British Health Research Articles

Tobacco, respiratory diseases, cardiovascular risk, and cancer: Classical approaches and new alternatives

Smoking tobacco is the main preventable aetiological factor of mortality worldwide, with a significant impact on respiratory and cardiovascular diseases and cancer. Smoking cessation and prevention must be prioritized in health care and legislative initiatives to reduce mortality and associated complications. To date, pharmacological treatments and behavioural therapies, along with community strategies, have been shown to be the most effective methods, especially when used in combination with a coordinated approach. However, their efficacy remains suboptimal and diminishes over time due to the high frequency of relapse. Data from the survey on alcohol and other drugs in Spain (EDADES) of the Spanish National Health System showed that the percentage of smokers has hardly decreased in recent decades and that many smokers do not intend to give up smoking, even those who have already suffered from some complications. In this context, the development of new products such as electronic cigarettes and heated tobacco may have some application in the population. The FDA recognition of risk-modifying products, the British Health System reports on electronic cigarettes, and the recommendations of the American College of Cardiology expert consensus on smoking cessation, among others, indicates the need to consider updating the multifactorial and multidisciplinary approach of smoking and its consequences.

Oral Health Education for Children: Development of a Serious Game with a User-Centered Design Approach.

Background: Children can learn efficiently with well-designed serious games. The use of applications to promote health has proliferated, but there is a lack of scientific studies on educational games in oral health. Materials and Methods: We developed the Brazilian version of a British and Jordanian oral health education game for children from the perspectives of Brazilian specialists and users. This descriptive study, with a qualitative and quantitative approach, comprised three phases: I-Experts' discussion of the appropriateness of the previous version of the game to Brazil; II-Development of the first Brazilian version of the game; and III-Evaluation of the first version with 15 children from 4 to 8 years of age. Results: In Phase I, the specialists agreed with the development of the Brazilian version of the game, with minor adjustments on: advice on eating; advice on oral hygiene habits, users' age group, game characters, and game purpose. Phase II: a version with a few changes in images and recommendations, written and spoken in Brazilian Portuguese. Phase III: The global average of correct answers in the game's tasks was 75.3%, ranging from 50.0% to 100%. Children reported having fun with the game, and most understood the content and its interface; their parents found the information relevant and enjoyed the gameplay with their children. Conclusions: The Oral Health Education Game offered basic information for preventing dental caries to Brazilian children aged 4-8 years old in an interactive and fun way; it could support professionals in improving oral health education.

Auditing Electroconvulsive Therapy

The first audit in medicine was reported in 1980 on the use of electroconvulsive therapy (ECT) for mental disorders in the United Kingdom. John Read and colleagues have recently conducted an update auditing the extent to which patients are informed of treatment hazards. Their report also audits the response of British health services to being audited about ECT. The response from services was poor on both the details given to patients and the extent to which services responded to questions from the audit team. This review questions how likely it was that Read and colleagues would get a response and given the heterogeneity of patients given ECT whether any response was likely to be meaningful.

Covid-19 contact-tracing apps and the public/private co-production of security

This article examines how the smartphone contributes to the co-production of security through an analysis of Covid-19 contact-tracing apps. Building on existing research in security studies that mobilizes the science and technology concept of co-production, the article proposes the notion of ‘appropriation’ as a concrete way of extending our understanding of the public/private co-production of security. Appropriation highlights how consumer technology may be repurposed for security and shows how private-sector actors that own consumer technology not only influence, but actively condition the co-production of security. Bringing new, typically commercial, concerns to bear on security practices, appropriation also has the effect of complicating conventional understandings of the relationship between liberty and security. Focusing on the NHS Covid-19 app and its contentious relationship with Google/Apple’s framework for digital contact-tracing, the article demonstrates how the smartphone enables private-sector actors to gain influence in the security domain. Google and Apple used their control over smartphone technology to compel the British health authorities to adopt a less effective but more privacy-preserving approach than they originally intended, and thus enforced a seemingly liberal response to an exceptional political situation.

What makes women receptive to breast self-examination, animation, or simulation? - a comparative study.

Breast self-examination (BSE) plays an important role in the early diagnosis of breast cancer in India owing to the stigma attached to cancer. The authors compared the efficacies of animation video versus simulation techniques in BSE. Women with no previous history of conditions affecting the breasts were included in this prospective observational study and divided into an animation or simulation arm. The latter was further divided into three subgroups as per the simulation models used : the German (Delta Healthcare), British (Health Edco), and Indian (low-cost, validated) models used for teaching BSE. The hybrid animation video had a 9min runtime with a lecture on BSE and a virtual character performing BSE. In both the arms, participants filled in a validated modified patient satisfaction questionnaire. A total of 500 women participated. The mean age of the participants in the animation video arm was 20.21±3.88 years and 19.34±2.27, 22.94±9.6, and 18.97±1.31(20.41±5.99) years in the Indian, German, and British simulation models arm, respectively. The age difference between the two arms was statistically significant (P<0.05). Both animation video and simulation models were found to be useful by the participants. The participants' response to animation video being a better organized tool for learning BSE was statistically significant (90.48±7.98 vs. 84.02±15.09 P≤0.001) when compared to simulation models. The younger women (≤20 years) found these tools significantly more useful than those aged >20 years. All models had good efficiency and utility as learning tools for BSE. However, large studies in BSE set up with combination models are needed.

Crises information dissemination through social media in the UK and Saudi Arabia: A linguistic perspective.

This study investigates health-promoting messages in British and Saudi officials' social-media discourse during the Coronavirus Disease 2019 (COVID-19) Pandemic. Taking discourse as a constructivist conception, we examined the crisis-response strategies employed by these officials on social media, and the role of such strategies in promoting healthy behaviors and compliance with health regulations. The study presents a corpus-assisted discourse analysis of the tweets of a Saudi health official and a British health official that focuses on keyness, speech acts, and metaphor. We found that both officials utilized clear communication and persuasive rhetorical tactics to convey the procedures suggested by the World Health Organization. However, there were some differences in how the two officials used speech acts and metaphors to achieve their goals. The British official used empathy as the primary communication strategy, while the Saudi official emphasized health literacy. The British official also used conflict-based metaphors such as war and gaming, whereas the Saudi official used metaphors that reflected life as a journey interrupted by the pandemic. Despite these differences, both officials utilized directive speech acts to tell audiences the procedures they should follow to achieve the desired conclusion of healing patients and ending the pandemic. In addition, rhetorical questions and assertions were used to direct people to perform certain behaviors favored. Interestingly, the discourse used by both officials contained characteristics of both health communication and political discourse. War metaphors, which were utilized by the British Health official, are a common feature in political discourse as well as in health-care discourse. Overall, this study highlights the importance of effective communication strategies in promoting healthy behaviors and compliance with health regulations during a pandemic. By analyzing the discourse of health officials on social media, we can gain insights into the strategies employed to manage a crisis and effectively communicate with the public.

Regional Institute of Ophthalmology and Government Ophthalmic Hospital: The Heart of Heritage

Regional Institute of Ophthalmology and Government Ophthalmic Hospital: The Heart of Heritage

Pengaruh Jenis Pekerjaan, Alat Pelindung Diri Dan Riwayat Atopi Tehadap Dermatitis Kontak Iritan Pada Petugas &lt;i&gt;Cleaning Service&lt;/i&gt;

Cleaning service (CS) is a job that often causes irritant contact dermatitis due to frequent contact with materials in the work environment, where the work is wet and is associated with water, soap, or other chemicals in a moment or repeatedly. This study aims to determine the effect of type of work, use of personal protective equipment, and history of atopy on the incidence of irritant contact dermatitis in cleaning service employees at the University of Muhammadiyah Malang. This study used an analytic observational method with a cross-sectional approach. The entire CS of the University of Muhammadiyah Malang population is 42 people with simple random sampling. The research data used a questionnaire from the British Health and Safety Executive (HSE UK) with the analysis technique using the Fisher Exact and Kruskal Wallis tests (alternative chi-square) in the bivariate test. In contrast, for multivariate, it used logistic regression. The research results obtained included: (1) bivariate, there was a relationship between the type of work (p=0.017), the use of personal protective equipment (p=0.047), and a history of atopy (p=0.001) in CS employees at the University of Muhammadiyah Malang. Furthermore, multivariate, there is a significant effect between the type of work (sig Wald = 0.029), use of personal protective equipment (sig Wald = 0.032), and history of atopy (sig Wald = 0.013). In conclusion, irritant contact dermatitis has a significant relationship with the type of work, use of PPE, and history of atopy.

The use of scanning electron microscopy (SEM) and energy dispersiveX-ray analysis (EDXA) as a measurement tool for EMPs tasks, guidelines

In a variety of European countries SEM/EDXA based methods are widely used for the measurements and judgements relating thereof regarding asbestos analysis. Most of these methods are used also for other fibrous particles, commonly indicated as Elongate Mineral Particles (EMPs).The span of guidelines reflects the broad use of SEM/EDXA as an analytical method. Guidelines regarding air measurements both for ambient and indoor air are well established. These methods are widely used as is shown in a proficiency testing scheme, organized by the British Health and Safety Executive (HSL) with participants from countries all over Europe and some countries from Asia and Africa. For workplaces a similar guideline with a reduced sensitivity is available, allowing measurements in higher dust concentrations. Features of the methods like analytical sensitivity, detection limits and measurement uncertainty are discussed.For material analysis we apply different analytical methods, using SEM/EDXA as a final step. They are different both in sample preparation and sensitivity. Most of the methods are qualitative or “semi-quantitative” and thought for the analysis of commercial asbestos containing products mainly. If quantitative analysis based on EDXA is used for identification other EMPs can be identified as well. An important tool is the morphological impression of the fibers or structures in the SEM in addition.Changes in regulations which may be expected, will modify some of the methods. Especially lowered Threshold Limit Values (TLV's) in occupational air measurements are difficult to achieve.

Monkeypox: A British sexual health clinic's experience of applying lessons from the COVID-19 pandemic.

Monkeypox: A British sexual health clinic's experience of applying lessons from the COVID-19 pandemic.

Management of antineutrophil cytoplasmic antibody-associated vasculitis: a review of recent guidelines.

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is an autoimmune rheumatic disease consisting of three discrete diagnoses of microscopic polyangiitis, granulomatosis with polyangiitis, and eosinophilic granulomatosis with polyangiitis. Among diseases treated in a rheumatology department, AAV has poor clinical outcomes, with high rates of mortality and progression to end-stage renal disease and frequent disease relapse. Due to the frequent negative patient outcomes, optimal therapeutic strategies are essential in the management of AAV. In the present review, four guidelines for management of AAV are summarized: British Society for Rheumatology (BSR) and British Health Professionals in Rheumatology (BHPR) guideline for the management of adults with AAV; European League Against Rheumatism (EULAR)/European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) recommendation for the management of AAV; 2021 American College of Rheumatology (ACR)/Vasculitis Foundation Guideline for the Management of AAV; Kidney Disease: Improving Global Outcome (KDIGO) 2021 Clinical Practice Guideline for the Management of Glomerular Diseases, which will aid in clinicians' medical decisions. Finally, the summary of the 2022 Update of the EULAR Recommendations on the Management of AAV, presented in the EULAR Congress 2022 is also introduced.

British Stress Management Standards Approach in the Post-Epidemic Era and Its Insight on Psychological Health Education

In 2019, British Health and Safety Administration released a report on how to cope with work stress, which proposed stress management. standards approach. Through a structured analysis of the stress management standards approach, this paper clarifies its main connotation and key issues in implementation, and explores its important significance. It found that British standards approach to stress management includes procedures of organizational preparation, risk identification, injury determination, plan implementation, and monitoring of action, with embedded standards of requirements, controls, support, roles, change, and relationship management. It promotes people’s awareness of stress and its effects to a certain extent. British stress management standards approach in the post-epidemic era enlightens people: psychological health education must guide children to discover sources of stress and restore their inner world; Help children to recognize stress injuries and protect their physical and mental safety; Participate in children’s stress relief actions to enhance children’s symbiotic ability; Give full play to children’s initiative in understanding questions and construct children’s reflective life.

A Study of British Urbanization and Health Reform in the 19th Century

A Study of British Urbanization and Health Reform in the 19th Century

Publics and their health: 50years of continuity and change.

This article explores a set of changes and continuities in relation to public health and its publics in the UK since the establishment of the Faculty of Public Health in 1972. The article draws on historical research to produce a synthetic analysis of key changes and continuities in British public health since 1972. Three key areas are identified. The first centres on the issue of who has responsibility for public health. The second examines the persistence of social and racial inequalities in population health. The third considers the 'return' of infectious disease as a threat to public health. Despite the trend to place more responsibility for individual and collective health on the public itself, there was a proliferation in the actors and authorities involved in securing and protecting the health of the public. The strong linkages between health and structural inequality, and the challenges of addressing these, demonstrate that public health never was (and never can be) solely an individual matter. The appearance of new diseases, such as HIV/AIDS and the return of ones thought to have been conquered, like tuberculosis, raised profound questions for public health authorities and the people they cared for.

Psychoeducation for psychological issues and birth preparedness in low- and middle-income countries: a systematic review

BACKGROUNDPsychological issues usually accompany the pregnancy of first-time mothers, and psychoeducational interventions might be effective in addressing these concerns and preparing first-time mothers for childbirth and the postnatal period.OBJECTIVEThis study aimed to identify, analyze, and synthesize the components and determine the effectiveness of psychoeducational interventions that are used for managing psychological issues and enhancing birth preparedness among primigravid women or couples in low- and middle-income countries.STUDY DESIGNA systematic search of 12 databases (APA PsycINFO, EmCare, Embase, MEDLINE(R), Ovid Nursing, British Nursing Index, Health & Medical Collection, ProQuest, CINAHL, Cochrane, Hinari, and PubMed) was conducted to identify relevant studies published between 1946 and October 2021. The quality of the included studies was appraised by the Joanna and Briggs Institute critical appraisal tool, and a narrative synthesis was performed to analyze data extracted from included articles. The systematic review protocol is registered with the International Prospective Register of Systematic Reviews (registration number: CRD42021237896).RESULTSThe initial search yielded 8658 articles. Of note, 16 articles, including 7 randomized controlled trials and 9 nonrandomized trials, met the inclusion criteria and were selected and reviewed for quality. In addition, 31 outcomes were measured in the studies, including psychological outcomes, birth preparedness outcomes, and other outcomes. The design of the interventions included antenatal education that was delivered through lectures, role plays, trainings, and antenatal counseling. All the psychoeducational interventions had a significant effect (P<.05; Cohen's d or Hedges’ g=0.2–1.9) on certain psychological outcomes, including childbirth attitude, fear of childbirth, depression, fear, and anxiety, and birth preparedness outcomes.CONCLUSIONAlthough first-time mothers experience a range of psychological issues during pregnancy, psychoeducational interventions were beneficial in addressing their psychological concerns. It would seem that these interventions are less expensive and could be easily implemented in low- and middle-income countries. However, rigorous research, such as randomized controlled trials, is hereby warranted to standardize the interventions and outcome assessment tools.

Nutritional evaluation of fatty acid compositions and the fat of Fujian characteristic snacks

To analyze the fat and fatty acid composition of Fujian characteristic snacks, and to evaluate their nutritional value. The fat and fatty acid composition of Fujian characteristic snacks were analyzed by the national standards, and analyzed by statistics such as correlation analysis, nonparametric test and cluster analysis. The nutritional value of fatty acid was evaluated by unsaturated index(UI), atherogenic index(AI), thrombosis index(TI). The contents of crude fat and total fatty acid were 0.11-26.35 g/100 g and 0.08-17.85 g/100 g. The correlation coefficient r=0.915(P&lt;0.01), crude fat and total fatty acid in poultry and livestock meats were higher than those in seafood(P&lt;0.05). The main saturated fatty acids(SFA) were palmitic acid(21.80%-34.00%)and stearic acid(7.72%-21.45%), and the main unsaturated fatty acids(UFA)were oleic acid(5.38%-41.17%) and linoleic acid(2.99%-23.54%). The content of eicosapentaenoic acid(EPA) in fish noodle(0.71%) and docosahexaenoic acid(DHA) in fried fish roll, fish slide, fish noodles(0.41%, 2.12%, 1.59%)were far higher than other snacks. Polyunsaturated fatty acids/saturated fatty acids(PUFA/SFA)ratios were 0.10-0.69, there were 8 kinds of snacks with PUFA/SFA ratio value&gt;0.4. The n-3 PUFA/n-6 PUFA ratios were 0.01-0.75, n-6 PUFA/n-3 PUFA ratios were 1.33-74.31. The n-6 PUFA/n-3 PUFA ratios of fish slide(1.33) and fish noodle(2.13) conform to the ideal ratio stipulated by the British Health Organization, and the ratio of flat food(6.36) conform to the recommended ratio of Food and Agriculture Organization. The SFA∶monounsaturated fatty acids(MUFA)∶PUFA ratios were 0.8∶1.0∶0.5-2.4∶1.0∶0.2, the ratios of pork zongzi, meat yan silk, spicy meat, pressed salted duck and fried oyster(1.2∶1.1∶0.5, 0.8∶1.0∶0.6, 1.0∶1.0∶0.7, 0.8∶1.0∶0.5 and 1.1∶1.1∶0.5) were close to 1∶1∶1. The UI of 15 snacks was 48.37-90.67. The AI was 0.40-1.44, and the TI was 0.97-2.32. When the distance scale was 9, snacks were divided into three categories, namely fish noodle, fish slide and others. Fish noodle was high EPA and DHA type, and fish slide was high DHA type. The fat and total fatty acid contents of the 15 snacks were wide, which were closely related to the raw materials and cooking style. Nutrition and health value of fish slide, fish noodles food, meat yan silk and spicy meat were high.

A Brief account of british health policies in assam under colonial government

Public health has become another important area of research in recent years and many studies have been done on endemic diseases like cholera, smallpox, kala-azar, plague etc in the British India. Response to the epidemic diseases both within the colonial administration and in different sections of the indigenous population–have also attracted the social historians. Historians have treated epidemics as an important event of the mid of the 19th century because it had created major transformation in the society. At first colonial government adopted some policies mainly to serve the needs of the colonizers and soldiers and were extended to urban areas to safeguard the Europeans in mines, plantations, factories and administrative centers. Later they realized that if their surrounding area remained diseased and unclean, it was difficult to protect them. So they adopted some health policies in India as well as in Assam. This paper focuses on public health policies that were adopted by British. This paper also focuses on impact of these policies on society.

Identifying health conditions associated with Alzheimer's disease up to 15 years before diagnosis: an agnostic study of French and British health records

The identification of modifiable risk factors for Alzheimer's disease is paramount for early prevention and the targeting of new interventions. We aimed to assess the associations between health conditions diagnosed in primary care and the risk of incident Alzheimer's disease over time, up to 15 years before a first Alzheimer's disease diagnosis. In this agnostic study of French and British health records, data from 20 214 patients with Alzheimer's disease in the UK and 19 458 patients with Alzheimer's disease in France were extracted from The Health Improvement Network database. We considered data recorded from Jan 1, 1996, to March 31, 2020 in the UK and from Jan 4, 1998, to Feb 20, 2019, in France. For each Alzheimer's disease case, a control was randomly assigned after matching for sex and age at last visit. We agnostically tested the associations between 123 different diagnoses of the International Classification of Diseases, 10th revision, extracted from health records, and Alzheimer's disease, by running a conditional logistic regression to account for matching of cases and controls. We focused on three time periods before diagnosis of Alzheimer's disease, to separate risk factors from early symptoms and comorbidities. Unadjusted odds ratios (ORs) and 95% CIs for the association between Alzheimer's disease and various health conditions were estimated, and p values were corrected for multiple comparisons. In both the British and French studies, ten health conditions were significantly positively associated with increased Alzheimer's disease risk, in a window of exposure from 2-10 years before Alzheimer's disease diagnosis, comprising major depressive disorder (UK OR 1·34, 95% CI 1·23-1·46; France OR 1·73, 1·57-1·91), anxiety (UK OR 1·36, 1·25-1·47; France OR 1·50, 1·36-1·65), reaction to severe stress and adjustment disorders (UK OR 1·40, 1·24-1·59; France OR 1·83, 1·55-2·15), hearing loss (UK OR 1·19, 1·11-1·28; France OR 1·51, 1·21-1·89), constipation (UK OR 1·31, 1·22-1·41; France OR 1·59, 1·44-1·75), spondylosis (UK OR 1·26, 1·14-1·39; France OR 1·62, 1·44-1·81), abnormal weight loss (UK OR 1·47, 1·33-1·63; France OR 1·88, 1·56-2·26), malaise and fatigue (UK OR 1·23, 1·14-1·32; France OR 1·59, 1·46-1·73), memory loss (UK OR 7·63, 6·65-8·76; France OR 4·41, 3·07-6·34), and syncope and collapse (UK OR 1·23, 1·10-1·37; France OR 1·57, 1·26-1·96). Depression was the first comorbid condition associated with Alzheimer's disease, appearing at least 9 years before the first clinical diagnosis, followed by anxiety, constipation, and abnormal weight loss. These results from two independent primary care databases provide new evidence on the temporality of risk factors and early signs of Alzheimer's disease that are observable at the general practitioner level. These results could guide the implementation of new primary and secondary prevention policies. Agence Nationale de la Recherche.

British surname origins, population structure and health outcomes\u2014an observational study of hospital admissions

Population structure is a confounder on pathways linking genotypes to health outcomes. This study examines whether the historical, geographical origins of British surnames are associated with health outcomes today. We coded hospital admissions of over 30 million patients in England between 1999 and 2013 to their British surname origin and divided their diagnoses into 125 major disease categories (of which 94 were complete-case). A base population was constructed with patients’ first admission of any kind. Age- and sex-standardised odds ratios were calculated with logistic regression using patients with ubiquitous English surnames such as “Smith” as reference (alpha = .05; Benjamini–Hochberg false discovery rate (FDR) = .05). The results were scanned for “signals”, where a branch of related surname origins all had significantly higher or lower risk. Age- and sex-standardised admission (alpha = .05) was calculated for each signal across area deprivation and surname origin density quintiles. Signals included three branches of English surnames (disorders of teeth and jaw, fractures, upper gastrointestinal disorders). Although the signal with fractures was considered unusual overall, 2 out of the 9 origins in the branch would only be significant at a FDR > .05: OR 0.92 (95% confidence interval 0.86–0.98) and 0.70 (0.55–0.90). The risk was only different in the quintile with the highest density of that group. Differential risk remained when studied across quintiles of area deprivation. The study shows that surname origins are associated with diverse health outcomes and thus act as markers of population structure over and above area deprivation.

Hospital Studies in the Ottoman State During the Crimean War: British Health Services According to Briıtish Consul Reports (1854-1856)

Kırım Savaşı’nda hastane gemileriyle aktif rol oynayan İngiliz yönetimi, savaş sırasında Ruslara karşı Osmanlı Devleti’ni desteklemek için İstanbul, İzmir ve Çanakkale şehirlerinde askerî hastaneler açmıştır. Savaşın kazanılmasında etkin rolü olan İngilizler önemli sağlık hizmetlerinin yanında ülkedeki hastanelerde değişim ve dönüşüm gerçekleştirmiştir. Bu bağlamda 1854-1855 yıllarında İngilizler Kırım Savaşı esnasında Osmanlı topraklarında yaptıkları sağlık hizmetlerinin her türlü evrakını kaydetmişlerdir. Bu çerçevede kaydedilen tüm kayıtların transkripti yapılmıştır. Kırım Savaşı esnasında Sağlık sistemini yenileyen İngilizler; yönetimleri altındaki hastanelerde öncelikle düzen sağlamış, hijyen getirmiş, salgın ve ölümlü asker sayılarını düşük rakamlara çekmiş, 40 kişilik hemşire ekibi getirterek hizmetlerin hızını ve kalitesini artırmıştır. Yine İngilizler hastanelerin kapasitelerini artırmış ve hastane olarak inşa edilmeyen binaları sağlık hizmetlerine uygun hâle getirmiştir. Farklı amaçlarla hizmet eden gemileri hastane gemilerine dönüştürmüş ve eksik doktor ihtiyacını gidermiştir. Savaş devam ederken İngiltere’den gelen sağlık heyetleri tarafından yapılan denetimlerle hızlı ve kaliteli sağlık hizmeti sunmuşlardır. Bu çalışmanın amacı Kırım Savaşı’nda İngilizlerin Osmanlı topraklarında sunduğu sağlık hizmetlerini ve hastanelerde yaşanan dönüşümleri ortaya koymaktır. Çalışma kapsamında İngiliz Dışişleri Bakanlığı “English War Department (31 July 1856) [İngiliz Savaş Departmanı]” tarafından tutulan “Offical Reports of the Hospitals at Scutari, Kululeli, Abydos and Smyrna [Üsküdar, Kuleli, Çanakkale ve İzmir Hastanelerinin Resmi Raporları]” adlı orijinal arşiv belgelerinden elde edilen raporlar, telgraflar ve tutanaklardan çıkan bilgiler bütünsel olarak sunulmuştur.