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Jun 2026 DOI 10.14302/issn.2474-7785.jarh-26-6358
Hip fractures, which remain an immense public health concern, have been subject to study and prevention efforts for many decades, but with limited success in averting either incident, second or subsequent hip fractures, commonly attributed to a combination of age related proclivity to fall, low bone and muscle mass. This review examines second hip fracture incidence rates and determinants of this serious functionally debilitating injury as observed over time remains a current 2026 public health concern. It specifically explores if more preventive efforts are currently warranted in this regard, and in what respect, if indeed, more frail older adults are living longer, but may be in excessively poor health, fearful of moving or falling, malnourished, weak with poor balance, or depressed. Based on what is published, it is concluded 1) second hip fracture incidence rates remain considerable, especially among those who are frail with osteoporotic bone disease, poor vision, heart/or cognitive conditions, plus those with muscle deficits of the lower limb, live alone and have a falls history; 2) studies to identify possible mitigation approaches appear promising in this regard, along with more routine efforts to minimize falls risk and bone attrition.
May 2026 DOI 10.14302/issn.2578-8590.ipj-26-6121
Aims Cardiac autonomic neuropathy is currently an untreatable progressive complication of type 1 diabetes (T1D). Impaired microcirculation is a suspected cause of nerve degeneration in TID. We investigated whether cardiovascular autonomic reflexes often used as indices of nerve functions, are associated with indices of microcirculatory function in young adults with T1D compared with non-diabetic controls. Methods In a cross-sectional study, 15 adults with T1D and 15 age-matched controls (20-40 years) underwent standardized cardiovascular autonomic reflex tests. Continuous recordings of electrocardiogram, cardiac vagal tone, beat-to-beat blood pressure and transcutaneous tissue oxygen (tcpO₂) and carbon dioxide partial pressures (tcpCO2) were done. Results Despite preserved baroreflex, parasympathetic, and sympathetic functions assessed using cardiovascular reflex tests, the individuals with T1D exhibited reduced baseline tcpO2 compared to the controls (37.5±3.75 vs. 49.6 mmHg). During the Valsalva manoeuvre, individuals with T1D exhibited a reduced systolic blood pressure response in phase I (31±10 vs. 43±18 mmHg) and early phase II (-1±15 vs. -18±17 mmHg), and an increased systolic (31±15 vs. 18±14 mmHg) and diastolic (45±11 vs. 33±16 mmHg) response in late phase II compared to controls. The early phase II diastolic response was inversely associated with baseline tcpO2. Conclusion The altered hemodynamic response to the Valsalva manoeuvre is suggestive of possible reduced arterial elasticity, higher vascular resistance, and splanchnic sympatho-vagal imbalance in T1D despite normal autonomic reflex ratios. The concomitant evidence of reduced tissue oxygenation and altered hemodynamics may represent early signs of dysautonomia but require longitudinal validation.
Oct 2024 DOI 10.14302/issn.2574-4518.jsdr-24-5287
Background/Aim This study aimed to examine the relationship between loneliness and bedtime procrastination in young adults in Germany, offering critical insights into the development and maintenance of both conditions. Specifically, it sought to test a new model that connects these two psychological constructs. Materials and Methods A quantitative online survey was conducted with 500 young adults (Mage = 23.3, 83.6% female). Loneliness was assessed using the UCLA Loneliness Scale, while bedtime procrastination was measured using the Bedtime Procrastination Scale. Results The results show a significant positive correlation between loneliness and bedtime procrastination in young adults. Sleep quality was also found to significantly correlate positively with loneliness as well as with bedtime procrastination. Conclusion The findings provide a crucial framework for understanding the relationship between the two psychological constructs of loneliness and bedtime procrastination. Implications for possible future interventions are discussed.
Sep 2024 DOI 10.14302/issn.2474-7785.jarh-24-5282
Persons with osteoarthritis often have signs of reduced muscle strength. Some studies suggest that this strength could be improved with exercise. However, does this form of therapy improve the disease status as assessed by improvements in cartilage viability, a hallmark of the disease? This brief describes the possible usage of exercises in general, plus those known to improve strength and function, and reduce pain and whether structural impacts that favor or impede disease regression have been observed in this context among the older osteoarthritis adult population. Since exercise may also do harm, rather than good in osteoarthritis management if excessive, contra indicated, or suboptimal, what is the consensus in this regard in 2024?
Jun 2024 DOI 10.14302/issn.2474-7785.jarh-24-5141
Efforts to mitigate or prevent painful disabling osteoarthritis have been pursued for more than a century with limited success. This current overview briefly summarizes how selected beliefs and behaviors, including coping and stress management approaches are potential mediators or moderators of osteoarthritis pain and its overall common adverse prognosis and outcome. Published data housed predominantly in PUBMED, PUBMED CENTRAL, SCIENCE DIRECT, and GOOGLE SCHOLAR sites and pertaining to selected aspects of the literature of current interest, cumulative results reported as of May 30, 2024, show a modest to strong rationale exists for considering the abovementioned factors in efforts to reduce pain and enable daily functions. Accordingly this line of research should be continued, and translated clinically without undue delay, especially in the face of increases in the aging population and osteoarthritis prevalence and undue suffering.
Jan 2024 DOI 10.14302/issn.2474-7785.jarh-24-4890
Knee joint osteoarthritis, a chronic condition resulting in considerable disability, particularly in later life, not only impacts life quality significantly and severely, but is also strongly associated with the persistence of intractable pain, depression, helplessness, and a high falls injury risk. This narrative overview synthesizes the knowledge base regarding painful knee osteoarthritis and what is known about Tai Chi exercise participation in the context of reducing knee joint disability and its associated risk of one or more injurious falls, as well as pain and depression. To this end, all relevant articles published in the English language on the topic were sought. While most reports rely on Eastern observations, rather than Western medicine studies, collectively, these data reveal that Tai Chi practiced widely in Asia for many centuries may have an enormous positive impact on reducing distress and increasing function and autonomy among older adults living in the community and diagnosed as having knee osteoarthritis. They specifically suggest the increasing numbers of older adults diagnosed as having knee osteoarthritis can safely practice selected Tai Chi exercises with the expectation that consistent applications will enhance mobility, reduce pain and depression, plus instability and possible injurious falls, while reducing fatigue, even if surgery is forthcoming.
Dec 2023 DOI 10.14302/issn.2574-4518.jsdr-23-4775
Background Diet, exercise and sleep are three pillars of a healthy life. These lifestyle factors influence one another in complex and dynamic ways. Consistent evidence exists about the bidirectional relationship between sleep patterns and food intake. Objectives We aim to assess the effect of the ultra-processed food(UPF) consumption on sleep disturbances in a sample of the Brazilian adults. Method We analyzed 77,298 persons aged 18 and older from the Brazilian National Health Survey (2019). A Propensity Score Matching (PSM) approach was used to address confounding bias and balance the matched exposed and control groups. The population average treatment effect (PATE) and the population average treatment effect on the treated (PATT) were estimated. Also, the Absolute Risk Increase and the Relative Risk Increase were computed. Results The findings revealed that Brazilian adults who consumed UPF experienced small but statistically significant sleep disturbances compared to non-UPF users. Furthermore, salty UPF showed small but significant worsening of sleep compared to sweet UPF users. Conclusion The consumption of UPF is associated with sleep disturbances in Brazilian adults. The consumption of salty UPF had a more significant effect on sleep disorders than sweet UPF in the overall population. However, among individuals who already consumed sweet or salty UPF, these foods had a more significant effect on sleep disorders. To gain a deeper understanding of the complex relationship between UPF consumption, sleep disorders, and their impact on health and quality of life, further research is needed, including precise measurements and consideration of personality traits using prospective designs.
Aug 2023 DOI 10.14302/issn.2379-7835.ijn-23-4701
Young adulthood is a sensitive phase that comes with many developmental tasks. Successful mastery of these challenges is crucial not only for long-term physical and mental health. A positive relationship with one's own body and associated healthy dietary and behavioral patterns are essential building blocks for healthy adolescence and adult life. But being overly concerned with healthy food may lead to decreased quality of life and negative (mental) health outcomes. This study was conducted via a cross-sectional online questionnaire including the Düsseldorfer Orthorexieskala(DOS), the WHO Quality of Life BREF and questions about life style and nutritional habits. We investigated the prevalence of ON and its relationship with different aspects of quality of life and lifestyle factors (sport and nu trtional habits) in a sample of young adults in Austria. No significant difference in the DOS-scores of male and female participants were found and no significant difference between students and non-students. High DOS-scores significantly impair all three domains of QoL. We did not find a significant relationship between high DOS-scores and taking nutritional supplements or being vegan, vegetarian or omnivore. Participants with high DOS-scores spent significantly more hours per week with sport/exercising.
Apr 2023 DOI 10.14302/issn.2474-7785.jarh-23-4550
Aim This review examines the research base concerning hand osteoarthritis and changes in muscle mass and quality known as sarcopenia and the possible use of vitamin-D supplementation for reducing this potentially adverse functionally disabling state. Methods Publications detailing a possible link between hand osteoarthritis manifestations and sarcopenia, plus those discussing vitamin D as a possible intervention strategy for minimizing sarcopenia in the older adult were systematically sought and reviewed. Results Collectively, data reveal hand osteoarthritis in the older population is common, and is possibly affected by age as well as disease associated muscle mass declines. Vitamin D, a powerful steroid required by the body to foster many life affirming physiological functions may help reduce the degree of any prevailing sarcopenia and thereby some degree of hand osteoarthritis disability. Conclusions Older individuals with hand osteoarthritis, as well as healthy older adults at risk for sarcopenia are likely to benefit physically from efforts to clarify the extent of this association and if indicated, to examine and intervene thoughtfully to maximize muscle composition as well as safe vitamin D levels where subnormal. Researchers can make highly notable impacts in multiple spheres in this regard and are encouraged to do so.
Feb 2023 DOI 10.14302/issn.2641-5526.jmid-23-4450
Acute appendicitis is one of the most common surgical emergencies globally, with a lifetime incidence of 8.6% in men and 6.7% in women. While acute appendicitis should be managed promptly to reduce the morbidity associated with perforated appendicitis, morbidity from negative appendicectomy is similar to morbidity from uncomplicated appendicitis. Computer tomography is widely used to aid in the diagnosis of acute appendicitis, however, is costly, often has a slow turn around time, and is associated with exposure to ionising radiation. In contrast, ultrasound is cheap, widely available, requires minimal patient preparation, and does not require exposure to ionising radiation. Ultrasonography is becoming increasingly used for adult patients in emergency settings. The literature has estimated the sensitivity of ultrasound for acute appendicitis in adult patients as between 39-96.4%. The sensitivity and specificity of ultrasound for the diagnosis of acute appendicitis is significantly increased when the appendix is visualised. In cases of a non visualised appendix, indirect ultrasound signs can improve the sensitivity to 93.9% and specificity to 85.7%. The variation in sensitivity and specificity for ultrasound in the diagnosis of acute appendicitis in adults may be due to multiple factors. Ultrasonographer experience, a retrocaecal appendix and obesity have all been described. Given the availability, cost and potential to reduce the rate of negative appendicectomy, ultrasound should be considered as the first line imaging modality for adult patients presenting with suspected AA.
Jun 2022 DOI 10.14302/issn.2474-7785.jarh-22-4229
Background Osteoarthritis, a serious joint disease, said to represent a generally declining state of wellbeing and function among many older adults has been shown to be affected to a considerable degree by various negative beliefs and inactions rather than degradation alone. Aim This review examines the case of depression as this pertains to the older adult with osteoarthritis of one or more joints. Specifically, the most up to date information on this topic was sought, as care improvements over the past decade have not shown any impactful population wide results. Method Reviewed were relevant 2021-2022 research and review articles specifically pertaining to what is being observed currently by researchers as far as osteoarthritis-depression linkages goes, as these may reveal opportunities for more profound research, and practice-based endeavors. Results In line with 60 years of prior research, it appears a clinically important role for depression in some osteoarthritis cases cannot be ruled out. It further appears that if detected and addressed early on, many older adults suffering from osteoarthritis may yet be enabled to lead a quality life, rather than a distressing and excessively impaired state of being. Those older osteoarthritis cases requiring surgery who suffer from concomitant depressive symptoms are likely to be disadvantaged in the absence of efforts to treat and identify this psychosocial disease correlate. Conclusion Providers and researchers are encouraged to pursue this line of inquiry and begin to map clinical osteoarthritis measures with those that can track cognitive patterns, musculoskeletal, features and inflammatory reactions along with valid depression indicators among carefully selected osteoarthritis sub groups.
Feb 2021 DOI 10.14302/issn.2474-7785.jarh-21-3752
Background Falls injuries continue to contribute to numerous premature deaths as well as high disability levels, and excess morbidity rates among older adults, worldwide. But can vitamin D account for excess falls injuries among older adults? This review specifically focuses on what is known about vitamin D in the context of postural stability or balance control, both fairly consistent independent predictors of falls among older adults. Methods and Procedures Drawn largely from a review of current relevant English language peer reviewed research publications published over the last 10 years detailing the relationship between vitamin D levels and balance control among the elderly, as this relates to falls injuries, evidence for any emerging consensus on this controversial topic was sought. Used to conduct the search were various key word combinations including: falls injuries and older adults, vitamin D or vitamin D deficiency and balance or postural control. The database used predominantly to provide input into this largely descriptive assessment and narrative overview was PUBMED. Results The prevailing data show falls injuries currently constitute a widespread costly major impediment to successful aging and longevity for many older adults, despite numerous efforts to prevent this disabling set of events over the past two to three decades. However, no consistent association appears to exist between the variables of vitamin D, falls, and balance attributes in the older population-despite years of research, regardless of study approach, and a strong rationale for hypothesizing a clinically meaningful relationahip. Conclusion It is not possible to arrive at any universal recommendation concerning the value of vitamin D supplementation as regards its possible influence on balance capacity among older adults in the realm of falls prevention efforts, as has been frequently proposed. However, until more definitive research is conducted, there still appears sufficient justification for considering the screening of vulnerable aging adults for serum vitamin D levels, along with balance impairments, and intervening as required in the case of deficits in either or both of these possible falls determinants.
Jan 2021 DOI 10.14302/issn.2474-7785.jarh-21-3702
Background Older adults with hip joint osteoarthritis, a major cause of chronic progressively disabling highly painful functional experiences, may require a surgical joint replacement procedure known as total joint arthroplasty surgery. Objective This review aimed to address the question of whether there an association between hip joint arthroplasty infection rates and prevailing pre or preoperative vitamin D levels that warrants consideration in efforts to prevent or minimize infection related hip arthroplasty complications among older adults particularly during the current ongoing COVID-19 pandemic. Methods PUBMED, SCOPUS, and WEB OF SCIENCE articles related to the topic and published between January 2016-2021 were searched, examined, and summarized. Results Older adults with hip joint osteoarthritis and low vitamin D serum levels who undergo total hip joint arthroplasty surgery may be at higher risk for post-operative infections than those with adequate vitamin D serum levels. Conclusion More research to verify whether efforts to screen for, and maximize vitamin D levels, before and after surgery, as indicated, may be helpful in the context of minimizing total hip joint arthroplasty surgery infection susceptibility and severity among older vitamin D deficient severely disabled hip osteoarthritis cases.
Dec 2020 DOI 10.14302/issn.2474-7785.jarh-20-3662
Background Most current Corona virus or COVID-19 pandemic deaths have been found to occur among populations older than 65 years of age, who often suffer from the presence of an array of chronic diseases that may be related to a co-occurring vitamin D deficiency. Another factor affecting older adults’ immune response mechanisms is air quality. In turn, air quality can impact the absorption of vitamin D from sunlight sources, a factor which could explain why older people, who are often vitamin D deficient, may be more likely than younger adults or healthy adults to be at risk for COVID-19 and poor outcomes. Aim This work was designed to examine the recent literature on COVID-19, vitamin D and air pollution and what it might imply for public health workers, policy makers, and others. Methods Available data accessed largely from the PUBMED data base for the year 2020 using the key words COVID-19, air pollution, and vitamin D deficiency were sought and selected items were carefully examined and documented in narrative and tabular formats. Results Many publications on COVID-19 prevail, but far fewer focus specifically on vitamin D deficiency and its possible role in explaining COVID-19 global health risk among older adults. A similar, albeit small number of publications, discuss the global pandemics of air pollution and its possible COVID-19 association, as well as its impact on vitamin D production. However, while most related articles support a possible independent as well as a dual role for both factors in COVID-19 the realm of this highly infectious widespread disease, very few actual studies have been conducted to date on any of these topical issues Conclusion More research to examine if vitamin D-based nutrients or supplements may provide some degree of community wide protection against COVID-19 in the older vitamin D populations, especially among those living in highly polluted areas may prove highly valuable. Controlling air pollution emissions globally and locally may also prove to be a highly impactful public health approach to reducing overall COVID-19 risk, and extent, and warrants study.
Dec 2020 DOI 10.14302/issn.2474-7785.jarh-20-3650
Background The coronavirus Covid-19 strain that emerged in December 2019, continues to produce a widespread and seemingly intractable negative impact on health and longevity in all parts of the world, especially, among older adults, and those with chronic health conditions. Aim The first aim of this review article was to examine, summarize, synthesize, and report on the research base concerning the possible use of vitamin-D supplementation for reducing both Covid-19 risk and severity, especially among older adults at high risk for Covid-19 infections. A second was to provide directives for researchers or professionals who work or are likely to work in this realm in the future. Methods All English language relevant publications detailing the possible efficacy of vitamin D as an intervention strategy for minimizing Covid-19 infection risk published in 2020 were systematically sought. Key words used were: Vitamin D, Covid-19, and Coronavirus. Databases used were PubMed, Scopus, and Web of Science. All relevant articles were carefully examined and those meeting the review criteria were carefully read, and described in narrative form. Results Collectively, these data reveal vitamin D is a powerful steroid like compound that is required by the body to help many life affirming physiological functions, including immune processes, but its deficiency may seriously impact the health status and well being of the older adult and others. Since vitamin D is not manufactured by the body directly, ensuring those who are deficient in vitamin D may prove a helpful overall preventive measure as well as a helpful treatment measure among older adults at high risk for severe Covid-19 disease outcomes. Conclusions Older individuals with chronic health conditions, as well as healthy older adults at risk for vitamin D deficiency are likely to benefit physically as well as mentally, from efforts to foster adequate vitamin D levels. Geriatric clinicians can expect this form of intervention to reduce infection severity in the presence of Covid-19 infection, regardless of health status, and subject to careful study, researchers can make a highly notable impact in this regard.
Aug 2020 DOI 10.14302/issn.2474-7785.jarh-20-3461
Background and Purpose The ability to respond effectively to perturbations is a key element of reactive postural control and is a crucial mediator of falls. Several studies exist in the literature that determine older adults’ responses to perturbations, however those studies typically involve procedures that lack objectivity or applicability outside a laboratory. A study involving waist-pull perturbations with a spring-scale (SS) is an exception. In that study, fall history was most accurately differentiated by a reactive stepping response to a perturbing force of 10% total body weight. Using data from that study, we retrospectively examined the association between fall history and the number of steps accompanying a SS perturbing force of 10% total body weight in older adults. For perspective, the association of fall history with Timed-Up-and-Go (TUG) and single limb stance (SLS) times was also determined. Methods Fifty-eight healthy older adults (mean age = 80.7 years) participated in the study. Their 2-year fall history (yes, no) was recorded. All participants underwent SS testing with one-pound incremental, horizontal sagittal plane manual waist-pull perturbations. The number of steps in response to perturbation with 10% total body weight was recorded; TUG and SLS tests were performed. Associations between variables were examined using Spearman (rank-biserial) correlations. Results The median number of steps for fallers was 5 in both anterior and posterior directions. For non-fallers, the median number of steps was 1 and 2 in the anterior and posterior directions, respectively. The significant correlations between fall status and number of steps were 0.772 and 0.813 for the anterior and posterior directions, respectively. Similarly, the significant correlations between fall status and balance tests were 0.722 and -0.456 for the TUG and the SLS, respectively. Conclusions The number of steps accompanying waist-pull perturbations with forces of 10% of body weight were highly explanatory of experiencing a fall during the preceding 2 years.
Jul 2020 DOI 10.14302/issn.2379-7835.ijn-20-3463
Background Evidence suggests that low birth weight (LBW) is associated with increased cardiovascular and metabolic risk in adulthood, including increased arterial stiffness, a marker of early vascular aging (EVA) assessable by pulse wave velocity (PWV), obesity and glucose homeostasis abnormalities. The present study aimed to explore the late impact of LBW on PWV and cardiometabolic phenotypes among young adult Cameroonians. Methods The study evaluated 120 subjects (mean age: 26 ± 5 years; 54% male sex) at the Cameroon Heart Institute, Douala, Cameroon, between January and June 2018. Birth weight (BW) and gestational age, sociodemographic, anthropometrics and fasting capillary blood glucose were recorded in all participants. Blood pressure (BP) and PWV were measured using an automatic oscillometric device (Mobil-O-Graph®). Multiple-adjusted linear regression was used to determine predictive factors for PWV. For assessment of potential impact of BW on EVA, PWV was adjusted for age, sex, body mass index (BMI) and mean arterial pressure (MAP). Results 28 participants (23.3%) of the study sample had LBW (<3000g). There was no gender difference between LBW or normal birth weight patients (NBW; controls). Age- and MAP-adjusted PWV (aPWV) were higher in women with LBW compared to NBW (5.6 m/s and 5.3 m/s respectively, P = 0.038). In men, aPWV was similar in LBW and NBW. In this study population, aPWV was higher (on average +15 cm/s) in LBW than in controls, although the difference was not statistically significant (P=0.083). Multivariate regression analysis showed age, male sex, BMI and MAP were independent determinants of PWV, but not LBW. Compared to NBW controls, the prevalence of overweight/obesity, impaired glucose homeostasis and diabetes was higher in LBW: 42.9% vs 37%; 10.7% vs 3.3%, and 3.6 % vs 1.1%, respectively. Moreover, compared with controls, LBW individuals who were overweight/obese in adulthood had a much higher mean fasting capillary glucose (1.54 ±0.17 g/l vs 0.87 ±0.11 g/l in NBW, p=0.003). Conclusion This study suggests that although LBW is associated with increased aortic stiffness in young adulthood, mainly in women, the association was predominantly driven by aging, MAP, BMI and male sex. In adulthood, LBW subjects exhibited higher obesity indices and altered glucose homeostasis.
Apr 2020 DOI 10.14302/issn.2574-4518.jsdr-20-3161
Delayed sleep phase syndrome (DSPS) is a circadian rhythm disorder where individuals experience difficulty modifying the time they go to sleep and wake up in response to environmental changes. The circadian rhythm itself is regulated by a variety of clock genes, and various other genes (e.g., AA-NAT gene, CKIϵ gene) code for proteins that regulate clock genes. Various polymorphisms of the clock gene influencers have been shown to increase susceptibility to DSPS. This paper seeks to examine how certain cultural characteristics (e.g., napping, timing of meals, exposure to artificial light) and the presence of the AA-NAT gene (G619A polymorphism) and the CKIϵ gene (S408N polymorphism) influence the prevalence of DSPS amongst Japanese and Brazilian populations.
Mar 2020 DOI 10.14302/issn.2641-4538.jphi-19-2610
Background The relationship between predictors and the variable of interest was estimated using a structural equation model which is used to predict latent variables. The main advantage of the SEM is the ability to estimate the direct and indirect pathways of the effect of the primary independent variable on the outcome, given sufficient sample sizes. Despite not directly modeling the mediated pathways, GLMMs excluding mediating variables performed well with respect to power, bias and coverage probability in modeling the total effect of the primary independent variables on the outcome. In longitudinal studies, data are collected from subjects at several time points. The main purpose of longitudinal analysis is to detecting the trends or trajectories of the variables of interest. Methods A longitudinal study was conducted on 792 adults living with HIV/AIDS who commenced HAART. Structural equation modeling was used to construct a model to detecting predictors of CD4 cell count change. The procedure was illustrated by applying it to longitudinal health-related quality-of-life data on HIV/AIDS patients, collected from September 2008 to August 2012 monthly for the first six months and quarterly for remaining study period. Results The result of current investigation indicates that CD4 cell count change was highly influenced by certain socio-demographic and clinical variables. Out of all the participants, 141 (82%) have been considered 100% adherent to antiretroviral therapy. Structural equation modeling has confirmed the direct effect that personality (decision-making and tolerance of frustration) has on motives to behave, or act accordingly, which was in turn directly related to medication adherence behaviors. In addition, these behaviors have had a direct and significant effect on viral load, as well as an indirect effect on CD4 cell count. The final model demonstrates the congruence between theory and data (x2/df. = 1.480, goodness of fit index = 0.97, adjusted goodness of fit index = 0.94, comparative fit index = 0.98, root mean square error of approximation = 0.05), accounting for 55.7% of the variance. Conclusions The results of this study support our theoretical model as a conceptual framework for the prediction of medication adherence behaviors in persons living with HIV/AIDS. Implications for designing, implementing, and evaluating intervention programs based on the model are to be discussed.
May 2018 DOI 10.14302/issn.2574-4518.jsdr-18-2065
Objective: Examining the correlation between physical activity measures and sleep in normal adolescents and adult population. Methods: A systematic review was conducted on the effects of exercise, its intensity, its frequency and its timing and sleep outcome. Using the databases including MEDLINE, PsycINFO and SPORTDiscus, keywords used were “sleep”, “circadian rhythm”, “exercise”, and “physical activity”. Results: To improve the general quality of sleep amongst adolescents and adults, individuals should engage in physical activity at any time of day. It also appears very advantageous to engage in long-term physical activity to maintain the positive effects on sleep. Nonetheless, it seems that sedentary individuals can also benefit from occasional physical activity to improve the quality of their subsequent sleep period. Conclusion: A virtuous relationship between physical activity and sleep may exist in normal adolescents and adults. People should seek to benefit from this link to improve both the quality of their sleep and of their daily functioning. However, larger scale studies, controlling for variables might help to better delineated this relationship.
Jan 2018 DOI 10.14302/issn.2474-7785.jarh-17-1911
Falls continue to be a health concern for older adults. Gender and age are key predictors of falls, particularly for those with low health literacy. Data were collected by a State Health Department using the state-led supplemental question option for the Centers for Disease Control and Prevention (CDC) Behavior Risk Factor Surveillance System (BRFSS) survey. Specifically, trend data for respondents were examined by gender, geographic location and health literacy rate. Results indicated the highest mean number falls occurred with men for those within the metropolitan statistical area (MSA) city code, lowest in suburban areas. Females reported to have a higher estimated mean number of falls and injuries than males. For males, the number of falls and injuries tended to decrease with higher health literacy. The findings support the importance of addressing fall prevention for older adults. Long term implications for improving fall prevention and health literacy for older adults include impact on individual outcomes.
Nov 2017 DOI 10.14302/issn.2576-9383.jhhr-17-1787
This paper discusses the challenges in recruiting a diverse sample of caregivers of older adults with multiple chronic conditions in two Canadian provinces – Ontario and Alberta, as well as the successful strategies to overcome these challenges. Four strategies were employed to overcome the recruitment challenges experienced. These included: (1) using a multi-pronged recruitment strategy with persistence; (2) knowing the location of the sample in the community; (3) weekly reporting by team members primarily responsible for recruitment and data collection, and; (4) regular team meetings to build on successful recruitment strategies while troubleshooting new approaches. These four strategies complemented one another. The most effective strategies in Alberta (recruiting over 50% of participants) were newspaper advertisements and working with the Alberta Caregivers Association and the Alzheimer Society of Alberta/NWT. In Ontario, the most effective strategy was door to door flyers (recruiting 61.5% of participants).
Jul 2017 DOI 10.14302/issn.2577-2279.ijha-17-1538
Status thymico-lymphaticus had ever been explained as a cause of sudden death usually in children, but few cases were reported in adults. We sought to determine the relationship between thymic hypertrophy and sudden unexpected death in adult (SUDA), and associated macroscopic and microscopic findings. Adult post mortems from 1984 to 2014 were reviewed and 23 thymic hypertrophy patients without SUDA, 33 thymic hypertrophy patients with SUDA and 172 SUDAs without thymic hypertrophy entered. The data of thymus, lymph nodes, spleen, heart, aorta, and adrenal glands were collected for macroscopic and histological analysis. Ten antibodies were used and applied to 3 children and 46 adult thymus specimens. We found, as an independent factor, thymic hypertrophy increased significantly the risk of SUDA (6.9 folds) in both male and female. What’s more, SUDAs associated with thymic hypertrophy were quite younger (22.5 years) than those without it. A majority of patients with hypertrophic thymus had a variable number of accompanied anomalies described as the typical characteristics of status thymico-lymphaticus, but no macroscopic and microscopic findings related to SUDA in patients with thymic hypertrophy. Cytokeratins (CKs) showed distinctly different immunohistochemical expression patterns in individuals who had different death causes and disease background. Instead of a disease entity “status thymico-lymphaticus” is a systematic abnormality with thymic hypertrophy as a feature involving mainly immune and/or cardiovascular system, probably caused by gene mutations.
Aug 2016 DOI 10.14302/issn.2474-7785.jarh-16-1157
Objectives: World has witnessed a considerable increase in the proportion of elderly population.Aging is associated with decreased physical activity and metabolism and thereby the changes in the nutritional requirements of older adults.The objective of this communication was to assess the nutritional status of rural elderly population in India. Methodology: A community based cross-sectional study; adopting multistage stratified random sampling procedure was carried out by the National Nutrition Monitoring Bureau (NNMB), during 2005-06 among the rural population of nine major states of India. A total of 3871 older adults were covered for anthropometry and of them, a total of 2138 older adults were covered for dietary assessment. Key Results: In general, the consumption of all the foods was below recommended daily intakes (RDI), and the in-adequacy (<70% of RDI) of intake was high with respect to leafy vegetables, milk & milk products, fats & oils and sugar & jaggery. Similarly, the in-adequacy of intakes of micronutrients such as vitamin A, iron, riboflavin and free folic acid was high among both genders. The poor intake of diet was reflected in high prevalence of chronic energy deficiency (CED) among the rural elderly in India. Conclusions: In general,the rural elderly were subsisting on inadequate diets in terms of both quantity and quality. Similarly, the prevalence of CED among elderly is a ‘‘very high’’ public health nutrition problem in India. Therefore, the Government of India should initiate appropriate nutrition intervention measures to improve the overall nutritional status and special nutrition policies to address the health and nutritional problems of the aging population.
Aug 2016 DOI 10.14302/issn.2474-7785.jarh-16-1104
Using NHANES 2007–2010, this cross‑sectional study examines associations between healthy lifestyle behaviors and hypertension among older U.S. adults, stratified by race and ethnicity. It explores how activity, diet, weight, and smoking patterns relate to blood pressure burden across groups. Findings inform tailored prevention strategies and equitable cardiovascular risk reduction.
Jul 2016 DOI 10.14302/issn.2474-7785.jarh-16-1123
This article describes COLLAGE 360, a person‑centered care model for older adults that integrates comprehensive assessment, goal‑setting, and coordinated community services. The approach seeks to promote health and function while reducing fragmentation across medical and social supports. Early implementation experience outlines feasibility and pathways to measure outcomes and scale within aging networks.
Mar 2016 DOI 10.14302/issn.2379-7835.ijn-15-903
Objectives: Accurate measurement of height is difficult in older adults because of the reduction in height that occurs during the ageing process. Therefore, several western studies have demonstrated the arm span as an alternative anthropometric measurement to height among older adults, as the length of arm span is less affected by aging. The aim of the study was to use arm span as an alternative to standing height for calculation of body mass index (BMI) amongst older adults. Methodology: A community-based cross sectional study was carried out during 2011-12 among 400 (Men: 180; Women: 220) urban geriatric population (age 60-years and over)of the town of Khammam. Weight, height and arm span were measured with standard procedures. Nutritional status of older adults was calculated by body mass index (BMI) classification using both height and arm span. Key Results: The mean (SD) height and arm span among men were 164.5 cm (6.6) and 175.3cm (7.9), respectively, while among women were 149.5cm (5.8) and 158.7cm (8.6). The mean difference between arm span and height was 10.8cm (10.1,11.4)in men and 9.2cm (8.3,10.0) in women (p<0.001). Similarly, significant (p<0.001) differences were observed between the BMIs derived using both height and arm span among both the genders. Conclusion: The conventional height is not a reliable anthropometric measurement for the assessment of nutritional status of older adults, where the BMI-height model over estimated the nutritional status of older adults compared to the BMI- arm span model. Therefore, arm span is the best alternative to height for calculation of body mass index (BMI) in older adults.
Mar 2016 DOI 10.14302/issn.2476-1710.jdt-15-825
The prevalence of young adults endorsing depressive symptomatology is thought to peak during late adolescence. While there has been a wealth of research assessing the relationship between decline of the prefrontal cortex and how this process impacts depression and therapy in older adults, very little is known about the relationship on the younger end of the continuum. The current study sought to explore whether there is also a significant relationship between executive functioning and depression in younger adults. In addition, different types of executive dysfunction were assessed to better understand the possible implications for therapy in younger adults with depressive symptomatology. Data from 1,730 college-aged participants were collected on measures of depression (Center for Epidemiological Studies-Depression, CES-D) and executive dysfunction (Dysexecutive Questionnaire, DEX). In addition, three factors of the DEX were assessed; Executive cognition (EC), emotional/ behavioral control (EMO), and metacognition (MC). Correlations between CES-D scores and the full DEX survey were statistically significant (R = .45, p < .001) as were correlations between CES-D scores and scores on each individual factor (p< .001). A multiple linear regression was run to demonstrate the predictive value of each individual DEX factor as a function of CES-D scores (p < .001). Results suggested that there was a clear relationship between depressive symptoms and executive dysfunction and that all factors of the DEX appeared to be affected by depressive symptoms in this population. The implications of these results for therapy, particularly the use of problem-solving therapy or complimentary executive functioning training are discussed.
Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-191
Objective: This cross-sectional study examined cognitive subtypes and influential factors in HIV-positive (HIV+) adults. Method: Two-step cluster analysis was conducted on a neurocognitive test battery in a sample (N = 78) of adults and older adults with HIV (Mage = 46.1). Next, cognitive, functional, and mental and physical health differences were compared between the HIV+ clusters and an HIV- reference group (N = 84; Mage = 47.9). Results: A two-cluster solution emerged, with a lower performing cluster exhibiting poorer performance across all domains except psychomotor speed, and a “normal” cluster displaying similar performance as the HIV- group. The most influential factors to classification in the lower performing cluster were older age and presence of stroke and hypertension. There were trends for longer duration of HIV-infection, higher unemployment rates, and greater prevalence of Hepatitis C co-infection in the lower performing cluster. Conclusions: These findings suggest that there are not unique cognitive subtypes in HIV, but rather a subset of individuals who exhibit globally normal performance and those with below average performance. Older age and the related cardiovascular comorbidities of both aging and HIV medications may be key influential factors to variability in neurocognitive functioning in this population and thus should be considered in future studies. Implications for research and practice are provided.
Jun 2026
Background A persistent gap remains between evidence-based health care and its application in routine practice. This challenge is particularly prominent in allied health professions like occupational therapy (OT), where interventions are complex, individualized and centred on patients' daily functioning. Objective To identify barriers, facilitators, and implementation strategies for integrating evidence-based OT interventions in multiple sclerosis (MS) rehabilitation. Methods A mapping review was conducted using searches in five databases. Eligible studies included adults with MS, examined OT interventions, and reported on factors influencing implementation. Data were extracted and categorized using Grol’s framework for barriers/facilitators and Mazza’s taxonomy for implementation strategies. Results Fifteen studies met inclusion criteria. Barriers and facilitators were identified at multiple levels of Grol’s framework: 1-Innovation-level: accessibility, feasibility, and perceived attractiveness supported implementation, particularly when interventions incorporated holistic approaches, gamification, or printed manuals. 2-Professional-level: therapists’ competencies and alignment between interventions and patients’ priorities. 3-Patient-related: facilitators included motivation, readiness to change, and peer support, whereas fatigue, pain, and cognitive challenges served as barriers. 4-Social and organizational: effective teamwork, resource availability, and flexible scheduling facilitated successful adoption. 5-Economic or political: no studies. Implementation strategies focused on using manuals, patient empowerment, gamification, and organizational supports. No financial or structural policy-level strategies were identified. Conclusion Successful implementation of evidence-based OT for MS requires multifaceted, context-sensitive strategies addressing innovation, professional, patient, and organizational determinants. Practical approaches enhance uptake, while substantial gaps persist at economic and policy levels. Strengthening these areas may improve longterm integration and sustainability of evidence-based OT in MS rehabilitation.
Mar 2026 DOI 10.14302/issn.2574-4518.jsdr-26-6010
Background/Aim Sleep disturbances are common and are associated with impaired daytime functioning, reduced quality of life, and increased health risks. Non-pharmacological neuromodulatory interventions have gained interest as alternatives to hypnotic medication. Pulsed electromagnetic field (PEMF) therapy has been proposed as a non-invasive approach to improve sleep quality and recovery, but evidence from large, well-controlled trials remains limited. The objective of this study was to evaluate the efficacy and safety of pulsed magnetic field therapy (PMT) on sleep quality, sleep-related symptoms, daytime functioning, and well-being in adults with heterogeneous sleep complaints. Materials and Methods In this remote, randomized, double-blind, placebo-controlled trial, 217 adults reporting non-restorative sleep, difficulties initiating sleep, or frequent nocturnal awakenings were assigned to active PMT using a PEMF device (Night Harmony Female/Male protocol) or a sham application for three weeks. Primary outcomes were changes in the Pittsburgh Sleep Quality Index (PSQI) global score and self-rated sleep satisfaction, restfulness, and sleep initiation difficulties. Secondary outcomes included sleep diary measures, daytime functioning, well-being (WHO-5), symptom burden (MYMOP), and daytime sleepiness (Epworth Sleepiness Scale). Analyses followed the intention-to-treat principle using ANCOVA with baseline values of the respective parameter as covariate. Results Both groups showed significant improvements over time in global sleep quality and most secondary outcomes (p < 0.001). Between-group differences in PSQI global score were not significant (p = 0.314). However, active PMT resulted in significantly greater improvements in subjective sleep satisfaction (p = 0.02) and restfulness (p = 0.02), particularly among participants with moderate to severe baseline sleep disturbances (p < 0.001 for both). Sleep continuity measures improved similarly in both groups. No serious adverse events were reported. Conclusions PMT produced modest but significant improvements in subjective restorative aspects of sleep beyond placebo effects and was well tolerated. Further studies using objective sleep measures and longer follow-up are warranted.
Aug 2025 DOI 10.14302/issn.3066-8042.jac-25-5652
Background Attention-deficit/hyperactivity disorder (ADHD) in adulthood is increasingly recognized not only as a psychiatric condition but also as a trait with behavioral and occupational implications—particularly in high-stakes, fast-paced financial environments. Traits such as impulsivity, sensation seeking, and altered reward sensitivity may influence decision-making among individuals engaged in stock trading or high-risk investment professions. Objective This systematic review and meta-analytic synthesis aims to investigate the relationship between ADHD, impulsivity, gender differences, and financial risk behavior, with a particular focus on decision-making outcomes in real or simulated trading contexts. Methods Seventeen peer-reviewed studies published between 2008 and 2025 were included. Studies employed behavioral experiments, fMRI paradigms, neurochemical analysis (e.g., glutamate levels), and ecological financial assessments to examine impulsive traits and investment behaviors among adults with and without ADHD. Both clinical samples and occupational cohorts (e.g., brokers, retail investors) were analyzed. The analysis followed PRISMA 2020 guidelines. Results ADHD symptoms—particularly impulsivity and reward hypersensitivity—were associated with increased delay discounting, higher risk-taking, and diminished cognitive control in financial tasks. Neuroimaging data revealed hypoactivation in prefrontal control regions and hyperactivation in reward-related circuits (e.g., ventral striatum). Gender-stratified analyses showed that males with ADHD displayed stronger preference for immediate rewards, higher portfolio turnover, and greater volatility. Preliminary evidence also suggests an overrepresentation of ADHD traits in high-frequency trading roles. Conclusion ADHD-related impulsivity significantly modulates financial risk behavior, particularly in high-stakes and fast-paced contexts such as trading. A convergence of behavioral, neurobiological, and ecological findings suggests that males with ADHD are disproportionately prone to rapid, high-risk financial decisions, whereas females may demonstrate greater regulatory control. These insights underscore the need for gender-sensitive interventions, occupational screening, and tailored psychoeducation. As financial environments become increasingly automated and fast-paced, understanding the neurocognitive vulnerabilities of individuals with ADHD may not only protect personal outcomes but also enhance systemic financial stability.
Aug 2025 DOI 10.14302/issn.2474-7785.jarh-25-5659
Background Older adults with disabling osteoarthritis may be severely impacted by negative emotions and pain, especially if they feel isolated. Review Aims 1) To summarize the research base concerning the presence of depression in older adults suffering from osteoarthritis; 2) To examine the degree to which mitigating loneliness is desirable in this regard and may be helped by one of the many emergent robotic social devices offering companionship; and 3) To provide directives for professionals who work or are likely to work with this population in the future. Methods Reviewed were current publications detailing some aspect of osteoarthritis in the older adult, depression, emergent loneliness and social isolation, and the role and impact of robotic personal ‘friends’ in this realm. Results Collectively, these data reveal efforts to reduce and mitigate different degrees of depression in older adult osteoarthritis cases are needed and that social robots may help quell isolation. Implication Those older adults with osteoarthritis suffering from depression and emergent loneliness and social isolation may benefit from robotic human or pet like contacts and interactions regardless of cause and overall health status, but the key is still loneliness prevention.
Jun 2025 DOI 10.14302/issn.2474-7785.jarh-25-5598
Osteoarthritis, the most prevalent joint disease and one affecting many aging adults is strongly associated with various degrees of disability and high health costs. Commonly deemed largely incurable and progressive, it appears muscle fat deposition and its encroachment on muscle tissue may account for multiple adverse health outcomes, especially the osteoarthritic disease process. This mini review examines whether contemporary evidence supports a role for efforts towards preventing excess fat infiltration into vulnerable muscles as one means of reducing osteoarthritic pain and disability. To this end, research on this theme and reported as of June 2025 on this issue was sought. We found that with few exceptions and regardless of joint examined a role for muscle mass infiltration in osteoarthritis disability appears of high clinical significance.
Sep 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5215
Background The understanding of older persons with non-communicable diseases (NCDs) regarding health well-being is paramount and can translate to increased self-efficiency, independence, and enhanced well-being. However, little is known about older persons' understanding of the concept of health-related quality of life (HRQoL) in Uganda. The study explored perceptions and unveiled understanding of older persons with NCDs on HRQoL in central Uganda. Methods This exploratory qualitative study design involved 23 participants recruited from selected Primary healthcare facilities in Central Uganda. Thematic analysis using an inductive approach generated themes that informed the study's qualitative findings. Results The study highlighted the physical domain as a key component of HRQoL, encompassing holistic well-being, lifestyle modification, and financial stability. To promote well-being and support a healthy aging journey, it is essential to adopt a person-centered approach that aligns with the perceptions of older adults on HRQoL.
Jun 2024 DOI 10.14302/issn.2379-7835.ijn-24-5117
In this study, the efficacy and safety of DKB-131 (extract of Siraitiagrosvenorii) in adults of both genders presenting mild symptoms of knee arthritis were evaluated in comparison to a placebo. This clinical trial was randomized, double-blind, multicenter, and lasted for 12 weeks. A total of 120 participants with Visual Analogue Scale (VAS) scores of 30 mm or higher in the knee area and Kellgren & Lawrence Grade I or II knee arthritis on X-ray were enrolled, with 60 subjects randomized to receive DKB-131 and 60 subjects receiving placebo. Following 12 weeks of consumption, the change in K-WOMAC total score assessed in the per protocol (PP) set revealed a reduction of 21.86±15.98 points in participants who received DKB-131 (p<0.0001), whereas those in the placebo group exhibited a reduction of 14.92±16.66 points (p<0.0001). This demonstrated a statistically significant difference between the test groups (p=0.0389). Additionally, significant differences were observed between the DKB-131 and placebo groups in the changes in K-WOMAC pain (p=0.0157) and physical function (p=0.0447). For the secondary efficacy endpoint, the change in Visual Analogue Scale (VAS) scores, analyzed in the PP set after 12 weeks of consumption, the test group showed a reduction of 17.82±13.80 mm (p<0.0001), while the control group exhibited a reduction of 11.81±13.99 mm (p<0.0001), indicating a statistically significant difference between the test groups (p=0.0359). Safety evaluations including hematological tests, biochemical tests, and urinalysis revealed no clinically significant differences between the consumption groups. Additionally, vital signs (pulse, blood pressure) and anthropometric measurements (body weight) did not exhibit clinically significant differences between the consumption groups, confirming the safety of DKB-131. We propose that the consumption of DKB-131 is safe for humans and may contribute to joint health. Trial registration (CRIS.NIH.go.Kr): KCT0008527
Apr 2024 DOI 10.14302/issn.2692-5257.ijgp-24-5041
Introduction Globally, 36.7 million individuals live with HIV/AIDS, with 2.5 million new cases annually. Youth (14-25 years) account for 45% of these new infections. Those aged 15-24 years are less likely to be aware of their HIV status and engage in HIV care compared to older adults. This study explores the use of HIV self-testing to improve access to HIV care among Kenyatta University undergraduates. Objective To identify barriers and facilitators to HIV self-testing in this group. Methodology Employing multistage cluster sampling, 398 students were surveyed using a self-administered questionnaire. Results Of the participants (median age 21 years, 1:1.03 male-to-female ratio), 91.7% understood HIV's seriousness, with sexual intercourse as the primary transmission mode. Self-testing usage was 28.8%. Key barriers included fear of partner reaction, stigma, and lack of confidence. Significant facilitators were being female, knowledgeable about HIV, and sexually active. Conclusion Only 24% had prior HIV testing experience. The study highlights the importance of addressing fears and misconceptions while leveraging knowledge and sexual activity awareness to promote HIV self-testing.
Dec 2023 DOI 10.14302/issn.2329-9487.jhc-23-4848
Introduction Rheumatic heart disease is mostly common in low-income or developing parts of the world, such as Sub-Saharan Africa, with a high morbidity and mortality rate. There are few data that are available in Chad on rheumatic heart disease. Our objective was to study the clinical, echocardiographic, therapeutic, and progressive aspects of rheumatic heart disease at the Renaissance University Hospital Center and the National Reference Teaching Hospital in N’Djamena, Chad. Patient and methods This was a prospective, multicenter and observational cohort study, covering a consecutive series of patients consulted and/or hospitalized for rheumatic heart disease, documented by an echocardiogram from January 2015 to January 2021. Results Among the 4456 patients consulted and/or hospitalized, 398 cases of rheumatic heart disease (8.9%) were collected, and 364 patients had met the inclusion criteria. The mean age was 31.2 ± 14.4 years, and 193 patients (53%) were female. On admission, heart failure was present in 214 patients (58.8%), ischemic stroke in 10 patients (2.7%) and supraventricular arrhythmias such as atrial fibrillation in 94 patients (25.8%) and atrial flutter in 6 patients (1.6%). Mitral regurgitation was observed in 49.7% (n=181) of cases, aortic regurgitation in 33.2% (n=121), mitral stenosis in 31.3% (n=114), and aortic stenosis in 7.7% (n=28). At least two valvular disorders were combined in 48.4% of cases. A surgical intervention such as a heart valve replacement and/or valvuloplasty was performed in 80 patients (22.2%). At least one rehospitalization was noted in 56.9% of patients. Forty-two of the 150 patients free of heart failure at inclusion (28%) had experienced the first episode of decompensated heart failure during follow-up. On the other hand, in 119 patients (55.6%), it was the second episode of decompensated heart failure. Other progressive complications included atrial fibrillation (13.8%), thromboembolic complications (6.3%), infective endocarditis (6.0%) and prosthetic valve dysfunction (1.4%). Altogether, the mortality rate was 10.4%. It was 9.9% in non-operated patients compared to 12.5% in operated patients (p=0.49). Conclusion The present study shows that morbidity and mortality of rheumatic heart disease remain high in our context and often affect children, young adults, and women. Treatment is essentially based on cardiac surgery which is not available in Chad.
Dec 2023 DOI 10.14302/issn.2324-7339.jcrhap-23-4634
Introduction Human Immunodeficiency Virus (HIV) remains a persistent global public health challenge. In 2020, approximately 37.9 million individuals were living with HIV globally, including 1.7 million children <15 years old, with a global HIV prevalence of 0.8% among adults. A larger portion of people living with HIV are found in low-and middle-income countries, and Sub-Saharan Africa (SSA) is home to about 68% of people living with HIV in the world. Strikingly, with increased uptakes in PMTCT, challenges in ART programs, and high viremia among children and adolescents in SSA, the success rate of ART might be quickly compromised, with possible HIVDR emergence, particularly after years of paediatric ART exposure. Therefore, monitoring ART response in children and adolescents in terms of HIVDR patterns and other socio-economic determinants of disease progression might help achieve better treatment outcomes at individual levels. At a programmatic level, this can guide further optimization of treatment options for SSA especially Zimbabwean rural where there is paucity of information on HIVDR prevalence in children and adolescents. Methods We enrolled 89 children and adolescents experiencing virologic failure from Chidamoyo Christian Hospital in Hurungwe. We managed to amplify all the 89 using nested PCR and 32.5% (29) had resistance to at least one ART drug and analysis was done using the 29 samples. Results Among the 89 participants with virologic failure,29 were resistant to at least one of their ART drugs. 39.2% of males and 23.07% of females had HIV-1 with resistance to at least one medication. Among 29 participants with HIVDR mutations, the prevalence of at least one HIVDR mutation to protease inhibitors (PIs), Nucleotide Reverse Transcriptase Inhibitors (NRTI), and Non-Nucleotide Reverse Transcriptase Inhibitors (NNRTI) were 6.47% ,46.76% and 46.76% respectively. Of the 29 participants who had HIVDR 19 (65.5%) had resistance to a drug they were currently taking and they needed to be switched to a better effective ART regimen Conclusion Use of HIVDR testing in guiding and monitoring development of HIVDR at the start of ART or at 1st failure can be very important in treatment options and patient management.
Sep 2023 DOI 10.14302/issn.2641-4538.jphi-23-4635
Tobacco use remains a leading cause of harm to public health. Despite nearly two decades of ratifying the WHO Framework Convention on Tobacco Control (FCTC), Oman is still striving to achieve the best practice approach in different FCTC measures. Current epidemiological data shows that the prevalence of tobacco use among adults in Oman is steadily increasing with time. This review highlights the progress that has been made in the various FCTC measures, as well as how Oman has the possibility to attain the best practice approach in the various FCTC measures, and even go beyond that by implementing policies that have the potential to achieve a tobacco-free Oman by 2040.
Aug 2023 DOI 10.14302/issn.2474-7785.jarh-23-4730
Background Osteoarthritis and depression are both key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. When combined what are the implications? Aim This mini review examines 2023 data pertaining to osteoarthritis and depression and older adults and a possible theoretical framework of stress that may direct our approaches in the future. Methods and Procedures Articles published between January 1 and August 15 2023 that addressed the current topic of interest and that were extracted from PUBMED, PubMed Central, Science Direct, and Google Scholar were carefully read and their key points arepresented in narrative form. Results As in the past, very few tangible theory-based prospective analyses that employ valid measures of depression and examine any association of any form of osteoarthritis longitudinally and in a consistent manner prevail. Several reports use the same or similar large cohort to draw upon, and find various degrees of clinical implications, but this may not embrace the need for more inclusivity, sampling strategies, control and diversity issues, as well as embracing the role of cognitions positive and negative. Conclusion Without efforts to develop sound research designs of diverse and carefully differentiated osteoarthritis substantive samples it is impossible to delineate the origin or implications of the osteoarthritis-depression linkage reported currently or arrive at a deep understanding of its relevance, to life quality and public health costs. What is needed to protect against or minimize either or both these clinically related disabling correlates in the aged population warrants timely study.
May 2023 DOI 10.14302/issn.2642-9241.jrd-23-4566
Safe and effective antitussive therapy remains a significant area of unmet need for cough management. Antitussive drugs are commonly used cough suppressants and include centrally acting (opioids and non-opioids) cough suppressants and peripherally acting antitussives. Authors searched PubMed, Google Scholar and additional studies from reference lists via cross-referencing to identify studies assessing levodropropizine for the treatment of cough. Of the 748 studies identified, 13 were included. Recent clinical evidence, guideline recommendations and findings from this review suggest that levodropropizine is a peripheral antitussive which reduces cough intensity, frequency, and nocturnal awakenings in children and adults and provides better efficacy outcomes with a more favourable risk/benefit ratio compared to centrally acting antitussive agents which pose greater safety concerns and present an unacceptable risk–benefit profile. This review is aimed at Indian primary care physicians for making effective cough management decisions where the clinical evidence needs to be translated to clinical practice. Key Messages The usage of currently available centrally acting antitussive agent is greatly limited by their central depressing action and frequent side effect. The findings of this review indicate that levodropropizine is an effective antitussive agent and well tolerated in the management of cough in patients of all ages.
Mar 2023 DOI 10.14302/issn.2474-3585.jpmc-23-4442
Objective Women have continued to bear a heavy burden of cardiovascular disease morbidity and mortality with hypertension as the flagship. This is partly because as the modifiable cardiovascular disease risk factors are falling in rate, gender specific risk factors have persisted. One of them is age at first pregnancy and delivery. Methods In order to contribute to this discourse, we secondarily analysed data generated in a previous field study on risk factors for cardiovascular diseases in free living adults in Plateau State, Nigeria. The women were divided into four groups and we looked at blood pressure at the time of study from the perspective of age at first pregnancy. Reults It was found that those who had their first pregnancy in the late teenage years had the lowest mean arterial blood pressure many years down the line; better than those who started child bearing earlier and those who started later. There was also significant within and between group differences in the blood pressures (p = 0.000). Conclusion To stem the tide of female hypertension later in life, child bearing should not start in the early teenage years nor be unnecessarily delayed. Sociocultural conditions that promote early teenage marriage and pregnancy should be discouraged.
Mar 2023 DOI 10.14302/issn.2576-9383.jhhr-22-4178
The study aimed to assess the oral health condition and its impact on the quality of life (QoL) among a sample of Yemeni population. The study including 256 individuals who responded to the Oral Health Impacts Profile (OHIP) through completing a face-to-face survey of the OHIP-14 Arabic version. The data were collected by one dentist trained in the terms of oral health-related quality of life (OHRQoL). The study revealed that the impact of OHRQoL among the study sample was found with a weighted OHIP-14 score of 1.1 (±0.9). Physical pain (3.7±2.3), followed by physical disability (2.4±2.2), and psychological disability (2.1±2.3) were the highest scoring. A significantly higher effect (p < 0.05) was found for the adults (18-44 years old) compared to those elderly individuals (> 64 years). The OHRQoL was better in male than in female and in employees than in both pensioners and un-employees. Females had a significantly higher effect when compared to males in the OHRQoL (p < 0.05). The unemployed subjects were significantly higher than those pensioners and employees in the OHRQoL (p < 0.05). The OHRQoL was also better in subjects with higher income and education than those participants with low. However, there were no significant differences for OHRQoL with respect to the educational level and monthly income of participants (p > 0.05). Conclusion, the quality of life is greatly affected by the oral health conditions of the elderly. This impact of oral health on quality of life has an association with individual and contextual variables.
Jan 2023 DOI 10.14302/issn.2474-7785.jarh-23-4432
Background Many older adults remain vulnerable to COVID-19 infections. They are also often at risk for frailty and poor health outcomes. Aim This exploratory review examines the correlates of long COVID and frailty and their association insofar as the older adult’s wellbeing may be jeopardized. Methods and procedures Articles that emerged between January 1 2022 and 2023 in major electronic data bases that addressed the current topic of interest were sought using the key words: Long COVID and Frailty. Those deemed relevant were duly downloaded, analyzed and summarized in narrative form. Results A high proportion of older adults can be expected to remain vulnerable to COVID-19 long term impacts, plus new variants of infection, along with frailty as both an outcome and mediator. Many too are at risk for persistent long COVID-19 complications and a low life quality if more concerted preventive and rehabilitation efforts to avert frailty early on are not forthcoming in a timely manner. Conclusion Prompt and continuing frailty assessments of older adults at risk for COVID-19 or recovering from this disease, especially those with long COVID manifestations who are frail or may become frail are strongly indicated.
Nov 2022 DOI 10.14302/issn.2372-6601.jhor-22-4344
This study characterizes an oncogeriatric cohort at a cancer institute, reporting tumor types, comorbidities, geriatric assessments, and treatment patterns. Findings inform service planning and individualized care for older adults with cancer.
Nov 2022 DOI 10.14302/issn.2641-4538.jphi-22-4235
This study investigates the effect of Aqueous extract of abelmoschus esculentus on the microanatomy of the small, large intestine and stomach and the body weight of Wister rats. Twenty-one adults male wistar rats weighing between 100-120 grams were assigned into three groups consisting of seven rats each; Group A (control), Group B (low dose), and Group C (high dose). The rats in the control group were fed with fed with feed and water only while the rats in groups B and C were treated with 0.1mg/kg body weight and 3.0mg/kg body weight of abelmoschus esculentus respectively for 14 days. At the end of administration, the final weights of all rats were recorded before sacrifice using cervical dislocation and the small, large intestine and the stomach were harvested, processed and stained using H&E stain. The results were revealed as significant (p<0.05) increased in the mean body weight compared with the weight in the control groups and experimental groups. The treated animal groups revealed increased cellularity, focal metaplasia of the mucosal cells with villous disruption in the small intestine and dysplasia of the mucosal with loss of epithelial shape in large intestine. The stomach histology showed gastric pits with goblet cells smooth muscles layer and surface epithelium in the control group. Sections from the low dose treated group showed deep epithelical gastric pit areas with marked depletion of pits and goblet cells while the high dose treated group revealed dysplasia of gastric pits, goblet cells and smooth muscles appear mildly eroded.
Nov 2022 DOI 10.14302/issn.2474-7785.jarh-22-4354
Background Osteoarthritis, the most common joint disease and one affecting a large number of older adults is not always amenable to the use of passive interventions such as surgery or pharmacologic interventions, but even then, to maximize any desirable intervention approaches, a trustworthy and supportive partnership with the sufferer is strongly indicated. Complicating this process are emerging equity and persistent health literacy issues, as well as post COVID-19 service associated ramifications and persistent disease risks. Aim This mini review was designed to examine what current data reveal as regards the presentation of osteoarthritis and its pathology among the older adult as of the current post COVID-19 pandemic period in 2022, and how health literacy and equity issues are likely implicated in some degree with the disease presentation and its outcomes and will be likely to continue, unless remediated. Methods Peer reviewed published articles on this topic were sought from multiple data bases using the key words- osteoarthritis, health equity, health literacy, prevention, and intervention. Results As in prior years, osteoarthritis continues to induce considerable physical disability and consistently impedes the attainment of a high life quality for many older adults. Although not studied to any degree, attention to health equity and literacy issues appear to pose additional osteoarthritis intervention challenges, especially among the long COVID affected older adults and those with low income and educational levels. Conclusions Many behaviourally oriented and necessary osteoarthritis management approaches and interventions may fail to reduce the functional disability and pain experienced by older people with any form of osteoarthritis to any meaningful degree if a) the provider does not tailor their recommendations in light of possible prevailing health literacy, economic, and educational challenges; b) the patient does not understand how their health behaviours impact joint disease as well as COVID-19 risk status, and are not empowered to undertake these.
Oct 2022 DOI 10.14302/issn.2381-862X.jwrh-22-4228
Background Gender based violence (GBV) refers to any violence targeted at an individual or group on the basis of their gender. It could occur in different forms with several clinical manifestations. The authors have described several clinical manifestations of GBV in a tertiary health centre, knowledge of which would help in case identification and early clinical management. Methods Retrospective descriptive study of all clients seen at a gbv clinic over a sixteen months period.Data was obtained from case records and clinical presentations were entered into excel. Data analysis was done usingIBM SPSS Statistics for Windows, version 25. The results were presented in frequency tables and graphs Results Of 86 clients studied, 56(65.1%) were of pediatric age (< 18years) while 30(34.9%) were adults with a mean age of 18.33+11.64(range 1-64years).72(82.6%) belonged to the low social class. Physical abuse in the forms of battering, human bite, walking and sitting disturbances, hearing loss possibly from slapping or hitting and red eye possibly from trauma on the eye, constituted 37.6% of the clinical presentations. Other presentations were; sexual abuse in the form of forced sex which constituted 34.9%, while gynaecological / obstetrics presentations in the forms of bleeding per vagina, pregnancy due to forced sex and vaginal pain made up 13.9%. Emotional/psychological abuse was observed in all clients irrespective of their different presenting complaints. Conclusion While various forms of physical abuse were common, emotional abuse was present in all clients but masked probably due to prioritization of physical injuries. Therefore we recommend that all GBV survivors be screened for psycholocal abuse and psychotherapy given.
Aug 2022 DOI 10.14302/issn.2474-7785.jarh-22-4271
Older adults suffering from chronically painful disabling osteoarthritis of one or more joints such as the hip joint continue to experience multiple health issues, commonly progressive debility, and excess disability. This mini review strove to examine current perspectives in the realm of hip joint osteoarthritis, a widespread disabling disease affecting many older adults in the face of the possible repercussions of the multiple COVID-19 restrictions in response to the SARS-CoV-2 pandemic that emerged in late 2019, along with the persistence of multiple evolving COVID-19 variants that remain lethal to many older adults, especially among the older chronically impaired population. Using multiple data bases, results reveal that very little progress has been made in recent times to mitigate hip osteoarthritis, along with very few innovative treatment approaches when severe, other than surgery and medication. Moreover, a multitude of non-pharmacologic approaches have not reduced numbers of cases requiring surgery to any extent, even when employed. In addition, outcomes of hip joint replacement surgery, and other treatments for ameliorating unrelenting pain remain largely suboptimal, especially where those undergoing surgery may now be more impaired than in pre pandemic times, and where high rates of opioid related deaths prevail in this regard. As such, it is concluded that whether in the community or being treated in hospital, exposure to COVID-19 remains risky especially in cases who are now weaker and frail, plus suffering from excess chronic disease manifestations, thus warranting more attention and protection of this high risk group, plus insightful preventive efforts to avert multiple interacting COVID-19 effects in the realm of osteoarthritis suffering, especially where patients are willing to risk infection by undergoing surgery.
May 2022 DOI 10.14302/issn.2474-7785.jarh-22-4191
Background The origin of osteoarthritis, the most common disabling disorder of older adults remains uncertain. Aim This mini review examines the possible role played by various neuromuscular deficits in the osteoarthritis etiopathogenic process. Methods and Procedures Articles that haveaddressed the current topic of interest and were located in the PUBMED,Google Scholar, and Web of Science electronic data bases as of 2017-2022 were carefully sought and examined. Results Various neuromuscular mechanisms may have a bearing on the development and progression of osteoarthritis, but the data are largely unrelated and observational in nature. Conclusion More research to examine this issue is sorely needed and could have considerable merit in light of the growing populations of older adults at risk for disabling osteoarthritis in the face of few intervention options to help them to achieve an optimal functional level.
Mar 2022 DOI 10.14302/issn.2575-1212.jvhc-22-4105
Aflatoxins are toxigenic metabolites that are definitely occurring by lethal strains of Aspergillus parasiticus and Aspergillus flavus that commonly dwell and colonize in feed components and various nutritive foodstuffs particularly milk and milk based products. This Review has three main objectives; those are causes of aflatoxin, effects and methods of control in milk and milk products. Drinking of cow milk polluted with aflatoxin may overwhelm immunity and subsidize to stunting in young children, as the young children are not immune-competent during early stage. It has been internationally assessed that aflatoxin is possibly accountable for 30% of the annual cases of liver cancer. Generally, control approaches of aflatoxin can be applied during pre-harvest, cautious management in the time of harvest and postharvest decontamination. Moreover, choosing breed for aflatoxin impervious crop diversities, prevention of aflatoxin production through biological decontamination by microorganisms and their metabolites, rejection of aflatoxin by physical means in addition to inactivation by chemicals are the typical approaches that have been described in different studies. For the reason that cow milk is the most important and principal diet of children, but the risk of exposed to the cancer are more in infants. In addition, according to various investigations it also well thought that young animals are also found to be more vulnerable to aflatoxin than adults. Thus; the contamination of cow milk and milk products by AFM1 should understood as undesirable for young human and animals.
Jan 2022 DOI 10.14302/issn.2474-7785.jarh-22-4070
Background Many older adults, including those who have acquired painful disabling osteoarthritis of one or more joints may be frail rather than obese as is often reported. Those older adults who are frail may acquire osteoarthritis in turn if they encounter excess joint stresses and injury. Aims This report sought to examine what has been published to date on both of these debilitating health states, namely osteoarthritis and frailty. Methods Reviewed were relevant articles published in ACADEMIC SEARCH COMPLETE, PUBMED, WEB OF SCIENCE, SCOPUS and GOOGLE SCHOLAR regardless of time period but that focused on osteoarthritis and frailty related topics. The focus was on ascertaining how these two conditions might interact among community-dwelling older adults and whether more should be done specifically to mitigate any potentially preventable ‘frailty’ induced negative health impact among this group. Results Older adults with osteoarthritis living in the community may suffer from both osteoarthritis and frailty. Those that do are at high risk for disability and injury and should be targeted more effectively. Conclusion Timely and concerted efforts are needed to offset frailty correlates as well as excess osteoarthritis disability among community dwelling older adults.
Dec 2021 DOI 10.14302/issn.2474-7785.jarh-21-4041
Background Many older adults are vulnerable to becoming frail. They are also often at risk for falling and serious injuries and poor health outcomes. Aim This exploratory review examines the correlates of frailty, and fear of falling and their association insofar as older adults wellbeing may be jeopardized. Methods and Procedures Articles extracted from major electronic data bases that addressed the current topic of interest were used. Key findings regarding the syndromes of frailty and fear of falling were duly downloaded, analyzed and summarized in narrative form. Results A high proportion of older adults can be expected to exhibit frailty or become frail as they age. Many too are at risk for falls and fear of future falls, regardless of frailty status. A persistent fear of falls may however, heighten frailty risk or manifestations if not duly addressed in a timely manner. Conclusion Prompt comprehensive assessment of at risk older adults, as well as the frail and pre frail older adult, plus those who have fallen may avert serious injury and long term disability plus excess frailty and its deleterious impacts this syndrome has on aging older adults as well as societies.
Nov 2021 DOI 10.14302/issn.2577-2279.ijha-21-3925
Introduction The nose is one of the important component of the face which is considered as the major clue for the ethnic origin. The proportion of the nose is determined on the same principal as that of the skull.The external nose extends the nasal cavities onto the front of the face and positions the nares so that they point downwards. The shape of the nose is pyramidal with its apex anterior in position. The upper angle of the nose between the openings of the orbits is continuous with the forehead. Materials and Methods This study was carried out among residents of Ramnagar Gaupalika-7, Sarlahi,Nepal, one of the core region of Madhesh Nepal dated Jan 2021 to April 2021.The cohort consists of independent adults of age group 17-45 and consenting adults from the metropolis. Ethical approval was sought prior to conducting the study from the supervising ethical committee of the Nobel Medical College Teaching Hospital, Biratnagar, Nepal. Written consents were taken from the subjects for the recruitment in the study. Results The present study involved 100 subjects of equal males and females subjects of age groups 17-45 years from Madheshis community of Nepal. The table 1, table 2, table 3 below shows the values obtained for different parameters for males and females. The mean value of nasal height for male and female is 52.59±1.89 and 50.27±2.16 mm and the nasal width for male and female is 37.64±1.72mm and 35.42±2.04mm and the value of mean nasal index for both the sexes are 71.59±2.31and 70.58±3.04 respectively. The dominant type of the nasal morphology in both the sexes are the mesorrhine type and the leptorrhine type as well. Conclusion The human nose is a dominant feature in facial region which differs in anatomy and morphology among racial groups and of the most characteristic differences during the analysis of ethnic and racial differences. The dominant type of the nasal index is the mesorrhine type in both the male and female of the Madheshis community. Hence the data obtained here will be useful for the differentiation of different ethnic groups of Nepal as well as in the field of forensic science and rhinoplastic surgery.
Oct 2021 DOI 10.14302/issn.2474-7785.jarh-21-3979
Background Aging, a state often associated with poor emotional health status greatly impedes life quality and independence for many. Aim This mini review examines the potential of the concept of positive psychology as an active approach to fostering successful or more successful, rather than suboptimal aging. Methods and Procedures Articles that addressed the current topic of interest and were located in the PUBMED, Medline, Web of Science, PsycINFO and Google Scholar electronic data bases were carefully sought and analyzed and presented in narrative form. Results Various forms of positive psychology appear to provide a safe efficacious evidence based approach for purposes of ameliorating various degrees of anxiety and depression and for improving cognition, life quality, and health well-being in diverse subgroups of older adults Conclusion More research to examine who might benefit most from this highly promising form of intervention, and in what respect appears to have considerable merit in light of the growing populations of older adults and few intervention options to help them to age optimally and as successfully as possible.
Oct 2021 DOI 10.14302/issn.2692-1537.ijcv-21-3951
This article has been retracted on July 20, 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2692-1537.ijcv-25-5866) In December 2019, a novel coronavirus, now named as SARS-CoV-2, caused a series of acute atypical respiratory diseases in Wuhan, Hubei Province, China. The disease caused by this virus was termed COVID-19. The virus is transmittable between humans and has caused pandemic worldwide. The number of death tolls continues to rise and a large number of countries have been forced to do social distancing and lockdown. In humans, COVIDs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. in our study , we consider the symptomatology , complications and mortality patterns of this disease in children.
Aug 2021 DOI 10.14302/issn.2474-7785.jarh-21-3935
Background Anxiety and depression are key barriers to healthy aging and greatly heighten the risk for many negative health issues that seriously impact life quality. Aim This mini review examines the potential of low level laser treatments or photobiomodulation therapy for ameliorating severe anxiety and depression in older adults. Methods and Procedures Articles that adressed the current topic of interest extracted from PUBMED and Google Scholar were carefully and presented in narrative form. Results Photobiomodulation therapy appears to be a safe efficacious modality for ameliorating various degrees of anxiety and depression and for improving cognition, and is supported by several well established mechanisms of action at the molecular, cellular, and tissue levels. Conclusion More research to examine who might benefit most from this form of therapy, and in what respect in this area of growing global concern and few intervention options is strongly warranted.
Aug 2021 DOI 10.14302/issn.2639-3166.jar-21-3858
The Fall armyworm (Spodoptera frugiperda) is considered among the economic important pests in Sudan. Therefore, it became necessary to study and understand its biology and find out the appropriate control measure (s). To achieve the above objective, experiments based on Randomized Complete Block Design (RCBD) were carried out during the period from September 2018 to August 2019, where the Fall armyworm (FAW) was reared in the laboratory and fed on a nutrient médium composed of Corn leaves. The results displayed the ranges of eggs laid by a female was 890–1169. The egg incubation period ranged between 3-13 days. The larval duration ranged between (13-50) days and the pupal duration was between (7-20) days under a temperature of 21-300c and a Relative Humidity (RH) of 65 ± 5%. The longevity of the adults was 1-20 days, and the range of the full lifecycle was (24-100). However, six generations of FAW were obtained within one year. This study concludes that in Sudan FAW breeds continously throughtout the year and it recommends further studies on the biology and effective management of this invasive pest
Apr 2021 DOI 10.14302/issn.2474-7785.jarh-21-3815
Background Aging, a commonly accepted time period of declining heath has been shown to vary in terms of its impact on function and independence. Aims This mini review examines the current impact of COVID-19 on the goal of ‘successful aging’, a conceptual model and outcome variable deemed desirable, but hard to attain. Methods Peer reviewed articles published between March 1 2020 and April 15 2021 focusing on ‘successful aging’ and COVID-19 secondary impacts, as located in the PUBMED data base were specifically sought. Results Despite a lack of consensus on the concept of ‘successful aging, and whether this can be achieved or not, ample evidence points to a severe secondary impact on efforts to age as successfully as possible by older adults, especially those isolated in the community as a result of lockdowns. Conclusion Pursuing more efforts to counter predictable harmful cognitive as well as physical impacts of lockdowns, resource and movement restrictions is urgently needed.
Apr 2021 DOI 10.14302/issn.2328-0182.japst-21-3772
Vitamin D3 (cholecalciferol) is a fat-soluble vitamin, which widely used for the prevention and treatment rickets, osteoporosis, arthritis, Parkinson’s and Alzheimer’s diseases, autoimmune disease, dementia, glucose intolerance, etc. The impact of the Trivedi Effect®-Consciousness Energy Healing Treatment on the structural properties and the isotopic abundance ratio of cholecalciferol were evaluated using LC-MS and GC-MS spectroscopy. The test sample cholecalciferol was divided into control and treated parts. Only, the treated cholecalciferol was received the Trivedi Effect®-Consciousness Energy Healing Treatment remotely by a renowned Biofield Energy Healer, Dahryn Trivedi. The LC-MS spectra of both the samples at retention time (Rt) ~22 minutes exhibited the mass of the molecular ion peak at m/z 385.25 (calcd for C27H45O+, 385.35). The LC-MS based isotopic abundance ratio of PM+1/PM in the treated cholecalciferol was increased by 0.74% compared with the control sample. But, the GC-MS based isotopic abundance ratio of PM+1/PM and PM+2/PM in the treated cholecalciferol was significantly increased by 66.39% and 62.69%, respectively compared with the control sample. Hence,13C, 2H, 17O, and 18O contributions from C27H44O+ to m/z 386 and 387 in the treated cholecalciferol were significantly increased compared with the control sample. The isotopic abundance ratios of PM+1/PM (2H/1H or 13C/12C or 17O/16O) and PM+2/PM (18O/16O) in the treated cholecalciferol were significantly increased as compared to the control sample. The increased isotopic composition of the Trivedi Effect®-Consciousness Energy Healing Treated cholecalciferol might have altered the neutron to proton ratio in the nucleus via the possible mediation of neutrino. The increased isotopic abundance ratio of the treated cholecalciferol may increase the intra-atomic bond strength, increase its stability. The new form of cholecalciferol would be better designing novel pharmaceutical formulations that might be more stable and more efficacious for the prevention and treatment of various diseases such as vitamin D deficiency, rickets, osteoporosis, arthritis, multiple sclerosis, cancer, diabetes mellitus, mental disorders, cardiovascular diseases, hypertension, infections, influenza, cognitive impairment in older adults, Parkinson’s and Alzheimer’s diseases, autoimmune disease, dementia, glucose intolerance, multiple sclerosis, etc.
Apr 2021 DOI 10.14302/issn.2576-6694.jbbs-21-3773
L-tryptophan is an essential α-amino acid, necessary for the normal growth in newborns, nitrogen balance in adults, protein synthesis, precursor of serotonin, melatonin, niacin, and albeit inefficiently in human, also the precursor of indole alkaloids and auxins in plants. This current study was designed to investigate the impact of the Trivedi Effect®-Biofield Energy Healing Treatment (Blessing) on the structural properties and the isotopic abundance ratio of L-tryptophan using LC-MS analytical technique. L-tryptophan sample was divided into two parts, one part of L-tryptophan was considered as the control sample (no Biofield Energy Treatment was provided), while the second part was treated with the Trivedi Effect®-Consciousness Energy Healing Treatment/Blessing remotely by a renowned Biofield Energy Healer, Dahryn Trivedi and termed as the treated sample. The mass spectra of both the control and treated samples with respect to the chromatographic peak at retention time (Rt) 2.1 minutes exhibited the mass of the molecular ion peak adduct with hydrogen ion at m/z 205.08 (calcd for C11H13N2O2+, 205.1), along with low molecular fragmented mass peaks at m/z 188, 159, and 102 for C11H12N2O2+, C10H11N2+, and C8H6+, respectively were also observed. The isotopic abundance ratio of PM+1/PM (2H/1H or 13C/12C or 15N/14Nor17O/16O) in the treated L-tryptophan was significantly increased by 35.93% compared with the control sample. Hence,the 13C, 2H, 15N, and 17O contributions from C11H13N2O2+ to m/z 206.08 in the treated L-tryptophan was significantly increased compared to the control sample. It could be hypothesized that the changes in the isotopic abundance and mass peak intensities due to the modification in nuclei possibly through the interference of neutrino particles using the Trivedi Effect®-Consciousness Energy Healing Treatment. The Biofield Energy Treated/Blessed L-tryptophan with increased stable isotopic abundance ratio might have changed the physicochemical properties with higher force constant in the molecule. The new form of treated L-tryptophan would be a better and more stable in the supplements, nutraceutical, and pharmaceutical formulations, which would be advantageous for the prevention and treatment of pellagra, depression, kynurenine. It could also maintain the normal label of tryptophan and avoid increase of its metabolite, lower the neurotoxin and a metabotoxin behavior, glutaric aciduria type I (glutaric acidemia type I) disorder, eosinophilia-myalgia syndrome (EMS), incurable and sometimes fatal flu-like neurological condition, etc. As tryptophan is the precursor for the plant hormones like indole alkaloids and auxins, hence, this treated L-tryptophan would be advantageous for the improvement of yield, productivity, and quality of crops and other plants.
Feb 2021 DOI 10.14302/issn.2379-7835.ijn-21-3709
Background Children need to drink enough water (1.1-1.3 litres) throughout the day to stay hydrated and for health benefits1. Wellbeing and cognitive function benefits have been identified for children who are hydrated2. Yet there is a dearth of research focusing specifically on children’s perceptions of their own fluid intake levels and who helps support them in ensuring they are drinking enough water, this is a novel area to investigate. Previous research3 identified that 44.2% of young children’s fluid intake were influenced the strongest by a family member. This paper will explore in further detail the influence of siblings on children’s fluid intake, in particular older versus younger siblings. Methods 130 children (67 girls and 63 boys, of which 45 had a younger sibling (s) and 85 having an elder sibling(s), from 4 primary schools in the South East of England, were questioned between January and April 2019 using an adapted version of Coppinger and Howells’ (2019)4 questionnaire, on their understanding of fluid intake, how much they perceived they drank and who supported them in prompting them to drink. Physical visual representations were used to aid question comprehension and to ensure the questions were appropriate for young children. The data was analysed using SPSS 24.0 using MANOVAs (P < 0.05) to consider statistical variance in gender and older sibling status. Results The most significant results were linked to elder siblings influence younger siblings in drinking too little fluids within a school day (F=0.530, p<0.05), whilst those without an elder sibling, thought they drank beyond the daily recommended guidelines and reported they drank over 2 litres. This illustrates that children misunderstand fluid intake recommendations regardless of whether they have an elder sibling or not. Children named adults, both parents and teachers as well as elder siblings as the key influencers of them drinking (F=3.67, p<0.05) and the data indicated that girls were more influenced by siblings than boys, whilst twins were not influenced by each other. Conclusion It is concluded that siblings do have an influence on the consumption of water, as siblings act as role models and other siblings follow their habits, therefore the whole family unit is important to ensure that the right fluid intake is consumed. It is recommended that further education, curriculum and community development is needed to continue to support young children’s knowledge and understanding of fluid intake.
Dec 2020 DOI 10.14302/issn.2474-7785.jarh-20-3682
Background to the Issue Many older adults, including those already suffering from chronically painful disabling osteoarthritis of one or more joints remain more susceptible than healthy age and gender matched adults to the COVID-19 corona virus. Aims This report sought to examine what has been published in 2020 on this health condition from the perspective of the variable of widely imposed social isolation strategies designed to mitigate the spread of this highly infectious disease, and to especially keep older community dwelling adults ‘safe’ from infection. Methods Reviewed were all articles published in 2020 in PUBMED from January 1-December 24, 2020 on osteoarthritis and COVID-19 isolation impacts, plus relevant past osteoarthritis and isolation literature among older adults. The focus was on ascertaining how social isolation and distancing strategies might impact current community-dwelling adults diagnosed with osteoarthritis and whether more should be done specifically to mitigate any potentially preventable ‘socially’ induced negative health impact among this group, in spite of the laudable goals of this public health strategy. Results Older adults with osteoarthritis living in the community who are asked to self-isolate, may incur more osteoarthritis pain and disability than would otherwise be encountered if actions taken to counter this possibility are not forthcoming. Advocated over and above basic care approaches are several psychosocial strategies including the role of mobilizing various forms of social support. Conclusion Data indicate a need for concerted thoughtful and immediate attention to offset isolation, fear, and anxiety and depression effects as part of a carefully devised integrated plan of management to reduce excess osteoarthritis disability, as well as excess COVID-19 risk among otherwise free living older adults already compromised by osteoarthritis.
Dec 2020 DOI 10.14302/issn.2329-9487.jhc-20-3611
Objective To understand the present status of high blood pressure in Jiangxi adults including the prevalence rate, overall awareness, and hypertension treatment. Methods a total of 7,200 adult participants (over 18 years old) lived in Jiangxi were recruited using a stratified sampling method. Blood pressure was measured for all the participants and a questionnaire survey was conducted. A 24-hour urine sample was also collected to understand urine sodium and potassium levels. Results Our findings revealed that the measured systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 125.9 mmHg (95% CI, 124.85-126.95) and 79.2 mm Hg (95% CI, 78.15-80.25). The prevalence of hypertension among the enrolled adults was 27.43% (95% CI, 26.38%–28.48%). Among the affected participants, less than 30% of them (95% CI) were aware of their hypertension condition, and only 28.56% (95% CI) were under anti-hypertension medications. The mean salt intake converted from urinary sodium was 10.92±4.07 g and the mean±SD of 24-h urinary sodium and potassium excretion were 185.51±65.44 mmol and 25.98±9.16 mmol, respectively. The high-salt condiments was determined to be the main source of sodium in the region. Conclusion Findings from this study form the baseline information to understand the hypertension condition in the region and indicate a possible solution for hypertension prevention through avoiding high-salt condiments.
Oct 2020
Background Osteoarthritis, a serious and increasingly prevalent disabling global health condition found largely among older adults, has been linked to the presence of excess body weight. But what contributes to this growing health epidemic of excess weight, which is increasingly observed in children? Moreover, can a case be made for predicting a possible negative linkage between the pervasive use of social media from the earliest point in time and possible subsequent childhood overweight or obesity and late life osteoarthritis that may be amenable to intervention? Methods To examine the most probable answers to these questions, the EBSCO, Scopus and PUBMED data bases were sourced for relevant data. The extracted data were carefully reviewed, categorized and documented in narrative format. Results While one cannot readily carry out research to answer the above questions, prevailing data imply that there is more risk of being overweight in childhood, as well as acquiring possible later life disabling osteoarthritis, or a more serious manifestation of this disease, through the prolonged, unfettered and frequent use of social media in early and middle childhood. Conclusion Those in the realm of developing preventive strategies against childhood overweight or obesity as well as osteoarthritis are strongly encouraged to examine the role of the media environment and messages children are exposed early on in this regard. Alternately, children who already have disabilities, joint pain due to arthritis or other health conditions, and who may have to rely more on social media than others who are active- may suffer more readily from an energy imbalance and become overweight if due precautions against this are not taken.
Aug 2020 DOI 10.14302/issn.2474-7785.jarh-20-3496
Osteoarthritis, a widespread joint disease, commonly results in considerable pain and functional disability, especially among older adults. At the same time, falls and fall injuries, also common among the older population, may not only contribute to the onset of osteoarthritis, but once established, to falls that lead to fractures and disability in their own right. But what does the research show specifically? Objective This report aimed to examine what is known about the interrelationship between falls and osteoarthritis and the implications that can be drawn from this information. Methods Using the PUBMED data base, studies describing an association between osteoarthritis and falls were sought. Those fulfilling the eligibility criteria were reviewed and summarized in narrative form. Results Consistent support for an osteoarthritis-falls associated linkage is limited and not as robust as one would predict. Whether the observed associations between these health determinants are a cause of osteoarthritis, a consequence or both, or simply spurious findings is hard to decipher. Conclusion More numerous and carefully designed research to examine this issue is warranted and may be extremely helpful in preventing, as well as ameliorating a high degree of excess disability and associated fiscal costs due to both falls as well as osteoarthritis among the elderly.
Aug 2020 DOI 10.14302/issn.2474-7785.jarh-20-3495
Hip fractures, which remain highly prevalent among the elderly and produce enormous social and economic costs, have not truly abated in prevalence despite years of research that outlines a multitude of preventable risk factors and intervention programs. This review aimed to examine if sleep disturbances have a bearing on the risk of incurring a hip fracture directly or indirectly, among older adults. The specific aim was to explore and summarize what we know, and how this might inform future research and practice. To this end, PUBMED, Web of Science, Scopus, and Google Scholar data bases were searched to uncover available data representing the topic of sleep in relation to hip fractures among the elderly. Articles of note were scrutinized and summarized in narrative form. Results showed very few studies on the topic prevail, even with no restriction on years examined, and of these, discordant, rather than any solid uniform conclusions prevail. It is concluded there is a need to explore this topic carefully, including both the direct, as well as the indirect impact of sleep that may place an older adult at heightened risk for a fall and hip fracture injury as well as subsequent fractures.
Mar 2020 DOI 10.14302/issn.2691-6622.ijar-20-3257
In order to contribute to the improvement of aquaculture production, reproductive parameters of three populations of Oreochromis niloticus of Cameroon were studied between March and May 2019 at the research station of Foumban. At this effect, a total of 81 parents (27 males and 51 females with respective weight 124 ± 6g and 144 ± 5g) coming from three hydrogeographicals origins (Niger, Sanaga and IRAD Station) were randomly distributed in triplicate in nine concrete tanks of a m² each with a sex ratio of one male for two females (1♂/2♀). Throughout the test, six females carrying eggs in the oral cavity were collected in each population and 45 days after the start of the trial, all the offspring were collected and the adults sacrificed. At the end of experiment, the IRAD population presented highest significant values (p ≤ 0.05) regardless of the performances considered. The values of the gonado-somatic and the gonado-metric characteristics significantly lower (p ≤ 0.05) were obtained in Niger population (GSR = 0.04 ± 0.02, GSI = 0.05 ± 0.03 and GMR=0.19 ± 0.08;GMI= 0.24±0.07). Considering sex, males presented the lowest significant values (p ≤ 0.05) for all the characteristics studied (GSR = 0.04±0.01, GSI = 0.04±0.01 and GMR= 0.23±0.08;GMI= 0.29±0.09).
Mar 2020 DOI 10.14302/issn.2641-4538.jphi-20-3242
Mental health and mental illness is a critical to a person’s overall health. In the United States alone, mental illness effects one in six adults. Furthermore, 40% of those individuals who die of suicide have been diagnosed with a mental health condition or illness. Yet, there is a paucity of research on innovative methods that help prevent suicide. The Contextual-Conceptual Therapy (CCT) approach introduces an innovative way to treat suicide by working to uncover the strengths of the suicidal person and addressing a person’s true self. The CCT approach was developed over the course of 25 years working with more than 16,000 suicidal patients in Seattle, Washington, and is tailored specifically for primary and secondary prevention of suicide. While there has been anecdotal evidence of the effectiveness of the CCT program, the program has yet to be formally evaluated. This qualitative research study aims to understand the impact the CCT approach has had on its clients. Eleven former CCT clients were recruited to participate in semi-structured interviews. Outcomes described by participants included an increase in curiosity and self-efficacy as a means through which to decrease suicide ideation and behavior, and proved to be incredibly powerful in changing long-term outcomes. This qualitative study is a first-step in providing critical insight on suicide prevention for wider dissemination. At a time when adverse mental health and illness is impacting the lives of millions of people, the CCT approach has the potential to address suicide, mental illness and mental health across diverse populations.
Feb 2020 DOI 10.14302/issn.2379-7835.ijn-20-3162
Aim Overconsumption of salt contributes to hypertension and increases the risks of cardiovascular diseases. Most studies that investigated salt intake by applying the Health belief model (HBM) have focused on urban settings. This study aims to identify the prevalence of salt overconsumption (>6 g per day) in a rural village in Southwestern China and to determine the association between knowledge regarding salt consumption/HBM constructs and salt overconsumption behavior among village residents. Methods Inthis cross-sectional study, 79 adults aged 18 years and above were interviewed using household-based and face-to-face questionnaires. Salt intake was measured using an electronic balance in accordance with a previous protocol. Results Our finding showed that the average daily salt intake is 11.19±11.14 (mean±SD) g. Moreover, 64.6% of the participants overconsumed salt. None of the participants was aware of the national recommendation for salt intake. Univariate logistic regression showed that i) knowledge about hypertension causing cardiovascular diseases (odds ratio [ORu]=3.02), ii) perceived severity of hypertension as a serious disease (ORu=4.92), and iii) perceived benefit of reducing salt intake to prevent hypertension (ORu=3.52) were unexpectedly positively associated with salt overconsumption behavior. All the studied sociodemographic factors were not associated with salt overconsumption behavior. Conclusions A high prevalence of salt overconsumption was found among residents of rural villages in Southwestern China. HBM was unable to explain the causal relationship between its constructs and salt overconsumption behavior. The extremely low awareness of the national salt recommendation highlighted the urgent need to provide relevant health education in rural China.
Jun 2019 DOI 10.14302/issn.2639-3166.jar-19-2858
The objective of this study was to evaluate the effectiveness of endophagous Encyrtid parasitic wasp Aenasiusarizonensis (Girault) (Hymenoptera, Chalcidoidea), as a natural enemy for controlling the Mealybug, Phenacoccussolenopsis Tinsley (Hemiptera: Pseudococcidae). Where a Randomized Complete Block Design (RCBD) was adopted. Both, field survey and Laboratory experiments were conducted to study some biological characteristics of the parasitoid A. arizonensis. The results of field study revealed that, the parasitioid was available most of the year, and was highly effective on adults and last larval instar of the mealy bug, P. Solenopsis, with a total percentage of parasitism of 31.26%. While the laboratory results showed that, the duration from oviposition to adult emergence were similar for both male and female. Longevity of male was 23± 2.33 days and female 23.37±1.89 days. Mean daily fecundity in terms of number of Parasitized hosts /female / day ranged from 20 to 24. The sex ratio was 1:1.6 for the male and female in the progeny. Generally, a mass rearing of this parasitoid, with a conservation and augmentation releases could help in the application of an effective management strategy for the control of the cotton mealy bug in the field.
Feb 2019 DOI 10.14302/issn.2637-6075.jpae-19-2586
Melia azedarach extract were applied by feeding the adult female flies on diets mixed with the extracts at different doses. The concentrations of Melia azedarach utilized were 1.8, 2.4 and 3.6%. The gonotrophic cycles of length of 90, 753, 67.6 and 84, 72, 68 hours were obtained after feeding at age 24 hours with diet mixed with doses of 1.8, 2.4 and 3.6% fruit extract; respectively. 98 & 96 hours were the length of gonotrophic cycle in the control groups. The length of 86.7, 72.3, 57.3 and 89.3, 75, 61 hours were obtained after feeding adults at age 48 hours with diets mixed with different doses of fruit extract of the same plant 97.3 and 98.7 hours were the length of the control groups. Proportions of the egg hatching reached 69, 55.3, 49 and 72.9, 64.2, 52 in groups of eggs obtained from 24 hours adults feeding with diets mixed with doses of 1.8, 2.4 and 3.6% fruit extract; respectively. Also 68.7, 53.3,48 5 and 81 2, 70, 56.3 were the proportions of egg hatching obtained from groups at age 48 hours after feeding with diets mixed with the same doses. 85, 77.6, 62.2 and 92.6, 88.9, 84.9 were the proportions of the egg hatching obtained from groups feeding with diets mixed with doses of 1.8, 2.4 and 3.6% fruit extract of Melia azedarach; respectively. The pupae showed larval-pupal intermediates which failed to complete the pupal period and died after emerging from the third larval instar.
Jan 2019 DOI 10.14302/issn.2474-7785.jarh-18-2458
Introduction Cognitive and physical (especially aerobic) training have been reported to enhance cognition in the elderly. The goal of this study was to compare the effectiveness of two types of training, namely combined cognitive-and-physical training and cognitive training alone, for cognition and in particular for executive function and working memory. Material and Method Healthy older adults (aged 65–86 years) were included in cognitive-and-physical - CAP (n=16) - or cognitive - COG (n=16) - training groups or in a passive control group – CONT (n=16). The training took place in 60-minute sessions conducted twice a week for 8 weeks. Cognitive functions were assessed before and immediately after the interventions and at a 1-month follow-up. Results In the short-term, the CAP and COG groups showed a transfer on updating, unlike the CONT group. In the long-term, although the gains achieved by both CAP and COG persisted, the benefit observed in the COG group was greater than that in the CAP group. Conclusion Our data suggest that there may be a complementarity between cognitive and physical training effects at the level of short-term transfer, given that physical training was able to boost cognitive training. Moreover, regarding transfer, physical training may help improve performance on untrained tasks. However, as far as the long-term persistence of the benefits of training is concerned, the results tend to indicate the superiority of cognitive training.
Jan 2019 DOI 10.14302/issn.2691-5014.jphn-18-2456
Vitamin D, the sunshine vitamin, is now recognized not only for its importance in promoting bone health in children and adults, but also for its other health benefits, including reducing the risk of chronic diseases such as autoimmune diseases, common cancer, and cardiovascular diseases. Ultraviolet radiation of the sun with wavelengths of 290-310 nm penetrates into the skin and converts 7-dehydrocholesterol to previtamin D3, which quickly transforms to vitamin D3. Vitamin D (D represents either D2 or D3) made in the skin or ingested through diet is biologically inert and requires two successive hydroxylations first in the liver on carbon 25 to form 25-hydroxyvitamin D 25(OH)D and then in the kidney for a hydroxylation on carbon 1 to form the biologically active form of vitamin D, 1,25-dihydroxyvitamin D (1,25(OH)2D) 121419. The concentration of the produced 25-hydroxy vitamin D in blood circulation is 1,000 times more than 1,25-dihydroxy vitamin D 4, and it is regarded as a standard indicator of vitamin D status in humans 3. 25-hydroxy vitamin D half-life is about 2-3 weeks and it is regulated by calcium (Ca), phosphorus (P), and serum parathyroid hormone (PTH) to some extent. 25-hydroxy vitamin D content also reflects the amount of vitamin D produced in the skin after exposure to sunlight or received through food intake 56. Guidelines for vitamin D insufficiency/deficiency defined by serum 25(OH)D concentrations have been published from many countries and regions all over the world 7891011. Vitamin D deficiency is a pandemic problem. According to global estimations, more than one billion people around the world suffer from vitamin D deficiency. Among Iranian population, the incidence of vitamin D deficiency varies from 2.5 to 98.5% based on geographic area 1213. Various factors may give rise to vitamin D deficiency, including skin pigments, low levels of vitamin D in diet (insufficient fish oil and egg yolk intake), malnutrition, genetic factors, exclusive breast feeding, vitamin D deficiency of mother during pregnancy, prematurity, chronic use of drugs (e.g., anticonvulsants, aluminum-containing anti-acids, rifampcin, isoniazid, antifungal drugs, antiviral drugs, and glucocorticoids), winter and obesity 113. Cultural habits, the need for full body coverage during outdoor activities and the lack of sunlight programs are the risk factors for low vitamin D levels in women 151617. Children enter foster care due to early childhood adverse experiences such as poor prenatal and infant health care, food insecurity, chronic stress, and the effects of abuse and neglect. As a result, they are at higher risk for poor physical, psychological, neuroendocrine and neurocognitive outcomes compared to others. Foster children are at risk for growth and nutritional deficiencies due to their poor nutritional environment prior to placement in foster care. Insufficient caloric intake results in growth deficiencies. Evidence showed that the risk of stunting and underweight is high in this population 18. The risk of developing hypovitaminosis D was significantly higher in children living in foster homes. One reason is that they are at higher risk of child abuse, emotional deprivation and physical neglect than children living with their families. Moreover, these children most likely do not spend much time outdoors and they lack adequate sun exposure. Another reason is that as children grow up in institutional care, they shift from a diet of vitamin D–fortified formula milk to cooked food, which may not be fortified with vitamin D 1. Iranian government has made some efforts to apply efficient interventions to reduce the prevalence of vitamin D deficiency, and the country’s healthcare system should be managed through accurate planning. Yet, in this country, studies on vitamin D deficiency in children living in foster homes are very limited, and given that timely diagnosis and treatment of this deficiency is vital, this research is conducted in Ali Asghar foster home in Mashhad, Iran.
Sep 2018 DOI 10.14302/issn.2474-7785.jarh-18-2295
Background: Osteoarthritis is a disabling joint disease with no known cure that negatively effects life quality among high numbers of aging adults. Aim: To examine the concept of health literacy as a potentially overlooked, but highly salient, disease correlate among this older chronically disabled group. Method: A literature search using the key terms osteoarthritis and health literacy was conducted using the major data bases. Results: Although almost no work has focused on health literacy and osteoarthritis, the concept of health literacy is clearly linked to health status and health outcomes. Varying from marginal to high, health literacy is not always assessed or recognized as being clinically relevant, however, despite a large volume of related literature. Conclusion: Acknowledging the possible role of limited health literacy in the context of osteoarthritis disease progression, and applying carefully tailored directives for overcoming any related health literacy limitations may offer a novel approach for improving the outcomes for older people with this condition.
Sep 2018
Groups of wild juvenile and adult mallard ducks were captured, ringed, measured, while, juvenile ones already ringed, were remeasured on a subsequent recapture between March and September over a period of 7 years, at a site in Piedmont (Italy). Measurements cover both the rates and the pattern of development of 4 morphological features (head-and-bill-length, bill-length, tarsus-length, and weight). Juveniles were examined and their measurements were compared with the asymptotic value obtained from adults’ measures. A functional data analysis growth model was fitted to data and it yielded plausible quantitative estimates. Tarsus appears to reach the asymptote faster than the other morphological features in this population. Finally, a functional principal components analysis was performed to discriminate sex in growing Mallard ducks.
Sep 2018 DOI 10.14302/issn.2328-0182.japst-18-2281
The role that Vitamin D plays in human health is no more hidden in this modern age where every individual carries the knowledge treasure in the pocket (The internet) but the unjustified deficiency or insufficiency is still a research question waiting for the answer from research community all over the world. Normal levels (30-50 ng/ml) are necessary for the development of teeth and bones in children and bone mineralization in adults. The deficiency or insufficiency causes rickets, arthralgia, arthritis, osteoporosis and Osteomalacia. Study Design: Observational study. Study Setting: Department of Orthopedic LUMHS Jamshoro. Study Duration: from April 2017 to Oct 2017. Sampling: 600 patients were selected through Consecutive sampling. Statistical Analysis: Descriptive statistics like mean, Standard deviation, minimum, and maximum were calculated Using SPSS version 22.Mean of two genders was compared using t-test setting <0.05 as level of significance. Results: Mean serum vitamin –D level was 16.11+10.07ng/ml in men while it was 16.63+11.73 ng/ml in women. 62% of the study population was found deficient (<20ng/ml) while 16.33% were having insufficient levels (<30ng/ml) and only 12% showed normal levels (30-50ng/ml). There was no significant difference between the two genders, p value 0.59 Conclusion: Vitamin –D deficiency is very common in both genders with no significant difference between males and females.
Jul 2018 DOI 10.14302/issn.2577-2279.ijha-18-2179
Cranial vault is the case surrounding the brain. Its structure differs in newborns than in adults in some aspects. Such differences should be clear for both health and family members. Moreover, the anatomy and embryology of fetal skull take a little attention in the previous literature and textbooks. Therefore, this short review aimed to clarify some aspects of anatomy and clinical importance of cranial vault features in newborns. The newborn vault is formed of multiple separate flat bones connected by fibrous tissues with wide soft gaps called fontanelles. Development of bones of skull vault is closely correlated with the expanding growth of the underlying brain. Such brain shouldn't be struggled by continuous tightening of the newborns' vault. Also, the newborn skull could be affected even by a fixed sleeping position.
Jun 2018 DOI 10.14302/issn.2574-4518.jsdr-18-2071
Study Objectives: Narcolepsy diagnosis has been associated with a long lag time between the onset of the disorder and the diagnosis itself among patients with the disorder. This article reviews the childhood epidemiology of idiopathic narcolepsy, including its prevalence, subtypes, and disease progression. Methods: A literature review was conducted to include both published and unpublished data on pediatric narcolepsy. All English language articles were included through April, 2015. Results: Time from symptom onset to diagnosis for children is approximately three years. The prevalence of cataplexy appears to be lower in children compared to adults, suggesting a later onset of cataplexy. The presence of cataplexy, however, was unrelated to demographic factors and laboratory findings. Conclusion: There is a substantial lag-time between initial symptom presentation and diagnosis in children with narcolepsy. A less quintessential presentation of narcolepsy might occur in children relative to adults, making diagnosis more challenging. Continued improvements in narcolepsy education for both pediatricians and parents might facilitate earlier identification and diagnosis of the disease, thus leading to improved outcome.
May 2018 DOI 10.14302/issn.2643-6655.jcap-18-2086
In 1979, a study conducted by Ehrhardt et al. retrospectively examined childhood behavioral patterns of 30 adults; 15 identified as lesbian women and 15 identified as transmen. All 30 adults had been assigned female at birth, and, as children, all were regarded as “tomboys.” The study found several key factors that distinguished the two cohorts. The goal of this study was to replicate and extend the 1979 study, utilizing a larger sample size and including a reference group of heterosexual women. Given the major social, technological, medical, and legal paradigm shifts that have occurred over the past four decades, we sought to determine if the previous findings still differentiate the cohorts. In light of the exponential rise in the number of gender diverse and dysphoric youth who request treatment, providing optimal, affirmative care and education is paramount, especially since many of these young people seek social and/or medical transition. Exploration of the early behavioral indices of the diverse trajectories may help to inform best practices for optimal care for these young people and their families.
May 2018 DOI 10.14302/issn.2381-862X.jwrh-18-2090
Background: The Ghanaian culture expects women of reproductive age to reproduce. This makes pregnancy an acceptable occurrence in most tertiary institutions in Ghana. Although Ghanaian Universities allow pregnancy in school, challenges associated with pregnancies do not exempt pregnant students from following the academic requirements of the universities. This study therefore explores students’ experiences of copying with pregnancy in an academic environment in Ghana. Methods: This was a case study, quantitative and qualitative design using structured questionnaires and semi-structured interview guides respectively for data collection. Respondents comprised twenty (30) pregnant full time and part time female students from campuses of University of Education, Winneba. Data collection was between October 2016 and May 2017. Quantitative data were analysed using statistical package for social sciences (SPSS) version 23. The qualitative data was transcribed and manually analysed thematically. Results: The study found that majority of participants were adults between ages 26 and 30 years. More than half of them (66.7%) had no child and this was their first pregnancy which they felt was mistimed as it occurred during schooling, posing some physiological, financial and academic challenges which compelled students to devise various coping strategies to combine academic work and pregnancy amidst limited University provisions for pregnant students. Conclusions: The study results have policy and programme implications for meeting women’s needs for pursuing academic and reproductive goals concurrently. The study recommends that public universities in Ghana should institutionalise programmes on preconception counselling and coping with pregnancy in academic environment to enable female students make informed decisions on exercising their reproductive rights in whilst in the university to ensure positive maternal health outcomes.
Nov 2017 DOI 10.14302/issn.2574-4518.jsdr-17-1754
Objective: Individuals diagnosed with Down syndrome (DS) are predisposed to obstructive sleep apnea (OSA). The aim of this study is to assess the prevalence of OSA and factors associated with OSA in this population. Study Design: Systematic literature review and meta-analysis. Methods: Studies of DS and OSA in the English language through May 2017 were reviewed. Since parental report of symptoms has limited validity related to the diagnosis of OSA, only studies using in laboratory polysomnography to diagnose OSA were included. Results: Twenty three studies examining OSA among 1,469 people with DS were found. Among ten studies using community referred samples, 71.5% of people with DS had OSA, compared to 69.6% in referred community samples suspected of having respiratory events. There was an inverse relationship between apnea hypopnea index (AHI) cutoffs and OSA prevalence as higher cutoffs were associated with somewhat lower prevalence. Examining age groups, adults had a higher prevalence of OSA (90.0%) compared to infants (66.5%) and children between 2-21 years of age (69.9%). Oxygen desaturation and gender did not affect prevalence. Although surgery had less effect on successfully treating OSA among DS individuals compared to those without DS in prior studies, lingual tonsillectomy had the greatest effect (mean AHI decrease of 9.0). Conclusion: OSA appears to occur frequently in children and adults with DS. Untreated, OSA may contribute to health problems and premature death, highlighting the potential importance of identifying OSA among people with DS. Even after traditional surgeries (i.e., adenotonsillectomy, tonsillectomy, adenoidectomy), repeating PSG is highly recommended as residual OSA can persist
Aug 2017 DOI 10.14302/issn.2324-7339.jcrhap-17-1686
Background: In the absence of a cure for HIV and AIDS, prevention remains the most effective strategy to eliminate the pandemic. Abstinence from sexual intercourse is, therefore, the primary prevention weapon among unmarried adolescents and young adults, especially the school-going ones. This study uses the main constructs of the Health Belief Model (HBM), as the theoretical framework to investigate the psychosocial predictors of sexual abstinence among senior secondary school students in an urban setting in the Southwest region of Cameroon Methods: This study adopted a cross-sectional design, collecting data from a stratified random sample of 420 students in November 2016, using a pretested structured questionnaire, and analyzing them using SPSS version 20 software programme, using binomial logistic regressions at the level 0.05. Results: Only 194 (46.2%) were abstaining from sex. Perceived susceptibility to HIV, perceived severity of HIV/AIDS, perceived benefits of sexual abstinence and perceived self-efficacy for sexual abstinence were not that high, 79.8%, 71.0%, 86.4% and 68.3% respectively. None of the above constructs of the HBM was a significant predictor of sexual abstinence. However, increasing age was significantly associated with an increased likelihood of sexual abstinence, OR=1.6 (95% CI 1.20-2.24, p=0.002). Conclusions: Senior secondary school students in urban Cameroon were not practicing sexual abstinence. Interventions and strategies to increase sexual abstinence are highly recommended and should focus on increasing the perception of risk of contracting HIV, which is assumed to be the immediate antecedent of sexual abstinence, on overcoming barriers to sexual abstinence and on sexual abstinence negotiating skills, and should target adolescent students (10-19 years old).
Jun 2017 DOI 10.14302/issn.2474-7785.jarh-17-1575
Background and Objective: Behavioral procedures have proven to be effective with elderly adults in nursing home. The purpose of this study was to evaluate the effectiveness of a shaping procedure as a means of increasing writing performance. More specifically, our aim was to reeducate a motor behavior in a patient for whom the behavior was no longer present. Materials and Methods: The participant was an elderly (76-year-old) who had sequelae from a cardiovascular accident since 2011, and was asked to write some selected words. Data were collected though face-to-face interviews then analyzed using cotation methods. Results: The shaping and chaining procedures were efficient and performance of writing increased, even for infrequent words. Conclusion: Increasing writing performance is possible for the elderly people, even if they have suffered from cardiovascular accidents in the past. Here we used a successful brief shaping procedure to enhance quickly that ability.
May 2017 DOI 10.14302/issn.2374-9431.jbd-17-1465
Objectives: The present study investigated biopsychosocial predictors (HbA1c, self-efficacy, and social support) of self-management and health-related quality of life among patients with type 2 diabetes. Methods: 160 adults referred to the Iranian Diabetes Society participated in this study. Participants completed General Self-Efficacy Scale, Perceived Social Support, Diabetic Self-care Behaviors scale, and D-39 (diabetics’ quality of life). Results: Data were analyzed with SPSS-19 and Lisrel 8.8, utilizing statistical path analysis. Results revealed significant positive correlations between self-efficacy and social support subscales, self-care and health-related quality of life. Also, HbA1c had not correlation with HRQOL. The final path model fitted well and showed that direct self-care paths with (β = 0.24) and indirect social support with (β = 0.32) had the most effects on health-related quality of life. Conclusions: The results confirmed the theoretical model and scientific evidence for providing psychological solution to promote quality of life in patients with type 2 Diabetes.
May 2017 DOI 10.14302/issn.2474-7785.jarh-16-1350
The prevalence of type-2 diabetes (T2DM) among Mexican-American older adults along the U.S.-Mexico border region is at epidemic proportions. Healthcare reform is trending toward long-term home-based management of chronic conditions. Under the Mexican cultural norm of familism, daily care for elders is also often provided by family caregivers whose competence levels may vary. Adherence to the prescribed medication regimen is critical to attainment of optimal glucose control. However, there is a startling lack of literature that addresses the link between family medication administration and care recipients’ health outcome. This paper explores the role of culture in medication administration by family caregivers of elders with T2DM from the perspective of caregiver capabilities and caregiving demands. A critical review of the literature offers suggestions to guide future studies.
Mar 2017
The objective of this study was to examine differences between Latino and White older adults in attitudes toward suicide and physician-assisted suicide in chronic pain scenarios. We used a cross sectional study design at four outpatient care sites in San Antonio, Texas. The study sample included 204 subjects (106 Whites and 98 Latinos), 60 years of age and older, with Mini Mental State Examination scores of 24 or higher. No statistically significant between ethnic group differences in attitudes toward suicide or physician-assisted suicide in chronic pain scenarios were found. However, separate analyses by ethnic group showed that the factors associated with these attitudes differed between ethnic groups, with attitudes among Whites significantly and negatively associated with religiosity and those among Latinos significantly and positively associated with depression, while acculturation was significantly and negatively associated with attitudes toward physician-assisted suicide in chronic pain scenarios. This study’s findings suggest that depression and acculturation among Latino elders and religion among White elders are determinant factors of these attitudes in chronic pain, end-of-life scenarios. Further research is needed with more heterogeneous study samples, including Latino subgroups (e.g. Mexican Americans, Puerto Ricans, Cubans) and more diverse ethnic groups in terms of socioeconomic status and educational level characteristics.
Jan 2017 DOI 10.14302/issn.2476-1710.jdt-16-1306
Background. Suicide prevention programs centred on reinforcing protective factors are uncommon. Aims. Since leading a meaningful life is incompatible with suicide, a 14-week program designed to help participants realize meaningful personal goals was created to improve the psychological well-being (PWB) of depressed older adults (≥ 65 years). Method. Persons scoring 9 or above on the Beck Depression Inventory- II (M = 22.05) took part in the program (n = 24). Their levels of PWB, depression, and suicidal thoughts were compared to those of a control group (n = 18). The questionnaires were completed three times: pre-test, post-test, and follow-up (six months later). Results. Analyses showed that the program participants improved significantly on most indicators of wellbeing, including suicidal ideation, indicating that increasing protective factors could be an innovative way to prevent suicidal ideation. However, the changes were not significantly higher than those observed in the control group, except for meaning in life. Conclusions. The absence of difference between groups was partly justified by unexplained improvements of controls between post-test and follow-up. Future studies should develop suicide prevention program thatincrease protective factors that provide individuals with means to achieve an optimal state of functioning.
Dec 2016 DOI 10.14302/issn.2329-9487.jhc-16-1338
Although inaccurate, non-reproducible blood pressure values can result from non-standardized assessments, recommended approaches to standardize blood pressure measurement are often not followed in research studies. An expert consensus of national and international health and scientific organizations developed recommended minimum standards for assessing blood pressure in research subjects where: 1) blood pressure or hypertension is a major endpoint, or 2) blood pressure is likely a major mediator of the research outcome. Minimum research standards are presented for training of observers, technical aspects of assessing blood pressure, and equipment for both adults and children. The standards are based on prior recommendations some of which did not conform to current evidence based methods. All new research should require adherence to these minimum standards on the patient populations described above. Readers need to use caution in interpreting studies if the standards are not met in the defined populations.
Sep 2016 DOI 10.14302/issn.2574-450X.jom-16-1062
Background: Obese adults with Type 2 Diabetes (T2D) have shown differences in body composition and response to varying diets when compared to obese adults without T2D. This difference in body composition affects management options for obesity. Such studies have not been done on adolescents thus far. Objectives: To estimate differences in fat mass at baseline as well as following a two-week high protein liquid diet in obese adolescents with and without T2D. Methods: Thiswas a pilot study using a non-randomized, unblinded pre/post intervention design without a control group. We planned to recruit 40 subjects (20 per group, with and without T2D) from ages 10 – 19 years, with Body mass index (BMI) ≥ 95 percentile. Body fat mass was measured via the Bod Pod® at baseline and after two weeks of following the diet with Ensure High Protein shakes. Change in fat mass is presented as mean differences and 95% confidence intervals. Results: We recruited 28 subjects, 19 completed the study and 12 were compliant with the diet. The mean difference in fat mass percent from baseline in subjects who completed the study (n=19) and without T2D was 1.4 (95% confidence interval (CI): -2.1 to -0.8) and in subjects with T2D was 1.2 (95% CI: -3.6 to 1.24). Conclusion: We did not find any meaningful difference in fat mass at baseline or after following a two-week high protein diet between the groups. High dropout rate and noncompliance with the diet were major limitations.
Mar 2016 DOI 10.14302/issn.2379-8572.joa-15-891
Background: Despite its expense, labor and intrusiveness, polysomnography (PSG) is the gold standard for diagnosing obstructive sleep apnea (OSA). Recently, commercially available electronic activity monitors, such as Fitbit, have become widely accepted and can provide an estimate of sleep patterns for screening children with possible OSA. A previous study demonstrated Fitbit to be valid compared to PSG in adults. To date, these devices have not been extensively utilized for research in children with sleep disordered breathing (SDB). Objective: To evaluate the validity of the Fitbit activity monitor compared to PSG in children and adolescents with SDB. Methods: Data was collected from 14 children, ages 3 through 11, who were scheduled for a PSG during the study period. Fitbit was worn concurrently during the night of the PSG. Analyses were performed by comparing total sleep time, number of awakenings, sleep efficiency and wake after sleep onset (WASO) Fitbit parameters with the corresponding parameters measured by PSG using Spearman’s rho. Fitbit movement epochs were also compared to PSG epochs showing movement behavior. Results: Pilot data suggest that Fitbit demonstrates a high sensitivity for sleep, a low specificity for wake and a trend suggesting good association of movement measurements. Conclusion: Although Fitbit is not as accurate as PSG for determining wakefulness, it may be a useful screening device to assess gross sleep quality in children. Further studies are indicated to validate these findings.
Dec 2015 DOI 10.14302/issn.2372-6601.jhor-15-776
Background: Patients with Thal (Thalassemia) are presumed to be inactive for many of the same reasons as healthy adults, though there are limited published data to support this claim. The primary aim of this study was to compare physical activity patterns in subjects with Thal to healthy controls as well as to explore the effects of transfusion therapy on physical activity in transfusion dependent patients with Thal. Methods: 37 Thal (23 Thal major, 14 Thal intermedia, 21 Female, 27.3±10.1 years) and 30 healthy controls (17 Female, 28.0 ± 13.7 years) wore an ActiGraph accelerometer for one to two weeks. Results: Thal subjects recorded a significantly fewer total number of steps per day and lower total energy expenditure compared to healthy controls (p=0.001). None of the adult Thal subjects met the recommended 10,000 steps/day as opposed to 27% of healthy adult controls (p=0.004). Thal spent significantly less time in moderate (p=0.03) to vigorous (p=0.005) activities and more time in sedentary activity (p=0.006). Conclusion: It is now clear that Thal spend significantly less time in physically demanding activities than age-matched healthy controls, a result that has long been assumed though not previously documented. Further research is needed to define an appropriate physical activity regimen best suited for patients with Thal while examining its effect on mental and physical health.
Jun 2015 DOI 10.14302/issn.2379-7835.ijn-14-591
Objectives Taste sensitivity is an important determinant of food choice and differs between children and adults. This difference is probably due to several factors that constitute an individual’s phenotype. The aim of this study was to explore taste perception in relation to the TAS2R38 and CAVI (gustin) genotypes in age classes from infancy to adulthood in a Mediterranean population. Methods In this cross-sectional study we evaluated the TAS2R38 and gustin genotypes and administered a standardized PROP taste test in 705 individuals (435 adults, 270 children); the sample included 224 mother-child dyads. We also explored the acceptance and consumption of bitter and non-bitter vegetables. Results Sensitivity to bitterness was strongly related to the TAS2R38 haplotype, and we observed an intriguing relationship with age. In fact, children were more sensitive than adults with the same TAS2R38 haplotype also within mother-child dyads. The mother-child tasting differences decreased with age and became minimal when children reached adolescence. Variations in the gustin gene did not contribute significantly to the overall taste phenotype, but helped to differentiate among non-tasters. Conclusions The genetic profile of the bitter-taste receptor TAS2R38 explains most of the variance in bitter taste perception, but the related phenotype is also strongly influenced by age, also in mother-child dyads that share the same genotype. This finding is likely to have a significant impact on the complex feeding relationship between mother and child.
Feb 2015 DOI 10.14302/issn.2379-7835.ijn-14-461
Objective: To investigate the association of meat consumption with self-reported chronic diseases (heart disease, hypertension, diabetes (type I or type II) and dyslipidemia), according to demographic, social and anthropometric variables. Methods: This was a cross sectional study, conducted at the Heart Institute, University of São Paulo, with 549 adults (≥ 18 years) who answered a questionnaire to select people for The CARVOS Study (Carotid Atherosclerosis, Aortic Stiffness and Risk Factors in Vegetarians and Omnivorous Subjects). The variables analyzed were: age, gender, education level, meat consumption, self-reported coronary heart disease, hypertension, diabetes (type I or type II) and dyslipidemia, smoking and body mass index (BMI) (kg/m2). Study subjects were classified as omnivorous (OMN=consumption of meat or fish four or more times/week) (n=228, 41.5 %), semi-vegetarians (SV=consumption of meat or fish 1-3 times/week) (n=97, 17.7%) and vegetarians (VEG=no consumption of meat or fish) (n=224, 40.8%). The differences between mean values was calculated by T-ANOVA test. To test the association between the variables, chi-square test and multiple logistic regression were used (p<0.05; CI = 95%). Results: There was a greater prevalence of smokers among OM than SV and VEG respectively 56.5%, 14% and 29.4 %, p=0.009, and a higher prevalence of overweight (41.7%) in OMN in comparison with SV (29.2%) and VEG (29.0%), p=0.008. Being OM significantly increased the risk of referring hypertension, regardless of sex and age (OR 2.19; CI 95% 1.08-4.46), and was also associated with dyslipidemia, regardless of body mass index, smoking, sex and age (OR 1.78; CI 95% 1.03-3.08). Conclusion: Higher meat consumption was associated with a greater prevalence of risk factors for hypertension and dyslipidemiachronic diseases.
Mar 2014 DOI 10.14302/issn.2372-6601.jhor-13-352
Variation in the lower and upper limits of haemoglobin (Hb) ranges will alter diagnosis and referral rates of anaemia or erythrocytosis. The haemoglobin ranges for adults in Irish laboratories were applied in the context of haemoglobin levels of a representative sample of Irish adults (SLAN). Between 2.8% and 8.5% of men would be diagnosed with anaemia in different laboratories for lower limit between 130-140g/L. For women, diagnosis of anaemia would range from 0.7% to 7.3% for the lower limit between 110-125g/L. Similar reference range variations occur in UK laboratories. A suggested “normal reference range” is extrapolated from the SLAN cohort.
Feb 2014 DOI 10.14302/issn.2374-9431.jbd-13-312
Objective: This study assessed the baseline knowledge, perceptions, attitudes and behaviors of prediabetes patients in order to tailor a new technology-enhanced primary care-based lifestyle modification intervention. Methods: Patients with a diagnosis of prediabetes were enrolled in a randomized, controlled pilot study, Avoiding Diabetes Thru Action Plan Targeting (ADAPT), a technology-based intervention to promote action plan discussions around patient-selected behavior change goals. Results: A total of 54 adults (82% female) were enrolled in the pilot study. Most (89%) had comorbid conditions and mean BMI was 36. Participants exhibited significant levels of diabetes risk knowledge and diabetes risk perception, as well as high levels of willingness to make changes to decrease diabetes risk. Number of daily steps was inversely correlated with perceived physical activity (r=-0.35082, p<0.001). Poorer scores on diet quality were inversely correlated with BMI. Conclusion: Participants in this sample demonstrated requisite levels of knowledge, self-efficacy, motivation and risk perception for effective behavior change. These data suggest that primary care-based prediabetes interventions can move beyond educational goals and focus on enhancing patients’ ability to select, plan and enact action plans.
May 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-137
Background: HAART has resulted in significant decline in morbidity and mortality from HIV. However, it is unclear if the trends have continued in the current HAART era. An understanding of healthcare utilization patterns is important for optimization of care and resource allocation. We examined the diagnoses for hospitalizations of patients with HIV and their clinical and demographic profile years after the introduction of HAART. Methods: A retrospective audit of the HIV admissions from July 2009 through June 2010. The case notes of all the adult admissions where one of the discharge diagnoses was HIV infection was reviewed. Data including the demographics, date of diagnosis, treatment and the follow up details, admission outcome and the final diagnosis were extracted from the case notes. Results: Over the 12 months period there were 154 admissions where one of the discharge diagnosis was HIV infection, and this accounted for 2.9% of all medical admissions in adults. 103(67%) admissions were in persons who were known to be HIV infected prior to the current admission. HIV infection was diagnosed for the first time during the current admission in 51(33%) cases. Nearly two-thirds of those hospitalized, had a CD 4 cell counts of < 200/µL and 63 (66%) had a viral load greater than 50,000 copies/ml. Over all, opportunistic infection was the commonest (47%) discharge diagnosis, followed by serious bacterial infections and HIV nephropathy. The median duration of hospitalization was 6 days (Range 2 to 71 days). There were 49 (32%) deaths. Conclusions: A significant proportion of patients admitted with HIV infection were still diagnosed on admission and were found to be severely immunosuppressed. An opportunistic infection continues to be the commonest discharge diagnosis in HIV infected patients.