Search results for “Trends

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23 articles

Temporal Trends in Syphilis Epidemiology in the UAE: A Five-Year Retrospective Analysis (2018-2022)

Apr 2024 DOI 10.14302/issn.2994-6743.ijstd-24-5005
Khatoon Hossein Mehdi Poor NargisCorresponding author

Objectives This study examined the frequency and dynamics of syphilis in the United Arab Emirates (UAE) between 2018 and 2022. Recognizing the significance of understanding syphilis trends, this study intends to conduct further research on sexually transmitted diseases in the context of the UAE. Methods This was a retrospective cross-sectional study. This study focused on patients who underwent syphilis screening between January 2018 and December 2022. Cases were classified as conclusive only if they passed the first screening and subsequent confirmatory tests. Results The findings demonstrate that Syphilis frequency varied throughout the UAE during the study period. Demographic trends and sex variations were discovered, providing insight into how syphilis patterns change. Additionally, this study identified a broad spectrum of clinical manifestations, confirming the complexity of the disease. It was also noted that males had a higher frequency of syphilis than females. Conclusion Understanding the complexity of the frequency of syphilis is critical for developing effective public health interventions. Variations in frequency, demographic trends, sex disparities, and clinical manifestations indicate the need for personalized preventive and control measures. This study provides important information that may be utilized to motivate focused initiatives to address the difficulties associated with syphilis in the UAE, thus enhancing overall public health.

Trends of Diabetes in Children and Adolescents in Pediatric Endocrinology Clinic and Clinical Pediatric Diabetes Center at Al Baha Central Hospital in Saudi Arabia

Dec 2016 DOI 10.14302/issn.2474-3585.jpmc-16-1281
H. Alghamdi AhmedCorresponding author Faculty of Medicine, Albaha University, Kingdom of Saudi Arabia.

Objectives This study describes and compares the epidemiological criteria of children with diabetes from 2007 to 2014. Methods A prospective study conducted with 372 children with diabetes mellitus. An access program was used for data collection, and SPSS 17 was used to analyses the results. Results A total of 372 cases with diabetes were studied and were divided into three groups according age. The first age group was between one day and six years and comprised 128 (34.4%) patients. The second group aged 7- 12 years of age comprised 174 (46.7%) patients. The third group aged 13-18 years of age comprised 58 (15.59%) patients. The average age was 8.32 years. Females constituted 52 % (194 cases) of all cases. T1DM constituted 95.4%, equal to 355 patients, T2DM constituted 1.88%, equal to seven cases. Monogenic diabetes affected three patients or 0.79%, with one case of monogenic neonatal diabetes confirmed by genetic study, and two other cases suspected to be MODY. The highest incidence was observed in the autumn months, with 105 children affected, constituting 27.8 % cases. The year 2012 had the highest incidence rate, with 59 children and adolescents affected at an incidence rate of 25.48 / 100000.Al-Baha region had the highest number of cases constituting 37.7 % of cases. Diabetic ketoacidosis was the first presentation and constituted 44.2% of cases. Conclusion. Diabetes in children is increasing significantly in recent years, requiring more detailed analysis of its epidemiological factors to find out any significant correlations which may help in its prevention.

Trends and inducing factors for illicit drug use in Grenada: Epoch 2001 – 2009.

Nov 2016 DOI 10.14302/issn.2474-9273.jbtm-16-1304
Fagorala AfolamiCorresponding author Trinity School of Medicine

Objective The psychosocial aspect of drug use is seldom researched in Caribbean nations. Drug use in the Caribbean has been on the rise since the 1990s. Statistical indicators have established evidence for the increased rates of illegal drug use. This study briefly reviewed these indicators and explored factors that influenced the state of drug affairs in Grenada from 2001 to 2009. Methods Interviews conducted in a semi-structured form were carried out on key stakeholders involved in drug prevention in Grenada. Literary review of pertinent articles from search engines was used to buttress results. Further search through statistical records provided by the Drug Control Secretariat and Grenada Drug Information Network/National Observatory on Drugs (GRENDIN/NOD) was used to obtain information on recent developments surrounding drug related activities in Grenada. Results Trends show marijuana as the drug of choice and males being primarily involved in illegal drug activities. Additionally, cultural, and psychological factors play major roles in the proliferation of the drug problem in Grenada. Conclusion Despite preventive measures used to raise awareness on the dangers of drug use, drug use/abuse/activities are still at an all-time high in Grenada. Focusing on the social, cultural, psychological factors influencing illicit drug activities, and increased cooperation between anti-drug organizations may be effective in curbing illegal drug use in Grenada.

Model Based Research Open Access

Mathematical Modelling of Typhoid Fever Transmission Dynamics and Intervention Impact in Harare, Zimbabwe (2018–2020)

Dec 2025 DOI 10.14302/issn.2643-2811.jmbr-25-5731
Mukeredzi InnocentCorresponding author

Background Typhoid fever remains a significant public health issue in Harare City, Zimbabwe, exacerbated by recurrent outbreaks between 2018 and 2020. Key challenges, including inadequate water supply and sanitation infrastructure, high population density, and limited healthcare access, have intensified the disease burden. Understanding the key transmission drivers and assessing the impact of various interventions are essential for informing policy and health strategies. Objectives This study aimed to: 1: To predict future trends in typhoid fever cases Harare City typhoid hot areas. 2: To develop a mathematical model to simulate the spread of typhoid fever incidence under different intervention scenarios and recommend evidence-based strategies for reducing the disease burden in Harare City. Methods A dynamic compartmental SIR-based model, adapted from the Pitzer Vaccine Effectiveness (VE) framework, was employed to simulate disease transmission. This model accounted for both short-cycle (human-to-human) and long-cycle (environmental) transmission pathways. Data from Harare City (2018–2020) were used for model calibration and forecasting, and sensitivity analysis was performed to assess the impact of different intervention levels. Findings The model identified inadequate sanitation, contaminated water sources, and low health- seeking behaviors as primary drivers of typhoid transmission. In the absence of interventions, the model projected a sustained high rate of transmission. However, treatment and WASH interventions could reduce the disease burden by 50–60%, while combined strategies incorporating vaccination and education led to an 80% reduction in cases. Sensitivity analysis indicated that treatment and WASH interventions were particularly impactful at moderate coverage levels. Conclusion Mathematical modeling effectively demonstrated the multifactorial drivers of typhoid fever transmission in Harare. Integrated interventions that combine WASH, vaccination, treatment, and education present the most promising approach for long-term control of the disease. The findings offer a solid, data-driven foundation for public health decision-making and resource allocation.

Integrating Analgesic Doses and Pain Trend Analysis: A Novel Clinical Support System

Dec 2025 DOI 10.14302/issn.2688-5328.ijp-25-5402
Yang Shih-ChiehCorresponding author

Background Prescribing appropriate analgesics with optimal dosages based on patients' pain severity is challenging, especially when multiple painkillers are involved. Tracking and analyzing the effectiveness of analgesics and their dosages over time is crucial for pain management. Existing systems lack the ability to integrate analgesic equivalent doses with temporal trends in pain scores, hindering effective decision-making. Methods We developed a Clinical Support System that calculates the daily oral morphine equivalent dose and analyzes trends in consumed equivalent doses of analgesics. The system provides a graphical user interface that displays medication prescriptions, actual medication usage, and pain scores. It offers features such as correlating analgesic drug usage with pain intensity, trend analysis of analgesic drug usage and pain intensity, and identification of effective oral morphine equivalent doses. Results The system overcomes previous barriers in drug analysis by providing real-time calculation of oral morphine equivalents and trend analysis of pain duration. It assists physicians in prescribing appropriate and safe medication dosages, enhancing medication safety for patients. Conclusions Our clinical support system offers a comprehensive solution for analyzing trends in consumed equivalent doses of analgesics. It integrates medication prescriptions, actual usage, and pain scores, providing decision-making support for pain management.

Electromagnetic Fields and Osteoarthritis 2025

Oct 2025 DOI 10.14302/issn.2474-7785.jarh-25-5784
Marks RayCorresponding author

This mini review examines the potential efficacy of applying electromagnetic field therapy for purposes of reducing osteoarthritis pain and other related disease features such as frailty, muscle sarcopenia, obesity, bone loss and fragility, and cartilage derangements and degradation in the older adult. Based on selected English language literature published largely on PUBMED between January 2000 and October 2025, papers describing the impact and potential synthetic and disease modifying impact of electromagnetic stimuli are explored. These data reveal a high degree of promise in fostering joint tissue reparative efficacy trends post electromagnetic stimulation. Its usage may allay the extent of the disease and its degree of disablement, while facilitating function.

Syphilis and Beyond: A Comprehensive Analysis of Associated Infections and Comorbidities in a Five-Year Retrospective Study in the United Arab Emirates (2018-2022)

Apr 2024 DOI 10.14302/issn.2994-6743.ijstd-24-5006
Khatoon Hossein Mehdi Poor NargisCorresponding author

Objectives This study explores the clinical characteristics, associated infections, and management outcomes of syphilis within a specific population over the years 2018 to 2022. With a focus on the frequency, clinical manifestations, and co-infections of syphilis, the research addresses a critical gap in understanding the nuanced dynamics of this sexually transmitted infection and its impact on public health. Methods The study employs a retrospective analysis of data collected from 2018 to 2022, utilizing three key serological tests (Syphilis AB, RPR/VDRL, and TPHA) to characterize syphilis infections within the population. Clinical manifestations and associated infections, including HIV, HBV, HCV, Chlamydia, Gonorrhea, and HPV, are systematically assessed. Treatment rates and re-infection patterns are also analyzed, providing a comprehensive overview of syphilis epidemiology within the studied timeframe. Results The frequency of syphilis, particularly indicated by the Syphilis AB test, exhibited a marked increase in 2020, reaching 96%, suggesting a heightened frequency within the population. RPR/VDRL test results demonstrated consistent frequency, emphasizing the persistent presence of active syphilis infections. Clinical manifestations, such as chancre, skin rashes, alopecia syphilitica, and lymphadenopathy, displayed dynamic patterns over the study years. Co-infection rates varied, with fluctuations observed in HIV, Chlamydia, Gonorrhea, and HPV, while HBV and HCV showed infrequent but stable frequency. The management of syphilis cases demonstrated commendable treatment rates, but an increase in re-infection rates in 2021 highlights the need for continued vigilance. Conclusion This study provides a comprehensive evaluation of syphilis epidemiology, clinical characteristics, and associated infections within the studied population. The results offer valuable insights into the dynamic nature of syphilis and its co-infections, informing public health initiatives and interventions. The findings contribute to our understanding of the epidemiological landscape and underscore the importance of sustained efforts in both prevention and treatment to curb the transmission of syphilis and its associated infections. The study, however, calls for continued vigilance and research to address the evolving trends and challenges in syphilis management within the specified population.

Comparative Study On ‘Dietary Education’ In Japan And Korea: From The Latest Nutritional Knowledge Perspective

Apr 2024 DOI 10.14302/issn.2693-1176.ijgh-24-5036
Saeki TamieCorresponding author

According to the Japan’s National Health and Nutrition Survey, trends in the intake of vegetables and fruits (1999-2018), which are considered effective in preventing lifestyle-related diseases, are far below the target value; In the under-50 age group, less than 30% achieved the target vegetable intake of 350g, and less than 15% achieved the target fruit intake of 200g 53. Against such background, it has become a challenge to nurture children's ‘self-management ability’ that leads to spontaneous and healthy dietary habits 16. Until now, almost all research on ‘Dietary education’ has been conducted in the field of nutrition, focusing on accumulating nutritional knowledge by explaining each nutritional component and its function. However, it is difficult to nurture spontaneous and healthy dietary habits simply through repeated nutrition-based education. It can be said that the pedagogical approach of this paper has made it possible to pursue from a broader perspective that influences food choices. Research on ‘nutrition transition’ points out “worldwide obesity dynamics and their determinants” based on “a shift in the broader patterns of dietary habits (Western-style diet) and corresponding nutrition-related diseases” 42. Nutrition transition research 5040 has a broad and holistic perspective on food and health, making it easy to understand nutrition. The purpose of this paper is to pursue how to nurture the ‘self-management ability’ for spontaneous and healthy dietary habits, based on these latest nutritional knowledges. Because nutrition transition is a global phenomenon, the author choses to use broader methods of international comparative research. Comparisons lead to discoveries and value creation. This can be said to have the greatest significance in comparative research.

Agronomy Research Open Access

Indian Agriculture needs a Strategic Shift for Improving Fertilizer Response and Overcome Sluggish Foodgrain Production

Dec 2021 DOI 10.14302/issn.2639-3166.jar-21-4018
Gupta RajCorresponding author Centre for Advancement of Sustainable Agriculture, National Agriculture Science Centre Complex, New Delhi, 110012, India

In India, loss of fertility through soil erosion is primarily a summer monsoons mediated phenomenon. Reversing the land degradation processes contribute to water availability, soil fertility maintenance, adapting to climate change and overall food security. Whereas kharif (monsoon/rainy season crop) foodgrain production largely depends on summer monsoons, the rabi season (post-rainy season/winter crop) rainfall is too little to exert a direct influence. In spite of larger acreage under kharif foodgrain crops, total fertiliser consumption during kharif and rabi seasons is comparable. Negative rainfall anomalies (deficit) adversely affected total fertiliser consumption and their use efficiency. Despite significant differences in fertiliser application rates, the response to applied fertiliser nutrients is almost similar in the two seasons. This implies that nutrient use efficiency (NUE) has a ‘manageable’ and an ‘unmanageable’ component wherein 4R practices are difficult to implement under unfavourable kharif weather conditions. Partial factor productivity of fertilizer nutrients (PFPF) has continuously declined over decades mainly because of depletion of soil organic carbon, imbalanced use of nutrients and inability to maintain soil moisture supplies. These observations plus yield-gap analysis permitted us to conclude that past trends of declining NUE can only be reversed through a shift either in sustainable land management practices or enhancing the genetic yield potential/ biomass of crop cultivars or by combining both and making kharif crop planting independent of monsoons rains through direct dry seeding.

Mathematical Modeling of Covid-19

Jan 2021 DOI 10.14302/issn.2766-8681.jcsr-21-3701
Zhao BinCorresponding author School of Science, Hubei University of Technology, Wuhan, Hubei, China.

Background The novel coronavirus (COVID-19) suddenly appeared in Wuhan, Hubei since December 2019, and quickly swept across China, then the whole world. Today, after more than 100 days of fighting against the virus, China's epidemic has been effectively controlled, but when we looking at the entire world, the novel coronavirus has rampaged globally, especially in the United States and many European countries. This paper mainly studies the impact of COVID-19 outbreaks at Hubei Province and the United States, fits the given data and predicts future trends. Methods Based on the theoretical basis of traditional differential equations and SIR infectious disease model1, and combined with the actual situation to improve the model. Hubei Province is modeled in different time periods, and the effects of birth rate and natural mortality on the model are analyzed. Since the birth rate and natural mortality in the United States in recent years cannot be found, the epidemic situation in the United States can only be analyzed based on the absence of births and natural deaths. Finally, we used Netlogo2 to establish a closed environment (Small World), and combined with known data to conduct simulation experiments on COVID-19 infection. Findings Through the analysis of given data through the SIR model, it is found that before the Chinese government has taken comprehensive measures to cure patients (before 10 February), the number of patients in Hubei Province will reach the peak at the end of February, and will gradually decline thereafter, and on 20 March, the epidemic will be effectively controlled in the future, which coincides with the fact that Wuhan closed the last mobile cabin hospital on 10 March. On the other hand, after the Chinese government tried its best to cure the patients (after 21 February), the number of patients continued to decline over time and will reach 0 in mid-April, which is also consistent with the actual data. According to the factors of birth and natural death, the sensitivity analysis of the above model found that when the epidemic situation is at its peak, it has little effect on the curve, but when the epidemic situation gradually flattens, it still has a certain effect on the trend of the curve. Finally, looking at the situation in the United States, due to the high transmission rate, the number of patients in the United States continues to rise and is expected to reach its maximum in mid-June. We also use Netlogo to simulate the environment in which the virus spread, and find that the general trend of the curves is also consistent with the actual curves. Interpretation The Chinese government has taken various measures to deal with the novel coronavirus pneumonia, including the establishment of two temporary hospitals and dozens of sheltered hospitals, the temporary transformation of university dormitories into isolation rooms345, the closure of Wuhan, the ban on the movement of people and so on. These measures have helped to reduce the spread of the virus and greatly increased the patient's cure rate. But the US government ’s actions are not as effective as China’s, not only because the government ’s actions are inappropriate and untimely, and the people’s opposition to isolation has not subsided. As a result, the virus has spread widely in the United States. More than one million people have been infected with the virus, and tens of thousands of people have died from COVID-196.

Sustainable Municipal Solid Waste Management - A case study of Kanpur, India

Sep 2020 DOI 10.14302/issn.2377-2549.jndc-20-3516
Bhargava AksheyCorresponding author Ex. Rajasthan Pollution Control Board, CEPT University, India

Municipal solid waste generation and disposal is a problem not only in India but all over the world. Presently majority of such waste is being dumped indiscriminately over vacant lands causing problems of odor, methane generation leading to air pollution, leaching effect polluting ground water and runoff polluting water bodies. Technological options are available to treat this solid waste and convert it into usable products but the biggest problem is its segregation preferably at the source of generation or even at the disposal area. Municipal solid waste generated in India consists of 15 percent non biodegradable which has high calorific contents and can be converted into power generation. Remaining 85 percent is degradable which can either be converted into compost or bio fuels. Under the present context, sustainable municipal waste management strategy needs to be evolved and put in place with effective implementation to address the issue of environmental pollution. An attempt has therefore been made by the authors of the present paper to take up a case study of Kanpur, India for managing such wastes having sustainable approach. The authors have worked out trends of population starting from the year 1951 and projected to 2051. Similarly waste generation trends established on the lines of population. An effort has also been made as to how much compost, bio fuel and power can be generated along with economic value to make it sustainable on a time scale.

COVID-19 Vaccine Development: Insights, Prospects and Challenges

Aug 2020 DOI 10.14302/issn.2691-8862.jvat-20-3513
Patel JainishCorresponding author Indira Gandhi National Open University, Regional Center, Surat, Gujarat, India

This paper explores the trends, issues and challenges confronting the successful vaccine development for the novel Coronavirus disease (COVID-19). Right from the commencement of the COVID-19 pandemic, no drugs or vaccine has been developed nor approved for treating those down with COVID-19. This year, the scientific community and the vaccine industry have been asked to respond urgently to SARS-COVID-2 pandemic. Presently numerous vaccine development platforms are under process and DNA- and RNA-based platforms showing great potential followed by recombinant-subunit vaccines. Through explorative research, it was established that companies involved in COVID-19 vaccine development are facing big challenges in the scientific, economic and logistical perspectives. Amongst these challenges are distrust, misinformation, and about understanding the immune system interaction with the vaccine being developed, as well as with the pathogen itself. Adjudged as insurmountable may be too early a conclusion. The race is on and progresses are being made. Proper understanding of trends, metrics and dynamics revolving around COVID-19 vaccine development is crucial in expanding possibilities for positive results from ongoing vaccine research. In this review, we spotlight on the most recent developments in COVID-19 vaccine, including top 10 early candidates that may hit the market in next few months.

Structural Equation Modeling to Detect Predictors of CD4 Cell Count Change due to Long Term Antiretroviral Therapy Administered to HIV-Positive Adults at Felege Hiwot Teaching and Specialized Hospital, Bahir Dar, Ethiopia

Mar 2020 DOI 10.14302/issn.2641-4538.jphi-19-2610
Seyoum Tegegne AwokeCorresponding author Dept. of statistics, Bahir Dar University, Ethiopia

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.

Agronomy Research Open Access

Geoscience and Remote Sensing on Horticulture as Support for Management and Planning

Nov 2019 DOI 10.14302/issn.2639-3166.jar-19-3065
Marcelo Scavuzzo CarlosCorresponding author Comision Nacional de Actividades Espaciales, CONAE. Gulich Institute, R. C45km8 Cordoba, Argentine

The importance of horticulture around the large cities, called green belt (GB), or proximity food production area is related to its contribution to the provision of food as well as its role on social, cultural and ecological aspects. Geoscience and Remote sensing (GRS) are tools that should aid in gathering and updating the information to develop science-based management plans of this areas. Recently, the improvement in terms of spatial, temporal and radiometric resolutions has changed the performance and the approach to the horticulture remote sensing. In this work, we make a brief review on the literature exploring the use of GRS techniques in horticulture, and future trends in order to exploit the available techniques for efficient crop management in the way to improve territorial planning and management. Specifically we found a lack of academic production in this area. In addition we examine the importance of this landscape areas from different points of view (food security, health, ecology, etc.). A systematic revision of published studies on remote sensing on horticulture including different platforms, sensors and methodologies are briefly presented. Finally some aspect related with future trends are discussed.

Agronomy Research Open Access

The Changing Scenario of Agriculture

Dec 2017 DOI 10.14302/issn.2639-3166.jar-17-1901
Narain PremCorresponding author Professor and Independent Researcher

This perspective reviews shifts in agriculture driven by technology, market forces, and climate pressures. It discusses productivity trends, resource constraints, and the transition toward sustainable, resilient practices. The article outlines policy and research priorities to balance yields with environmental stewardship and rural livelihoods.

Development of a Chronic Obstructive Pulmonary Disease Severity Classification System Using A Japanese Health Insurance Claims Database

Sep 2017 DOI 10.14302/issn.2474-7785.jarh-17-1727
Akazawa ManabuCorresponding author Public Health and Epidemiology, Meiji Pharmaceutical University

Background: Healthcare services provided to patients should vary depending on disease severity. However, disease severity bias, a type of selection bias, is a commonly encountered problem in administrative database studies. Herein, we selected chronic obstructive pulmonary disease (COPD), which commonly affects elderly Japanese citizens, for the development and validation of a severity classification system based on a health insurance claims database. Methods: Patients who received COPD-related diagnostic codes in 2011 were selected from a commercially based health insurance claims database. COPD patients were randomly divided into two groups to develop and validate severity scores. A principal component analysis was used to estimate factor loadings used to weight calculations of COPD severity scores. Score validity was evaluated using a linear trend test to predict COPD treatment costs and acute exacerbation events. Results: Using records from 880 patients, ten variables were created: acute exacerbation events, emphysema diagnoses, laboratory test and oxygen therapy procedures, prescribed anticholinergic, inhaled corticosteroid (ICS), short acting beta-agonist, and long acting bronchodilator (LABA) agents, asthma diagnosis and patient birth years. Factor loadings from LABA and ICS prescriptions had the strongest impacts on estimated severity scores (0.50 and 0.49, respectively). Among 300 validation group patients, scores were found to associate with increasing trends of median costs and exacerbation risks (p for trend < 0.05). Conclusions: Estimatedseverity scores would help to predict COPD-related medical costs and exacerbation events. For further clinical implementation, this classification system should be re-evaluated using clinical lung functions information indicative COPD severity and treatment choices.

Turnover of Registered Nurses in Israeli Hospitals: A Secondary Analysis from a National Survey

Aug 2017
Toren OrlyCorresponding author Hadassah Hebrew University Medical Center, Mount Scopus

Aim: To assess the extent and directions of internal hospital turnover of registered nurses and to examine the associated factors and stressors. Background: Internal turnover of hospital nurses is mainly horizontal. Occurring on a large scale, it could lead to dropout of skilled personnel, burdening hospitals both financially and in terms of human resources, affecting the quality of care. Methods: A secondary analysis based on data from the national study on "Patterns and trends of the nursing workforce in Israel". A structured telephone interview was conducted of 2,098 hospital nurses (October 2008-February 2009). Results: The rate of internal turnover between hospital departments was 29.7%. The main departments from which nurses moved were medical and surgical. The main departments from which nurses moved were oncology departments, Intensive Care Units, nursing administration. The major work-related stressor concerned salary (59%), two predictors of internal turnover were nurses with children under the age of 18 and academic degree nurses. Conclusions and Implications for Health Policy: Internal turnover rate in Israeli hospitals is moderate, with high rates in medical and surgical departments. It is vital to identify the main factors associated with high turnover rates and implement focused managerial retention strategies and other intervention programs.

Risk Factors for Stunted Growth among Children Aged 6–59 Months in Rural Uganda

Jan 2017 DOI 10.14302/issn.2379-7835.ijn-16-1408
Bukusuba JohnCorresponding author School of Food Technology, Nutrition and Bio-engineering, Makerere University, Kampala, Uganda

Despite the agreed global and national stunting reduction targets, Uganda has made very little progress. Understanding context-specific risk factors for stunted growth is therefore pertinent to designing programs to address the problem. A cross-sectional study was conducted in 32 randomly selected villages in Buhweju district, Southwest Uganda. Data entry, cleaning and analysis were carried out using Statistical Package for Social Sciences (SPSS) version 21. A regression analysis was conducted to examine the associations between potential risk factors and stunted growth. The survey covered 256 households and anthropometric measurements were taken for 221 children aged 6–59 months. The majority of the households (66%) in the district were food insecure and had a low socioeconomic status (84%). The prevalence of stunting in Buhweju district was 51%, which is significantly higher than the regional and national averages. Only 28% of the children were exclusively breastfed in the first 6 months of life, and only 10% of them received the minimum acceptable diet (MAD). The findings of this study demonstrate that reductions in stunted growth at national or regional levels has not necessarily translated into similar trends in rural areas of Uganda. The notable contributors to stunting in these areas include morbidity, sub-optimal infant and young child feeding (IYCF) practices, low consumption of animal-source foods, food insecurity, lack of access to high-quality drinking water, sanitation and hygiene (WASH) facilities and poverty. Increased investment in both nutrition specific and sensitive interventions is therefore crucial to address these risk factors.

Clinical and Immunological Beneficial Effects of Phyto V7 Consumption by HIV-1 Seropositive Individuals

Dec 2015 DOI 10.14302/issn.2324-7339.jcrhap-13-264
J. R WernikCorresponding author Facultad de Medicina, UDELAR, Montevideo, Uruguay;

Phytochemicals (PHT) are a large group of biologically active plant chemicals that may have positive effects on human health such as immune system stimulation, down regulation of inflammatory responses, radical scavenging activities, cell repair function, and antibacterial and antiviral activity. In this proof of principle 6 months study, the effects of supplementing a PHT mix, Phyto V7, to HIV-1 seropositive individuals and AIDS patients were examined. Individuals with CD4+ T-cells below 350 counts/mm3were assigned to one of the following treatments: CG1 - no treatment, CG2 - only highly active antiretroviral treatment (HAART), TG1 - only Phyto V7, and TG2- both Phyto V7 and HAART. After 3 months of treatment there were approximately (-)1%, 1%, 2% and 4% increase in the mean weight of the CG1, CG2, TG1 and TG2 groups, respectively. The tendency for the body mass index (BMI) was similar. The CD4+ counts increased by 13%, 39%, 53% and 35%, respectively. Similar trends were noted after 6 months with 2%, 79%, 53% and 69% increases in the CD4+ counts, respectively. There was a significant reduction in viremia only in groups receiving HAART. Overall better results were obtained in the group of patients receiving both HAART and Phyto V7, in which the mean weight increased by 5.7% and the CD4+ T-cell counts increased by 69% after 6 months. This study indicates that providing Phyto V7 to HIV-1 seropositive individuals and AIDS patients, receiving or not receiving HAART, improves their physical wellbeing and CD4+ counts, enabling them to cope better with the viral infection.

New Regulations for Foods Offered to School Children in Chile: Barriers to Implementation

Jun 2015 DOI 10.14302/issn.2379-7835.ijn-14-615
Prochownik KatherineCorresponding author The Johns Hopkins University Baltimore, Maryland

Objective: To prevent childhood obesity, the Chilean government has recently implemented food regulation laws that apply to schools. This paper reviews the literature regarding the challenges in successfully integrating policies to regulate foods offered in schools. In addition, to understand some of the potential implementation barriers, a survey was conducted to evaluate how well food regulation laws were understood and implemented in Chilean schools. Methodology: A narrative literature review was conducted regarding food regulation policies in Chilean schools and potential barriers to implementation. This informed a subsequent descriptive, qualitative survey which was conducted in the Valparaíso region of Chile to examine knowledge, practices, and potential barriers to implementation of the new regulations. Twelve randomly-selected school food kiosk owners completed a survey and structured interview. Visual observations were also performed at each food kiosk. Content analysis identified trends in food items sold and determined the depth of understanding kiosk owners have of a specific new food law, "La Composición Nutricional de los Alimentos y Su Publicidad (20.606)." Key Results: 7 articles in Spanish and 10 in English were reviewed. The literature review revealed that unhealthful food options are readily available to Chilean students in school kiosks. The results of the survey and interview indicated that the school kiosk owners surveyed have a general understanding of the food law. 10 out of 12, however, were unsure of the law's exact contents. Unhealthful food options, inconsistent with regulation 20.606 were observed in all 12 visited kiosks. Conclusion: Evidence from a literature review and the survey findings confirm that unhealthful foods persist in Chilean schools, despite government food regulations. Although the majority of the school kiosk owners acknowledge law 20.606, most lack an understanding of its exact contents and their role in promoting healthier foods in schools. Further education of vendors and school administrators is needed to enhance compliance with the new Chilean food regulations.

Cognitive Functioning in Adults Aging with HIV: A Cross-Sectional Analysis of Cognitive Subtypes and Influential Factors

Feb 2014 DOI 10.14302/issn.2324-7339.jcrhap-13-191
L. Fazeli PariyaCorresponding author Edward R. Roybal Center for Translational Research in Aging and Mobility; University of Alabama at Birmingham; Birmingham, AL, USA

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.

Demographics, Clinical Profile and Outcome among the HIV Infected Persons Hospitalized in the HAART Era in Barbados.

May 2013 DOI 10.14302/issn.2324-7339.jcrhap-12-137
Kumar AlokCorresponding author Ladymeade Reference Unit, Ministry of Health, Government of Barbados; School of Clinical Medicine and Research, University of the West Indies and Queen Elizabeth Hospital, Barbados.

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.

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