Cogent Medicine最新文献

{"title":"Changing phenotype of inflammatory bowel disease and neglected metabolic health","authors":"J. O’Grady, F. Shanahan","doi":"10.1080/2331205X.2021.1918318","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1918318","url":null,"abstract":"Abstract With modern treatment, an increasing proportion of patients with inflammatory bowel disease (IBD) are achieving deep, sustained remission. However, as control of inflammation has become more effective, the general health needs of patients become more evident. Therefore, we assessed the metabolic health and trends in body mass index (BMI) of patients over the past decade. 181 patients with IBD were included (102 with Crohn’s disease; 79 with ulcerative colitis), each attending the same IBD clinic (median follow up 18 years). A significant trend for rising BMI was found for Crohn’s disease (p < 0.001) which appeared to be independent of the use of biologic drugs. In addition, the proportion of patients with abnormalities of serum lipids was higher than expected for these young patients, median age 46 (38–55 interquartile range). These serum data, together with a higher proportion of smokers and higher BMI trends among those with Crohn’s disease compared with ulcerative colitis, illustrate the need for metabolic health awareness. Crohn’s disease, once strongly associated with nutritional deficit, is now characterized by rising BMI and the emergence of metabolic disorders. Whether this reflects the interaction between inflammatory and cytokine cascades or is solely related to similar trends in the background population is uncertain, but it appears to be independent of the use of biologic drugs. Regardless, the trends observed over the past decades suggest that the metabolic health of patients with IBD will require greater attention when planning management strategies at sub-specialty clinics.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78277011","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":"Improving upon the working environment of informal sector workers in Ghana: The role of planning","authors":"D. Adei, I. Braimah, J. Mensah, Anthony Acquah Mensah, Williams Agyemang-Duah","doi":"10.1080/2331205X.2021.1911441","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1911441","url":null,"abstract":"Abstract Abstract: The formalization of the informal sector in Ghana can never be achieved without planning the working environment of the informal sector workers. Although studies have touched on various aspects of the informal sector working environment, no review studies are available on the role of planning in the working environment of the informal sector in Ghana. The purpose of this review was to identify the working environment of informal sector workers and highlight the role of planning as a first step in formalizing the sector to improve their working environment. The study is based on descriptive and narrative content analyses of the literature on the working environment of informal sector workers and the role of planning. The analysis revealed that the working environment of the informal sector workers is hazardous, devoid of social protection, and polluted, which poses risks of injuries and diseases to workers thereby undermining their health and well-being. The poor nature of the working environment of the informal sector workers makes the social, spatial, environmental and facilitating roles of planners crucial in the informal sector. Through planning, the informal sector could be sufficiently guided to appreciate the opportunities and challenges in their working environment to find lasting solutions to the inherent health and safety problems. There is a need for government to formulate a national occupational health and safety policy and regulatory framework to regulate the informal sector.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"25 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83398245","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":"Quintile distribution of health resourcing in Africa","authors":"M. Cerf","doi":"10.1080/2331205X.2021.1997161","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1997161","url":null,"abstract":"Abstract Africa has a limited health workforce that tackles the morbidity of complex, variable and highly prevalent diseases, often with limited resourcing. This study assesses health worker resourcing in African regions and countries stratified in quintiles (Q). African countries were categorized according to five regions viz. Northern, Western, Central, Eastern and Southern Africa. Each region was assessed according to the distribution of the (medical) doctor and nurse (and midwife) density, nurse to doctor ratio, and hospital bed density, followed by ranking of the health resources and even distribution across Q i.e. Q1-5, with Q1 reflecting the best resourced, Q2-4 intermediate resourced and Q5 the most under-resourced countries in Africa. The doctor and nurse densities, nurse to doctor ratio, and hospital bed availability in Q1 African countries were all higher compared to Q2-5 African countries, reflecting better health resourcing. Both nurse densities and nurse to doctor ratios were higher in Q2 African countries relative to Q4 and Q5 African countries; with hospital bed availability in Q2 African countries higher compared to Q3-5 African countries, and in Q3 African countries compared to Q5 African countries. The best resourced African countries (Q1) were better geared to provide decent healthcare, particularly those meeting global standard thresholds, whereas the remaining countries (Q2-4), and particularly the most under-resourced (Q5) countries, lagged the best resourced African countries, and face extreme challenges in providing decent healthcare. Health resourcing across Africa requires urgent strengthening to enable better healthcare delivery.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82116648","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":"Using ICF and ICHI to promote sexual health","authors":"K. Josefsson, Ann-Helene Almborg, U. Schumacher","doi":"10.1080/2331205X.2021.1898084","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1898084","url":null,"abstract":"Abstract Abstract: Sexual health is an important but often neglected field in health and welfare practice. Using structured documentation in a systematic work process can promote sexual health care including rehabilitation. Objectives: To present an overview of the usefulness of International Classification of Functioning, Disability and Health (ICF) and International Classification of Health Interventions (ICHI) concerning sexual health in the care process, in the electronic health record (EHR) and for follow-up of results. Using experience from practice and research to identify relevant information in health care processes related to sexual health, which are coded by using ICF and ICHI. The ICF and ICHI can be useful tools to describe functioning, patient´s goals, results, planned and performed interventions for investigation, treatment, prevention, and follow-up at individual level in care processes concerning sexual health with unified and unambiguous terms, concepts, and codes in the EHR. Using the ICF and ICHI can support improvement of individual sexual health care including rehabilitation, and also support follow-up and quality management at local to global level within the domain of sexual health.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"32 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80172154","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":"“Taking back control together”: Definition of a new intervention designed to support parents confronted with childhood cancer","authors":"D. Ogez, K. Péloquin, L. Bertout, C. Bourque, D. Curnier, S. Drouin, C. Laverdière, V. Marcil, Jennifer Aramideh, Rebeca Ribeiro, É. Rondeau, D. Sinnett, S. Sultan","doi":"10.1080/2331205X.2021.1944476","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1944476","url":null,"abstract":"Abstract Parental distress is a major issue in pediatric oncology. The literature shows that intervention programs aimed at supporting parents are effective in reducing parental distress following their child’s cancer diagnosis. However, most programs bear limitations, most often related to their focus on the individual (rather than the family), and their dissemination possibilities. TAKING BACK CONTROL TOGETHER is an integrative program which was developed to respond to these limitations and take the best of effective existing components. In line with development standards from behavioral medicine (ORBIT model), this 6-sessions program aims to reduce parental distress by reinforcing both Problem Solving Skills Techniques (PSST) in 4 individual sessions and communication within the couple and dyadic coping in 2 sessions with the parent couple. The program was first developed in French-language and is now being adapted in English. Because the program addresses both individual PSST and dyadic coping, it is expected to yield more benefits for parents than existing interventions. After this first phase of definition, the program should be pre-tested for refinement, and pilot-tested. This article aims to present the definition of this program, including handbooks for caregivers and parents, as well as worksheets and electronic resources.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"95 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80427789","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":"Comparative study of proportions of post-operative sepsis _ maternity versus general surgical ward","authors":"O. Kizito","doi":"10.1080/2331205X.2021.1889100","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1889100","url":null,"abstract":"Abstract: Abstract: Post-operative sepsis tends to complicate the recovery course of many patients. Across the globe, the proportion of post-operative sepsis varied from 2.9% to 30% in various studies. To determine mean proportion of post-operative sepsis in Maternity and General Surgical wards (GSW) and establish whether there was a significant difference in the proportion of post-operative sepsis between the two departments. The design was part of an Unmatched Retrospective Cohort study of post-operative patients admitted to the Maternity and General Surgical ward over the past 6 months. Random samples of 169 respondents from Maternity and 245 respondents from GSW were compared. Mean proportion of post-operative sepsis was 4.4% and 3.1% for Maternity ward and GSW, respectively. Test statistic, Z2 (4.98) , Z1 (1.96), fell in the rejection region; hence, Ho was rejected (significant difference in the proportion of sepsis). In the Maternity ward, the risk of post-operative sepsis was more among the unmarried (p = 0.023, COR = 5.550 [1.272–24.219] at 95% CI). In General Surgical Ward (GSW), emergency surgery (11.9%) and complex surgeries (16.3%) carried more risk. Risk of post-operative sepsis in maternity was more among the unmarried (27.3%). For GSW, emergency surgery (11.9%) and complex surgeries (16.3%) carried more risk. Therefore, more effort is needed to combat post-operative sepsis.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80099276","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 health insurance enrolment and associated factors among persons with disabilities in Ghana","authors":"Doris Nana Anansewa Wiredu, C. Peprah, Williams Agyemang-Duah","doi":"10.1080/2331205X.2021.1901379","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1901379","url":null,"abstract":"Abstract Abstract: Research into healthcare-financing mechanisms remains an important public health issue and has therefore, received considerable attention in both international and local contexts. However, studies on healthcare-financing mechanisms among vulnerable population including persons with disabilities (PWDs) are under-researched in low- and middle-income countries. Based on this knowledge deficit, this study examined the prevalence of national health insurance scheme (NHIS) enrolment and associated factors among PWDs in Ghana. A cross-sectional survey with quantitative approach-accessed data from 180 PWDs from the Asokwa Municipality using simple random and cluster sampling techniques. Multivariate logistic regressions were used to estimate the demographic, socio-demographic and health-related factors associated with NHIS enrolment among PWDs in Ghana. The study revealed that the majority (80%) of the respondents had enrolled in the NHIS before with 65.3% being classified as active enrollees. The study revealed that 38.9% of the participants paid premium 21–25 cedis. The study found that males (AOR: 0.033, CI: 0.002–0.576, p = 0.019) and those who earned more than 500 cedis a month (AOR: 0.54, CI: 0.005–0.596, p = 0.017) were significantly less likely to enroll in NHIS. Furthermore, the study revealed that participants with primary education (AOR: 1.006, CI: 0.250–1.465, p = .021) and those with perceived poor health status (AOR: 4.140, CI: 0.275–62.406, p = 0.005) were significantly more likely to enroll in NHIS. In view of the study results, policy recommendations necessary for improving NHIS enrolment among PWDs have been offered.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81697037","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":"2021 EIP abstract book","authors":"J. Danisi, A. Maningat, M. Jonas, V. Woods-Reinicke, N. Slater","doi":"10.1080/2331205x.2021.2002558","DOIUrl":"https://doi.org/10.1080/2331205x.2021.2002558","url":null,"abstract":"Background and Objectives: In March 2020, approximately 57 million children were affected by massive school closures in the wake of the SARS-CoV-2 pandemic. Many child advocates expressed concerns about the impact of physical school closures and transition to virtual learning on school-aged children's mental health and well-being, particularly those who utilized resources, such as counselling or special education, within the school system. This systematic review was done to identify a) the effect and impact of school closures on the mental health of children in grades K-12, if any, and b) to guide future research on the topic. Methods: A systematic review focused on published articles addressing the effect that COVID-19 related school closures and transition to virtual learning had on school-aged children's and adolescents' mental health. Inclusion criteria included: human studies, scholarly papers, school-aged children, SARS-CoV-2 research, mental health impacts, an article written in English, and research-based in the United States. Exclusion criteria included: not human studies, studies not available in English, individuals over 18 years old, and SARS-CoV or MERS-CoV research. The search was conducted between March 20, 2021, and April 18, 2021. Articles were further screened utilizing the PRISMA flow diagram. Once screened, included articles were reviewed by one member of the research team and a PICO-style analysis was used for each article. After the initial review, a total of 11 articles were included in this systematic review. Learning Points Discussion: We identified several areas of a child's life that school closures limited access to, such as reduced-cost meals, mental health services, and special education. Since the school closures and subsequent transition to online schooling, these resources became unavailable or limited by virtual technology. Children from lower socioeconomic backgrounds and marginalized communities were particularly vulnerable to negative mental health changes due to school closures and decreased access to school-based resources. These individuals belonging to a lower socioeconomic class are more likely to have inadequate computers to utilize in-home learning, have more unstable internet connections, and are less likely to have a caregiver that can stay home to help with their distanced learning. This research will be vital in understanding any adverse effects on children and shaping the future development of school-based programs and their funding.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81828669","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":"Determinants of caesarean section rates in private-not-for-profit healthcare facilities: St. Joseph’s Hospital_ Kitovu","authors":"O. Kizito","doi":"10.1080/2331205X.2021.1928939","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1928939","url":null,"abstract":"Abstract Abstract: Caesarean delivery, often called a C-section, is the delivery of the baby through incisions in the mother’s abdomen and uterus. Caesarean deliveries, whether elective or medically necessary, have risen dramatically in recent decades across the globe, more than the recommended 10–15% by WHO. To determine the mean CSR, ascertain the determinants of Caesarean Section and attitudes of managers toward monitoring and evaluation C-Section. It was descriptive and analytical cross-sectional study design, both qualitative and quantitative. 318 respondent mothers who were admitted to Maternity ward or deliver from the said ward were interviewed. Document review guide, interview guides, and semi-structured questionnaires were used. The study found the Average CSR for St. Joseph’s Hospital _ Kitovu was 47.6%. Determinants associated or which influenced Caesarean delivery were; Age of respondent less than 20 years (p = .041), not being married (p = .015), educational level of respondents (p = .000), living in urban setting (p = .001), among others. Socio-economic determinants (regular household income, p = .000, and occupation, p = .000) highly influenced caesarean delivery. There were mixed views of the health manager toward regularizing monitoring and evaluation of Caesarean Section Rates (CSR). The Caesarean Section Rate (47.6%) in Private Not-For Profit Healthcare organization is still unacceptably higher WHO recommendation of 10–15%. Therefore, there is stronger need to regularize monitoring and evaluation of CSR.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76980645","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":"The ocular health and visual function status of sewing professionals of garment factories of Kathmandu Valley","authors":"Sadhana Sharma, R. Kharel Sitaula, S. Mishra, Gulshan Bdr Shrestha, A. Sharma","doi":"10.1080/2331205X.2021.1996673","DOIUrl":"https://doi.org/10.1080/2331205X.2021.1996673","url":null,"abstract":"Abstract Sewing professionals are engaged in extensive near work in a small and intensely condensed workspaces, thereby exposing themselves to different ocular and vision-related problems. In a cross-sectional study, 305 sewing professionals of garment factories were included and assessed for ocular and vision-related problems. The assessment included detailed anterior and posterior segment examination and vision assessment comprising of visual acuity, static refraction, dynamic refraction, eye alignment, convergence, fusional vergence, amplitude of accommodation, accommodative facility, color vision, and stereopsis. The findings were recorded on preset proforma and data were analyzed in SPSS version 20. Ocular and Vision-related problems were reported for all participants by descriptive data (number, frequency, median, IQR). The median age of the sewing professional was 30 (24–39) years with male predominance (65.2%). On anterior segment assessment, meibomitis (24.26%) was the most prevalent anterior segment disorder. Prevalence of refractive error was seen in 79.7% of the subjects of which hyperopia (44.5%) was the most prevalent form of refractive error. In participants of age group less than 40 years, 79.5% of the population were found to be consistent with some form of vergence and accommodative disorder; 44.5% manifesting convergence excess with accommodative insufficiency. These participants reported ocular, visual, and asthenopic symptoms at a higher rate as compared to other dysfunctions. Association between vision-related problems and symptoms was analyzed using a Chi-square test. A significance level of 0.05 was applied for a 95% confidence interval. Ocular, visual, and asthenopic symptoms were significantly associated with binocular and accommodative disorders (r = 18.726, p = 0.04). Ocular morbidity and binocular vision anomalies were significantly prevalent in sewing professionals of garment factories.","PeriodicalId":10470,"journal":{"name":"Cogent Medicine","volume":"82 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79956996","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}