Received: February 07, 2020; Accepted: February 21, 2020; Published: February 25, 2020 A woman standing in the supermarket line felt her eyes fill with tears from the pain caused by stress of taking care of her dying husband with incurable dementia. She was upset with herself because she couldn’t fix the problem. She felt guilty because she didn’t spend enough time with him. She was stressed because she couldn’t enjoy a cup of coffee before returning home. This is level-10 stress. Too many people in communities throughout the country have unhealthy severe stress every day. There is another option. People can learn to have zero stress throughout their lives.
{"title":"Eplerian philosophy model for managing stress at home and in the Community","authors":"G. Epler","doi":"10.15761/PMCH.1000139","DOIUrl":"https://doi.org/10.15761/PMCH.1000139","url":null,"abstract":"Received: February 07, 2020; Accepted: February 21, 2020; Published: February 25, 2020 A woman standing in the supermarket line felt her eyes fill with tears from the pain caused by stress of taking care of her dying husband with incurable dementia. She was upset with herself because she couldn’t fix the problem. She felt guilty because she didn’t spend enough time with him. She was stressed because she couldn’t enjoy a cup of coffee before returning home. This is level-10 stress. Too many people in communities throughout the country have unhealthy severe stress every day. There is another option. People can learn to have zero stress throughout their lives.","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67506343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Abnormalities in heart rate variability analysis (HRV) have been found in patients with postural orthostatic stress syndrome (POTS), indicating impaired autonomic function. We screened HRV in children in a 5-minute active standing test. Methods: 48 of nearly 500 (9.6%) screened children had a heart rate increase of more than 35 bpm on average in the first 5 minutes active standing test. These data are compared to well-defined indication groups: Healthy controls (N=47), Anorexia Nervosa (N=43), Obesity (N=52) and operated Congenital Heart Disease (N=38). 150 patients have additional 24-hours Holter ECG. Results: We found nearly no differences of supine and 24-hours heart rate and HRV between POTS patients and the healthy controls. However, there is a collapse of the vagus in the standing position indicated by a highly significant decrease of the HRV parameters RMSSD, pNN50, pNN20, High Frequency Power and the increase of the LF to HF ratio. Linear regression analysis show the significant impact of the patients height on the heart rate increase (T=5.9, p<0.0001) and an inverse impact of the body mass index (T= (-)2.33, p=0.021). Conclusion: We uncover the probably most important point of POTS physiology – the collapse of the vagus in the standing position. We identify the high-risk POTS patients – the tall lean teenagers and children with G-protein coupled receptor autoantibodies.
背景:在体位应激综合征(POTS)患者中发现心率变异性分析(HRV)异常，表明自主神经功能受损。我们通过5分钟主动站立测试筛选儿童HRV。方法:近500名筛查儿童中有48名(9.6%)在活动站立试验的前5分钟平均心率增加超过35 bpm。这些数据与明确的适应症组进行了比较:健康对照组(N=47)，神经性厌食症(N=43)，肥胖症(N=52)和手术先天性心脏病(N=38)。150个病人有额外的24小时动态心电图。结果:我们发现POTS患者与健康对照组的仰卧位和24小时心率和HRV几乎没有差异。HRV参数RMSSD、pNN50、pNN20、High Frequency Power均显著降低，LF / HF比值升高，表明站立位迷走神经崩溃。线性回归分析显示，患者身高对心率增加有显著影响(T=5.9, p<0.0001)，与体重指数呈负相关(T= (-)2.33, p=0.021)。结论:我们揭示了可能是POTS生理学最重要的一点-迷走神经在站立时的崩溃。我们确定高风险的POTS患者-高瘦的青少年和儿童与g蛋白偶联受体自身抗体。
{"title":"The postural orthostatic stress syndrome in childhood: HRV analysis and the active standing test","authors":"Buchhorn Julia, Buchhorn Reiner","doi":"10.15761/pmch.1000148","DOIUrl":"https://doi.org/10.15761/pmch.1000148","url":null,"abstract":"Background: Abnormalities in heart rate variability analysis (HRV) have been found in patients with postural orthostatic stress syndrome (POTS), indicating impaired autonomic function. We screened HRV in children in a 5-minute active standing test. Methods: 48 of nearly 500 (9.6%) screened children had a heart rate increase of more than 35 bpm on average in the first 5 minutes active standing test. These data are compared to well-defined indication groups: Healthy controls (N=47), Anorexia Nervosa (N=43), Obesity (N=52) and operated Congenital Heart Disease (N=38). 150 patients have additional 24-hours Holter ECG. Results: We found nearly no differences of supine and 24-hours heart rate and HRV between POTS patients and the healthy controls. However, there is a collapse of the vagus in the standing position indicated by a highly significant decrease of the HRV parameters RMSSD, pNN50, pNN20, High Frequency Power and the increase of the LF to HF ratio. Linear regression analysis show the significant impact of the patients height on the heart rate increase (T=5.9, p<0.0001) and an inverse impact of the body mass index (T= (-)2.33, p=0.021). Conclusion: We uncover the probably most important point of POTS physiology – the collapse of the vagus in the standing position. We identify the high-risk POTS patients – the tall lean teenagers and children with G-protein coupled receptor autoantibodies.","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67506156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Prevalence of goiter and its determinants among children in Southern Ethiopia: An implication for designing family-centered prevention strategy","authors":"Million M Asfaw, Beminet M Gebremariam","doi":"10.15761/pmch.1000143","DOIUrl":"https://doi.org/10.15761/pmch.1000143","url":null,"abstract":"","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67506368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Yearbooks: A reflection of our times","authors":"D. Engelman","doi":"10.15761/PMCH.1000145","DOIUrl":"https://doi.org/10.15761/PMCH.1000145","url":null,"abstract":"","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67506091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
George W Senabulya, J. B. Alege, C. Atuhairwe, I. Taremwa
Background: There has been an increasing public health concern as a result of bed bug infestation, with devastating effects on health and quality of life in Uganda. This study provided the first community-based report on the situation of bed bugs in Lubaga division, Kampala Capital City, Uganda. Methods: This was a descriptive cross-sectional study design, in which data was collected using questionnaire, key informant interview guide and a data abstraction tools. Results: Out of the 356 respondents interviewed, 249(69.9%) had bed bugs in their homes. The study further revealed a significant statistical relationship between the variables of gender, sex, level of education, employment status. The health systems factors that include availability of professional personnel to control bed bugs, use of effective and recommended chemicals, availability of funds, and resistance of bed bugs to insecticides were all found to have an influence on the risk of bed bugs. Conclusion: The study has established the need to strengthen vector control programs in a city suburb. *Correspondence to: Ivan Mugisha Taremwa, Clarke International University, P.O Box 7782, Kampala, Uganda, Tel: +256774346368; Email: imugisha@ymail.com
{"title":"Prevalence and associated factors of bed bug infestations (Cimex lectularius) in lubaga division, Kampala capital city, Uganda","authors":"George W Senabulya, J. B. Alege, C. Atuhairwe, I. Taremwa","doi":"10.15761/PMCH.1000123","DOIUrl":"https://doi.org/10.15761/PMCH.1000123","url":null,"abstract":"Background: There has been an increasing public health concern as a result of bed bug infestation, with devastating effects on health and quality of life in Uganda. This study provided the first community-based report on the situation of bed bugs in Lubaga division, Kampala Capital City, Uganda. Methods: This was a descriptive cross-sectional study design, in which data was collected using questionnaire, key informant interview guide and a data abstraction tools. Results: Out of the 356 respondents interviewed, 249(69.9%) had bed bugs in their homes. The study further revealed a significant statistical relationship between the variables of gender, sex, level of education, employment status. The health systems factors that include availability of professional personnel to control bed bugs, use of effective and recommended chemicals, availability of funds, and resistance of bed bugs to insecticides were all found to have an influence on the risk of bed bugs. Conclusion: The study has established the need to strengthen vector control programs in a city suburb. *Correspondence to: Ivan Mugisha Taremwa, Clarke International University, P.O Box 7782, Kampala, Uganda, Tel: +256774346368; Email: imugisha@ymail.com","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44421664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-04-01Epub Date: 2019-04-19DOI: 10.15761/pmch.1000122
Lyons Sp Doherty, S Bari, F Gany, J Leng, T Duch, D Reveille, J S Morris, M Hernandez, A Nadas, M Costa, J T Zelikoff
Following a 1983 chromic acid (hexavalent chromium [CrVI]) spill from a Garfield, NJ electroplating plant, CrVI-contaminated water was found in a local firehouse basement in 1993. An ATSDR public health advisory was issued for the plant site in 2010, and from 2008-2015, fourteen residential properties have required remediation to address CrVI-contaminated dust in the basements. As part of the Community Outreach and Engagement Core of the NYU NIEHS Center, seventytwo Garfield residents aged 18-65 years, participated in a community survey with the goal of identifying concerns related to environmental and community health. Thirty-two percent responded that they 'didn't know' if they were exposed to chemicals or pollutants where they live. This finding suggests a limited awareness of environmental chemical exposures, chromium contamination and/or potential exposure to CrVI. Furthermore, toenail clippings were collected from forty-seven Garfield residents and analyzed for total chromium levels to assess potential long-term exposure. On average, residents living on/inside the contaminated plume area had higher total chromium levels in their toenail clippings than residents living outside the plume area. However, chromium levels for all participants were within the range of historical normal. This study highlights the value of partnerships between environmentally-impacted community's and academic scientists working together to identify potential contaminant exposures and address public health concerns through research and environmental health education.
{"title":"Community health perceptions and human environmental exposure to chromium contamination in a small New Jersey City.","authors":"Lyons Sp Doherty, S Bari, F Gany, J Leng, T Duch, D Reveille, J S Morris, M Hernandez, A Nadas, M Costa, J T Zelikoff","doi":"10.15761/pmch.1000122","DOIUrl":"https://doi.org/10.15761/pmch.1000122","url":null,"abstract":"<p><p>Following a 1983 chromic acid (hexavalent chromium [CrVI]) spill from a Garfield, NJ electroplating plant, CrVI-contaminated water was found in a local firehouse basement in 1993. An ATSDR public health advisory was issued for the plant site in 2010, and from 2008-2015, fourteen residential properties have required remediation to address CrVI-contaminated dust in the basements. As part of the Community Outreach and Engagement Core of the NYU NIEHS Center, seventytwo Garfield residents aged 18-65 years, participated in a community survey with the goal of identifying concerns related to environmental and community health. Thirty-two percent responded that they 'didn't know' if they were exposed to chemicals or pollutants where they live. This finding suggests a limited awareness of environmental chemical exposures, chromium contamination and/or potential exposure to CrVI. Furthermore, toenail clippings were collected from forty-seven Garfield residents and analyzed for total chromium levels to assess potential long-term exposure. On average, residents living on/inside the contaminated plume area had higher total chromium levels in their toenail clippings than residents living outside the plume area. However, chromium levels for all participants were within the range of historical normal. This study highlights the value of partnerships between environmentally-impacted community's and academic scientists working together to identify potential contaminant exposures and address public health concerns through research and environmental health education.</p>","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8188903/pdf/nihms-1588168.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39082839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Soy Ty Kheang, A. Preston, Emma Louise Collins, Y. An, Hok Phalla, P. Ir, Dysoley Lek, R. Huy, Sovannaroath Siv, Hala J AlMossawi, N. Kak
Background: Malaria elimination campaigns are making huge strides in Cambodia with a target of elimination by 2025. However, pockets of transmission remain. Predominately in border forested areas in Western Cambodia populations are often part of Mobile and Migrant Populations (MMPs). Methods: The Cambodian Mobile and Migrant Population Survey aimed to gain further insight into MMPs. The cross-sectional survey was carried out across ten malaria endemic health districts in 2017. Separation of MMPs into four main occupational subgroups; construction workers, seasonal workers, forest goers and security personnel, was used for analysis. Results: All MMPs questioned knew what malaria was and most MMPs knew mosquito bites caused malaria. However, there were other misconceptions about how it could be transmitted. Only 6% could correctly name three preventative measures. Overall net ownership was found to be 95% although high it remains lower than the national level. Furthermore, insecticide treated net (ITN) ownership 58%. MMPs reported to sleep under a mosquito net last night was 87% but only 37% of them did use effective ITN. Variation in subgroups was found regarding demographics of MMPs, and mobility. Conclusion: MMPs are not a homogenous group and malaria interventions should focus on specific subgroups. This information should inform and improve effectiveness of future interventions to allow Cambodia to move closer to the 2025 elimination goal. *Correspondence to: Soy Ty Kheang, University Research Co., LLC, Phnom Penh, Cambodia, Tel: +855 17 988 388; E-mail: ksoyty@urc-chs.com
背景:柬埔寨的消除疟疾运动正在取得巨大进展，目标是到2025年消除疟疾。然而，小范围传播仍然存在。主要是在柬埔寨西部的边境森林地区，人口往往是流动和移民人口(MMPs)的一部分。方法:柬埔寨流动和流动人口调查旨在进一步了解MMPs。2017年在十个疟疾流行卫生区进行了横断面调查。MMPs分为四个主要职业亚组;建筑工人、季节性工人、森林游客和保安人员被用于分析。结果:所有被调查的MMPs都知道疟疾是什么，大多数MMPs知道蚊虫叮咬导致疟疾。然而，还有其他关于它如何传播的误解。只有6%的人能正确说出三种预防措施。总体净拥有率为95%，虽然很高，但仍低于全国水平。此外，经杀虫剂处理的蚊帐(ITN)拥有率为58%。据报道，87%的MMPs昨晚睡在蚊帐里，但只有37%的人使用了有效的ITN。在MMPs的人口统计学和流动性方面，亚组存在差异。结论:疟疾患者不是一个同质的群体，疟疾干预应侧重于特定的亚群体。这一信息应为今后干预措施提供信息并提高其有效性，使柬埔寨能够更接近2025年消除目标。*通讯:Soy Ty Kheang, University Research Co, LLC，金边，柬埔寨，电话:+855 17 988 388;电子邮件:ksoyty@urc-chs.com
{"title":"A cross-sectional survey of knowledge of malaria prevention among mobile and migrant populations in Cambodia","authors":"Soy Ty Kheang, A. Preston, Emma Louise Collins, Y. An, Hok Phalla, P. Ir, Dysoley Lek, R. Huy, Sovannaroath Siv, Hala J AlMossawi, N. Kak","doi":"10.15761/pmch.1000127","DOIUrl":"https://doi.org/10.15761/pmch.1000127","url":null,"abstract":"Background: Malaria elimination campaigns are making huge strides in Cambodia with a target of elimination by 2025. However, pockets of transmission remain. Predominately in border forested areas in Western Cambodia populations are often part of Mobile and Migrant Populations (MMPs). Methods: The Cambodian Mobile and Migrant Population Survey aimed to gain further insight into MMPs. The cross-sectional survey was carried out across ten malaria endemic health districts in 2017. Separation of MMPs into four main occupational subgroups; construction workers, seasonal workers, forest goers and security personnel, was used for analysis. Results: All MMPs questioned knew what malaria was and most MMPs knew mosquito bites caused malaria. However, there were other misconceptions about how it could be transmitted. Only 6% could correctly name three preventative measures. Overall net ownership was found to be 95% although high it remains lower than the national level. Furthermore, insecticide treated net (ITN) ownership 58%. MMPs reported to sleep under a mosquito net last night was 87% but only 37% of them did use effective ITN. Variation in subgroups was found regarding demographics of MMPs, and mobility. Conclusion: MMPs are not a homogenous group and malaria interventions should focus on specific subgroups. This information should inform and improve effectiveness of future interventions to allow Cambodia to move closer to the 2025 elimination goal. *Correspondence to: Soy Ty Kheang, University Research Co., LLC, Phnom Penh, Cambodia, Tel: +855 17 988 388; E-mail: ksoyty@urc-chs.com","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67505750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Case study on prepubescent vaginal bleeding","authors":"Charles Haddad, Sofia Muenyi, J. Haddad-Lacle","doi":"10.15761/pmch.1000129","DOIUrl":"https://doi.org/10.15761/pmch.1000129","url":null,"abstract":"","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67505896","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Kheang, E. Collins, A. Preston, Y. An, P. Ir, Hok Phalla, Dysoley Lek, R. Huy, Sovannaroath Siv, H. Almossawi, N. Kak
Background: Malaria elimination campaigns are making huge strides in Cambodia with a target of malaria elimination by 2025. However, pockets of transmission remain. Predominately in border forested areas in Western Cambodia, the populations residing here are often part of mobile and migrant populations (MMPs). Moreover, the rise of drug resistance makes the goal of malaria elimination ever more urgent. Materials and methods: The Cambodia Mobile and Migrant Population Survey was a cross-sectional survey aimed to gain further insight into MMPs to inform malaria control and elimination interventions. A purposive sampling technique was used to identify study participants, given the difficulty of identifying and accessing MMPs. The survey was conducted across ten malaria endemic health districts in 2017. Separation of MMPs into four main occupational subgroups; construction workers, seasonal workers, forest goers and security personnel, was used for analysis. Results: The results from this study confirm MMPs are a key group at higher risk of malaria due to their associated risky behaviours. MMPs have a significantly different risk of suffering from fever between subgroups with forest goers and seasonal workers far more likely to report suffering from fever within the last three months. However, the willingness to seek healthcare because of fever was remarkably good, and similar among subgroups. A concerning finding was the low numbers of suspected malaria cases being diagnosed with parasitological blood testing and just under half of MMPs were not aware that malaria should be confirmed by parasitological blood test. Conclusion: MMPs are at an elevated risk of malaria compared to the general population, and this risk varies within MMPs depending on the subgroup. Although health seeking behaviour was reportedly good for all MMP subgroups to public health facilities and volunteers, barriers in access to care were significantly different. This highlights that MMPs can no longer be treated as a homogenous group when targeted by malaria interventions. *Correspondence to: Soy Ty Kheang, University Research Co., LLC, Phnom Penh, Cambodia, Tel: +855 17 988 388; E-mail: ksoyty@urc-chs.com Received: June 10, 2019; Accepted: June 24, 2019; Published: June 27, 2019 Background The past decade has seen impressive improvements in malaria control, presenting the possibility for renewed attempts for elimination [1]. Cambodia made huge strides in reducing malaria, and over the last decade, cases caused by Plasmodium falciparum have reduced by 81% [2]. As a result, Cambodia aims to completely eliminate malaria by 2025 [3]. However, the emergence and spread of P. falciparum artemisinin drug resistance poses major challenges to achieving these goals as treatment failure becomes increasingly common [4,5]. Resistance was first reported on the Thai-Cambodia border in 2008 and has since spread to several more countries in the Greater Mekong Sub-region (GMS) causing increasing
背景:柬埔寨的消除疟疾运动取得了巨大进展，目标是到2025年消除疟疾。然而，小范围传播仍然存在。主要在柬埔寨西部的边境森林地区，居住在这里的人口通常是流动人口和移民人口(MMPs)的一部分。此外，耐药性的上升使得消除疟疾的目标更加紧迫。材料和方法:柬埔寨流动和移民人口调查是一项横断面调查，旨在进一步了解MMPs，为疟疾控制和消除干预措施提供信息。考虑到识别和获取MMPs的困难，采用了有目的的抽样技术来识别研究参与者。该调查于2017年在十个疟疾流行卫生区进行。MMPs分为四个主要职业亚组;建筑工人、季节性工人、森林游客和保安人员被用于分析。结果:本研究的结果证实，由于其相关的危险行为，mmp是疟疾风险较高的关键群体。MMPs在不同亚群之间发烧的风险有显著差异，森林游客和季节性工人在过去三个月内报告发烧的可能性要大得多。然而，因发烧而寻求医疗保健的意愿非常好，并且在亚组之间相似。一个令人关切的发现是，通过寄生虫血液检测诊断出疑似疟疾病例的人数很少，略低于一半的MMPs不知道应该通过寄生虫血液检测确诊疟疾。结论:与一般人群相比，MMPs患疟疾的风险较高，并且这种风险在MMPs内部因亚组而异。尽管据报告，在公共卫生设施和志愿者中，所有MMP亚组的求医行为都是有益的，但在获得保健方面的障碍有很大不同。这突出表明，在疟疾干预措施的目标人群中，不能再将中西医结合患者视为一个同质群体。*通讯:Soy Ty Kheang, University Research Co, LLC，金边，柬埔寨，电话:+855 17 988 388;邮箱:ksoyty@urc-chs.com收稿日期:2019年6月10日;录用日期:2019年6月24日;过去十年，在疟疾控制方面取得了令人印象深刻的进展，这为重新尝试消除疟疾提供了可能。柬埔寨在减少疟疾方面取得了巨大进展，在过去十年中，由恶性疟原虫引起的病例减少了81%。因此，柬埔寨的目标是到2025年彻底消灭疟疾。然而，恶性疟原虫青蒿素耐药性的出现和传播对实现这些目标构成了重大挑战，因为治疗失败变得越来越普遍[4,5]。2008年首次在泰国-柬埔寨边境报告了耐药性，此后已蔓延到大湄公河次区域(GMS)的其他几个国家，引起对全球疟疾死亡率的日益关注[6,7]。柬埔寨当前社会格局的特点，包括人口流动性高，获得公共医疗服务的机会减少，以及不受管制的私人医疗服务使用率高，可能进一步加剧现有的耐药性问题。在消除情况下，剩余病例往往集中在特定群体中，通常是那些最脆弱和被边缘化的人，他们从事高风险行为[9,10]。因此，要实现消除，最需要了解的就是这些疫源地。在柬埔寨，疟疾传播往往集中在流动人口和移徙人口中。研究发现，与一般人群相比，MMPs发生临床疟疾发作的可能性要高出三倍，而且在泰国-柬埔寨边境地区，移民人数较多的地区也相应地具有较高的疟疾发病率[11,12]。由于MMPs的高流动性，他们往往无法获得常规监测或健康促进举措，他们更有可能寻求更容易获得的无证私人医疗保健，正如在缅甸MMPs中发现的情况[13-16]。因此，这一人群的特征被认为是疟疾传播和耐药性传播的主要驱动因素之一[5,16,17]。令人担心的是，这可能导致疟疾重新传入以前无疟疾的地区，特别是当移徙者返回其住所接受治疗时经常报告病例[17,18]。移徙对消除疟疾构成重大挑战，在更好地了解MMPs之前，这将无法得到有效处理。Kheang ST(2019)柬埔寨流动人口和移民人口的求医行为和获得保健的机会第2卷:2-7预防医疗公共卫生，2019 doi: 10.15761/PMCH。 背景:柬埔寨的消除疟疾运动取得了巨大进展，目标是到2025年消除疟疾。然而，小范围传播仍然存在。主要在柬埔寨西部的边境森林地区，居住在这里的人口通常是流动人口和移民人口(MMPs)的一部分。此外，耐药性的上升使得消除疟疾的目标更加紧迫。材料和方法:柬埔寨流动和移民人口调查是一项横断面调查，旨在进一步了解MMPs，为疟疾控制和消除干预措施提供信息。考虑到识别和获取MMPs的困难，采用了有目的的抽样技术来识别研究参与者。该调查于2017年在十个疟疾流行卫生区进行。MMPs分为四个主要职业亚组;建筑工人、季节性工人、森林游客和保安人员被用于分析。结果:本研究的结果证实，由于其相关的危险行为，mmp是疟疾风险较高的关键群体。MMPs在不同亚群之间发烧的风险有显著差异，森林游客和季节性工人在过去三个月内报告发烧的可能性要大得多。然而，因发烧而寻求医疗保健的意愿非常好，并且在亚组之间相似。一个令人关切的发现是，通过寄生虫血液检测诊断出疑似疟疾病例的人数很少，略低于一半的MMPs不知道应该通过寄生虫血液检测确诊疟疾。结论:与一般人群相比，MMPs患疟疾的风险较高，并且这种风险在MMPs内部因亚组而异。尽管据报告，在公共卫生设施和志愿者中，所有MMP亚组的求医行为都是有益的，但在获得保健方面的障碍有很大不同。这突出表明，在疟疾干预措施的目标人群中，不能再将中西医结合患者视为一个同质群体。*通讯:Soy Ty Kheang, University Research Co, LLC，金边，柬埔寨，电话:+855 17 988 388;邮箱:ksoyty@urc-chs.com收稿日期:2019年6月10日;录用日期:2019年6月24日;过去十年，在疟疾控制方面取得了令人印象深刻的进展，这为重新尝试消除疟疾提供了可能。柬埔寨在减少疟疾方面取得了巨大进展，在过去十年中，由恶性疟原虫引起的病例减少了81%。因此，柬埔寨的目标是到2025年彻底消灭疟疾。然而，恶性疟原虫青蒿素耐药性的出现和传播对实现这些目标构成了重大挑战，因为治疗失败变得越来越普遍[4,5]。2008年首次在泰国-柬埔寨边境报告了耐药性，此后已蔓延到大湄公河次区域(GMS)的其他几个国家，引起对全球疟疾死亡率的日益关注[6,7]。柬埔寨当前社会格局的特点，包括人口流动性高，获得公共医疗服务的机会减少，以及不受管制的私人医疗服务使用率高，可能进一步加剧现有的耐药性问题。在消除情况下，剩余病例往往集中在特定群体中，通常是那些最脆弱和被边缘化的人，他们从事高风险行为[9,10]。因此，要实现消除，最需要了解的就是这些疫源地。在柬埔寨，疟疾传播往往集中在流动人口和移徙人口中。研究发现，与一般人群相比，MMPs发生临床疟疾发作的可能性要高出三倍，而且在泰国-柬埔寨边境地区，移民人数较多的地区也相应地具有较高的疟疾发病率[11,12]。由于MMPs的高流动性，他们往往无法获得常规监测或健康促进举措，他们更有可能寻求更容易获得的无证私人医疗保健，正如在缅甸MMPs中发现的情况[13-16]。因此，这一人群的特征被认为是疟疾传播和耐药性传播的主要驱动因素之一[5,16,17]。令人担心的是，这可能导致疟疾重新传入以前无疟疾的地区，特别是当移徙者返回其住所接受治疗时经常报告病例[17,18]。移徙对消除疟疾构成重大挑战，在更好地了解MMPs之前，这将无法得到有效处理。Kheang ST(2019)柬埔寨流动人口和移民人口的求医行为和获得保健的机会第2卷:2-7预防医疗公共卫生，2019 doi: 10.15761/PM
{"title":"Health seeking behaviour and access to care for mobile and migrant populations in Cambodia","authors":"S. Kheang, E. Collins, A. Preston, Y. An, P. Ir, Hok Phalla, Dysoley Lek, R. Huy, Sovannaroath Siv, H. Almossawi, N. Kak","doi":"10.15761/pmch.1000126","DOIUrl":"https://doi.org/10.15761/pmch.1000126","url":null,"abstract":"Background: Malaria elimination campaigns are making huge strides in Cambodia with a target of malaria elimination by 2025. However, pockets of transmission remain. Predominately in border forested areas in Western Cambodia, the populations residing here are often part of mobile and migrant populations (MMPs). Moreover, the rise of drug resistance makes the goal of malaria elimination ever more urgent. Materials and methods: The Cambodia Mobile and Migrant Population Survey was a cross-sectional survey aimed to gain further insight into MMPs to inform malaria control and elimination interventions. A purposive sampling technique was used to identify study participants, given the difficulty of identifying and accessing MMPs. The survey was conducted across ten malaria endemic health districts in 2017. Separation of MMPs into four main occupational subgroups; construction workers, seasonal workers, forest goers and security personnel, was used for analysis. Results: The results from this study confirm MMPs are a key group at higher risk of malaria due to their associated risky behaviours. MMPs have a significantly different risk of suffering from fever between subgroups with forest goers and seasonal workers far more likely to report suffering from fever within the last three months. However, the willingness to seek healthcare because of fever was remarkably good, and similar among subgroups. A concerning finding was the low numbers of suspected malaria cases being diagnosed with parasitological blood testing and just under half of MMPs were not aware that malaria should be confirmed by parasitological blood test. Conclusion: MMPs are at an elevated risk of malaria compared to the general population, and this risk varies within MMPs depending on the subgroup. Although health seeking behaviour was reportedly good for all MMP subgroups to public health facilities and volunteers, barriers in access to care were significantly different. This highlights that MMPs can no longer be treated as a homogenous group when targeted by malaria interventions. *Correspondence to: Soy Ty Kheang, University Research Co., LLC, Phnom Penh, Cambodia, Tel: +855 17 988 388; E-mail: ksoyty@urc-chs.com Received: June 10, 2019; Accepted: June 24, 2019; Published: June 27, 2019 Background The past decade has seen impressive improvements in malaria control, presenting the possibility for renewed attempts for elimination [1]. Cambodia made huge strides in reducing malaria, and over the last decade, cases caused by Plasmodium falciparum have reduced by 81% [2]. As a result, Cambodia aims to completely eliminate malaria by 2025 [3]. However, the emergence and spread of P. falciparum artemisinin drug resistance poses major challenges to achieving these goals as treatment failure becomes increasingly common [4,5]. Resistance was first reported on the Thai-Cambodia border in 2008 and has since spread to several more countries in the Greater Mekong Sub-region (GMS) causing increasing ","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67505643","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mokhtar I Yousef, Moustafa AFH Mahdy, Heba M. Abdou
Thalidomide is used experimentally to treat various cancers, also carboplatin is a chemotherapy drug used against some forms of cancer. Grape Seed Proanthocyanidin Extract (GSPE) has an enormously beneficial role in overcoming the adverse effects of chemotherapeutic agents due to its excellent antioxidant properties. Animals were divided into four groups as follows: The first group was used as control, the second group were treated orally for 28 consecutive days with GSPE (200 mg/ kg BW), the third group were treated intraperitoneally (i.p) with thalidomide (60 mg/kg BW) for 14 consecutive days then followed by carboplatin (196 mg/kg BW) for another 14 days and the animals of the fourth group were treated with the combination of GSPE (200 mg/kg BW) and thalidomide (60 mg/kg BW) for 14-day and then followed by GSPE (200 mg/kg BW) and carboplatin (196 mg/kg BW) for other 14-day. Inflammatory cytokines, P53, oxidative stress markers, biochemical parameters, and histological analysis measured. Carboplatin and thalidomide caused oxidative stress via the elevation in free radicals and nitric oxide and the reduction in the antioxidant enzymes and glutathione in liver and heart. Tumor suppressor gene P53, tumor necrosis factor-α, and interleukin-6 were significantly increased in liver and heart. Thalidomide and carboplatin caused biochemical and histological changes in the liver and heart. Grape seed proanthocyanidin extract reduced carboplatin and thalidomide -induced liver and heart injury throughout its potent antioxidant activity. In conclusion, carboplatin and thalidomide caused hepatotoxicity and cardiotoxicity and grape seed proanthocyanidin extract showed hepatic and cardiac protective effects due to its antioxidant and anti-inflammatory potentials. *Correspondence to: Heba Mohamed Abdou, Department of Zoology, Faculty of Science, Alexandria University, Egypt, Tel:+203-3921595; E-mail: dr.heba_ abdou3000@yahoo.com
{"title":"The potential protective role of grape seed proanthocyanidin extract against the mixture of carboplatin and thalidomide -induced hepatotoxicity and cardiotoxicity in male rats","authors":"Mokhtar I Yousef, Moustafa AFH Mahdy, Heba M. Abdou","doi":"10.15761/pmch.1000136","DOIUrl":"https://doi.org/10.15761/pmch.1000136","url":null,"abstract":"Thalidomide is used experimentally to treat various cancers, also carboplatin is a chemotherapy drug used against some forms of cancer. Grape Seed Proanthocyanidin Extract (GSPE) has an enormously beneficial role in overcoming the adverse effects of chemotherapeutic agents due to its excellent antioxidant properties. Animals were divided into four groups as follows: The first group was used as control, the second group were treated orally for 28 consecutive days with GSPE (200 mg/ kg BW), the third group were treated intraperitoneally (i.p) with thalidomide (60 mg/kg BW) for 14 consecutive days then followed by carboplatin (196 mg/kg BW) for another 14 days and the animals of the fourth group were treated with the combination of GSPE (200 mg/kg BW) and thalidomide (60 mg/kg BW) for 14-day and then followed by GSPE (200 mg/kg BW) and carboplatin (196 mg/kg BW) for other 14-day. Inflammatory cytokines, P53, oxidative stress markers, biochemical parameters, and histological analysis measured. Carboplatin and thalidomide caused oxidative stress via the elevation in free radicals and nitric oxide and the reduction in the antioxidant enzymes and glutathione in liver and heart. Tumor suppressor gene P53, tumor necrosis factor-α, and interleukin-6 were significantly increased in liver and heart. Thalidomide and carboplatin caused biochemical and histological changes in the liver and heart. Grape seed proanthocyanidin extract reduced carboplatin and thalidomide -induced liver and heart injury throughout its potent antioxidant activity. In conclusion, carboplatin and thalidomide caused hepatotoxicity and cardiotoxicity and grape seed proanthocyanidin extract showed hepatic and cardiac protective effects due to its antioxidant and anti-inflammatory potentials. *Correspondence to: Heba Mohamed Abdou, Department of Zoology, Faculty of Science, Alexandria University, Egypt, Tel:+203-3921595; E-mail: dr.heba_ abdou3000@yahoo.com","PeriodicalId":74491,"journal":{"name":"Preventive medicine and community health","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"67506168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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