Unit Increase In Level Research Articles

Relationship between Level of Knowledge and 5 moment Hand Hygiene Practice among Assistant Healthcare in Malaysia Teaching Hospital.

Hand hygiene is a handwashing method that significantly lowers the likelihood of pathogens (dangerous germs) on the hands. While assistant healthcare workers are part of the healthcare team, they always deal with patients' care but did not get proper training like nurses or doctors before becoming assistant healthcare This study is to assess the relationship between level of knowledge and five moments hand hygiene practice among assistants healthcare in one of the teaching hospitals in Malaysia. A cross-sectional research methodology was used; 154 Assistants healthcarewere chosen using random number generators after the sample size was calculated. The Knowledge, Attitude, and Practice on Hand Hygiene questionnaire used was adopted from WHO publications. The ANOVA revealed a significant effect of Level of Knowledge on Level of Practice (F(1, 152) = 3.416, p = 0.006). Specifically, for each unit increase in Level of Knowledge, Level of Practice increased by 57.725 units (β = 57.725, p = 0.006). These findings emphasise the need for targeted interventions and training programmes aimed at bridging the knowledge-practice divide and eventually raising hand hygiene compliance in the medical setting

Study on the Effects of Maritime Piracy and Sea Robbery on Economic Growth in Nigeria

The study investigated the effects of the level of global and local attacks against ships on economic development in Nigeria. It also examined the effects of volume of cargo pilfered in Nigeria ports as a result of insecurity on the economic growth in Nigeria. The study employed secondary data sourced from from the Nigerian ports authority, the National bureau for statistics (NBS) and the International Maritime Bureau (IMB) on the Gross Domestic Product (GDP), levels of pirate attacks against ships in local and global waters, and volume of cargo pilferages in ports. The multiple regression analysis method was used to analyze the dataset obtained using GDP as the dependent variable while global attacks, local attacks and volume of cargo pilfered were used as independent variables. It was found that the effect of maritime piracy and sea robbery on economic growth and development is expressed by the equation: GDPt = 1638944 + 5745.61GLOTAKSt – 34587.7LOTAKSt + 193.25VOCARPt. This implies that economic growth in Nigeria increase with increase in attacks against ships in global waters, it decreases with increase in attacks against ships in Nigerian maritime domain and increases with increase in volume of cargo pilfered from the ports. A unit increase in level of global attacks increases the GDP by 5745.61 units while a unit increase in local attacks against ships trading in Nigerian waters decreases the Gross Domestic Product (GDP) by 34587.7 units. Similarly, a unit increase in volume of cargo pilfered from the ports increase the GDP by 193.25 units. It concluded that maritime piracy and sea robbery attacks against ships have significant impact on economic growth and development in Nigeria.

Evaluation of the Relationship between Maritime Piracy and Port Revenue

The study investigated the relationship between maritime piracy and sea robbery on revenue generated in the Nigerian ports between 1995 and 2013. The study used secondary data sourced from the Nigerian ports authority, and the International Maritime Bureau (IMB) on the port revenue, levels of pirate attacks against ships in local; and global waters, level of cargo pilferages in ports and used for the study. It used multiple regression analysis method to analyze the dataset obtained using port revenue as the dependent variable while global attacks, local attacks and volume of cargo pilfered were used as independent variables. It was found that there is significant relationship between port revenue generated in the Nigerian ports and level of maritime piracy and sea robbery against ships in Nigeria waters. The result indicates that for every unit increase in pirate attacks against ships trading in global waters, revenue generated in the Nigerian ports increased by 60872.47 units. Similarly, for each unit increase in local attacks against ships in Nigerian waters, the revenue generated in the ports increased by 548297.8 units and for a unit increase in level of insecurity induced cargo pilferage in the seaports, port revenue decreases by 562,96 units. It was also found that this is a significant relationship between revenue generated in the ports and maritime piracy and sea robbery against ships in the maritime industry.

Factors Affecting Client Satisfaction in a Large Community-based Youth Mental Health Promotion Programme (Yuva Spandana) in Karnataka, India

Background: Yuva Spandana (YS) is a Youth Mental Health Promotion programme in Karnataka. Under YS, youth facing challenges are provided counselling and support services by trained youth named Yuva Samalochakas and Yuva Parivarthakas at Yuva Spandana Kendras (YSKs). We planned to understand the satisfaction (CS) perspectives of beneficiaries of this mental health promotion model in India.Method: Telephonic interviews were conducted among 140 randomly selected clients who visited YSKs between August and October 2018. Multivariate Linear Regression was done with CS as the outcome and several hypothesised variables as potential exposures that contribute towards CS. All variables that were significantly associated with the outcome (p < 0.10) in univariate and which altered the β-coefficient of at least one preceding variable by 10% were retained in the final model.Results: For every unit increase in cleanliness score at YSK, CS increased by 30%. For every unit increase in level of confidentiality maintained, CS increased by 26%. CS increased among clients who felt multiple options were provided “to a great extent” and “to a moderate extent” to resolve their issue/ problem.Conclusion: Cleanliness, level of confidentiality maintained, and providing multiple options at YSK are associated with increased CS among clients

Subjective Cognitive Decline Prediction of Mortality: Results from the Einstein Aging Study.

The relation of pre-dementia stages to mortality has not been fully explored. Previous work examining subjective cognitive decline (SCD) and mortality is limited and mixed regarding methods used and consistency of findings. To examine SCD and mortality in a longitudinal, community-based cohort, using item response theory (IRT) methodology to form a composite SCD measure. Also, to assess whether this relationship was independent of clinical cognitive status. The Einstein Aging Study is a diverse longitudinal cohort of adults aged ≥70. SCD items were extracted from baseline CERAD questionnaires and a composite score was formed using IRT methodology. A total of 1,741 participants with complete data were clinically diagnosed as cognitively normal, or as having amnestic mild cognitive impairment (aMCI), nonamnestic mild cognitive impairment (naMCI), or dementia. 645 deaths occurred over a period of 8,912 person-years of follow-up. Cox proportional hazard models predicted time to death adjusting for covariates. A one standard deviation unit increase in level of SCD was associated with >20% higher risk of mortality. However, when models were adjusted for clinical cognitive status, the association was no longer significant. Both dementia and aMCI predicted mortality. Furthermore, when analyses focused only on those without cognitive impairment, SCD level did not predict mortality. The association of SCD with mortality may be due to the association of SCD with clinical cognitive status. Thus, SCD may be used as a community-based screen to initially identify those with cognitive impairment who may be at greatest risk for death.

Event Related Brain Potentials (ERP) Could Not Assess the Risk of Cognitive Impairment in Relapse-Remitting Multiple Sclerosis (RRMS)

Objectives: The first objective of our study was to determine differences between groups of patients receiving disease modifying therapy (DMTs) (INFβ-1a and INFβ-1b), patients without DMTs and a control group, in terms of neuropsychological tests and event-related brain potentials (ERP). The second objective was to determine factors that may serve to assess the risk of cognitive impairment in patients with relapsing remitting multiple sclerosis (RRMS). Methods: A total of 81 RRMS patients (mean age 41.09 ± 8.71 years old, 51 women, mean disease duration 133.05 ± 76.56 months) and 32 healthy controls participated in the study. Cognitive functions were evaluated using a standard PASAT-3, the symbol digit modality test (SDMT) and ERP. Results: There were statistically significant differences between the mean values for parietal (Pz) (p ≤ 0.05) and central (Cz) latency (p<0.05) between the four groups of study participants. RRMS increased the risk of cognitive impairment approximately 3.5 fold. Each year of age raised the risk of cognitive impairment by 6.0%. Each unit increase in level of education reduced the risk of cognitive impairment approximately 2.5 fold. Increase in reaction time (RT) Cz by 1 ms elevated the risk of cognitive impairment by 0.5%. Conclusions: There were statistically significant differences between the mean values of Pz and Cz latency between the four groups of study participants. Factors that may be used to assess the risk of developing cognitive impairment in patients with RRMS include age, education level, and RT Cz. However, ERP (latency and amplitude) did not independently assess the risk of cognitive impairment in RRMS patients.

Cost benefit analysis of malaria rapid diagnostic test: the perspective of Nigerian community pharmacists

BackgroundIn 2010, the World Health Organization issued a guideline that calls for a shift from presumptive to test-based treatment. However, test-based treatment is still unpopular in community pharmacies. This could be due to unwillingness of customers to spend extra finance on rapid diagnostic test (RDT). It could also result from lack of interest from community pharmacists since they may perceive no financial gain attached to this service. This study assessed the cost-benefit of test-based malaria treatment to community pharmacists.MethodsThe study was a community pharmacy-based cross sectional survey. Potential benefit of RDT was determined using customers’ willingness-to-pay (WTP) for service. Average WTP was estimated using contingent valuation. Binary logistic regression was used to assess correlates of WTP acceptance while multiple linear regression was used to model the relationship between the independent variables and WTP amount. Cost associated with provision of RDT was estimated from provider’s perspective. Probabilistic sensitivity analysis was used to capture parameter uncertainty. Benefit-cost ratio (BCR) was calculated to determine study objective.ResultsA total of 135 out of 235 participants (57.4%) responded to the WTP question. Of this subset, 111 participants (82.2%) preferred RDT before malaria treatment. Average WTP [minimum–maximum] was US$1.23 [US$0.0–US$5.03]. Educated participants had 1.8 times higher odds of WTP for RDT. Participants that understood RDT as described in the questionnaire had 18.3 times higher odds of WTP for RDT compared to participants that did not understand RDT as described in the questionnaire. Additionally, a unit increase in level of education (e.g. from primary to secondary school) led to US$0.298 increase in WTP amount for RDT. Also, a unit increase in malaria frequency (e.g. from ‘never’ to ‘rarely’) led to US$0.293 decrease in WTP amount for RDT. Average cost [minimum–maximum] of RDT test kit and pharmacist time spent in administering the test were US$0.15 [US$0.13–US$0.17] and US$0.41 [US$0.18–US$0.52], respectively. BCR of test-based malaria treatment was 6.7 (95% CI 6.4–7.0).ConclusionTest-based malaria treatment is cost-beneficial for pharmacy practitioners. This finding could be used as an advocacy tool to increase community pharmacists’ interest and uptake of test-based malaria treatment.

Prevalence and impact of disability and sexual dysfunction on Health-Related Quality of Life of Nigerian stroke survivors

Purpose: To investigate the impact of disability and sexual dysfunction on Health-Related Quality of Life (HRQoL) among Nigerian stroke survivors (SSv) and to determine their association using sexual functioning (SF), Global Disability Measure and Function (GDMF), and demographic profiles.Methods: This study involved 121 consecutive SSv attending healthcare services in two tertiary health facilities in Nigeria. Demographic details were obtained through interview while HRQoL, SF, and Global Disability (GD) were assessed using Stroke-Specific Quality of Life (SS-QoL-12), Changes in Sexual Functioning Questionnaire (CSFQ-14), and World Health Organization Disability Assessment Schedule (WHODAS-2.0), respectively. Determinants of HRQoL were explored using the Poisson regression analysis.Results: Most of the SSv had moderate/severe GD (95%) and low SF (86.8%). Their HRQoL decreased with increase in their age (p = 0.005) and with increase in GD (p = 0.001). This association remained unchanged even when adjusted for SF (p = 0.001). Those with low SF but with mild GD had relatively better HRQoL than those with moderate/severe GD even when they had higher SF. Their HRQoL was negatively impacted by their GD but not by their SF despite direct correlation between SF and HRQoL. With a unit increase in level of GD, there was 8% decrease in HRQoL scores in psychosocial and 17% decrease in physical domains.Conclusion: Although sexual dysfunction and global disability are prevalent among Nigerian SSv, their low HRQoL is determined by their disability and not by SF. Hence, effort at reducing global disability should be the focus of rehabilitation after stroke.Implication for RehabilitationGlobal functional and sexual deficiencies abound in stroke survivors and they impact negatively on their overall quality of life.Sexual dysfunction correlates negatively on physical and psychosocial wellbeing of stroke survivors.Rehabilitation goal(s) should focus disability reduction and improvement of sexual functioning to enhance quality of life.Rehabilitation professionals should equip themselves with tools to counsel stroke survivors on sex issue since sexual dysfunction is common post stroke.

Exposure to Beta-(1,3)-D-glucan in house dust at age 7-10 is associated with airway hyperresponsiveness and atopic asthma by age 11-14.

BackgroundMould exposure has been linked to childhood asthma and bronchial hyper-responsiveness. Few studies have assessed beta-(1,3)-d-glucan (beta-glucan), a significant fungal cell wall constituent, in relation to asthma in adolescence.ObjectiveTo determine whether house dust-derived beta-glucan exposure at age 7–10 is associated with the development and persistence of atopic and non-atopic asthma, and bronchial hyper-responsiveness (BHR) by age 11–14.MethodsDust samples were collected from the 1995 Study of Asthma, Genes, and Environment (SAGE) birth cohort. This cohort was derived from Manitoba provincial healthcare administrative records of children high and low risk for asthma. Samples were collected from the homes of 422 children at age 7–10 and analyzed using beta-glucan and endotoxin-specific Limulus Amoebocyte Lysate assays. Asthma, atopy, and BHR status of each child were also assessed at ages 7–10 and 11–14.ResultsAt age 7–10, beta-glucan dust levels in the home were associated with persistent atopic asthma at age 11–14 (OR 1.79 for each unit increase in levels, 95% CI 1.14–2.81), independent of endotoxin exposure, and Alternaria or Cladosporium sensitization. The likelihood of BHR almost doubled with unit increases in dust beta-glucan in asthmatic children. In children without asthma, exposure to high beta-glucan levels at age 7–10 also elevated risk for BHR in adolescence (OR 1.74, 95% CI 1.05–2.89). New-onset atopic asthma was twice more likely following high beta-glucan exposure in children without asthma but the association did not reach statistical significance. No associations were evident with concurrent asthma phenotype at age 7–10 or non-atopic asthma at age 11–14.ConclusionThese findings implicate home beta-glucan exposure at school-age as a risk factor for persistent atopic asthma and new-onset BHR. The higher prevalence of BHR in urban adolescents may be propagated by this home exposure.

Baseline Markers of Inflammation Are Associated With Progression to Macroalbuminuria in Type 1 Diabetic Subjects

OBJECTIVEThe current study aimed to determine in the Diabetes Control and Complications Trial (DCCT)/Epidemiology of Diabetes Interventions and Complications cohort whether or not abnormal levels of markers of inflammation and endothelial dysfunction measured in samples collected at DCCT baseline were able to predict the development of macroalbuminuria.RESEARCH DESIGN AND METHODSLevels of inflammation and endothelial cell dysfunction biomarkers were measured in 1,237 of 1,441 patients enrolled in the DCCT study who were both free of albuminuria and cardiovascular disease at baseline. To test the association of log-transformed biomarkers with albuminuria, generalized logistic regression models were used to quantify the association of increased levels of biomarkers and development of abnormal albuminuria. Normal, micro-, and macroalbuminuria were the outcomes of interest.RESULTSIn the logistic regression models adjusted by DCCT treatment assignment, baseline albumin excretion rate, and use of ACE/angiotensin receptor blocker drugs, one unit increase in the standardized levels of soluble E-selectin (sE-selectin) was associated with an 87% increase in the odds to develop macroalbuminuria and one unit increase in the levels of interleukin-6 (IL-6), plasminogen activator inhibitor 1 (PAI-1; total and active), and soluble tumor necrosis factor receptors (TNFR)-1 and -2 lead to a 30–50% increase in the odds to develop macroalbuminuria. Following adjustment for DCCT baseline retinopathy status, age, sex, HbA1c, and duration of diabetes, significant associations remained for sE-selectin and TNFR-1 and -2 but not for IL-6 or PAI-1.CONCLUSIONSOur study indicates that high levels of inflammatory markers, mainly E-selectin and sTNRF-1 and -2, are important predictors of macroalbuminuria in patients with type 1 diabetes.

003 Demographic analyses of primary bone cancer in 0–49 year olds in Great Britain, 1980–2005: a small-area approach

ObjectiveTo examine geographical patterning in the incidence of primary bone cancers diagnosed in 0–49 year olds in Great Britain (GB) during the period 1980–2005. The analyses focussed on the two...

Enteric methane emissions from growing beef cattle as affected by diet and level of intake

A study was conducted to determine whether enteric methane (CH4) emissions from growing feedlot cattle fed backgrounding diets based on barley silage could be reduced through grain supplementation. A second objective was to determine the effects of feed intake on CH4 emissions. Eight Angus beef heifers (initial and final body weight, 328 ± 28 and 430 ± 29 kg) were used. The experiment was designed as a split-plot crossover with two diets and two 8-week periods. The main plot was the diet [dry matter (DM) basis]: high forage (70% barley silage, 30% barley-based concentrate) or high grain (30% barley silage, 70% corn-based concentrate). The sub-plot was the feeding level: unrestricted (ad libitum feed intake, 5% orts) or restricted (65% of ad libitum intake) feed intake. Methane emissions were measured during each sub-plot over 3 d using whole animal chambers. Changing the forage to concentrate ratio and substituting barley for corn did not affect CH4 emissions (141.5 g d-1; P = 0.26), and the average emission was about 10% higher than the emission calculated using the International Panel on Climate Change (IPCC) Tier 1 approach. Methane conversion rate was also similar for both diets [6.23% of gross energy intake (GEI), P = 0.29], and was similar to the value of 6.0 used in the IPCC Tier 2 approach to calculating CH4 emissions from cattle. Restricting intake reduced CH4 emissions (169 vs. 114 g d-1; P &lt; 0.002), with the reduction in CH4 proportional to the decline in intake. Level of intake relative to maintenance energy requirements was moderately inversely related (r = -0.30; P = 0.04) to CH4 (% GEI). The proportion of GEI lost as CH4 declined by 0.77 percentage units per unit increase in level of intake above maintenance. This study shows that supplementing barley-silage-based diets with corn grain to increase diet quality has only small effects on reducing CH4 emissions. In contrast, maximizing feed intake above maintenance energy requirements increases daily CH4 emissions, but improves efficiency of CH4 conversion because CH4, as a percentage of GEI, declined. Thus, feeding cattle for maximum gain is an important CH4 mitigation strategy for the cattle industry as it reduces the proportion of feed energy lost as CH4 each day, as well as, reduces the number of days to market and associated CH4 production. Key words: Cattle, methane, greenhouse gasses

Religiosity and the earliest stages of adolescent drug involvement in seven countries of Latin America.

To investigate the role of religiosity in the earliest stages of drug involvement, the authors studied recent-onset occurrence of first chances to try a drug and first actual drug use, expressed as a function of religious practice behaviors, levels of religious devotion, and religious affiliation. Based upon standardized questionnaire assessments of nationally representative samples of school-attending youths drawn in Panama, the five Spanish heritage countries of Central America, and the Dominican Republic (n = 12,797), the 1999-2000 study estimates indicate that higher levels of religious practice are inversely associated with the earliest stages of tobacco and cannabis experiences (i.e., the first chance to try and the first actual use) but not so for alcohol. To illustrate, for each unit increase in levels of religious practice behaviors, there was an associated reduced occurrence of the first chance to try tobacco (odds ratio = 0.76, 95% confidence interval: 0.62, 0.94). Occurrence of first actual use of tobacco and cannabis was not associated with levels of religious practice behaviors among youths exposed to the opportunity to try these drugs. As such, these behaviors apparently have not strengthened resistance. Rather, autarcesis may be at work, functioning to shield youths from drug exposure opportunities.

Enhanced contact tracing and spatial tracking of Mycobacterium tuberculosis infection by enumeration of antigen-specific T cells

Identification of individuals latently infected with Mycobacterium tuberculosis is an important part of tuberculosis control. The current method, the tuberculin skin test (TST), has poor specificity because of the antigenic cross-reactivity of purified protein derivative (PPD) with M bovis BCG vaccine and environmental mycobacteria. ESAT-6 is a secreted antigen that is highly specific for M tuberculosis complex, but is absent from M bovis BCG. With an enzyme-linked immunospot (ELISPOT) assay for interferon gamma, we have identified ESAT-6-specific T cells as an accurate marker of M tuberculosis infection. We did a prospective, masked study of 50 healthy contacts, with varying but well defined degrees of exposure to M tuberculosis, who attended an urban contact-tracing clinic. We assessed and compared the efficacy of our assay and TST for detection of symptomless infected individuals by correlation of test results with the degree of exposure to an infectious index case. The ESAT-6 ELISPOT assay results had a strong positive relation with increasing intensity of exposure (odds ratio=9.0 per unit increase in level of exposure [95% CI 2.6--31.6], p=0.001), whereas TST results had a weaker relation with exposure (1.9 [1.0--3.5], p=0.05). By contrast, ELISPOT results were not correlated with BCG vaccination status (p=0.7), whereas TST results were significantly more likely to be positive in BCG-vaccinated contacts (12.1 [1.3--115.7], p=0.03). This new antigen-specific T cell-based assay could allow more accurate identification of symptom-free individuals recently exposed to M tuberculosis, and thereby help to improve tuberculosis control.