People Attending Research Articles

Immediate smoking cessation support versus usual care in smokers attending a targeted lung health check: the QuLIT trial

ObjectivesLung cancer screening programmes offer an opportunity to address tobacco dependence in current smokers. The effectiveness of different approaches to smoking cessation in this context has not yet been established....

Technology, Audio-visual Adaptation and Cultural Re-education of Opera

Considering the various uses that cinema has made of opera, this paper focusses on the new exhibitive and distributive mediums of musical theatre on the big screen today. This ranges from live broadcasts to the use of the screen in contemporary opera stagings. The paper raises several challenges, but particularly analyses the common market shared between opera and the audio-visual industry, from the perspective of the opera business in theatres. After defining the technological and commercial features that transform these broadcasts into sustainable film products, the focus is on ascertaining the audio-visual properties that establish opera simulcasts as a new media event in sociological terms.
 Once the technological perspective has been explored, the paper goes on to an aesthetic analysis of the audio-visual formats offered by combining opera and cinema. This analysis also offers an explanation of some of the sociological behaviours adopted by people attending films in theatres. Determining the characteristic narrative quality of opera enjoyed by audiences can facilitate a new exploration in the film industry of the future relations between these traditional art forms.

Epidemiological Community and Differences of Transmissive Infections in Astrakhan Region

Relevance. The territory of the Astrakhan region hosts natural foci of severe infections of arbovirus etiology – Crimean-Congo hemorrhagic fever (CCHF) and Astrakhan fever (spotted fever resembling the Mediterranean spotted fever, Astrakhan spotted fever (ASF). The long-term average incidence of CCHF and ASF in the Astrakhan region is to 11 and 135 times higher, respectively, than the average incidence in the Russian Federation. Aims. To present, based on epidemiological data, a comparative characterization of transmissible infections of CCHF and ASF in the Astrakhan region. Materials & Methods. The main method of the study was epidemiological. The data for 2000−2016 of primary medical documentation Ф.058/у «Emergency notification of infectious disease, food, acute occupational poisoning, unusual reaction to vaccination», federal statistical observation Ф. 2 «Information on infectious and parasitic diseases», Ф. 357/у «Epidemiological examination card of infectious disease focus», Ф. .003/у «Medical card of inpatient patient», presented by Center of hygiene and epidemiology in Astrakhan region. For retrospective epidemiological analysis, we studied the absolute and intensive morbidity indicators (per 100 ths population), by age, professional groups, and among the urban and rural population. Based on the average long-term morbidity indicators of the population, a mapping of the territory of the Astrakhan region was carried out. The influence of natural and climatic conditions on the epidemic process of CCHF and ASF was assessed by meteorological data (amount of precipitation, air temperature, etc.). Materials of long-term observation over 11 districts of Astrakhan region and Astrakhan city were analyzed, including data on the spread of Ixodid ticks, population contact with them (according to the attendance of people to treatment-and-prophylactic organizations of the region). Statistical data processing was carried out using the method of straight-line alignment of dynamic series of morbidity indicators, calculation of the average annual rate of decrease/increase. Correlation analysis was used to assess the direction and strength of the relationship between the indicators, and quantitative dependence between epidemic process characteristics. Differences between the indicators were considered to be reliable if p < 0.05. Results. During the analyzed period 151 cases of CCHF and 3951 cases of ASF were identified. By 2016. CCHF was registered in all 11 districts of the region and the area of foci covered 44,000 km2 and 44,100 km2, respectively. There are no differences significantly affecting the epidemic process of CCHF and ASF, so preventive measures are mainly aimed at controlling the vectors of the pathogens of these infections. The comprehensive study of the territory of Astrakhan region carried out in 2000–2016 revealed expansion of CCHF and ASF areal of disease (by 11.8% and 23.4% respectively) and determined the territories with the highest risk of infection, which allowed to increase and redistribute the volumes of acaricide treatments of the territories with the highest infection risk and ensure the decrease of CCHF and ASF morbidity rates. Conclusion. As a result of the comprehensive study conducted in 2000–2016 in the territory of Astrakhan region, the expansion of CCHF and ASF areal of disease was revealed (by 11.8% and 23.4% respectively) and the areas of highest infection risk were identified, which allowed to increase and redistribute the volume of acaricide treatments of the areas of highest infection risk and ensure the reduction of CCHF and ASF morbidity.

COVID-19 Vaccine Behaviour among People Attending a Tertiary Care Center, Punjab, India

Introduction: Coronavirus Disease 2019 (COVID-19) appropriate behaviour and vaccination are two critical defenses in the fight against this pandemic. As these need to be followed religiously, this preventive behaviour should be thoroughly investigated. Aim: To examine the COVID-19 vaccine behaviour amongst people attending tertiary care centre at Patiala, Punjab, India. Materials and Methods: A cross-sectional study was conducted on 200 individuals attending the Outpatient Department of Government Medical College at Patiala, Punjab, India, from 15th July to 22nd July 2021. Individuals were administered sociodemographic questionnaire, General Health Questionnaire-12- Hindi version (GHQ-12), and COVID-19 vaccine related and COVID-19 appropriate behavior related questionnaire. Actual observation by the clinician regarding proper use of face masks, hand hygiene and social distancing was done and objectively scored on 0-10 for each item with a scale interval of 2. Analysis was conducted using IBM Statistical Package for the Social Sciences (SPSS) version 22.0. Results: Only 40% individuals were vaccinated. After eligibility, there was a mean delay of 4.20±3.51 weeks (median: 4 weeks) and 13.40±3.33 weeks (median: 12 weeks) in the vaccinated and unvaccinated individuals. Out of 120, 86 unvaccinated participants planned to get vaccinated in future. Significantly lower scores were obtained for actually observed COVID-19 appropriate behaviour (proper mask usage, hand hygiene and social distancing) as noted by the clinician vs the scores as reported by the participants. Conclusion: There were few takers for the COVID-19 vaccine, even weeks after eligibility. The COVID-19 appropriate behaviour was largely not being followed properly and the false sense of following the same complicated issues further. With multiple waves of the pandemic one after the other, and booster doses of vaccination, there is still an urgent need to sensitise the population at the grass root level regarding the COVID-19 vaccine behaviour to fight this pandemic.

Should Disabled People Attend Livestock Activities? Disable People, Instructors and Employer Perspective

The aim of the study is to examine the positive/negative effects of both disabled people and livestock enterprises with the participation of disabled people in livestock farm activities with survey researches. The current situation and problems on disabled individuals, trainers and livestock farm owners related to the employment of disabled individuals in livestock farm activities have been revealed, the necessity of providing the necessary training and state incentives for the disabled individuals to enter business life has come to the fore. It has been foreseen that it is necessary by both the livestock farm owners and it has been concluded that those responsible for this area should carry out studies. As a result, when the answers are evaluated, it can be said that disabled individuals want to take responsibility for the care and feeding of animals and they are positively affected when spending time with animals. Additionally, participants in the research believe that disabled people can be included in business life if given the opportunity, when they receive vocational training on a correct and sectoral basis.

Spirituele voorkeure en die ervaring van ere-dienste in die Nederduitse Gereformeerde Kerk1 Spiritual preferences and the experience of worship services in the Dutch Reformed Church

OPSOMMING Daar is 'n wêreldwye tendens van afname in lidmaatgetalle van hoofstroomkerke. Hierdie artikel fokus op die Nederduitse Gereformeerde Kerk (NGK) in Suid-Afrika. Dit ondersoek of die hoofsaaklik rasionele verstaan van God eerder as 'n persoonlike spirituele ervaring 'n rede vir die afname in die spesifieke Gereformeerde kerklike tradisie kan wees. Die gewildheid van charismatiese en pinksterkerke in die konteks kan toegeskryf word aan hulle klem op subjektiewe ervaring, wat ook kenmerkend is van die postmoderne kultuur. Mense woon eredienste by met die verwagting dat hulle spirituele behoeftes bevredig sal word. Mense se spirituele en emosionele behoeftes verander saam met hulle leefwereld. In die moderne era was die klem op rasionele kennis terwyl die klem in 'n postmoderne era meer op subjektiewe ervaring is. Hierdie paradigmaskuif beïnvloed die wyse waarop mense godsdiens ervaar en beoefen. Die ondersoek maak gebruik van Corinne Ware se spirituele tipologie om insig te verkry in mense se ervaring van eredienste in die NG Kerk. Die resultate dra by tot 'n beter verstaan van lidmate se spirituele behoeftes met betrekking tot eredienste om by te dra tot hulle geestelike groei. Die vraag is hoe die NG Kerk getrou kan bly aan die gereformeerde tradisie terwyl 'n meer holistiese en inklusiewe benadering gevolg word, spesifiek wat eredienste betref. Trefwoorde: gereformeerd, spiritualiteit, spiritualiteitstipes, erediens, eredienservaring, liturgie, katafaties, apofaties, modern, postmodern ABSTRACT Membership of mainstream churches is declining all over the world. This article focuses on the Dutch Reformed Church (DRC) in South Africa. It investigates whether a reason for the decline in this specific Reformed ecclesial tradition could be the predominantly rational understanding of God rather than that of a personal spiritual experience. The popularity of charismatic and Pentecostal churches in the context could be attributed to their emphasis on subjective experience, which is also characteristic of postmodern culture. People attend worship services with the expectation of having their spiritual needs met. People's spiritual and emotional needs evolve as their lifeworld changes. In the modern era, the emphasis was on rational knowledge. In this era people resonated with the rational approach of the mainstream churches. The influence of the postmodern era is visible in the emphasis on subjective experience. This paradigm shift influences how people experience and practice religion. They tend to search for congregations that address their needfor a fulfilling spiritual experience. Many prefer worship services where they have a personal, emotional experience of God. Every person has unique spiritual needs and experiences God in unique ways. Therefore people exercise their faith in different ways. Spirituality plays an important role in people's lives. A qualitative approach was used to gain insight into people's experiences. The empirical part of the study was based on responses from volunteers who participated by completing spirituality questionnaires and took part in semi-structured interviews. The aim was to ascertain whether the DRC is experienced to be exclusive regarding spiritual preferences and, if so, whether this could be a contributing factor when it comes to the decline in membership of the Church. In 1980 Urban T Holmes wrote a handbook on spirituality, titled A history of Christian spirituality. Holmes' valuable contribution is a typology of spiritual preferences, specifically focused on prayer. In 1995 Corinne Ware used this typology and expanded it. She specifically focused on the way people responded to worship patterns. She explained differences in spirituality and spiritual preferences by distinguishing between four groups. She called the spirituality preferences "spirituality types" and named them "head", "heart", "mystic" and "hand". Ware developed a questionnaire to determine a person's "spirituality type". This investigation utilised Corinne Ware's spiritual typology to gain insight into people's experiences of worship services in the DRC. The results contribute to a better understanding of members' spiritual needs with regard to worship services in order for these experiences to contribute to their spiritual growth. The question is how the Dutch Reformed Church can remain true to its Reformed tradition while taking a more holistic and inclusive approach to spirituality, specifically with regard to worship. Keywords: reformed, spirituality, spirituality-types, worship service, worship experience, liturgy, cataphatic, apophatic, modern, postmodern

COVID-19 Vaccine Hesitancy among the Non Medical Adult Population Attending a Tertiary Care Hospital of Kolkata, India: A Cross-sectional Study

Introduction: Vaccines play an important role in the fight against diseases whose cure is unavailable. In the battle against pandemics such as Coronavirus Disease-2019 (COVID-19), the vaccine is the only available course of prevention. The hesitancy has been found all over the world, while some find it against their religious values, others are concerned about safety, or have doubts about its efficacy. Some are hesitant due to fear of needles while some show brass negligence. Being the second most populated country globally and a developing nation, India had faced its fair share of struggles with her citizens vaccinated. Even a minute percentage of people accounts for millions; hence, it is of utmost importance to get to the root of the causes of delay in vaccination. Aim: To find the causes of delay or hesitancy among the people attending COVID-19 vaccination centre of a tertiary care hospital of Kolkata, (a year after vaccines were introduced to the general population). Materials And Methods: A cross-sectional study was performed in the COVID-19 vaccination centre of Medical College Kolkata, West Bengal, India, from 14th January to 14th April 2022. Total 74 non medical (not related to healthcare work) people who had come for 1st or 2nd dose of COVID-19 vaccination were included in the study. A prestructured, pretested, prevalidated questionnaire was used to collect data from the participants of the study. The Likert scale comprising of nine questions were used to assess hesitancy. Data were analysed using Chi-square test. Binary logistic regression was done to confirm any predictability of occupation, literacy rate, age and gender on vaccine hesitancy. Results: The participants comprised of 45 (60.8%) females and 29 (39.2%) males, aged between 18 to 60 years with the mean age of 33.75±11.06 years. The participants included 22 (29.7%) people who had just taken their first dose. Twenty six (35.1%) participants were hesitant. The most common causes of hesitancy were individuals’ fear of the vaccine and its impact on general health, unavailability of slots for vaccination and reluctance. Out of total, 58 (78.4%) people had faith in vaccines made in India and 48 (64.9%) persons believed that the vaccine would provide complete protection against COVID-19. Conclusion: People were mainly concerned about safety issues as adequate and reliable information was not available to them. Some of them ignored the importance of vaccination while some could not get vaccinated due to the unavailability of slots.

Knowledge, Attitude, and Practice towards Malaria among People Attending Mekaneeyesus Primary Hospital, South Gondar, Northwestern Ethiopia: A Cross-Sectional Study.

Background Malaria is one of the most severe public health problems worldwide. It is a leading cause of suffering, death, and socioeconomic problem, especially in many developing countries like Ethiopia. To introduce appropriate preventive and control measures, assessment of community's levels of knowledge, attitude, and preventative practices regarding malaria is crucial. This study was aimed at assessing the knowledge, attitude, and practice (KAP) towards malaria and its preventive and control methods among people attending Mekaneeyesus primary hospital, South Gondar, northwestern Ethiopia. Methods A hospital-based cross-sectional study was conducted from September 2017 to April 2018. A structured questionnaire was administered to collect data on sociodemographic characteristics and KAP of 390 randomly selected individuals. The data collecting tool was pretested before commencing the actual data collection. The data were analyzed using the SPSS version 21 software. P values less than 0.05 were considered statistically significant. Results The overall prevalence rate of malaria in the study area was 8.5%. Nearly two-third of the participants had good knowledge (63.1%) and positive attitude (62.6%) scores towards malaria while only half of the participants had (50.8%) good practice score towards malaria prevention and control measures. Sex, age category, family monthly income, residence, and occupational and educational status of the participants were significantly associated with knowledge and practice scores (P < 0.05). The odds of malaria were 26.93 (CI = 3.67‐197.47, P = 0.001) and 13.09 (CI = 0.93‐183.47, P = 0.036) times higher among individuals who had poor knowledge and poor practice towards malaria, respectively, as compared to individuals who were knowledgeable and had good practice score towards malaria. Conclusion The overall knowledge score, attitude, and practice level of respondents towards malaria was relatively good. However, significant proportion of the participants still have misconception about the cause, sign and symptoms, modes of transmission, and practices towards prevention methods of malaria. Thus, health education which is aimed at raising community's awareness about the disease is necessary to address the gaps identified by this study.

Point-of-care hepatitis C testing and treatment strategy for people attending harm reduction and addiction centres for hepatitis C elimination.

According to WHO goals, the elimination of Hepatitis C Virus (HCV) by 2030 requires enhancing and simplifying HCV testing. Our aim was to create a model to assess and compare different strategies for HCV testing, linkage to care and treatment among people who access harm reduction centres (HRC) and Addiction Centres in Catalonia. A decision tree model was designed to evaluate two strategies: Hepatitis C Point‐of‐care (POC) “test and treat”, at the community versus standard‐of‐care (SOC), in which HCV testing was performed at community and therapy at the hospital. Both strategies were assessed separately in HRCs (6,878 users) and Addiction Centres (13,778 users). with a time horizon of 18 months. Healthcare outcomes were HCV testing, linkage to care, treatment outcomes and reinfection rate. HCV testing was performed in 3,178 (46%) of the HRC users. Compared with SOC, POC increased access to treatment by 57% (63% vs. 6%). SVR rates were 64% in POC vs. 23% in SOC. Reinfection rates were 21% with POC compared to 24% with SOC. With POC, losses to follow‐up were reduced by 41%. In the Addiction Centres, 12,566 users (91%) were screened using the two strategies. Compared to the SOC, POC increased access to treatment and linkage to care by 19% along with SVR at the same rate. Reinfection rates decreased by 6%. Thus, the implementation of a POC “test and treat” strategy at HRCs and Addiction Centres has shown to be an effective public health strategy to help eliminating HCV in accordance with WHO goal.

Health literacy and healthcare service utilisation in the 12-months prior to entry into residential alcohol and other drug treatment

IntroductionHealth literacy refers to an individual’s capacity to gather, process and understand health information, make appropriate health decisions, and engage adequately with healthcare services. Inadequate health literacy has been linked to an increase in acute healthcare utilisation. Research suggests that people living with substance use disorders also access acute healthcare services at high rates. The study investigates whether overall health literacy is related to this population’s use of general healthcare services. MethodsA total of 568 participants were recruited from residential substance use treatment services located in NSW, Australia, as part of a randomised controlled trial; the Continuing Care Project. All participants completed a face-to face baseline questionnaire, which included the Health Literacy Questionnaire; a measure of multidimensional health literacy. Latent profile analysis was used to examine health literacy profiles, with multinominal regression analysis examining if healthcare service utilisation was related to these profiles. ResultsThree profiles of health literacy were identified and termed lowest (n = 86, 15.1%), moderate (n = 338, 59.5%) and highest health literacy (n = 144, 25.4%). The sample accessed both primary and acute healthcare services at high rates. When controlling for demographic variables, there were no significant differences identified between health literacy profiles and service use. Discussion/ConclusionsThis study was the first to use a multidimensional health literacy tool to examine health literacy and general healthcare service utilisation for people attending residential substance use disorder treatment. This population access high levels of healthcare services, however the role that health literacy may play in helping reduce acute healthcare use requires further investigation.

The Prevalence of Functional Disability and Associated Factors among Older People Attending Primary Health-care Centers in Riyadh City

BACKGROUND: The burden of disability among the older population is increasing as older people grow with significant social and economic negative impacts. AIM: This study examines functional disability and its associated risk factors among older Saudi citizens attending primary health-care centers (PHCCs) in Riyadh city. METHODS: This descriptive cross-sectional study was carried out on 504 older Saudi citizens aged ≥60 years who attended a PHCC in Riyadh city between December 2019 and May 2020. Interviewer-administered questionnaire was used to assessing the disability in activities of daily living (ADL) and instrumental activities of daily living (IADL) using the Katz Index and Lawton scale. RESULTS: The prevalence of ADL and IADL disability among participants was 24.6% and 58.5%, respectively. Smoking (p = 0.019), dyslipidemia (p = 0.018), rheumatoid arthritis (p = 0.028), history of falls (p = 0.014), and an emergency visit (p = 0.049) were risk factors associated with ADL disability. Predictors of IADL disability were advanced age (p = 0.004), being female (p = 0.029), and the need for a caregiver (p = 0.000). The need for homecare was positively associated with ADL dependency (p = 0.008) and IADL dependency (p = 0.003). Furthermore, regular physical activity was a protective factor against ADL functional disabilities (p = 0.002) and IADL functional disabilities (p = 0.000). CONCLUSION: This study found a high prevalence of ADL and IADL disability among elderly Saudis. Disability was associated with several sociodemographic and health status factors. The findings of this study highlight the priority of effective and targeted preventive interventions for disability.

Eye Health Service Uptake among People with Visual Impairment and Other Functional Difficulties in Bangladesh: A Cross-Sectional Study with Short-Term Follow Up.

People with visual impairments are disproportionately likely to also have other impairments. However, little is known about whether these other impairments affect access to eye health services. This study among cataract and refractive error patients in four districts in Bangladesh explores the relationship between self-reported difficulties in hearing, mobility, self-care, communication and cognition domains, eye health service uptake, and location of initial eye health assessment. Cataract and refractive errors were diagnosed through ophthalmic clinical assessment, and the Washington Group Short Set (WG-SS) was used to ascertain difficulties in other functional domains. Univariate and multivariate analyses were used to examine the relationship between functional difficulties and uptake of cataract and refractive error services. We found that people with self-reported functional difficulties were less likely to take up refractive error services compared to people with same need but with no functional difficulties, and that they were more than twice as likely to access surgical services after attending an outreach camp compared with a hospital facility. Since a high proportion of people attending eye health assessment services have difficulties in a range of functional domains, strategies to improve the uptake of hospital-based health services are urgently required.

Appropriateness of aspirin prescribing for primary and secondary prevention of cardiovascular disease in type 2 diabetes in different care settings

BackgroundType 2 diabetes is associated with an increased cardiovascular risk. Use of aspirin has been shown to be of benefit for secondary prevention of cardiovascular disease in patients with type 2 diabetes; benefits in primary prevention have not been clearly proven.AimsThis study aims to (a) determine if aspirin is prescribed appropriately in type 2 diabetes for primary or secondary prevention of cardiovascular disease (CVD) and (b) evaluate whether there are differences in aspirin prescribing according to where people receive their care.DesignCross-sectional studyMethodsThe medical records of individuals with type 2 diabetes aged over 18 years and attending Elmwood Primary Care Centre and Cork University Hospital Diabetes outpatient clinics (n = 400) between February and August 2017 were reviewed.ResultsThere were 90 individuals exclusively attending primary care and 310 persons attending shared care. Overall, 49.0% (n = 196) of those were prescribed aspirin, of whom 42.3% were using it for secondary prevention. Aspirin was used significantly more in people attending shared care (p < 0.001). About 10.8% of individuals with diabetes and CVD attending shared care met guidelines for, but were not prescribed aspirin.ConclusionA significant number of people with type 2 diabetes who should have been prescribed aspirin for secondary prevention were not receiving it at the time of study assessment. In contrast, a substantial proportion who did not meet criteria for aspirin use was prescribed it for primary prevention.

Psychiatric liaison service referral patterns during the UK COVID-19 pandemic: An observational study

Background and objectivesCOVID-19 has had a profound effect on mental health. Liaison psychiatry teams assess and treat people in mental health crises in emergency departments (EDs) and on hospital wards. During the first pandemic wave, new Mental Health Crisis Assessment Services (MHCAS) were created to divert people away from EDs. Our objective was to describe patterns in referrals to psychiatric liaison services across the North Central London care sector (NCL) and explore the impact of a new MHCAS. MethodsRetrospective study using routinely collected data (ED and ward referrals) from five liaison psychiatry services across NCL (total population 1.5 million people). We described referrals (per week and month) by individual liaison services and cross-sector, and patterns of activity (January 1st 2020 -September 31st 2020, weeks 1–39) compared with the same period in 2019. We calculated changes in the proportion of ED attendees (all-cause) referred to liaison psychiatry. ResultsFrom 2019–2020, total referrals decreased by 16.5% (12,265 to 10,247), a 16.4% decrease in ED referrals (9528 to 7965) and 16.6% decrease in ward referrals (2737 to 2282). There was a marked decrease in referrals during the first pandemic wave (March/April 2020), which increased after lockdown ended. The proportion of ED attendees referred to liaison psychiatry services increased compared to 2019. ConclusionsPeople in mental health crisis continued to seek help via ED/MHCAS and a higher proportion of people attending ED were referred to liaison psychiatry services just after the first pandemic wave. MHCAS absorbed some sector ED activity during the pandemic.

Microbiological air quality in a Community Family Health Center of Talcahuano, Biobío Region, Chile

Indoor air quality in health centers is essential to protect the health of people. In Chile, the Community Family Health Centers (CECOSF) are places with large attendance of people, favoring the dissemination of microorganisms, and there are no reports of the microbial air loading these health centers. To evaluate the microbiological indoor air quality in CECOSF-Centinela in Talcahuano, Biobío Region. Air samples were taken in 6 rooms of the CECOSF, every 15 days between July 2018 and June 2019, with the MAS-100 NT equipment using trypticase and Sabouraud agars. Different morphotypes of bacteria and fungi were identified by PCR. The bacterial and fungal counts varied between 9.1 × 101 - 2.4 × 103 cfu/m3 and 10 - 1.5 × 102 cfu/m3, respectively. The air in the waiting room presented the highest counts, both for bacteria and fungi (P < 0.05). Staphylococcus, Enterococcus, Pseudomonas, Acinetobacter were identified, highlighting the species Staphylococcus aureus and Pseudomonas oryzihabitans, the latter described as a nosocomial pathogen. Among the fungi, Aspergillus, Meyerozyma and Rhodotorula were identified. The indoor air of the CECOSF-Centinela presents microorganisms of importance in human health. Therefore, it is necessary to formulate more regular monitoring programs for the control of air quality inside these health centers.

Telemedicine and decentralized hepatitis C treatment as a strategy to enhance retention in care among people attending drug treatment centres.

People attending drug treatment centres have a high burden of hepatitis C virus (HCV) and face barriers to diagnosis and treatment. Dried blood spot (DBS) testing has been proposed to simplify diagnosis, but many patients remain untreated. In this retrospective study, we evaluated the reasons for non-retention in care in an intervention using on-site DBS testing and the effect of telemedicine and decentralized care compared to standard of care among people attending drug treatment centres who were lost to follow-up. In a first phase, retention in care, adherence to treatment, and predictive factors in the DBS testing program of patients in drug treatment centres were analyzed and compared to a cohort of patients treated at the hospital outpatient clinic. Subsequently, in a second phase we evaluated in patients lost to follow-up from drug treatment centres the efficacy of one-step testing and telemedicine linked to a decentralized dispensation of HCV treatment or standard of care. Among 512 patients attending drug treatment centres, 467 (91.2%) agreed to be tested and 53.4% (237 patients/444 valid tests) tested positive (46±9 years, 87.3% male) for HCV antibodies. After excluding patients negative for RNA or under surveillance, 178 patients were scheduled to meet with a specialist. Overall, 44 patients did not attend and 25 did not complete the pre-treatment evaluation. The only factor associated with retention in care was patient's knowledge of HCV infection. Treated patients attending drug treatment centres (n=68) compared to the hospital outpatient clinic cohort (n=135) had lower rates of treatment adherence. Among the patients who attended drug treatment centres that were lost to follow-up (n=69), the proportion of patients who completed the program was significantly higher among those assisted by telemedicine than by standard of care (62.5% vs. 24.3%, p=0.002). Although there was a high participation rate in a DBS testing program in drug treatment centres, non-retention in care is a challenge. Importantly, telemedicine linked to a decentralized dispensation of HCV treatment re-engages patients and may be effective for HCV microelimination.

Effectiveness of Intensive Voice Therapy Versus Weekly Therapy for Muscle Tension Dysphonia: A Noninferiority Randomised Controlled Trial With Nested Focus Group

To investigate the noninferiority of intensive voice therapy and compare its effects with weekly voice therapy on multidimensional outcomes of voice and well-being, satisfaction, and attendance in people with muscle tension dysphonia (MTD). The study further aimed to explore clinician's perceptions of barriers and enablers to implementation of intensive therapy. Noninferiority randomised controlled trial with nested focus group. Twenty adults with MTD were randomised to receive either weekly voice therapy (1 hour per week for 8 weeks) or intensive voice therapy (1 hour, 4 days per week for 2 weeks). Participants were assessed by a blinded assessor twice before treatment, once post treatment and once at 4 weeks follow up on the primary outcome measure VHI and a range of secondary auditory-perceptual, acoustic, and patient (i.e., VoiSS, satisfaction) and clinician reported outcome measures (i.e., AusTOMs, attendance rates). Five Speech Language Pathologists also participated in a focus group to explore barriers and enablers to implementing intensive therapy, with questions and analyses guided by the Theoretical Domains Framework. While noninferiority for the primary outcome measure VHI was not confirmed, secondary outcome measures revealed comparable within group clinically important improvements for VoiSS and the AusTOMs, as well as selected acoustic and auditory-perceptual measures for both groups. A trend of more improvements being maintained in the intensive group was identified. Comparably high satisfaction and attendance was also found between groups. Clinicians reported more enablers than barriers to providing intensive therapy which included beliefs that it led to greater progression and consolidation of patient learning, was supported by the local context and was associated with positive emotions. Barriers related to difficulties with booking and scheduling and the belief that intensive therapy was not for all patients. While the current study was likely underpowered to establish non-inferiority of intensive therapy, secondary outcomes suggested that intensive therapy may produce comparable benefits to voice, wellbeing, satisfaction and attendance compared to weekly therapy and may be a viable therapy option for individuals with MTD. When implementing intensive therapy, clinicians should consider patient's preferences and availability, as well as systems which allow for flexible booking and therapy provision for patients. Clear recommendations for future research including the use of a larger sample and telehealth are also provided.

Influence of Applying Preventive Health Conditions Strategy during Coronavirus Pandemic in KSA

This research was for "Influence of Applying Preventive Health Conditions Strategy (PHCS) during Coronavirus Pandemic (CVP) in Kingdom of Saudi Arabia (KSA)". The target was through questionnaire to individuals in KSA. That application of PHCS and persons contribution accountable establishments, to cover Coronavirus infection (CVI), caused CVP and control to redact it, numbers to maintain Saudi health (SH). Using "Cross-sectional Study Method", were on Network for survey study in Saudi community (SC), collected data and had analyzed. Remained 99% participants to questionnaire about everyone, remained 89% dedicated to smearing PHCS closely a total. It was 100% reinforced PHCS, that 98% had approving support non-compliance PHCS. As stayed 83% stationary numerous parties from their doings, and was 100% all individuals, braked family visits in anticipation of any CVI. That stared 85% immobile market exit except for about individuals since it was a need to achieve family responsibilities, and others dedicated at home to decrease CVI. Experiential 74% produced the PHCS to have injury in three quarters because of discontinuing the numerous doings. Here 26% originated that a quarter of persons had cases of CVI, where 55% the relations applied the PHCS about partial because of the attendance of people with the similar family. That concluded the results showed the existence of the PHCS importance in the existence and importance of the CVP. The extent to KSA individuals helped to reduce CVI and protect SH. That recommended PHCS position to SH reserve, deliver a fit culture, and reinforce persons for their help.

Healthy recovery: A stepped wedge cluster randomised controlled trial of a healthy lifestyle intervention for people attending residential alcohol and other drug treatment

BackgroundUnhealthy lifestyle behaviours contribute to the poor health of people attending alcohol and other drug (AOD) treatment. Healthy Recovery is an 8-session group-based intervention that targets smoking, diet and physical inactivity as part of an integrated healthy lifestyle approach. The current study aimed to examine the effectiveness of Healthy Recovery when delivered within residential AOD treatment settings. MethodsThe study design was a stepped-wedge cluster randomised trial. Participants were 151 current smokers attending residential AOD programs provided by the Australian Salvation Army (n = 71, Control condition; n = 80, Intervention condition). The primary outcome was number of cigarettes smoked per day. Secondary outcomes examined other smoking behaviours (7-day point prevalence, use of nicotine replacement therapy [NRT]), diet (servings and variety of fruit and vegetables), and physical activity. ResultsThe mean number of cigarettes smoked per day was significantly lower in the Intervention condition at 2-, 5-, and 8-month follow-up. There were also significant differences in favour of the Intervention condition for number of quit attempts, use of NRT and variety of fruit. There were no other significant differences for other dietary or physical activity variables. ConclusionsHealthy Recovery had a positive impact on smoking behaviours. Future research should consider strategies to further promote smoking cessation (e.g. promoting longer-term use of NRT), as well as addressing physical activity and dietary behaviours. The introduction of broader organisational approaches (e.g. smoke free policies, organised group exercise and cooking activities) might help to enhance healthy lifestyle approaches within AOD treatment settings.

Crimean Ulama Who Participated in the Huzur Lessons and Publications of Quranic Commentary Texts of Mohammed Emin Efendi

Osmanlı döneminde her yıl Ramazan ayında, padişahın huzurunda yapılan tefsir derslerine “huzur dersleri” denilmiştir. 1172/1759 yılında başlayan dersler, Osmanlı Devleti'nin sonuna kadar sürmüştür. Huzur derslerine, başta padişah olmak üzere, şeyhülislâm, dersi sunacak olan mukarrir, müzâkereci konumundaki muhataplar ve dinleyici statüsündeki diğer zâtlar katılırdı. Mukarrir ve muhataplar şeyhulislâm tarafından seçilir, padişah tarafından atanırdı. Derste tefsir edilecek âyetler iki ay önce mukarrir ve muhataplara bildirilir, derse hazırlanmaları sağlanırdı. Her dersin süresi iki saat civarında olup ders bitiminde yüksek rütbeli muhataptan başlamak üzere sırasıyla mukarrire sorular sorulur, müzâkereler yapılırdı. Mukarrir âyetin tefsirini yaptıktan sonra kendisine yöneltilen sorulara ve itirazlara cevaplar verirdi. Huzur dersleri, bir âlimin bulunabileceği en yüksek ve prestijli ilim meclisi idi. Bu meclise iştirak etmek de İstanbul dersiâmlarından olmayı gerektiriyordu. Söz konusu derslere Anadolu şehirlerinden âlimler katıldığı gibi Ahıska, Dağıstan, Bosna gibi Osmanlı coğrafyasının farklı bölgelerinden âlimler de katılmışlardır. Bu âlimlerin bir kısmı da Kırımlıdır.Kırım Osmanlıya bağlandığı andan itibaren Osmanlı ulemasının Kırım’da, Kırım ulemasının da Osmanlı coğrafyasında etkili oldukları bilinmektedir. Nitekim Kırım uleması İstanbul, Mekke, Medine, Kudüs, Bağdad, Şam, Mısır gibi Osmanlı Devleti’ne bağlı olan devrin önemli merkezlerinde müderrislik, müftülük, kadılık, kadıaskerlik gibi üst düzey vazifelerde görev yapmışlardır. Bu durum, Rus işgalinden sonra da aynı şekilde devam etmiştir. Bu çalışmada Kırım ulemasından huzur derslerine katılan Abdülhalim Efendi (öl. 1210/1795), Muhammed (Emin) Efendi (öl. 1243/1827), Abdullah Efendi (öl. 1242/1827 sonrası), Abdülhayy Efendi (öl. 1339/1920), Ahmed Efendi (öl. 1205/1791 sonrası), Ali Şücâî Efendi (öl. 1341/1922), Hasan Rüşdü Efendi (öl. 1311/1894), Selim Efendi (öl. 1260/1844) ve Şerafeddin Şerif Efendi (öl. 1331/1913) ele alınacak ve bu bağlamda hayat hikâyeleri, huzur derslerine katıldıkları yıllar, bulundukları meclisteki konumları ile ilmî rütbeleri hakkında kısaca bilgi verilecek, ardından Kırımlı Muhammed Emin Efendi’nin takrir ettiği huzur dersine ait eser tahlil edilip transkripsiyonu yapılacaktır. Huzur derslerinin muhtevasına dair yegâne kaynak, takrir ve müzâkere metinleridir. Ancak bu metinlerden günümüze ulaşanlar ve bilhassa eski tarihli olanlar oldukça azdır. Bunlardan biri de Kırımlı Muhammed Efendi’ye aittir. 13 varaklık bu eser, İstanbul Üniversitesi Kütüphanesi, Türkçe Yazmalar Bölümü nr. 7297’de yazma halinde olup dili Türkçe’dir. Sultan II. Mahmud devrinde, 1238 senesinde icra edilen huzur derslerinin III. meclisinde müzâkere edilen Âl-i İmrân sûresinin 139-142. âyetlerinin tefsir edildiği bu eser huzur derslerinin muhtevasına ve âyetlerin tefsir metoduna dair bazı fikirler vermektedir. Sadece müzâkere metninin yer aldığı eserde, tıpkı temel kaynak olarak kullanılan Beydâvî’nin Envâru’t-Tenzîl’i ile Fahruddîn er-Râzî’nin Mefâtîh’inde olduğu gibi, rivayet tefsir yöntemi de kullanılmış olmakla birlikte dirâyet yöntemine ağırlık verildiği görülmektedir. Bu bağlamda âyetler âyetle, hadisle, ilk dönem âlimlerinin görüşleri ile tefsir edildiği gibi ekseriyetle geniş dilsel tahlillere, kelâmi tartışmalara, kıraatların manaya etkisine ve benzeri konulara girilmiştir. Anlaşıldığı kadarıyla klasik dönem tefsir metinlerinde de sıkça kullanılan bu yöntem huzur dersleri mukarrirleri tarafından da benimsenmiş ve uygulanmıştır.Bu çalışmadaki tespitlerimize göre, oldukça üst düzey ilmi bir faaliyet olan huzur derslerine, iki mukarrir sekiz muhatap olmak üzere Kırımlı on âlim katılmıştır. Bu veriler şu ana kadarki kayıtlardan hareketle elde edilmiştir. Bazı yıllarla ilgili hiçbir kayıt günümüze ulaşmadığından derslere katılan toplam kişi sayısı ile meclis sayısı konusunda verilen bilgilere ihtiyatlı yaklaşılmalıdır. Yeni belgelere ulaşıldıkça bu rakamların değişme olasılığı vardır.