Current Health Conditions Research Articles

Using Explainable Artificial Intelligence to Interpret Remaining Useful Life Estimation with Gated Recurrent Unit

In engineering, prognostics can be defined as the estimation of the remaining useful life of a system given current and past health conditions. This field has drawn attention from research, industry, and government as this kind of technology can help improve efficiency and lower the costs of maintenance in a variety of technical applications. An approach to prognostics that has gained increasing attention is the use of data-driven methods. These methods typically use pattern recognition and machine learning to estimate the residual life of equipment based on historical data. Despite their promising results, a major disadvantage is that it is difficult to interpret this kind of methodologies, that is, to understand why a certain prediction of remaining useful life was made at a certain point in time. Nevertheless, the interpretability of these models could facilitate the use of data-driven prognostics in different domains such as aeronautics, manufacturing, and energy, areas where certification is critical. To help address this issue, we use Local Interpretable Model-agnostic Explanations (LIME) from the field of eXplainable Artificial Intelligence (XAI) to analyze the prognostics of a Gated Recurrent Unit (GRU) on the C-MAPSS data. We select the GRU as this is a deep learning model that a) has an explicit temporal dimension and b) has shown promising results in the field of prognostics and c) is of simplified nature compared to other recurrent networks. Our results suggest that it is possible to infer the feature importance for the GRU both globally (for the entire model) and locally (for a given RUL prediction) with LIME.

Veterans in Northern Ireland: Evaluation of chronic pain experience, service type, and physical and mental health functioning.

Chronic pain is common and associated with disruptions in quality of life (QoL) and psychosocial functioning. These issues are particularly pronounced in veterans, although data in this regard primarily come from the United States Veterans Affairs System, meaning less is known regarding veterans of other countries and regions. The present study evaluated veterans living in Northern Ireland (NI), a region with historic high rates of both chronic pain and psychosocial difficulties associated with the decades-long period of civil and military conflict preceding the 1999 armistice (the Good Friday Agreement). Unique to the Northern Ireland military operation was the initiation of Home Service battalions comprised of local recruits, a role with increased risk due to the conflict's nature and the fact that they were serving as a military and security presence in their home region. A cross-sectional assessment of veterans living in Northern Ireland (N = 722) provided details of service type (Home Service vs other service), current health conditions (including chronic pain), and current psychosocial functioning (including physical and mental health QoL, anxiety, depression, and post-traumatic stress disorder [PTSD] symptoms). Findings indicated that those with chronic pain had worse QoL, anxiety, depression, and PTSD. Those with chronic pain were also more likely to have served in the Home Services, be unemployed, and be receiving disability payment. Contrary to hypotheses, there was no interaction between chronic pain and service type. These results extend previous work with veterans to the unique circumstances of a post-conflict military that engaged in operations within its own country and underscore the need for coordinated, efficacious interventions for co-morbid chronic pain and anxiety, depression, and PTSD.

INDICADORES DE SALUD EN BOVINOS DE UNIDADES DE PRODUCCIÓN DOBLE PROPÓSITO EN TRÓPICO SECO

<p><strong>Background:</strong> Beef ranks third in consumption in the Mexican market, where the diversity in supply sources and management systems used in production units is notable. This diversity is reflected in the health and welfare conditions of cattle. <strong>Objective:</strong> To evaluate health indicators of dual-purpose cattle in Michoacán, Mexico, aiming to promote quality in the meat industry. <strong>Methodology:</strong> Data were collected using the protocol adapted from UC Davis Cow-Calf Health and Handling. Bivariate and multivariate statistical techniques (principal component analysis and cluster analysis) were applied to analyze the data. <strong>Results:</strong> Six factors explain the cattle's current and past health conditions. From these, three groups of cattle were obtained with statistically significant differences in eight key indicators. Group 1 (G1) was characterized by good body condition and favorable past health status. Group 2 (G2) showed recent health problems, skin lesions, wildlife attacks, and parasitosis. Group 3 (G3) presented moderate conditions regarding past and recent health. <strong>Implications:</strong> This study provides a foundation for designing tools to enhance livestock living conditions by identifying and addressing individuals with poor health and welfare. These actions benefit livestock and directly improve the quality of meat derived from them. <strong>Conclusions:</strong> Group 2 (G2) was identified as having the greatest health problems, while G3 showed intermediate conditions and G1 grouped cattle with better health indicators. These findings underscore the importance of implementing improved animal health and welfare practices in production units to enhance the quality of meat produced.</p>

The High Prevalence and Complexity of Over-the-Counter Medication Misuse in Older Adults.

Older adults (≥65 years) are the largest consumers of over-the-counter (OTC) medications and exceptionally vulnerable to the risks of these medications, including adverse drug events (ADEs). However, little is known about how older adults select and use OTCs. This is the first multisite study designed to prospectively quantify the type and intended use of OTCs selected by older adults in community pharmacies where products are purchased. Older adults (n = 144) were recruited from 10 community pharmacies from a Midwestern health system. Participants were given hypothetical symptoms and asked to select one or more OTCs for self-treatment. They were asked to report how they would use the products at symptom onset and when symptoms persisted or worsened. They also reported their current medication list and health conditions. Participants' OTC selections were evaluated for 4 types of misuse: drug-age, drug-drug, drug-disease, and drug-label. Of the 144 participants, 114 (79%) demonstrated at least one type of misuse when describing how they would use their OTC selections at symptom onset. Drug-drug and drug-label misuse had the highest prevalence. Overall, 26 (18%) and 28 (19%) participants showed only drug-drug or drug-label misuse, respectively. Notably, 55 (38%) of participants demonstrated misuse in 2 or more misuse categories. Misuse potential was exacerbated when participants described treating persistent or worsening symptoms. The results highlight the high prevalence and complexity of OTC misuse in older adults and the need for additional work to improve OTC safety.

Reviewing Criminal Threats Against Falsification of Covid-19 Certificate by Medical Personnel

This article discusses the relationship between law and society, beginning with a review of the statement “where there is society, there is law” (ubi societas ibi ius). The research highlights how societies form laws in an effort to protect themselves or their groups. However, societal developments are often faster than legal reforms, resulting in some regulations becoming irrelevant to the current situation. The Covid-19 pandemic, for example, has changed various aspects of people's lives, including travel restrictions and requirements. Documents such as the Covid-19 Certificate have become important in a pandemic situation, but cases of forgery have also increased. Syndicates of Covid-19 Certificate forgery, including perpetrators who are medical personnel, indicate a serious violation of the law. The imposition of criminal and administrative sanctions is necessary to uphold justice and emphasize the importance of complying with the code of ethics, especially in the context of health services. Through an understanding of applicable regulations and laws, as well as fair enforcement of sanctions, it is hoped that the community can obtain justice and protection in accordance with current social and health conditions.

A novel machine learning approach for diagnosing diabetes with a self-explainable interface

This study introduces the first-ever self-explanatory interface for diagnosing diabetes patients using machine learning. We propose four classification models (Decision Tree (DT), K-nearest Neighbor (KNN), Support Vector Classification (SVC), and Extreme Gradient Boosting (XGB)) based on the publicly available diabetes dataset. To elucidate the inner workings of these models, we employed the machine learning interpretation method known as Shapley Additive Explanations (SHAP). All the models exhibited commendable accuracy in diagnosing patients with diabetes, with the XGB model showing a slight edge over the others. Utilising SHAP, we delved into the XGB model, providing in-depth insights into the reasoning behind its predictions at a granular level. Subsequently, we integrated the XGB model and SHAP’s local explanations into an interface to predict diabetes in patients. This interface serves a critical role as it diagnoses patients and offers transparent explanations for the decisions made, providing users with a heightened awareness of their current health conditions. Given the high-stakes nature of the medical field, this developed interface can be further enhanced by including more extensive clinical data, ultimately aiding medical professionals in their decision-making processes.

Counseling in menopausal women: How to address the benefits and risks of menopause hormone therapy. A FIGO position paper.

Menopause marks the end of menstrual cyclicity and, depending on individual vulnerability, has several consequences related to gonadal steroid deprivation, especially if it is premature. Menopause may be more burdensome for some women than for others. Individual factors, such as personal history, socioeconomic status, ethnicity, and current health conditions, affect symptomatology and, thereby, the menopausal experience. In addition, some menopausal symptoms, such as severe hot flashes, sleep disorders, and depression, are markers of future health risks. Counseling is a fundamental part of health care in the peri- and postmenopause periods. It must include an assessment of the patient's symptoms, needs, desires, and risk profile to address the benefits and risks of menopausal hormone therapy (MHT) on an individual basis and promote a healthy lifestyle. Indeed, healthcare practitioners can and must protect the health and lives of mid-life women by increasing awareness of menopausal symptoms and ensuring healthcare options, especially MHT. The type and duration of MHT should be tailored based on the patient's history, menopausal age, physical characteristics, and current health status so that the benefits always outweigh the risks. This FIGO position paper focuses on the benefits and risks of MHT on health domains, target organs, and systems, and on systemic and vaginal MHT regimens, to provide indications that can be used in the clinical practice for menopausal counseling. Moreover, it offers insights into what FIGO considers the mainstay for the healthcare management of women in peri- and postmenopause, worldwide.

Health and Working Conditions of Delivery Workers in Ulsan, South Korea Article type

Objective: This study aimed to determine the current work environment and health conditions for delivery workers in Ulsan Metropolitan City.Methods: Data from 64 delivery workers were collected, including their sociodemographic and employment information, and their opinions on labor environment, health status, health check-ups, and national health services. Quantitative data were analyzed through frequency analysis to explore the results. Qualitative data, such as descriptive responses, were examined through a process of categorization and multi-frequency responses.Results: The primary risk exposure of delivery workers in workplace was vibration from machines, high temperatures enough to sweat even when not working, smoke, gas, dust, etc. (each at 50.0%). Physical threats during work included postures that caused fatigue or pain (76.6%) and direct interaction with people (76.6%). Challenges in welfare and support within the work environment included the lack of rest time or difficulty in utilizing it (60.9%), no regular mealtime (65.6%), and no provision of protective equipment by the company (57.8%). A total of 48.8% of delivery workers responded that there were health and safety risks in their work environment, and overall job satisfaction was low (59.4% expressed dissatisfaction). While the general health condition was good, there were numerous complaints of pain (79.7%). Specific health issues included upper limb muscle pain (70.3%), lower limb muscle pain (62.5%), and the most diagnosed disease was hyperlipidemia (23.4%). Over the past two years, 10.9% of the participants had not had health check-ups. 71.9% expressed their willingness to participate in health promotion services, followed by improvement in working conditions and the management of harmful substances, musculoskeletal disorders, and cardiovascular diseases.Conclusion: This study, by examining the health status of delivery workers in Ulsan Metropolitan City, provides valuable foundational data for improving their work environment and preventing occupational diseases among them.

Nursing diagnoses as factors associated with delirium among intensive care unit patients with sepsis: A retrospective correlational study.

To examine whether nursing diagnoses were associated with delirium in patients with sepsis. Nursing diagnosis is a nurse's clinical judgement about clients' current or potential health conditions. Delirium is regarded as an important nurse-sensitive outcome. Nonetheless, nursing diagnoses associated with delirium have not yet been identified. Retrospective correlational study. This study was carried out from December 2021 to January 2023. We analysed electronic health records of patients with sepsis admitted to the intensive care units (ICUs) of a tertiary hospital in Seoul, South Korea. Delirium was defined based on the Intensive Care Delirium Screening Checklist score. Nursing diagnoses established within 24 h of admission to the ICU were included and were based on the North American Nursing Diagnosis Association diagnostic classification. The data were analysed using logistic regression. Demographics, comorbidities, procedures and physiological measures were adjusted. Regression model was evaluated via receiver operating characteristic curve, Nagelkerke R2, accuracy and F1 score. The prevalence of delirium in patients with sepsis was 51.8%. Ineffective breathing patterns, decreased cardiac output and impaired skin integrity were significant nursing diagnoses related to delirium. Age ≥ 65 years, Acute Physiology and Chronic Health Evaluation II score, mechanical ventilation, continuous renal replacement therapy, physical restraint and comatose state were also associated with delirium in patients with sepsis. The area under the receiver operating characteristic curve was 0.806. Ineffective breathing patterns, decreased cardiac output and impaired skin integrity could manifest as prodromal symptoms of delirium among patients with sepsis. The prodromal symptoms of delirium revealed through nursing diagnoses can be efficiently used to identify high-risk groups for delirium. The use of nursing diagnosis system should be recommended in clinical practice caring for sepsis patients. STROBE checklist. No patient or public involvement.

Autonomy and Coping with Stress in Persons with ASD

This article presents empirical analysis of selected issues related to autonomy of persons with ASD, along with the psychosocial conditions of its development. This analysis is an attempt to determine direct causes and particular types of conditions necessary for the development of autonomy in people with autism, manifested in the capacity of coping with stress. The theoretical basis for the research is the three-component model of autonomy, under which autonomy is an internal attribute of each person, manifesting itself in the qualities of authorship (the person feels to be the author of his/her own behaviour), interest-taking (reflection on internal and external events), and absence of the perceived sense of pressure or control.
 The research problems in this study concern the level of autonomy in people with ASD, the level of their psychosocial functioning in the dimension of coping with stress, and the potential correlations between the two parameters.
 A diagnostic survey method was used to obtain the research material, which employed the following research tools: Index of Autonomous Functioning, The Autism-Spectrum Quotient, Coping Inventory, the author’s own Interview Questionnaire, developed for the purposes of our study regarding age, gender, marital status, residence, education, income, past therapy and current health conditions.

A-GSTCN: An Augmented Graph Structural-Temporal Convolution Network for Medication Recommendation Based on Electronic Health Records.

Medication recommendation based on electronic health records (EHRs) is a significant research direction in the biomedical field, which aims to provide a reasonable prescription for patients according to their historical and current health conditions. However, the existing recommended methods have many limitations in dealing with the structural and temporal characteristics of EHRs. These methods either only consider the current state while ignoring the historical situation, or fail to adequately assess the structural correlations among various medical events. These factors result in poor recommendation quality. To solve this problem, we propose an augmented graph structural-temporal convolutional network (A-GSTCN). Firstly, an augmented graph attention network is used to model the structural features among medical events of patients' EHRs. Next, the dilated convolution combined with residual connection is applied in the proposed model, which can improve the temporal prediction capability and further reduce the complexity. Moreover, the cache memory module further enhances the model's learning of the history of EHRs. Finally, the A-GSTCN model is compared with the baselines through experiments, and the efficiency of the A-GSTCN model is verified by Jaccard, F1 and PRAUC. Not only that, the proposed model also reduces the training parameters by an order of magnitude.

Associations between Differential Aging and Lifestyle, Environment, Current, and Future Health Conditions: Findings from Canadian Longitudinal Study on Aging

Introduction: An aging population will bring a pressing challenge for the healthcare system. Insights into promoting healthy longevity can be gained by quantifying the biological aging process and understanding the roles of modifiable lifestyle and environmental factors, and chronic disease conditions. Methods: We developed a biological age (BioAge) index by applying multiple state-of-art machine learning models based on easily accessible blood test data from the Canadian Longitudinal Study of Aging (CLSA). The BioAge gap, which is the difference between BioAge index and chronological age, was used to quantify the differential aging, i.e., the difference between biological and chronological age, of the CLSA participants. We further investigated the associations between the BioAge gap and lifestyle, environmental factors, and current and future health conditions. Results: BioAge gap had strong associations with existing adverse health conditions (e.g., cancers, cardiovascular diseases, diabetes, and kidney diseases) and future disease onset (e.g., Parkinson’s disease, diabetes, and kidney diseases). We identified that frequent consumption of processed meat, pork, beef, and chicken, poor outcomes in nutritional risk screening, cigarette smoking, exposure to passive smoking are associated with positive BioAge gap (“older” BioAge than expected). We also identified several modifiable factors, including eating fruits, legumes, vegetables, related to negative BioAge gap (“younger” BioAge than expected). Conclusions: Our study shows that a BioAge index based on easily accessible blood tests has the potential to quantify the differential biological aging process that can be associated with current and future adverse health events. The identified risk and protective factors for differential aging indicated by BioAge gap are informative for future research and guidelines to promote healthy longevity.

Anxiety, Depression, and Associated Factors among General Population in Indonesia during COVID-19 Pandemic: A Cross-Sectional Survey.

The 2019 coronavirus pandemic (COVID-19) has affected the physical and mental health of individuals, families, and communities worldwide including Indonesia. This study aimed to examine anxiety and depression in the general population and factors related to anxiety and depression due to the COVID-19 pandemic. This study employed an online cross-sectional survey of 1149 respondents. We assessed self-reports regarding current health conditions and exposure to COVID-19, anxiety, and depression in the general population in Indonesia. The results showed that 26.6% and 30.5% of the participants experienced mild to severe anxiety and depression, respectively. The ordinal regression test showed that anxiety in the community was significantly related to age, feeling infected with COVID-19, feeling that a friend/colleague is infected with COVID-19, sufficient information regarding COVID-19, and the types of symptoms that are felt (fever, cough, and cold/sore throat, difficulty breathing). Besides, education level, occupation, feeling that family is infected with COVID-19, symptoms experienced, and anxiety were significantly related to depression. The COVID-19 pandemic has caused anxiety and depression in the general population in Indonesia. This study's results can be a catalyst in providing psychological interventions for the general public facing the COVID-19 pandemic.

State-Level Anti-Immigrant Sentiment and Policies and Health Risks in US Latino Children.

Although systemic inequities, broadly defined, are associated with health disparities in adults, there is a dearth of research linking contextual measures of exclusionary policies or prejudicial attitudes to health impairments in children, particularly among Latino populations. In this study, we examined a composite measure of systemic inequities in relation to the cooccurrence of multiple health problems in Latino children in the United States. Participants included 17 855 Latino children aged 3 to 17 years from the National Survey of Children's Health (2016-2020). We measured state-level systemic inequities using a factor score that combined an index of exclusionary state policies toward immigrants and aggregated survey data on prejudicial attitudes toward immigrants and Latino individuals. Caregivers reported on 3categories of child health problems: common health difficulties in the past year, current chronic physical health conditions, and current mental health conditions. For each category, we constructed a variable reflecting 0, 1, or 2 or more conditions. In models adjusted for sociodemographic covariates, interpersonal discrimination, and state-level income inequality, systemic inequities were associated with 1.13 times the odds of a chronic physical health condition (95% confidence interval: 1.02-1.25) and 1.24 times the odds of 2 or more mental health conditions (95% confidence interval: 1.06-1.45). Latino children residing in states with higher levels of systemic inequity are more likely to experience mental health or chronic physical health conditions relative to those in states with lower levels of systemic inequity.

Voluntary interruption of pregnancy and sexual and reproductive health in migrant women in BarranquillaInterrupção voluntária da gravidez e saúde sexual e reprodutiva em mulheres migrantes em Barranquilla

Identify knowledge about and barriers to effective access to voluntary interruption of pregnancy (VIP), and to sexual and reproductive health (SRH) services in general, among women from Venezuela (Venezuelan migrants and Colombian returnees). Qualitative study of 20 semi-structured interviews with women from Venezuela who are residents of Barranquilla and who carry out leadership activities in communities or who participate in or benefit from those activities. The interviews included opinions and experiences related to access to VIP, and to SRH in general, as well as suggestions for improving access for migrant women. The relationship between access to these services and the migration process was explored, as well as the role of social organizations. A lack of information on SRH-related rights was identified as the main access barrier to VIP. Other identified barriers were: attitude towards VIP, excessive steps involved in accessing medical care, difficulties in admission to the social security system, lack of training and care in SRH, and xenophobia in hospitals. The interviewees said they did not understand the legal framework in Colombia and did not know the channels for safe abortion care. Despite the efforts of institutions and international cooperation, Venezuelan migrant women in Barranquilla are in a situation of vulnerability due to their lack of access to sexual and reproductive health, including voluntary interruption of pregnancy. Implementing strategies for comprehensive care for migrants will improve current health conditions and the effective enjoyment of SRH-related rights.

Association of Retrospectively Reported Concussion Symptoms with Objective Cognitive Performance in Former American-Style Football Players.

Sustaining concussions has been linked to health issues later in life, yet evidence for associations between contact sports exposure and long-term cognitive performance is mixed. This cross-sectional study of former professional American-style football players tested the association of several measures of football exposure with later life cognitive performance, while also comparing the cognitive performance of former players to nonplayers. In total, 353 former professional football players (Mage = 54.3) completed both (1) an online cognitive test battery measuring objective cognitive performance and (2) a survey querying demographic information, current health conditions, and measures of past football exposure, including recollected concussion symptoms playing professional football, diagnosed concussions, years of professional play, and age of first football exposure. Testing occurred an average of 29years after former players' final season of professional play. In addition, a comparison sample of 5,086 male participants (nonplayers) completed one or more cognitive tests. Former players' cognitive performance was associated with retrospectively reported football concussion symptoms (rp = -0.19, 95% CI -0.09 to -0.29; p < 0.001), but not with diagnosed concussions, years of professional play, or age of first football exposure. This association could be due to differences in pre-concussion cognitive functioning, however, which could not be estimated based on available data. Future investigations of the long-term outcomes of contact sports exposure should include measures of sports-related concussion symptoms, which were more sensitive to objective cognitive performance than other football exposure measures, including self-reported diagnosed concussions.

OLDER ADULTS DURING THE COVID-19 PANDEMIC: ROLE OF HEALTH CONDITIONS IN RESILIENCY AND PERCEIVED STRESS

Abstract The COVID-19 pandemic has necessitated protracted lockdowns, exacerbating the challenges associated with social isolation. Older adults, who often suffer from social isolation, may have a harder time coping with the added isolation imposed by COVID-19. In this study, we investigated the resiliency and coping skills of older adults amidst the COVID-19 pandemic, and whether they were associated with different co-morbidities. We conducted a 45-minute telephone survey of 107 participants to assess their experiences during the COVID-19 pandemic. Participants were recruited from existing Johns Hopkins studies. The survey included the Brief Resilient Coping Scale, the Perceived Stress Scale, and questions about current health conditions (arthritis, osteoporosis, high blood pressure, heart disease, and depression/anxiety) and whether these conditions worsened, improved, or remained unchanged since the beginning of the pandemic. We regressed scores for resiliency and coping scores on a series of indicators of whether co-morbidities had worsened during the pandemic. On average, participants were 76 years old and 63% were female. There was no association between resiliency scores and any of the co-morbidities (r2=2.8%). With respect to perceived stress, participants who reported their depression/anxiety worsened during the pandemic also reported greater levels of perceived stress (B=0.83, 95% confidence interval: 0.30, 1.36). We were surprised that additional co-morbidities did not affect resiliency or stress. In order to better serve geriatric populations, health professionals should closely monitor those patients who have depression and anxiety during times of social distancing, epidemics, or pandemics.

Implementation of a Health Risk Assessment into Workflow of the Appointment-Based Model at an Independent Community Pharmacy.

Health risk assessments (HRAs) are tools used to collect information on patients' current health conditions, personal and family medical history, and lifestyle factors that can impact their overall health. The objectives of this pilot project were to implement an HRA as part of the appointment-based model workflow and to assess the resulting pharmacy-patient-care service opportunities. Sixteen HRA questions from a single health plan were incorporated into the appointment-based model workflow at an independent community pharmacy. Questions were administered either telephonically or in person over two patient encounters. Pharmacy staff were trained on how to administer the HRA, what to do if patients needed immediate assistance, how to provide referrals, and how to document of responses. Forty-nine patients were contacted and 38 (77.6%) completed the HRA. The median time for HRA completion was 19 min and the identified opportunities were vaccination (49), smoking cessation (15), diabetes prevention program (14), asthma control assessments (8), and substance use disorder screening and referral (3). This pilot project demonstrates that community pharmacies can implement HRAs and utilize the results to identify new pharmacy-patient-care service opportunities that can contribute to improved patient care and practice sustainability.

Perfil do conhecimento de mulheres sobre a atuação do fisioterapeuta na saúde da mulher

ABSTRACT This study aimed to evaluate the profile of knowledge of Brazilian women about the physical therapist’s role in women’s health. The women answered an online questionnaire containing: socioeconomic, demographic data, knowledge about the role of physical therapy in women’s health, and current health conditions. Descriptive analyses were carried out to characterize the sample, levels of knowledge and self-report of pelvic floor dysfunctions, and the association between general knowledge, self-report of dysfunctions, and knowledge of the sub-areas of physical therapy in women’s health. In total, 446 women from all regions of Brazil participated: 86.3% from the Southeast, 9.4% from the South, 1.6% from the Northeast, 1.3% from the Midwest, and 1.3% from the North. The mean age was 30.1±10.5 years; the self-report of pelvic floor dysfunctions was 20.4% urinary incontinence, 27.6% sexual dysfunctions, 25.8% intestinal symptoms, and 6.7% chronic pelvic pain. Of the participants, 61% had some knowledge about the role of physical therapy in women’s health and 96.9% would like to know more about this specialty. Although many women are aware of this area, a minority has been referred to or has undergone specialized physical therapy treatment for women’s health. There was a statistically significant association between the level of knowledge of women about the physical therapist’s role in women’s health with the self-report of pelvic floor dysfunctions and the level of knowledge of the sub-areas of performance.

Individual-level permethrin exposure biomarkers in U.S. army soldiers: comparison of two treatment formulations for military uniforms.

Evidence suggests that wearing permethrin-treated military uniforms is not associated with current adverse health conditions. However, exposure through this route results in permethrin biomarker concentrations considerably higher than those in the U.S. The U.S. Army is exploring different methods of uniform treatment that reduce exposure while maintaining effective protection from insect vector-borne diseases. To compare permethrin exposure when wearing two types of permethrin-treated military uniforms. Eight male soldiers participated in a 32-day crossover design study to compare permethrin exposure when wearing the current Army uniform (CurrU) and a uniform with a new applied fabric treatment (NewU). Each soldier wore the uniforms for designated 8 h/day time periods over 3 consecutive days separated by a 'wash-out' week of no exposure. Permethrin exposure was assessed from the urinary concentrations of 3-phenoxybenzoic acid (3-PBA) and of the sum of cis- and trans-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid (∑DCCA). Estimated dose was determined based on ∑DCCA concentrations. Permethrin exposure biomarkers were 21% (3-PBA, p = 0.025) and 35% (∑DCCA, p < 0.001) lower when wearing the NewU compared to the CurrU; the dose was 33% lower (p = 0.05). Findings suggest the new treatment reduces human permethrin exposure biomarkers resulting from wearing-treated military uniforms.