bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological well being toward adolescents in disaster-prone areas in Padang city
Authors: Patricia Helena , Rahmatiqa Chamy , Apriyeni Emira
Published: October 2020

Background: Indonesia, particularly Padang City, West Sumatra, is a prone-area toward natural disasters related to geographical, geological and demographic conditions. Natural disasters give a very significant impact on physical, psychological and social. The psychological impact that most often appears in disaster cases is Post Traumatic Stress Disorder (PTSD). One who is prone to experiencing PTSD is adolescents. To prevent PTSD from occurring, good psychological well-being is needed. The factors that influence psychological well-being are religiosity, personality, coping strategies, self-concept and social support.Methods: This study is an analytical study with a cross sectional approach. This research was conducted in three disaster-prone districts in Padang City, namely North Padang, South Padang, and Koto Tangah. Data were collected through distributing questionnaires to 156 adolescents who were selected by purposive sampling. Data were collected by questionnaire and analyzed descriptively using univariate analysis, bivariate analysis with chi square test, and multivariate logistic regression analysis.Results: The results of this study found that 85 respondents (54.5%) had low psychological well-being, 98 respondents (62.8%) had low religiosity, 108 respondents (69.2%) had introverted personality types, 105 respondents (67.3%) used emotional focused coping, 90 respondents (57.7%) had negative self-concept and 91 respondents (58.3%) had low family support. The results of the bivariate analysis found a relationship between religiosity (0.000), personality type (0.010), coping strategy (0.00), self-concept (0.035) and family support (0.04) toward psychological well-being.Conclusions: The results of the final multivariate modeling found that adolescents with negative self-concept had 12 times chance of having low psychological well-being in disaster-prone areas in Padang City.
Prevalence and determinants of under-nutrition among children aged 5-10 years in an urban area of Kancheepuram district, Tamil Nadu
Authors: M. K. Jasmine Sharmila , R. Umadevi Jeyakumar , V. M. Anantha Eashwar
Published: October 2020

Background: Childhood is a phase of swift growth and development after infancy. One of the foremost public health problems in developing countries like India is extensive prevalence of under nutrition among school children resulting in delayed cognitive development and severe health impairment. Hence early detection helps in prompt prevention and treatment of complications. Aim was to assess the prevalence and factors associated with under-nutrition among children aged 5-10 years in an urban area of Kancheepuram district, Tamil Nadu.Methods: A descriptive cross sectional study conducted among 210 children in the age group of 5-10 years residing at Anakaputhur, an urban field practice area of Sree Balaji Medical College and hospital for a duration of 4 months by simple random sampling technique. A pre-tested semi-structured questionnaire was employed to interview the children and their mothers. The data obtained was subjected to statistical analysis using SPSS version 22.Results: Prevalence of underweight among children was found to be 52.4% of which 58.5% of the undernourished children were boys when compared to 47.4% among girls. Underweight was significantly associated with source of drinking water [(p<0.0125), OR=2.0566], episode of diarrhea [(p<0.0054), OR=2.3624] and ARI [(p<0.0000), OR= 8.6417] in the last 3 months, history of passing worms [(p<0.0348), OR=1.8878], meal frequency <3 times/day [(p<0.0000), OR=7.5432].Conclusions: Half of the children (52.4%) in the study had poor nutritional status. To combat under-nutrition good living conditions, education to the mothers, clean water source, good personal hygiene, period deworming and delivery of integrated programs are recommended.
Oral health care-seeking behaviour and influencing factors among 18-34 years old women in Kochi, India
Authors: A. Nija M. , Gireesh Geethu , Mathew Minu Maria , Venkitachalam Ramanarayanan
Published: October 2020

Background: Oral health, though an integral part of general health, is accorded low priority and remains an issue of neglect. Women during their reproductive years suffer from various oral problems that warrant timely utilization of care. Understanding factors affecting health-seeking behavior is necessary. The objective of this study was to determine the personal level and system-level factors that affect utilization of oral health care among 18-34 year-old women visiting a dental health care facility.Methods: A cross-sectional questionnaire-based study was conducted among 18-34 year old women. Participants were recruited using convenience sampling from a tertiary dental health care facility. A Chi-square test was used to determine the association of sociodemographic variables on factors affecting the utilization of oral care.Results: A total of 194 responses were obtained. The mean age of study participants was 27.1±5.2 years. Around 62% of women suffered from multiple dental problems in the past year of which tooth decay and swelling of gums were most common. About 68% of them sought treatment with a dentist. Half of the respondents were themselves responsible for making health care decisions. 55% of the participants reported barriers in availing dental care. The cost of dental treatment, fear of pain, and lack of time were the most commonly reported barriers.Conclusions: Oral health-seeking behaviour among women was found to be good with regard to dental attendance. Personal level barriers were greater than system-level barriers in availing dental care.
Prevalence of diabetes, hypertension, and the socio-demographic predictors of the type of facility utilized for related services in rural Telangana
Authors: Wassey M. Abdul , Giri Ashish , Raikwar Aakash , Dogra Vishal
Published: October 2020

Background: Diabetes mellitus and hypertension are chronic conditions that, on one hand demand early detection, screening, and treatment and on the other, require longitudinal follow-up for their successful management. Piramal Swasthya’s Arogyaseva program uses two contrasting methods (MMU and static clinic) to deliver diabetes and hypertension-related care. The MMU provides doorstep delivery of care, while the static clinic is located by the highway, is equipped with a telemedicine center, and has slightly higher diagnostic and therapeutic capabilities. The study aims to find the prevalence of diabetes and hypertension, and determine the association between the sociodemographic factors and the type of facility utilized for these conditions.Methods: This cross-sectional study is a secondary data analysis of the aggregated data of patients who availed health services at the Mobile Medical Unit and the static clinic. The data was analyzed to find out the prevalence of diabetes and hypertension, and Binary logistic regression was used to determine socio-demographic predictors of the type of health facility used for diabetes and hypertension-related care.Results: Overall hypertension and diabetes prevalence was 24% and 7%, respectively. Women (aOR 1.3; 95% CI 1.122–1.510), illiterate (aOR 2.61; 95% CI 2.021-3.392), hypertensives (aOR 3.28; 95% CI 2.807-3.846) and the elderly (aOR 1.43; 95% CI 1.204-1.721) were significantly more likely to utilize MMU based outreach facility compared to their respective baseline counterparts.Conclusions: The mobile medical unit can play a significant role in delivering hypertension and diabetes-related care, especially to women and the elderly.
A cross-sectional study on socio-demographic profile and associated risk factors of chronic kidney disease patients in a tertiary care hospital of Andhra Pradesh
Authors: Kanyari S. Suneeti , Panda Sangram , Shruthi Peethala
Published: October 2020

Background: Chronic kidney disease (CKD) is a global problem, and its prevalence is increasing dramatically. In chronic kidney disease (CKD) there is progressive loss in kidney function over a period of time. The objectives of this study were to study the socio-demographic characteristics and associated risk factors in CKD patients so as to suggest preventive measures for CKD and its long term health consequences.Methods: A cross-sectional study was conducted at MIMS Medical College, Vizianagaram, Andhra Pradesh among 194 confirmed CKD patients. A pre-tested, pre-designed questionnaire was used for collecting data on socio-demographic characteristics like age, education, occupation, residence, income etc. After completion of the questionnaire, the patients were subjected to anthropometric measurements, abdominal ultrasonography and their laboratory reports were assessed.Results: Out of 194 CKD patients, 148 were males and 46 were females. Hypertension and diabetes were present in 74.2% and 41.2% cases respectively and both of these risk factors were found to be significantly associated with CKD. Family history of diabetes/hypertension/CKD were present in 40.2% of cases and the association was found to be significant.Conclusions: Early screening and intervention is necessary for prevention of risk factors of CKD. All patients with hypertension, diabetes, family history of CKD/hypertension/diabetes, history of chronic NSAID use should be periodically screened for CKD for its early detection and effective management.
Clinicoepidemiological profile of ear, nose, throat patients in outpatient clinic of tertiary health care facility in Punjab
Authors: Munjal Manish , Chowdhary Anurag , Bhatti Harsimran , Rishi Porshia , Tuli Nitika , Munjal Shubham , Garg Avantika
Published: October 2020

Background: This study evaluated the profile of ailments in patients presenting to outpatient clinic of tertiary care hospital of North India that caters to ENT diseases in population of Punjab, Haryana, Himachal Pradesh and Jammu and Kashmir.Methods: A retrospective study was undertaken by analysing the medical records of patients managed at the department of otorhinolaryngology and head and neck surgery at the tertiary care hospital, Punjab from Jan 2018 to Dec 2018 and all essential data was collected.Results: Total no. of patients presenting to the ENT OPD during the period of assesment were 32,475.  49.30% were males and 50.70 % were females, respectively. 29.70% were children below 15 years. The number of patients presenting per month were 2706, with maximum no. of patients presenting in the month of August to November. Patients with ear diseases were 9280 (28.57%), Nose diseases were 11963 (36.83%), and throat diseases were 11232 (34.58%).Conclusions: This study showed that awareness of ENT ailments and visits for specialised treatment is on the rise rather than primary level treatment at local or general medicine or family physician level.
Knowledge and practice survey of biomedical waste management among health care workers in tertiary care hospital of Vijayapura district
Authors: Totad Raveendra D. , Ganganahalli Praveen
Published: October 2020

Background: Biomedical waste is defined as any solid or liquid waste generated during diagnosis, treatment or immunisation of human beings and animals or during research that may present a threat of infections to humans. The Government of India had launched a law known as “Bio-medical Waste (Management and Handling) law 1998". To assess the knowledge level and status of current practice of biomedical waste management among health care workers of tertiary level teaching hospital.Methods: Cross-sectional study was conducted among health care workers like nursing staff, laboratory technicians and class-IV workers (willing to participate). Questionaries’ were asked to test the basic knowledge regarding BMW and current practices related to BMW management.Result: The knowledge level of BMW management among the health workers was around 74% whereas current practice of it among them was around 73%. The knowledge and practice of BMW management was more among nursing staff followed by lab technicians and low among class-IV workers.Conclusion: Despite of training in BMW management the awareness level and current practice of BMW handling appears to be less among class-IV workers who are exposed to it at very frequently and hence are at high risk of getting infections compared to others.
Anxiety, obsession and fear from coronavirus in Indian population: a web-based study using COVID-19 specific scales
Authors: Srivastava Amit , Bala Renu , Srivastava Anoop K. , Mishra Anuj , Shamim Rafat , Sinha Prasenjit
Published: October 2020

Background: The mental health and well-being have been severely impacted by the COVID-19 crisis. People are distressed due to the immediate impacts as well as the consequences of physical isolation, which could have lasting effect on overall well-being. The study aimed to assess the psychological effect of the pandemic on the general population of India using COVID-19 specific scales.Method: An online, cross-sectional study was conducted from 20th June 2020 to 4th July 2020 on persons of both sexes and aged 18 years or more. A convenient sampling method was used for recruiting participants. An online Google form was designed and distributed using social media platforms. The psychological effect of the pandemic was assessed using validated scales of coronavirus anxiety scale, obsession with COVID-19 scale, and fear of COVID-19 scale respectively.Result: The study received responses from 2004 participants from 31 states and union territories of India. The overall prevalence of psychological disorder due to COVID-19 was 53.3% (n=1068). The prevalence of anxiety was found to be 3.29% (n=66), obsession 13.47% (270) and fear 46.9% (1045). Around 2.8% (55) of the participants suffered from all three psychological disorders. Pearson correlation test showed a significant positive correlation between all the three psychological morbidities.Conclusions: The study findings showed high prevalence of mental health problems among Indian population during the COVID-19 outbreak with a positive correlation between them.
Prevalence, combinations and associations of components of MetS among adults aged 40 years and above from rural Kerala: a cross-sectional study
Authors: Palanichamy Thiyagarajan , Elango Vasantha
Published: October 2020

Background: Metabolic syndrome (MetS) is a growing public health concern worldwide. A nation-wide diabetes screening campaign by the union health ministry found rural areas of selected district of Kerala had16% prevalence of lifestyle diseases. One of the objectives of WHO developed action plan for global implementation of strategies in prevention and control of non-communicable diseases (NCDs) advocates identifying MetS, a simple clinical tool, for predicting diabetes mellitus and cardiovascular diseases among population. The study aimed to estimate the prevalence of metabolic syndrome and its components among the adults aged 40 and above from rural Kerala and to determine the association with socio-demographic characteristics like co-variables of the study population.Methods: A cross-sectional study conducted among adult subjects aged 40 and above from rural field practice areas visiting RHTC. Socio-demographic profile, personal habits and history on NCDs recorded. Blood pressure and abdominal circumference measured. Fasting plasma glucose (FPG), triglyceride (TG), and high-density lipoprotein (HDL) levels were estimated. Modified NCEP-ATP III (SAS), 2009 criteria was used to diagnose MetS. Study variables were analysed for associations and comparison of means with appropriate statistical methods.Results: The prevalence of metabolic syndrome (MetS) was 29.3%. 57.9% elevated FPG, 37% Triglyceridemia, 24% sub-optimal HDL, 38.3% abdominal obesity, 38.3% elevated BP, 52% insulin resistance were recorded. Among MetS subjects 50% were in 50-59 years age group and MetS had statistically significant association with age (p value 0.005).Conclusions: Moderate prevalence of metabolic syndrome among rural subjects needs strengthening health education and screening services on NCDs.
Impact of COVID-19: nursing perspective and concern
Authors: Sharma Rakesh , S. Vishwas A. , Jelly Prasuna
Published: October 2020

The Nurses' contribution to the Health care sector globally is always delightful. The abrupt and undetected spread of Coronavirus disease 2019 (COVID-19) worldwide, with variant mortality and morbidity rates in different countries, had put the health system into crisis. Response to the outbreak, preventing the spread of infection and control strategies, and nursing care during the pandemic is vital to attain goals of present medical emergency. Authors took efforts to discuss the perspective of nurses being front line health care workers, in an imperative situation in which the human population is undergoing with uncertainty, along with issues and concerns involved in managing the situation. The leadership qualities among nurses to overcome the complex COVID-19 is once again proved in this episode of the pandemic. The concern to individual nurse in preserving the ethical and moral values with the fundamental framework and training undergone is recalled and channelized. Nurses play an essential job responsibility in numerous ways while dealing with mankind, sick or well; either in a health care setting or at the community level. Vital domains involved in full filling nurses role during pandemic (COVID-19) noticeably creating awareness, screening services, and support for the general public who are high-risk conditions, infection prevention and surveillance, implementing appropriate preparations and precautions in health care settings, protecting the patients with immunodeficient and or co-morbidities, care of COVID-19 patients with acute and chronic illness.
Modified office practice in COVID-19 pandemic - an otorhinolaryngologist perspective
Authors: Tripathi Juhi , Kumari Shweta , Rastogi Shalabh
Published: October 2020

COVID-19 spreads through contact, minute droplets and aerosol from infected person which may be symptomatic or asymptomatic. Nose and throat had very high load of severe acute respiratory syndrome (SARS-CoV-2) virus. Otorhinolaryngologists by virtue of their work which requires close examination of these part are at very high risk of infection. Many studies are available for precautions to be taken in patient management related to COVID-19 in wards and surgical intervention in operation theaters but very little information is available regarding precautions in working in outpatient clinic setting. Our article highlights some changes we made in ear, nose and throat (ENT) outpatient clinics after going through various guidelines to make it safe in current scenario. These changes may inspire others to move toward safer work practices in their outpatient area to provide ENT consultations. The main changes were categorized into infrastructural changes, identification of frugal but effective personal protective equipment (PPE) for ENT, training for use of different level of PPE as per risk, new modus operandi, and new infection prevention measures. These changes had taken into account safety guidelines by Ministry of health and family welfare (MOHFW) government of India and various international associations specific to specialty. The modification and its advantages were presented.
Risk factors of morbidity among construction workers: a review
Authors: S. Gopalakrishnan , P. Mohan Kumar
Published: October 2020

Construction industry is the second largest employer of workers the world over and is second only to the number of workers in the agricultural sector. Since construction industry and workers come under the un-organized sector, they are not benefitted by any of the advantages enjoyed by the workers in the organised sector. Most of the workers belong to the poor socioeconomic background and illiterates who are hired by the agents based on the construction manpower needs on a daily wages manner. Migrant workers from poorer and under developed areas of the country are increasingly being exploited for this purpose. The rigorous and strenuous construction work and their temporary and shabby living conditions make them vulnerable for several types of diseases and ill health, for which they may not get adequate and timely medical care and support. Workplace safety and workers safety are often compromised. They constantly face physical, chemical and biological risk factors. Risk factors and risk behaviour like smoking, tobacco use, alcoholism and even substance abuse among the construction workers contribute to their high morbidity and even mortality. This review article focuses on the various risk factors and the risk behaviours, which the construction workers are exposed and are prone to develop, leading to different types of morbid conditions at the work place as well as in their places of living.
Prevalence of SARS-CoV-2 in Patients with Severe Pneumonia in Khuzestan Province, Iran
Authors: Abolnezhadian Farhad , Makvandi Manoochehr , Alavi Seyed Mohammad , Azaran Azarakhsh , Jalilian Shahram , Rashno Mohammad , Kaydani Gholam Abbas , Arshadi Maniya , Hosseinizadeh Seyed Mehdi , Boostani Hatam , Seyedian Seyed Saeed , Moogahi Sasan , Salmanzadeh Shokrolah , Varnaseri Mehran , Neisi Niloofar , Keifarrokhi Hooman , Shariati Gholamreza , Amiri Homayoun , Parsanahad Mehdi , Nashibi Roohangiz , Yousefi Farid , Ahmadi Fatemeh , AhmadiAngali Kambiz
Published: October 2020

The emergence of a highly pathogenic virus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) accounts for severe pneumonia throughout the world. More than 7 million world population have been infected with SARS-CoV-2, and the number of deaths is increasing every day. This study aimed to evaluate the frequency of SARS-CoV-2 in hospitalized patients with acute respiratory infection (ARI). During an outbreak of the SARS-CoV-2, the nasopharyngeal and oropharyngeal swabs were collected from 909 hospitalized patients with severe pneumonia, including 517 (56.9%) males and 392 (43.1%) females. All the collected samples were from different cities of Khuzestan province from 19 February to- 27 March 2020. The RNA was extracted from samples and subjected to real-time polymerase chain reaction (PCR) tests for the detection of the SARS-CoV-2. Simultaneously, the computerized tomography (CT) scan was tested for the presence of ground-glass opacity in the lung among the patients. Of the total number of 909 specimens, 328 (36.08%) cases, including 185 (20.35%) females and 143 (15.73%) males, were positive for the SARS-CoV-2 while, 581 (63.9%) cases, including 374 (41.14%) males and 207 (22.77%) were negative for the SARS-CoV-2 by real-time PCR (p=0.001).Four hundred sixteen (45.76%) cases were positive for ground-glass opacity in the lung by CT scan, while 328/909 (36.08%) trials proved positive for SARS-CoV-2 by the real-time PCR (p=0.003). In this study, 36.08% of patients were positive for SARS-CoV-2. Although the results of positive cases by CT scan showed higher than real-time PCR, screening the SARS-CoV-2 with a real-time PCR method is the first line of choice.
Up-regulation of CD200/CD200R1 Immunomodulatory Axis of Allogenic Peripheral Blood Mononuclear Cells in a Co-culture with Adipose-derived Mesenchymal Stem Cells
Authors: Heidari Nishtman , Mohammadi Mobin , Rezaee Mohammad Ali , Amini Abbas Ali , Fakhari Shohreh , Rahmani Mohammad Reza
Published: October 2020

Co-inhibitory molecules modulate immune responses. Immunomodulatory properties of mesenchymal stem cells (MSCs) turn them into ideal candidates for cell therapy. This study was designed to investigate the immunomodulatory effect of adipose-derived stem cells (ASCs) on inflammatory environment of a co-culture of allogenic peripheral blood mononuclear cells (PBMCs) in a two-way mixed leukocyte reaction (twMLR) setting. ASCs were co-cultured with allogenic PBMCs in twMLR setting for four days. The proliferation of peripheral blood mononuclear cells (PBMCs), levels of interleukin (IL)-10, and expression of interferon-gamma (IFN-γ), B7-1, cytotoxic T-lymphocyte-associated protein 4 (CTLA-4), programmed death-ligand 1 (PD-L1), +, and CD200R1 genes, as well as cell surface expression of CD200 and CD200R1, were measured in twMLR as control, and co-culture groups on days 0, 2 and 4 of the experiment. The proliferation of PBMCs was suppressed on days 2 and 4 of co-culture. The expression  of CD200 (p=0.014), CD200R1, CTLA-4, and PD1 genes increased on days 2 and 4 of the co-culture compared to twMLR. CD200 expressing PBMCs decreased by 1.75% on day 2 of the co-culture but increased by 6.23% on day 4 of the co-culture (p=0.013) compared to the same days of  twMLR. IL-10 levels increased in the co-culture supernatants on days 2 and 4 compared to twMLR (p<0.05). Our results showed that ASCs upregulate the CD200/CD200R1 axis more than PD-1/PD-L1 and CTLA-4/B7-1 pathways in the twMLR. Also, elevated expression of CD200R1 in the final day of co-culture was similar to PD-1 expression pattern. This finding suggests a role for the CD200/CD200R1 axis in later modulation of the immune response.
A Case of Linear IgA Bullous Dermatosis Induced by Aspirin Therapy
Authors: Nabavi Mohammad , Rezaeifar Afshin , Sadeghinia Ali , Arshi Saba , Bahrami Sima , Bemanian Mohammad Hassan , Fallahpour Morteza , Shokri Sima , Vakilazad Zahra
Published: October 2020

Linear IgA bullous dermatosis (LABD) is a rare autoimmune blistering disease that may be triggered by some diseases and medications. For the latter one, non-steroidal anti-inflammatory drugs (NSAIDs) have been identified as one of the potential causative agents to develop LABD. Here, a rare case of drug-induced LABD is introduced. A 13-month-old Iranian boy presented with a history of generalized blisters, displaying the classic “string of pearls” sign who was eventually diagnosed as a case of LABD. In his admission, he was diagnosed whit Mucocutaneous lymph node syndrome and treated with aspirin.  Some features like appearing the characteristic lesions one week following the administration of aspirin, rapid clearance of lesions after the withdrawal of the drug, and reappearance of new lesions after readministration of aspirin were highly suggestive of aspirin-induced LABD. To establish the diagnosis, we used the “Naranjo probability score” which determined the probable causative role of aspirin. The diagnosis was confirmed by showing the positive IgA deposition in the basement membrane zone in a direct immunofluorescence study of the skin biopsy. The child was treated with dapsone with dramatical response to the drug.
Experience of Uncertainty in Patients with Thalassemia Major: A Qualitative Study
Authors: Ahmadi Mehrnaz , Gheibizadeh Mahin , Rassouli Maryam , Ebadi Abbas , Asadizaker Marziyeh , Jahanifar Mojtaba
Published: October 2020

Background: Uncertainty leads to a stressful situation in patients with thalassemia major that can dramatically affect their psychosocial coping ability, treatment process and disease outcomes, and reduce patients' quality of life. As one of the important factors affecting the health of thalassemia patients, understanding the concept of uncertainty is of major importance to health care providers especially nurses as the first line of exposure to these patients. The present study aimed to explore the experiences of uncertainty in patients with thalassemia major.
Materials and Methods: The present qualitative study was conducted through in-depth face-to-face semi-structured interviews held with 18 patients with major thalassemia selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed with conventional content analysis method of Landman and Graneheim using MAXQDA10 software.
Results: Two main themes, including 'living in the shadow of anxiety' and 'coping with uncertainty' emerged from patients’ experiences of illness uncertainty of thalassemia. 'Living in the shadow of anxiety' included four categories of 'fear of complications', 'contradictory views on treatment', 'unknown future' and 'stigma'. 'Coping with uncertainty' included three categories of 'spiritual coping', 'psychosocial coping' and 'knowledge acquisition'.
Conclusion: According to the results of this study, uncertainty is a major psychological stress in patients with thalassemia major. Healthcare providers should therefore consider the challenges and concerns faced by patients and, through utilizing appropriate training and communicational practices, plan interventions and strategies to empower patients for coping with uncertainty.
For which patient subgroups does exist positive outcomes from a medication review? A systematic review
Authors: Abrahamsen Bjarke , Hansen Rikke N. , Rossing Charlotte
Published: October 2020

Background: A medication review is a possibility to assess and optimise a patient’s medicine. A model that includes a medication review and a follow-up seem to provide the best results. However, it is not known whether specific subgroups of patients benefit more from a medication review than others.

Objective: This literature review summarises the evidence that is available on which patient subgroups exist positive outcomes from a medication review carried out in a primary care setting.

Methods: We performed a PICO analysis to identify keywords for setting, medication review and effect. We then conducted a search using the PubMed database (2004 to 2019) to identify studies relevant for our investigation. A screening process was carried out based on either title or abstract, and any study that matched the aim and inclusion criteria was included. All matching studies were obtained and read, and were included if they met predefined criteria such as study design, medication review and primary care. The studies were divided into subgroups. First, each subgroup was divided according to the studies’ own definition. Secondly, each subgroup was allocated as either risk patients if the subgroup described a specific patient subgroup or risk medication, if the subgroup was defined as using a specific type of medication. This was done after discussion in the author group.

Results: 28 studies from a total of 935 studies were included. Identified studies were divided into either risk patients; frail, recently discharged or multimorbid patients, or risk medication; heart medication, antithrombotic medication, blood pressure lowering medication, antidiabetic medication, anti-Parkinson medication or medication increasing the risk of falls. The subgroups identified from a medication review in primary care were defined as being frail, recently discharged from hospital or multimorbid (risk patients), or defined as patients using anticoagulant or blood pressure lowering medication (risk medication). Most of the medication reviews in the studies that showed an economic effect included at least one follow-up and were delivered by a pharmacist.

Conclusions: The literature review demonstrates that medication reviews delivered by pharmacists to specific subgroups of patients are a way of optimising the economic effect of medication reviews in primary care. This is obtained by reducing health-related costs or the number of contacts with primary or secondary health care services.
Effect Of Inorganic Components Of Fire Foaming Agents On The Aquatic Environment
Authors: GURBANOVA Maya , LOBOİCHENKO Valentyna , LEONOVA Nataliia , STRELETS Victor
Published: October 2020

Impact on the aquatic medium of the number of inorganic additives that are part of the foaming agents for firefighting is considered in paper. The influence of the most widespread inorganic components on aquatic organisms is analyzed. Significant variability of data is noted. It is proved that the magnesium and sodium chlorides are the safest for the environment and the most dangerous ones are aluminum compounds and sulfamic acid. Inorganic additives based on aluminum, sulfamic acid and sodium bicarbonate are the most dangerous for aquatic living organisms, in the short and long term, and the safest compounds are magnesium and sodium chlorides
Open letter to all readers, reviewers, and authors
Authors: Davis Sheila P.
Published: October 2020

Editorial by Dr. Sheila Davis, editor-in-chief of the Online Journal of Health Ethics.
Universalidade do acesso e acessibilidade no quotidiano da atenção primária: vivências de usuários do SUS
Authors: Silva Lívia Silveira , Viegas Selma Maria da Fonseca , Nascimento Leila Cristine do , Menezes Cássia , Martins Jéssica Rauane Teixeira , Potrich Tassiana
Published: October 2020

Objetivo: Compreender o acesso e a acessibilidade à saúde na perspectiva de usuários, em atendimento à demanda espontânea em unidades de Atenção Primária à Saúde (APS). Métodos: Estudo de Casos Múltiplos Holístico-qualitativo, fundamentado na Sociologia Compreensiva do Quotidiano com 60 participantes, em município de grande porte de Minas Gerais. Resultados: Revelam a Saúde como uma questão de luta no quotidiano da APS, destacando as dificuldades enfrentadas pelos usuários do Sistema Único de Saúde (SUS), no que concerne o acesso aos serviços, ações, exames e medicamentos. Denotam a desorganização administrativa e morosidade do Sistema, a questão política, a judicialização. A situação contemporânea do SUS foi questionada: o que precisa no SUS? Conclusão: A realidade vivenciada pelos usuários indica que ainda não foi alcançada a idealização de um Sistema universal, equânime e integral. Ademais, a pesquisa possibilitou reflexões de todos os atores envolvidos, usuários, profissionais de saúde e gestores, sobre o exercício da participação social no SUS e a formação de sujeitos proativos na tomada de decisões políticas para o cumprimento e vigor das legislações que implementam o SUS.
Validação aparente e de conteúdo de uma cartilha de autocuidado para prevenção de lesão por pressão
Authors: Ferreira Isabela Rodrigues , Santos Laysla Luiza , Moraes Juliano Teixeira , Cortez Daniel Nogueira
Published: October 2020

Objetivo: Descrever o processo de construção e validação de uma cartilha de autocuidado para prevenção de Lesão por Pressão (LP). Método: Trata-se de uma pesquisa metodológica, com abordagem quantitativa, que construiu uma cartilha de autocuidado para prevenção de pacientes com risco para desenvolver LP. A pesquisa foi desenvolvida em 4 etapas: levantamento bibliográfico; construção do material educativo (ilustração, layout, design e textos), cálculo do índice de Facilidade de Leitura de Flesch e validação do material por experts da área. Resultados: A cartilha foi validada quanto ao conteúdo e aparência por 11 experts, com o Índice de Validade de Conteúdo (IVC) de 0,93%. Os textos da cartilha foram avaliados como de leitura, razoavelmente fácil, com Índice de Facilidade de Leitura de Flesch (IFLF) de 71%. Conclusão: A cartilha foi validada quanto ao conteúdo e aparência, podendo ser usada como material educativo aos pacientes que apresentam risco de desenvolver LP.
Prince Charming na licencji? Totalizacja baśni
Authors: Bednarek Magdalena
Published: October 2020

The aim of the paper is to present how the culture of convergence has influenced the fairy tale. Jack Zipes stated that since Snow White and the Seven Dwarfs the “sense of wholeness, seamless totality, and harmony” has become a basic experience of the fairy tales’ audience. The totalisation of the fairy tale is both a continuation and a transformation of the described tendency, claims the author. Creating fairy tales’ universes in comics, TV series, movies etc. and building fairy tales’ supersystems are the expressions of the phenomenon. As opposed to Disney productions, contem-porary fairy tales are patchworks, with visible stitches between heterogenic elements. Due to open composition new elements (plots, characters etc.) could be added without end, but creating connec-tions between them is challenging and nowadays one of the most interesting aspects of fairy tales.
A Stochastic H-U Model for Malaria Transmission via Markov Theory
Authors: Arku Dennis , Kallah-Dagadu Gabriel
Published: October 2020

The purpose of this study is to estimate the mean transitioning probabilities from a Healthy state to malaria positive uncomplicated state or to malaria positive severe state. It also classifies the various transitioning probabilities of moving through the various states based on some baseline characteristics. Malaria test results for 2019 over a 12-month period were collected from the University of Ghana school clinic. An H-U model for the study was developed and the transition rates from the cross-sectional data are indicated. With two states Healthy (H) and Uncomplicated (U) forming a state space, there were four possible transitions. The results show that the probability of transitioning from a Healthy state to a malaria positive state is 0.03% while the probability that an individual will remain at Healthy state (H) after the test is 99.73%. It was found that if an individual is already positive and has taken medication the probability that its second test came out negative is 6.45% while the chances that it will remain positive but uncomplicated is 93.55%. The study also showed that in the long run, about 95.98% of persons who visited the student clinic with malaria symptoms recorded negative tests for malaria parasite while about 4% recorded positive for malaria. In terms of disaggregation by gender, it was realized that the number of reported negative test results were higher for females (97.08%) than for males (96.13%). However, the infection rate is higher for males (3.87%) than females (2.92%). It is recommended that in as much as the University of Ghana has two health centers (a clinic and hospital), there should be a centralized system to track students’ health so research done would not be biased.
Determinants of Absenteeism Among Primary School Children in the EAG States of India
Authors: SAHOO DHIREN , Kujur Archana
Published: October 2020

Introduction: Enrolment in school in India does not necessarily translate into attendance, and absenteeism is an early indicator of lower levels of academic performance and school dropout and has its origins in early life. EAG states of India already have some of the lowest school enrolment rates; therefore, it becomes necessary to keep the children in school by curtailing absenteeism to reduce the dropout rates. Objective: This study attempts to understand the factors which affect absenteeism and chronic absenteeism in EAG states. Data and Analysis: This study uses IHDS-II (2012) data for children 8-11 years of age currently enrolled in primary school. Bivariate analysis and logistic regression analysis are done. Results: The results show that children were more likely to be absent when experiencing morbidity (OR:1.9, 95% CI 1.6-2.3) got a beating in school (OR:1.3, 95% CI 1.0-1.6) and repeating grade morbidity (OR:1.5, 95% CI 1.1-2.1). Children were more likely to be chronically absent due to morbidity (OR:1.6, 95% CI 1.3-1.8) and getting beating (OR:1.3, 95% CI 1.0-1.6) in school. Fathers schooling of more than five years and the increased time spent by the children in doing homework, parents' involvement in school and performance in Maths reduced their odds of absenteeism and chronic absenteeism. Conclusions: The increased involvement of parents and conducive school learning environment in school could encourage children to take an interest in school activities, prevent the children from being absent which can have curtail dropping out of primary school to some extent.
Animal Sound Classification Using Dissimilarity Spaces
Authors: Nanni Loris , Brahnam Sheryl , Lumini Alessandra , Maguolo Gianluca
Published: October 2020

The classifier system proposed in this work combines the dissimilarity spaces produced by a set of Siamese neural networks (SNNs) designed using 4 different backbones, with different clustering techniques for training SVMs for automated animal audio classification. The system is evaluated on two animal audio datasets: one for cat and another for bird vocalizations. Different clustering methods reduce the spectrograms in the dataset to a set of centroids that generate (in both a supervised and unsupervised fashion) the dissimilarity space through the Siamese networks. In addition to feeding the SNNs with spectrograms, additional experiments process the spectrograms using the Heterogeneous Auto-Similarities of Characteristics. Once the similarity spaces are computed, a vector space representation of each pattern is generated that is then trained on a Support Vector Machine (SVM) to classify a spectrogram by its dissimilarity vector. Results demonstrate that the proposed approach performs competitively (without ad-hoc optimization of the clustering methods) on both animal vocalization datasets. To further demonstrate the power of the proposed system, the best stand-alone approach is also evaluated on the challenging Dataset for Environmental Sound Classification (ESC50) dataset. The MATLAB code used in this study is available at https://github.com/LorisNanni.
Operational Challenges, From PMO to EPMO Execution and Operation Case Study Within Electricity Producing Companies (Four Selected Companies Within EU28)
Authors: Metuge Ekomenzoge , Otegi Olaso José Ramón
Published: October 2020

During the European unification process, they stated the need for drawing up a common energy strategic plan that will affects electricity production system in terms of infrastructure, production and generation. The EU strategic action plans included; reduction in emissions, an increase in renewable energies, energy efficiency. In this light therefore the energy efficiency was booked for researching. This article presents an in-depth study of the challenges in transforming a functioning PMO model to an EPMO model within four electricity companies from different countries within the EU and how those challenges can be address within companies implementing same methodology to bring about electricity production efficiency. Will these identified challenges make it impossible for the companies to achieve electricity production efficiency in the transformation from PMO to EPMO? PMO has been the major methodology used by these companies. To achieve production efficiency, the need for a heavyweight methodology was identified (EPMO) and implemented in four mega electricity producing companies with cross boarder distributions, one from France; Germany; Spain and UK
PELATIHAN PENGOLAHAN AIR KELAPA MENJADI KECAP DI DESA MATTIRODECENG, KECAMATAN TIROANG, KABUPATEN PINRANG
Authors: Natsir Hasnah , Arif Abdur Rahman , Arfah Rugaiyah A , Zakir Muhammad , St Fauziah St Fauziah , Budi Prastawa
Published: October 2020

Mattirodeceng is a village located in Pinrang Regency, which has considerable natural resource potential in coconut production. But the utilization of coconut plants, especially the water of coconut, is still low. Coconut water only used for consumption purposes at certain times. The purpose of this activity is to provide training on the benefits and ways of processing coconut water into soy sauce for PKK groups in the Mattirodeceng village. The method used in this activity consisted of the pre-activity stage, which included a survey of the location and trial making of soy sauce made from coconut water. The implementation of activities carried out by counseling methods and training on the benefits and ways of processing coconut water into soy sauce. The result of the application of this activity was an increase in participants' knowledge about coconut water, namely its nutritional content, and its processed products in the form of soy sauce. The Organoleptic test showed the level of panelists' preference for taste, flavour, texture, and color showed good results, where all panelists liked the coconut water soy sauce products
 
Keywords: Coconut water, soy sauce, organoleptic Mattirodeceng Village.
 
ABSTRAK
Mattirodeceng merupakan salah satu desa yang terletak di Kabupaten Pinrang yang memiliki potensi sumber daya alam yang cukup besar dalam produksi kelapa. Namun pemanfaatan tanaman kelapa, terutama air kelapa masih rendah. Air kelapa hanya digunakan untuk keperluan konsumsi pada saat-saat tertentu. Tujuan dari kegiatan ini yaitu untuk memberikan pelatihan manfaat dan cara pengolahan air kelapa menjadi kecap kepada kelompok PKK di desa mattirodeceng. Metode yang digunakan dalam kegiatan ini terdiri dari tahap pra kegiatan yang meliputi survei lokasi dan uji coba pembuatan kecap air kelapa. Tahap pelaksanaan kegiatan dengan metode penyuluhan dan pelatihan tentang manfaat serta cara pengolahan air kelapa menjadi kecap. Hasil dari pelaksanaan kegiatan ini adalah meningkatnya pengetahuan peserta tentang air kelapa, yaitu kandungan gizinya, dan produk olahannya berupa kecap. Hasil uji organoleptik menunjukkan tingkat kesukaan panelis terhadap rasa, aroma, tekstur dan warna menunjukkan hasil yang baik, dimana seluruh panelis menyukai produk kecap air kelapa.
 
Kata kunci: Air kelapa, kecap, organoleptik, Desa Mattirodeceng.
Analisis Pengendalian Persediaan Obat Dengan Metode ABC, VEN dan EOQ di Rumah Sakit Bhayangkara Kediri
Authors: Rofiq Abdul , Oetari Oetari , Widodo Gunawan Pamudji
Published: October 2020

Abstrak: Pengelolaan persediaan obat yang optimal memberikan penghematan biaya pengadaan obat. Dua permasalahan sangat penting dalam pengendalian persediaan obat yaitu memutuskan jenis dan jumlah obat yang harus dipesan. Untuk mendapatkan solusi pengendalian persediaan maka diperlukan identifikasi dan analisis permasalahan tersebut. Tujuan penelitian ini menganalisis sistem pengendalian dan meningkatkan efisiensi siklus pengelolaan obat pasien BPJS Kesehatan klasifikasi AE di Instalasi Farmasi Rumah Sakit Bhayangkara Kediri. Obat klasifikasi AE menggambarkan obat dengan indek kritis tinggi dengan pemakaian dan item banyak, selanjutnya dianalisis menggunakan metode ABC, VEN dan EOQ. Jenis penelitian ini adalah penelitian deskriptif analitik, pengambilan data dilakukan secara retrospektif. Data yang digunakan obat pasien BPJS Kesehatan di Instalasi Farmasi Rumah Sakit Bhayangkara Kediri periode Januari - Desember 2018. Pengumpulan data primer dan sekunder melalui observasi dokumen di lapangan dan wawancara dengan pihak terkait. Analisis menggunakan metode ABC, VEN dan EOQ untuk klasifikasi obat AE. Selanjutnya hasil pengolahan data dibandingkan dengan parameter Reorder Point, Inventory Value, Inventory Turn Over Ratio, Customer Service Level, Safety Stock dan Maximum level inventory untuk menilai efisiensi pengendalian persediaan guna memperoleh persediaan obat yang efisien. Penelitian ini diperoleh hasil analisis pengendalian obat pasien BPJS Kesehatan menggunakan metode ABC dan VEN mampu meningkatkan pengelolaan obat menjadi efektif dan efisien khususnya obat katagori AE. Data perencanaan, pengadaan dan pemakaian obat pasien BPJS Kesehatan tahun 2018 dianalisis dengan metode EOQ selanjutnya dibandingkan nilai parameter yang digunakan dapat mengurangi nilai Stock Out, tetapi efektifitas dan efisiensi pengendalian obat tidak tercapai.
Profil Pasien dan Penggunaan Antibiotik pada Kasus Community-Acquired Pneumonia Rawat Inap di Rumah Sakit Akademik wilayah Sukoharjo
Authors: Farida Yeni , Putri Verina Widyati , Hanafi Muchtar , Herdianti Nurmayda Sukma
Published: October 2020

Pneumonia merupakan  penyakit infeksi yang masih menjadi permasalahan di dunia turut menyumbang angka mortalitas dan morbiditas. Penyakit infeksi dapat disebabkan oleh bakteri, virus, dan jamur. Pengobatan utama penyakit infeksi akibat bakteri adalah penggunaan antibiotik. Tingginya intensitas penggunaan antibiotik yang dapat menimbulkan berbagai permasalahan dan ancaman bagi kesehatan perlu untuk dikaji. Penelitian yang dilakukan merupakan penelitian observasional untuk mengetahui profil pasien dan penggunaan obat pasien pneumonia. Sampel dalam penelitian ini diambil menggunakan teknik total sampling. Data diambil secara retrospektif dari rekam medis dan dianalisis secara deskriptif. Hasil penelitian menunjukkan bahwa sebagian besar pasien pneumonia adalah pasien usia >65 tahun berjenis kelamin laki-laki dengan lama perawatan terbanyak 1-7 hari (81,8%), derajat keparahan terbanyak “Ringan” (45,5%), dan penyakit komorbid terbanyak kardiovaskuler (50,9%). Terapi antibiotik tunggal terbanyak adalah levofloxacin (38,2%), evaluasi penggunaan obat yang telah sesuai sebanyak 14,5%, dan potensi interaksi obat  terbanyak pada levofloxacin dengan methylprednisolon (26,4%).