Miracle-dz/UniFAR-FTUs huggingface dataset:
Well‐being in Wandsworth: a public mental health audit

This paper describes a survey of mental health and well‐being in the adult population served by Wandsworth Primary Care Trust. The survey was designed as a pilot to obtain benchmark data on public mental health. The findings support the argument that absence of mental ill health does not equate with mental health. More than 12% of the sample were found to have symptoms of mental illness yet reported good mental health, while just over 10% had no symptoms but reported poor mental health. Looking at predictors, the most vulnerable to mental ill health were younger, divorced or separated adults who were unemployed and had a long‐term illness or disability. Older couples in good health were among those least likely to have mental health problems. The authors conclude that more sensitive and reliable public mental health indicators are needed to demonstrate clear evidence of improved mental health and to inform future work to improve the mental health and well‐being of the local population.
Skills development and family interventions in an early psychosis service

Background: Little is known about the development and use of skills within functionally differentiated specialist mental health teams. Method: A prospective cohort study of skills acquisition and a cross-sectional investigation of family work in a specialist early psychosis service (COAST) were carried out, using generic community mental health teams (CMHTs) for comparison data. Results: Self-reported skills improved over time in the COAST team, but not in the comparison CMHT. All staff acknowledged the importance of family work in psychosis, but COAST staff had access to supervision and engaged more in family work. The pattern of family work undertaken differed from that reported in research studies. Conclusions: Tracking the acquisition of skills by mental health staff is feasible. However, clinical skills are used differently in routine services and in research settings. Most families in early episodes of psychosis need relatively low intensity support, such as information and a clear contact point.
Learning Processes and Study Strategies Influential to College Adjustment

This study investigated relationships between entry-level learning processes and study strategies and student adaptation to college. A regression model consisting of the Learning and Study Skills Inventory (LASSI; Weinstein & Palmer, 2002) subscales and GPA significantly predicted student adaptation to college as measured by the Student Adaptation to College Questionnaire (SACQ; Baker & Siryk, 1999). The attitude and anxiety subscales emerged as significant predictors in this model. Correlational results indicated that attitude and anxiety were significantly correlated with four specific aspects of college adaptation (i.e., academic, personal-emotional, or social adjustment; and institutional attachment). Attitude was most strongly correlated with academic adjustment. Anxiety was most strongly correlated with personal-emotional adjustment. Consideration of these findings provides practical insights into the college adjustment process. Implications are discussed and suggestions for orientation and retention programs are offered.
Does an increase in non‐antihypertensive pill burden reduce adherence with antihypertensive drug therapy?

Objectives Hypertensive patients often are prescribed multiple medications for their hypertension as well as for other chronic conditions. Poor adherence has been both positively and negatively associated with increasing numbers of medications or required daily doses. We sought to determine whether adherence with antihypertensive drugs changes in response to a change in non‐antihypertensive pill burden.
Evaluation of the disposable Vital View™ laryngoscope

The Vital View™ laryngoscope (Vital Signs, NJ, USA) consists of a plastic disposable blade containing a fibrelight and a non‐disposable handle; there is therefore no need to sterilise the blade and no concern about disintegration of the fibrelight. In a random cross‐over design, we compared the Vital View laryngoscope with a conventional metal fibrelight laryngoscope (Welch Allyn, NY, USA) in 100 patients. The Vital View laryngoscope produced a brighter field than the metal laryngoscope (p < 0.001), whereas there was no significant difference in the view of the glottis or the success rate of tracheal intubation. In no patient did any problem occur, such as damage to the laryngoscope blade or loss of light during laryngoscopy. In another 10 patients, prevention of light emission from the side of the laryngoscope blade reduced the brightness (p < 0. 01). This indicated that the brightness of the Vital View laryngoscope is produced by light emission not only from the tip of the blade but also from the side of the blade. Therefore, the disposable Vital View laryngoscope can be used as effectively as a conventional non‐disposable laryngoscope.
THE EFFECT OF REMINISCENCE GROUP THERAPY ON THE DEPRESSION OF THE ELDERLIES IN NURSING HOMES OF URMIA

Today, with medical advances and higher levels of health, number of elderly people has increased. Mental disorder by serious depression, anxiety and social isolation is prevalent in the elderly. The aim of this study was to evaluate of reminiscence group therapy effect on the depression of elderlies in 4 different nursing homes of Urmia. Materials & Methods: This study was an experimental study in which elderly people in nursing homes of Ferdous, Azahra, Ara and khane sabz after having the conditions to be included in the study were enrolled. After balancing the two groups, they were randomly assigned into intervention and control groups. Reminiscence group therapy sessions in the intervention group at each center consisted of 8 sessions, held twice a week. Geriatric Depression Scale questionnaire were completed by seniors both before and after the intervention. The data Analyzed by using SPSS software. Results: Results showed that the mean of depression decreased in the intervention group after group reminiscence therapy. The difference between mean numbers of the intervention and control groups was statistically significant (P<0/001) comparing before to after intervention. Conclusion: Implementing of reminiscence group therapy had a positive influence on the depression of elderlies. This technique can be used in a simple, inexpensive and applicable way in all nursing homes.
Helping Older Adults and Their Families Develop and Implement Care Plans

Abstract As people age, they are at increased risk of needing assistance with household tasks and personal care. After summarizing research on older adults' preparation for future health care needs, we introduce a process model for promoting preparation processes. Our focus is on how social workers may best help individuals cope with these risks, that is, how to overcome barriers that inhibit preparation, find an option that fits the older adult's needs, and help the older adult implement care plans. Finally, we provide a case example for the application of the suggested model.
Determinants of Animal Bite and Practices Following Bite Among the Victims Attending a Block Primary Health Centre of West Bengal.

Background: Rabies is a zoonotic disease, caused by Lyssavirus type 1. It usually spreads through close contact with infected animal via bites or scratches. More than 95% of human deaths due to rabies occur in Asia and Africa. Objective: i) To find out the epidemiological determinants of animal bite. ii) To assess the practices of the victims following bite. Materials & Methods: A descriptive, cross sectional study was conducted at anti rabies vaccine clinic of Amdanga Block Primary Health Centre, North 24 Parganas, West Bengal, which is the Rural Training Centre of R.G. Kar Medical College, Kolkata from 1 st October to 31 st October, 2013. All the victims (Total 102) receiving anti rabies vaccine in the clinic were included. Result: About 57% individuals were below 25 years age group and 57.8% victims were males. 49.0% victims were bitten by dog and 45.1% by cat. Category II bite cases were 53.9% and rest were of category III bites. Most of the individuals were attacked by stray animals (57.8%). Maximum number of bites was in lower limbs (58.8%). After bite, 63.7% victims washed their wounds with soap and water, 6.9% applied indigenous product and 3.9% performed spiritual activity as first measure. Within 24 hours of bite, 65.7% victims attended anti rabies clinic and only 4.9% received first dose of anti rabies vaccine. Conclusion: Unfavourable Practices were present among the respondents following bite. Delay in vaccination was mostly due to fixed day vaccination at health centre.
Epilepsy in Tuberous Sclerosis Complex

Abstract Tuberous sclerosis complex (TSC) is associated with a high rate of epilepsy, which often presents in the first month of life. An early diagnosis of TSC can allow a close electroencephalography monitoring and a prompt detection of subtle or subclinical seizures, thus guaranteeing a prompt treatment. Seizures in TSC are caused by an imbalance between excitation and inhibition, which can be considered as the final step of the genetic mutation and the subsequent overactivation of the mammalian target of rapamycin pathway. Epilepsy is often associated with cognitive and behavioral comorbidities, including learning disability, autism, and attention deficit/hyperactivity disorder. A prompt treatment of early-onset seizures is able to reduce the risk of a subsequent epileptic encephalopathy and cognitive and behavioral sequelae, but it cannot totally revert the final outcome. Treatment options for epilepsy include antiepileptic drugs, epilepsy surgery, ketogenic diet, and vagus nerve stimulation, but even after their application about two-thirds of patients still continue to present seizures. All these treatment options represent symptomatic treatment acting on seizures but not on the underlying cause of epilepsy. Mammalian target of rapamycin inhibitors represent a potential novel treatment strategy able to target the pathophysiologic mechanisms underlying epilepsy and other TSC-related manifestations.
Cold versus hot dissection tonsillectomies: The Nigerian experience

Background: Tonsillectomy is performed by various techniques but the commonest used in Nigeria is the cold dissection method. Our study highlights our experience from comparing the cold and hot dissection methods of tonsillectomy. Methods: This is a prospective randomized single-blind study spanning fifty seven months comparing operative time, intraoperative hemorrhage and postoperative morbidity such as hemorrhage and pain following both methods of tonsillectomy. Results: Thirty eight of 43 patients were studied aged between 10 years and 31 years with 21 (55.3%) males and 17 (44.7%) females, M:F ratio of 1.2:1. Removal of tonsils by cold dissection took an average of 11.14 (SD= 9.89) minutes and by diathermy, 9.10 (SD=7.86) minutes (p=0.001). Average intraoperative blood loss was 20mls for cold dissection and 25mls by diathermy. Thirty two (84.2%) patients consistently affirmed that the diathermy side was more painful than the cold dissection side. No postoperative hemorrhage. More eschar was noticed on the diathermy sides with less than 25% healing compared with the cold blunt dissection sides on the 7th postoperative day. Conclusion: From this experience, diathermy tonsillectomy has the advantage of shorter operative time but cold dissection tonsillectomy is still more advantageous because it is a safer and more effective method with lesser postoperative morbidity. East and Central African Journal of Surgery . 2011 Nov/ December;16 (3)
RACE, STRESS, AND SOCIAL SUPPORT: ADDRESSING THE CRISIS IN BLACK INFANT MORTALITY

A recent front-page story in the New York Times reported a significant escalation in the number of African American babies in the southern United States who die as a consequence of preterm delivery and low birthweight. Having seen some marginal improvements in the rates of preterm delivery and low birthweight, health care professionals for mothers and their infants had been hopeful that further progress would be made. However, the current precipitous rise in poor birth outcomes undermines successes to date and raises major questions about what can be done to quell an escalating epidemic. Explanations for the increasingly poor birth outcomes among African American women are complex, involving a number of biological, psychological, social, and economic factors that surround pregnancy and birth. Diabetes, hypertension, and obesity are being scrutinized as major risks for adverse birth outcomes. However, more attention must be given to psychosocial risk factors, which may directly or indirectly trigger physiological responses, leading to premature births and low birthweights. This report examines the impact of stress and stress mediators on pregnancy outcomes for African American women.
The LP-ESP Lumbar Disc Prosthesis: Concept, Development and Clinical Experience

Because of its impairment of patients' personal, social, and professional lives, degenera‐ tive disk disease has become an important public health problem with multiple dimen‐ sions. The current therapeutic strategy remains controversial and is also a medical and surgical challenge. Conservative treatment, based mostly based on physical therapy, constitutes the first-line approach, but persistent symptomatic disease may be treated surgically in selected patients [1-4]. Lack of pain relief, stiffening of the lumbar spine, nonunion, sagittal balance misalignment, bone graft donor site morbidity, and, last but not least, adjacent segment disease are the pitfalls of intervertebral fusion that led to the idea of total disk replacement (TDR) [5-12]. Since 1966 and Fernstrom’s first TDR implantation [13], many designs and concepts have been proposed [14-23]. The devices are usually articulated implants, and their mobility depends on the designs of the bearing surfaces. Ball-and-socket two-piece prostheses have 3 degrees of freedom in every rotation around a single fixed center of rotation. Three-piece devices allow additional translation compo‐ nents, providing 5 degrees of freedom. Articulated TDRs have demonstrated their clinical utility in several patient series. Specifically, the non-inferiority of TDR versus fusion is now generally accepted [18-20, 24]. However, in vitro testing of the two types of implants reveals that both designs have biomechanical advantages and limitations.
Topical fluoride for caries prevention: executive summary of the updated clinical recommendations and supporting systematic review.

BACKGROUND A panel of experts convened by the American Dental Association (ADA) Council on Scientific Affairs presents evidence-based clinical recommendations regarding professionally applied and prescription-strength, home-use topical fluoride agents for caries prevention. These recommendations are an update of the 2006 ADA recommendations regarding professionally applied topical fluoride and were developed by using a new process that includes conducting a systematic review of primary studies. TYPES OF STUDIES REVIEWED The authors conducted a search of MEDLINE and the Cochrane Library for clinical trials of professionally applied and prescription-strength topical fluoride agents--including mouthrinses, varnishes, gels, foams and pastes--with caries increment outcomes published in English through October 2012. RESULTS The panel included 71 trials from 82 articles in its review and assessed the efficacy of various topical fluoride caries-preventive agents. The panel makes recommendations for further research. PRACTICAL IMPLICATIONS The panel recommends the following for people at risk of developing dental caries: 2.26 percent fluoride varnish or 1.23 percent fluoride (acidulated phosphate fluoride) gel, or a prescription-strength, home-use 0.05 percent fluoride gel or paste or 0.09 percent fluoride mouthrinse for patients 6 years or older. Only 2.26 percent fluoride varnish is recommended for children younger than 6 years. The strengths of the recommendations for the recommended products varied from "in favor" to "expert opinion for. " As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences.
Incidence and Properties of Neurologic Disorders Recovered from Iranian Patients with HIV Infection: A Case Series

Background: In the pre-antiretroviral era, the frequency of neurologic complications was associated with low baseline CD4+ T-cell counts. Introduction of antiretroviral therapy (ART) has largely decreased the incidence of opportunistic infections and CNS neoplasia in the recent two decades; however, virus replication persists in the cerebrospinal ﬂuid (CSF) and neuronal tissues due to variabledrugpenetrationaswellasdevelopmentof drugresistance. Althoughmanypreviousstudieshaveaddressedthepresence of neurologicmanifestationsinthecourseof HIVinfection;anupdateonthetypeof neurologicinvolvement,presentingsignsand symptoms, radiologic ﬁndings, and response to treatment is essential. Methods: In a case series, we recruited 42 patients presenting with neurologic symptoms/signs and concomitant HIV infection in 12monthsduring2015and2016atatertiaryacademichospital. Informationregardingthecourseof diagnosis,laboratoryﬁndings, radiologic ﬁndings, and ﬁnal diagnosis were documented and analyzed in relation to the survival status of each patient during up to one month of hospitalization. Results: The mean age of the patients was 39.7; 25 were men, 19 were newly diagnosed. Thirteen patients (31%) died during treatment; from them, six were newly diagnosed. Median CSF white blood cell counts were signiﬁcantly higher in nonsurvivors; the most common diagnosis was focal brain lesions; toxoplasmosis and tuberculosis were the ﬁrst common etiologies; 79% recovered with the intended treatment regimen. History of drug abuse, not receiving antiretrovirals, low baseline CD4 counts, and loss of consciousness at the time of admission has been seen more among deceased patients. Conclusions: Neurologic presentations or complications of HIV infection lead to high mortality rates. Early diagnosis of infection and improvement of patient compliance with antiretroviral treatment can reduce the mortality associated with neurologic diseases.
Bebê de risco: acompanhando o crescimento infantil no primeiro ano de vida

Objective: To monitor the growth of high-risk babies in the first year of life. Methods: Analytical, cohort study, conducted with 237 babies born in Maringa - PR, between May 1 to October 31, 2008, under the Program for the Surveillance of At-Risk Infants. Results: Growth changes were present in 188 (79.3%) infants and occurred mainly after the first trimester of life. A slower than expected growth rate showed statistical association with maternal age of less than 18 years, education of less than 8 years, presence of congenital anomalies, and birth weight greater than or equal to 2,500g born at term. Conclusion: The evaluation of growth in at-risk infants should include a multidimensional analysis, considering the biological and maturational aspects of each specific risk condition, and adaptation of the baby and his/her family on this evolutionary path.
Human papilloma virus in cervical neoplasia Manipal University

The prospective study was conducted on women in a tertiary care centre to determine the incidence of Human papilloma virus genome in women with cervical neoplasiaand to correlate the available risk factors for HPV infection and cervical cancer.Cervical smears were taken and graded according to Bethesda system.Women who had Pap smear suggestive of CIN either underwent colposcopy and guided biopsy or 4 quadrant biopsy. Women who had a frank growth underwent cervical biopsy. A cervical swab was also taken from the ectocervix and endocervix which were kept in a sterile container and stored at - 4°C. Patients with histological confirmation of CIN (Cervical intraepithelial neoplasia) / ICC (Invasive cervical cancer) were taken as cases and subjected to HPV DNA study. Incidence of HPV positivity among cases was 38.23% with an odds ratio of 21.66. All HPV positive women were infected with a single virus. The most commonvirus identified was HPV 16 with incidence of 32.35%. High parity, low economic status and illiteracy were a significant risk factor in causing infection & cervical neoplasm.
PREDICTING FACTORS OF PATIENTS’ SATISFACTION WITH OUTPATIENT SERVICES IN MILITARY HOSPITAL

ABSTRACT Background: Patients are the main customer of the health services. Predictors of level of patients’ satisfaction are important to determine the effectiveness of health care delivery and quality of medical care. This study aims to determine the predicting factors of patients’ satisfaction with outpatient services at Specialist Clinics of Malaysian Armed Forces (MAF). Materials and Methods: A cross-sectional study was conducted at specialist clinics of a MAF Hospital, whereby 931 patients were selected using stratified sampling technique. Patients list from appointment books of various clinics served as sampling frame. Self-administered validated service oriented questionnaire which consist of 36 items in Malay and English version was used. Result: The response rate was 93.7% (873 respondents), of whom 479 (54.9%) were satisfied and 394 (45.1%) were not satisfied. There were 10 factors that has significant association with level of patients’ satisfaction; age ( P < 0.015), education ( P = 0.037), ethnicity ( P = 0.019), type of specialist clinics ( P < 0.0001), experience with doctor’s service ( P < 0.0001), experience with pharmacy service ( P < 0.0001), actual waiting time at registration counter ( P = 0.001), actual waiting time at the clinic ( P = 0.003), waiting experience ( P < 0.0001) and public facilities ( P < 0.0001). They were 5 predictors contributing to the level of patients’ satisfaction; experience with good doctor’s services (OR= 10.896), appropriate waiting experiences (OR= 4.116), good public facilities (OR= 3.297), good experience with pharmacy services (OR= 2.644) and Non-Malay ethnicity (OR= 1.645). Conclusion: The overall level of patients’ satisfaction at MAF Specialist clinics was average. Availability of good doctor’s service, appropriate waits experience, good public facilities, good pharmacy service and Non-Malay ethnicity found to be the predicting factors of patients’ satisfaction. Keywords: Predicting factors, patient satisfaction, specialist clinic
Self-Renewal: The Individual and the Innovative Society.

In this book the author is for self-development, flexibility, individuality, commitment, courage, and love. He is against tyranny, vested interests, deadwood, inflexibility, moral decay, morbid pessimism—and sin. Moreover, the book deals with some rather general ideas, concepts and abstractions such as "society," "self-knowledge," and "creativity" which are almost innately soporific. In short, it should be pretty dull reading—but it is not. Rather, this very short book is thought-provoking, often very amusing, and continuously interesting. It is reviewed in these pages because so much of what is said has relevance to what is perhaps the most important determinant of the quality of medical care—the continuing self-renewal of the physician. Parts of this long essay deal with the factors which further or impede innovation in society and these comments have application to the problems of adapting our systems of medical education and medical care to fit the changing society they serve. Of