Key Protective Factors Research Articles

The mental health of married immigrant women in South Korea and its risk and protective factors: A literature review.

Married immigrant women in South Korea undergo a wide array of psychosocial challenges in the process of adapting to a new culture and marriage with a Korean husband. For an integrative understanding of women's mental health status and to determine the key risk and protective factors, we systematically reviewed empirical articles about the mental health of married immigrant women. We searched and reviewed articles from nine online databases: PubMed, Scopus, PsycINFO, Embase, DBpia, KISS, KMbase, KoreaMed and RISS, which were published up until January 2017. We identified 38 quantitative studies that examined psychiatric symptoms and pertinent factors for this population. The relative risks of psychiatric symptoms among married immigrant women varied across diverse samples. We summarized the associated factors existing prior to and after marriage migration that may moderate their mental health consequences. We identified five key risk factors: acculturative stress, country of origin, family stress, domestic violence and extended family structure, and two protective factors: social support and marriage satisfaction, which were consistently supported by the included studies. With the paucity of prospective studies, longitudinal research is needed that addresses the long-term processes of married immigrant women's psychological adaptation and the underlying risk and protective factors at diverse settlement phases. Furthermore, we suggest that future research should focus on how women's personal attributes interact with macro-level, socio-cultural contexts, including familial relationship and the community social-support system. Future evidence-based policy and interventions should comprehensively address married immigrant women's socio-cultural, economic and mental health needs.

Identifying Ingrained Historical Cognitive Biases Influencing Contemporary Pastoral Responses Depriving Suicide-Bereaved People of Essential Protective Factors

(1) Background: Historically and collectively, the Church has not responded to suicide-bereaved people with compassion, denying pastoral care in the form of spiritual, emotional, and practical support, considered key protective factors along with community support in facilitating funeral rite for their loved one in their deepest, darkest, hour of need, thereby placing them at risk to disenfranchised grief. (2) Aims: The study explores the presence of historical ingrained cognitive biases in contemporary pastoral responses from caregivers within Evangelical and Pentecostal streams. (3) Methods: Caregivers were provided with training offering greater understanding of the multifarious issues involved in the life of a person who has died by suicide and challenges faced by the bereaved. Responses to pre-workshop self-contemplating surveys based on workshop objectives were then compared to post-workshop survey responses of participant’s subjective evaluation of knowledge and skills gained through information presented. (4) Results: Post-workshop survey data revealed healthy shifts in historically ingrained cognitive biases; (5) Conclusions: These shifts provide the foundation for future pastoral encounters to offer spiritual, emotional, and practical support, considered key protective factors for those bereaved by suicide.

Prevalence and risk factors of needle stick and sharp injury among tertiary hospital workers, Vientiane, Lao PDR.

Health care workers (HCWs) face risks of needle stick and sharp injuries (NSIs). Most NSIs occur in developing countries, however, no epidemiological study on NSIs is publicly available in Lao PDR. The objective of this study is to identify the prevalence and risk factors of NSIs among HCWs in Lao PDR. This cross-sectional study was designed to determine the prevalence and risk factors of NSIs among four tertiary hospitals in Vientiane, Lao People's Democratic Republic. Six months before the survey, 11.4% (106/932) of hospital staff had experienced NSIs, while 42.1% did in their entire career. Key protective factors of NSIs among nurses included adequate availability of needles, syringes, and sharp equipment (p = 0.042; odds ratio [OR], 0.47) and attendance to educational or refresher courses on safety regarding NSIs (p = 0.038; OR, 0.50). As an on-site practice, single-handed recapping was prevalent (46.7%, 257/550) among participants. The result showed that high rates of NSIs persist among HCWs. The findings of this research call for comprehensive health and injection safety programs for HCWs involved in clinical practice.

Social Support as a Key Protective Factor against Depression in HIV-Infected Patients: Report from large HIV clinics in Hanoi, Vietnam

Depression is the most common mental health issue among people living with HIV/AIDS (PLWHA). This study explored how different types and sources of social support are associated with depression among HIV-infected patients in Vietnam. We carried out a cross-sectional survey on 1,503 HIV-infected patients receiving antiretroviral therapy at two HIV clinics in Hanoi in 2016. Depression was prevalent in 26.2% of participants. Higher score of social support, especially emotional/informational support and positive social interaction, showed significant association with lower depression rate. Although family was primary source of all types of social support, receiving emotional/informational support not only from family but also from outside of family correlated with a lower proportion of depression. In countries with constrained social resources and/or with family-oriented social structures, as in Vietnam, expanding social networks between HIV populations and society is a potentially important option for reducing depression.

Comparing the different response of PNS and CNS injured neurons to mesenchymal stem cell treatment

Mesenchymal stem cells (MSCs) are adult bone marrow-derived stem cells actually proposed indifferently for the therapy of neurological diseases of both the Central (CNS) and the Peripheral Nervous System (PNS), as a panacea able to treat so many different diseases by their immunomodulatory ability and supportive action on neuronal survival. However, the identification of the exact mechanism of MSC action in the different diseases, although mandatory to define their real and concrete utility, is still lacking. Moreover, CNS and PNS neurons present many different biological properties, and it is still unclear if they respond in the same manner not only to MSC treatment, but also to injuries. For these reasons, in this study we compared the susceptibility of cortical and sensory neurons both to toxic drug exposure and to MSC action, in order to verify if these two neuronal populations can respond differently.Our results demonstrated that Cisplatin (CDDP), Glutamate, and Paclitaxel-treated sensory neurons were protected by the co-culture with MSCs, in different manners: through direct contact able to block apoptosis for CDDP- and Glutamate-treated neurons, and by the release of trophic factors for Paclitaxel-treated ones. A possible key soluble factor for MSC protection was Glutathione, spontaneously released by these cells. On the contrary, cortical neurons resulted more sensitive than sensory ones to the toxic action of the drugs, and overall MSCs failed to protect them. All these data identified for the first time a different susceptibility of cortical and sensory neurons, and demonstrated a protective action of MSCs only against drugs in peripheral neurotoxicity.

The Associations of Perceived Social Support with Key HIV Risk and Protective Factors Among Young Males Who Have Sex with Males in Bangkok and Chiang Mai, Thailand.

This study used respondent-driven sampling to explore the effects of social support on HIV risk and protective factors among young males who have sex with males (YMSM) in Bangkok (N=273) and Chiang Mai (N=243), Thailand. It compared different measures of social support, including living situation, the proportion of family and friends to whom the respondent had disclosed their same-sex attraction, and scores on the multi-dimensional scale of perceived social support as predictors of two outcomes of interest-coerced first sex and HIV knowledge. Social support from family played a mediating role in both outcomes among YMSM in Bangkok but not those from Chiang Mai. Though social support from friends was also studied, it was less strongly associated with the outcomes of interest. The findings support interventions designed to leverage social support networks to increase HIV knowledge and decrease coerced first sex among YMSM. At the same time, they demonstrate that there is not a single risk or demographic profile encompassing all YMSM. Successful programs and policies will need to consider the specific attributes and social environment of YMSM in particular locations in order to effectively address HIV risks.

Sustainable Use of Pesticide Applications in Citrus: A Support Tool for Volume Rate Adjustment.

Rational application of pesticides by properly adjusting the amount of product to the actual needs and specific conditions for application is a key factor for sustainable plant protection. However, current plant protection product (PPP) labels registered for citrus in EU are usually expressed as concentration (%; rate/hl) and/or as the maximum dose of product per unit of ground surface, without taking into account those conditions. In this work, the fundamentals of a support tool, called CitrusVol, developed to recommend mix volume rates in PPP applications in citrus orchards using airblast sprayers, are presented. This tool takes into consideration crop characteristics (geometry, leaf area density), pests, and product and application efficiency, and it is based on scientific data obtained previously regarding the minimum deposit required to achieve maximum efficacy, efficiency of airblast sprayers in citrus orchards, and characterization of the crop. The use of this tool in several commercial orchards allowed a reduction of the volume rate and the PPPs used in comparison with the commonly used by farmers of between 11% and 74%, with an average of 31%, without affecting the efficacy. CitrusVol is freely available on a website and in an app for smartphones.

The mistreatment of public service workers: identifying key risk and protective factors

This paper investigates the dynamics of worker mistreatment in a new public management (NPM) environment. It explores the combination of organizational and individual risk and protective factors. It reveals that the cumulative effects of organizational and individual factors radically increase the likelihood of mistreatment. Implications of these findings are outlined.

Effects of treadmill running with different intensity on rat subchondral bone

Subchondral bone (SB) is recognized as a key factor in normal joint protection, not only does it provide a shock absorbing and supportive function for the cartilage, but it may also be important for cartilage metabolism. Mechanical loading is considered to be a critical regulator of skeletal homeostasis, including bone and cartilage. It is suggested that both cartilage and bone may respond to mechanical loading in an intensity-dependent manner. In this report, we have discovered that the subchondral plate became thicker with higher bone mineral density (BMD) and lower porosity, while trabecular bone became more plate-like and denser with higher BMD in high-intensity running (HIR) group. Further, HIR led to highly remodeled, less mineralized, and stiffer subchondral plate and trabecular bone. On the contrary, low-intensity running and moderate-intensity running failed to result in considerable changes in microstructure, composition and hardness. Our findings suggested that running affects SB in an intensity-dependent manner. In addition, HIR may induce change in organization and composition of SB, and consequently alter its mechanical properties. HIR-induced “brittle and stiff” SB may adversely affect the overlying articular cartilage.

Mastering Resilience in Oncology: Learn to Thrive in the Face of Burnout.

Oncology clinician burnout has become a noteworthy issue in medical oncology directly affecting the quality of patient care, patient satisfaction, and overall organizational success. Due to the increasing demands on clinical time, productivity, and the evolving medical landscape, the oncology clinician is at significant risk for burnout. Long hours in direct care with seriously ill patients/families, limited control over daily responsibilities, and endless electronic documentation, place considerable professional and personal demands on the oncologist. As a result, the oncology clinician's wellness is adversely impacted. Physical/emotional exhaustion, cynicism, and feelings of ineffectiveness evolve as core signs of burnout. Unaddressed burnout may affect cancer clinician relationships with their patients, the quality of care delivered, and the overall physical and emotional health of the clinician. Oncology clinicians should be encouraged to build upon their strengths, thrive in the face of adversity and stress, and learn to positively adapt to the changing cancer care system. Fostering individual resilience is a key protective factor against the development of and managing burnout. Empowering clinicians at both the individual and organizational level with tailored resilience strategies is crucial to ensuring clinician wellness. Resilience interventions may include: burnout education, work-life balance, adjustment of one's relationship to work, mindful practice, and acceptance of the clinical work environment. Health care organizations must act to provide institutional solutions through the implementation of: team-based oncology care, communication skills training, and effective resiliency training programs in order to mitigate the effects of stress and prevent burnout in oncology.

Unpacking the impact of adverse childhood experiences on adult mental health

Exposure to childhood adversity has an impact on adult mental health, increasing the risk for depression and suicide. Associations between Adverse Childhood Experiences (ACEs) and several adult mental and behavioral health outcomes are well documented in the literature, establishing the need for prevention. The current study analyzes the relationship between an expanded ACE score that includes being spanked as a child and adult mental health outcomes by examining each ACE separately to determine the contribution of each ACE. Data were drawn from Wave II of the CDC-Kaiser ACE Study, consisting of 7465 adult members of Kaiser Permanente in southern California. Dichotomous variables corresponding to each of the 11 ACE categories were created, with ACE score ranging from 0 to 11 corresponding to the total number of ACEs experienced. Multiple logistic regression modeling was used to examine the relationship between ACEs and adult mental health outcomes adjusting for sociodemographic covariates. Results indicated a graded dose-response relationship between the expanded ACE score and the likelihood of moderate to heavy drinking, drug use, depressed affect, and suicide attempts in adulthood. In the adjusted models, being spanked as a child was significantly associated with all self-reported mental health outcomes. Over 80% of the sample reported exposure to at least one ACE, signifying the potential to capture experiences not previously considered by traditional ACE indices. The findings highlight the importance of examining both cumulative ACE scores and individual ACEs on adult health outcomes to better understand key risk and protective factors for future prevention efforts.

Youth–Adult Connectedness:: A Key Protective Factor for Adolescent Health

Over the past 30 years, prevention science in the adolescent health field has moved from interventions focused on preventing single problem behaviors to efforts employing a dual approach, addressing risk factors that predict problems while simultaneously nurturing protective factors and promoting positive development. Through an examination of previous research and empirical case examples with vulnerable youth, this article considers the hypothesis that adolescents' sense of connectedness to caring adults acts as a protective factor against a range of risk behaviors. Multivariate analyses with existing data examined indicators of youth-adult connectedness among two groups at high risk for poor health outcomes: (1) mentor-youth relationship quality in an urban, ethnically diverse sample of students in a school-based mentoring program (2014 survey, N=239); and (2) parent-youth connectedness in a statewide sample of high school students who reported homelessness in the past year (2013 survey, N=3,627). For youth in the mentoring program, a high-quality youth-mentor relationship was significantly associated with positive social, academic, and health-related behaviors. Among students who experienced homelessness, all measures of parent connectedness were significantly associated with lower sexual risk levels. Collectively, findings from these analyses and previously published studies by this research group provide evidence that strong, positive relationships with parents and other caring adults protect adolescents from a range of poor health-related outcomes and promote positive development. Youth-adult connectedness appears to be foundational for adolescent health and well-being. Program, practice, and policy decisions should consider what strengthens or hinders caring, connected youth-adult relationships.

RETRACTED ARTICLE: RIPK3 interactions with MLKL and CaMKII mediate oligodendrocytes death in the developing brain

Oligodendrocyte progenitor cells (OPCs) death is a key contributor to cerebral white matter injury (WMI) in the developing brain. A previous study by our group indicated that receptor-interacting proteins (RIPs) are crucial in mediating necroptosis in developing neurons. However, whether this mechanism is involved in OPCs death is unclear. We aimed to explore the mechanisms of RIP-mediated oligodendrocytes (OLs) death in the developing brain. Oligodendrocytes necroptosis was induced by oxygen-glucose deprivation plus caspase inhibitor zVAD treatment (OGD/zVAD) in vitro. Western blotting and immunofluorescence were used to detect RIPK1, RIPK3, mixed lineage kinase domain-like protein (MLKL), and Ca2+ and calmodulin-dependent protein kinase IIδ (CaMKIIδ). Immunoprecipitation was used to assess the interactions between RIPK3 and RIPK1, MLKL, and CaMKIIδ. Necrostatin-1 was used to disturb the RIPK3–RIPK1 interaction, and siRNA was used to inhibit RIPK3 or MLKL expression. Oligodendrocytes death was examined using PI staining, EM, and cell membrane leakage assays. In vivo, brain damage in neonatal rats was induced by hypoxia–ischemia (HI). This was followed by an examination of myelin development. We found that OGD/zVAD treatment upregulates the expression of RIPK3 and the interaction of RIPK3 with RIPK1, MLKL, and CaMKIIδ. Inhibition of the RIPK3-MLKL or RIPK3-CaMKIIδ interaction attenuates OLs death induced by OGD/zVAD. These protective mechanisms involve the translocation of MLKL to the OLs membrane, and the phosphorylation of CaMKIIδ. However, inhibition of the RIPK3–RIPK1 interaction did not protect OLs death induced by OGD/zVAD. In vivo studies indicated that the disrupted development of myelin was attenuated after the inhibition of RIPK3-MLKL or RIPK3-CaMKIIδ interaction. Taken together, our data indicate that RIPK3 is a key factor in protection against OLs death and abnormal myelin development via its interaction with MLKL and CaMKIIδ after HI. This suggests that RIPK3 may be a potential target for the treatment of WMI in neonates.

Guanylate-binding protein 1 (GBP1) contributes to the immunity of human mesenchymal stromal cells against Toxoplasma gondii

Mesenchymal stromal cells (MSCs) have recently been shown to play important roles in mammalian host defenses against intracellular pathogens, but the molecular mechanism still needs to be clarified. We confirmed that human MSCs (hMSCs) prestimulated with IFN-γ showed a significant and dose-dependent ability to inhibit the growth of two types of Toxoplasma gondii [type I RH strain with green fluorescent proteins (RH/GFP) or type II PLK strain with red fluorescent proteins (PLK/RED)]. However, in contrast to previous reports, the anti-T. gondii activity of hMSCs was not mediated by indoleamine 2,3-dioxygenase (IDO). Genome-wide RNA sequencing (RNA-seq) analysis revealed that IFN-γ increased the expression of the p65 family of human guanylate-binding proteins (hGBPs) in hMSCs, especially hGBP1. To analyze the functional role of hGBPs, stable knockdowns of hGBP1, -2, and -5 in hMSCs were established using a lentiviral transfection system. hGBP1 knockdown in hMSCs resulted in a significant loss of the anti-T. gondii host defense property, compared with hMSCs infected with nontargeted control sequences. hGBP2 and -5 knockdowns had no effect. Moreover, the hGBP1 accumulation on the parasitophorous vacuole (PV) membranes of IFN-γ-stimulated hMSCs might protect against T. gondii infection. Taken together, our results suggest that hGBP1 plays a pivotal role in anti-T. gondii protection of hMSCs and may shed new light on clarifying the mechanism of host defense properties of hMSCs.

Attrition from antiretroviral treatment services among pregnant and non-pregnant patients following adoption of Option B+ in Haiti

ABSTRACT Background: Access to antiretroviral therapy (ART) has expanded in Haiti because of the adoption of Option B+ and the revision of treatment guidelines. Retention in care and treatment varies greatly and few studies have examined retention rates, particularly among women enrolled in Option B+. Objective: To assess attrition among pregnant and non-pregnant patients initiating ART following adoption of Option B+ in Haiti. Methods: Longitudinal data of adult patients initiated on ART from October 2012 through August 2014 at 73 health facilities across Haiti were analyzed using a survival analysis framework to determine levels of attrition. The Kaplan–Meier method and Cox proportional hazards regression were used to examine risk factors associated with attrition. Results: Among 17,059 patients who initiated ART, 7627 (44.7%) were non-pregnant women, 5899 (34.6%) were men, and 3533 (20.7%) were Option B+ clients. Attrition from the ART program was 36.7% at 12 months (95% CI: 35.9–37.5%). Option B+ patients had the highest level of attrition at 50.4% at 12 months (95% CI: 48.6–52.3%). While early HIV disease stage at ART initiation was protective among non-pregnant women and men, it was a strong risk factor among Option B+ clients. In adjusted analyses, key protective factors were older age (p < 0.0001), living near the health facility (p = 0.04), having another known HIV-positive household member (p < 0.0001), having greater body mass index (BMI) (p < 0.0001), pre-ART counseling (p < 0.0001), and Cotrimoxazole prophylaxis during baseline (p < 0.01). Higher attrition was associated with rapidly starting ART after enrollment (p < 0.0001), anemia (p < 0.0001), and regimen tenofovir+lamivudine+nevirapine (TDF+3TC+NVP) (p < 0.001). Conclusions: ART attrition in Haiti is high among adults, especially among Option B+ patients. Identifying newly initiated patients most at risk for attrition and providing appropriate interventions could help reduce ART attrition.

Understanding the Mental Health of Rural Young Adults: Risk and Protective Factors

Objective: Psychological distress is a serious concern for all young people, with an estimated one in four young Australians living with a mental disorder. In rural communities young adults may face greater challenges in addressing mental health concerns than their urban counterparts with factors such as social stigma, limited availability of services, problems recognising symptoms, and confidentiality concerns being significant barriers. Addressing the determinants of young people's mental health is crucial if they are to fulfil their potential and contribute fully in their communities. This presentation will describe risk and protective factors for psychological distress among young rural adults. Methods: Data from the Australian Rural Mental Health Study were analysed, with young adults aged 18-35 completing four surveys about mental health and wellbeing over a period of five years. Predictors of psychological distress for young rural adults were determined using generalised linear mixed models. Results: For respondents aged 18-35 years, the strongest predictor of psychological distress across the five years of data collection was unemployment, with findings suggesting that this was independent from its economic value. Unemployment increased the odds of distress 12-fold even after controlling for key correlates including financial position, gender, and relationship status. Key protective factors included social support, sense of community and level of social involvement, while increased alcohol use was a risk factor for distress. Conclusion: Opportunities for rural young people to connect formally and informally with their community are crucial to mental health. Supporting improved mental health is not exclusively the domain of specialised clinical and community-based mental health services (although these services are important), but also that of the diverse sporting, social, cultural, educational, religious, and vocational groups that operate within rural communities. This highlights the importance of holistic and integrated approaches to promoting mental health.

Ecological Momentary Assessment of Adolescent Problems, Coping Efficacy, and Mood States Using a Mobile Phone App: An Exploratory Study.

BackgroundMobile technologies have the potential to be used as innovative tools for conducting research on the mental health and well-being of young people. In particular, they have utility for carrying out ecological momentary assessment (EMA) research by capturing data from participants in real time as they go about their daily lives.ObjectiveThe aim of this study was to explore the utility of a mobile phone app as a means of collecting EMA data pertaining to mood, problems, and coping efficacy in a school-based sample of Irish young people.MethodsThe study included a total of 208 participants who were aged 15-18 years, 64% female (113/208), recruited from second-level schools in Ireland, and who downloaded the CopeSmart mobile phone app as part of a randomized controlled trial. On the app, participants initially responded to 5 single-item measures of key protective factors in youth mental health (formal help-seeking, informal help-seeking, sleep, exercise, and sense of belonging). They were then encouraged to use the app daily to input data relating to mood states (happiness, sadness, anger, stress, and worry), daily problems, and coping self-efficacy. The app automatically collected data pertaining to user engagement over the course of the 28-day intervention period. Students also completed pen and paper questionnaires containing standardized measures of emotional distress (Depression, Anxiety, and Stress Scale; DASS-21), well-being (World Health Organization Well-Being Index; WHO-5), and coping (Coping Strategies Inventory; CSI).ResultsOn average the participants completed 18% (5/28) of daily ratings, and engagement levels did not differ across gender, age, school, socioeconomic status, ethnicity, or nationality. On a scale of 1 to 10, happiness was consistently the highest rated mood state (overall mean 6.56), and anger was consistently the lowest (overall mean 2.11). Pearson correlations revealed that average daily ratings of emotional states were associated with standardized measures of emotional distress (rhappiness=–.45, rsadness=.51, ranger=.32, rstress=.41, rworry=.48) and well-being (rhappiness=.39, rsadness =–.43, ranger=–.27, rstress=–.35, rworry=–.33). Inferential statistics indicated that single-item indicators of key protective factors were related to emotional distress, well-being, and average daily mood states, as measured by EMA ratings. Hierarchical regressions revealed that greater daily problems were associated with more negative daily mood ratings (all at the P<.001 level); however, when coping efficacy was taken into account, the relationship between problems and happiness, sadness, and anger became negligible.ConclusionsWhile engagement with the app was low, overall the EMA data collected in this exploratory study appeared valid and provided useful insights into the relationships between daily problems, coping efficacy, and mood states. Future research should explore ways to increase engagement with EMA mobile phone apps in adolescent populations to maximize the amount of data captured by these tools.Trial RegistrationClinicaltrials.gov NCT02265978; http://clinicaltrials.gov/ct2/show/NCT02265978 (Archived by WebCite at http://www.webcitation.org/6mMeYqseA).

An Evaluation of the Buffering Effects of Types and Sources of Support on Depressive Symptoms Among Natural Disaster–Exposed Chinese Adults

Objective: Social support is a key protective factor for people exposed to natural disasters. The effect of type and source of this support is not well documented. Investigations are needed to identify the specific modifying role of received and perceived support from family and friends on the association between disaster exposure and depressive symptoms. Methods: Face-to-face household interviews were conducted in 2014 with a random sample of 751 adults recruited from Yuexiu and Tianhe districts in Guangzhou, China. Sampling was accomplished through spatial epidemiological methods. Participants’ exposure to disaster, depressive symptoms, and social support networks was recorded on tablet devices. Multiple regression analysis was used to test the potential moderating role of social support on depression symptoms. Results: A total of 30.24% reported natural disaster exposure. Disaster exposure and received family support were significantly and positively related to depressive symptoms. In contrast, perceived family support moderated the relationship between disaster exposure and depressive symptoms. No association was found between support from friends and depressive severity. Conclusion: Perceived family support buffered the effect of disaster exposure in this sample, while received family support was associated with increased depression. Perceived family support is an important resource among those who experience disaster exposure and actual provision of family support may be harmful or miscarried.Natural disasters are becoming increasingly prevalent in Asia. According to the Economic and Social Commission for Asia and the Pacific (ESCAP, 2015a), a total of 119 disaster events, accounting for more than half of the total number of disasters occurred in the world, took place in Asia in 2014, affecting 79.6 million people, among whom 6050 died. The Chinese Mainland experienced several major natural disasters, including the earthquake in Wechuan, Sichuan Province, in 2008 and natural disasters affected more than 500,000 people causing 0.4% of GDP loss (roughly US$3 trillion; ESCAP, 2015b). The current study investigated the effect of social resources on mental health following natural disaster exposure.

Effect of Cardiovascular Injury on Catabolism of Adenosine and Adenosine 5-'Triphosphate in Systemic Blood in a Freely Moving Rat Model In Vivo.

Previous studies have shown that catabolism of adenosine 5'-triphosphate (ATP) in red blood cell (RBC) may be a key factor for cardiovascular protection and maintaining cardiovascular homeostasis. To investigate the effect of cardiovascular injury on adenosine and ATP catabolism in systemic blood using a freely moving rat model in vivo. After acclimatized to the experimental environment, Sprague Dawley (SD) rats were each given either isoproterenol (30 mg/kg) or saline (1 mL/kg) by subcutaneous (sc) injection. Blood samples were collected sequentially for up to 6 hours for measurement of red blood cell (RBC) concentrations of adenine nucleotides and plasma concentrations of adenosine and its oxypurine metabolites. We have found isoproterenol induced 50% mortality under the experimental condition. Plasma concentrations of adenosine (ADO) and uric acid (UA) and red blood cell (RBC) concentrations of adenosine 5'-diphosphate (ADP) and adenosine 5'-monophosphate (AMP) in RBC were significantly higher in the isoproterenol treated rats (p < 0.05 for all the comparison). On the other hand, plasma concentrations of hypoxanthine (HYP) were higher in the control group (p < 0.05), but there was no statistically significant changes in ATP concentrations in the RBC (p > 0.05). Cardiovascular injury induced by isoproterenol resulted in breakdown of ATP to ADP and AMP in the RBC and also breakdown of ADO to UA in plasma and other tissues.

Enteric pathogens and factors associated with acute bloody diarrhoea, Kenya.

BackgroundShigellosis is the major cause of bloody diarrhoea worldwide and is endemic in most developing countries. In Kenya, bloody diarrhoea is reported weekly as part of priority diseases under Integrated Disease Surveillance and Response System (IDSR) in the Ministry of Health.MethodsWe conducted a case control study with 805 participants (284 cases and 521 controls) between January and December 2012 in Kilifi and Nairobi Counties. Kilifi County is largely a rural population whereas Nairobi County is largely urban. A case was defined as a person of any age who presented to outpatient clinic with acute diarrhoea with visible blood in the stool in six selected health facilities in the two counties within the study period. A control was defined as a healthy person of similar age group and sex with the case and lived in the neighbourhood of the case.ResultsThe main presenting clinical features for bloody diarrhoea cases were; abdominal pain (69 %), mucous in stool (61 %), abdominal discomfort (54 %) and anorexia (50 %). Pathogen isolation rate was 40.5 % with bacterial and protozoal pathogens accounting for 28.2 % and 12.3 % respectively. Shigella was the most prevalent bacterial pathogen isolated in 23.6 % of the cases while Entamoeba histolytica was the most prevalent protozoal pathogen isolated in 10.2 % of the cases. On binary logistic regression, three variables were found to be independently and significantly associated with acute bloody diarrhoea at 5 % significance level; storage of drinking water separate from water for other use (OR = 0.41, 95 % CI 0.20–0.87, p = 0.021), washing hands after last defecation (OR = 0.24, 95 % CI 0.08–.076, p = 0.015) and presence of coliforms in main source water (OR = 2.56, CI 1.21–5.4, p = 0.014). Rainfall and temperature had strong positive correlation with bloody diarrhoea.ConclusionThe main etiologic agents for bloody diarrhoea were Shigella and E. histolytica. Good personal hygiene practices such as washing hands after defecation and storing drinking water separate from water for other use were found to be the key protective factors for the disease while presence of coliform in main water source was found to be a risk factor. Implementation of water, sanitation and hygiene (WASH) interventions is therefore key in prevention and control of bloody diarrhoea.