General Ill-health Research Articles

Assessment of Factors Associated with Increased Number of Sexually Transmitted Infection Cases among the Youth in Serenje Urban District, Zambia

Introduction: Sexually transmitted infections among the youth are of paramount concern to all people who work on improving the health status of populations worldwide as the highest reported rates of sexually transmitted infections are found among the people between 15-24 years of age which predispose them to infertility, general ill-health, pelvic inflammatory diseases in women, three-fold HIV transmission with mother-to-child sexually transmitted infections resulting in still births, neonatal deaths, prematurity, sepsis, pneumonia, congenital deformities and other morbidities. Therefore the study aimed to assess the factors associated with increased number of sexually transmitted cases in the youth of Serenje Urban District, Zambia. Methodology: A cross-sectional study was conducted on 138 youth of Serenje urban district selected using simple random sampling technique. The data were collected using a structured, pre-tested interviewer-administered questionnaire. Chi square and multivariate logistical regression analyses were employed through SPSS version 22 to assess and identify factors associated with increased sexually transmitted cases in the youth of Serenje urban district. Odds Ratio with a 95% confidence interval was computed to determine the level of association. In the multivariate analysis, variables with p-value less than 5% were considered as statistically associated, association between covariates and sexually transmitted infections. Results: The prevalence of sexually transmitted infections among the youth of Serenje Urban District was found to be 55%. About 47.8% of the respondents had high knowledge levels on STIs, 60% had multiple sexual partners, 34.8% used condom during the last intercourse, 27.5% experienced sexual coercion and 24.5% utilized youth friendly services. Most (43.5%) respondents in this study had poor practices towards STI prevention. Service related such as lack of consumable for STI treatment (92%) and erratic supply ........

Neoliberal Misfits: Reconceptualizing Debility in the Critical Medical Humanities.

In recent years, the concept of debility has gained a lot of attention. In critical theory and in the critical medical humanities, the concept has come to refer specifically to the general ill-health of ordinary lives under neoliberal capitalism; as such, it has triggered a surge of interest in large-scale affective assemblages that incapacitate multitudes of bodies. This article proposes neoliberal misfit as a conceptual tool to remedy the dissolution of subjectivity in these discussions. Pushing back against Jasbir Puar specifically, it argues that processes of debilitation produce a particular type of subject formation often ignored in this body of work. The article does so by distinguishing this subject formation in three contemporary illness narratives that dramatize encounters between ill bodies and accelerating rhythms, competitive atmospheres, and mobile attachments, respectively. Ultimately, the aim is to help the critical medical humanities capture how neoliberal environments affect the self-perception of people suffering from ill-health.

Nutritional Status of Adolescent Afghan Refugees Living in Peshawar, Pakistan.

Pakistan has hosted millions of Afghan refugees over the last several decades. Due to poor socioeconomic status, food insecurity and inadequate access to health care, these refugees are considered to be at high risk of malnutrition. Previous studies on nutritional assessment of high-risk populations (refugees) have focused mainly on women and children (0–59 months). The current study aims to assess nutritional status of adolescent Afghan refugees; the population who are equally vulnerable to malnutrition and its consequences. In this cross sectional study, the nutritional status of 206 adolescent (10–19 years old) Afghans boys and girls living in a refugee camp in Peshawar, Pakistan was assessed using standard methods. The results indicate a prevalence of stunting, thinness, and overweight and obesity at 35.3%, 4.4% and 14.8%, respectively. Furthermore, there was a significantly high prevalence of micronutrient deficiencies (vitamin D, 80.5%; vitamin B12, 41.9%; and folate, 28.2%); and anemia (10.1%). Together, these findings indicate that this vulnerable population group suffers from the double burden of malnutrition and are thus at serious risk of impaired psychosocial cognitive development, general ill-health and diminished wellbeing. This study therefore highlights the urgent need to include adolescents in regular screening and intervention programs of such at-risk populations.

Myocardial Fat: Physiological or Pathological? A Case Report

The presence of myocardial fat is not a finding that is infrequent during postmortem examinations. The case under discussion showed an extensive amount of fat, markedly on the right and mildly on the left ventricles. The differentiation of physiological fat from pathological entities is essential. In this case, two entities were initially suspected namely Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia and excessive physiological fat deposition of the heart. A 66-year-old averagely build, a mentally subnormal, previously healthy female was found dead after a nonspecific, mild, general ill-health. Trauma and the possibility of poisoning were excluded. The cause of death was concluded as coronary artery disease with further investigations. The incidental finding of an excessive amount of fat as seen in this case warrants explanations and future research in Sri Lanka.

More than metabolic: Considering the broader paleoepidemiological impact of vitamin D deficiency in bioarchaeology.

Vitamin D deficiency has traditionally been viewed as a metabolic bone disease by bioarchaeologists and considered primarily in terms of the development of specific musculoskeletal changes used for diagnosis in paleopathological research. These skeletal manifestations are usually interpreted as representing general ill-health. Clinical research shows that vitamin D is also integral to a number of extra-skeletal physiological processes including immunoregulation, blood pressure homeostasis, cell division, and programmed cell death. Vitamin D deficiency and sub-clinical insufficiency are thought to be risk factors for infectious and autoimmune diseases, as well as certain cancers and cardiovascular diseases. Epidemiological work indicates that the skeletal manifestations of vitamin D deficiency represent the extreme end of a spectrum of morbidity associated with negative health outcomes, including increased risk for secondary tuberculosis. This article provides a review of clinical research on the extra-skeletal roles of vitamin D and the pathological consequences of poor vitamin D status. Additionally, it presents an interpretive model for bioarchaeological analyses of rickets and osteomalacia for consideration of the whole-body impact of poor vitamin D nutriture and possible comorbidities that may have affected the wider population. Am J Phys Anthropol 160:183-196, 2016. © 2016 Wiley Periodicals, Inc.

The role of scurvy in Scott’s return from the South Pole

Scurvy, caused by lack of vitamin C, was a major problem for polar explorers. It may have contributed to the general ill-health of the members of Scott's polar party in 1912 but their deaths are more likely to have been caused by a combination of frostbite, malnutrition and hypothermia. Some have argued that Oates's war wound in particular suffered dehiscence caused by a lack of vitamin C, but there is little evidence to support this. At the time, many doctors in Britain overlooked the results of the experiments by Axel Holst and Theodor Frølich which showed the effects of nutritional deficiencies and continued to accept the view, championed by Sir Almroth Wright, that polar scurvy was due to ptomaine poisoning from tainted pemmican. Because of this, any advice given to Scott during his preparations would probably not have helped him minimise the effect of scurvy on the members of his party.

A spatial structural equation model with an application to area health needs

Indices of population ‘health need’ are often used to distribute health resources or assess equity in service provision. This article describes a spatial structural equation model incorporating multiple indicators of need and multiple population health risks that affect need (analogous to multiple indicators–multiple causes models). More specifically, the multiple indicator component of the model involves health outcomes such as hospital admissions or mortality, whereas the multiple risk component models the impact on the need for area social and demographic indicators, which proxy population-level risk factors for different diseases. The latent need construct is allowed (under a Bayesian approach) to be spatially correlated, though the prior assumed for need allows a mix of spatially structured and unstructured influences. A case study considers variations in need for coronary heart disease (CHD) care over 625 small areas in London, using recent mortality and hospitalization data (the ‘indicators’) and measures of general ill-health, income and unemployment, which proxy variations in population risk for CHD.

Medical history-taking in psychiatry

A good medical history is an essential starting point in ensuring that the physical health needs of people with severe mental illness are addressed. Psychiatrists have an important role in helping to tackle the general ill health, excess of undiagnosed physical illness and reduced survival rates among their patients. To do this they need to use their medical training, communication skills and regular contact with patients. Assessments should include family history, past and current physical health, medication, lifestyle, healthcare and physical symptoms. Some groups of patients will need more detailed assessments.

Cognitive therapy and behavioural coping in the management of work-related stress: An intervention study

Transactional models of stress emphasize the importance of cognitive appraisal of potential stressors in the determination of the stress response. This appraisal can be modified by the use of techniques normally associated with cognitive therapy. The contribution of a specifically cognitive component when intervening in work-related stress has not been well evaluated to date. This research seeks to determine the effectiveness of stress management training in the treatment of the work-related effects of stress by comparing the role of modifying dysfunctional cognitions with the teaching of appropriate behavioural coping strategies. Participants were allocated to one of two intervention conditions or to a waiting list control group. Those in the intervention conditions received group stress management either with the focus on delivering cognitive therapy techniques or with the focus on behavioural coping skills. Measures of general health were taken at the beginning and end of intervention and at 3-month follow-up. Participants in the cognitive therapy groups who were reporting symptoms of general ill-health at the start of the intervention showed a significant improvement at follow-up. Cognitive therapy appears to have been an effective intervention in work-related stress. Those in the behavioural group showed a smaller but still clinically effective improvement. Results are discussed in terms of methodological issues and implications for future research. It is suggested that changes in cognitive appraisal may need to be developed.

Sex differences in health at ages 11, 13 and 15

This paper tests the hypothesis of an emerging or increasing female excess in general ill-health and physical symptoms, as well as psychological distress, during early to mid-adolescence. Self-reported data on general health (longstanding illness and health in the last 12 months), recent symptoms (classified as ‘physical’ and ‘malaise’) and depressive mood were obtained from a large, Scottish, school-based cohort at ages 11, 13 and 15. Generally high levels of health problems at age 11 tended to increase with age, these increases being greater for females than males, not only in respect of depression and ‘malaise’ symptoms, but also limiting illness, ‘poor’ self-rated health, headaches, stomach problems and dizziness. The consequence, by age 15, is the emergence of a female excess in general ill-health and depressive mood, and a substantial strengthening of the small excess in both ‘physical’ and ‘malaise’ symptoms already apparent at 11 years. These findings are discussed in relation to explanations for the adult female excess in poorer health, and the emergence of a female excess of depression during adolescence.

The relation between the number of symptoms and other health indicators in working men and women

Simple symptom counts are widely used Indicators of ill-health in health survey research. However, there has only been little research aimed at a better understanding of symptom counts. The purpose of this study was to explore the number of symptoms (a summary score derived from 10 unspecific self-reported symptoms) in a ‘healthy’ population. We reanalysed data on a sample of 850 employed men and women (Berne Workplace Health Project). Stepwise ordinal logistic regression analysis was used to study the relation of the number of symptoms to contextual, person-related, behavioural, and health-related variables. In neither men nor women were any of the sociodemographic Indicators significantly associated with the number of symptoms. Of the work-related variables, low job discretion and adverse work environment were significantly associated with the number of symptoms and there was a statistical trend for high job demands. In women, dissatisfaction with salary was the only work-related variable which was significant. The private context, on the other hand, seemed to be more influential for women than for men and there was a statistical trend for strain at home. Among the person-related factors studied, age and emotional problems were significantly associated to the number of symptoms in both men and women. Psychological ill-health and negative future orientation were significant only in men and immersion only in women. Physical inactivity in leisure time was the only behavioural variable found to be significantly associated to the number of symptoms. Among the health-related factors, poor self-rated health was significant for both gender groups, while obesity was significant only in men. Only categories of variables being hypothesized to be unfavourable in terms of health were associated with a higher number of symptoms. Most of the associations found seem to be theoretically meaningful. Despite methodological provisos, our findings support a conception of the number of symptoms as an indicator of general ill-health.

BLOOD AND PROTEIN LOSS VIA SMALL-INTESTINAL INFLAMMATION INDUCED BY NON-STEROIDAL ANTI-INFLAMMATORY DRUGS

Nearly three-quarters of patients on long-term treatment with non-steroidal anti-inflammatory drugs (NSAIDs) have small-intestinal inflammation, the consequences of which are largely unknown. Two potentially important complications, blood and protein loss from the small intestine, have been studied. 49 patients on NSAIDs underwent study with an indium-111 labelled leucocyte technique which localises and measures intestinal inflammation. 32 patients underwent simultaneous study with technetium-99m labelled red blood cells (RBC), which showed identical sites of localisation to 111In-leucocytes in 19. Intestinal blood loss was measured in 8 patients by use of chromium-51 labelled RBC, and a significant correlation between blood loss and intestinal inflammation was found. Intestinal protein loss was assessed in 9 patients with 51Cr-labelled proteins; patients with NSAID-induced small-intestinal inflammation were found to have a protein-losing enteropathy. These studies show that small intestinal inflammation caused by NSAIDs is associated with blood and protein loss, both of which may contribute to the general ill-health of rheumatic patients.

Miliaria in Bengali children in Calcutta city

A survey undertaken amongst children of the lower socio-economic group in Calcutta during the hot season showed that “prickly heat” and other dermal lesions produced by sweat retention (miliaria), including mamillaria (miliaria profunda), were present in 97 per cent. The distribution and types of lesions, including those due to secondary infection, are discussed. The possibilities that general ill-health due to interference with sweating may be common amongst this type of children is suggested. Methods and inadequacies of treatment are mentioned.

The rice enrichment project in Bataan, Philippines.

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Dental Health in Britain

THE Interim Report of the Interdepartmental Committee on Dentistry (Cmd. 6565. H.M. Stationery Office, 1944) records this Committee's opinion that the dental health of Britain is bad and that its effect upon general health is also bad. The dental profession itself cannot be blamed for this. Its ideals are high. They see in dentistry, not merely attention to teeth, but also that basic relation between dental disease and general ill-health which is the basis of the scheme of dental education outlined by C. Bowdler Henry (Lancet, 26, Jan. 6, 1945), who advocates a basic medical education for dental students and also the education of stomatologists who would act as consultants to dentists and would study dental problems in relation to other diseases and tp the general biology of man. But the best dental profession in the world cannot operate in a vacuum; it must have the respect and co-operation of the people whom it seeks to serve; and the facts recorded in this report show that the British people not only do not take full advantage of the public dental services which now exist, but also they do not appreciate the effects of dental disease upon their general health.

THE EARLY DIAGNOSIS OF PARESIS

It is with much hesitation that I attempt to discuss so difficult a subject as the early recognition of paresis, for here we are confronted with borderland conditions and overlapping states. I know of no subject which is so important and no subject concerning which error is more frequently made both on account of the gradual invasion and also because of the generalized character of the symptoms. The recognition of the disease in its early stage is especially difficult because, in the average case, general disturbances for a long time precede the appearance of special symptoms indicative of organic change. In cases in which a satisfactory and detailed history of the very early period can be obtained, we usually receive an account of general ill-health, an ill-health evidenced both by complaints on the part of the patient, as well as by the observations of his friends. As a rule, we find that the patient has not been well for some time,-usually months. If during this preliminary period of ill-health, the patient visit his physician, the case is not infrequently mistaken for one of neurasthenia, and yet when the symptoms presented are closely analyzed, it is found that they resemble those of neurasthenia only superficially. It is true we have quite commonly the symptom of ready fatigue and in addition inability to maintain the attention for any length of time Upon affairs of business or other every-day matters. Notwithstanding, the typical fatigue syndrome of neurasthenia is wanting, as an analysis of the early symptoms will show. The friends of the patient often maintain that his appearance and manner

GASTRO-HYSTEROPEXY AS A SAFE AND RELIABLE MEANS OF CORRECTING PROLAPSUS AND RETRO-DISPLACEMENTS OF THE UTERUS.

By far the most frequent displacements to which the uterus is liable are the downward and backward, namely, the various degrees of prolapsus, retroversion and retroflexion. But few if any troubles in the entire field of gynecology impose more of suffering and misery than is entailed by the consequences of these affections. The reflex disturbances and the general ill-health that usually follow often lead to melancholia, hysteria, and even more pronounced insanity. In many instances the physical health is wrecked, and the functions of the various systems of the body are so perverted as to lead to a condition of general impairment of nutrition, which predisposes to the activity of any inherited tendency to disease. I should like to emphasize the significance of the phrase, inflammatory consequences, in this connection; for it is to these that symptoms are chiefly due; for example, pelvic peritonitis, with adhesions binding the uterus,