Abstract: The management of pharmacotherapy and the process of dispensing medicines is becoming critical in clinical pharmacy due to the increase of incidence and prevalence of chronic diseases, the complexity and customization of therapeutic regimens, the introduction of innovative and more expensive medicines, the unbalanced relation between expenditure and revenue as well as due to the lack of rationalization associated with medication use. For these reasons, co-payments emerged in Europe in the 70s and have been applied over the past few years in healthcare. Co-payments lead to a rationing and rationalization of user’s access under healthcare services and products, and simultaneously, to a qualification and improvement of the services and products for the end-user. This analysis, under hospital practices particularly and co-payment strategies in general, was carried out on all the European regions and identified four reference countries, that apply repeatedly this tool and with different approaches. The structure, content and adaptation of European co-payments were analyzed through 7 qualitative attributes and 19 performance indicators, and the results expressed in a scorecard, allowing to conclude that the German models (total score of 68,2% and 63,6% in both elected co-payments) can collect more compliance and effectiveness, the English models (total score of 50%) can be more accessible, and the French models (total score of 50%) can be more adequate to the socio-economic and legal framework. Other European models did not show the same quality and/or performance, so were not taken as a standard in the future design of co-payments strategies. In this sense, we can see in the co-payments a strategy not only to moderate the consumption of healthcare products and services, but especially to improve them, as well as a strategy to increment the value that the end-user assigns to these services and products, such as medicines.
Abstract: Shear walls made of cold formed steel are used as lateral force resisting components in residential and low-rise commercial and industrial constructions. The seismic design analysis of such structures is often complex due to the slenderness of members and their instability prevalence. In this context, a simplified modeling technique across the panel is proposed by using the finite element method. The approach is based on idealizing the whole panel by a nonlinear shear link element which reflects its shear behavior connected to rigid body elements which transmit the forces to the end elements (studs) that resist the tension and the compression. The numerical model of the shear wall panel was subjected to cyclic loads in order to evaluate the seismic performance of the structure in terms of lateral displacement and energy dissipation capacity. In order to validate this model, the numerical results were compared with those from literature tests. This modeling technique is particularly useful for the design of cold formed steel structures where the shear forces in each panel and the axial forces in the studs can be obtained using spectrum analysis.
Abstract: In both developed and developing countries, obesity among women is increasing, but in different patterns and at very different speeds. It may have a negative effect on health, leading to reduced life expectancy and/or increased health problems. This research studied the age distribution among obese women, the types of overweight and obesity, and the extent of the problem of overweight/obesity and the obesity etiological factors among women in Hillah city in central Iraq. A total of 322 overweight and obese women were included in the study, those women were randomly selected. The Body Mass Index was used as indicator for overweight/ obesity. The incidence of overweight/obesity among age groups were estimated, the etiology factors included genetic, environmental, genetic/environmental and endocrine disease. The overweight and obese women were screened for incidence of infection and/or diseases. The study found that the prevalence of 322 overweight and obese women in Hillah city in central Iraq was 19.25% and 80.78%, respectively. The obese women types were recorded based on BMI and WHO classification as class-1 obesity (29.81%), class-2 obesity (24.22%) and class-3 obesity (26.70%), the result was discrepancy non-significant, P value < 0.05. The incidence of overweight in women was high among those aged 20-29 years (90.32%), 6.45% aged 30-39 years old and 3.22% among ≥ 60 years old, while the incidence of obesity was 20.38% for those in the age group 20-29 years, 17.30% were 30-39 years, 23.84% were 40-49 years, 16.92% were 50-59 years group and 21.53% were ≥ 60 years age group. These results confirm that the age can be considered as a significant factor for obesity types (P value < 0.0001). The result also showed that the both genetic factors and environmental factors were responsible for incidents of overweight or obesity (84.78%) p value < 0.0001. The results also recorded cases of different repeated infections (skin infection, recurrent UTI and influenza), cancer, gallstones, high blood pressure, type 2 diabetes, and infertility. Weight stigma and bias generally refers to negative attitudes; Obesity can affect quality of life, and the results of this study recorded depression among overweight or obese women. This can lead to sexual problems, shame and guilt, social isolation and reduced work performance. Overweight and Obesity are real problems among women of all age groups and is associated with the risk of diseases and infection and negatively affects quality of life. This result warrants further studies into the prevalence of obesity among women in Hillah City in central Iraq and the immune response of obese women.
Abstract: Student counseling programs can provide many benefits to students in schools all around the world. In theory, the government of the Kingdom of Saudi Arabia (Saudi Arabia) has committed itself to school counseling programs in educational institutions throughout the country. Student counselors face a number of burdens and obstacles that impact student counseling programs. It is also widely known that Saudi Arabia has extremely high prevalence rates for overweight and obesity, anxiety and depression, and diabetes in children. It has also been demonstrated that teachers and staff are inadequately prepared when dealing with health issues relating to diabetes in schools in Saudi Arabia. This study will clearly demonstrate how student counselors in Saudi Arabia could become 'New Educators' in Saudi schools in relation to these health issues. This would allow them to leverage their position as student counselor to improve the management of these health issues in Saudi schools, to improve the quality of care provided to school children, and to overcome burdens and obstacles that are currently negatively affecting student counseling in Saudi schools.
Abstract: A study was done to establish determinants of selenium intake in a high HIV prevalence fishing community in the Pala Bondo district, Kenya. It was established that most of the respondents (61%) were small holder Farmers and Fishermen {χ2 (1, N=386) p
Abstract: Nursing is recognized as a stressful occupation and has indicated a probable high prevalence of distress. It is a helping profession requiring a high degree of commitment and involvement. If stress is intense, continuous and repeated, it becomes a negative phenomenon or "distress," which can lead to physical illness and psychological disorders. The frequency of common psychosomatic symptoms including sleeping problems, tension headache, chronic fatigue, palpitation etc. may be an indicator of nurses’ work-related stress level. Objectives of the study were to determine psychiatric morbidity among nurses and to find its association with selected variables. The study population consisted of 1040 registered nurses working in selected medical college hospitals and government hospitals of Udupi and Mangalore districts. Descriptive survey design was used to conduct the study. Subjects were selected by using purposive sampling. Data were gathered by administering background proforma and General Health questionnaire. Severe distress was experienced by 0.9% of nurses and 5.6% had some evidence of distress. Subjects who did not have any distress were 93.5%. No significant association between psychiatric morbidity in nurses and demographic variables was observed. With regard to work variables significant association is observed between psychiatric morbidity and total years of experience (z=10.67, p=0.03) and experience in current area of work (z=9.43, p=0.02).
Abstract: Aims and Objectives: Assessment of health status and detection disorders of external respiration functions (ERF) during preventative medical examination among physicians of Armenia. Subjects and Methods: Overall, fifty-nine physicians (17 men and 42 women) were examined and spirometry was carried out. The average age of the physicians was 50 years old. The studies were conducted on the Micromedical MicroLab 3500 Spirometer. Results: 25.4% among 59 examined physicians are overweight; 22.0% of them suffer from obesity. Two physicians are currently smokers. About half of the examined physicians (50.8%) at the time of examination were diagnosed with some diseases and had different health-related problems (excluding the problems related to vision and hearing). FVC was 2.94±0.1, FEV1 – 2.64±0.1, PEF – 329.7±19.9, and FEV1%/FVC – 89.7±1.3. Pathological changes of ERF are identified in 23 (39.0%) cases. 28.8% of physicians had first degree of restrictive disorders, 3.4% – first degree of combined obstructive/ restrictive disorders, 6.8% – second degree of combined obstructive/ restrictive disorders. Only three physicians with disorders of the ERF were diagnosed with chronic bronchitis and bronchial asthma. There were no statistically significant changes in ERF depending on the severity of obesity (P> 0.05). Conclusion: The study showed the prevalence of ERF among physicians, observing mainly mild and moderate changes in ERF parameters.
Abstract: Headache is one of the most ubiquitous and frequent
neurological disorders interfering with everyday life in all countries.
India appears to be no exception. Objectives are to assess the
prevalence of headache among adult population in urban area of
Varanasi and to find out factors influencing the occurrence of
headache. A community based cross sectional study was conducted
among adult population in urban area of Varanasi district, Uttar
Pradesh, India. Total 151 eligible respondents were interviewed by
simple random sampling technique. Proportion percentage and Chisquare
test were applied for data analysis. Out of 151 respondents,
majority (58.3%) were females. In this study, 92.8% respondents
belonged to age group 18-60 years while 7.2% was either 60 year of
age or above. The overall prevalence of headache was found to be
51.1%. Highest and lowest prevalence of headache was recorded in
age groups 18-29 year & 40-49 year respectively. Headache was
62.1% in illiterate and was 40.0% among graduate & above.
Unskilled workers had more headache 73.1% than other type of
occupation. Headache was more prevalent among unemployed
(35.9%) than employed (6.4%). Females had higher family history of
headache (48.9%) as compared to males (41.3%). Study subjects
having peaceful relation with family members, relatives and
neighbors had more headache than those having no peaceful relation.
Abstract: Background: The 2004 World Health Assembly called for specific actions to halt the overweight and obesity epidemic that is currently penetrating urban populations in the developing world. Adolescents require particular attention due to their vulnerability to develop obesity and the fact that adolescent weight tracks strongly into adulthood. However, there is scarcity of information on the modifiable risk factors to be targeted for primary intervention among urban adolescents in Ethiopia. This study was aimed at determining the magnitude and risk factors of overweight and obesity among high school adolescents in Addis Ababa. Methods: An institution-based cross-sectional study was conducted in February and March 2014 on 456 randomly selected adolescents from 20 high schools in Addis Ababa city. Demographic data and other risk factors of overweight and obesity were collected using self-administered structured questionnaire, whereas anthropometric measurements of weight and height were taken using calibrated equipment and standardized techniques. The WHO STEPS instrument for chronic disease risk was applied to assess dietary habit and physical activity. Overweight and obesity status was determined based on BMI-for-age percentiles of WHO 2007 reference population. Results: The prevalence rates of overweight, obesity, and overall overweight/ obesity among high school adolescents in Addis Ababa were 9.7% (95%CI = 6.9-12.4%), 4.2% (95%CI = 2.3-6.0%), and 13.9% (95%CI = 10.6-17.1%), respectively. Overweight/obesity prevalence was highest among female adolescents, in private schools, and in the higher wealth category. In multivariable regression model, being female [AOR(95%CI) = 5.4(2.5,12.1)], being from private school [AOR(95%CI) = 3.0(1.4,6.2)], having >3 regular meals [AOR(95%CI) = 4.0(1.3,13.0)], consumption of sweet foods [AOR(95%CI) = 5.0(2.4,10.3)] and spending >3 hours/day sitting [AOR(95%CI) = 3.5(1.7,7.2)] were found to increase overweight/ obesity risk, whereas high Total Physical Activity level [AOR(95%CI) = 0.21(0.08,0.57)] and better nutrition knowledge [AOR(95%CI) = 0.160.07,0.37)] were found protective. Conclusions: More than one in ten of the high school adolescents were affected by overweight/obesity with dietary habit and physical activity are important modifiable risk factors. Well-tailored nutrition education program targeting lifestyle change should be initiated with more emphasis to female adolescents and students in private schools.
Abstract: Gender-based violence is a reflection of the inequalities that are associated within a society between the men and women that affects the health, dignity, security and autonomy of its victims. There are various determinants that contribute to the health risk of young women who have experienced sexual violence, in countries that have a high prevalence rate for HIV. For instance, in South Africa, where the highest prevalence rate for HIV is among young women, their susceptibility to the virus has been increased by sexual violence and cultural inequalities. Therefore, this study is a review of literature that explores how gender-based violence increases the possibility for HIV/AIDS among young women in South Africa.
Abstract: Housing Associations (HAs) contribute circa 20% of the UK’s housing supply. HAs are however under increasing pressure as a result of funding cuts and rent reductions. Due to the increased pressure, a number of processes are currently being reviewed by HAs, especially how they manage and learn from defects. Learning from defects is considered a useful approach to achieving defect reduction within the UK housebuilding industry. This paper contributes to our understanding of how HAs learn from defects by undertaking an initial round table discussion with key HA stakeholders as part of an ongoing collaborative research project with the National House Building Council (NHBC) to better understand how house builders and HAs learn from defects to reduce their prevalence. The initial discussion shows that defect information runs through a number of groups, both internal and external of a HA during both the defects management process and organizational learning (OL) process. Furthermore, HAs are reliant on capturing and recording defect data as the foundation for the OL process. During the OL process defect data analysis is the primary enabler to recognizing a need for a change to organizational routines. When a need for change has been recognized, new options are typically pursued to design out defects via updates to a HAs Employer’s Requirements. Proposed solutions are selected by a review board and committed to organizational routine. After implementing a change, both structured and unstructured feedback is sought to establish the change’s success. The findings from the HA discussion demonstrates that OL can achieve defect reduction within the house building sector in the UK. The paper concludes by outlining a potential ‘learning from defects model’ for the housebuilding industry as well as describing future work.
Abstract: This research provides a technical account of
estimating Transition Probability using Time-homogeneous Markov
Jump Process applying by South African HIV/AIDS data from the
Statistics South Africa. It employs Maximum Likelihood Estimator
(MLE) model to explore the possible influence of Transition
Probability of mortality cases in which case the data was based on
actual Statistics South Africa. This was conducted via an integrated
demographic and epidemiological model of South African HIV/AIDS
epidemic. The model was fitted to age-specific HIV prevalence data
and recorded death data using MLE model. Though the previous
model results suggest HIV in South Africa has declined and AIDS
mortality rates have declined since 2002 – 2013, in contrast, our
results differ evidently with the generally accepted HIV models
(Spectrum/EPP and ASSA2008) in South Africa. However, there is
the need for supplementary research to be conducted to enhance the
demographic parameters in the model and as well apply it to each of
the nine (9) provinces of South Africa.
Abstract: The occurrence of adult Taenia saginata in major
abattoirs in Port Harcourt metropolis was investigated. Out of 514
cattle investigated, an overall prevalence of 35(6.8%) was recorded.
Infected male and female cattle represented 1.2% (6/514) and 5.6%
(29/514) of the overall prevalence respectively. There was a
statistical significant difference (P< 0.05) in prevalence of adult
Taenaia saginata between male and female cattle examined in the
study area. Old cattle have a significant (P< 0.05) infestation rate
than young ones. Adult Taenia saginata exists in cattle and still
remains a public health concern in the study area. Deliberate effort is
needed from stake-holders and the Government to design and
implement programs that will lead to the prevention and possible
eradication of the parasite.
Abstract: Purpose: The key aim of the research was to identify
the secondary stressors experienced by businesses affected by single
or repeated flooding and to determine to what extent businesses were
affected by these stressors, along with any resulting impact on health.
Additionally the research aimed to establish the likelihood of
businesses being re-exposed to the secondary stressors through
assessing awareness of flood risk, implementation of property
protection measures and level of community resilience. Design/methodology/approach: The chosen research method
involved the distribution of a questionnaire survey to businesses
affected by either single or repeated flood events. The questionnaire
included the Impact of Event Scale (a 15-item self-report measure
which assesses subjective distress caused by traumatic events). Findings: 55 completed questionnaires were returned by flood
impacted businesses. 89% of the businesses had sustained internal
flooding, while 11% had experienced external flooding. The results
established that the key secondary stressors experienced by
businesses, in order of priority, were: flood damage, fear of
reoccurring flooding, prevention of access to the premise/closure,
loss of income, repair works, length of closure and insurance issues.
There was a lack of preparedness for potential future floods and
consequent vulnerability to the emergence of secondary stressors
among flood affected businesses, as flood resistance or flood
resilience measures had only been implemented by 11% and 13%
respectively. In relation to the psychological repercussions, the
Impact of Event scores suggested that potential prevalence of posttraumatic
stress disorder (PTSD) was noted among 8 out of 55
respondents (l5%). Originality/value: The results improve understanding of the
enduring repercussions of flood events on businesses, indicating that
not only residents may be susceptible to the detrimental health
impacts of flood events and single flood events may be just as likely
as reoccurring flooding to contribute to ongoing stress. Lack of
financial resources is a possible explanation for the lack of
implementation of property protection measures among businesses,
despite 49% experiencing flooding on multiple occasions. Therefore
it is recommended that policymakers should consider potential
sources of financial support or grants towards flood defences for
flood impacted businesses. Any form of assistance should be made
available to businesses at the earliest opportunity as there was no
significant association between the time of the last flood event and
the likelihood of experiencing PTSD symptoms.
Abstract: Objective: Acute coronary syndrome is a clinical
condition encompassing ST segments elevation myocardial
infraction, Non ST segment is elevation myocardial infraction and un
stable angina is characterized by ruptured coronary plaque, stress and
myocardial injury. Angina pectoris is a pressure like pain in the chest
that is induced by exertion or stress and relived with in the minute
after cessation of effort or using sublingual nitroglycerin. The present
research was undertaken to study the drug utilization pattern of
antiplatelet drugs for the ischemic heart disease in a tertiary care
hospital. Method: The present study is retrospective drug utilization
study and study period is 6months. The data is collected from the
discharge case sheet of general medicine department from medical
department Rajiv Gandhi institute of medical sciences, Kadapa. The
tentative sample size fixed was 250 patients. Out of 250 cases 19
cases was excluded because of unrelated data. Results: A total of 250
prescriptions were collected for the study according to the inclusion
criteria 233 prescriptions were diagnosed with ischemic heart disease
17 prescriptions were excluded due to unrelated information. out of
233 prescriptions 128 are male (54.9%) and 105 patients are were
female (45%). According to the gender distribution, the prevalence of
ischemic heart disease in males are 90 (70.31%) and females are 39
(37.1%). In the same way the prevalence of ischemic heart disease
along with cerebrovascular disease in males are 39 (29.6%) and
females are 66 (62.6%). Conclusion: We found that 94.8% of drug
utilization of antiplatelet drugs was achieved in the Rajiv Gandhi
institute of medical sciences, Kadapa from 2011-2012.
Abstract: Escherichia coli (E. coli) is the most isolated bacteria
from blood circulation of septicemic calves. Given the prevalence of
septicemia in animals and its economic importance in veterinary
practice, better understanding of changes in clinical signs following
disease, may contribute to early detection of disorder. The present
study has been carried out to detect changes of clinical signs in
induced sepsis in calves with E. coli. Colisepticemia has been
induced in 10 twenty-day old healthy Holstein- Frisian calves with
intravenous injection of 1.5 X 109 colony forming units (cfu) of
O111:H8 strain of E. coli. Clinical signs including rectal temperature,
heart rate, respiratory rate, shock, appetite, sucking reflex, feces
consistency, general behavior, dehydration and standing ability were
recorded in experimental calves during 24 hours after induction of
colisepticemia. Blood culture was also carried out from calves four
times during experiment. ANOVA with repeated measure is used to
see changes of calves’ clinical signs to experimental colisepticemia,
and values of P≤ 0.05 was considered statistically significant. Mean
values of rectal temperature and heart rate as well as median values
of respiratory rate, appetite, suckling reflex, standing ability and feces
consistency of experimental calves increased significantly during
study (P 0.05). The
results of present study showed that total score of clinical signs in
calves with experimental colisepticemia increased significantly,
although score of some clinical signs such as shock did not change
significantly.
Abstract: In the recent past, discussing about sex among
children and youths was frowned at by traditional norms and as such
sexual discussions and behavior were approached with great respect.
Things are actually falling apart with the increasing number of young
people that engage in premarital sex. Due to lack of experience and
sex education, many young people are becoming increasingly
exposed to the risk of HIV infection. In the light of the above, this
study discussed premarital sex, HIV, and use of condom among
youths in Nigeria. Data for this study came from 2013 Nigeria
Demographic and Health Survey and other secondary data. The
survey revealed that only 18.5 percent of young women that had sex
in the 12 months preceding the survey used condom. Out of 3306
never-married sexually active men and women, 1728 representing 52
percent live in urban areas and 43 percent of them did not use
condom during sexual intercourse in the 12 months preceding the
survey. This study concludes that for there to be reduction in
prevalence of HIV/AIDS among Nigerian youths, there is need for
concerted effort to be made towards educating youths on the
expedient of the use of condom during sexual intercourse.
Abstract: Hypertension is a common condition causing cardio
and cerebrovascular complications. Portugal has one of the highest
mortality rates from stroke and a high prevalence of hypertension.
Systolic Blood Pressure (SBP) is an important risk factor for
cardiovascular events (myocardial infarction and stroke) and
premature mortality, particularly in the elderly population. The
present study aims to estimate the prevalence of hypertension in a
Portuguese population living in a coastal city and to identify some of
its determinants (namely gender, age, the body mass index and
physical activity frequency). A total of 91 adults who attended three pharmacies of a coastal
city in the center of Portugal, between May and August of 2013 were
evaluated. Attendants who reported to have diabetes or taking
antihypertensive drugs in the 2 previous weeks were excluded from
the study. Sociodemographic factors, BMI, habits of exercise and BP
were assessed. Hypertension was defined as blood pressure ≥140/90
mmHg. The majority of the studied population was constituted by women
(75.8%), with a mean age of 54.2±1.6 years old, married or living in
civil union and that had completed secondary school or had higher
education (40%). They presented a mean BMI of 26.2±4.76 Kg/m2.,
and were sedentary. The mean BP was 127.0±17.77mmHg- 74.69 ±
9.53. In this population we found 4.3% of people with hypertension
and 16.1% with normal high blood pressure. Men exhibit a tendency to present higher systolic blood pressure
values than women. Of all the factors considered, SBP values also
tended to be higher with age and higher BMI values.
Despite the fact that the mean values of SBP did not present values
higher than 140 mmHg we must be concerned because the studied
population is undiagnosed for hypertension. Although this is a preliminary study, it might be a prelude to the
upcoming research about the underlying factors responsible for the
occurrence of SBP.
Abstract: Breast cancer is in the top rate of cancer. We analyzed
the prevalence of obesity and its association with breast cancer and
finally we reviewed 25 article that 320 patient and 320 control which
enrolled to our study. The distribution of breast cancer patients and
controls with respect to their anthropometric indices in patients with
higher weight, which was statistically significant (60.2 ± 10.2 kg)
compared with control group (56.1 ± 11.3 kg). The body mass index
of patients was (26.06+/-3.42) and significantly higher than the
control group (24.1+/-1.7). Obesity leads to increased levels of
adipose tissue in the body that can be stored toxins and carcinogens
to produce a continuous supply. Due to the high level of fat and the
role of estrogen in a woman which is endogenous estrogen of the
tumor and regulates the activities of growth steroids, obesity has
confirmed as a risk factor for breast cancer. Our study and other
studies have shown that obesity is a risk factor for breast cancer. And
it can be prevented with a weight loss intervention for breast cancer
in the future.
Abstract: Obesity and osteoporosis are the two diseases whose
increasing prevalence and high impact on the global morbidity and
mortality, during the two recent decades, have gained a status of
major health threats worldwide. Obesity purports to affect the bone
metabolism through complex mechanisms. Debated data on the
connection between the bone mineral density and fracture prevalence
in the obese patients are widely presented in literature. There is
evidence that the correlation of weight and fracture risk is sitespecific.
This study is aimed at determining the connection between
the bone mineral density (BMD) and trabecular bone score (TBS)
parameters in Ukrainian women suffering from obesity. We
examined 1025 40-89-year-old women, divided them into the groups
according to their body mass index: Group A included 360 women
with obesity whose BMI was ≥30 kg/m2, and Group B – 665 women
with no obesity and BMI of