Miracle-dz/UniFAR-FTUs huggingface dataset:
The Importance of Independence in Toileting: the Views of Stroke Survivors and their Occupational Therapists

The profession of occupational therapy claims to be patient centred; however, research shows that the views of patients and health care professionals often differ. Toileting is a fundamental daily activity, yet to date there have been few studies investigating the perceived importance of independence in toileting. A qualitative study was conducted to determine the views of stroke survivors and their occupational therapists regarding the importance of independence in toileting. A symbolic interactionistic framework was used, allowing the views of these two disparate groups to be compared. Thirteen stroke survivors and seven occupational therapists were interviewed. Five categories were identified in the data collected: the occupational form normally used in toileting; incontinence and continence; independence and dependence in toileting; issues relating to toileting and hospital discharge; and the role of occupational therapy. Both participant groups agreed that independence in toileting was important in avoiding the need for assistance and in avoiding feelings of decreased self-esteem. However, the patient participants' views extended further in that they stated that the method of toileting was important, not merely that it was conducted independently. In conclusion, it is essential that occupational therapists consider how they can facilitate a return to the method usually undertaken for toileting by patients. If a return to the previous methodology for toileting will not be possible, then the occupational therapists must give consideration as to how to facilitate adjustment by the patients.
Association Between Estimated Net Endogenous Acid Production and Subsequent Decline in Muscle Mass Over Four Years in Ambulatory Older Chinese People in Hong Kong: A Prospective Cohort Study.

BACKGROUND Findings regarding dietary acid-base balance and muscle loss were mainly reported in Caucasian populations and seldom documented in Chinese population with different dietary habits. This prospective study examined such association in 3,122 Chinese community-dwelling older people aged 65 and over in Hong Kong. METHODS Baseline dietary intakes were assessed using a validated food frequency questionnaire. Estimated net endogenous acid production (NEAP) was calculated using Frassetto's method based on the diet's protein to potassium ratio. Nutrient intakes and estimated NEAP were energy-adjusted by residual method. Estimated NEAP was divided into sex-specific energy-adjusted quartiles for data analysis. Four-year change in appendicular skeletal muscle mass (ASM) from baseline was assessed using dual-energy X-ray absorptiometry. Analysis of covariance was used to investigate the association between quartiles of estimated NEAP and 4-year change in ASM with adjustments for potential covariates. RESULTS Median estimated NEAP of the participants was 47.3 (IQR: 35.5, 61) mEq/d. Participants in the highest sex-specific quartile of energy-adjusted estimated NEAP lost significantly more ASM over 4-year than those in the lowest sex-specific quartile of energy-adjusted estimated NEAP in both crude and adjusted models (adjusted mean ± SE: 0.486±0.054 vs 0.384±0.055 kg, p(trend) = . 026). Change in gait speed was not associated with the estimated NEAP. CONCLUSIONS Our findings provide evidence of a slower decline in muscle mass in older adults with a lower dietary acid load. More prospective cohort studies in populations with different dietary habits and randomized controlled trials are warranted to examine the role of dietary acid-base balance in age-related decline in muscle loss.
Voltage-Mode Universal Biquadratic Filter Using Single DVCC

A voltage-mode universal biquadratic filter using a differential voltage current conveyor (DVCC), two capacitors, and two resistors is presented. The proposed circuit has four input terminals and three output terminals and can realize all the standard filter functions, which are lowpass, bandpass, highpass, notch, and allpass filters, without changing the circuit topology. Three simultaneous output filter responses can be obtained from some derived filter types. The proposed circuit employs only one DVCC that simplifies the configuration.
La lógica de una de las creencias tradicionales en salud: eclipse y embarazo en Ocuituco, México

An analysis of the logic of one of the commonest health beliefs in rural areas of Mexico is made, taking as a starting point testimonies collected in the area of Ocuituco, in the state of Morelos. This belief suggests that a pregnant woman is in danger of having a harelipped baby during a solar eclipse. The importance of the knowledge about the logic of this kind of beliefs is discussed from a public health perspective. These beliefs are associated with specific forms of suffering and give way to particular preventive measures which must be taken into account if the efficacy of health programs is to be increased. The interrelation of these beliefs with other traditional elements (such as the "loss of the shadow" and the "hot-cold theory") is discussed. Also, some of the already existing interpretations of this belief which seek to link the "loss of the shadow" with the solar eclipse belief are reviewed. Finally, an alternative interpretation of this belief is made from a structuralist methodological perspective. This interpretation is grounded in the Nahuatl myth on the creation of the sun and the moon, and in an analysis of the nature of rabbits in the Nahuatl culture, according to historic secondary sources. It is suggested that the belief about the danger of a solar eclipse must be interpreted in connection to the "hot-cold theory", but not to the "loss of the shadow". This paper concludes by emphasizing the importance of this type of research within the public health field, as it enables us both to understand the underlying logic of this type of conceptions, and to reinforce the dialogue between modern and alternative medicine, so that the daily encounter between these two types of medicine can be facilitated.
Efficacy of topical tranexmic acid in the treatment of melasma

Melasma is a common acquired dyspigmentation, characterized by light to dark brown patches in the sun-exposed areas. The role of factors such as genetic susceptibility, ultraviolet exposure, hormonal factors, phototoxic drugs, and cosmetics have been reported in its appearance. Its therapy is a big challenge. Sunscreens, bleaching agents, tretinoin, topical corticosteroids, peeling agents, and lasers have been used in treating melasma (1). Tranexamic acid (TA) is a hemostatic drug. This agent seems to be effective in treating melasma through its antiplasmin activity and subsequent decreased levels of arachidonic acid and alpha-melanocyte-stimulating hormone (1). Herein, we have summarized studies which have assessed the efficacy of topical TA in treating melasma: 1. In a split-face trial, Kanechorn Na Ayuthaya evaluated the efficacy of topical 5% TA in comparison with its vehicle. This study revealed that not only the therapeutic response induced by TA was not superior, but also erythema as side effect was seen only with TA (2). 2. Na et al. assessed the effect of oral and topical TA combination. This study revealed its clinical effectiveness and also showed reversion of melasma-related pathologic changes like vessel number and increased numbers of mast cells (3). 3. In a split-face trial, the efficacy of topical 3% TA was compared with topical3% hydroquinone 1 0.01% dexamethasone. In this study, Ebrahimi and Naeini concluded that the topical TA was effective and safe therapeutic option (1). 4. In a split-face trial, Banihashemi et al. compared the efficacy of topical 5% liposomal TA with 4% hydroquinone cream. The authors showed that topical TA can be as an effective and safe therapeutic option (4). 5. In combination with intense pulsed light therapy, Chung et al. in a randomized split-face clinical trial compared topical TA with placebo. The authors revealed the effectiveness and safety of TA as adjuvant to conventional therapy (5). Commentary: Although most of the mentioned therapy revealed the effectiveness of TA in treating melasma, more robust studies with more cases are needed to confirm this effectiveness.
Efficacy and Safety of In-Asia-manufactured Interferon alpha-2b in Combination with Ribavirin for Therapy of Naïve Chronic Hepatitis C Patients: A Multicenter, Prospective, Open-Label Trial

Background : An open-label, multi center and non-comparative study was conducted to evaluate the efficacy and safety of a more affordable in-Asia-manufactured interferon a-2b product in combination with ribavirin to treat naive chronic hepatitis C patients. Method : Thirty chronic naive hepatitis C patients were treated with in-Asia-manufactured interferon a-2b subcutaneously 3 MIU thrice weekly and ribavirin 800-1,200 mg daily for 48 weeks. Follow-up was done until 24 weeks after the end of treatment. Efficacy was assessed by examining serologic and biochemical parameters at pre and post-treatment. Safety was assessed by evaluating clinical symptoms and laboratory parameters. Results : The virological response and sustained virological response rates of all Hepatitis C Virus (HCV) genotypes were 83.3% and 76.7% respectively. Post-treatment, 80% patients had significant alanine transaminase (ALT) decreased into normal level and remained normal in 76.7% patients at 24th week follow up period. At that time, the ALT level and sustained virological response were lower in HCV genotypes 1 and 4 than in non-1 and non-4 genotypes. The most frequent adverse event was flu-like syndrome. Conclusion : The efficacy and safety study on combination therapy of in-Asia-manufactured interferon a-2b and ribavirin has shown a good result based on the current standard of interferon alpha and ribavirin combination therapy. Keywords : interferons, combination drug therapy, chronic hepatitis C, treatment efficacy, safety
Causes and pattern of tooth mortality among adult patients in a teaching dental hospital

This study aims to determine the c auses and pattern of tooth mortality among adult patients visiting the dental clinics of Ajman University of Science and Technology (AUST), Faculty of Dentistry, UAE and compare results with other international studies. The study was also aiming to determine the future preventive measures. Materials & method : Retrospective study design, 1000 files of the adult patients from September 2006 till April 2007 have been selected randomly. Results : Out of 519 patients undergone extraction, 1301 teeth were extracted for different reasons. The results of the study show that the major reason for extraction was caries 40.96% followed by periodontitis 33.7%, 21.1% for the endo-perio. lesions. Patients were commonly from the twenties age group 28.1%. Male patients were in general more than female patients except in the age group (12-30). Minitab 15 was used to statistically analyze the data. Conclusion : Caries was the main reason for tooth loss in AUST dental clinics among all patients, upper molars were the teeth most commonly extracted and the twenties age group was the commonest age group came for extraction. Key words : Dental extraction, Tooth mortality, Tooth loss, cohort study.
PREVALENCE AND CAUSES OF HEARING HANDICAP IN ARDABIL PROVINCE, WESTERN IRAN

Background and Aim: Hearing impairment is the most prevalent sensorineural defect in human. Epidemiological studies and the following preventive programs are the first steps to save many individuals from being handicapped and non-productive. Hereby, we aimed to study the prevalence of hearing impairment in Ardabil province and to assess the prevalent causes of hearing impairment in Ardabil. Methods: In this study, 10718 cases were selected by random cluster sampling from rural and urban population in Ardabil province. Data was gathered using screening questionnaire, normaland impaired-hearing individual questionnaire, and clinical audiometry. Statistical indices were calculated and data was analyzed using chi-square test. Results: 7.1 per thousand individuals suffer hearing impairment and 4.3 per thousand are deaf. Hearing impairment was significantly more among villagers and aged individuals (p=0.46). However, there was no significant deference between two genders (p>0.05). Our results also showed significant deference in consanguineous marriage (p=0.031), accidents in pregnancy (p=0.007), older age of mother (p=0.007), parents hearing loss, severe illness during childhood (p=0.001), low family income (p=0.004), rural housing and educational level of parents (p=0.001) with hearing impairment. Conclusion: Health status, economical, cultural and educational level of society are the most important factors associated with hearing impairment in Ardabil province. Consequently, extensive preventive programs are required to limit such factors.
Student and Course Factors Predicting Satisfaction in Undergraduate Courses at Harvard University.

This study investigated predictors of Harvard University (Massachusetts) student ratings of courses. Data were drawn from 33,180 evaluations of 1,114 undergraduate courses in 47 departments. Predictors examined at the student level included satisfaction with the course, perceived course difficulty, whether the course was in the student's major, whether the course was required, and whether or not the student was a freshman. Course-level variables included mean student rating of difficulty, proportion of students who were majors, proportion of students taking the course as a requirement, proportion of students who were freshmen, course size, faculty rank, course format, and whether the course was introductory. Hierarchical linear modeling of the data found that factors positively influencing course satisfaction included: social sciences/humanities/core curriculum courses; higher level of difficulty; high proportion of majors; tutorial courses; course taught by an assistant or associate professor; and being in a freshman class with few freshmen. Factors found to have a negative influence on satisfaction included: math/science courses; high proportion of students taking the course as a requirement; and being in a math/science course and finding it more difficult than others. The rating form and statistical summaries are appended. (Contains 11 references.) (MSE) *********************************************************************** Reproductions supplied by EDRS are the best that can be made from the original document. *********************************************************************** Student and Course Factors Predicting Satisfaction in Undergraduate Courses at Harvard University Mailing address. Janet T. Civian Office of Institutional Research Wellesley College 106 Central Street Wellesley, MA 02181 Janet T. Civian Robert T. Brennan
Adolescent health promotion: The value of being a peer leader in a health education/ promotion peer education programme

Objective To explore the process of adolescent peer leaders and the benefits of being a peer leader in a sexual health HIV/AIDS peer education programme. Design A qualitative study using the principles of grounded theory method. Setting Individual interviews were carried out by the researcher in a room within the building where training of peer leaders took place. Method Fifteen semi-structured in-depth interviews, followed by grounded theory investigation. Results Findings indicated that the process of peer leadership although complex was largely beneficial. The peer leaders were able to identify areas where the experience had benefited them as individuals. Conclusion The peer leaders that participated in the study highlighted positive changes in attitudes and also discussed the effects on their personal lifestyles. From the findings a correlation framework emerged that could be used for studying the interrelationship of factors that determine the effects of being a peer leader.
Association of Antithrombotic Drug Use With Subdural Hematoma Risk

Importance Incidence of subdural hematoma has been reported to be increasing. To what extent this is related to increasing use of antithrombotic drugs is unknown. Objectives To estimate the association between use of antithrombotic drugs and subdural hematoma risk and determine trends in subdural hematoma incidence and antithrombotic drug use in the general population. Design, Setting, and Participants Case-control study of 10 010 patients aged 20 to 89 years with a first-ever subdural hematoma principal discharge diagnosis from 2000 to 2015 matched by age, sex, and calendar year to 400 380 individuals from the general population (controls). Subdural hematoma incidence and antithrombotic drug use was identified using population-based regional data (population: 484 346) and national data (population: 5.2 million) from Denmark. Conditional logistic regression models were used to estimate odds ratios (ORs) that were adjusted for comorbidity, education level, and income level. Exposures Use of low-dose aspirin, clopidogrel, a vitamin K antagonist (VKA), a direct oral anticoagulant, and combined antithrombotic drug treatment. Main Outcomes and Measures Association of subdural hematoma with antithrombotic drug use, subdural hematoma incidence rate, and annual prevalence of treatment with antithrombotic drugs. Results Among 10 010 patients with subdural hematoma (mean age, 69.2 years; 3462 women [34.6%]), 47.3% were taking antithrombotic medications. Current use of low-dose aspirin (cases: 26.7%, controls: 22.4%; adjusted OR, 1.24 [95% CI, 1.15-1.33]), clopidogrel (cases: 5.0%, controls: 2.2%; adjusted OR, 1.87 [95% CI, 1.57-2.24]), a direct oral anticoagulant (cases: 1.0%, controls: 0.6%; adjusted OR, 1.73 [95% CI, 1.31-2.28]), and a VKA (cases: 14.3%, controls: 4.9%; adjusted OR, 3.69 [95% CI, 3.38-4.03]) were associated with higher risk of subdural hematoma. The risk of subdural hematoma was highest when a VKA was used concurrently with an antiplatelet drug (low-dose aspirin and a VKA: 3.6% of cases and 1.1% of controls; adjusted OR, 4.00 [95% CI, 3.40-4.70]; clopidogrel and a VKA: 0.3% of cases and 0.04% of controls; adjusted OR, 7.93 [95% CI, 4.49-14.02]). The prevalence of antithrombotic drug use increased from 31.0 per 1000 individuals from the general population in 2000 to 76.9 per 1000 individuals in 2015 (P < .001 for trend). The overall subdural hematoma incidence rate increased from 10.9 per 100 000 person-years in 2000 to 19.0 per 100 000 person-years in 2015 (P < .001 for trend). The largest increase was among older patients (>75 years; n = 4441) who experienced an increase from 55.1 per 100 000 person-years to 99.7 per 100 000 person-years (P < .001 for trend). Conclusions and Relevance In Denmark, antithrombotic drug use was associated with higher risk of subdural hematoma; and the highest odds of subdural hematoma was associated with combined use of a VKA and an antiplatelet drug. The increased incidence of subdural hematoma from 2000 to 2015 appears to be associated with the increased use of antithrombotic drugs, particularly use of a VKA among older patients.
A school-based helminth control programme successfully implemented in KwaZulu-Natal

The design of the school-based Parasite Control Programme (referred to below as a helminth control programme) run in the province of KwaZulu-Natal, South Africa, from 1997-2000 is described. Emphasis is given to the role of the Parasite Control Task Group which provided a forum for a wide variety of issues relating to the programme to be debated before they were agreed upon. The programme targeted the three common geohelminths (Trichuris trichiura, Ascaris lumbricoide and hookworm) and the urinary schistosomiasis (bilharzia) fluke, Schistosoma haematobium. It is expected that a national control programme will be setup in South Africa in the future. With this in mind, new opinions and experiences in several aspects of helminth control that have become available since 2000 are included so that they can be considered for any future programme.
Impact of Single or Repeated Dose Intranasal Zinc-free Insulin in Young and Aged F344 Rats on Cognition, Signaling, and Brain Metabolism

Novel therapies have turned to delivering compounds to the brain using nasal sprays, bypassing the blood brain barrier, and enriching treatment options for brain aging and/or Alzheimer’s disease. We conducted a series of in vivo experiments to test the impact of intranasal Apidra, a zinc-free insulin formulation, on the brain of young and aged F344 rats. Both single acute and repeated daily doses were compared to test the hypothesis that insulin could improve memory recall in aged memory-deficient animals. We quantified insulin signaling in different brain regions and at different times following delivery. We measured cerebral blood flow (CBF) using MRI and also characterized several brain metabolite levels using MR spectroscopy. We show that neither acute nor chronic Apidra improved memory or recall in young or aged animals. Within 2 hours of a single dose, increased insulin signaling was seen in ventral areas of the aged brains only. Although chronic Apidra was able to offset reduced CBF with aging, it also caused significant reductions in markers of neuronal integrity. Our data suggest that this zinc-free insulin formulation may actually hasten cognitive decline with age when used chronically.
Association Between Lifestyle Factors and the Incidence of Multimorbidity in an Older English Population

Background Evidence on the role of lifestyle factors in relation to multimorbidity, especially in elderly populations, is scarce. We assessed the association between five lifestyle factors and incident multimorbidity (presence of ≥2 chronic conditions) in an English cohort aged ≥50 years. Methods We used data from waves 4, 5, and 6 of the English Longitudinal Study of Ageing. Data on smoking, alcohol consumption, physical activity, fruit and vegetable consumption, and body mass index were extracted and combined to generate a sum of unhealthy lifestyle factors for each individual. We examined whether these lifestyle factors individually or in combination predicted multimorbidity during the subsequent wave. We used marginal structural Cox proportional hazard models, adjusted for both time-constant and time-varying factors. Results A total of 5,476 participants contributed 232,749 person-months of follow-up during which 1,156 cases of incident multimorbidity were recorded. Physical inactivity increased the risk of multimorbidity by 33% (adjusted hazard ratio [aHR]: 1.33, 95% confidence interval [CI]: 1.03-1.73). The risk was about two to three times higher when inactivity was combined with obesity (aHR: 2.87, 95% CI: 1.55-5.31) or smoking (aHR: 2.35, 95% CI: 1.36-4.08) and about four times when combined with both (aHR: 3.98, 95% CI: 1.02-17.00). Any combination of 2, 3, and 4 or more unhealthy lifestyle factors significantly increased the multimorbidity hazard, compared with none, from 42% to 116%. Conclusion This study provides evidence of a temporal association between combinations of different unhealthy lifestyle factors with multimorbidity. Population level interventions should include reinforcing positive lifestyle changes in the population to reduce the risk of developing multimorbidity.