Health Problem In Terms Research Articles

An Assessment of Magnitudes and Patterns of Socioeconomic Inequalities across Various Health Problems: A Large National Cross-Sectional Survey in Korea.

Magnitudes of health inequalities present consequences of socioeconomic impact on each health problem. To provide knowledge on the size of health problems in terms of socioeconomic burden, we examined the magnitudes and patterns of health inequalities across 12 health problems. A total of 17,292 participants older than 30 years were drawn from the Korea National Health and Nutrition Examination Survey (KNHANES, 2010–2012). The age-adjusted prevalence ratios were compared across socioeconomic positions (SEPs) based on income, education, and occupation. The magnitudes of socioeconomic inequalities varied across 12 health problems and, in general, the patterns of socioeconomic inequalities were similar among groups of health problems (i.e., non-communicable diseases (NCDs), mental health, and subjective health states). Significant health inequalities across NCDs, such as diabetes, hypertension, ischemic heart disease, and arthritis, were observed mainly in women. Socioeconomic inequalities in mental health problems, such as depression, suicidal ideation, and suicide attempts, were profound for both genders and across SEP measures. Significant socioeconomic inequalities were also observed for subjective health. No or weak associations were observed for injury and HBV infection. The patterns of socioeconomic inequalities were similar among groups of health problems. Mental illnesses appeared to require prioritization of socioeconomic approaches for improvement in terms of absolute prevalence and relative socioeconomic distribution.

Mental health problem or workplace problem or something else: what contributes to work perception?

Purpose: Work perception is an important predictor for work ability and, therefore, of interest for rehabilitation. Until now it is unclear to which extent different psychological aspects explain work perception. This study investigates in which way workplace problems on the one hand, and mental health and coping on the other hand, contribute to work perception.Methods: A heterogeneous sample of 384 persons in working age with and without mental health problems was recruited. Participants gave self-reports on workplace problems, mental health problems, work-coping, work-anxiety, and work perception.Results: Persons with mental health problems and workplace problems (M + W) perceive the highest degree of work demands, followed by persons with workplace problems but without mental health problems (NM + W). Work-anxiety appeared as the strongest factor explaining perception of high work demands, whereas general mental health problems did not contribute significantly to variance explanation.Conclusions: Persons with specific mental health problems in terms of work-anxiety may be expected to perceive higher work demands. They may be detected when asking for work perception, e.g., within the frame of return-to-work interventions in rehabilitation, or in occupational health settings by mental hazard analysis.Implications for rehabilitationWork perception is an important predictor for work ability. Work-anxiety plays a key role for work perception. Thus, work perception and work anxiety should be explored in the diagnostic phase of rehabilitation treatments.Work-anxiety should be considered not only in rehabilitation diagnostics and interventions in clinical settings, but considered in preventive activities at work: Self-ratings on work-anxiety and work perception (instead of general wellbeing) may be included in assessments for workplace exploration, or mental hazard analysis. They give hints concerning concrete work-related health problems.

Alendronate release from calcium phosphate cement for bone regeneration in osteoporotic conditions

Osteoporosis represents a major health problem in terms of compromising bone strength and increasing the risk of bone fractures. It can be medically treated with bisphosphonates, which act systemically upon oral or venous administration. Further, bone regenerative treatments in osteoporotic conditions present a challenge. Here, we focused on the development of a synthetic bone substitute material with local diminishing effects on osteoporosis. Composites were created using calcium phosphate cement (CPC; 60 wt%) and polylactic-co-glycolic acid (PLGA; 40 wt%), which were loaded with alendronate (ALN). In vitro results showed that ALN-loaded CPC/PLGA composites presented clinically suitable properties, including setting times, appropriate compressive strength, and controlled release of ALN, the latter being dependent on composite degradation. Using a rat femoral condyle bone defect model in osteoporotic animals, ALN-loaded CPC/PLGA composites demonstrated stimulatory effects on bone formation both within and outside the defect region.

INACTIVATION OF PISTACHIO CONTAMINANT ASPERGILLUS FLAVUS BY ATMOSPHERIC PRESSURE CAPACITIVE COUPLED PLASMA (AP-CCP)

Aspergillus flavus toxin contamination of pistachio nuts is a serious problem in terms of health and food security. In this paper, in order to increase the nut shelf life by eliminating or reducing the amount of toxin-producing fungus Aspergillus flavus, pistachios were irradiated with cold plasma, using Atmospheric Pressure Capacitive Coupled Plasma (AP-CCP) generating device using Argon gas. The advantages of this device are both its mobility, adjoining a nuts carrying container for thorough irradiation of the nuts and that the device can be designed in the form of an array of torches for treatment of large quantities of nuts in open air as against in a vaccum chamber. In this way, the sample of nuts are firstly soaked with fungus and then irradiated in different conditions in terms of power, pressure and time. The analysis of experimental results indicates 4 log (66.6%) fungus reductions. This pathogen reduction was observed in 100 Watts, at atmospheric pressure and irradiation duration of 10 minutes.

Trauma brain injury following a road traffic accident: Data from the Rhône Register, France

Introduction Road accidents cause serious cranial lesions and affect a young population. They constitute a major public health problem in terms of mortality and morbidity. The objective is to describe the cranial trauma resulting from a road accident according to the accidental and individual characteristics of the casualties, the severity of injuries and evolution in time. Methods The data come from the Rhone Register of victims from road traffic accidents. It is a permanent and exhaustive collection of any person killed or injured as a result of an accident occurring in the Rhone area. It has its source in the health environment. The information collected concerns the victim, his accident, his injuries and outcome. The lesions are coded according to the Abbreviated Injury Scale (AIS), which has six levels of severity ranging from 1 (minor) to 6 (fatal). The selected victims are those with cranio-encephalic lesions, injured during the period 2005–2014. Results Over the 2005–2014 period, the Registry counted 4913 victims with traumatic brain injuries. The average annual incidence is 28.5 traumatic brain injuries per 100,000 population. The sex ratio is 2.6. There is a shift in the peak of incidence between men and women, earlier and more marked in men (15–19 years) than women (20–24 years). Victims with traumatic brain injuries are mainly motorists (36%), followed by motorized two-wheelers (24%), pedestrians and cyclists (17% each). The lethality is 7.7%. Severe head injuries (AIS ≥ 3) were less observed in two-wheeled motorized helmet users: 26% versus 37% for those who did not wear a helmet. The base of the skull is more often injured than the vault. The most frequent intra-cranial lesions are, in order of frequency, subarachnoid hemorrhages (15%), brain contusions (8%), subdural haematomas (7%), cerebral edemas (6%), intracerebral haematomas (3%), and finally the extra-durals (3%). The injuries of cerebellum (2%) of brainstem (1%) and vascular nervous system (1%) are less frequent. The type of lesion varies according to the types of users: subdural haematomas are frequent in pedestrians; extra-dural haematomas are more common in motorized and non-motorized two-wheelers users; brain contusions are mostly observed in car occupants. Since 2005 there has been a decrease in head injuries (−48%) for motorists, (−38%) for pedestrians, (−20%) for motorized two-wheelers. It is less pronounced for the cyclists (−11%). This noticeable decline among motorists is due to the road safety policies implemented in France since 2002. Cyclists are hardly affected by this decline due to their increase in numbers, due to the introduction of self-service bikes and due to the fact that wearing the helmet are not mandatory. Conclusion Head injuries have almost divided by two among motorists, but efforts need to be made for vulnerable road users. An effective strategy for all types of users must prevail. A first measure taken in France in March 2017, making the use of bicycle helmets mandatory for children under twelve, could be evaluated in the following years on the incidence of head trauma.

Childhood trauma, pubertal timing, and cardiovascular risk in adulthood.

An association between childhood trauma and adult health outcomes has been widely reported, but little is known about the developmental pathways through which childhood trauma influences adult cardiovascular disease (CVD). Hypotheses were tested with a sample of 405 African Americans from the Family and Community Health Study (FACHS). Path modeling was used to test our theoretical model. Replicating prior research, exposure to childhood trauma was associated positively with increases in symptoms of CVD risk across young adulthood even after controlling for a variety of health-related and health behavior covariates. Further, the association of childhood trauma with CVD risk was mediated by early pubertal maturation. There were no gender differences in the magnitude of this effect. Our findings support an evolutionary-development perspective (Belsky & Shalev, 2016) suggesting that early adverse life experiences lead to early biologically embedded changes reflected in early physical maturation and that these early changes predict later negative adult health outcomes. The results imply that early pubertal maturation is a precursor to vulnerability to long term health problems. From an intervention standpoint, identifying such developmental pathways may help inform future health-promoting interventions. (PsycINFO Database Record

Abstract 695: Exposure to World Trade Center (WTC) dust initiates a pro-cancer inflammatory signature in mice

Abstract The World Trade Center destruction exposed many individuals to chemicals associated with inflammation and cancer including insulation fibers, asbestos, glass fibers and dioxins. Though the exposure to WTC dust was short, responders experienced an acute intake of harmful dust particles may be at risk for developing long term health problems. To date, responders have shown higher rates of prostate and thyroid cancer compared to non-exposed individuals. Curiously, rates of lung cancer have not shown to increase. To model the effects of WTC dust exposure on inflammation and cancer, we have taken a genetic approach including treatment of Wt C57/Bl6j mice and mice with genetic predisposition to prostate or lung cancer. Using a dosing strategy consisting of 4 consecutive exposures to WTC dust (3 mg/30 ul in PBS dosed via nasal instillation), we assayed for changes in immune and inflammatory gene expression at short term (7 days post exposure) and longer (3 wks. post exposure) time points. RNAs from normal prostate, spleen, lung and blood were assessed using RT2 Profiler PCR Arrays (Inflammation Panel). Organs harvested from WTC dust treated mice showed increased expression of markers including prostate (Ctla4, Cxcl5, IL17a, Il6), lung (Cxcl5, Cxcr1, Bcl2l1), spleen (Ccl20, Cxcl11, Ccl28, Il17a) and blood (Il6) when normalized to PBS controls. As an extreme test of WTC dust effects in a target organ, WTC dust was introduced directly to the mouse prostate (4 mg, orthotoptic injection), resulting in significantly increased prostate size associated with marked elevation of inflammatory/immune gene expression (Cxcl5, Il17a, Ccl20, Il6, Ifng). Histological analysis showed massive immune cell infiltration as well as increased proliferation of prostate epithelia (5-7% Ki67+) compared to PBS controls (0.1%). Collectively, these data indicate that WTC dust can induce a strong inflammatory response systemically or by contact with the cells of the prostate. To determine whether WTC dust exposure promotes cancer progression, we applied two genetically mouse (GEM) models of cancer susceptibility. These include use of prostate specific Cre recombinase (Probasin Cre), to induce susceptibility to prostate cancer by loss of function of key tumor suppressors (Ptenloxp/Wt, p53loxp/Wt) or activation of oncogenes (Krasloxp-G12D) but also to induce cancer susceptibility in lung in a GEM model with Adeno cre virus mediated excision of p53loxp/Wt and KrasG12D. These studies indicate that WTC dust exposure is capable of inducing a strong inflammatory response in mice including elevated expression of multiple cytokines that are associated with human cancer progression. Current studies will determine whether WTC dust exposure can induce cancer or promote progression in responders with or without genetic susceptibility to tumorigenesis. Citation Format: Lin Wang, Andriy Kobryn, Kyeongah Kang, Emanuela Taioli, William Oh, Paolo Boffetta, Shu-Hsia Chen, Stuart Aaronson, David J. Mulholland. Exposure to World Trade Center (WTC) dust initiates a pro-cancer inflammatory signature in mice [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 695.

The Effect of Resveratrol in the Proliferation and Autophagy of Breast Cancer Cell Lines

Breast cancer (BC) is one of the most universal malignant tumors of worldwide in women and it is a significant public health problem in terms of both morbidity and mortality. BC is the second leading cause of death among American women. It is estimated 250,000 new cases of invasive BC will be diagnosed in women in 2017. For instance, there still existing the need for developing or identify new effective compounds to fight this disease. For example resveratrol, which is a plant derived polyphenol with anti‐estrogenic and antioxidant properties. In‐vitro studies indicated resveratrol has anticancer properties such as cell cycle arrest, apoptosis induction, prevention of DNA damage, and angiogenesis inhibition. However, scientific literature studying the effect of resveratrol on DNA synthesis and in autophagy is limited. For this reason we studied the effect of resveratrol in the proliferation of three breast cell lines CCD‐1074 (non‐malignant cells), CCD‐1097 (transitional cells), and MCF‐7 (malignant non‐invasive cells); and autophagy induction in the MCF‐7 cell line. We hypothesized that resveratrol will decrease cell proliferation and increase autophagy in BC cells when compared to control treatments. We studied the proliferation effect in cells treated with resveratrol at 25, 50, 100, 200 μM during 24 hours post treatment. We used Bromodeoxyuridine (BrdU) and the detection of translocation of LC3 via flow cytometry to study proliferation and autophagy, respectively. Our results showed a significant decrease in cell proliferation at resveratrol concentrations of 100 and 200 μM across all cell lines when compared to the vehicle control (p<0.05). Importantly, at 50 μM resveratrol affected only transitional and malignant cell lines without affecting our non‐malignant cell line. Induction of autophagy was significantly higher when MCF‐7 cells were treated with 100 μM and 200 μM compared to the vehicle control (p <0.05). However, we are currently in the process of evaluating the effects of resveratrol in other malignant and non‐malignant cell lines. We consider that the 50 μM concentration as a possible therapeutic window selectively to inhibit cell proliferation and induce autophagy.Support or Funding InformationDo not applyThis abstract is from the Experimental Biology 2018 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.

Common Sleep, Psychiatric, and Somatic Problems According to Work Schedule: an Internet Survey in an Eastern European Country.

A wide range of health problems was investigated, aiming to identify the presence and severity of a set of self-reported and common sleep, psychiatric, and somatic health problems among working professionals in four different shift schedules (morning, evening, rotating, and day) in several cities in Romania. A heterogeneous sample of 488 workers of different professions completed online a battery of tests, namely the Basic Nordic Sleep Questionnaire, the Parasomnia Questionnaire, the Epworth Sleepiness Scale, and the Patient Health Questionnaire, designed to identity symptoms of insomnia, sleepiness, snoring, parasomnia, as well as of depression, anxiety, eating, somatoform, and alcohol use disorders, respectively. The timing and the duration of the sleep, along with the presence of high blood pressure and type 2 diabetes mellitus were also inquired. The prevalence of the different health problems in relation to the type of shift schedule was evaluated with the Pearson Chi-square test. ANOVA was used to calculate the significance of the difference between the means, while associations with different health problems were estimated by binary logistic regression. The most common mental health problems were depression (26%), insomnia (20%), alcohol misuse (18%), and anxiety (17%). No significant differences based on the type of shift in terms of health problems were found, except for high blood pressure and symptoms of panic disorder that were more frequently reported by the workers in early morning shifts. Together with the workers in rotating shifts, they also reported increased sleepiness, poorer sleep quality, and shorter sleep duration. In contrast, the workers in evening shifts reported less severe health problems and longer sleep duration. Working in early morning shifts was found to be associated with poorer health outcomes, while working in rotating and early morning shifts with more severe sleep-related problems.

A qualitative study of health care providers\u2019 perceptions and experiences of working together to care for children with medical complexity (CMC)

BackgroundChildren with medical complexity (CMC) have a wide range of long term health problems and disabilities that have an adverse impact on their quality of life. They have high levels of family identified health care needs and health care utilisation. There is no Australian literature on the experiences of health care providers working in the Australian tertiary, secondary and primary health care system, whilst managing CMC. This information is essential to inform the design of integrated health care systems for these children. We address this knowledge gap by exploring the perceptions and experiences of health care providers on the provision of health care for CMC aged 0 to 18 years.MethodA qualitative research study was undertaken. Stakeholder forums, group and individual in depth interviews were undertaken using a semi-structured interview guide. The stakeholder forums were audio recorded and transcribed verbatim. Field notes of the stakeholder forums, group and individual interviews were taken. Inductive thematic analysis was undertaken to identify key themes.ResultsOne hundred and three providers took part in the stakeholder forums and interviews across 3 local health districts, a tertiary paediatric hospital network, and primary health care organisations. Providers expressed concern regarding family capacity to negotiate the system, which was impacted by the medical complexity of the children and psychosocial complexity of their families. Lack of health care provider capacity in terms of their skills, time and availability to manage CMC was also a key problem. These issues occurred within a health system that had impaired capacity in terms of fragmentation of care and limited communication among health care providers.ConclusionWhen designing integrated care models for CMC, it is essential to understand and address the challenges experienced by their health care providers. This requires adequate training of providers, additional resources and time for coordination of care, improved systems of communication among services, with timely access to key information for parents and providers.

Retracted: MicroRNA‐29b‐3p prevents Schistosoma japonicum‐induced liver fibrosis by targeting COL1A1 and COL3A1

Schistosomiasis is one of the world's major public health problems in terms of morbidity and mortality, causing granulomatous inflammation and cumulative fibrosis. This study explored in vivo and vitro effects of miR-29b-3p in granulomatous liver fibrosis by targeting COL1A1 and COL3A1 in Schistosoma japonicum infection. Thirty male Balb/c mice were assigned to normal control and model (percutaneous infection of cercariae of S. japonicum) groups. NIH-3T3 mouse embryonic fibroblasts were designated into blank, NC, miR-29b-3p mimic, TGF-β1, TGF-β1 + NC, and TGF-β1 + miR-29b-3p mimic groups. HE and Masson staining were employed to observe the pathological changes and collagenous fibrosis. The expression of α-SMA, COL1A1, COL3A1, TIMP-1 was determined by immunohistochemistry. The RT-qPCR, Western blotting and immunofluorescence staining were conducted to determine expression of miR-29b-3p, COL1A1, and COL3A1. CCK-8 assay and flow cytometry were performed to evaluate viability and apoptosis. The relative expression of miR-29b-3p decreased in the model group. The model group showed marked fibrosis in liver tissues. The expression of α-SMA, COL1A1, COL3A1, TIMP-1 was higher in the model group than that in the normal control group. Dual luciferase reporter gene assay revealed that miR-29b-3p directly targeted COL1A1 and COL3A1. Compared with the blank, NC, TGF-β1 and TGF-β1 + NC groups, the miR-29b-3p mimic group exhibited up-regulated expression of miR-29b-3p and MMP-9 but down-regulated expression of TIMP-1, HSP47, α-SMA, COL1A1, and COL3A1; while lower cell viability but higher apoptosis rate showed. It indicated that miR-29b-3p prevents S. japonicum-induced liver fibrosis by inhibiting COL1A1 and COL3A1.

Impact of the National Population Register in Improving the Health Information System of Malignant Diseases in Kosova.

Introduction:Malignant diseases are serious socio-medical problem, being that they cause grave problems in terms of health, social and economic perspective to an individual, in particular, and society in general. A proper reporting and monitoring system enables adequate calculation of indicators and evidence based decision making.Aim:The study aims to examine the appearance of malignancies diagnosed and reported in Kosovo for a three years period: 2012, 2013, and 2014 by its modalities such as by the years of appearance, gender, age, and most frequent types of malignancies.Material and methods:The study is a retrospective cohort research whereas source data we used are reports of malignant diseases from National Cancer Register (NCR) in the Health Information System (HIS) at the National Institute of Public Health of Kosova (NIPHK).Results and discussions:In Kosova during years 2012, 2013 and 2014 a total of 7437 cases of malignant diseases were reported; in 2012 were 31%, in 2013 were 24.3%, and during 2014 higher number of cases were reported, 3320 or 44.6%. During the reporting period, the appearance of malignant diseases in both sexes is about equal, with a light predominance of male cases with 50.8% (or 3780 cases), while by age group were represented with the elderly, from ages 50 to 79 years with 5111 cases or 68.8% of total malignancies.Conclusion:The highest number of malignant diseases was reported during year 2014 due to better reporting through HIS and NCR. Malignancies attacked both genders equally, whereas the most common types of malignancies were: melanoma and other malignant neoplasms of the skin, malignant diseases of the respiratory and intrathoracic organs, digestive tract, breast and female genital tract. The most affected the older ones.

Prevention of Catheter Associated Urinary Tract Infection (CAUTI)

Urinary tract infections (UTIs) are a major public health problem in terms of morbidity and incur the highest total health care cost among urological diseases, exceeding that of chronic renal failure even when renal dialysis and renal transplantation are included. This study was conducted to assess the practice of staff nurses regarding prevention of UTI in clients with indwelling catheter.

Assessment of Relationship between Vitamin D Deficiency and Pain Severity in Patients with Low Back Pain: A Retrospective, Observational Study.

Background:Vitamin D is associated with musculoskeletal function in our body, and its deficiency is a common health problem all over the world. Low back pain (LBP) is an important health problem in terms of low quality of life, loss of work power, and cost of diagnosis and treatment approaches.Aims:The purpose of this study is to investigate the relationship between pain severity and Vitamin D deficiency in patients who applied to pain polyclinic with LBP.Settings and Design:This was a retrospective, observational study.Subjects and Methods:The files of patients aged between 18 and 70 years who applied to our hospital between January and February 2018 were examined retrospectively by a specialist. Serum 25-hydroxyvitamin D (25(OH)D) level, Visual Analogue Scale (VAS), age, education level, marital status, working status, and body mass index (BMI) values recorded in patient files were included in the study. The limit value of Vitamin D was accepted as 20 ng/mL. Patients were divided into two groups according to their levels of Vitamin D. Patients with serum 25(OH)D levels below 20 ng/mL were considered as the deficiency of Vitamin D (Group 1) and patients with 20 ng/mL and over 20 ng/mL values were considered as normal in terms of Vitamin D (Group 2).Statistical Analysis Used:Descriptive statistical data were presented as mean, standard deviation, numbers, and percentage. There was no difference between the normally distributed group and the non-normally distributed group in terms of vitamin D levels. To compare the frequencies, the Chi-square test was used. To define the linear association between independent variables and Vitamin D level, Spearman's rho correlation coefficients were calculated.Results:The level of Vitamin D was measured in 98 patients aged 18–70 years who applied to our hospital's polyclinic due to LBP during the study period. The deficiency of vitamin was detected in 84 (85.7%) of the patients, while Vitamin D was found in 14 (14.3%) as normal. Groups were similar in terms of age, gender, BMI, educational level, marital status and working status (p> 0.05); however, there was a statistically significant difference between the two groups in terms of VAS score and levels of Vitamin D (P < 0.001 and P < 0.001, respectively). While there was a negative correlation between D vitamin level and VAS score (r = −0.594, P < 0.001), there was no correlation between age, gender, BMI, education level, marital status, and working status (P > 0.05).Conclusions:The deficiency of Vitamin D is often asymptomatic, and also, it can cause bone and muscle pain. In our study, we determined that the severity of pain increased in patients with LBP as the deficiency of Vitamin D increased. For this reason, we recommend to be evaluated the level of Vitamin D in patients with LBP.

Knowledge Attitude and Practice towards Visceral Leishmaniasis among Residents and Health Professionals in Welkait District, Western Tigray, Ethiopia

Visceral Leishmaniasis is becoming a major public health problem both in terms of geographical spread and incidence in Ethiopia although failed to attract the attention it deserves. Magnitude,public health impact and dynamics of the disease in Ethiopia are not well studied. Hence,this study was conducted in Welkait district to determine public awareness about the disease. Wekait is a highly productive area having a conducive environment for the spread of the parasite. A cross sectional study was employed in purposively selected sub-districts in which house to house survey was carried out using a pre-tested semi-structured questionnaire. A total of 288 participants (264 household heads and 24 health professionals) were interviewed to assess their knowledge, attitude and practice towards visceral leishmaniasis. Overall score of the participants showed that 59%, 95% and 53% of them were knowledgeable have positive attitude and good practice on visceral leishmaniasis, respectively. Sex, educational status and history of travel profile showed significant association with the knowledge of participants. The study also revealed a gap in the knowledge and practices of health professionals about the disease. The present study highlighted an overall positive attitude regarding the disease. However, the gap in knowledge and poor practice calls for an intervention to improve the public awareness regarding visceral leishmaniasis in the study area.

DNA damage and repair proteins in cellular response to sulfur mustard in Iranian veterans more than two decades after exposure

Delayed effects of sulfur mustard (SM) exposure on the levels of five important damage/repair proteins were investigated in 40 SM-exposed veterans of Iran-Iraq war and 35 unexposed controls. A major DNA damage biomarker protein – phosphorylated H2AX – along with four DNA repair proteins in cell response to the genome damage MRE11, NBS1, RAD51, and XPA were evaluated in blood lymphocytes from the veterans and controls using western blotting. Mean levels of XPA, MRE11, RAD51 and NBS1 were lower in SM-exposed patients and the decrease in NBS1 was significant. Even though the raised level of phosphor-H2AX in SM-poisoned group compared to the controls was not significant it was consistent with DNA damage findings confirming the severity of damage to the DNA after exposure to SM. There were correlations between the values of RAD51 and NBS1 proteins as well as XPA and MRE11 proteins. More than two decades after exposure to SM, there is still evidences of DNA damage as well as impaired repair mechanisms in cells of exposed individuals. Such disorders in cellular level may contribute to long term health problems of the SM veterans.

Mental Health and Mental Disorder Recommendation Programs.

Background: The characteristic differences among the Greater Mekong Subregion (GMS) countries in terms of trade and investment, society and cultural values, medical information and technology, and the living and working environ-ment have become major health problems in terms of mental disorders. The purpose of this article is to identify the gaps in those aspects, to propose mental health and mental disorder recommendation programs, and to recommend policies for policy makers and research investors.Methods: A comparative analysis and literature review of existing policy, including overviews of previous research were used to generate a synthesis of the existing knowledge of the mental health and mental disorder recommendation programs.Results: The review results recommend mental health and mental disorder programs for policy makers, research investors, and stakeholders in order to strengthen the directions for implementing these programs in the future.Conclusion: The healthcare provision in each country will not be limited only to its citizens; the healthcare markets and tar-get groups are likely to expand to the neighboring countries in the context of changes in domestic and international factors, which have both positive and negative impacts according to the political, economic, and social situations of the influencing countries.

Bel ve sırt ağrısı olan hastada muhtemel faktör: D vi̇tami̇ni̇ eksi̇kli̇ği̇

Aim: Vitamin D is associated with many musculoskeletal system functions and its deficiency is a common health problem in the world. Lowback and back pain arealso an important health problems in terms of low quality of life, cost of labor loss, diagnosis and treatment approaches. The aim of this study was to investigate the deficiency of vitamin D in patients with complaints of lowback or back pain. Methods: The outpatients between 18-45 years of age, whose vitamin D levelsaremeasured in 2015, were scanned through the hospital information system. Serum 25-(OH) D levels below 20 ng/mL wereconsidered as vitamin D deficiency, 20 ng / mL and above were normal. Patients were divided into two groups according to the presence of pain. The patients who were with lowback or back pain were treated as group 1, and patients who did not complain pain as group 2. Group 1 and group 2 were compared in terms of the presence of vitamin D deficiency. In the analysis of the data, descriptive statistics, mean and standard deviation for continuous variables, and number and percentage for categorical data were used. Chi-square test was used for comparisons. Significance was assessed at a 95% safety interval and p <0.05 was considered as significant. Results: Vitamin D levels were measured in 28,148 of the patients between the ages of 18 and 45 who applied to our hospital during the study period. Vitamin D deficiency was 84.5% in group 1 patients whereas it was 75.7% in group 2 patients. A statistically significant difference was found in patients with lowback or back pains, with a higher incidence of vitamin D deficiency compared to the other group (p = 0.001). Conclusion: Vitamin D deficiency is often asymptomatic and may cause bone and muscle pain. In our study, we frequently observed deficiency of vitamin D in patients with lumbar or back pain. In this context, the level of vitamin D should be evaluated during the approach to lowback and back pain.

THE COMPLIANCE TREATMENT OF A PULMONARY TUBERCULOSIS PATIENTS AT TRIENGGADENG COMMUNITY HEALTH CENTER REGENCY OF PIDIE JAYA

Pulmonary Tuberculosis (TB) is still a public health problem in the world. Not only in the world, in Indonesia is also a public health problem both in terms of mortality, the incidence of the disease and its diagnosis and treatment. A lot of factors affect whether a person is obedient and submissive in treatment of pulmonary TB disease, which are due to the role of health workers, the role of the PMO (supervisors of taking medicine), distance and knowledge of the patient. Pulmonary tuberculosis patients must be able to do the treatment on an ongoing basis, where the treatment is done for 6 months without stopping. Noncompliance treatment of pulmonary tuberculosis patients can increase the number of smear-positive pulmonary tuberculosis patients. Keywords: Compliance treatment, age, distance, PMO's role and the role of health workers

Serological investigation of visceral Leishmania infection in human and its associated risk factors in Welkait District, Western Tigray, Ethiopia

Visceral leishmaniasis (VL) is major neglected public health problem in terms of geographical spread and incidence in Ethiopia. Magnitude, public health impact and dynamics of VL were not well studied in Welkait District, Western Tigray, though the area is known for VL. Hence, this study aimed to determine sero-prevalence of human VL and associated risk factors in Welkait as new foci. A cross sectional study design was employed in this study. Two stage stratified random sampling method was used to select study participants. Hence, a total of 329 human study participants were included for serological survey using ITleish and leishmanin skin tests. Semi structured questionnaire was also used to identify VL associated risk factors. Univariate and multivariate logistic regression statistical methods were used to determine the degree of association. The overall sero-prevalence of human VL in the study area was found to be 8.81%. Statistical significant difference in the prevalence of the disease was found among Sub-districts, sex, re-settlement, sleeping outdoor and dog ownership (P<0.05). Participants who resettled from their original place were found 2 times (AOR=2.143; 95% CI=1.02, 14.20) more vulnerable to VL infection. Those who had an experience of sleeping outdoor were found almost 4 times (AOR=4.29; 95% CI=1.58, 11.69) more likely to be at risk of acquiring VL infection than those sleep indoor. Furthermore, individuals who owned dogs were 3 times more prone to the VL infection than their counterparts (AOR=3.37; 95% CI=1.29, 8.76). Alarming sero-positivity of human VL was recorded from new foci. Hence, it is recommended to improve the VL health services in the study area. The investigation also invites further study on VL dynamics in the study area.