Health consultations at a performing arts health centre among classical music students based on electronic health record data: a cross-sectional study

Physical and mental health problems in music students are usually identified using self-reported data. The use of an Electronic Health Record database can avoid biases to give an overview of the extent of health problems in this population. Therefore, the aim of this study is to gain insight into both physical and mental health related issues in classical music students using this type of data collection. An Electronic Health Record database including five years of data from a Performing Arts Health Centre (PAHC) of a university or the arts, was used to analyze the number and characteristics of health consultations in music students. The total number of students, health consultations and the average number of visits per health consultation were calculated over five years. Furthermore, numbers and percentages of both physical and mental health consultations were registered. Also, the number and percentage of health consultations per instrument group were compared to the proportion of each instrument group within the specific sample. Over a period of five years, 230 students visited the PAHC and 417 health consultations were reported. 43.5% of the students who visited a health professional indicated at least one physical health consultation, 29.1% at least one mental health consultation and 27.4% at least one in both categories. An injury was the most frequently registered physical health consultation (40.2%), followed by performance improvement (9.8%) and stress (9.6%). Voice students registered relatively most health consultations. As far as we know, this is the first cross-sectional study using Electronic Health Record data from a PAHC to gain insight into both physical and mental health related issues in a population of classical music students. Looking at the variety of health consultations registered in the database, a multidisciplinary team and multidisciplinary approach are necessary to meet the needs of the students in terms of physical and mental health support and performance improvement.

Reflections of the COVID-19 pandemic on health problems of children with special needs

OBJECTIVE

This research aimed to examine changes caused by the COVID-19 pandemic in activities of daily living and health status of children with special needs.

METHOD

The current descriptive and comparative study was carried out with 82 students studying at a special education practice school that provided daytime education to children with special needs before and during the COVID-19 pandemic. The Personal Information Form, the Katz Index of Independence in Activities of Daily Living, and the Omaha System Problem Classification Scheme were employed as data collection tools in the research.

RESULTS

The 10 most common problems during the COVID-19 pandemic were stated as cognition (86.6%), mental health (75.6%), speech and language (85.4%), interpersonal relationships (79.3%), personal care (79.3%), social contact (64.6%), growth and development (63.4%), neighborhood/workplace safety (58.5%), communication with community resources (57.3%), and caretaking/parenting (n = 47, 57.3%). The incidence of "cognition," "speech and language," "neighborhood/workplace safety," "communication with community resources," and "caretaking/parenting" problems of children with special needs was significantly higher during the pandemic than before the pandemic (p < 0.05; p < 0.001).

CONCLUSION

The current research emphasized the significant impacts on the health of children with physical and mental disabilities and loss of opportunity, as their education was considerably interrupted during the quarantine. During a pandemic, the regular evaluation of health benefits/risks is essential to ensure the continuity of medical follow-up, rehabilitation, education, and support mechanisms for children with disabilities.

A systematic review of work-related health problems of factory workers in the textile and fashion industry

OBJECTIVES

The purpose of this study was to present a systematic review of the health-related problems of factory workers in the textile and fashion industry. These workers endure long sitting postures, poor workspace conditions, and long working hours to complete their overload of tasks. This situation results in several health problems that affect the productivity, mental health, and well-being of the workers.

METHODS

The relevant data (21 article publications) were obtained from the Scopus database. Analysis of the 21 articles was grouped under 3 research themes based on the critical reading of the content and abstracts: respiratory problems, musculoskeletal disorders, and psychological stressors and other health issues.

RESULTS

The findings show that factory workers are exposed to dust particles of cotton and other raw materials, fumes, and chemicals from manufacturing processes. This prolonged exposure without the use of personal protective equipment (PPE) leads to respiratory diseases like byssinosis that affect the workers' health. Additionally, working in a particular posture due to the workstation design for prolonged hours causes musculoskeletal disorders or pains. Workers also suffer from anxiety, depression, and stress from workload and pressure, hence making them unstable with reduced productivity.

CONCLUSIONS

The findings of the study reinforce the need for a safe workspace and spacious work environment, provision of PPE, training in occupational hazards, frequent health checks, and ergonomic assessment of workstations to reduce prolonged work postures. Stakeholders, employers, policymakers, and governments should collaborate to safeguard and protect the well-being and health of the workers at these factories.

Injuries in male youth football: a one season prospective cohort study of 223 Danish elite players

Objectives

This study prospectively investigated injury prevalence, incidence, and burden in male elite under-17 football players (N = 223) during a full season.

Methods

The players weekly completed a standardized web-based injury survey (OSTRC-H2) and a physical exposure report throughout the study.

Results

Average weekly response rate was 89.5%. Football exposure accounted for 52.4% of total physical exposure. On average (±SD), the players participated in individual football, strength, and rehabilitation practices for 1.2 ± 1.5, 3.0 ± .2.1, and 1.9 ± 3.4 h/week, respectively. In total, 742 health problems were reported. Mean weekly prevalence of health problems, injuries and illnesses were 20.1%, 16.5% and 3.8%, respectively. The injury incidence per 1,000 h of football exposure, match play and team practice were 8.28 (95% CI: 7.54-9.08), 16.77 (95% CI: 13.65-20.4), and 7.24 (95% CI: 6.5-8.04), respectively. Sudden-onset and gradual-onset injuries accounted for 36.7% and 43.4% of the total proportion of health problems. Hip/groin injuries had the highest incidence (1.58/1,000 h), whereas knee injuries had the highest burden (20.86 days lost/1,000 h). On average, the players experienced 3.33 health problems (average duration: 7.8 days). On average pr. player, 2.7 (95% CI: 2.2-3.3) wks of football exposure were lost.

Conclusion

Sudden and gradual-onset injuries influenced player availability during the season. Health problem prevalence fluctuated markedly, and injury incidence was higher during match play than training. The players had substantial volumes of training beyond football-specific training and matches. Our findings could assist medical and sports science practitioneers in enhancing training and recovery processes to maximize player availability.

Self-help/mutual aid groups for health and psychosocial problems: Key features and their perspectives in the 21st century

In this virtual special issue, a set of 26 papers previously published in the American Journal of Community Psychology (AJCP), focused on self-help/mutual aid groups (SH/MAGs), are being curated given their significant impact in this domain. SH/MAGs constitute an important component of the community psychology's proposal to address various psychosocial and health problems. The American Journal of Community Psychology has played an important role in exploring the characteristics of self-help/mutual aid groups in various fields. These articles cover important areas of the study of self-help/mutual-aid groups. More specifically, the selected articles address issues such as the definition and key characteristics of self-help/mutual aid groups, the main fields that are applied, such as mental health, addictions, and disabilities. The article also addresses important issues such as the place of self-help/mutual aid groups in health systems, the experiential knowledge generated within these groups and the relationship of health professionals with these groups. The aim is this VSI to contribute to contemporary discussion on self-help/mutual aid groups, their challenges, and their perspectives and to highlight the crucial role that community psychology has in this field.

Sitting vs. standing: an urgent need to rebalance our world

During their activities of daily living, humans run, walk, stand, sit and lie down. Recent changes in our environment have favored sedentary behavior over more physically active behavior to such a degree that our health is in danger. Here, we sought to address the problem of excessive time spent seated from various theoretical viewpoints, including postural control, human factors engineering, human history and health psychology. If nothing is done now, the high prevalence of sitting will continue to increase. We make a case for the standing position by demonstrating that spending more time upright can mitigate the physiological and psychological problems associated with excessive sitting without lowering task performance and productivity. The psychological literature even highlights potential benefits of performing certain tasks in the standing position. We propose a number of recommendations on spending more time (but not too much) in the standing position and on more active, nonambulatory behaviors. There is a need to inform people about (i) harmful consequences of excessive sitting and (ii) benefits of spending more time performing active, nonambulatory behaviors. One clear benefit is to reduce detrimental health consequences of excessive sitting and to provide potential additional benefits in terms of productivity and performance.

Health Problems of Increasing Man-Made and Climate-Related Disasters on Forcibly Displaced populations: A Scoping Review on Global Evidence

Forcibly displaced populations are among the most vulnerable groups in disasters. They experience poorer health conditions compared with nondisplaced individuals. However, a clear picture is lacking regarding the overall health problems encountered by disaster-induced mid- to long-term displaced people. This study investigated these disorders prevalence and identified their correlates among long-settled displaced populations worldwide. The current scoping review follows the PRISMA-ScR guidelines; a systematic search was conducted on PubMed, Web of Science, and CINAHL and included original peer-reviewed studies, commentary, reviews, and grey literature published in English between January 1990 to June 2022. In the thematic and content analysis, the authors applied the narrative review approach to identify themes and sub-themes. Forty-eight documents were identified as fully relevant to this study. The largest number of published papers were from Asia, followed by the Middle East, the United States, and Europe. IDPs in developed countries were the most researched populations. Human-made disasters were addressed by 89% of the included studies. The four main thematic categories included were "physical health," "mental health," "inadequate facilities," and "lack of healthy behaviour." The worsening of noncommunicable diseases had the highest prevalence, followed by communicable diseases. Due to their condition, forcibly displaced migrants face a triple burden of communicable diseases and noncommunicable diseases such as mental health issues. Health-related research and policy need to consider the links among disasters, health problems, and forced migration as a determinant of health in the new era of climate change-driven displacements.

Larval Wound Therapy: Possibilities and Potential Limitations-A Literature Review

Patient-centered care (PCC) is recognized as a standard in healthcare for determining high quality. Honoring patients' values, experiences, needs, and preferences in devising, coordinating, and delivering care underscores the enhancement of the therapeutic rapport between patients and healthcare providers. Wound treatment involves a multi-stage process encompassing diagnostics and local wound dressing, which reduces the risk of infection through a coordinated interdisciplinary team. Within this team, nurses undertake specific professional functions and roles. The implementation of local therapy using innovative and scientifically substantiated methods may be hindered by a deficit of knowledge or inappropriate knowledge among staff and patients themselves. This study presents the challenges concerning the care of patients with chronic wounds treated using Lucilia sericata larvae, based on a review of the current scientific literature. A critical analysis of the literature spanning from 2002 to 2022 was conducted using the Medline, PubMed, Cochrane, and Termedia databases, employing keywords such as "maggot debridement therapy" in relation to acceptance and perception. As a result of the preliminary selection, 472 papers were identified, of which 12 publications were included in the development of this concept. The acquired data were organized and presented in the concluding section in the form of tables, accompanied by descriptions and references to individual studies. Negative psychological and somatic sensations were among the most prominent challenges among patients treated with Maggot Debridement Therapy (MDT). Pain related to peripheral ischemia or infection in this group of patients requires pain prophylaxis, including hyperalgesia and allodynia, in order to improve method tolerance. On the other hand, augmenting patients' understanding of MDT diminishes negative emotions, reinforces positive behaviors, and mitigates anxiety levels. MDT constitutes an effective and safe method. Its widespread use for chronic wounds requires substantial knowledge among healthcare professionals and patient education, along with that of their caregivers, to develop a positive attitude.

Health behaviors and problems in Polish homeless men

Introduction

Homelessness is considered to be a global problem, independent of the material situation of a given country and occurring in most societies around the world.

Aim of the study

Assessment of the preferred health behaviors of homeless people.

Materials and methods

The study covered 153 men who are homeless and 312 men who are not homeless. The original questionnaire of homeless, and validated the Satisfaction with Life Scale (SWLS), the Health Behavior Inventory (HBI), the General Self-Efficacy Scale (GSES) and the Multidimensional Health Locus of Control (MHLC) Scale were used. The research covered fully completed questionnaires from 153 homeless men staying in Białystok and Gdańsk homelss centers.

Results

On average, the homeless men assessed their health at 6.0 ± 2.7 points, and the non-homeless at 7.8 ± 2.2 points (p < 0.001). Significant differences were found between people experiencing a homelessness crisis and the control group in selected aspects concerning the everyday life hygiene of the respondents, health self-assessment, declarations of visits to a specialist and carrying out check-ups, level of satisfaction with life, coping with difficult situations, preferred pro-health behaviors and dimensions of health control. In the used scales, SWLS, HBI, GES, and MHCL, the majority of homeless men obtained average scores. They were rather dissatisfied with their lives, with a low level of effectiveness in coping with difficult situations and obstacles, a low level of health behaviors, and in the scope of health, control increasing the impact of chance.

Conclusion

The level of the presented health behaviors showed statistically significant diversification with all dimensions of the health locus of control, and its internal dimension with age, homelessness phase, the respondents' criminal history, being under constant medical care, and self-assessment of health.

Procrastination and health: A longitudinal test of the roles of stress and health behaviours

OBJECTIVES

Procrastination is a common form of self-regulation failure that a growing evidence base suggests can confer risk for poor health outcomes, especially when it becomes habitual. However, the proposed linkages of chronic procrastination to health outcomes have not been tested over time or accounted for the contributions of higher-order personality factors linked to both chronic procrastination and health-related outcomes. We addressed these issues by examining the role of chronic procrastination in health outcomes over time in which the hypothesized links of procrastination to health problems operate via stress and health behaviours.

DESIGN

Three-wave longitudinal study with 1-month intervals.

METHODS

Participants (N = 379) completed measures of trait procrastination at Time 1, and measures of health behaviours, stress and health problems at each time point, in a lab setting.

RESULTS

Procrastination and the health variables were inter-related in the expected directions across the three assessments. Chronic procrastination was positively associated with stress and negatively with health behaviours at each time point. Path analysis testing a cross-lagged longitudinal mediation model found an indirect relationship operating between procrastination and health problems via stress, after accounting for the contributions of conscientiousness and neuroticism.

CONCLUSIONS

This research extends previous work by demonstrating that the links between chronic procrastination and poor health are accounted for mainly by higher stress, after accounting for other key traits, and that these associations are robust over time. The findings are discussed in terms of the importance of addressing habitual self-regulation failure for improving health.

Are older people worse off in 2040 regarding health and resources to deal with it? - Future developments in complex health problems and in the availability of resources to manage health problems in the Netherlands

Introduction

Developing sustainable health policy requires an understanding of the future demand for health and social care. We explored the characteristics of the 65+ population in the Netherlands in 2020 and 2040, focusing on two factors that determine care needs: (1) the occurrence of complex health problems and (2) the availability of resources to manage health and care (e.g., health literacy, social support).

Methods

Estimations of the occurrence of complex health problems and the availability of resources for 2020 were based on registry data and patient-reported data. Estimations for 2040 were based on (a) expected demographic developments, and (b) expert opinions using a two-stage Delphi study with 26 experts from policy making, practice and research in the field of health and social care.

Results

The proportion of people aged 65+ with complex health problems and limited resources is expected to increase from 10% in 2020 to 12% in 2040 based on demographic developments, and to 22% in 2040 based on expert opinions. There was high consensus (>80%) that the proportion with complex health problems would be greater in 2040, and lower consensus (50%) on an increase of the proportion of those with limited resources. Developments that are expected to drive the future changes refer to changes in multimorbidity and in psychosocial status (e.g., more loneliness).

Conclusion

The expected increased proportion of people aged 65+ with complex health problems and limited resources together with the expected health and social care workforce shortages represent large challenges for public health and social care policy.

Therapeutic actions of tea phenolic compounds against oxidative stress and inflammation as central mediators in the development and progression of health problems: A review focusing on microRNA regulation

Many health problems including chronic diseases are closely associated with oxidative stress and inflammation. Tea has abundant phenolic compounds with various health benefits including antioxidant and anti-inflammatory properties. This review focuses on the present understanding of the impact of tea phenolic compounds on the expression of miRNAs, and elucidates the biochemical and molecular mechanisms underlying the transcriptional and post-transcriptional protective actions of tea phenolic compounds against oxidative stress- and/or inflammation-mediated diseases. Clinical studies showed that drinking tea or taking catechin supplement on a daily basis promoted the endogenous antioxidant defense system of the body while inhibiting inflammatory factors. The regulation of chronic diseases based on epigenetic mechanisms, and the epigenetic-based therapies involving different tea phenolic compounds, have been insufficiently studied. The molecular mechanisms and application strategies of miR-27 and miR-34 involved in oxidative stress response and miR-126 and miR-146 involved in inflammation process were preliminarily investigated. Some emerging evidence suggests that tea phenolic compounds may promote epigenetic changes, involving non-coding RNA regulation, DNA methylation, histone modification, ubiquitin and SUMO modifications. However, epigenetic mechanisms and epigenetic-based disease therapies involving phenolic compounds from different teas, and the potential cross-talks among the epigenetic events, remain understudied.

Potentially inappropriate medications in geriatric blood or marrow transplantation (BMT) survivors: A BMT Survivor Study report

BACKGROUND

Blood or marrow transplantation (BMT) is increasingly offered to older individuals with hematologic malignancies. The high prevalence of chronic health conditions in such individuals necessitates use of multiple medications. Beers Criteria represent a list of potentially inappropriate medications (PIMs) shown to increase the risk of health problems in the elderly. We sought to determine the prevalence and predictors of PIM use in older BMT survivors and identify associations with health problems.

METHODS

Study participants were drawn from the BMT Survivor Study, a cohort study of patients transplanted at three US transplant centers between 1974 and 2014 and surviving ≥2 years. For this report, the survivors were aged ≥65 years. Siblings served as a comparison group. Participants self-reported sociodemographics, chronic health conditions, and medication use. Logistic regression analyses identified predictors of PIM use and associations with health problems.

RESULTS

Overall, PIM use was comparable between BMT survivors (49.4%) and siblings (49.3%) (odds ratio [OR] = 0.9; 95% CI, 0.7-1.2); however, BMT survivors were more likely to use >1 PIM (17.4% vs. 12.4%; OR = 1.5; 95% CI, 1.01-2.4) and central nervous system-related PIMs (8.3% vs. 4.3%; OR = 2.18; 95% CI, 1.17-4.09). Predictors of PIM use included presence of severe/life-threatening chronic health conditions (OR = 1.5; 95% CI, 1.1-2.0), and chronic graft versus host disease (OR = 1.7; 95% CI, 1.1-2.7). Survivors taking >1 PIM reported more issues with vertigo (OR = 2.3; 95% CI, 1.1-4.7), balance (OR = 2.6; 95% CI, 1.7-4.1), faintness/dizziness (OR = 2.8; 95% CI, 1.8-4.6), and personal care (OR = 4.5; 95% CI, 1.4-14.8).

CONCLUSIONS

This study shows the health problems associated with PIM use and identifies vulnerable populations at higher risk for PIM use, providing evidence for caution in using PIMs in high-risk populations.

Recent Advancements in Prevention and Treatment of Osteoporosis with Traditional Chinese Medicine: A Long Way from Lab Bench to Bedside

Osteoporosis is becoming more prevalent in the ageing society, however, its treatment is still a problem for both society and individuals. Traditional Chinese Medicine (TCM) has a long history in treating osteoporosis and is receiving increasing attention. Multiple formulas of TCM showed satisfactory effects in treating osteoporosis in both animal models and clinical patients. However, because TCM usually consists of multiple plant and/or animal products, it is difficult to clarify the mechanism of TCM according to the requirements of Western medicine regarding purity, efficacy, dosage, and safety. With increasing researchers have started to investigate the TCM using modern scientific tools such as bioinformatics and network pharmaceutics in osteoporosis and the addition of TCM in the latest version of International Statistical Classification of Diseases and Related Health Problems (ICD-11 version, 2019) by WHO, TCM is showing large potential in treating osteoporosis although there is still a long way. The review aimed to summarize recent advancements of TCM treating osteoporosis.

Functional Ability and Health Problems of Stroke Survivors: An Explorative Study

Background A stroke is an emergency medical condition that needs to be treated promptly. Patients who suffer from stroke frequently experience varying degrees of impairment, necessitating emergency hospital treatment and prolonged home care. It can lower the quality of life which leads to social isolation and makes it harder to function independently. The purpose of this research was to assess the health issues and functional capacity of individuals living with stroke. Methodology An exploratory study was conducted in the neurological outpatient department of tertiary care hospitals in Chennai. A total of 30 post-stroke participants were selected using a convenient sampling technique. Data were collected by structured interviews using the Post-Stroke Checklist and Barthel Index. The data were analyzed through descriptive and inferential statistics. Results The majority of the patients were (86.7%) men in the age group of 55-65 years. Regarding the health problems identified with the Post-Stroke Checklist, the activities of daily living (80%) were the most common, and spasticity (48%) and pain (34%) were the least common. However, 60% of the participants had new problems related to vision, 66% had problems with hearing, 76% had problems with getting around inside or outside, and 60% had a history of a recent fall. Further, 52% had problems with remembering and concentrating on things, 72% had problems sleeping, and 45% were worried about their relationship with their spouse after the stroke. The median Barthel Index score was 43.5. Conclusions More than half of all stroke survivors were dependent on others for everyday activities. We recommend that a well-designed and focused assessment is needed to identify the functional ability and stroke-related health problems among individuals by all healthcare professionals for the successful rehabilitation of stroke survivors.

Health-Related Quality-of-Life among Pregnant Women after First, Second, and Multiple Cesarean Sections in the Perinatal Period: A Short-Term Longitudinal Study

The primary objective of this study was to compare assessments of health-related quality-of-life (HRQoL) in women who had a medical qualification for cesarean section (CS), depending on the number of CSs in their medical history. A short longitudinal study was conducted among 115 women on the day before a planned cesarean section (CS)-T1, and on the third day after CS-T2. They were divided into three groups. G1: no CS (n = 17); G2: one CS (n = 34); G3: two or more CSs (n  =  64). Participants completed a set of questionnaires concerning sociodemographic aspects and psychological outcomes: the HRQoL questionnaire (EQ-5D-3L). A chi-square test, McNemar's test, and repeated measures ANOVA were used to compare the three groups in T1 and T2. Regardless of the number of CSs, before a CS, women mainly experience health problems with pain and anxiety/depression, and after a CS, mostly problems with pain, usual activity, and mobility. All participants experienced an increase in the amount of health problems with mobility and pain after a CS. Women who have had two or more CSs also had problems with self-care and usual activities. Women who have had one or two CSs experienced a decrease in the general assessment of the HRQoL, which is not observed in the group of women with multiple CSs. However, the HRQoL of women in the group with multiple CSs was lower before the CS than in the other groups. The results indicated the significance of the number of CSs, not only in postoperative, but also in preoperative HRQoL.

Complementary and alternative medicines chosen for specific health problems: Internet survey using the I-CAM-Q in Japan: A STROBE-compliant cross-sectional study

This study investigated the different complementary and alternative medicines (CAMs) adopted by people in Japan, as well as the health problems treated with CAMs. Understanding more about this topic will facilitate the appropriate incorporation of CAMs into conventional medicine when treating health problems. Data were collected through an online survey based on the International Questionnaire to Measure Use of Complementary and Alternative Medicine (I-CAM-Q). The study examined CAM utilization among people aged 20 years or older; 164 valid responses were collected (18.9%). We adopted a cross-sectional design. We then compared the relationships between the specific health problems reported by participants, their self-help practices, and the kinds of healthcare specialists consulted. We also examined participants' reasons for using CAMs and their responses regarding the usefulness of the CAMs adopted. We found that self-help/CAM practices differed for specific health problems. Participants with musculoskeletal and heart problems were more likely to use poultices. Those with respiratory and digestive problems were more likely to practice yoga, tai chi, and qigong. Those with digestive and neurological problems were more likely to use aromatherapy. The I-CAM-Q questionnaire also revealed the purpose and usefulness of the CAMs utilized as well as the participants' attitudes regarding conventional medicine. The study showed that participants find physicians less helpful than other options for treating their health problems. Additionally, when asked whether it was helpful to consult with a specific professional for health problems, there was a higher percentage of participants who answered "Very helpful" for professionals, like massage, judo, acupuncture, and moxibustion therapists, than for physicians. The results of this study will help to inform medical providers of the most appropriate types of CAMs for dealing with various health problems.

Why Do Community-Dwelling Persons with Spinal Cord Injury Visit General Practitioners: A Cross-Sectional Study of Reasons for Encounter in Swiss General Practice

Purpose

In a country of free selection of providers, general practitioners (GPs) remain the most visited health-care professionals by the vast majority of persons with spinal cord injury (SCI) in Switzerland; yet, little is known about these contacts. The study aims to explore reasons for encounters (RFEs) in general practice, and their relationships to first-contact of care (GP or specialist) and GP’s competence in managing SCI-specific problems.

Patients and Methods

Cross-sectional study from baseline data of non-randomized controlled trial. Persons with SCI in the chronic phase and living in Swiss rural communities were invited. Participants were asked about RFEs (reasons and health problems) of their last visit to a GP. RFEs were coded according to the International Classification of Primary Care (ICPC-2), and analyzed according to first-contact and participants’ ratings of GPs’ competence in managing SCI-specific problems.

Results

Out of 395, 226 (57%) persons participated, of which 89% have reported 2.1 (SD ±1.4) RFEs and 2.4 (±1.7) health problems per GP visit, on average. Participants visited GPs for medications (49%), urgent medical problems (33%) and follow-up (30%). Most RFEs were related to general/unspecified problems (65%). Persons whose first contact was a specialist were more likely to visit GPs for medications (Specialist = 60% vs GP = 42%). There were no associations between RFEs and the perceived GP’s competence at P < 0.05.

Conclusion

Irrespective of first contact of care, persons with SCI visit GPs for medication, urgent issues, and follow-up care, and more often for general problems than for secondary health conditions. Strengthening collaboration between GPs in rural communities and specialized centers is recommended; promoting such a connection potentially aids GPs in meeting their information needs for managing secondary health conditions and improving the quality of SCI care for this population.

Americans' Health Priorities During the COVID-19 Pandemic

OBJECTIVES

This study aimed to examine how Americans' opinions of the seriousness of various health-related problems have changed over time and to quantify the public's preferences for research prioritization.

METHODS

We conducted a survey that asked respondents to rate the seriousness of 80 health-related problems on a 4-point Likert scale ("very serious problem," "somewhat serious problem," "not too serious of a problem," or "not a problem at all"). Results were compared with past surveys from 2001 and 2013 that examined the same set of health-related problems (with the exception of COVID-19). The survey also included best-worst scaling questions that asked respondents to select, from 20 health problems, those they considered most and least important for research funding. Respondents were recruited from the KnowledgePanel, a nationally representative sample of American households.

RESULTS

A total of 768 adults completed the survey between September 3, 2020, and September 14, 2020. The health-related problems that Americans consider to be "very serious" generally align with the leading causes of death and noncommunicable diseases such as heart disease, diabetes, and mental health; nevertheless, several social determinants of health are also identified. COVID-19 was an unsurprising top priority, whereas cancer remains the highest and a persistent priority for research funding.

CONCLUSIONS

Americans consider a diverse set of health-related problems to be "very serious," with recognition of social determinants of health rising. Our findings offer guidance as to the disease areas for which the public would value further public and private investment in treatment innovations.

Health Problems in Adults with Prader-Willi Syndrome of Different Genetic Subtypes: Cohort Study, Meta-Analysis and Review of the Literature

Prader−Willi syndrome (PWS) is a complex, rare genetic disorder caused by a loss of expression of paternally expressed genes on chromosome 15q11.2-q13. The most common underlying genotypes are paternal deletion (DEL) and maternal uniparental disomy (mUPD). DELs can be subdivided into type 1 (DEL-1) and (smaller) type 2 deletions (DEL-2). Most research has focused on behavioral, cognitive and psychological differences between the different genotypes. However, little is known about physical health problems in relation to genetic subtypes. In this cross-sectional study, we compare physical health problems and other clinical features among adults with PWS caused by DEL (N = 65, 12 DEL-1, 27 DEL-2) and mUPD (N = 65). A meta-analysis, including our own data, showed that BMI was 2.79 kg/m2 higher in adults with a DEL (p = 0.001). There were no significant differences between DEL-1 and DEL-2. Scoliosis was more prevalent among adults with a DEL (80% vs. 58%; p = 0.04). Psychotic episodes were more prevalent among adults with an mUPD (44% vs. 9%; p < 0.001). In conclusion, there were no significant differences in physical health outcomes between the genetic subtypes, apart from scoliosis and BMI. The differences in health problems, therefore, mainly apply to the psychological domain.

An Update on the Implications of New Psychoactive Substances in Public Health

The emergence of new psychoactive substances has earned a great deal of attention, and several reports of acute poisoning and deaths have been issued involving, for instance, synthetic opiates. In recent years, there have been profound alterations in the legislation concerning consumption, marketing, and synthesis of these compounds; rapid alert systems have also been subject to changes, and new substances and new markets, mainly through the internet, have appeared. Their effects and how they originate in consumers are still mostly unknown, primarily in what concerns chronic toxicity. This review intends to provide a detailed description of these substances from the point of view of consumption, toxicokinetics, and health consequences, including case reports on intoxications in order to help researchers and public health agents working daily in this area.

Driver's Personality and Behavior for Boosting Automobile Security and Sensing Health Problems Through Fuzzy Signal Detection Case Study: Mexico City

Automobile security became an essential theme over the last years, and some automakers invested much money for collision avoidance systems, but personalization of their driving systems based on the user's behavior was not explored in detail. Furthermore, efficiency gains could be had with tailored systems. In Mexico, 80% of automobile accidents are caused by human beings; the remaining 20% are related to other issues such as mechanical problems. Thus, 80% represents a significant opportunity to improve safety and explore driving efficiency gains. Moreover, when driving aggressively, it could be connected with mental health as a post-traumatic stress disorder. This paper proposes a Tailored Collision Mitigation Braking System, which evaluates the driver's personality driving treats through signal detection theory to create a cognitive map that understands the driving personality of the driver. In this way, aggressive driving can be detected; the system is then trained to recognize the personality trait of the driver and select the appropriate stimuli to achieve the optimal driving output. As a result, when aggressive driving is detected continuously, an automatic alert could be sent to the health specialists regarding particular risky behavior linked with mental problems or drug consumption. Thus, the driving profile test could also be used as a detector for health problems.

Sense of Coherence in partners to persons with Huntington's disease

OBJECTIVES

Huntington's disease (HD) is a progressive neuropsychiatric disease characterized by involuntary movements and behavioural symptoms. This study aimed to explore the association between the level of Sense of Coherence (SOC) and health problems, and psychological distress factors in partners to HD affected persons and their need of support.

MATERIALS & METHODS

A cross-sectional, descriptive, correlational design was used. Data was generated from 94 HD partners from almost all networks, outpatient clinics and nursing homes specialized in HD across Sweden. HD partners filled out questionnaires with scales measuring SOC, health problems, psychological distress factors and the Total Functional Capacity Scale (TFC). Non-parametric analysis was used to analyse group differences.

RESULTS

Huntington's disease partners with a lower level of SOC experienced more health problems than those with a higher level. Health problems among HD partners were most common among HD affected in TFC stage 3, indicating that the partners need most support during this period. Lower level of SOC was associated with loneliness in the relationship; less possibilities to socialize with friends; worries about the future as well as being subjected to physical aggression. The experience of physical aggression from the HD affected person was common (44.7%) and 28.6% of the partners expressed worries about being subjected to physical aggression.

CONCLUSION

Our findings suggest that knowledge about the partners' SOC score may be a helpful indicator identifying HD partners who are more vulnerable and need additional help caring for the person with HD and can be a complementary tool in assessment protocols.

Work intensification in the road transport industry: An approach to new working scenarios with automated vehicles

BACKGROUND

The deployment of automated vehicles is causing transport systems to undergo a transition period. Notwithstanding such technology advancements, the work activity in road transport remains severe in terms of working conditions, given an ever-increasing work intensification scenario.

OBJECTIVE

To analyze the drivers' point of view over factors that determine the intensification of their work, to take preventive measures for future working conditions with automated vehicles.

METHODS

A sample of 336 Portuguese professional drivers answered the Health and Work Survey.

RESULTS

Work at an intense pace (70.6%) or working beyond the assigned timetable (68.5%) were reported as conditions that may induce work intensification. The need to follow production norms/meet strict deadlines or feeling exploited at work doubles the risk of musculoskeletal disorders. Moreover, dealing with tense situations with the public, exposure to constant interruptions, and once again feeling exploited at work, are risk factors that increase, at least, four times as much the perception of generalized discouragement, anxiety, or irritability.

CONCLUSIONS

The recommendations that emerge from our findings aim at ensuring that automation does not end up becoming a new source of work intensification.

Stakeholders' Perspectives on the Unmet Needs and Health Priorities of the Urban Poor in South-East Nigeria

Relatively little is known about readiness of urban health systems to address health needs of the poor. This study explored stakeholders' perception of health needs and strategies for improving health of the urban poor using qualitative analysis. Focus group discussions (n = 5) were held with 26 stakeholders drawn from two Nigerian states during a workshop. Urban areas are characterised by double burden of diseases. Poor housing, lack of basic amenities, poverty, and poor access to information are determinants of health of the urban poor. Shortage of health workers, stock-out of medicines, high cost of care, lack of clinical practice guidelines, and dual practice constrain access to primary health services. An overarching strategy, that prioritises community-driven urban planning, health-in-all policies, structured linkages between informal and formal providers, financial protection schemes, and strengthening of primary health care system, is required to address health needs of the urban poor.

Health, Work, and Social Problems in Spanish Informal Caregivers: Does Gender Matter? (The CUIDAR-SE Study)

(1) Background: The aim of this study was (i) to analyze problems faced by informal caregivers in three areas of their life: health, work and finances, and family and social relationships, (ii) to investigate the main determinants of these problems, and (iii) to explore differences between men and women. (2) Methods: The study population consisted of people aged ≥18 years living in a family home who were providing unpaid care to a dependent person in the same or another home and who were registered as caregivers with the Primary Health Care District of Granada or the Provincial Council of Gipuzkoa. Several logistic regression models were built to analyze the likelihood of caregivers experiencing health, work-related, or social problems as a result of their caregiving responsibilities. (3) Results: Informal female caregivers were more likely to experience problems attributed to caregiving than their male counterparts, particularly in the areas of health and work. Additional factors associated with an increased likelihood of problems were low perceived social support, performance of ungratifying tasks, and fewer years as a caregiver. (4) Conclusions: Informal caregivers in Spain face significant problems as a result of their caregiving duties, and the impact on men and women is different. Policies and interventions to mitigate the negative effects of unpaid caregiving should incorporate differential strategies to meet the specific needs of male and female caregivers in different caregiving contexts.

Health care provided to immigrants in a humanitarian aid center in Spain

OBJECTIVE

Objective of this study is to explore the most prevalent pathologies of the population received in the Spanish coast and to know the nursing prehospital interventions required, as well as the treatments applied and their follow-ups.

DESIGN AND MEASURES

A descriptive and retrospective study.

SAMPLE

A total of 481 immigrants cared for by the Red Cross in the study period.

RESULTS

Dermatological pathologies were more frequent in men (32.1). In women, the most prevalent pathology was headache (19%). According to age, dermatological pathologies prevail in those over 18 years of age (31.9%) and in children, respiratory pathologies (42.9%). Relationships were found statistically significant between gender and type of disease and between specifying or not nursing interventions (p < .001). Age was also related to the type of diagnosis and the type of nursing interventions to be carried out (p < .001).

CONCLUSION

In general, a good state of health was considered in the migrants, concluding that knowing the pathologies or activities to be carried out according to the sociodemographic variables would help improve the quality of the assistance.

Environmental Conditions of Dance Rooms and Its Impact on Dance Conservatories Teachers' Health (An Andalusian Study)

Dance teachers have to be in long hours dancing. That entails repetitive movements, loud live music, and as well as forcing their voices. These demands can implicate severe health problems and other kind of illness as discomfort, stress, etc. However, the Spanish Ministry of Health only recognize as professional disease for this line of work, the vocal nodules. For this reason, this research studies the health problems in dance teachers in Andalusia, correlating the results of a survey carried out in different conservatories from Andalusia with measurement of noise emissions levels, assessment of noise exposure, and assessment of thermal environment in the classes measuring the thermal environment variables. To the authors' knowledge, this is the first study where the influence of several sounds, such as tapping, castanets, and live music, on the health of dance teachers, musicians, and singers during flamenco classes has been researched. Results showed a correlation between some diseases, such as stress and the high level of sound in the classes. The sound levels were well above those established by European regulations reaching values higher than 85 dB(A) as equivalent continuous sound levels during the class time. This European regulation is stablished for an 8 h/day period, five days per week. The thermal environments are no adequate for this activity, mainly for high temperatures in Cordoba during summer. To improve the current working conditions, some recommendations were given to reduce the number of class hours and establish rest shifts, provide more information on health risks, or renovate the floor of some classrooms.

Futuristic Non-antibiotic Therapies to Combat Antibiotic Resistance: A Review

The looming problem of resistance to antibiotics in microorganisms is a global health concern. The drug-resistant microorganisms originating from anthropogenic sources and commercial livestock farming have posed serious environmental and health challenges. Antibiotic-resistant genes constituting the environmental "resistome" get transferred to human and veterinary pathogens. Hence, deciphering the origin, mechanism and extreme of transfer of these genetic factors into pathogens is extremely important to develop not only the therapeutic interventions to curtail the infections, but also the strategies to avert the menace of microbial drug-resistance. Clinicians, researchers and policymakers should jointly come up to develop the strategies to prevent superfluous exposure of pathogens to antibiotics in non-clinical settings. This article highlights the present scenario of increasing antimicrobial-resistance in pathogenic bacteria and the clinical importance of unconventional or non-antibiotic therapies to thwart the infectious pathogenic microorganisms.

Llama and Alpaca Management in Germany-Results of an Online Survey among Owners on Farm Structure, Health Problems and Self-Reflection

Simple Summary

The keeping of llamas and alpacas is becoming increasingly attractive, resulting in veterinarians being consulted to an increasing extent about the treatment of individual animals or herd care and management. At present, there is little information on the maintenance practices for South American camelids in Germany and on the level of knowledge of animal owners. To gain an overview of the number of animals kept, the farming methods and management practices in alpaca and llama populations, as well as to obtain information on common population problems, a survey was conducted among owners of South American camelids. The findings can help prepare veterinarians for herd visits and serve as a basis for the discussion of current problems in South American camelid husbandry.

Abstract

An online survey of llama and alpaca owners was used to collect data on the population, husbandry, feeding, management measures and health problems. A total of 255 questionnaires were evaluated. In total, 55.1% of the owners had started keeping South American camelids within the last six years. The majority managed small farms with fewer than 15 animals (66.4% of 250 farms). More than half of the participants stated that they kept the camelids as hobby animals (64.3%), although they used them for wool production (55.7%) and/or for breeding (51.8%). Vaccination and deworming were carried out on more than 80% of the farms. The most common diseases occurring on the farms were endo- and ectoparasites. A total of 55.3% of the owners estimated their own knowledge of South American camelids as good, 14.5% as very good. In contrast, more than half of the owners agreed little or not at all with the statement that veterinarians generally have sufficient knowledge about South American camelids. Further research is needed to include veterinarians’ perspectives and thus optimise animal husbandry.

Impact of COVID-19 pandemic on adolescent health in India

SARS CoV2 is an emerging infectious pandemic. The preemptive measures taken to curtail the spread has its effects far and wide across different sectors and all age groups. The most unspoken sufferers are adolescents. In this article, we have reflected on how adolescent issues addressed by the government's dynamism, have had collateral damage due to the COVID initiatives. Globally, around 89% are currently not in school because of COVID-19. They will pave a way to unforeseen collateral effects on the physical, social, psychological health, and future of the young minds. From an increase in school drop-outs, interrupted learning, worsening of the gender gap in education to technology dependence and addictions, this pandemic is going to unravel the uninvited social evils. The regular benefits of adolescents from the government have not been paid heed to. Supply of IFA tablets, sanitary napkins, provision of supplementary nutrition, health education, and implementation of immunization activities are a few of the services to mention which are being hampered. We have recommended a few strategies like establishing the peer educator system in disseminating COVID-related awareness, engaging them in a smooth public distribution system, and act as a potential linkage for the families in distress. We have proposed a few modus operandi like direct cash transfer or food supplements as take-home rations will be able to sustain the nutrition of the adolescents to keep the flow of uninterrupted amenities to adolescents in education, nutrition, mental health, personal hygiene, and other such sectors.

Geographic mobility among older people and their adult children: The role of parents' health issues and family ties

This research examines the relationship between older parents' health issues and (i) their relocations closer to their faraway adult children, (ii) their relocations into institutionalised care facilities, or (iii) having distant children move closer. Additionally, we investigate how these relocations are structured by children's gender and location. We focused on parents aged 80 years and older and their distant children. Multinomial logistic regression models were employed for older men and women based on data from administrative registers of Sweden. Whereas severe health problems were associated with an increased likelihood of parent relocations closer to their children or into institutions, they were not associated with the likelihood of children's moves towards parents. Mothers were more likely to move towards daughters or towards distant children who had at least one sibling living nearby. Children moved closer to their parents when there was at least one sibling living near the parent or in response to their own life circumstances.

Desire to lose weight and need of weight loss support in the adult population-Results from a cross-sectional study in Sweden

OBJECTIVE

Evidence-based methods to lose weight are important in tackling increasing obesity trends in adult populations. More knowledge about persons who want to lose weight and do not/do need weight loss support is necessary to design effective preventive practices. Thus, the aim of the study was to investigate the prevalence of desire to lose weight in the general population and the prevalence of health problems and health-related factors in persons with overweight or obesity who want to lose weight and believe that they do not/do need weight loss support.

METHODS

The study included 14 126 persons aged 30 to 69 years who responded to a questionnaire sent to a random sample. Persons with overweight or obesity (BMI ≥ 25 kg/m2) were divided into three groups: those who do not want to lose weight (n = 1236), those who want to lose weight but do not believe they need support (n = 5484), and those who want to lose weight and believe they need weight loss support (n = 1462).

RESULTS

In total, 69% of the women and 59% of the men reported that they wanted to lose weight. The prevalence of hypertension, musculoskeletal pain, poor self-rated health, anxiety/worry, and depression was highest among persons with overweight or obesity who wanted to lose weight and believed they need weight loss support. They were also more physically inactive and reported less social support.

CONCLUSIONS

To want to lose weight is very common among adults. People with overweight or obesity who want to lose weight and believe they need weight loss support have higher frequency of various health problems, including mental health problems, and less social support.

Morbidity Pattern, Availability and Utilization of Health Services: A Study among the Male Youth (15-24 Years) Living in the Slums

Background

Youth is considered as a healthy period but their health is greatly influenced by the hostile living conditions in the slums. When this is accompanied by poor health infrastructure, health risk escalates multiple times.

Objectives

The objective was (1) to study the health problems of the male youth living in the slums and (2) to study the availability and utilization of health services for the male youth living in the slums.

Subjects and Methods

Study design: Cross-sectional study. Study population: Male youth (15-24 years). Study settings: Four urban slums of Amritsar city. Study period: January 1, 2017-December 31, 2017. Sample size: One thousand male youths. Inclusion criteria: Male youth (15-24 years) with consent. Exclusion criteria: Male youth (15-24 years) not given consent, not available at home on the third repeat visit, and mentally unstable or deaf or dumb.

Results

The morbidity pattern showed that 47.5% suffered from any disease during the past 3 months and 3.3% were hospitalized in the past 1 year. Majority of the cases were due to diseases of the respiratory system and gastrointestinal system. Private health sectors including chemist shops were utilized more in case of both outpatient (88.9%) and inpatient services (57.6%) as compared to public health sector. The private health facilities were within 500 m from majority (89.6%) of households in the slums of Amritsar city.

Conclusions

Primary health care needs to be strengthened in the slums. Effective and easily accessible health-care services should be provided by the government at the doorsteps of slum households. The Information Education Communication/Behavior Change Communication activities regarding disease prevention should be strengthened to promote and protect good health.

Health-related quality of life (Nottingham Health Profile) in patients with endometriomas: correlation with clinical variables and self-reported limitations

INTRODUCTION

Endometriosis is a chronic disease that involves the development of endometrium outside the uterine cavity with pain component predominance. The aim of the study was to discuss the occurrence of health problems in patients with endometriomas and simple cysts and the effect of these problems on the daily functioning of the patients.

MATERIAL AND METHODS

The study included patients (n = 40) treated laparoscopically and/or by laparotomy due to lesions in the form of endometriomas or simple cysts. The control group (n = 36) consisted of healthy patients of the Gynecological Clinic, with no changes in adnexa confirmed in vaginal ultrasound examination. The original authors' questionnaire and the Nottingham Health Profile Questionnaire (NHP) were used as research tools.

RESULTS

Analysis of the correlation with Spearman's test demonstrated a statistically significant relationship between the size of the tumor and the occurrence of sleep disorders only in the group of women suffering from endometriomas (r = -0.348; p = 0.041). Women with endometriomas significantly more often reported problems (Cramer's V) in the sphere of "paid work" (p < 0.001), "housework" (p < 0.001), in social life (p < 0.001), problems in sexual life (p < 0.001) as well as problems in continuing hobbies (p < 0.001) and in spending free time (p < 0.001).

CONCLUSIONS

Since the stage of endometriosis does not correlate with subjective complaints, it seems that an additional routine evaluation of quality of life, including an assessment of the severity of the disease, is warranted. Routine use of the Nottingham Health Profile Questionnaire in patients with endometriosis can improve also the assessment of the treatment.

Linking Daily-Life Interpersonal Stressors and Health Problems Via Affective Reactivity in Borderline Personality and Depressive Disorders

OBJECTIVE

Borderline personality disorder (BPD) is associated with unstable interpersonal relationships, affective instability, and physical health problems. In individuals with BPD, intense affective reactions to interpersonal stressors may contribute to the increased prevalence of health problems.

METHODS

BPD (n = 81) and depressed participants (DD; n = 50) completed six daily ambulatory assessment prompts for 28 days. At each prompt, participants reported interpersonal stressors (disagreements, rejections, feeling let down), negative affect, and health problems in four domains (gastrointestinal, respiratory, aches, depressive symptoms). In multilevel moderated mediation models, we examined the indirect effects of interpersonal stressors on health problems via negative affect, by group.

RESULTS

Interpersonal stressors were positively associated with negative affect in both groups (β values > 0.12, p values < .001), but more so for participants with BPD (βDay = 0.05, p < .001). Negative affect was positively associated with health problems across all domains (βMoment/Day values > 0.01, p values < .046), but associations were larger at the day level for respiratory symptoms in BPD (β = 0.02, p = .025) and for depressive symptoms in DD (β = 0.04, p < .001). Negative affect mediated the association of interpersonal stressors and health problems in both groups, with larger effects for the DD group for depressive problems (β = 0.02, p = .092) and for the BPD group for the other three domains (β values > 0.02, p values < .090).

CONCLUSIONS

Interpersonal stressors may contribute to increased physical health problems via an inability to regulate affective responses to such events. This pathway may be stronger in several health domains for those with BPD and may contribute to an elevated risk of morbidity and mortality in this disorder, suggesting a target for intervention to reduce these risks.

Telling Medical Professionals About Victimization by Intimate Partner: Analysis of Women Surviving Intimate Partner Violence

This study investigated factors in women’s disclosure of intimate partner violence (IPV) to medical professionals. Its sample of 3,226 women surviving IPV was extracted from the National Intimate Partner and Sexual Violence Survey public-use dataset, dated 2010. The dichotomous outcome variable was told medical professional about IPV. Explanatory variables were physical violence experienced in the past year, need for medical services for IPV, injury, fear, poor physical health, number of health problems, poor mental health, African American, Latina, other ethnic minority, education, family income, inability to afford seeing doctor, age, and being married. Logistic regression results showed likelihood of IPV disclosure increased with 31 or more physical IPV episodes in preceding year, needed medical services for IPV, IPV-related injury, 2 or more health problems, fear of partner, poor mental health, inability to afford seeing doctor, and age 55 and over. Disclosure likelihood was decreased by other ethnic minority and absence of high school graduation. Our findings support standardized protocols identifying recent IPV, IPV injury, and multiple health problems, along with corresponding response training for medical professionals. Our findings also support making victim advocates and behavioral health specialists available in medical facilities to address patients’ fears and mental health.

Symptoms of Discomfort and Problems Associated with Mode of Delivery During the Puerperium: An Observational Study

Despite abundant literature on antenatal and delivery care received by pregnant women, there is a wide knowledge gap on the prevalence of symptoms of discomfort or problems during the postpartum period and their relationship with the mode of delivery. This cross-sectional study, carried out with 3324 participants in Spain in 2017, aimed to investigate the association between the mode of delivery and self-reported postpartum symptoms of discomfort and maternal problems during the puerperium. An ad hoc online questionnaire was used to collect data on socio-demographic and obstetric variables, symptoms of discomfort, and maternal problems during the puerperium. The crude odds ratios (OR) and adjusted OR (aOR) and their 95% confidence intervals (95%CI) were calculated using binary logistic regression. In total, 3324 women participated. Compared to a normal vaginal delivery, having a cesarean section was associated with increased odds of an infected surgical wound (aOR: 11.62, 95%CI: 6.77–19.95), feeling sad (aOR: 1.31, 23 95%CI: 1.03–1.68), and symptoms of post-traumatic stress (aOR: 4.64, 95%CI: 2.94–7.32). Instrumental delivery vs. normal vaginal delivery was a risk factor for constipation (aOR: 1.35 95%CI: 25 1.10–1.66), hemorrhoids (aOR: 1.28, 95%CI: 1.04–1.57), urinary incontinence (aOR: 1.30, 95%CI: 26 1.05–1.61), and fecal incontinence (aOR: 1.94, 95%CI: 1.29–2.92) during the puerperium. Women who gave delivery via cesarean section or instrumental delivery had higher incidences of infection and psychological alterations than those who had a normal vaginal delivery. Identifying women at risk of giving birth by cesarean section and informing them about subsequent symptoms of discomfort and maternal problems during the puerperium must be included in pregnancy health program policies and protocols to allow women to make informed decisions regarding their birthing plan.

Nonpharmacological methods: frequency of use and follow-up actions among healthcare staff in the care of older people

Older people are at risk of developing multi-comorbidity and thus being exposed to multiple treatments and drugs to manage the emerging health complaints. More focus has been put on nonpharmacological alternatives. However, studies revealing the healthcare staff perspective on using nonpharmacological methods (NPMs) in the care of older people are still lacking. Thus, the aim of this study was to map the use of NPMs in daily practices and the follow-up thereof. A population-based survey with questionnaires was performed, included all healthcare professionals (n = 163; nurses and paramedical professionals) working in one district of elderly care in Sweden. The older person's anxiety and worry (76.1%), sleeping problems (53.1%) and pain (41.1%) were the health problems in daily life most likely to trigger use of NPMs. To manage the emerging health problems, interactions (87.1%), diet and nutrition supplements (63.2%) and physical activity were commonly used, particularly by nurses. One third (n = 54) stated that they did not evaluate the NPMs used, with no statistical differences between nurses and paramedical professionals. The present study indicated that NPMs were used in care of older people among nurses and paramedical professionals, but not in a systematic way and often without follow-up.

Occupational Hazards and Health Problems among Butchers in Uyo, Nigeria

Introduction:

Butchers are exposed to various types of hazards in the course of their work, which could lead to health problems of varying severity. The aim of this study was to identify the occupational hazards and health problems of butchers in Uyo and also assess the physical conditions of their slaughter facilities.

Materials and Methods:

A descriptive cross-sectional study was carried out among 157 butchers in Uyo using a semi-structured questionnaire for data collection. Facility assessment was made using a checklist. Analysis was carried out using Statistical Package for Social Sciences version 20. Level of significance was set at 0.05.

Results:

The mean age of respondents was 33 ± 9.94 years. Most respondents were males (83.4%). The most commonly reported workplace hazards were knife (93.6%), bones (57.3%), and slippery floor (24.8%). The most common health problems were knife cuts (87.3%), cuts from bones (50.3%), and neck pain (36.9%). Having injuries from live animals and back pain were significantly associated with working with cows (P < 0.05). The most common de-furring method was burning with firewood (61.1%). The slaughter facilities lacked many expected amenities of a standard abattoir.

Conclusion:

Identified hazards and health problems of butchers were numerous. The slaughter facilities lacked appropriate equipment that promotes workers’ health and safety. It is recommended that slaughter facilities be upgraded to meet the standard abattoir practice. Regular training of butchers should be organized by their association to encourage safer practice, including the use of appropriate protective wears. Use of the chemical method of de-furring should also be encouraged to limit exposure to harmful gases.

Health problems in healthcare workers: A review

Much has been written about the well-being and quality of patients in recent years but little attention has been focused on well-being of healthcare workers (HCWs) who provide comprehensive healthcare to patients. It has been found that the HCWs are more stressed because of less staffs, increasing work load, longer working hours, high clientele expectation and peculiar problems and hazards of work place. There is increased morbidity in HCWs in comparison to general population. Though they are aware, measures of well being, engaging the HCWs in promotion of their workplace and making changes to enhance its realization needs to be done to improve their health by themselves, at administrative and institutional level.

Health problems of Iraqi police dogs referred to Baghdad Veterinary Hospital during 2015-2017

Background and Aim:

Police dogs in Iraq have been working mostly as explosive detectors since 2003. The health problems of these dogs are unique and have not been reported in literature. This investigation assessed the prevalence of health problems in Police dogs referred to Baghdad Veterinary Hospital during 2015-2017.

Materials and Methods:

A total of 1220 police dogs that were referred to Baghdad Veterinary Hospital in 2015-2017 were studied. The dogs were mostly German Shepherd dogs (GSDs) or Belgian Malinois (BM), with an average age of 4.6 years. The dogs’ health problems and some of their risk factors were studied.

Results:

Congestive heart failure (CHF), babesiosis, various malignancies, and intestinal parasites were the most commonly diagnosed health problems, followed by general aging, bronchopneumonia, otitis, nutritional deficiencies, and anemia. GSDs were more prone to CHF, while BM had more diagnoses of malignancies. Age was associated with both health conditions.

Conclusion:

The presence of health problems in these working dogs highlights the need for a stricter and more organized preventive schedule to keep the dogs healthy and efficient at old age.

Identifying the health problems of slum residents using social determinants of health: Kerman, Iran

INTRODUCTION

Although slum emerged in industrialized countries, today, all cities in the world are somehow facing this phenomenon. Slums create many problems in different areas, especially health for residents. Therefore, this research was conducted with the aim of identifying the health problems of the slum residents of Kerman city by using the social determinant of health approach.

METHOD

The present study is an applied study that was carried out qualitatively using semistructured interviews. Samples were selected using purposeful and snowball sampling methods. Data were analyzed using the Colaizy method.

RESULTS

In this study, the health problems of residents of slums in the city of Kerman were identified by interviews. In total, seven main themes and 32 sub-themes were extracted. The main concepts extracted include the economic and social class, the early childhood development, social exclusion and social support, employment and unemployment, addiction, food, transport, and traffic.

CONCLUSION

The problems of slums people are very widespread, and almost all of the problems affect the health of slums people. The place of living, job, income, the early childhood development and nutritional status are determinants that affect people's health.

Subjective health in relation to hedonic and eudaimonic wellbeing: Evidence from the Gallup World Poll

This study investigated the relationships between subjective health, hedonic wellbeing (i.e. positive affect, negative affect, and life satisfaction), and eudaimonic wellbeing (i.e. psycho-social functioning). The sample was drawn from the Gallup World Poll and included a total of 1,567,295 individuals in 165 countries. We found that both hedonic and eudaimonic wellbeing were uniquely associated with subjective health. However, the relative contributions of each dimension to subjective health varied, with negative affect demonstrating the strongest relationship with subjective health and life satisfaction demonstrating the weakest association. The moderating effects of some national-level variables were also explored.

Linking Healthcare and Social Service Databases to Study the Epidemiology of Child Maltreatment and Associated Health Problems: Hong Kong's Experience

OBJECTIVE

To examine the incidence and trend of child maltreatment and its associated health problems in Hong Kong by linking healthcare and social service databases.

STUDY DESIGN

Data on 4816 children under the age of 18 years registered with the Child Protection Registry and matching health records in public hospitals in Hong Kong from 2003 to 2010 were extracted. Associations were examined between different types of child maltreatment and child's medical diagnosis according to the International Statistical Classification of Diseases and Related Health Problems, 10th Revision codes including suicidal attempt (X60-X84), nonchild maltreatment related injuries (S00-S99; T00-T98, excluding T74 and T76 that are maltreatment related injuries), mental health problems (F00-F99), and congenital malformations/chromosomal abnormalities (Q00-Q99).

RESULTS

Significant rising trends were found for child physical abuse, neglect, and sexual abuse during the period from 2003 to 2010. Psychological abuse remained stable. Risk of suicide attempt was higher among children suffering from sexual abuse, psychological abuse, and children experiencing multiple abuses; mental health diagnoses were more common in victims of psychological and multiple abuses. Congenital malformations and chromosomal abnormalities were more commonly found among neglected children.

CONCLUSIONS

In contrast to the decreasing trend observed in the West during the study period, there has been an escalating trend in child maltreatment in Hong Kong and child maltreatment is strongly associated with major health problems. This is one of the first studies to demonstrate the power of linking healthcare and social service databases, which allows for both a better understanding of the impact of child maltreatment and as a guide future policy and service planning.

The Need for School Nursing in Spain: A Mixed Methods Study

Background: Teachers are not trained or feel prepared for urgent action. Nevertheless, the presence of children with health problems is relevant. We identified vital health risk problems and complications among students, as well as the related training and perception of teachers. Methods: An explanatory sequential design was employed. The study sample consisted of a cross-sectional study of an intentional nonprobabilistic sample of 3246 teachers in the quantitative phase, and a total of 16 semistructured interviews were conducted in its qualitative phase. Results: 56.6% (1837) of teachers show high concern about facing such situations and only 0.6% (19) feel appropriately trained. For 81.8% (2556), the existence of school nursing would be quite relevant. The presence of nursing professionals in schools could lead to an improvement in the quality of life of both the students and teachers. Conclusions: There is a significant percentage of children with diseases that often require specific care and there is a high probability that teachers, throughout their professional lives, have to deal with situations of vital urgency. The presence of professionals in educational centres seems to be a relevant option. These data suggest that it is necessary for nurses to establish a pilot programme for the incorporation of professional nurses in educational centres to determine its implications, benefits in health prevention and promotion issues, as well as costs.

It's more than skin-deep: The relationship between social victimization and telomere length in adolescence

This study examined the relationship between peer victimization and telomere length (TL), an indicator of biological aging that is associated with stressors (Epel, 2009). It was predicted that social victimization would have a greater impact upon TL, as well as the frequency and severity of health complaints than physical victimization. Adolescents (M_age  = 15.91 years, SD_age  = 1.65) and their parents completed measures of peer victimization and physical health problems; adolescents also submitted a DNA sample for telomere analysis. Greater instances of being socially, but not physically, victimized were associated with shorter telomeres, as well as more frequent and severe health complaints. TL was also negatively related to both the frequency and severity of health problems, even after controlling for BMI, age, and sex of participant. The relationship between social victimization and health complaints via TL held only at higher levels of social victimization. These findings are the first to find an association between peer victimization and shortened telomeres.

Refusal to take a sick leave as an estimate of the phenomenon of presenteeism in Poland

Introduction

Absenteeism and presenteeism are two main phenomena related to health problems and professional activity. Presenteeism is the involvement in a professional activity despite being ill. The purpose of the current study is to estimate the prevalence of presenteeism in Poland on the basis of medical records and to explore associations between presenteeism and patients’ age, gender and type of medical problem. Another purpose is to provide estimates of the length of sick leave if it was accepted.

Results

The amount of patients who refused to take a sick leave was 27.4%. There was a minor relationship between the refusals and gender (slightly higher in men) as well as strong effects of the age of patients (periods of sick leave were longer in older patients) and ICD-10 diagnosis (largely in acute diseases of the upper respiratory tract). The estimated number of days spent on sick leave in the group of patients that refused to take it, assuming that they made a different decision and complied to it, was in the range between 5 and 10 days.

Discussion

The prevalence of presenteeism in Poland is relatively high. Since the largest proportion of refusals took place in the case of potentially contagious diseases, the negative impact on productivity may be even higher. Even though the relationship between presenteeism and wages remains unclear, the remarkable increase of wages in Poland within the last 20 years may explain the propensity to work despite being ill. Further research needs to consider the simultaneous use of medical records and self-measured productivity loss.

Materials and Methods

The current study is based on data from medical records concerning 550,360 patients aged 19–64. Associations between refusals to take a sick leave and patients’ age, gender, as well as diagnosis in terms of ICD-10 (International Statistical Classification of Diseases and Related Health Problems), were tested. Linear regression analysis on the data acquired from the patients who accepted to take a sick leave were further used to estimate the possible length of sick leave in the group of patients that refused to take it.