Public Health Hospital Research Articles

Undernutrition and associated factors among adults with mental and neurological disorders in public health hospitals, Eastern Ethiopia, 2019: a cross-sectional study

BackgroundPoor nutritional status can be consequence of impaired mental health that may lead to involuntary weight gain, weight loss, or deficiency of essential nutrients. However, little has been documented about the nutritional status of adults with mental disorders and the contributing factors in low-income countries like Ethiopia. The aim of this study was to assess the magnitude of undernutrition and associated factors among adults with mental disorders in public hospitals of Eastern Ethiopia.MethodsInstitution-based, cross-sectional study was conducted among 507 adults with mental disorders from March 1, 2019 to April 1, 2019. Interviewer administered pretested structured questionnaire was used to collect data. Anthropometric data were collected using calibrated weighing scale and height measuring board. Descriptive statistics was computed to describe the data. Bivariable and multivariable logistic regression analyses were applied to identify factors associated with the undernutrition. Odds ratio alongside 95% confidence interval (CI) were estimated to measure the strength of the association. Level of statistical significance was declared at p-value less than 0.05.ResultsUndernutrition affected 62.7%; 95% CI: (58.3%, 67.7%) of the patients. Undernutrition was associated with meal frequency < 3 per day (adjusted odds ratio [(AOR = 2.07, 95% CI: (1.18, 3.63)], use of multiple medication (adjusted odds ratio [(AOR = 3.02, 95% CI: (1.88, 4.84)], being non-smoker [(AOR = 0.50, 95%CI: (0.25, 0.91)], and use of prescribed diet [(AOR = 0.45, 95%CI: (0.26, 0.78)].ConclusionsThe magnitude of undernutrition was high among the study participants. Multiple medication, cigarette smoking, frequency of meal and taking prescribed diet were significantly associated with undernutrition. Nutrition education for patients with mental disorders and their caregivers about the impact of taking multiple medication and substance use needs to be emphasized alongside nutritional screening and support to improve their nutritional status.

The development and evaluation of a self-efficacy enhancement program for older adults with mild cognitive impairment

ObjectiveThe aims of this study were to develop a self-efficacy enhancement program and to evaluate its effect on cognitive function, dementia knowledge, self-efficacy, depression, and dementia preventive behaviors in older adults (age ≥ 65 years) with mild cognitive impairment (MCI). MethodsThis equivalent control group pretest-posttest study was conducted at a tertiary hospital in Seoul, South Korea. Older adults with MCI were randomly allocated to an experimental (EG, n = 16) or control group (CG, n = 16). The EG underwent an 8-week intervention (weekly 60-min session) utilizing self-efficacy enhancement strategies; the CG received usual care. The intervention was comprised of physical, cognitive, and emotional activities and was followed by 4-week maintenance during which both groups engaged in self-learning at home with a dementia preventive guidebook. Outcome data were evaluated at the pretest and 8, 10, and 12 weeks later. This study adhered to the CONSORT guidelines. ResultsThere were significant differences in cognitive function, dementia knowledge, self-efficacy, and dementia preventive behaviors, but not in depression between the two groups over the time. Regarding cognitive function subdomains, significant differences were observed in visuospatial/executive, attention, language, and delayed recall. ConclusionThe integrated intervention consisting of physical, cognitive, and emotional activities was effective in improving cognitive function, dementia knowledge, self-efficacy, and dementia preventive behaviors. This suggests that this program can be utilized as an educational program to prevent dementia in older adults with MCI in dementia support centers, public health centers, clinics, and hospitals. Trial registrationKCT0006094 in the Clinical Research Information Service. Retrospectively registered 23 April 2021, https://cris.nih.go.kr/cris/search/listDetail.do

Inventory management practices: implications on the pharmaceuticals expenditure of rabies vaccine in public health facilities, Namibia

BackgroundTo achieve well-regulated distribution, storage, and utilization of the rabies vaccine, health facilities should adhere to standard operating procedures. In Namibia, information on inventory management, utilization, monitoring, and reporting of rabies vaccine adherence to standard operating procedures in public healthcare facilities is insufficient. The aim of this study was to assess adherence to rabies vaccine standard operating procedures and inventory management and to compare rabies vaccine expenditure to the number of patients who received rabies vaccination at the Ministry of Health and Social Services’ public healthcare facilities from 2018 to 2020.MethodsA cross-sectional, web-based questionnaire consisting of closed-ended questions was sent to 147 pharmacy staff and warehouse managers working in the 14 regions of Namibia during the period of May 1, 2021, to June 2, 2021. The overall expenditure and the total number of patients vaccinated from 2018 to 2020 were obtained from national-level logistic and vaccination program coordinators. Data were coded and transcribed into Microsoft® Excel® 2013 and analyzed using SPSS® version 27.ResultsOne hundred and thirty-three completed questionnaires were received from sixty-nine public health centers and hospitals. The group of respondents consisted of pharmacist assistants (50%), pharmacy technicians (12%), pharmacists (36.8%), senior pharmacists (0.8%), and chief pharmacists (1.5%). Overall, adherence to standard operating procedures was poor (27.1%). Rabies vaccine distributed to public health facilities from 2018 to 2020 was worth N$75,381,419.91 (~ US$4,074,671.46) and was expected to vaccinate 87,269 patients; however, only 95 cases of both rabies and rabid dog-bite patients were reported. The major inventory management challenges for public healthcare facilities include an inadequate number of pharmacy staff, poor adherence to standardized pharmaceutical warehousing, lack of regular supervision, and inadequate staff training.ConclusionInventory management practices in public healthcare facilities were not in compliance with standard operating procedures. There is a significant discrepancy between rabies vaccine expenditure and the number of patients that were vaccinated. Therefore, there is a need for adequate staff training on inventory management and regular facility supervision to enforce optimal rabies vaccine inventory management practices.

Diabetic foot in Mexico: risk factors for mortality after a major amputation, at 5 years, in a second-level public health hospital

Diabetic foot in Mexico: risk factors for mortality after a major amputation, at 5 years, in a second-level public health hospital

Motivation as a Factor for Enhancing Employees’ Satisfaction: A Case Study of Juba Teaching Hospital, South Sudan

Since issues of employees’ motivation are recorded to be emerging with the current and predicted increases in low salary, delayed salary encourages turnover rates marked that human resources got dehumanized and stopped happiness to people. This study was designed to examine the relationship between motivation and employees’ satisfaction, explore the factors influencing Motivation to enhance employees’ satisfaction and determine the factor structure of Motivation, enhancing employees’ satisfaction in Public Health Hospital. &#x0D; This research design was cross-sectional and descriptive, using quantitative approaches from a population of 838 persons. The purposive and simple random sampling technique was employed to select 260 respondents using The Likert scale. A set of attitude statements was presented as closed-end structure questionnaires and interview guides. SPSS version (20.0) and EPIDATA Program for coding (CSpro 7.5 version) were used to analyze the data. The results were presented using Spearman correlations coefficient, Regressions, ANOVA of variance and factor analysis structure loading to predict the variable relationship. &#x0D; The finding showed that there is a significant positive relationship between motivation and employees’ satisfaction (r=0.003, P-value &lt; 0.01). Enhancing and employees’ satisfaction (r=0.082, p-value &lt;0.01). Motivation is significantly correlated with employees’ satisfaction. However, motivation and employee’s satisfaction (r=0.128, p-value &lt; 0.01)), the staff with more opportunities for motivation are more likely to offer quality services. Indeed, employees with high motivation deliver quality services, indicating that employees’ satisfaction depends on motivation. The regression analysis shows the relationship between motivation, enhanced employees’ satisfaction (F= 1.984, sig=0.000) motivation and enhancing extremely explained employee’s satisfaction of (

Effective Prediction of Mortality by Heart Disease Among Women in Jordan Using the Chi-Squared Automatic Interaction Detection Model: Retrospective Validation Study.

Many current studies have claimed that the actual risk of heart disease among women is equal to that in men. Using a large machine learning algorithm (MLA) data set to predict mortality in women, data mining techniques have been used to identify significant aspects of variables that help in identifying the primary causes of mortality within this target category of the population. This study aims to predict mortality caused by heart disease among women, using an artificial intelligence technique-based MLA. A retrospective design was used to retrieve big data from the electronic health records of 2028 women with heart disease. Data were collected for Jordanian women who were admitted to public health hospitals from 2015 to the end of 2021. We checked the extracted data for noise, consistency issues, and missing values. After categorizing, organizing, and cleaning the extracted data, the redundant data were eliminated. Out of 9 artificial intelligence models, the Chi-squared Automatic Interaction Detection model had the highest accuracy (93.25%) and area under the curve (0.825) among the build models. The participants were 62.6 (SD 15.4) years old on average. Angina pectoris was the most frequent diagnosis in the women's extracted files (n=1,264,000, 62.3%), followed by congestive heart failure (n=764,000, 37.7%). Age, systolic blood pressure readings with a cutoff value of >187 mm Hg, medical diagnosis (women diagnosed with congestive heart failure were at a higher risk of death [n=31, 16.58%]), pulse pressure with a cutoff value of 98 mm Hg, and oxygen saturation (measured using pulse oximetry) with a cutoff value of 93% were the main predictors for death among women. To predict the outcomes in this study, we used big data that were extracted from the clinical variables from the electronic health records. The Chi-squared Automatic Interaction Detection model-an MLA-confirmed the precise identification of the key predictors of cardiovascular mortality among women and can be used as a practical tool for clinical prediction.

Determinants of Artificial Intelligence Adoption in Disease Diagnosis for Improving Health Sector Services in Tanzania: A Case of Muhimbili National Hospitals

The study was conducted at Muhimbili national Hospitals to assess the use of Artificial Intelligence in Disease Diagnosis for Improving Health Sector Services in Tanzania. Specifically, the study was interested to assess factors affecting AI adoption in public hospital, examine health workers perception on AI adoption in public hospital and find out effectiveness of AI adoption in proper diagnostic of diseases for improving patient health in public hospitals. The study guided by Technology Acceptance Model. It employed quantitative research approach and survey research design. A sample size of 47 respondents was used where questionnaire were used in data collection. The study revealed that artificial intelligence was useful in diseases diagnosis as it provides accurate information pertaining to patient health; it is quicker in diseases diagnosis and quicker in predicting and diagnosis of patient health. The findings also posited that artificial intelligence is effective in monitoring heart attack and asthma in real time, AI is effective in managing health services, AI is also effective in improving diagnostic and patient. The study recommends the government to provide health workers with training regularly on how to use AI in diseases diagnosis.

Https://universepg.com/journal-details/ejmhs/outcome-of-early-versus-delay-hip-spica-casting-for-children-with-femoral-shaft-fractures

Femoral shaft fractures are among the most prevalent fractures of the lower extremities in children. Although many approaches and options are available for their treatment, the most appropriate treatment option for school going children is still debatable. In this study 34 children with femoral fractures were recruited between Jan. 2018 and Jan 2019 at the Nangarhar university and public health Hospital. which is divided into two groups: (Group-A) immediate reduction with hip Spica consists 22 children and (Group -B) treatment consist of skin traction for 2-3 weeks precede with hip Spica casting consists 12 children and we studied gender distribution, fracture side, site and type of the fracture, also we note complications include; initial shortening, axial, sagittal and rotational alignment and hospital stay. All patients were under observation for a period of 3 months after removal of Spica cast. The study found that boys were more affected than girls, which the middle third of the femoral shaft was the most common site fracture (58.92%), that the spiral fracture was the most common type of femoral shaft fracture (43.18%), as well as that side way alignment was observed more than other kinds of complications in both treatment modalities; for immediate Spica, four children (18.18%) and three cases (25%).Conclusions: There was minimal difference between early and delayed Spica in terms of treatment complications and functional result. However, early Spica greatly reduced hospitalization time and treatment costs while producing equivalent results as delayed Spica use.

ALGORITHMS, ADDICTION, AND ADOLESCENT MENTAL HEALTH: An Interdisciplinary Study to Inform State-level Policy Action to Protect Youth from the Dangers of Social Media.

A recent Wall Street Journal investigation revealed that TikTok floods child and adolescent users with videos of rapid weight loss methods, including tips on how to consume less than 300 calories a day and promoting a "corpse bride diet," showing emaciated girls with protruding bones. The investigation involved the creation of a dozen automated accounts registered as 13-year-olds and revealed that TikTok algorithms fed adolescents tens of thousands of weight-loss videos within just a few weeks of joining the platform. Emerging research indicates that these practices extend well beyond TikTok to other social media platforms that engage millions of U.S. youth on a daily basis.Social media algorithms that push extreme content to vulnerable youth are linked to an increase in mental health problems for adolescents, including poor body image, eating disorders, and suicidality. Policy measures must be taken to curb this harmful practice. The Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED), a research program based at the Harvard T.H. Chan School of Public Health and Boston Children's Hospital, has assembled a diverse team of scholars, including experts in public health, neuroscience, health economics, and law with specialization in First Amendment law, to study the harmful effects of social media algorithms, identify the economic incentives that drive social media companies to use them, and develop strategies that can be pursued to regulate social media platforms' use of algorithms. For our study, we have examined a critical mass of public health and neuroscience research demonstrating mental health harms to youth. We have conducted a groundbreaking economic study showing nearly $11 billion in advertising revenue is generated annually by social media platforms through advertisements targeted at users 0 to 17 years old, thus incentivizing platforms to continue their harmful practices. We have also examined legal strategies to address the regulation of social media platforms by conducting reviews of federal and state legal precedent and consulting with stakeholders in business regulation, technology, and federal and state government.While nationally the issue is being scrutinized by Congress and the Federal Trade Commission, quicker and more effective legal strategies that would survive constitutional scrutiny may be implemented by states, such as the Age Appropriate Design Code Act recently adopted in California, which sets standards that online services likely to be accessed by children must follow. Another avenue for regulation may be through states mandating that social media platforms submit to algorithm risk audits conducted by independent third parties and publicly disclose the results. Furthermore, Section 230 of the federal Communications Decency Act, which has long shielded social media platforms from liability for wrongful acts, may be circumvented if it is proven that social media companies share advertising revenues with content providers posting illegal or harmful content.Our research team's public health and economic findings combined with our legal analysis and resulting recommendations, provide innovative and viable policy actions that state lawmakers and attorneys general can take to protect youth from the harms of dangerous social media algorithms.

Critical Elements of an Mpox Vaccination Model at the Largest Public Health Hospital System in the United States.

In the spring of 2022, mpox spread to non-endemic countries, including the United States. In New York City (NYC), vaccine demand grew as quickly as case counts. With the leadership of the Regional Emerging Special Pathogens Treatment Center (RESPTC) at NYC Health and Hospitals/Bellevue (NYC H+H)-part of the largest public hospital system in the United States-an innovative vaccination model was established that overcame challenges involving health inequities, inadequate access, and lack of vaccine uptake, to successfully administer JYNNEOS vaccines to over 12,000 patients. Transmission has slowed since its peak in August 2022, which has been attributed to successful vaccination campaigns, infection-induced immunity, and behavioral changes among those at highest risk; however, a Centers for Disease Control and Prevention (CDC) assessment released on 4 April 2023 suggests jurisdictions with low vaccination levels (<35%) remain at risk for an mpox resurgence. Here, we summarize the critical aspects of our mpox vaccination model in NYC, which include integration into routine clinical care, prioritization of health equity, and reutilization of COVID-19 vaccination systems, to provide valuable insights for healthcare institutions as we move into the next stage of this ongoing outbreak.

P-454 Assisted reproduction techniques, ovulation induction cycles and spontaneous pregnancies: are there differences in perinatal outcomes?

Abstract Study question Are perinatal outcomes different in pregnancies resulting from frozen embryo transfers (FET), fresh embryo transfers (IVF-ET), ovulation induction (OI) cycles and spontaneous pregnancies (SP)? Summary answer Assisted reproduction techniques (ART) pregnancies are associated with differences in perinatal outcomes when compared to SP, even when different socioeconomic scenarios were considered. What is known already Earlier reviews have suggested that IVF-ET pregnancies are associated with higher gestational risks. However, there have been recent advances in the way ART is performed and studies show controversy as to whether IVF-ET and FET singletons are associated with higher perinatal risks and which are these risks. The objective of this study was to analyze if there are differences when comparing perinatal outcomes in pregnancies resulting from FET, IVF-ET, OI cycles and SP. Study design, size, duration Retrospective cohort study performed at two medical centers in southern Brazil. Data refers to a period from 2013 to 2022 and was collected from electronic records. Participants/materials, setting, methods Data from 6705 singleton pregnancies, divided into four groups: G1, FET (n = 54), G2, IVF-ET (n = 471), G3, OI (n = 121) and G4, SP (n = 6059). Sample included patients from a private reproductive medicine center (G1,G2,G3) and public health hospital (G4) in Brazil. Variables regarding neonatal outcomes were compared between groups and were expressed as mean±SD/median[IIQ] or n(%). Anova and Kruskal-Wallis tests were applied, considering p &amp;lt; 0.05. Main results and the role of chance Comparing G1 vs. G2 vs. G3 vs. G4, the following results found, respectively, mean±DP: maternal age (35.8±5.2 vs. 35.0±3.7 vs. 33.3±3.6 vs. 26.1±6.8, p &amp;lt; 0.001); newborn's weight, kg (3364.7±553.4 vs. 3115.6±565.9 vs. 3195.9±506.3 vs. 3165.1±651.5, p = 0.043); and length, cm (48.6±2.4 vs. 48.1±2.7 vs. 48.2±2.8 vs. 50.4±1.1, p = 0.971); median[IIQ]: gestational age, weeks.days (39[33-41.3] vs. 38.5[22-41] vs. 39[28-41.5] vs. 39 [25-46], p = 0.809); n%: prematurity (11.3 vs. 13.8 vs. 9.8 vs. 8.9, p = 0.006); Apgar 5thmin≥7 (100 vs. 98.4 vs. 99.1 vs. 96.4, p = 0.020); macrosomia (9.2 vs. 3.1 vs. 3.2 vs. 6.0, p = 0.028); C-section (88.6 vs. 91.0 vs. 85.2 vs. 32.0, p &amp;lt; 0.001). It's important to highlight Brazil's health care differences between public and private services, as public's poor assistance could explain lower Apgar index and C-sections (performed only if obstetric indication). Even so, higher macrosomia and preterm rates were found after ART. Limitations, reasons for caution Women who deliver in public hospitals in Brazil usually have a lower socioeconomic status and less access to adequate prenatal care, which could bring bias in some analysis. Also, there is a sample size discrepancy between groups and no data regarding fertile status in the SP patients. Wider implications of the findings The higher prematurity rates and, in FET cases, macrosomia, reinforces previous studies findings on this subject. As infertility is a worldwilde growing condition, comparing SP and ART is essential for better understanding the implantation processes that could improve ART's perinatal results in the future. Trial registration number not applicable

“It Seems like it’s Helping”: Complementary and Alternative Medicine Use among Breast Cancer Patients at a South African Breast Clinic

The use of complementary and alternative medicine in the treatment of breast cancer is widely documented in low- and middle-income countries. However, there are limited data on the use of complementary and alternative medicine among breast cancer patients in South Africa. In this study, we examined the use of complementary medicine among a small sample of women attending a breast cancer clinic in a public health hospital in the Western Cape, South Africa; a context in which structural violence is rife. A convenience sample of 17 women participated in semi-structured interviews. We used an interpretative phenomenological analysis approach. We found that breast cancer patients’ use of complementary and alternative medicine was motivated by (1) pragmatic reasons related to health system delays in obtaining biopsy results, confirmation of diagnosis and between diagnosis and start of treatment, (2) psychological benefits, namely, enhancing holistic well-being and fostering a sense of hope and agency despite the physical disease, and (3) sociocultural influences. Such information was based on folk knowledge and cultural beliefs. Patient-centred care in this context may be enhanced by collaboration between biomedical and practitioners who provide complementary and alternative medicine to support transparency in patient treatment options, negotiate the various domains of patient care (physical, psychological, sociocultural) and contribute to earlier detection, diagnosis and better treatment outcomes. In addition, further research on the systemic complexities of structural violence and the way in which it shapes the illness experiences of women is necessary.

Analysis of quality of life and functional capacity in cancer patients receiving chemotherapy in Paraná Southwest, Brazil

Understanding psychosocial responses in cancer patients is fundamental for prognosis and quality of life (QoL). Chemotherapy is the primary and essential treatment for cancer. However, patients submitted to chemotherapy frequently show emotional and cognitive disruptions, which negatively influence the overall QoL. Here we evaluated the relationship between the functional capacity (FC) and QoL of cancer patients submitted to chemotherapy in a public health hospital in Paraná southwest, Brazil. We included 101 patients with cancer receiving chemotherapy who were enrolled from June to December 2017. Karnofsky Performance Status Scale (KPS) and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) were used to evaluate FC and QoL, respectively. Patients presented a mean age of 59.6±13 years and were predominantly female. Breast cancer was the most common neoplasia (43.56%), and most patients exhibited advanced disease (73%) and distant metastasis (66.33%) at diagnosis. The global health score evaluated by EORTC QLQ-30 was 67.5%, and about 63% of patients presented a KPS of 80%. The working function was the one most affected FC (R=0.515; p&lt;0.05). Emotional and social functions were strongly associated with patients' global health status (R=0.960; p&lt;0.05). Our data showed that the KPS is an excellent tool for evaluating the QoL in patients undergoing chemotherapy, which correlates positively with their global health and is affected by the emotional and social functions of patients.

Comparative Prospective Study: Treatment of Distal Third Tibial Fracture through Medial and Lateral Compression Plate Methods

The most frequent fracture of a long bone is a tibial fracture. Anatomical reduction and rigid fixing may arise from open reduction and plating. To assess and contrast the outcomes of medial and lateral locking compression plates for fractures in the distal part of the tibia. 32 patients with distal tibial fractures were enrolled in the prospective clinical study from November 22, 2019, to November 12, 2020, at Nangarhar University and Public Health Hospital. With a mean age of 34.57 years, 26 closed fractures, and 6 open fractures. Based on the manner of therapy, 32 patients were split into two groups, with the medial plating group (16) included (16 patients) and the lateral plating group. After being released, they were monitored for at least 5 months. The clinical assessment criteria developed by Tinny and Wiss were used to evaluate the functional outcomes. Malunion arose in two cases of the medial plating group and two cases of the lateral plating group as a result.4 cases of superficial and 2 cases of deep infections, 1 nonunion, and 2 wound dehiscence were found in the medial plating group. There were two cases of superficial and one case of deep infection as well as two nonunion in the group3 cases that were classified as excellent-1, good-7, fair-8, and poor. In the lateral plating group, the scores were Excellent 2, good 6, fair 7, and poor 1 respectively. Ankle dorsiflexion and plantar flexion ultimate ranges of motion in the medial plating group were 18.2° and 29.5°, respectively. The end range of motion for the lateral plating group was 20° for ankle dorsiflexion and 33.2° for ankle plantar flexion. Finally, it is safe and practical to plat the distal tibia laterally, which can provide biological fixation and avoid soft tissue complications.

Suicidal behavior among inpatients with severe mental conditions in a public mental health hospital in Uganda

BackgroundSuicidal behaviors are prevalent among inpatients with severe mental conditions and may result in many dying by suicide. Few studies have focused on the burden of suicidal behaviors among these inpatients in low-income settings, despite suicide being consistently higher in lower-income countries such as Uganda. This study, therefore, provides the prevalence and associated factors of suicidal behaviors and suicide attempts among inpatients with severe mental conditions in Uganda.MethodThis was a retrospective chart review of all individuals admitted with severe mental conditions to a large psychiatry inpatient unit in Uganda for four years (2018–2021). Two separate logistic regressions were conducted to determine the factors associated with suicidal behaviors or suicidal attempts among the admitted individuals.ResultsThe prevalence of suicidal behavior and suicidal attempts among 3104 (mean age = 33, Standard deviation [SD] = 14.0; 56% were males) were 6.12% and 3.45%, respectively. Having a diagnosis of depression increased the likelihood of both suicidal behaviors (adjusted odds ratio [aOR]: 5.36; 95% confidence interval [CI]: 2.14–13.37; p =0.001) and attempts (aOR: 10.73; 95% CI: 3.44–33.50; p < 0.001). However, a diagnosis of substance-related disorder increased the likelihood of having attempted suicide (aOR: 4.14; 95% CI: 1.21–14.15; p = 0.023). The likelihood of having suicidal behavior decreased as one increased in age (aOR: 0.97; 95% CI: 0.94–0.99; p = 0.006) and increased among individuals reporting stress from financial constraints (aOR: 2.26; 95% CI: 1.05–4.86; p = 0.036).ConclusionSuicidal behaviors are common among inpatients managed for severe mental health conditions in Uganda, especially those with substance use and depressive disorders. In addition, financial stressors are a main predictor in this low-income country. Therefore, regular screening for suicide behaviors is warranted, especially among individuals with depression, and substance use, among those who are young, and among those reporting financial constraints/stress.

Efforts to Increase Public Knowledge About Health and the Use of Gadgets for Digital Marketing at RW 01 Babakan Ciparay Bandung City

Community service activities carried out by Working Group 1 Immanuel Bandung Health Institute in RW 01 Babakan Ciparay Village, Babakan Ciparay District, Bandung City. Community service aims to Increasing public knowledge about health and utilization gadgets for digital marketing at RW 01 Babakan Ciparay Bandung City. Activities involving 8 lecturers from the S1 Nursing, S1 Public Health, S1 Nutrition, D3 Nursing and D3 Hospital Service Management (MPRS) study programs. There were 10 students involved, consisting of 2 students from the S1 Kesmas Study Program, and 8 people from the D3 MPRS Study Program. Community service methods are carried out by means of counseling, lectures and questions and answers, using videos, posters, stickers, and direct practice. The media used are televisions, and laptops to display material in the form of power points. The material presented to the community was carried out in 2 stages and took place at the house of the head of RW 01 Babakan Ciparay. Phase 1 was held on Wednesday, September 8, carried out by 2 lecturers to deliver material on the use of gadgets in the era of digital marketing, family mental health and video screenings on the prevention of COVID-19, hypertension and diabetes mellitus. The second phase was held on Tuesday, 27 September 2022. The material presented includes: mental health of pregnant women and the importance of eating fruits and vegetables by means of lectures using power point media. Material on hypertension is delivered directly through lectures and questions and answers. Material on handling cardiac arrest at home, carried out with direct practice to the community. Media used for learning using mannequin aids. In addition, posters about COVID-19 prevention and stickers on how to sort waste were also given. The results of community service can increase public knowledge about health in general and the use of gadgets for digital marketing. The constraints of this community service activity have not been evaluated in a structured manner using questionnaires. The suggestion that can be recommended is that the implementation of community service be carried out in the same location with different materials, and that IKI should have a target area. Community service activities can then be continued with research first to find out the problems that exist in the community.

Comparative Activities of Novel Therapeutic Agents against Molecularly Characterized Clinical Carbapenem-Resistant Enterobacterales Isolates.

Limited treatment options exist for the treatment of carbapenem-resistant Enterobacterales (CRE) bacteria. Fortunately, there are several recently approved antibiotics indicated for CRE infections. Here, we examine the in vitro activity of various novel agents (eravacycline, plazomicin, ceftazidime-avibactam, imipenem-relebactam, and meropenem-vaborbactam) and comparators (tigecycline, amikacin, levofloxacin, fosfomycin, polymyxin B) against 365 well-characterized CRE clinical isolates with various genotypes. Nonduplicate isolates collected from the largest public health hospital in Singapore between 2007 and 2020 were subjected to antimicrobial susceptibility testing (broth microdilution or antibiotic gradient test strips). Susceptibilities were defined using Clinical and Laboratory Standards Institute (CLSI) or Food and Drug Administration (FDA) interpretative criteria. Sequence types and resistance mechanisms were characterized using short-read whole-genome sequencing. Overall, tigecycline and plazomicin exhibited the highest susceptibility rates (89.6% and 80.8%, respectively). However, the tigecycline susceptibility breakpoint utilized here may be outdated in view of prevailing pharmacokinetic-pharmacodynamic (PK/PD) data. Susceptibility varied by carbapenemase genotype; the β-lactam/β-lactamase inhibitor combinations were equally active (92.3 to 99.2% susceptible) against KPC producers, but only ceftazidime-avibactam retained high susceptibility (98.7%) against OXA-48-like producers. Against metallo-β-lactamase producers, only plazomicin exhibited moderate activity (77.0% susceptible). Aminoglycoside activity was also influenced by carbapenemase genotypes. This work provides an insight into the comparative activity and presumptive utility of novel agents in this geographic region. IMPORTANCE This study determined the susceptibilities of carbapenem-resistant Enterobacterales isolates to various novel antimicrobial agents (ceftazidime-avibactam, imipenem-relebactam, meropenem-vaborbactam, eravacycline, and plazomicin). Whole-genome sequencing was performed for all strains. Our study findings provide insights into the comparative activities of novel agents in this geographic region. Plazomicin and ceftazidime-avibactam exhibited the lowest nonsusceptibility rates and may be considered promising agents in the management of carbapenem-resistant Enterobacterales infections. We note also that antibiotic activity is influenced by genotypes and that understanding the geographic region's molecular epidemiology could aid in the definition of the presumptive utility of novel agents and contribute to antibiotic decision-making.

Effect of fetal malposition, primiparous, and premature rupture of membrane on Neonatal Near miss mediated by grade three meconium-stained amniotic fluids and duration of the active first stage of labor: Mediation analysis.

In many low-income countries, including Ethiopia, neonatal mortality remains a major concern. For every newborn that dies, many more neonates survived (near-miss neonates) the first 28 days after birth from life-threatening conditions. The generation of evidence on neonatal near-miss determinants could be a critical step in reducing neonatal mortality rates. However, studies causal pathway determinants are limited in Ethiopia. This study aimed to investigate the Neonatal Near-miss determinants in public health hospitals in Amhara Regional State, northwest Ethiopia. A cross-sectional study was conducted on 1277 mother-newborn pairs at six hospitals between July 2021 and January 2022. A validated interviewer-administered questionnaire and a review of medical records were used to collect data. Data were entered into Epi-Info version 7.1.2 and exported to STATA version 16 in California, America for analysis. The paths from exposure variables to Neonatal Near-Miss via mediators were examined using multiple logistic regression analysis. The adjusted odds ratio (AOR) and ß-coefficients were calculated and reported with a 95% confidence interval and a p-value of 0.05. The proportion of neonatal near-misses was 28.6% (365/1277) (95% CI: 26-31%). Women who could not read and write (AOR = 1.67,95%CI:1.14-2.47), being primiparous (AOR = 2.48,95% CI:1.63-3.79), pregnancy-induced hypertension (AOR = 2.10,95% CI:1.49-2.95),being referred from other health facilities (AOR = 2.28,95% CI:1.88-3.29), premature rupture of membrane (AOR = 1.47,95% CI:1.09-1.98), and fetal malposition (AOR = 1.89,95% CI:1.14-3.16) were associated with Neonatal Near-miss. Grade III meconium stained amniotic fluid partially mediated the relationship between primiparous (ß = 0.517), fetal malposition (ß = 0.526), pregnant women referred from other health facilities (ß = 0.948) and Neonatal Near-Miss at P-value < 0.01. Duration of the active first stage of labour partially mediated the relationship between primiparous (ß = -0.345), fetal malposition (ß = -0.656), premature rupture of membranes (ß = -0.550) and Neonatal Near-Miss at P- value <0.01.It had also a significant indirect effect (ß = 0.581, P<0.001) on NNM with variables (primiparous, fetal malposition, and premature rupture of membranes). The relationship between fetal malposition, primiparous, referred from other health facilities, premature rupture of membrane, and Neonatal Near miss were partially mediated by grade III meconium stained amniotic fluid and duration of the active first stage of labour. Early diagnosis of these potential danger signs and appropriate intervention could be of supreme importance in reducing NNM.

Molecular aspects of the common types of β-thalassemia mutations among Sudanese patients: a cross sectional study.

The study sought to identify the most common types of mutations in beta-thalassemia Sudanese patients in Khartoum State, as well as their relationship to anemia severity. From July 2017 to July 2021, a cross-sectional study was conducted on 100 samples from known beta-thalassemia patients attending public health hospitals in Khartoum State, and fifty samples were taken from apparently healthy controls. Using a PCR test, blood samples were analyzed to detect the most common types of mutations. For the five mutations included in the study (IVS-I-110(G-A), IVS-I-1(G-A), IVS-I-6(T-C), IVS-I-5(G-C), and β_87(C-G)), 25% of the patients were positive and 75% were negative, while the entire control group was negative for all five mutations. Positive results were found in only three of the five mutations tested; the most common was IVS-I-110, which was found in 14 (56%) of the subjects, followed by IVS-I-6 (T) in 7 (28%), and IVS-I-1 in only 4 (16%) of the subjects. IVS-I-5 and β_87 mutations were not found in the study subjects. The Hb electrophoresis pattern revealed an increase in HbA2 (6.455±0.1318%), a decrease in HbF (1.865±0.1668%), and a decrease in HbA (78.50±0.2858%). The mean serum iron level was 82.99±3.063 ug/dL, which was considered normal. According to the findings, the IVS-1-110 mutation is the most common among Sudanese beta-thalassemia patients. Each type of positive mutation caused mild to moderate anemia.

Preliminary Study of the Physical Fitness Test for Screening of Cognitive Impairment in the Korean Elderly

This study aimed to evaluate the usefulness of physical fitness measurement for cognitive dysfunction screening in elderly Koreans. The subjects of the study were 88 elderly people (16 males and 72 females) aged 60 years or older who visited the Gyeonggi-do public health center and hospital associated with the neurology department of a university hospital in Gyeonggi-do, agreed with the purpose of this study, and wished to participate. Physical fitness measurement variables were isometric muscle strength, muscular endurance, flexibility, cardiorespiratory endurance, agility and dynamic balance, and coordination, and cognitive function tests performed using K-RBANS(Korean-Repeatable Battery for the Assessment of Neuropsychological Status) and CDR(clinical dementia rating), which were dementia screening tools. As a data processing method, correlation analysis was conducted to analyze the correlation between physical fitness and cognitive function. By conducting Receiver Operating Characteristic (ROC) analysis, the diagnostic accuracy and optimal cut-off of each physical fitness test for cognitive impairment were defined as CDR 0.5. As a result of the study, the F8WT, TUG(Time Up & Go Test ), and T-wall tests showed a large area under the curve (AUC) that defined cognitive impairment (TUG=.768, 95%CI=.650~.885; F8WT=.735, 95%). CI=.612~.857, T-wall=.682, 95% CI=.545~.819). The optimal cut-off for predicting cognitive impairment was 6.0 seconds in TUG (sensitivity = 73.2%, specificity = 73.1%), 26.3 seconds in F8WT (sensitivity = 71.4%, specificity = 73.1%), and T-wall. 94.5 seconds (sensitivity = 62.5%, specificity = 65.4%). The F8WT, TUG, and T-wall test were confirmed as accurate and convenient measurement methods for screening cognitive dysfunction in elderly Koreans. In addition, the availability for screening cognitive dysfunction in the elderly population with various levels of education was confirmed.