# Preventive Health Science

Spanish: Ciencias de la Salud Preventiva

## Introduction

The development of science includes training in research, teaching based on research and the establishment of research departments and scientific journals. It is recommended for all health professionals to include orientation in scientific journals as part of the continuing education (Hippocrates). Reading of scientific articles is the basis for evidence-based medical practice, teaching and research (EBM/MBH). The "Preventive Health Science" journal is an electronic scientific "School" publication for free, not indexed, related to The Ramazzini Center . The objective of this "School journal" is to serve students and health professionals in their continuing education. The use of everyday scientific literature is a key part of the scientific education. In other words, the aim is to contribute to create a culture of health risk prevention based on scientific evidence and critical thinking. The objective is to raise awareness about the risk factors that improve or damage the environment, in order to preserve the quality of life and contribute to social welfare. Another objective is to be familiar with the IMRAD structure in scientific works. The publication plan: When a new relevant article /summary is ready, it is published quickly. The philosophy is that it is most convenient to be orientated in one subject in a few minutes, instead of many articles in a traditional scientific journal. One important objective is to bring study abstracts from other countries even years ago that is relevant to be repeated in our country as subject for a thesis alone or in a group work. So far the epidemiological studies in Public Health from Panama have focused on infectious diseases and diseases related to diet, lack of activity, smoking and alcohol, i.e. cardiovascular diseases, diabetes and cancer. We want to inspire students and professionals to do research in occupational and environmental health in a wider scope Occupational Medicine. The abstracts in this journal intend to encourage the students and health professionals to use scientific literature in their thesis work and for solving daily health problems. Further, we offer research training courses and training in writing academic papers for students and professionals. Legal Rights: The texts are under the Creative Commons License. This means that the works are free of known restrictions of authors' rights. The Public Domain Label allows the work to be easily discovered, and provides valuable information about the work.

# Authors:

Prediabetes, as part of the metabolic syndrome is a critical condition that indicates elevated blood sugar levels, although not yet high enough to be classified as Type 2 Diabetes Mellitus (T2D). This condition significantly increases the risk of progression to T2D, even without any prediabetes symptoms.(1) The growing evidence that Prediabetes can be reversed through lifestyle changes, forms the basis for the Prediabetes-Remission Study with the objectives: To educate and encourage seafarers to reverse their newly diagnosed prediabetes in a 16-week prediabetes coaching and learning intervention study – and to apply the course materials in educational programs on Prediabetes/T2D and Hypertension for seafarers and other maritime personnel.(2)
However, the early diagnosis of prediabetes is unfortunately often prohibited due to lack of the A1c test the maritime health clinics. Now the use of the cheaper Glucometer finger-prick test opens up for a new frontier in maritime health by screening for Prediabetes and early start of prevention in a much wider perspective than before. A glucometer is a handheld device used to measure the concentration of glucose in the blood. The inclusion criteria for the Prediabetes-Remission Study is updated to include either A1c, where this is possible, or Fasting- or Postprandial Glucometer test. The availability of Glucometers in the ship’s medicine chest and the seafarers bringing their personal test Glucometer kits on board, is encouraged. The use of glucometers in maritime medicine could greatly benefit health monitoring in developing countries for early diagnostics and prevention of prediabetes and T2D as was done excellently in Nepal recently.(3)
Internationally, the screening criteria for Prediabetes and T2D are homogenous based on A1c and/or the Fasting and Postprandial glucose laboratory blood test (Table 1). However, since the A1c blood test is not available in most of the maritime medical clinics, there is a need for specific criteria that allow the use of the cheaper Glucometers for diagnostics of Prediabetes and T2D.
The inclusing criteria for the Prediabetes-Remission study was originally A1c prediabetes values of 5.7–6.4% / (39–47 mmol/mol. However, being aware the A1c test is often not available, candidates for the Prediabetes-Remission Study cannot be selected and invited to the study and the seafarers don’t know whether they might have prediabetes or not for early prevention.
Our proposed criteria for the Glucometer mediated diagnostics for prediabetes (Table 2) is based on the American Diabetes Association (ADA) criteria for the Fasting glucose level and the Postprandial glucose level based on the two hour Oral Glucose Tolerance (OGTT) Test level(4)
By implementation of the economically feasible glucometer finger-prick test (0.20-0.27USD/test) (Website) with quick results, the seafarer and fishermen can travel to their destinations for embarcation immediately. They will also learn how to use the Glucometer for self control to adjust their dietary- and fitness status. Those with Glucometer based elevated fasting blood glucose and/or postprandial finger prick test (Table 2) can be referred to the GPs or visit a medical clinic in the next port for a A1c measurement. To participate in the study, the seafarers need to bring a glucometer, a blood pressure measurement and a travel weight scale on board for weekly self-testing (estimated total costs for all 3 items: 60-92 USD Website shopping). Application for funding of the 3 items is relevant where the ship does not bring them on board.
Using the cheap and rapid glucometer test could help to eliminate health disparities by promoting early diagnosis of prediabetes and comorbidities for seafarers and all the population in the developing countries. (5)
Diagnostic accuracy of the portable Glucometer finger-prick test
Our recommendation to use portable glucometers in maritime health examinations, where A1c testing is not available, is supported by the growing evidence of their diagnostic accuracy: The diagnostic accuracy for two glucometers was found to be equally accurate across the wide range of blood glucose values.(6) Choukem SP et al. tested the accuracy and precision of four commonly used glucometers in Cameroon, compared to reference laboratory methods. Katz et al. tested two different types of portable glucose meters and found that both meter systems were accurate over a wide glucose range and were well received by patients in a short take-home trial.(7). Chen et al. evaluated the accuracy of four different blood glucose monitoring systems and found that all BGMS met the ISO accuracy criteria for this type of measurements. (8) Prabhakar and Halder aimed to determine diagnostic accuracy of two glucometers with laboratory venous glucose. Both glucometers were equally accurate and performed uniformly well across the wide range of blood glucose values.(6)
Implementing glucometers in maritime health practice would allow seafarers and fishermen to monitor their blood glucose levels both on board and at home and the maritime doctors can refer the seafarers and fishermen for A1c test at hospital laboratories and for further .
Should the young seafarers and fishermen also be tested for prediabetes?
Given the rising prevalence of prediabetes and type 2 diabetes among adolescents aged 12–19, it is crucial to extend prediabetes testing to younger seafarers and fishermen (9,10) (11) (12). Just as hypertension is a well-established public health concern in young adults – serving as an important marker for cardiovascular risk later in life – the surveillance of prediabetes and hypertension in young seafarers and fishermen from maritime schools is equally important. Early detection and preventive education is essential, also for the youngest.(13)
Conclusions
The use of the Glucometer finger-prick test opens up for screening and prevention of Prediabetes and T2D in a much wider perspective than before. The inclusion criteria for the Prediabetes-Remission Study is updated to include either A1c or Fasting-/Postprandial Glucometer test. Having Glucometers in the ship’s medicine chest and bringing personal Glucometer test kits on board is encouraged. The use of Glucometers could greatly benefit health monitoring and prevention in developing countries.

## Continuing education

Continuing education, is a core issue for all health professionals consisting of all types of health preventive practices, conferences, education and scientific articles.To remember one of the sentences in the Hippocratic Oaths: "That I will recognize the limits of my knowledge and pursue lifelong learning to better care for the sick and to prevent illness"

## Publication Strategy

With the aim to create interest for scientific work. Due to the sparse original publications from Panama, we reprint translated abstracts from international studies, that are of relevance also for Panama. We search globally to find scientific articles every month or more frequent within occupational-, public- and environmental health. Especially subjects of interest for ongoing research studies, like the planned study on PTSD (Post traumatic stress disease) in train drivers after episodes of sudden suicide in front of the train and the “Acoso Laboral” study project. The orginal title of the citing artcle is kept while the editors write a subheading for a quick orientation of the content. All are invited to propose new abstracts for translation and reprint and to help with the editorial work. Scientific work e.g. students thesis, are very welcome to be published in full text by following the guidelines for authors and after peer review. The PDF files are downsized to facilitate the reading in one of the available online programs e.g. Compress-pdf for free

## Rules of good conduct

* Members of the editorial committee are active and able to edit issues of the journal
* We agree to comply with the international medical ethical principles
* Commercial interests are not accepted

## Guidelines for publication of Abstracts

* Open TEMPLATE here

## Guidelines for original contributions

All texts should be as short as possible, systematic, precise and easy to read with: Title, names of authors, email, telephone and institutions, type of contribution, a summary, text and references, three lines with the main messages and a photo. The preparation of the original manuscripts follow the Equator-Network standards . The main manuscript has an extension of 1000-2500 words + summary + figures and tables (separated pages) + bibliography. For correspondence, e-mail and telephone. An original text will consist of the following sections (you can add acknowledgments): IMRAD Explanation to open
* Introduction
* Material and methods
* Results
* Discussion
* Bibliography
* Bibliographic citations
* To be presented by the use of Zotero or similar program - often in Vancouver style.
* In the text will appear the numbering of the bibliographic citations in Arabic numerals flown.
* Tables and figures are on separate pages of the text, always a table or a figure by sheet
* Acronyms or abbreviations be defined in the foot of the table or chart
* The structured summary, should not exceed 200 words and preferably consist of: Objectives, Methodology, Results, Conclusions and 4-6 Keywords
* Structured summaries of the thesis (for masters): (200-300 words) consist of: Title, Objectives, Methodology, Results and Conclusions . 4-8 keywords
* Send your contribution to ocj@health.sdu.dk in Word

## Peer review process

The peer review process is a way of ensuring that the information is verifiable and of a good quality. Any research paper is forwarded to the editorial group who assess quality, accuracy and relevance. The chairman of the group will assess whether the manuscript will comply with the guidelines, advice the authors and take the final decision whether it should be published or not.

## The Journal Content

* Abstracts from national and international studies of relevance for the Panamenean population
* Comments: opinion, on current issues
* Originals: Epidemiological and clinical research works (-2500)
* Protocols for scientific studies
* Standardized questionnaires: with references where they have been used
* Structured summaries of the theses made for masters
* International window: Articles presented in international forums
* Informative: About activities of the Scientific Associations
* Visual documentation: Photos that show the areas of studies
* Permanent education: Materials for learning
* Share knowledge of conferences: power points, articles, etc
* Meetings for editors, authors and subscribers
* General advice on preventive health care
* Current topic