Good Health Status Research Articles

Patient report outcomes in cryoballoon ablation of atrial fibrillation during the COVID Era: Insights from the 1STOP project.

Pulmonary vein isolation by cryoablation (PVI-C) is a standard therapy for the treatment of patients with symptomatic atrial fibrillation (AF). AF symptoms are highly subjective; however, they are important outcomes for the patient. The aim is to describe the use and impact of a web-based App to collect AF-related symptoms in a population of patients who underwent PVI-C in seven Italian centers. A patient App to collect AF-related symptoms and general health status was proposed to all patients who underwent an index PVI-C. Patients were divided into two groups according to the utilization of the App or the non-usage. Out of 865 patients, 353 (41%) subjects composed the App group, and 512 (59%) composed the No-App group. Baseline characteristics were comparable between the two cohorts except for age, sex, type of AF, and body mass index. During a mean follow-up of 7.9±13.8 months, AF recurrence was found in 57/865 (7%) subjects with an annual rate of 7.36% (95% CI:5.67-9.55%) in the No-App versus 10.99% (95% CI:9.67-12.48%) in the App group, p=0.007. In total, 14,458 diaries were sent by the 353 subjects in the App group and 77.1% reported a good health status and no symptoms. In only 518 diaries (3.6%), the patients reported a bad health status, and bad health status was an independent parameter of AF recurrence during follow-up. The use of a web App to record AF-related symptoms was feasible and effective. Additionally, a bad health status reporting in the App was associated with AF recurrence during follow-up.

Physical activity and quality of life of people aged 50 and over living with HIV/AIDS: A cross-sectional study in a cohort in Yaounde, Cameroon

IntroductionHIV infection has become a chronic disease. Management has shifted to the prevention and treatment of chronic diseases. Regular physical activity (PA) reduces the impact of HIV. Our objectives were to determine levels of PA, assess quality of life (QoL) and determine the degree to which Brief WHOQOLHIV domains and PA influence QoL in older PLHIV. MethodsWe conducted a cross-sectional study between March 2020 and March 2021 among 136 older PLHIV at Mvog Ada District Hospital in Yaoundé. Two questionnaires were administered to assess the level of PA (Ricci and Gagnon) and the brief WHOQOL HIV. A bivariate and multivariate analyses were performed. ResultThe mean age of the participants was 57.07 ± 6.7 years and the female/male ratio was 1.6. Physical inactivity was found in 56.60% of the participants; 43.40% of them felt they had a good quality of life and 65.40% had a good health status. The environmental domain and social relationship had low scores compared to the spiritual domain and the level of independence. Scores for the different domains were higher in active participants than in inactive participants; with the psychological domain more related to physical inactivity (p < 0.001). ConclusionPhysical activity remains very insufficient among PLHIV aged 50 years and over. There is a need to encourage regular physical activity among PLHIV, and adapted physical activity programs should be developed for people living with HIV in sub-Saharan countries.

Effectiveness of electronic patient reporting outcomes, by a digital telemonitoring platform, for prostate cancer care: the Protecty study.

The benefits of Electronic Patient -Reported Outcomes (e-PRO) for telemonitoring are well established, allowing early detection of illnesses and continuous monitoring of patients. The primary objective of the PROTECTY study was to assess the compliance with patient use of the telemonitoring platform Cureety. An exploratory objective was to assess if the first-month health status is a prognostic factor of progression free-survival (PFS) and overall survival (OS) for prostate cancer patient. This prospective study was conducted at the Military Hospital Bégin on prostate cancer patients. Patients were allowed to respond to a symptomatology questionnaire based on CTCAE v.5.0, personalized to their pathology and treatment. An algorithm evaluates the health status of the patient based on the reported adverse events, with a classification into 2 different states: Good Health Status (GHS) and Poor Health status (PHS). Sixty-one patients were enrolled between July 1st, 2020 and September 30th, 2021. The median age was 74.0 (range 58.0-94.0). 78% presented a metastatic stage, and the most represented cancer was mHSPC. Overall, 2,457 questionnaires were completed by the patients, 4.0% resulted in a health classification in to monitor or critical state. 87% of patients were classified in the GHS group. The compliance was 72% in the overall population during the first month, 71% in GHS group and 75% in PHS group. The median follow-up was 8 months. PFS at 6 months was 84% in GHS group vs. 57% in PHS group, p = 0.19. OS at 6 months was 98% in GHS group vs. 83% in PHS group, p = 0.31. Our study showed that compliance was satisfactory. The feasibility of remote monitoring for prostate cancer patients means that they should benefit from its implementation. Our study is also the first to assess the correlation between treatment tolerance and survival. The initial results suggest that e-PRO assessment could help identify in the early stages the patients that require further health assessment and potential therapeutic changes. While further follow-up of more patients will be required, our study highlights the importance of e-PRO in cancer patient care.

Medical Ethnobotany of the Bissau-Guinean Community of Migrants Living in Northern Italy and Comparison with the Ethnopharmacology of Guinea-Bissau.

This study compares the knowledge of medicinal plants of Bissau-Guinean migrants now established in Italy with the ethnopharmacology still present in their country of origin. We also investigated how traditional ethnobotanical knowledge is changing following the phenomenon of migration from Africa to Europe. The ethnobotanical data were collected during 2017-2018, by interviewing 49 informants belonging to 8 ethnic groups, living in 8 provinces of northern Italy. The final inventory of botanical taxa included 81 species belonging to 34 families, with Fabaceae and Malvaceae the most represented, followed by Euphorbiaceae, Apocynaceae, Combretaceae, and Solanaceae. Plant remedies were used to treat 21 ailment categories, such as fever, internal infections, intestinal and respiratory problems, and pains. The traditional ethnobotanical knowledge of Bissau-Guinean migrants in Italy was associated with gender, with women showing the highest knowledge. In addition, a negative relationship was observed between the maintenance of this knowledge and the number of years migrants have spent in Italy. Overall, a loss of knowledge was observed in the less numerous ethnic groups. However, traditional preparations based on plants from the country of origin are in general well preserved to maintain a good state of health. Our work could help in transferring to the next generation the cultural heritage of Bissau-Guinean people permanently moved to European Countries.

Measuring direct non-medical burden among patients with advanced non-small cell lung cancer in China: is there a difference in health status?

This study was conducted to estimate the direct non-medical cost of advanced non-small cell lung cancer (NSCLC) patients and explore whether its associated factors vary by health status. Data were obtained from 13 centers in five provinces for patients with advanced NSCLC in China. The direct non-medical cost of patients since the patients were diagnosed with NSCLC included the cost of transportation, accommodation, meal, hired caregiving, and nutrition. We measured patients' health status by EQ-5D-5L instrument and divided them into good (≥0.75) and poor (<0.75) groups based on the utility score. A generalized linear model (GLM) was used to assess independent associations between statistically significant factors and non-medical financial burden in health status subgroups. Data from 607 patients were analyzed. The direct non-medical cost associated with advanced NSCLC since diagnosis was $2,951 per case ($4,060 in the poor health group and $2,505 in the other), with nutrition costing the most. GLM results showed that residence(Urban area vs. Rural area: -1.038, [-2.056, -0.02]), caregivers' occupation type (Farmer vs. Employee: -1.303, [-2.514, -0.093]), hospitalization frequency (0.077, [0.033, 0.12]), average length of hospital stay (0.101, [0.032, 0.17]), and pathological type (Squamous carcinoma vs. Non-squamous carcinoma: -0.852, [-1.607, -0.097]) were independent factors influencing direct non-medical cost in the poor health group. Among participants with good health status, residence (Urban area vs. Rural area: -0.621, [-1.005, -0.236]), marital status (Others vs. Married: 0.762, [0.035, 1.488]), patients' employment status, current caregiving time per day (more than 9 hours per day vs. less than 3 hours per day: 0.471, [0.134, 0.807]), duration of disease (0.015, [0.007, 0.024]), and hospitalization frequency (0.091, [0.068, 0.113]) were statistically associated factors. The direct non-medical economic burden of advanced NSCLC patients in China is considerable and differs by health status. Strengthening accessibility for more effective therapies and early nutritional intervention to improve prognosis, and further promoting accessible care forms within relevant healthcare insurance coverage may be potentially feasible approaches to alleviate the direct non-medical economic burden for patients and their families.

Analysis of cork quality and cork tree health in stands of western Spain

Good knowledge of the factors that influence cork quality and the health of forests is essential when making decisions regarding the management of productive cork oak forests. The quality of cork planks depends on: plank thickness, plank porosity and the presence of anomalies. So far, no studies have evaluated cork quality based on cork anomalies, partly due to the difficulty of obtaining adequate data. In 1985, it was developed the first Cork Quality Field Assessment Plan (CQFAP) to provide information about the quality of harvested cork by collecting data of very high quality. This work analyzes the anomalies present in 2049 cork sampling units collected from ten stands under the CQFAP for the period 1986–2012 in three consecutive cork stripping cycles. Data on diseases, pests and stripping damages are also analyzed in the 654 trees where cork sampling units were collected in the third stripping cycle. Additionally, mean monthly temperature and precipitation values for the 35 years covering the three stripping periods were calculated. A progressive deterioration of cork quality was observed in the sampled cork oak stands. It was found a positive relationship between cork thickness and temperature indicating that the cork growing period could be extended when temperatures are moderate. Sampled cork oaks were more affected by Cerambycidae attacks and Coraebus undatus indicating their prevalent nature. The presence of Coraebus undatus were higher in stands with good health status. The studied diseases were Biscogniauxia mediterranea, Phytophthora sp. and fungi of the family Botryosphaeriaceae, finding a not previously reported correlation between the presence of Crematogaster scutellaris and the three studied diseases. Stripping damages increase with smaller cork thickness but climate is not a decisive factor for a proper stripping. Although having room for improvement, the CQFAP is proving to be an effective tool for assessing the quality of cork, the health status of cork oak forests and the evolution of these forests over time. The information provided could be also used to identify places worthy of further studying. The main recommendation for improving the CQFAP would be to monitor the same trees in each consecutive sampling for properly monitoring cork thickness and the presence of defects to be used as a proxy for tree health. Regarding forest management, the main recommendations would be to extend the length of stripping cycles to enhance cork production, and to use the new tools and systems for cork stripping to reduce damage.

Three-dimensional facial swelling evaluation of piezo-electric vs conventional drilling bur surgery of impacted lower third molar: a randomized clinical trial

BackgroundAmong the post-surgical complications of lower wisdom teeth surgery, swelling is considered by patients one of the most impairing, with both social and biological influences and impacting patients' quality of life. Aim of the study was to evaluate the swelling following the osteotomy when performed with drilling burs versus piezo-electric instruments in the mandibular impacted third molar extraction, using a facial reconstruction software.Materials and methodsA randomized, split-mouth, single-blind study was conducted on patients, ranging between 18 and 40 years of age, requiring lower third molars extraction and referred at the Oral Surgery Unit of the School of Dentistry of the University of Messina. Twenty-two patients were recruited during an 8 months period according to the following criteria: good general health conditions; bilateral, symmetrical, impacted third molars; no use of medication that would influence or alter wound healing; no temporomandibular joint disorder history; no smoking. All patients underwent bilateral surgical removal. For each patient, a facial scan was obtained prior to the surgical procedures. The two extractions were conducted performing, in a randomized way, osteotomy with rotatory burs or use of piezo surgical instruments. Facial scans were repeated at 3 and 7 days after the surgical procedures. Volumetric differences were calculated via superimposition using a dedicated software. The data obtained were processed using paired t-test.ResultsThe results obtained from our study showed no significant differences between two groups regarding post-operative swelling. To the best of our knowledge, this study represents the first experience of using an objective method that can be reproducible on the collection of patients' clinical parameters.ConclusionsThe 3D digital analysis, in the evaluation of facial swelling, is a technique of simple application, objective, reproducible, reliable, decreasing the variables of error.Based on these data, it is possible to conclude that piezo surgery is a safe way for performing the osteotomies during third molar surgery. However, regarding the post-operative swelling, it does not show an advantage over classical rotary instruments.Trial registrationRegistered on ClinicalTrials.gov (ID: NCT05488028, on 04/08/2022).Approved by Ethical Committee of Messina: (ID 01–2020, on 27/04/2020).

Sociobehavioral, Biological, and Health Characteristics of Riverside People in the Xingu Region, Pará, Brazil.

This study aimed to evaluate the sociodemographic, behavioral, and biological profile and its relationship with the emergence of chronic non-communicable diseases in riverside populations in the Xingu region, Pará, Brazil. Characteristics related to health indicators and which risk factors are considered most important were analyzed. This is a cross-sectional, exploratory, and descriptive study. The sample consisted of riverside people of over 18 years of both sexes. The sample size (n = 86) was calculated with a confidence level of 95% and a sample error of 5%. The K-means clustering algorithm was adopted through an unsupervised method to divide the groups, and the values were expressed as a median. For continuous and categorical data, the Mann-Whitney and chi-square tests were used, respectively, and the significance level was set at p < 5%. The multi-layer perceptron algorithm was applied to classify the degree of importance of each variable. Based on this information, the sample was divided into two groups: the group with low or no education, with bad habits and worse health conditions, and the group with opposite characteristics. The risk factors considered for cardiovascular diseases and diabetes in the groups were low education (p < 0.001), sedentary lifestyle (p < 0.01), smoking, alcoholism, body mass index (p < 0.05), and waist-hip ratio, with values above the expected being observed in both groups. The factors considered important so as to be considered to have good health condition or not were the educational and social conditions of these communities, and one part of the riverside population was considered healthier than the other.

Knowing nodal Rouviére: the power of human intelligence in toxicity reduction.

Patients with nasopharyngeal carcinoma (NPC) represent a distinct group of head and neck cancer patients. They are often non-smokers, non-drinkers, and on average 10 to 20 years younger than those with cancers of other head and neck sites. Given good baseline health status and the effectiveness of contemporary treatment [1], patients with NPC typically have long projected life expectancies and commonly develop late treatment adverse effects, such as dysphagia and swallowing dysfunction. Delineation and coverage of microscopic disease within the clinical target volume (CTV) are crucial in head and neck radiation treatment planning. The retropharyngeal lymph node (RPLN) is the first echelon nodal drainage for NPC. RPLN represents a special entity as they are usually not clinically detectable. Their diagnosis is based on computed tomography (CT) and magnetic resonance imaging (MRI). RPLN was identified almost one hundred years ago. French anatomist Henri Rouviére (1875-1952), through his extensive work in the delineation and classification of human lymph nodes using fresh cadavers, identified a set of lymph nodes in the lateral retropharyngeal space (RPS) [2]. These lateral RPLNs were later named nodes of Rouviére. The nodes of Rouvière, along with the medial RPLN, form the retropharyngeal nodal group, which is located within the RPS. Above the level of the hyoid, RPS contains RPLN and adipose tissues. At the infrahyoid level, the RPS contains only adipose tissues. It is a common practice to delineate the entire RPS up to the level of the hyoid as a CTV target. In this era when technology dominates the field of oncology, tremendous resources have been invested in the development of high-tech radiation delivery machines and pharmaceuticals. Much less effort has been put into the artistry of oncology, such as refining the delineation of target volumes in radiation planning, albeit a significantly less cost-effective and labor-intensive approach [3-6]. Recently, Mao et al. [7], in a multicenter randomized phase III trial, demonstrated how sparing of the medial retropharyngeal nodal group alone in radiation planning – a process that solely relies on human intelligence without any additional human effort or technological resources – results in 39% reduction in ≥ grade one clinician-rated acute dysphagia and 24% reduction in ≥ grade one weight loss. In addition, there was a significant improvement in patient-reported quality-of-life outcomes at 3 years, such as global health status, role-social function and swallowing function. No recurrence was observed in the medial RPLN sparing group. After adjusting for covariates, the regional relapse-free survival rates were similar in medial RPLN sparing and the medial RPLN non-sparing groups [7]. In the study by Mao et al. [7], utilizing the medial RPLN sparing approach, the mean dose to the middle pharyngeal constrictors decreased from 54 Gy to 49 Gy. Why would such a mild decrease in dose result in such modest improvement in clinician- and patient-rated swallowing function? It is a common misunderstanding that swallowing dysfunction from radiation is a direct result of muscle damage. The neural contribution of swallowing dysfunction is commonly overlooked. By sparing pharyngeal constrictor muscles, one also inevitably spares the pharyngeal nerve plexus, which lies on the posterior surface of the middle pharyngeal constrictor muscle. The pharyngeal nerve plexus contains fibers of cranial nerves IX, X, and superior sympathetic ganglion - the main sensory and motor nervous supply of the pharynx. Objective assessment of swallowing function using video fluoroscopic swallow study or high-resolution manometry of pharyngeal swallow pressure would help us to define the objective outcome of this medial RPLN and pharyngeal plexus sparing approach. Developmentally, medial RPLN undergoes atrophy before puberty, and it usually disappears by the age of 5. Lateral RPLN, however, persists in adulthood. Tumor involvement of the medial RPLN is very rare [8]. In a study of 3,100 newly diagnosed NPC, using contemporary MRI techniques, medial PRLN involvement was only identified in 0.2% of the patients, and they were all located at the level of the second or third cervical vertebra [8]. The group by Mao et al. [7], by leveraging and transferring the knowledge of lymphatic development and pattern of tumor spread – human intelligence – into clinical treatment planning and toxicity reduction. Much of the practice in medicine is based on myth and tradition. In the field of radiation oncology, it is common for clinicians to follow the one-size-fits-all rule by following national or protocol guidelines without understanding patterns of tumor spread or employing the-bigger-the-better approach while believing that a larger CTV would result in improved local control. It is not until we combine human intelligence with technological advancements will we see improved tumor control and quality of life in our patients. Annie W. Chan contributed substantially to the conception and drafted the article. The author has nothing to report. The author declares no conflicts of interest. Not applicable. Not applicable. Not applicable. Not applicable.

Case Report: Tracheal infiltration with wheezing revealing Hodgkin's disease

Hodgkin's disease with an initial tracheobronchial involvement is extremely rare. The symptoms might be misleading, resulting in a diagnosis delay. We report the case of a 38-year-old woman with a one-month history of wheezing and a non-productive cough. The physical examination revealed a good general state of health, bilateral diffuse wheezing and supra-clavicular lymphadenopathy. The adenopathy biopsy's histopathology revealed Hodgkin's disease. The whole body FDG-PET scan was an important tool to assess the diagnosis as well as for the staging. The patient was treated with chemotherapy. Another unusual aspect is the tracheobronchial metastasis confirmed by a bronchial biopsy. Thus, our patient was put on a second-line chemotherapy. She died one year after the initial diagnosis. To conclude, it is a rare case of an Hodgkin lymphoma with a tracheobronchial relapse. It should be considered in the differential diagnosis of a tracheal tumor.

The Role of Community Cohesion in Older Adults During the COVID-19 Epidemic: Cross-sectional Study.

The community environment plays a vital role in the health of older adults. During the COVID-19 epidemic, older adults, who were considered the most impacted and most vulnerable social group, were confined to their homes during the implementation of management and control measures for the epidemic. In such situations, older adults may have to contend with a lack of resources and experience anxiety. Therefore, identifying the environmental factors that are beneficial for their physical and mental health is critical. This study aimed to assess the association between community cohesion and the physical and mental health of older adults and to identify the related community services and environmental factors that may promote community cohesion. This community-based cross-sectional study was designed during the COVID-19 epidemic. A multistage sampling method was applied to this study. A total of 2036 participants aged ≥60 years were sampled from 27 locations in China. Data were collected through face-to-face interviews. The neighborhood cohesion instrument consisting of scales on 3 dimensions was used to assess community cohesion. Self-efficacy and life satisfaction, cognitive function and depression, and community services and environmental factors were also measured using standard instruments. Statistical analyses were restricted to 99.07% (2017/2036) of the participants. Separate logistic regression analysis was conducted to assess the association among community cohesion and physical and mental health factors, related community services, and environmental factors among older adults. The results showed that high levels of community cohesion were associated with good self-perceived health status and life satisfaction (odds ratio [OR] 1.27, 95% CI 1.01-1.59 and OR 1.20, 95% CI 1.15-1.27, respectively) and high levels of self-efficacy and psychological resilience (OR 1.09, 95% CI 1.05-1.13 and OR 1.05, 95% CI 1.03-1.06, respectively). The length of stay in the community and the level of physical activity were positively associated with community cohesion scores, whereas the education level was negatively associated with community cohesion scores (P=.009). Community cohesion was also associated with low levels of depression and high levels of cognitive function. Community cohesion was significantly associated with community services and environmental factors on 4 dimensions. High levels of community cohesion were associated with transportation services and rehabilitation equipment rental services as well as high levels of satisfaction with community physicians' technical expertise and community waste disposal (OR 3.14, 95% CI 1.87-5.28; OR 3.62, 95% CI 2.38-5.52; OR 1.37, 95% CI 1.08-1.73; and OR 1.23, 95% CI 1.01-1.50, respectively). Community cohesion was found to be associated with the physical and mental health of older adults. Our research suggests that enhancing community services and environmental resources may be an effective strategy to increase community cohesion during major infectious disease epidemics.

Long-term results of autologous periosteum-derived micro-grafts with poly(lactic-go-glycolic acid) in sinus lift augmentation surgeries: A 7-years follow-up observational study

Introduction and importanceThe study aimed to present the long-term results of autologous and homologous micrografts for bone regeneration aimed at positioning dental implants after sinus lift augmentation surgeries, by combining autologous Rigenera® micrografts with poly(lactic-go-glycolic acid). Case presentationA total of 5 patients (2 males and 3 females) from 36 to 71 years were involved in the observational study. All the patients showed a good health status system (ASA1 and 2), according to their clinical history with neither system diseases, nor under medication able to interfere with osseointegration. Clinical discussionThe radiographic evaluations, after the implant placement and during the continuous follow-up upto 7 years, were carried out through periapical endoral x-rays. The survival and implant success rate was 100 %. Histological analyses were performed after 3 and 7 months after the surgical procedure. ConclusionNo adverse events have been observed that can be traced back to the use of autologous micrografts with poly(lactic-go-glycolic acid), showing safety and predictable results even in long term.

A Practical Study of a Nursing Manpower Deployment Program Under Temporary Tasks

<i>Objective</i> We aim to investigate the practical methods and effects of hospital nursing manpower allocation under large temporary tasks and emergency situations of public emergencies. <i>Methods</i> A TFF nursing manpower deployment plan based on the principle of a three-level nursing management system, fixed and dedicated shift scheduling, and the assistance of flexible nurses was constructed. Under the condition of ensuring the normal work of in-hospital treatment, 936 nursing staff was flexibly deployed from the whole hospital to support large temporary tasks outside the hospital and emergency tasks of public emergencies. <i>Results</i> During the period of facing large temporary tasks, our hospital managed human resources from April to August 2022 on the basis of ensuring the quality and safety of in-hospital nursing work, and efficiently completed all emergency medical treatment tasks issued by the superior. The nursing staff was 95% satisfied with the manpower deployment program, and the SRQ questionnaire after reasonable manpower deployment showed that the nursing staff had good mental health status. <i>Conclusion</i> The TFF nursing manpower deployment program, with good operational effect, can smoothly cope with large temporary tasks like COVID-19, optimize nursing manpower organization and management, and complete large temporary rescue tasks in an efficient and orderly manner.

Establishment of an optimized guinea pig model of cisplatin-induced ototoxicity.

Cisplatin is among the most effective antineoplastic agents and has revolutionized the treatment of many cancer diseases. However, one of its serious side effects is a progressive and irreversible hearing loss, occurring in both adults and children. For the development of otoprotective therapies that prevent this side effect, cisplatin-induced hearing loss animal models are indispensable. Due to the high toxicity of cisplatin, the establishment of such animal models is a difficult and time-consuming task. Here we introduce the detailed protocol of a sophisticated guinea pig model with a sufficient and permanent hearing loss induced by cisplatin. This manuscript is intended to provide guidance in the development of future cisplatin guinea pig models which may reduce the mortality rate of the animals and help to gain more reproducible results. Pigmented and unpigmented guineapigs were treated with an intravenous single application of 8 mg/kg cisplatin under general anesthesia. An extensive and long-term intensive care protocol consisting of scheduled application of fluids, antiemetics, analgesics, glucose and supportive feeding among others, was used to ensure wellbeing of the animals. Hearing tests were performed prior to and 5 days after cisplatin application. Animals were then euthanized. The ABR audiometry 5 days after cisplatin application revealed a hearing threshold ranging from 70 dB to 90 dB in the frequencies from 1 kHz to 32 kHz respectively.All animals presented a good health condition despite the treatment with cisplatin. The introduced care protocol in this manuscript is intended to serve as a guidance for the establishment of a stable guinea pig model for short- and long-term investigation regarding the inner ear and its protection in the frame work of cisplatin-induced damage.

Factors Influencing the Purchasing and Consumption of Unprescribed Pharmaceutical Products in Africa

The proliferation of pharmaceutical shops, licensed chemical sellers with it attendant over-the-counter-drugs, the limited availability of health facilities and the vast difference between the cost of attending a hospital and the cost of buying known-drugs for use has necessitated the readily preference for majority of people in Africa particularly the middle and the low income groups to buy unprescribed medicines from pharmaceutical shops for use whenever they detect a family member or a relative is not in a good state of health. The researchers sought to find out factors influencing majority in Africa buying medicines from medical shops for use without prescription, an issue destroying the youth as a result of abuse and in some cases putting the health of many in danger due to the little know how of the sales attendants in the medical shops. A sample size of 200 was used with a non-probability sampling method used to gather data obtained and a descriptive analysis used. The researchers identified the need for cost reduction for treatment to encourage hospital attendance and about a 200 bed capacity hospital per thousand of every household should be a policy in Africa. That a prescription should be inspected by both the pharmaceutical shops and other retailers prior to sale of pharmaceutical products or medicines. Keywords: pharmaceutical shops, medicines, self-medication, consumption, unprescribed

A baseline for the monitoring of Mediterranean upper bathyal biogenic reefs within the marine strategy framework directive objectives

The Marine Strategy Framework Directive (MSFD, 2018) was adopted to achieve a Good Environmental Status (GES) in the EU's marine waters and to protect resources and ecosystem services, including the deep-sea waters and seafloor. The deep sea (below 200 m) is the largest biome on Earth, and its biodiversity plays a key role, despite being strongly threatened by several anthropogenic stressors, potentially affecting some ecosystem functions. Among the main deep-sea structuring species, the habitat-forming cold-water corals (CWCs) are known to form Vulnerable Marine Ecosystems (VMEs). In the Mediterranean Sea, in the last two decades, a significant effort has been devoted to unveiling the distribution, extension and ecological role of scleractinian CWCs (Madrepora oculata and Desmophyllum pertusum), but quantitative data on their conservation status are very limited. Because of their ecological importance and vulnerability, Italy has extended the implementation of the MSFD to the deep sea, carrying out specific monitoring programmes on these scleractinian CWCs. In this regard, this study established, for the first time, an extensive standardized baseline for national monitoring programmes focusing on two recently discovered upper bathyal areas dominated by scleractinian CWCs (Dohrn Canyon and Corsica Channel). The goal was to evaluate the ecological status of the bathyal biogenic reefs using traditional diversity and impact variables as well as the innovative photogrammetry tool. In both areas, the investigations have increased the knowledge about the extent of the habitat and new CWC assemblages in good health conditions were discovered. The pressure extent is limited with respect to the total extent of the CWC habitat, accounting for approximately 32% and 63% of the fishing-related items entangled on structuring species. The photogrammetric approach showed a deviation of about 33% in the measurement of the population size structures. Moreover, the use of a standardised operative protocol has been proposed to obtain reliable, coherent, and comparable data for future monitoring activities. This approach improved scientific knowledge for the two studied areas and it is pivotal in defining long-term monitoring activities useful to assess the effectiveness of specific protection measures, for these VMEs.

Smart Aquarium Monitoring System Using IoT

Abstract: Smart aquarium monitoring system is an automatic system that is taking care of the pet fish in the aquarium is a tedious process and should be properly set up and maintained in a healthy manner or else the fish will be destined for an unpleasant and short period of life. Therefore, it is critical to monitor aquarium conditions and improve the water quality of the mini aquarium tanks. Fishes require the utmost care, they need some specific conditions like a temperature level, pH, and suitable oxygen. The aquarium in which they are kept should contain proper monitoring parameters to keep it in good health condition. The parameters include automatic fish feeding motor temperature, pH, and dissolved oxygen level indicators. They can be accessed through a database that stores the values determined by the indicators where we can connect the database to the developed IoT mobile application and get information in mobile. This reduces human effort and errors in owning an aquarium full of aquatic animals and prevents unusual death of fish.

Common Health Education Needs of Children and Adolescents with Chronic Complex Diseases and Their Families

Introduction: Chronic complex diseases during childhood and adolescence are associated with morbidity and mortality, and present an emotional and social burden for patients and caregivers. Health education in self-care activities and patient empowerment are essential aspects in improving the quality of life of this population. Children and adolescents with chronic complex diseases, as well as their families, tend to present common health education needs related to disease management and patient’s empowerment. Objective To identify the common health education needs of children and adolescents with chronic complex diseases and their families. Materials and Methods Qualitative design study though two focus groups with 15 family members and patient representatives. Setting Sant Joan de Déu Children’s Hospital, Barcelona (Spain). Period of the study: From November 2021 to March 2022. The Study was Carried out in Three Phases 1) Review of bibliographic and grey literature 2) Field work: design implementation, data collection and analysis 3) Development of recommendations. Results Patients and families need to receive training and education on the patient’s disease and medical devices, as well as clear information at the beginning of the disease process. It is important to maintain the main caregiver’s good health status and well-being. The patient-provider relationship and patient’s relationship with friends and school are essential to achieve a good adaptation to the recovery process. Information on economic and social aids for families is necessary. The mixed format combining face-to-face and online sessions is the most preferable for patient and family health education. Conclusions: It is important to develop basic content for all patients and family members about common health education needs, regardless of the specific pathology they present. This training must include caring for emotions, psychological support and well-being; as well as the main aids or resources available for patients and families, among other topics of interest.

Common health education needs of children and adolescents with chronic complex diseases and their families

Introduction: Chronic complex diseases during childhood and adolescence are associated with morbidity and mortality, and present an emotional and social burden for patients and caregivers. Health education in self-care activities and patient empowerment are essential aspects in improving the quality of life of this population. Children and adolescents with chronic complex diseases, as well as their families, tend to present common health education needs related to disease management and patient’s empowerment. Objective To identify the common health education needs of children and adolescents with chronic complex diseases and their families. Materials and Methods Qualitative design study though two focus groups with 15 family members and patient representatives. Setting Sant Joan de Déu Children’s Hospital, Barcelona (Spain). Period of the study: From November 2021 to March 2022. The Study was Carried out in Three Phases 1) Review of bibliographic and grey literature 2) Field work: design implementation, data collection and analysis 3) Development of recommendations. Results Patients and families need to receive training and education on the patient’s disease and medical devices, as well as clear information at the beginning of the disease process. It is important to maintain the main caregiver’s good health status and well-being. The patient-provider relationship and patient’s relationship with friends and school are essential to achieve a good adaptation to the recovery process. Information on economic and social aids for families is necessary. The mixed format combining face-to-face and online sessions is the most preferable for patient and family health education. Conclusions: It is important to develop basic content for all patients and family members about common health education needs, regardless of the specific pathology they present. This training must include caring for emotions, psychological support and well-being; as well as the main aids or resources available for patients and families, among other topics of interest.

Moderate Beer Consumption Is Associated with Good Physical and Mental Health Status and Increased Social Support

There is little large-scale evidence on the effect of alcoholic beer consumption on physical, mental and, above all, socio-emotional health. Here, we conducted a secondary data analysis of the 2012 and 2017 National Health Surveys with 33,185 individuals aged 18 years and older to assess beer consumption in relation to self-perceived health, functional limitations, mental health, and social support. Logistic regression models assessed the association of alcohol consumption (abstainers, ex-drinkers, occasional drinkers, moderate beer drinkers, and heavy beer drinkers) with self-perceived health (poor or good), limitations of type (none, physical, mental, or both) and intensity (none, mild, or severe), mental health (poor, average, or good) and social support (poor, average, or good). Analyses were adjusted for sex, age, occupational social class, educational level, place of residence, survey, part-time physical activity, dietary information, smoking, and body mass index. Compared to abstainers, occasional and moderate beer drinkers were associated with better mental and self-perceived health and social support, and were less likely to report mild or severe physical limitations. In contrast, former drinkers were associated with worse indicators of self-perceived health, physical health, mental health, and social support than abstainers. Alcoholic beer consumption showed a J-shaped relationship with self-perceived, physical, mental, and social-emotional health, with better values at moderate levels.