se sugiere una nueva tipo4ogle da 41s enfenneddas colrctivm, t o m m d o p o ~

The notion of partnerships and co-production has been introduced in the latest public services policies, suggesting that the key to reforming them is to encourage users to design and deliver services in equal partnerships with professionals. It is argued that coproduction has the potential to deliver a major shift in the way we provide health, education, policing and other services in ways that make them much more effective, more efficient, and therefore more sustainable.

This report presents findings from an evaluation study of the co-production processes in a
community-based mental health project at the London Borough of Wandsworth. The evaluation sought to describe actions, changes, and functions that brought about a coproductive way of offering Improve Access to Psychological Therapies (IAPT) services in this locality. The study aimed at producing transferable knowledge about a novel model of public service provision, which was developed by Wandsworth Community Empowerment Network (WCEN) in association with the South West London and St George’s Mental Health Trust. The ‘Wandsworth Model’ entails canvassing partnerships with local faith based and other community groups, who got engaged in co-producing responsive mental health services, in an attempt to address issues such as access and effectiveness of service delivery.

The study applied a participatory research approach to capture the co-production processes that took place in establishing the partnership between the mental health services and WCEN and the impact of such initiatives in reaching out to local BME communities. Our main method of gathering evidence was narrative interviews which were conducted with key informants from the three groups involved in delivering co-produced services: IAPT professionals, WCEN workers, and community/religious leaders. The thematic interview areas were: the participants’ involvement in the co-produced services, views about co-production, benefits and challenges of co-production for all stakeholders, and suggestions for improvement.

The findings for this study suggest that co-production can be very rewarding for both public agencies and communities, if supported and implemented with a view to empower people instead of making false economies for the welfare services. The ultimate goal should be that service users become partners in managing their own health however this is a major shift that requires a lot of experience and commitment in the co-production of services and, perhaps, it can only be possible when systemic barriers at community, public agency and state levels are brought down. Nonetheless, the ‘Wandsworth model’ of co-production appears to be a promising approach and should be further explored and supported to achieve its full potential.

Isaac Kuzmar. Facultad de Ciencias de la Salud. Departamento de Investigación Universidad Simón Bolívar. Barranquilla, Colombia. https://orcid.org/0000-0001-89262434, José Rafael Consuegra. Facultad de Ciencias de la Salud. Universidad Simón Bolívar. Barranquilla, Colombia. https://orcid.org/0000-0002-4479-6632, Ernesto Cortés-Castell. Departamento de Farmacología, Pediatría y Química Orgánica. Universidad Miguel Hernández. España. https://orcid.org/0000-0002-8079-1695, Mercedes Rizo-Baeza. Facultad de Ciencias de la Salud. Universidad de Alicante, España. https://orcid.org/0000-0002-6754-6505, Carlos Almanza. Facultad de Ciencias de la Salud. Universidad Simón Bolívar. Barranquilla, Colombia. https://orcid.org/0000-0003-4449-3970, Keisy Antonio. Facultad de Ciencias de la Salud. Departamento de Investigación. Universidad Simón Bolívar. Barranquilla, Colombia. https://orcid.org/0000-0001-8663-5944, Miguel De la Hoz. Facultad de Ciencias de la Salud. Departamento de Investigación. Un...

The uninephrectomised and three-quarter nephrectomised (3/4nx) rats present dopamine-sensitive enhanced natriuresis. This is accompanied in uninephrectomised rats by a reduced jejunal Na + ,K + -ATPase activity with recovered sensitivity to inhibition by dopamine. The present study examined the jejunal Na + ,K + -ATPase activity and the role of dopamine in 3/4nx animals. Methods: Fourteen days after surgery, the L-amino acid decarboxylase activity (AADC) activity, the enzyme responsible for the synthesis of dopamine, and the Na + ,K + -ATPase activity, were determined in jejunal epithelial cells from 3/4nx and Sham rats. In addition, the effect of dopamine (1 µmol/L) on jejunal Na + ,K + -ATPase activity was evaluated in both groups. Results: The 3/4nx rats presented a reduced AADC activity in jejunal epithelial cells (V max in nmol/mg prot/ 15 min, 142 ± 6 vs 190 ± 10, P < 0.05). In addition, the jejunal Na + ,K + -ATPase activity was increased in 3/4nx rats (Pi release in nmol/mg prot/min, 137 ± 1 vs 122 ± 2, P < 0.05). However, dopamine was unable to inhibit the Na + ,K + -ATPase activity in jejunal epithelial cells from both 3/4nx and Sham animals. Conclusions: In contrast to uninephrectomy, the jejunal Na + ,K + -ATPase activity is increased in 3/4nx rats and is not sensitive to inhibition by dopamine.

This is a study of 52 consecutive Human immunodeciency virus (HIV) positive cases with lymphadenopathy undergoing Fine Needle Aspiration Cytology (FNAC) of lymph nodes, including 25 male patients and 27 female patients. Maximum number of cases were seen in fourth and fth decades of life. Cervical lymphadenopathy was the commonest presentation. Tuberculous lymphadenitis was the most common lesion accounting for 31 cases followed by reactive lymphoid hyperplasia (eight cases). Other lesions included acute suppurative lymphadenitis (three cases), metastasis (ve cases), Non Hodgkin Lymphoma (four cases) and suspicious of malignant cells (one case). Caseating granulomatous lymphadenitis was the commonest cytological pattern of tuberculosis (41.93%). AFB positivity was most commonly seen in cases of tuberculosis with caseating pattern of lymphadenitis (80%)

Aim: Osteoporosis is a skeletal disorder that is characterized by low bone mass, micro-structural degeneration of bone and high risk of fracture. In this study our aim was to detect the frequency of osteoporosis in hemodialysis (HD) and continuous ambulatory peritoneal dialysis (CAPD) patients according to Parathyroid Hormone (PTH) after vitamin D therapy during the two years period. Materials and method: 18 HD patients (12 male, 6 female) and 12 CAPD patients (8 male, 4 female) undergoing to dialysis therapy in dialysis center of Medicine Faculty Hospital in Dicle University were enrolled to the study. The patients were evaluated with bone mineral density which was measured by left heel quantitative ultrasound before and after the active vitamin D therapy. The blood samples were collected for biochemical analysis in the morning after 12 hours fasting period before and after the active vitamin D therapy. Results: After the therapy T and Z scores bone mineral density and ALP values were increased in the group that PTH values were between 120-250 pg/ml and more than 250 pg/ml. But these parameters were decreased in the group that PTH were lower than 120 pg/ml. Osteoporosis percentage were 23 % in PTH value <120 pg/ml, %20 in PTH value between 120-250 pg/ml and 20 % in PTH >250 pg/ml in the initial measurement. After the therapy these were 30 %, 0 % and 20 % relatively. Conclusion: Before the treatment there was not a statistical difference between T score of 3 groups. After the treatment there was a statistically significant difference. Especially T score was better after the therapy in the second group that PTH values were between 120-250 pg/ml.

Flowers are playing an important role in our day to day life directly or indirectly. Flowers are the sexual reproductive parts of the plants. They have been an integral part of human beings since ancient times for various purposes like ornamental, decorations, medicine (fresh, distillates, decoction and powdered form), nutrients/foods (fresh garnishes, dried, in cocktails, canned sugar), during religious rites, to pray gods, culinary preparations, essential oils, and in beauty care products etc. As there are several flower drugs (Dawa) in Unani system of medicine which are useful for treating different types of disease conditions/ailments, a review has been made focusing on the therapeutic uses, brief description, major chemical constituents and dosages of some important flowers used in Unani System of Medicine as single drugs and in compound formulations contributing to the popularization of various important medicinal uses of these flowers.

Background: Many intensive care units (ICUs) utilize telemedicine in response to an expanding critical care patient population, off-hours coverage, and intensivist shortages, particularly in rural facilities. Advances in digital health technologies, among other reasons, have led to the integration of active, well-networked critical care telemedicine (tele-ICU) systems across the United States, which in turn, provide the ability to generate large-scale remote monitoring data from critically ill patients. The objective of this study was to explore opportunities and challenges of utilizing multisite, multimodal data acquired through critical care telemedicine. Using a publicly available tele-ICU, or electronic ICU (eICU), database, we illustrated the quality and potential uses of remote monitoring data, including cohort discovery for secondary research. Methods: Exploratory analyses were performed on the eICU Collaborative Research Database that includes deidentified clinical data collected from adult patients admitted to ICUs between 2014 and 2015. Patient and ICU characteristics, top admission diagnoses, and predictions from clinical scoring systems were extracted and analyzed. Additionally, a case study on respiratory failure patients was conducted to demonstrate research prospects using tele-ICU data. The eICU database spans more than 200 hospitals and over 139,000 ICU patients across the United States with wide-ranging clinical data and diagnoses. Although mixed medical-surgical ICU was the most common critical care setting, patients with cardiovascular conditions accounted for more than 20% of ICU stays, and those with neurological or respiratory illness accounted for nearly 15% of ICU unit stays. The case study on respiratory failure patients showed that cohort discovery using the eICU database can be highly specific, albeit potentially limiting in terms of data provenance and sparsity for certain types of clinical questions. Conclusions: Large-scale remote monitoring data sources, such as the eICU database, have a strong potential to advance the role of critical care telemedicine by serving as a testbed for secondary research as well as for developing and testing tools, including predictive and prescriptive analytical solutions and decision support systems. The resulting tools will also inform coordination of care for critically ill patients, intensivist coverage, and the overall process of critical care telemedicine.

Background: Hemoglobin A1C (HbA1c) is the predominant hemoglobin found in HbA1 fractions. A1c assay is the recommended assay for diagnosing diabetes and any condition that changes red cell turnover such as Iron deficiency Anemia (IDA), will lead to spurious A1C results. Therefore, the present study was aimed at determining the effect of IDA on HbA1c in diabetic patients attending Black Lion

Screening of blood and blood products is important to reduce the risk of transfusion transmitted infections (TTIs). The transfusion of unscreened or inadequately screened blood and blood products are the major source of TTIs. The aim of this paper is to find out the prevalence of TTIs in ABO blood groups and Rh type system. A total of 4128 blood donors were screened from January 2010 to April 2014. Serological tests were performed for hepatitis B surface antigen (HBsAg), anti hepatitis C virus (Anti-HCV), anti HIV-1 and 2, venereal disease research Laboratory test (VDRL) and malaria parasite (MP) antigen. In seroreactive donors, HBsAg, Anti-HCV, VDRL, MP antigen and anti HIV were positive in 40 cases, 26 cases, 19 cases, 6 cases and 2 cases, respectively. Highest percentage of HBsAg, Anti HCV, VDRL, MP antigen and anti HIV was observed in blood group A negative (2/50), O negative (1/66), B negative (1/91), AB positive (2/377) blood group respectively. In the present study, the total...

Staphylococcus aureus (S.aureus) is an important zoonotic pathogen implemented in various hospital, community as well as livestock infections. Pets as dogs and cats have increased their close social relation with human leading to significant elevation in transmission of zoonoticmultidrug resistant virulent pathogens.Diplex polymerase chain reaction was applied on ten clinical Staphylococcus aureus isolates obtained from wound and nasal samples from dogs and cats for detection of twoslime formation encoding genes;icaA andicaD. The positive genes carrying isolates were encouraged to produce biofilm and evaluated phenotypically by cultivation onto Congo red medium. Quantitative assessment was done using a microtiter plate assay, also the formed biofilm examined by fluorescent and scanning electron microscopy. Four out of tested tenStaphylococcus aureus isolates were found to harbor the two genes separately.The four isolates displayed positive biofilm production onto Congo red medium wh...

Artificial intelligence (AI) represents the latest trend in dentistry, offering precise tools that can reshape the outcomes of our treatments. Considering the need to support and enhance the clinical decision-making process, this systematic review provides insights into the effectiveness and accuracy of various AI models. The aim is to evaluate the evidence on the effectiveness of various AI models for implant dentistry in diagnosis, treatment planning, prognosis, and implant system classification. In accordance with the PRISMA-DTA guidelines, a comprehensive search was conducted across multiple databases, including PubMed/Medline, Google Scholar, and Cochrane from the year 2016 to 2024. During the article screening and selection process, the PICO guidelines were followed. The methodological quality and bias of the study were assessed using the Critical Appraisal Skills Programme (CASP) 2023 checklist for systematic review and the CASP checklist for clinical prediction rule. It has been found that AI models are highly effective in detecting anatomical landmarks, improving surgical planning for implant positioning, predicting the outcome based on alveolar bone patterns around the implant, and providing accurate classification in detecting implant systems. For clinicians to achieve the greatest benefits for their patients, a broader knowledge of AI applications in implant dentistry and a deeper understanding of its insights are essential.

Introduction: migratory flows towards countries that have more labor supply are not recent. In this sense, the arrival of immigrants in host countries, in many cases, makes this population more susceptible to health risk situations because of work activities, lack of integration with the local population and the immigration process itself. Methods: the study used a bibliographic review of the literature as a method. In this context, integration policies and the recognition of educational training in the country of origin can contribute to improving the living conditions of this population in Brazil. Results: in this context, this study aims to provide a summary of the challenges faced by immigrants in search of improved living conditions. Furthermore, this study contributes to identifying the main challenges facing immigrants recently arrived in Brazil and the difficult process of integration into local society. It is observed that the authors highlight in common that, worldwide, in the different receiving countries, regardless of the social, political, and economic context in which the immigrants find themselves, there is some destructive process that conditions the health-disease process of this population, resulting from the various factors mentioned above. Conclusion: yet the positive contribution of migration to development is increasingly recognized, and these targeted policies will maximize their benefits in both countries of origin and destination.

Background: Cardiovascular diseases (CVDs) are the number one cause of death worldwide. An estimated 17.5 million people died worldwide in 2012 due to CVDs, representing 31% of all global deaths. In Ghana, CVDs were responsible for 14% of institutional deaths. Risk factors for coronary heart disease and stroke begin in childhood that develops in adulthood. The aim of this paper is to review CVD risk factors among secondary school students, prevalence and primary prevention of the disease. Methods: Detailed English-language literature search published between 2001 to present was conducted from Pub Med, Google Scholar and Cochrane library that identified ninety five published articles in exploring CVD risk factors among adolescent secondary school students. Eighty two of the papers were research articles from Ghana, Sudan, Congo, Nigeria, USA, UK, China, Canada, Turkey, Holland, and Poland, while thirteen were reports from World Health Organization (WHO), Institute of Medicine (IOM), ...

The thyroid seems to be an part of the endocrine system that is placed toward the front of neck and produces thyroxine, which are essential for our overall health. If it fails, thyroid hormone production will either be insufficient or excessive. Machine learning techniques and data mining are critical in processing large amounts of data, particularly in the health care system, where there has been a massive amount of information and data need to be managed. In our research on thyroid disease, we used machine learning approaches. In our study, we used statistics from patients, a few of which has hyperactive thyroid glands moreover those have hypothyroidisms; therefore, overall algorithms were used. These study aims to divide this disease in few categories like as hypothyroidism, regular and hyperthyroidism. Support vector machine include KNN, naive-bayes, logistic regressions, decision tree, random forest, discriminant function analysis, and multilayer perceptron (MLP). To the thyroi...