Quality Health Research Articles

Preparedness of Filipino Neurologists on the Provision of Medical Care Toward Patients of the Lesbian, Gay, Bisexual, Transgender, Queer Plus Community

ABSTRACT The study aimed to describe the preparedness of active members of the Philippine Neurological Association (PNA) in providing medical care to LGBTQ+ patients. We electronically sent out a 21-item self-administered online survey adapted from the 2019 American Academy of Neurology LGBTQ+ Survey Task Force to 511 active members of PNA that included questions about demographic information, knowledge, attitude, and clinical practices. Descriptive statistics were used to analyze variables. Text responses were transcribed and summarized. Seventy-nine (15.5%) of 511 PNA members participated. Most participants were aware of local (53%) and national (56%) barriers that preclude patients in the LGBTQ+ sector from accessing quality health care. The majority (90%) of participants agreed that LGBTQ+ patients experience disproportionate levels of physical and psychological problems. Forty-two percent (42%) of respondents believed that sexual and gender issues have no bearing on neurological management, although a majority (53%) reported individualizing their management considering these issues. The majority were cognizant of the challenges that LGBTQ+ patients face in the health care system. However, awareness has not translated into modifications in neurological management. The openness of the participants to educational opportunities concerning health care related to LGBTQ+ can be leveraged to address this gap.

A qualitative study of the barriers and facilitators impacting the implementation of a quality improvement program for emergency departments: SurgeCon

BackgroundThe implementation of intervention programs in Emergency Departments (EDs) is often fraught with complications due to the inherent complexity of the environment. Hence, the exploration and identification of barriers and facilitators prior to an implementation is imperative to formulate context-specific strategies to ensure the tenability of the intervention.ObjectivesIn assessing the context of four EDs prior to the implementation of SurgeCon, a quality improvement program for ED efficiency and patient satisfaction, this study identifies and explores the barriers and facilitators to successful implementation from the perspective of the healthcare providers, patients, researchers, and decision-makers involved in the implementation.SettingsTwo rural and two urban Canadian EDs with 24/7 on-site physician support.MethodsData were collected prior to the implementation of SurgeCon, by means of qualitative and quantitative methods consisting of semi-structured interviews with 31 clinicians (e.g., physicians, nurses, and managers), telephone surveys with 341 patients, and structured observations from four EDs. The interpretive description approach was utilized to analyze the data gathered from interviews, open-ended questions of the survey, and structured observations.ResultsA set of five facilitator-barrier pairs were extracted. These key facilitator-barrier pairs were: (1) management and leadership, (2) available resources, (3) communications and networks across the organization, (4) previous intervention experiences, and (5) need for change.ConclusionImproving our understanding of the barriers and facilitators that may impact the implementation of a healthcare quality improvement intervention is of paramount importance. This study underscores the significance of identifing the barriers and facilitators of implementating an ED quality improvement program and developing strategies to overcome the barriers and enhance the facilitators for a successful implementations. We propose a set of strategies for hospitals when implementing such interventions, these include: staff training, champion selection, communicating the value of the intervention, promoting active engagement of ED staff, assigning data recording responsibilities, and requiring capacity analysis.Trial registrationClinicalTrials.gov. NCT04789902. 10/03/2021.

Mothers’ choice of health management services for under-five children with common illnesses: evaluating social workers’ impact in Nigerian health sector

ABSTRACT Introduction Every child deserves the right to life. In Nigeria like other African countries, a high burden of child mortality prevails. Attaining a low-mortality rate of children entails that mothers who are the primary caregivers are in the best position to provide quality healthcare management. Method With the phenomenological approach in qualitative research, the researchers sourced data using Focus Group Discussions (FGDs) and In-Depth Interviews (IDI) from 38 mothers of various categories. The participants were purposively selected from four government and mission health institutions in a semi-urban Nsukka town, Enugu State. Data were analyzed thematically. Findings Results revealed that mothers utilize health institutions including government, mission, private, pharmacies and patent medicine vendors when seeking healthcare for their children. Their inability to recognize potential life-threatening conditions is the leading factor in increasing child mortality. Findings show that because participants were concerned about financial challenges; they were ready to adopt traditional medicine as an alternative to modern medicine. The study showed evidence of unsafe strategies mothers adopt for the health management of their under-five children with common illnesses. Participants indicated little knowledge of social workers’ engagement in health institutions. Conclusion Healthy living is essential in the protection from illnesses. Since under-five children are vulnerable to illnesses, their mothers should provide them with quality healthcare management. The study recommends that social workers’ engagement with health providers and users in semi-urban societies could help propagate healthcare awareness and strategies in mothers’ choice of health management for under-five children in Nigeria. Overall, adequate health policy consideration should be given to all under-five children in Nigeria.

The relationship between the duration of diabetes and dimensions of general health and quality of life associated with the health of diabetic patients

ABSTRACT Introduction: Diabetes is one of the most common chronic diseases in the world. Diabetes has a major impact on the quality of life of patients. The purpose of this study is the relationship between the duration of diabetes and dimensions of general health and quality of life associated with the health of diabetic patients. Materials and Methods: In this cross-sectional-analytical study, diabetic patients with more than 1-year history who were not suffering from other chronic diseases were included in the study. Then, using 15 questions for diabetes quality of life, questionnaires and GHQ28 general health were investigated in terms of quality of life and general health. The data were statistically analyzed using SPSS version 24 software. Results: The average age was equal to 42.8 ± 14.4 years (with a median of 40 years). The average duration of the disease in the patients was equal to 7.7 ± 7.2 years (with a median of 5 years). The average quality of life score of the patients was equal to 50.3 ± 7.8 (out of 75). A negative and significant correlation between age and quality of life of patients was observed (P < 0.001). The duration of the disease had a direct and significant relationship with the general health score. But a significant difference between the quality of life of married and single people was not observed (P = 0.613). A direct and significant relationship between duration of disease, age with physical symptoms (P < 0.001), anxiety and insomnia (P = 0.001), social activity failure (P = 0.013), and depression (P = 0.001) was observed and was also observed with the overall score of general health (P < 0.001). Discussion and Conclusion: The duration of diabetes disease affects the quality of life and general health of diabetic patients, and discomfort, depression, and anxiety are the main problems that affect the quality of life of diabetic patients.

Community case management to accelerate access to healthcare in Mali: A realist process evaluation nested within a cluster randomised trial.

The Proactive Community Case Management (ProCCM) trial in Mali reinforced the health system across both arms with user fee removal, professional Community Health Workers (CHWs), and upgraded primary health centres (PHCs)-and randomized village-clusters to receive proactive home visits by CHWs (intervention) or fixed site-based services by passive CHWs (control). Across both arms, sick children's 24-hour treatment and pregnant women's four or more antenatal visits doubled, and under-five mortality halved, over three years compared to baseline. In the intervention arm, proactive CHW home visits had modest effects on children's curative and women's antenatal care utilization, but no effect on under-five mortality, compared to the control arm. We aimed to explain these results by examining implementation, mechanisms, and context in both arms. We conducted a process evaluation with a mixed method convergent design that included 79 in-depth interviews with providers and participants over two time-points, surveys with 195 providers, and secondary analyses of clinical data. We embedded realist approaches in novel ways to test, refine, and consolidate theories about how ProCCM worked, generating three context-intervention-actor-mechanism-outcome nodes that unfolded in a cascade. First, removing user fees and deploying professional CHWs in every cluster enabled participants to seek health sector care promptly and created a context of facilitated access. Second, health systems support to all CHWs and PHCs enabled equitable, respectful, quality healthcare, which motivated increased, rapid utilization. Third, proactive CHW home visits facilitated CHWs and participants to deliver and seek care, and build relationships, trust, and expectations, but these mechanisms were also activated in both arms. Addressing multiple structural barriers to care, user fee removal, professional CHWs, and upgraded clinics interacted with providers' and patients' agency to achieve rapid care and child survival in both arms. Proactive home visits expedited or compounded mechanisms that were activated and changed the context across arms.

The Right to Healthcare Must Include the Right to Ease of Physical Access: Exploring Geography-Health Nexus in GIDA Communities in the Philippines.

Using the United Nations' 'leave no one behind' framework for the achievement of sustainable development goals, this article underscores the key role of geography as one of the core factors why certain people are left behind, deprived, and continue to experience inequality in terms of access to (quality) health care facilities and services. This article specifically examines the consequences of physical inaccessibility to health outcomes and health-seeking behavior in geographically isolated and disadvantaged areas (GIDAs) in the Philippines. This article illustrates that physical accessibility is an ignored aspect of the public health paradigm. For that reason, public health facilities, no matter how critical the facility is to a person's care, are not an immediate option for GIDA residents who seek medical aid. Responsive policy measures are vital to address this seemingly paradigmatic error. Subsidizing transportation costs and allocating funds for road improvements are called for, among other changes. The government must act on the people's right to ease of access as part of fulfilling fundamental health-related state obligations. But for the government to act, it will be crucial for claimants to health rights to proactively demand these changes. The latter is key for the fulfillment of the affected people's right to get easier access to meaningful health care.

Epidemiological study of health profile and quality of life of postmenopausal women in the urban field practice area of a teaching medical institute in a metropolitan city

ABSTRACT Background: Menopause is one of the most significant phases in the life of a woman which brings about various physiological changes called postmenopausal syndrome. A health programme catering to the needs of postmenopausal women is lacking in our health system. Methodology: A cross-sectional study was conducted in an urban health and training centre. Sample size of 171 was taken by simple random sampling. Women of age more than or equal to 45 and having 12 months of amenorrhea were enrolled in the study after obtaining their consent. Results: The mean age of menopause was found to be 45.31 years. In the vasomotor domain, the most common postmenopausal symptom was hot flushes (47.95%) followed by sweating (25.73%) while in the psychological domain it was seen that the most common symptom was feeling depressed down or blue (37.43%) followed by being dissatisfied with personal life, feeling anxious or nervous (36.26%) and being impatient with other people and feelings of wanting to be alone (34.50%). In physical domain, the most common symptom was ache in muscles and joints (92.98%) followed by low backache (86.55%), feeling tired or worn out (84.80%), decrease in physical strength (83.63%) and aches in the back of neck or head (81.87%). The other domain was the sexual domain in which the most common symptom was a change in sexual desire (93.57%) followed by avoiding intimacy (92.98%). Conclusion: It was found that the domain, most severely affecting quality of life was sexual followed by physical and psychological domain. Awareness should be created regarding the psychosocial, physical, nutritional and sexual needs of postmenopausal women.

Medical Malpractice in Neurosurgery: An Analysis of Claims in the Netherlands.

Studying malpractice claims is important to improve quality of health care and patient safety and to educate the individual healthcare providers. The objective of this study was to describe characteristics of neurosurgical claims in the Netherlands. A nationwide retrospective observational study of neurosurgery-related claims closed by Centramed and MediRisk, 2 major insurance companies in the Netherlands, was performed. Relevant data, including type of neurosurgical pathology, theme and category of the claim, type and severity of injury, outcome, and financial burden, were extracted from anonymized claim files. The estimated annual risk was used to determine the risk for claims by adjusting for the number of annually practicing neurosurgeons in the Netherlands. A total of 388 claims against neurosurgeons were closed between 2007 and 2021. Liability was denied in a slight majority of claims (n = 230; 59%). The total burden during this period was €6 165 000 (amount paid out to patients: €5 497 000). The estimated annual risk per Dutch neurosurgeon for a claim was 15.5%, meaning 1 claim per 6.5 years. The case-level analysis of 238 available anonymized claims revealed that most claims were related to spinal pathology (81.5%), followed by cranial pathology (10.9%) and peripheral nerve (7.6%). The motivations for filing claims were mostly related to alleged surgical (56.3%) or diagnostic errors (22.3%). Most of these claims were denied (151/238; 63.4%), and fewer were settled (42/238; 17.6%), sustained (31/238; 13.0%), or closed without final decision (14/238; 5.9%). Neurosurgery-related malpractice claims primarily involved spinal pathology and were mostly related to alleged treatment errors. Most claims did not result in compensation because there seemed to be no liability or culpable injury. However, the annual risk for a claim for Dutch neurosurgeons is considerable.

Role of augmented reality and virtual reality from the Indian healthcare education perspective – A systematic review

ABSTRACT Augmented reality (AR) and virtual reality (VR), are upcoming technologies with considerable potential to revolutionizing healthcare education, enhancing patient safety, and improving healthcare quality particularly in the Indian context. This review is conducted to view the current scenario of Indian context considering the impact of COVID-19. The current systematic review study was done following PRISMA 2020 guidelines using the key terms “Augmented Reality,” “Virtual Reality,” “Healthcare,” and “India.” Only the PubMed database was selected based on its reputation and authenticity, which is the only limitation of this study and strength. Both qualitative and quantitative methods are used for synthesis of results. In Indian context, 12 (1.7%) and 36 (2.2%) articles related to AR and VR were found, respectively. Six abstracts could not be retrieved, and after screening abstracts, three were found not suitable in VR and eight were found duplicate. A total of 30 articles were considered for this review. 18 (50%) were original, 12 (33.3%) were review, and 6 (16.7%) were other articles. 03 (8.3%), 21 (58.3%), and 12 (33.3%) articles were related to AR, VR, and both AR and VR, respectively. Considering the single database search and six unretrievable abstract, AR, VR, mixed reality (MR), soft e-skin, and extended reality (XR) technologies have the potential to revolutionize healthcare education and training, reducing real-life errors and improving patient safety. Although the Indian healthcare sector only contributes 1.7–2.2% to PubMed publications related to AR and VR.. The review was not registered.

Intercultural competence development: A qualitative case study

AimThe aim of this study was to explore Bachelor of Science in Nursing (BSN) students' perceptions of the effectiveness of a unique teaching-learning strategy using their results from the Intercultural Development Inventory (IDI), an instrument for the assessment of intercultural competence, with their customized Intercultural Development Plan (IDP) in enhancing their cultural competence development in a nursing senior practicum. The study also examined student insights about how having a plan to develop their intercultural competence will have an impact on their future nursing practice. BackgroundIntercultural competence is vital for providing quality healthcare, yet there is a gap in understanding how educational interventions are designed and implemented to enhance cultural competence among nursing students. This paper describes a strategy for developing intercultural competence. The IDI was administered to Bachelor of Science in Nursing (BSN) students in the fourth semester of a five-semester BSN program. Based on their IDI results, each student received a customized IDP that suggested specific activities and encouraged guided self-reflection to enhance intercultural competence development. In the fifth-semester senior practicum course, the students developed personal intercultural competence development goals based on their IDP. They also kept weekly journals on their intercultural competence development during their practicum. DesignThis study used a Qualitative Case Study design. MethodsThis study was conducted from January to July 2021 with 47 senior practicum students in a large BSN program in the Southeastern United States. Data consisted of student written responses to prompts on how the IDI/IDP influenced their intercultural development and its potential effect on their future practice. The data were analyzed through inductive content analysis. ResultsThree key themes emerged: self-awareness, recognition of cultural influences and growth goals. Student reflections suggested that they desired to develop intercultural competence so they could provide the best possible nursing care for their patients. Still, most students did not have a plan for how to grow in this area. Many students reported that their IDI/IDP heightened cultural awareness throughout their practicum, guiding their development of intercultural competence and leading to a deeper and broader understanding of culture. Students suggested that this enhanced cultural understanding, along with their IDP, will facilitate their continued development of intercultural competence in their future professional practice. ConclusionThis study contributes to existing knowledge about intercultural competence development and effective teaching methods by providing empirical evidence of the positive impact of the IDI/IDP on nursing students' perceived intercultural development. These findings can inform the development and implementation of pedagogical strategies to enhance intercultural competence, which will ultimately improve patient care outcomes in all healthcare settings.

Prevalence of dysphagia following posterior fossa tumor resection: a systematic review and meta‑analysis

ObjectiveDysphagia is common in individuals who have undergone posterior fossa tumor (PFT) resection and negatively impacts on the individual’s quality of life, nutritional status, and overall health. We aimed to quantitatively synthesize data from studies of the prevalence of dysphagia following PFT resection.MethodsPubMed, Web of Science, the Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wanfang database, and VIP database were searched for case-control and cross-sectional studies that evaluated the prevalence of dysphagia after PFT surgery. Meta-analyses were performed to determine the prevalence of dysphagia. Subgroup and meta-regression analyses were performed to determine the sources of heterogeneity among the studies.ResultsA total of 22 studies were included, involving 20,921 cases. A meta-analysis of the random-effects model showed that the pooled global prevalence of dysphagia following PFT resection was 21.7% (95% confidence interval: 16.9–26.6). The subgroup and meta-regression analyses demonstrated that participant age (P < 0.001), assessment methods (P = 0.004), and geographical region of the study participants (P = 0.001) were sources of heterogeneity among the studies.ConclusionsDysphagia has a high prevalence following PFT resection. Individuals with PFTs who are at a high risk for dysphagia should be identified early through screening. Multidisciplinary diagnosis and treatment of dysphagia are required to improve the outcomes in the early stages after PFT resection.

Applying Adverse Childhood Experience (ACE) Screening in Adolescent Inpatient Mental Health

ABSTRACT This quality improvement project aimed to implement screening for adverse childhood experiences (ACEs) and other related life stressors in inpatient adolescent psychiatry and to assess their relationship with mental health clinical and quality indicators. The project was conducted in a 25-bed adolescent inpatient unit in Los Angeles County from 2022 to 2023. The Pediatric ACEs and Related Life Events Screener (PEARLS) was used for systematic ACE screening. ACE screening results, demographic and clinical data, youth perceptions of trauma-informed care, new PTSD diagnoses, and length of hospitalization were collected throughout the project period. Linear and logistic regression models were used to examine the relationship between ACE scores, stressful life events, and outcome measures. The sample included 103 adolescents admitted for a psychiatric emergency. Most patients were girls (75.7%), and 94% had at least one ACE. The average length of stay was 6.4 days, and 30% of youth received a new diagnosis of PTSD during hospitalization. Higher ACE scores were associated with increased odds of a new PTSD diagnosis. Sexual abuse and death of a parent/caregiver were the only individual items associated with new PTSD diagnosis. This quality improvement project implementing ACE screening in inpatient adolescent psychiatry demonstrated a high prevalence of ACEs among the target population and the need for trauma-informed care. Our findings contribute to the growing efforts to address ACEs and improve the quality of trauma-informed care in child-serving systems.

A chatbot based question and answer system for the auxiliary diagnosis of chronic diseases based on large language model

In recent years, artificial intelligence has made remarkable strides, improving various aspects of our daily lives. One notable application is in intelligent chatbots that use deep learning models. These systems have shown tremendous promise in the medical sector, enhancing healthcare quality, treatment efficiency, and cost-effectiveness. However, their role in aiding disease diagnosis, particularly chronic conditions, remains underexplored. Addressing this issue, this study employs large language models from the GPT series, in conjunction with deep learning techniques, to design and develop a diagnostic system targeted at chronic diseases. Specifically, performed transfer learning and fine-tuning on the GPT-2 model, enabling it to assist in accurately diagnosing 24 common chronic diseases. To provide a user-friendly interface and seamless interactive experience, we further developed a dialog-based interface, naming it Chat Ella. This system can make precise predictions for chronic diseases based on the symptoms described by users. Experimental results indicate that our model achieved an accuracy rate of 97.50% on the validation set, and an area under the curve (AUC) value reaching 99.91%. Moreover, conducted user satisfaction tests, which revealed that 68.7% of participants approved of Chat Ella, while 45.3% of participants found the system made daily medical consultations more convenient. It can rapidly and accurately assess a patient’s condition based on the symptoms described and provide timely feedback, making it of significant value in the design of medical auxiliary products for household use.

Road to a National Health Information Network: US Trusted Exchange Framework and Common Agreement (TEFCA).

The Trusted Exchange Framework and Common Agreement (TEFCA) is a U.S. government initiative aimed at promoting the secure and interoperable exchange of electronic health information (EHI) across the healthcare ecosystem. In the U.S., TEFCA was established as part of the 21st Century Cures Act, signed into law in December 2016. Methods: A literature search using the PRISMA guidelines will be conducted through PubMed, CINAHL, Google Scholar, and Web of Science, for dates 2013-2024 will be conducted. Results will be demonstrated with a timeline, graphics, and written text on the key points of technical and operational standards for HIE, rules and expectations for data sharing under the Common Agreement, governance framework for implementation and enforcement principles, stakeholders and collaborators, and interoperability challenges. TEFCA seeks to improve patient care, reduce healthcare costs, and enhance overall healthcare quality by facilitating the seamless exchange of data between different healthcare entities. Sharing this information can contribute to nursing informatics practice and knowledge as the U.S. and other countries strive towards better interoperability in the race to improve patient care and outcomes using health information technology.

Towards an understanding of the biopsychosocial determinants of CVD in SLE: a scoping review

ObjectiveSystemic lupus erythematosus (SLE) is a chronic autoimmune condition with significant physical, mental, psychosocial and economic impacts. A main driver of SLE morbidity and mortality is cardiovascular disease (CVD). Both...

Effect of medication adherence on quality of life, activation measures, and health imagine in the elderly people: a cross-sectional study

BackgroundUsually, old age brings a poor quality of life due to illness and frailty. To prolong their lives and ensure their survival, all elderly patients with chronic diseases must adhere to their medications. In our study, we investigate medication adherence for elderly patients and its impact on the general health of the patient.MethodsWe implemented a cross-sectional survey‐based study with four sections in April 2022 in Saudi Arabia. Data about the participants’ demographic characteristics, the Morisky Medication Adherence Scale, Patient Activation Measure (PAM) 13, and EQ-5D-5 L.ResultsA total of 421 patients participated in this study, their mean age was 60.4 years, and most of them were males. Most of our population is living independently 87.9%. The vast majority of people have a low adherence record in the Morisky Medication Adherence Scale (8-MMAS) classes (score = < 6). Moreover, the average PAM13 score is 51.93 (Level2) indicating a low level of confidence and sufficient knowledge to take action. Our analysis showed a significant correlation between socioeconomic status and medication adherence. Also, there was an association between housing status and medication adherence. On the other hand, we found no correlation between medication adherence and quality of life (QOL) by EQ-5D-5 L.ConclusionMedication adherence is directly affected by living arrangements, as patients who live with a caretaker who can remind them to take their medications at the appropriate times have better medication adherence than those who live alone. Medication adherence was also significantly influenced by socioeconomic status, perhaps as a result of psychological effects and the belief of the lower-salaried population that they would be unable to afford the additional money required to cure any comorbidities that arose as a result of the disease. On the other hand, we did not find any correlation between medication adherence and quality of life. Finally, awareness of the necessity of adherence to medication for the elderly is essential.

Digital Health Innovations to Promote Physical Activities in Patients with Cancer.

This study evaluates the Exercise Planning and Tracking (EPT) tool, a digital health solution, designed to enhance physical activity (PA) in patients with cancer. Utilizing a tailored PA database, the tool aids in tracking and planning exercises and monitoring symptoms. A pre-post study shows the tool improves patients' anxiety, depression, and walking distances, especially in high-exertion individuals, highlighting its potential to boost quality of life and physical health for patients with cancer.

Barriers to HPV vaccine series completion among a predominantly hispanic border population: a mixed method evaluation

BackgroundHuman Papillomavirus (HPV) infections are the most common sexually transmitted infections in the United States. The HPV vaccine is a vital tool to prevent against several cancers, namely cervical cancer. Unfortunately, the uptake of the HPV vaccine among Hispanics is relatively low. Some barriers to uptake include language barriers, cultural taboos, and cost.PurposeThis study aims to explore barriers to HPV vaccination in a predominantly Hispanic US-Mexico border county between June 2015 and March 2018.MethodsA mixed-method approach was used to analyze covariates associated with HPV vaccine uptake and to evaluate barriers to HPV vaccination from participant follow-up calls or reminder notes.ResultsThe total number of participants was 1,787. Young adults were less likely to complete the vaccination series than those aged 9-17, while individuals born in Mexico were more likely to do so. Failure to contact was the most common barrier (n=1,801, 86.42%), followed by scheduling concerns (n=99, 4.5%), being ineligible (74, 3.55%), completing series outside of the program (40, 1.92%), having medical concerns (36, 1.73%), and other reasons (34, 1.63%).ConclusionWe predominantly identified structural barriers and various health-related determinants regarding healthcare access and quality.

Temporal trends of polycyclic aromatic hydrocarbons in soils amended with sludge, compost, and manure in a Scotland pasture: An 8-year field experiment

To optimize the effective utilization of organic waste in agricultural practices, a comprehensive assessment of associated risks and benefits is crucial. This study investigated the impact of three types of organic wastes (sludge, compost, and manure) on polycyclic aromatic hydrocarbons (PAHs) in contaminated soil in a Scottish pasture. The experimental setup comprised 16 plots with four treatments (compost, manure, sludge, and inorganic fertilizer) and four replicates. After eight years of this study, notable disparities in ΣPAH16 concentrations were observed among the different treatments, with compost-amended soil at 378 μg kg−1, sludge-amended soil at 331 μg kg−1, and manure-amended soil at 223 μg kg−1. The concentrations of ΣPAH16 in soil amended with compost and sludge exhibited a linear increase with extended sampling time. Significant changes in ΣPAH16 concentration were evident in the compost treatment plot, with an increase of 20% in the first year and 82% in the eighth year. Risk assessment suggested a low level of health risk from exposure to PAHs at the measured concentrations in the three organic wastes. In conclusion, this study highlights the importance of considering the effects of organic waste amendments on soil PAH levels to make informed decisions in sustainable agricultural practices. It also underscores the need for ongoing research to fully understand the implications of different organic waste applications on soil health and environmental quality.

Oral health in obese children common findings, prevention, treatment, and outcome

Childhood obesity is a significant global public health issue, closely linked to various oral health challenges, including dental caries, periodontal disease, and malocclusion. Obese children are more prone to these dental problems due to dietary habits that include high sugar and carbohydrate intake, poor oral hygiene practices, and systemic inflammation. This review explores the common oral health issues faced by obese children and emphasizes the importance of preventive strategies and tailored treatment approaches. Preventive measures include promoting healthy dietary habits, improving oral hygiene practices, and ensuring regular dental check-ups. Dietary modifications, such as reducing the intake of sugary snacks and beverages, play a crucial role in preventing tooth decay and other dental problems. Educating children and caregivers about proper brushing and flossing techniques and the use of fluoride toothpaste and dental sealants further supports oral health. Regular dental visits allow for early detection and management of dental issues, with professional cleanings, fluoride treatments, and appropriate restorative and periodontal therapies being integral components of care. The outcomes of these comprehensive treatment strategies are generally positive, leading to improved oral health and overall quality of life for obese children. Multidisciplinary collaboration among healthcare providers, including dentists, pediatricians, and nutritionists, is essential to develop effective care plans that address both obesity and oral health. This integrated approach ensures that obese children receive holistic care that promotes lifelong healthy habits, reducing the risk of future dental and systemic health problems. The review underscores the necessity of a concerted effort to address the intertwined issues of obesity and oral health in children, highlighting the potential for significant health improvements through targeted prevention and treatment strategies.