Syrian Refugees, Health and Migration Legislation in Turkey

Abstract

This paper discusses the crucial effects of Turkish health and migration laws on Syrian refugees' access to public health services and social determinants of health. Key aspects of current Turkish laws affect the health of both refugees and Turkish citizens in many ways. The huge influx of refugees is increasing communicable disease risks, overcrowding hospitals, and more generally straining financial and health resources. Turkey's United Nations membership and its candidacy for European Union (EU) have led to increased alignment of Turkey's refugee and migration policies with international law. Major differences remain, however, and Turkey's remaining noncompliance with international refugee laws is a major force driving Syrian refugee's flight to EU countries, as refugees desperately seek the right to better health and social services.

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Segmentation of Mexican-Heritage Immigrants: Acculturation Typology and Language Preference in Health Information Seeking

Abstract

With the fast growing number of Mexican immigrants in the United States, more attention is needed to understand the relationship between acculturation and language preference in health information seeking. Latent class analysis provides one useful approach to understanding the diversity in sample of Mexican immigrants (N = 238). Based on 13 linguistic, psychological and behavioral indicators for acculturation, four discrete subgroups were characterized: (1) Less acculturated, (2) Moderately acculturated, (3) Highly acculturated, (4) Selectively bicultural. A Chi-square test revealed that three sub-groups were significantly different in language preference when seeking health information. Less acculturated and moderately acculturated groups sought health information in Spanish, whereas the highly acculturated group preferred English for health information. Selectively bicultural group preferred bilingual health information. Implications for health campaign strategies using audience segmentation are discussed.

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GROUPING OF MIDDLE INCOME COUNTRIES IN TERMS OF VARIABLES AFFECTING THEIR HEALTH EXPENDITURES

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Pınar Yalçın Balçık, Songül Çınaroğlu, Gülnur İlgün.
It is known that health care resources and expenditures are limited in middle income countries compared to those with developed countries. However these countries usually compared in terms of health care expenditures with OECD countries. It is mentioned in the literature that, in comparisons to be made based on health expenditures for middle income countries, these countries should be compared within groups to be formed according to similar properties within themselves rather than being compared based on developed countries such as OECD countries. Due to this requirement, in this study it was aimed at making groups in terms of variables considered to be affecting health expenditures using WHO and WB data for middle income countries. As a result of hierarchical cluster analysis, it was seen that two groups representing a total of 95 countries were formed. Analysis results indicated that within middle income countries, countries located in Eastern and Western Asia which were in a higher income group were included in the first cluster and countries in Southern Africa and Southern Asia which were in a lower income group were included in the second cluster. According to study results, it could be said that the formed country clusters were similar to the classification made by World Bank according to the income levels of the countries. Study results provided beneficial information about the comparison of middle income countries indicating heterogeneous characteristics in terms of variables affecting health expenditures.


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Assessment of its Compliance with the Standards of The Handicapped Ramps of Health Care Institutions in Kirikkale Province

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
TEVFİK PINAR, MERAL SAYGUN, EMRAH MURAT AÇIKGÖZ, İSMAİL ATÇEKEN, HASAN DEMİRTAS.
Disability is not just a health issue, It is a complex phenomenon that affects deeply the lives of people with disabilities in terms of health, social and psychological. Over 1 billion people globally experience disability at any level. According to data from TÜİK (2002) Turkey's 12,29% of the population is disabled. Physical barriers to accessing health services is a significant problem. In this study, Handicapped ramps in health care facilities in kırıkkale province, were examined for legal compliance with regulations and standards. Materials and Methods: The study is of descriptive nature. All handicapped ramps in the entrances of all the health institutions were enrolled the study. 37 ramps have been investigated in 26 Health Organization. Evaluations were made on the basis of the Institute of Turkish standards (TS12576 and TS9111 standards). The ramps were evaluated for the following properties: presence and type of the ramps, the suitability of the surface, slope angle, length and height of the ramp, the handrail, the width, the platform presence/absence and suitability of the input and the output of the ramp platform, guide signs, and the warning signs, the stimulant surface. The slopes of the ramps were calculated as the percentage using the ramps heights and lengths. Results: In this study, there was no any ramps that conforming to standarts in terms of their all properties and measurements. Three of health institutions did not have any handicapped ramps, although they were necessary. There were no any input and output guide signs and warning signs for the visually impaired person and stimulant surface in any of the ramps. %94 of the ramps did not have drainnage channel Keywords: Handicapped ramps, Handicap, Health Institutions


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THE IMPORTANCE OF HEALTH LITERACY FOR COMMUNITY HEALTH

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Gülay YILMAZEL, Fevziye ÇETİNKAYA.
Health literacy have been specified as being an item that enhances years of healthy life and quality, for healthcare professionals ensures acquisition of communication and clinical skills and for individuals involvement decision-mechanism in the health care field. Health literacy based on social and cultural factors in society and serves as a mediator between the individuals with the health system, education system and health issues. For planning health promotion activities, health literacy is considered as an important step and six general themes help to determine why health literacy is important for population health: Affecting the large numbers of people, poor health outcomes, increasing rates of chronic disease, rising health care costs, health information demands and equity. It was stated that supporting evidence of inadequate health literacy effects had incereased on individuals health. These evidences were shown as; using preventive health services in low level, delay to seek health care in symptomatic period, inability of individulas to understand their medical condition, lack adherence on medical advice/instructions, lack of self-care and increased mortality. Assessing of health literacy levels focuses on patient information. However, regardless the development level of countries, it had seen that health literacy levels were low in all over the world. In a report of World Health Organization Commission on Social Determinants of Health, the development of health literacy was accepted as an important tool for reduction of health inequalities. In this respect, proposed approaches were to start in health literacy education in early childhood, health literacy, to focus on the concept of health promotion in school education and to put an emphasis to adult education.


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ANALYSIS OF UNIVERSTY STUDENTS’ ASSERTIVENESS LEVEL

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Yasin UZUNTARLA, Necmettin CİHANGİROĞLU, Sümeyra CEYHAN, Uğur UĞRAK.
This research aims to present university students assertiveness level and analyze whether the assertiveness level indicates significant difference in terms of participants sociodemographic characteristics. The descriptive research conducted in Bingöl University Faculty of Economics and Administrative Sciences covers 400 students. For data collection, questions to determine sociodemographic characteristics and Voltan Turkish Adaptations of Rathus Assertiveness Scale, which was originally developed by Rathus were used. The data acquired was analyzed with SPSS 22.0 package program and statistical comparison of the data was evaluated by using Independent T-Test, Mann Whitney-U, One-Way ANOVA, and Tukey Post-Hoc Tests. Consequently, it was found that 63,2% of the students were assertive and ones who had a opposite sex friend and ones who had higher family income were more assertive than ones who hadnt.


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Outbreak of Food-Poisoning After a Wedding Feast; Cayirbag, Afyonkarahisar, 2014

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Yasemin Demirbilek, Hüseyin Öztürk, Mehmet Şenol, Ramazan Özçelik, Serap Çetin Çoban, Fehminaz Temel, Belkıs Levent, Mustafa Bahadır Sucaklı, Seher Musaonbaşıoğlu.
Aim: Provincial Public Health Directorate reported an acute gastroenteritis outbreak in Cayirbag Village. An investigation was conducted to identify the cause, mode of transmission and to prevent the recurrence of similar outbreaks. Methods: In this retrospective cohort investigation, we interviewed 174 residents and detected 112 probable cases. Odds ratios (ORadj) were obtained through unconditional logistic regression model including sex, age, rice and okra. Results: The attack rate was 64.4%. Main symptoms were vomiting (88.4%), nausea (85.7%), abdominal pain (77.7%), diarrhea (54.5%). Epidemic curve revealed a point source outbreak. Mean incubation period was 3.5 hours (min-max:1-11.5). Meals were prepared outside, at the soil ground, and served one day later. Foods other than rice were stored in the refrigerator. We were unable to obtain information about the storage conditions of the rice. Females developed the illness 1.3 times more compared to males (95%CI:1.01%-1.6%). Risk of disease differed by age groups (p=0.016). After controlling for other factors, consuming rice was 11 times more (95%CI:1.1-109.7). Water, food and stool specimens were tested negative. Conclusion: Symptoms, incubation period, unsafe food preparation conditions, lack of information on rice storage conditions and epidemiological evidence suggest that this outbreak was due to contaminated rice.


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Healthy Lifestyle Behaviors and Preventive Health Applied to Women Ages 18-64: A Sample from the Çorum Province

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Gülay YILMAZEL, Nuriye BÜYÜKKAYACI DUMAN.
Aim/background: The aim of this study was to determine healthy lifestyle behaviors and preventive health applied among women ages 18-64 women. Methods: This descriptive and cross-sectional study was performed in December 2014 in the two family health centers with 249 women. To determine healthy lifestyle behaviors of women, the Healthy Lifestyle Behaviors Scale-48 items were used. Results: The total average score from the scale was 115.78±36.20 and the average scores from the items were 2.57±0.46. The highest average scores were obtained from interpersonal support sub dimension, the lowest were from exercise. Age groups, working status, smoking, physical activity, body mass index and general health perceptions were the effective variables on scores. Women who didn't measured their blood-glucose and cholesterol level, who didn't practice self-breast examination and mammography during the last year, had significantly lower health responsibility, self-actualization, exercise, and stress management scores. Conclusion: In the present study we found healthy lifestyle behaviors of women in moderate levels. Scores obtained from scale were low in women who had risky health behaviors and didnt implement preventive health applications. In preventive health care, health education, and counselling services should be given to women aged 18-64, women should be encouraged to participate in health promoting programmes.


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DISTRUBITION OF INTERNAL DISEASES CAUSING UNFITNESS FOR MILITARY SERVICE AMONG CANDIDATES IN TURKEY

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
necmettin kocak, ercan göcgeldi, ramazan akyildiz, hakan istanbulluoglu, ibrahim aydin, abdullah taslipinar, selim kilic.
Background: In Turkey, compulsory military service applies to all male citizens from twenty to forty-one years. This study was conducted to investigate the distribution of the cases to be determined as unfit for the military service due to internal diseases among young adults who underwent medical examinations for compulsory military service. Methods: This cross-sectional study was carried out to collect data by examining the medical reports of 1.777.500 candidates drafted into Turkish Armed Forces for military medical examination between 2009 and 2011. Results: The prevalence of internal diseases by years was found to be 18.3 for 2009, 24.62 for 2010 and 25.63 for 2011 per 1000 people. Leading causes for candidates to be rejected from military service were found as obesity 11.72, underweight 1.73, diabetes mellitus 1.47, congenital heart disease 1.22, valvular heart disease 1.09 per 1000 people respectively. In our study essential hypertension prevalence was found to be 0.17 ‰. Conclusions: In this study, it was ascertained that the prevalence of obesity and underweight characterized by nutritional deficiency/malnutrition and essential hypertension increased over the years. We suggest that running various obesity programs or campaigns for individuals in early childhood could be of crucial importance in addressing these endemic health problems in Turkey. It is proposed that detailed examination of these data by public health administrators, could be utilized to address the major health problems in the society.


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THE CURRENT SITUATION OF CRIMEAN-CONGO HEMORRHAGIC FEVER

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Önder SER, Hüseyin ÇETİN.
Crimean-Congo hemorrhagic fever (CCHF) is a fatal disease caused by infection with a tick-borne virus, a member of Nairovirus genus in the family Bunyaviridae. The CCHF virus is transmitted to humans by the bites of infected ticks, contact with blood or body fluids of CCHF patients or viremic livestock or crushing infected ticks with unprotected hands. Ixodid (hard) ticks, especially Hyalomma genus, are both vector and reservoir for the CCHF virus. CCHF disease have been recorded in an expanding geographic area that currently includes more than thirty countries in Africa, southeastern Europe (especially the Balkans), Asia and the Middle East. Migratory birds and movement of livestock may play an important role in the transportation of infected ticks or CCHF virus from endemic areas to non-endemic areas. Risk groups include humans living in endemic areas, farmers, veterinarians, health-care workers, butchers and soldiers. The incubation period of disease is generally 3-14 days. While the case fatality rate is approximately 30% in the world, this rate is approximately 5% in Turkey. The first CCHF case was reported in 2002 from Tokat province which is located in the Kelkit Valley in Turkey. According to Turkish Ministry of Health data, totally 8047 CCHF cases were declared and 396 of these cases dead between 2002 and 2014. H. marginatum is main tick species responsible for CCHF epidemic in Turkey. Laboratory diagnosis of CCHF is performed by identification of the viral RNA and/or antigens, the detection of specific antibodies and isolation of virus. Currently, there are no vaccine for protection from CCHF and specific antiviral drug for treatment of disease. The main treatment of disease is supportive therapy. Ribavirin is the only antiviral drug used in the treatment of CCHF patients but its effectiveness remains controversial. To protect people from disease, tick populations should be controlled and avoided from contact with ticks and virus.


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THE EFFECT OF BIRTH FEAR ON LACTATION, INFANT SUCKING ABILITY AND FIRST BREASTFEEDING RESULTS

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Asuman Tatarlar, Merlinda Aluş Tokat.
Objective: The impact of the fear experienced during vaginal birth on lactation, the baby's sucking behavior and first breastfeeding results. Methods: It is a descriptive study. A total of 102 mother who gave birth in hospitals depended to health ministry participated. The Introduction characteristics form, The birth process evaluation form, Birth fear scale, Lactation, baby's sucking behavior and evaluating of the first breastfeeding results forms was used for data collection. For data analysis T test, Kruskal Wallis, Mann Whitney and Spearman correlation were used. Results: The fear of mothers in active phase of birth was statistical higher than fear in latent phase of birth (73.84; 47.16; p=0.001). Mothers with higher fear in active phase, spend more time for placement the infant to the breast(p=0.001), infants were less willing to breastfeed (p=0.001), they did not catch areola properly (p=0.001), fail in attach to breast(p=0.001), there was no eye contact between infants and mothers and they did not hold their infants properly (p=0,001), the act of swallowing was slow (p=0.001), after breastfeeding, infants and mothers were more uneasy(p=0.001), they had more breastfeeding problems (p=0.001), and mother were more tense (p=0.001). Conclusions: The birth fear especially in active phase negatively affect breastfeeding. According to this results health professionals should decrease mothers birth fear by giving appropriately and adequate care before, during and after birth.


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Neonatal Screening for Congenital Adrenal Hyperplasia

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Ediz Yeşilkaya, Erkan Sarı.
Congenital adrenal hyperplasia (CAH) is an autosomal recessive disease causing gender differentation disorder. 21-Hydroxylase deficiency comprises more than 90% of patients and leads to cortisol deficiency. Cortisol deficiency causes life threatining adrenal failure. The diagnosis could be missed and the disease may cause to death especially in male neonate and girls with virilised severely. After the CAH diagnosis, the management of disease is possible both medical and surgical. Therefore neonatal CAH screening program is performed in many developed countries. Both male and female infant death can be prevented as well as early medical/surgical intervention correct the problems without grow-up. Europe and American Societies of Pediatric Endocrinology recommend the neonatal CAH screening. Because of all these reason neonatal CAH screening is important and necessary in our country that has high prevalence of consanguineous marriage.


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Antagonistic effects of lactic and acetic acid bacteria on Shigella sp. SS10 in co-culture

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Anthony Opeyemi Ayeni, Funmilola Abidemi Ayeni.
Backgroud- Recent upsurge in bacterial resistance has led to search for alternative to antibiotics in treatment of infectious diseases including diarrhea. One of the common causative agent of diarrhea is Shigella sp. Lactic acid bacteria has been used in probiotic formulation for prevention of various form of diarrhea. This study investigates possible antagonistic effects of lactic and acetic bacteria on Shigella sp in co culture. Method- Antibiotic susceptibility of Shigella spp. SS10 to ofloxacin, gentamycin, cefuroxime, ceftazidine, lincomycin, oxacillin, cloxacillin, cefotaxime, ciprofloxacin and nitrofurantoin was tested by disc diffusion method. Shigella spp. SS10 was co-incubated in two different experiments with 3 Lactobacillus species (Lactobacillus plantarum QN01, Lactobacillus parabuchneri SM03 and Lactobacillus fermetum SH01) and 1 Acetobacter pasteurianus RV04 which has been previously isolated from Nigeria-produced yogurts. An 8h old Shigella spp. SS10 was introduced into an overnight culture of LAB and a fresh Shigella spp. SS10 was inoculated into overnight culture of LAB. Viable counts of pathogens at 0h and after 24h co-incubation at 37oC were observed. Results -Shigella spp. SS10 was resistant to 50% of the tested antibiotics. The co culture of tested LAB revealed an average of 4 log reduction in viable counts of the Shigella strain. The Acetobacter strain displayed very good inhibitory activity with a 4 log reduction in microbial load of Shigella spp SS10. Conclusion - Lactic and Acetic acid bacteria isolated from Nigerian yoghurt has considerable activity against Shigella sp. in co culture experiment.


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THE EFFECT OF JOB SATISFACTION AND MOTIVATION OF HEALTH CARE PROFESSIONALS ON THEIR ORGANIZATIONAL COMMITMENT: THE CASE OF TURKEY

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Oğuz Işık, Özgür Uğurluoğlu, Salih Mollahaliloğlu, Mustafa Kosdak, Serap Taşkaya.
Objectives: The objectives of this study are to propound the relationship between job satisfaction levels, motivation and organizational commitment of health care professionals who work in the public sector in Turkey and to specify the effect of their job satisfaction levels and motivation on organizational commitment. Method: This study was carried out as a part of Healthcare Employee Satisfaction Survey conducted in Turkey where the research sample consisted of 4,396 health care professionals from all around the country. The questionnaire which was used in the survey included, in addition to demographic features of the participants, 22 statements for job satisfaction, 26 statements for motivation and 16 statements for commitment. Regression and correlation analysis, t-test and ANOVA test were employed in addition to descriptive statistics in the analyses. The error level was set at α=0.05. Findings: It was observed that job satisfaction of health care professionals showed statistically significant difference with respect to gender and marital status variables, their motivation showed statistically significant difference with respect to age, profession and service region variables whereas their organizational commitment showed statistically significant difference with respect to age, profession and service region (p


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The Relationship Among Satisfaction, Commitment and Loneliness : An Application in TAF Ankara Special Care Center

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Özay Çelen, Hüseyin Abuhanoğlu, Abdulkadir Teke.
The Purpose of this study is to investigate to correlation among customer satisfaction, customer commitment, and loneliness. The population of the research involves totally 103 person entitled residing in TAF Ankara Special Care Center. Person Entitled Satisfaction were measured by adapting items from Çimen et al. Commitment level of person entitled were measured by adapting items from Erdem et al. The information concerning the loneliness level of person entitled was collected by using UCLA Loneliness Scale. As a result of evaluations, ıt was found that there was correlation between Person Entitled Satisfaction and Person Entitled Commitment, but there was no correlation between Person Entitled Satisfaction, and Person Entitled Commitment and Loneliness.


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THE ANALYSIS OF RELATIONSHIP BETWEEN NURSES’ RATIONAL USE OF DRUGS AND THEIR PERSONAL CHARACTERISTICS

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Yasin UZUNTARLA, Necmettin CİHANGİROĞLU.
This study aims to assess the attitudes and behaviours for nurses, who are an indispensible part of the health services, using medicines rationally and analyse difference between these attitudes and behaviours based on these personal characteristics. In the descriptive research which was conducted in a training hospital with the capacity of 1200 beds in Ankara province, 251 nurses reached. In the first chapter of the questionnaire form, Assessment Form on Nurses using drugs rationally titled questionnaire form which includes 17 articles, developed by Republic of Turkey Ministry of Health Pharmaceuticals and Medical Devices Agency in order to analyse nurses socio-demographic characteristics as well as their attitudes and behaviours for rational use of medicines was applied. In the second chapter, Five-Factor Personality Inventory which was developed by Benet-Martinez and John (1998), and which consists of 44 articles was applied. All of the respondents were women and their average of age was 33,53±4,21. The most often encountered (47,8 %) mistake with regards to using the medicine was using medicine in the wrong time, the pharmacological information source from which highest advantage (70,1 %) is made is the source books on drugs (vademecum etc.). 42,2 % of nurses stated that they had very high knowledge about how to use medicines, 82,9 % of them stated that they always follow the date of expiration of medicines, 84,9 % of them stated that patients are given education about the medicines to be used and 62,6 % of them stated that they do not make feedback about the adverse effects of medicines. There was a significant relationship between patients questioning the food and medicine allergy before using the medicine and extraversion and openness for improvement ratios. The relationship between adverse impact feedback and rate of openness for improvement was also significant.


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EVALUATION OF SATISFACTION LEVELS OF THE PATIENTS WHO APPLIED TO THE EMERGENCY ROOM OF GÜLHANE MILITARY FACULTY OF MEDICINE TRAINING HOSPITAL

2016-03-19T18-00-20Z
Source: TAF Preventive Medicine Bulletin
Bayram ALICI, Yasin UZUNTARLA, Ülkü TÜRKUĞUR, Mustafa GÜLEÇ.
Patient satisfaction is quite important as an indicator of healthcare service provided in emergency rooms. The purpose of this study is to evaluate the satisfaction of the patients who apply to the emergency services which is ready to serve at any time and constitutes the most dynamic power of the hospitals. Within the scope of the study, 250 patients who applied to the Emergency Room of Gülhane Military Faculty of Medicine Training Hospital for various reasons were contacted. Survey method was used for data collection. Emergency Room Patient Satisfaction Survey, which was developed by the Ministry of Health, General Directorate for Health Services, Quality in Health and Accreditation Department and consists of 17 questions, was used. Data was analysed using SPSS 22.0 software and analyses were conducted using Independent T-Test and One-Way ANOVA. It was found that the satisfaction from Emergency Room is quite high and satisfaction does not vary generally according to the demographic characteristics. It was found that the patients who used the services of the hospital before were significantly more satisfied compared to the patients who applied for the first time.


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Identification and characteristics analysis of toll-like receptors family genes in yak

Abstract

Toll-like receptors (TLRs) are innate pattern recognition receptors that play an important role in host resistance to pathogenic microbes. In this study, we cloned the coding region of the yak TLR family (1–10) genes and used bioinformatics to analyze gene characteristics. Real-time fluorescence quantitative polymerase chain reaction was used to detect TLR expression levels in different tissues. Yak TLR genes exhibited high homologies with other species. At the nucleotide level, yak shared more than 96 % homology with cattle and sheep and 75–87 % homology with human and mouse. At the amino acid level, yak shared 90–99 % homology with cattle and sheep and 64–86 % homology with human and mouse. Yak showed close evolutionary relationship with cattle and sheep, which formed a branch of mammals together with TLRs from human, horse, and mouse, among others, and formed a branch with a longer genetic distance with chicken. TLR1, 2, 6, and 10 and TLR7, 8, and 9 were clustered in 2 individual branches, respectively. Fluorescent quantitation results showed that TLRs were expressed in all yak tissues, but different members showed different expression patterns. TLR2, 4, and 6 showed the highest expression in the spleen, followed by ovary, small intestine, kidney, and liver. TLR1, 5, 7, 8, 9, and 10 were most highly expressed in the kidney and showed higher expression in the liver, kidney, spleen, and other tissues. Our results will be useful for studies on immune molecular mechanisms and disease resistance breeding of yak and other plateau animals.

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Limits of Evidence Based Medicine for rare diseases: The case of Budd-Chiari syndrome

Diffusion of the concepts of Evidence Based Medicine (EBM) as a rule for clinical field-practise has certainly had a positive and effective impact on the management of patients affected by different diseases. Moreover, EBM has long been a watershed between traditional medicine basically without rules, and a new approach to patients and diseases based only on evidence proven, so undeniably having an important social value. Through his own personal and deep thought, Pagliaro here outlines both the achievements and boundaries of EBM [1].

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Correlation of anemia status with worsening bowel damage as measured by Lémann Index in patients with Crohn's disease

There is evidence that anemia in Crohn's disease (CD) is a predictor of disease severity.

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Comorbidities in functional gastrointestinal diseases: Do we need a lone ranger or a dream team?

There are many papers dealing with the concept of a multidisciplinary approach to gastrointestinal (GI) diseases. A search on PUBMED in September 2015, by typing the words "multidisciplinary approach to gastrointestinal diseases", found about 1100 articles, with an increase in this topic in recent years [1] (Fig. 1).

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Towards a Determination of the Physiological Characteristics Distinguishing Successful Mixed Martial Arts Athletes: A Systematic Review of Combat Sport Literature

Abstract

Background

Mixed martial arts (MMA) is a combat sport underpinned by techniques from other combat disciplines, in addition to strategies unique to the sport itself. These sports can be divided into two distinct categories (grappling or striking) based on differing technical demands. Uniquely, MMA combines both methods of combat and therefore appears to be physiologically complex requiring a spectrum of mechanical and metabolic qualities to drive performance. However, little is known about the physiological characteristics that distinguish higher- from lower-level MMA athletes. Such information provides guidance for training interventions, performance testing and talent identification. Furthermore, while MMA incorporates techniques from both grappling and striking sports, it is unknown precisely how these disciplines differ physiologically. Understanding the relationship between higher-level competitors in grappling and striking combat sports can provide further insight into the development of the optimal performance profile of a higher-level MMA athlete.

Objective

This article aims to analyse the scientific literature on MMA and the primary combat sports underpinning it to determine the physiological adaptations that distinguish superior competitors, with a view to defining the optimal physiological profile for higher-level MMA performance. Furthermore, this article will explore the differences in these capabilities between grappling- and striking-based combat sports in the context of MMA.

Methods

A literature search was undertaken via PubMed, Web of Science, SportDiscus and Google Scholar. The following sports were included for systematic review based on their relevance to MMA: mixed martial arts, boxing, Brazilian jiu-jitsu, judo, karate, kickboxing, Muay Thai and wrestling. The inclusion criteria allowed studies that compared athletes of differing competition levels in the same sport using a physiological performance measure. Only male, adult (aged 17–40 years), able-bodied competitors were included. The search history spanned from the earliest record until September 2015.

Results

Of the eight combat sports searched for, five were represented across 23 studies. Sixteen investigations described maximal strength or neuromuscular power variables, while 19 articles reported anaerobic or aerobic measures. The results indicate that a number of strength, neuromuscular power and anaerobic variables distinguished higher- from lower-level combat sport athletes. However, these differences were less clear when groups were stratified within, rather than between competition grades. Greater aerobic power was generally not present amongst superior combat sport competitors.

Conclusion

There appear to be differing physiological profiles between more successful grappling and striking combat sport athletes. This is represented by high-force demands of grappling sports causing an upwards shift of the entire force–velocity relationship driven by an increase in maximal strength. In comparison, smaller increases in maximal force production with more notable enhancements in lighter load, higher velocity actions may better identify superior performance in striking sports. Anaerobic capabilities largely distinguished higher- from lower-level combat sport athletes. In particular, longer-term anaerobic efforts seem to define successful grappling-based athletes, while superior competitors in striking sports tend to show dominance in shorter-term measures when compared with their lower-level counterparts. Given the demand for both forms of combat in MMA, a spectrum of physiological markers may characterize higher-level competitors. Furthermore, the performance profile of successful MMA athletes may differ based on combat sport history or competition strategy.

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Limits of Evidence Based Medicine for rare diseases: The case of Budd-Chiari syndrome

Diffusion of the concepts of Evidence Based Medicine (EBM) as a rule for clinical field-practise has certainly had a positive and effective impact on the management of patients affected by different diseases. Moreover, EBM has long been a watershed between traditional medicine basically without rules, and a new approach to patients and diseases based only on evidence proven, so undeniably having an important social value. Through his own personal and deep thought, Pagliaro here outlines both the achievements and boundaries of EBM [1].

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Correlation of anemia status with worsening bowel damage as measured by Lémann Index in patients with Crohn's disease

There is evidence that anemia in Crohn's disease (CD) is a predictor of disease severity.

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Comorbidities in functional gastrointestinal diseases: Do we need a lone ranger or a dream team?

There are many papers dealing with the concept of a multidisciplinary approach to gastrointestinal (GI) diseases. A search on PUBMED in September 2015, by typing the words "multidisciplinary approach to gastrointestinal diseases", found about 1100 articles, with an increase in this topic in recent years [1] (Fig. 1).

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Promotion of knowledge, attitude and practice towards MERS-CoV among health care workers in Makkah Al-Mukaramh - an intervention study

2016-03-19T12-23-59Z
Source: International Journal of Medical Science and Public Health
Mohammed Asad Albouq, Mohammad Alkot, Mahmoud Adel Shakuri, Mohanna Saleh Subahi.
Background: Saudi Arabia (KSA) showed a higher number of Middle East respiratory syndromecoronavirus (MERS-CoV) infection in Eastern Mediterranean Region. Satisfactory knowledge, positive attitude, and healthful practice of health-care workers (HCWs) regarding MERS-CoV are a cornerstone in prevention of virus spread and disease outbreak. Objective: To assess and improve knowledge, attitude, and practice (KAP) of HCWs toward MERS-CoV. Materials and Methods: An interventional prospective study was conducted during the year 2015 on a randomly selected 398 HCWs in primary health-care centers of Makkah Al-Mukarramah, KSA. The participants were invited after their consent to fill a predesigned closed-ended Arabic-based questionnaire before and 3 months after exposure to a structured health education program. Result: The level of satisfactory knowledge, positive attitude, and good practice of studied HCWs significantly improved after exposure to the program, as it increased from 43.3%, 45%, and 57.4% before intervention to 67.9%, 63.8%, and 64.8% after intervention, respectively (P

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International challenge to predict the impact of radioxenon releases from medical isotope production on a comprehensive nuclear test ban treaty sampling station

Publication date: June 2016
Source:Journal of Environmental Radioactivity, Volume 157
Author(s): Paul W. Eslinger, Ted W. Bowyer, Pascal Achim, Tianfeng Chai, Benoit Deconninck, Katie Freeman, Sylvia Generoso, Philip Hayes, Verena Heidmann, Ian Hoffman, Yuichi Kijima, Monika Krysta, Alain Malo, Christian Maurer, Fantine Ngan, Peter Robins, J. Ole Ross, Olivier Saunier, Clemens Schlosser, Michael Schöppner, Brian T. Schrom, Petra Seibert, Ariel F. Stein, Kurt Ungar, Jing Yi
The International Monitoring System (IMS) is part of the verification regime for the Comprehensive Nuclear-Test-Ban-Treaty Organization (CTBTO). At entry-into-force, half of the 80 radionuclide stations will be able to measure concentrations of several radioactive xenon isotopes produced in nuclear explosions, and then the full network may be populated with xenon monitoring afterward. An understanding of natural and man-made radionuclide backgrounds can be used in accordance with the provisions of the treaty (such as event screening criteria in Annex 2 to the Protocol of the Treaty) for the effective implementation of the verification regime.Fission-based production of ⁹⁹Mo for medical purposes also generates nuisance radioxenon isotopes that are usually vented to the atmosphere. One of the ways to account for the effect emissions from medical isotope production has on radionuclide samples from the IMS is to use stack monitoring data, if they are available, and atmospheric transport modeling. Recently, individuals from seven nations participated in a challenge exercise that used atmospheric transport modeling to predict the time-history of ¹³³Xe concentration measurements at the IMS radionuclide station in Germany using stack monitoring data from a medical isotope production facility in Belgium. Participants received only stack monitoring data and used the atmospheric transport model and meteorological data of their choice.Some of the models predicted the highest measured concentrations quite well. A model comparison rank and ensemble analysis suggests that combining multiple models may provide more accurate predicted concentrations than any single model. None of the submissions based only on the stack monitoring data predicted the small measured concentrations very well. Modeling of sources by other nuclear facilities with smaller releases than medical isotope production facilities may be important in understanding how to discriminate those releases from releases from a nuclear explosion.



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Optimized measurement of radium-226 concentration in liquid samples with radon-222 emanation

Publication date: June 2016
Source:Journal of Environmental Radioactivity, Volume 157
Author(s): Frédéric Perrier, Jean Aupiais, Frédéric Girault, Tadeusz A. Przylibski, Hélène Bouquerel
Measuring radium-226 concentration in liquid samples using radon-222 emanation remains competitive with techniques such as liquid scintillation, alpha or mass spectrometry. Indeed, we show that high-precision can be obtained without air circulation, using an optimal air to liquid volume ratio and moderate heating. Cost-effective and efficient measurement of radon concentration is achieved by scintillation flasks and sufficiently long counting times for signal and background. More than 400 such measurements were performed, including 39 dilution experiments, a successful blind measurement of six reference test solutions, and more than 110 repeated measurements. Under optimal conditions, uncertainties reach 5% for an activity concentration of 100 mBq L⁻¹ and 10% for 10 mBq L⁻¹. While the theoretical detection limit predicted by Monte Carlo simulation is around 3 mBq L⁻¹, a conservative experimental estimate is rather 5 mBq L⁻¹, corresponding to 0.14 fg g⁻¹. The method was applied to 47 natural waters, 51 commercial waters, and 17 wine samples, illustrating that it could be an option for liquids that cannot be easily measured by other methods. Counting of scintillation flasks can be done in remote locations in absence of electricity supply, using a solar panel. Thus, this portable method, which has demonstrated sufficient accuracy for numerous natural liquids, could be useful in geological and environmental problems, with the additional benefit that it can be applied in isolated locations and in circumstances when samples cannot be transported.

Graphical abstract

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Rpb1 foot mutations demonstrate a major role of Rpb4 in mRNA stability during stress situations in yeast

Publication date: Available online 18 March 2016
Source:Biochimica et Biophysica Acta (BBA) - Gene Regulatory Mechanisms
Author(s): A.I. Garrido-Godino, M.C. García-López, J. García-Martínez, V. Pelechano, D.A. Medina, J.E. Pérez-Ortín, F. Navarro
The RPB1 mutants in the foot region of RNA polymerase II affect the assembly of the complex by altering the correct association of both Rpb6 and the Rpb4/7 dimer. Assembly defects alter both transcriptional activity as well as the amount of enzyme associated with genes. Here, we show that the global transcriptional analysis of foot mutants reveals the activation of an environmental stress response (ESR), which occurs at a permissive temperature under optimal growth conditions. Our data indicate that the ESR that occurs in foot mutants depends mostly on a global post-transcriptional regulation mechanism which, in turn, depends on Rpb4-mRNA imprinting. Under optimal growth conditions, we propose that Rpb4 serves as a key to globally modulate mRNA stability as well as to coordinate transcription and decay. Overall, our results imply that post-transcriptional regulation plays a major role in controlling the ESR at both the transcription and mRNA decay levels.



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Clinical Implications of Assisted Peak Cough Flow Measured with External Glottic Control Device for Tracheostomy Decannulation in the Patients with Neuromuscular Diseases and Cervical Spinal Cord Injuries: A Pilot Study

Publication date: Available online 19 March 2016
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Seong-Woong Kang, Won Ah Choi, Yu Hui Won, Jang-Woo Lee, Hoo Young Lee, Dong Jin Kim
ObjectiveTo investigate the clinical usefulness and significance of an external control device substituting glottic function in determining feasibility of decannulation in tracheostomized patients with neuromuscular diseases or cervical spinal cord injuries, whose assisted peak cough flows (APCFs) were unmeasurable or lower than 160L/min.DesignBefore-after trialSettingInpatient setting in a university hospitalParticipantsSixteen tracheostomized subjects, 11 with neuromuscular diseases and 5 with cervical spinal cord injuries were recruited.InterventionsUnassisted and assisted peak cough flows (PCFs) were measured with and without an external glottic control device. Among the patients whose APCFs without the device were lower than 160L/min, if their APCFs with the device were measured as 160L/min or higher, they were decannulated. After decannulation, unassisted and assisted PCFs were measured again.Main Outcome MeasuresAPCF with and without an external glottic control device, and APCF after decannulation.ResultsAfter successful decannulation, the APCFs were equal to or higher than those measured with the device before decannulation. No patients received intubation or re-tracheostomy, and there were no respiratory complications.ConclusionsThe external glottic control device substituting for innate glottic function is beneficial for determining tracheostomy decannulation. It provides an objective and accurate APCF. It is particularly helpful for patients whose APCFs are 160L/min or more while using the device, even if the APCFs are lower than 160L/min without it.



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Oral clonidine: a simple yet effective and safe premedicant for hemodynamic stability during laparoscopic surgery and a calm post-operative period

2016-03-19T02-07-09Z
Source: International Journal of Basic & Clinical Pharmacology
Ketaki Marodkar, Anjali Savargaonkar.
Background: Laparoscopy is the essence of modern surgery but the carbon dioxide pneumoperitoneum used therein significantly impairs patients cardiopulmonary function. Clonidine, by its central sympatholysis, reduces perioperative hemodynamic instability and also has multiple added advantages in post-operative period. Methods: In this prospective, randomized, double-blind, placebo-controlled study on 60 ASA I/II patients, clonidine 150 µg for weight 55 kg was administered per oral to 30 patients (clonidine group) 90 minutes before induction of general anaesthesia and intra-operative haemodynamics were monitored at specific time periods and compared with the placebo group patients (n=30) who received oral vitamin C. We also noted pre-operative anxiety score, post-operative sedation and pain scores and the presence of nausea-vomiting, shivering and dry mouth at the end of first and sixth postoperative hours. Results: Clonidine group patients remained haemodynamically stable throughout the intra-operative period. In clonidine group, less number of patients required fentanyl for tachycardia (1 vs 11) and NTG for hypertension (none vs 7). Similarly the pain and anxiety scores were significantly less in clonidine group patients. At the end of first postoperative hour incidence of pain, shivering and vomiting in placebo group was 33%, 36% and 20% respectively whereas in clonidine group incidence was 6%, 0 and 0. At the end of 6 post-operative hours, incidence of pain and vomiting was 73% and 36% in placebo group whereas it was 10% and 0 in clonidine group. Conclusions: Oral clonidine in the present dose is able to maintain stable intra-operative haemodynamics and achieve a calm post-operative period during laparoscopic surgeries in ASA I/II patients.


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