Current Innovations in Disease and Health Research Vol. 8

The purpose of this review is to investigate the prevalence and relationship between malnutrition, metabolic syndrome, obesity and hypertension and to provide more evidence justifying the management of cardio-metabolic problems in obese hypertensive individuals.

The prevalence of malnutrition among people living with obesity and hypertension signifies the coexistence of cardio-metabolic problems with 0besity and hypertension. Obesity can lead to a form of malnutrition characterized by excess body fat and excess or inadequate micronutrient intake. This nutritional paradox can exacerbate hypertension and increase the risk of cardiovascular disease. Factors contributing to this issue include poor dietary choices, limited access to nutritious foods, metabolic factors, and medications. Addressing malnutrition in obese hypertensive individuals is crucial for promoting their health and reducing complications, emphasizing the need for adequate diet, physical activity, and weight management.

Obesity is a growing public health problem and should be kept in mind when treating patients with hypertension because it is a strong predictor of uncontrolled hypertension. As obesity and its metabolic and vascular effects remained during the years, research has provided evidence justifying the management of metabolic components in obese individuals.

Obesity is a multi factorial pathology and chronic diet related non-communicable disease. The most widely used parameter for its diagnosis is the body mass index (BMI) which is not suitable for assessing the body fat and other metabolic components. Obesity specifically abdominal obesity is an independent risk factor for hypertension.

Anthropometrics like the waist circumference, waist to height ratio (WHtR), waist-hip ratio (WHR) and metabolic/biochemical components should be considered in the diagnosis of obesity.

Nutrition is pivotal in supporting the immune system. Immune homeostasis is indeed well-regulated by a balanced nutrition. It is key in the defense against viral threats. The world has been in a state of a pandemic for more than a year, humanity is suffering great losses. Millions of people have died, and countries have been in proper lockdowns to stay safe which has led to the greater economic and social loss. The virus that turned the world over is referred to as the sars COV 2 virus commonly known as the coronavirus. Aim of this review is to the aim of this study was to determine the mutation(s) in the sequence of the spike protein of the SARS-CoV-2 that might be favoring human to human transmission and to determine nutritional role.

The goal of this study is to translate the Sniffin' Sticks Olfactory Identification Test into Spanish and get normative values for the Spanish population, taking into account the characteristics of free recall and subjective odor intensity. 'Sniffin' Sticks' is a new test of nasal chemosensory performance based on pen-like odor dispensing devices. It comprises three tests of olfactory function, namely tests for odor threshold (n-butanol, testing by means of a single staircase), odor discrimination (16 pairs of odorants, triple forced choice) and odor identification (16 common odorants, multiple forced choice from four verbal items per test odorant). The influence of possible demographic covariates such as sex, age, smoking, or educational level are taken in consideration, and the items that best discriminate are studied. In addition, the internal structure validity of the blue and purple versions is studied as a parallel measure, and a cultural adaptation of the purple version is carried out and, three independent samples of normosmic healthy volunteers were studied.  To obtain normative values, the sample was of 417 participants (18–89 years). For the internal structure validity study of both versions, the sample was 226 (18–70 years), and for familiarity of the purple version, the sample was 75 participants (21–79 years). Results indicated that men and women and smokers and non-smokers perform equally. However, significant differences were found as age progresses, being more pronounced after 60 years old in all three measurements of the identification test. This study provides normative data of the scores that make up the validation of the Spanish version of the identification test are free recall, recognition and intensity. This research also provides the items that best discriminate in the blue version and a cultural adaptation for the purple version.  In summary, the Sniffin’ Sticks Odor Identification Test proves to be a fitting instrument for evaluating olfaction among the Spanish population. This tool has been enhanced with the incorporation of two additional scores, accompanied by normative data categorized by age. The parallel version of the test appears suitable for assessment, given the cultural adaptation of its items and the demonstrated internal structural validity for both versions.”

The assessment of olfactory function is increasingly pertinent, particularly in cases of cognitive decline, where olfactory changes might serve as early biomarkers. The Sniffin’ Sticks Olfactory Test, validated internationally, offers an objective measure of olfactory performance. Olfactory testing is comprised of three different components: olfactory threshold, odor discrimination, and odor identification. The Sniffin’ Sticks Olfactory Test is an optimal performance test that evaluates these three components of olfaction to generate a composite score resulting from the summation of threshold, discrimination, and identification. This study sought to validate the test in a Spanish cohort. The normative sample comprised 209 healthy normosmic volunteers (154 females, 55 males), aged 20 to 79 years (mean age = 50.11 ± 15.18 years). Additionally, 22 participants were retested for test-retest reliability, and odor familiarity in the olfactory identification test was explored in an independent healthy sample (n = 69), necessitating cultural adaptations. The findings revealed comparable performance between genders and smokers/non-smokers across all tests. However, significant intergroup differences emerged in scores across age brackets. Notably, olfactory function exhibited a progressive decline with age, with individuals over 60 years displaying the lowest scores. This comprehensive dataset, coupled with culturally tailored adjustments, enables the administration of the Sniffin’ Sticks Olfactory Test within the Spanish population. In summary, our study underscores the applicability of the Sniffin’ Sticks Olfactory Test in Spain. This tool's validation, coupled with insights into cultural nuances and normative data, provides a robust foundation for its implementation, facilitating accurate olfactory assessments in Spanish individuals across various age groups.

The goal of this research is to present evidence-based recommendations for enhancing the priority setting process in large hospitals.  Priority setting is a decision-making process that involves the allocation of resources. The disparity between available resources and public demand for health services, as well as the intrinsic complexity of healthcare organizations, make priority setting one of the most difficult health management concerns.  Nonetheless, the processes of prioritizing and policymaking at the hospital strategic planning level, i.e., the prioritization of clinical activities, have received little attention. As a result, a qualitative case study at the McGill University Health Centre (MUHC) was conducted.  A priority setting exercise is detailed in this paper, and the process is evaluated using an accountability for reasonableness paradigm. In-depth, one-on-one interviews with important participants, a review of significant documents, and on-the-ground observation were all used to collect data. To evaluate the priority setting process, this article compares it to the five requirements of accountability for reasonableness and identifies effective practices and areas for development.  The collected information gave decision-makers the ability to effectively evaluate clinical activities and to make good decisions. Moreover, the priority setting process was perceived equitable, and there was a general satisfaction from stakeholders with the way the exercise was performed.

This chapter aims to understand the perceptions that structure women's relationship with reproductive health services based on an influence matrix. Health is a complete state of general well-being, physical as well as mental and social, of the human person in everything that concerns the genital system, its functions and its functioning and not just the absence of disease or infirmity^[1]. According to this viewpoint, every person, regardless of origin or living environment, must have access to health care in accordance with the Alma-Ata Declaration on Primary Health Care issued in 1978. However, the current study demonstrates that reproductive health services in Côte d'Ivoire have been heavily criticized. On that basis, this paper examines the types of perceptions mobilized by women around reproductive health services in hospitals in Côte d'Ivoire. Data collection focused on observation, individual and group interviews. The results of the study indicate that several factors are determining in the accomplishment of tasks related to the prenatal consultation, in particular the love of the role of midwife and of the doctor is essential. However, despite the free policy advocated by the government, use of prenatal health services is low and even non-existent in some places due to the high cost of consultation fees, particularly for vulnerable populations. The poor reception, especially the insults from midwives, push women not to visit health centers. In the opinion of those interviewed “the majority of midwives are the opposite of the clothes they wear”. The inadequate behavior of certain health workers has caused people to have a negative outlook on production health services. The work describes the social resources that structure and legitimize women's relationship with reproductive health services as well as the modalities of recourse or not that this implies.

This chapter aims to explain Microbiota Diseases as a process that combines a number of ailments brought on by Intestinal dysbiosis and occurring in the devices and systems: Immunological, Gastrointestinal, Dermatological, Psychiatric, Neurological, and others. Microbiota describes the living microorganisms found in a defined environment, such as oral and gut microbiota.  This evaluation is released in an effort to highlight the necessity of fortifying the bonds of union between all parties with an interest in the topic, as well as the need to allocate resources more quickly and set development standards. Without any doubt, it will help this disease become accepted, so that it may be strengthened and help the millions of people affected by it.  

Background: One of the leading risk factor for absenteeism and loss of working capability is represented by work related musculoskeletal disorders (WMSD). Lifting heavy objects, working with the neck in a flexed position, are just some of the risk factors that can lead to WMSD, which can develop into chronic lumbar pain, hernias or other neck, shoulder, elbow, hand, wrist and back diseases. In regards to the Italian situation, in the last decade there has been a double increase in WMSD cases between 2005 and 2009 (7926 cases in 2005, 16593 in 2009). Evidence today, underlines the necessity to create and effective and sustainable health and safety organization to think global (all risks – work and individual, all fonts – organizational or individual) and act on a single or max two activities each year.  

Objective: Introduce a new strategy in promoting health and safety in the workplace starting with a border line risk. Describe, the experience of the Italian Umbra Group in introducing WHP philosophy and all the steps and outcomes aimed to avoid, prevent and treat musculoskeletal disorders (WMSD).

Methods: Re-organized and created the WHP group. Recruited 52 voluntary among workers reporting to be affected by low back pain and/or neck pain and/or Skeletal Muscle Disorders (DMS). Four validated questionnaires were used: anamnestic questionnaire, Neck Pain Questionnaire, Oswestry Low Back Pain Questionnaire, and Numeric Pain Intensity Scale. Based on the results the participated where divided in five small heterogeneous  groups. Two checkups and face to face counseling. For each participate was prepared a specific protocol of therapeutic exercises. Included a phase of direct observation, with the aim of identify incorrect behaviors, and an educational program aimed to modify or remove them. A second direct observation period was organized 6 months after to evaluate the effective change in habits.

Results: The main results for NRS back in T0 is 6.1± 3.2, in T1 it is 3.88 ± 2.9. The Oswestry Low Back Pain in T0 24.4 ± 17.8,in T1 it is 16.1 ± 7.2.Postural analysis using the Posture Score Sheet 57.3 ± 10.7 in T0 and in T1 of 63.7 ± 9.8.

Conclusions: The first experience by the WHP group was completed with success. From the decision making, to the therapeutic protocol as a result of the multidisciplinary table for health for a recognized "border" risk: WMSD was completed with satisfaction by the management and workers. The planning process had two main outcomes: Demonstrated that it is more convenient to program, then repair; that a participatory procedure guarantees participation, and gives the management the power to take the next step: free internal resources: introduce an internal gym and free courses for correct posture. The idea is to replay the same participatory process for other issues, in order to become, step by step, a Salutogenic workplace.

The purpose of this study is to determine the reasons for non-adherence to home physiotherapy in pediatrics. Physiotherapy aims to provide improvement in muscle strength and to increase the joint mobility which requires a significant amount of contributions from the patients for a period of time.  The success of an intervention is determined not only by the treatment but also by the rate at which the patients adhere to the advised and prescribed exercises. Adherence is the frequency with which the suggested exercises are completed. Non-adherence becomes the chief cause for the delay or failure in treatment in paediatrics long-term conditions. This observational study was conducted with convenient sampling carried out in Physiotherapy outpatient department. In this study, 30 children were chosen based on the selection criteria, and their parents were requested to fill out the questionnaire.  The biggest reason for non-adherence was a lack of time to complete the exercise (n=13; 43.33%). The second most prevalent reason given was because it interferes with their social life (n=9; 26.66%). According to the findings of this study, there are numerous reasons for non-adherence to home physiotherapy in pediatrics. The most common explanation given by parents is that there is not time to exercise and it interferes with their social life.

Iraq witnessed a new phenomenon, thousands of young demonstrates were flooding streets of Baghdad, chanting their poignant trademark slogan "Nureedwaten". In Iraq, a little research was focusing on mental health. No published data on mental health of protestors. A total of 460 protesters from Al-Tahrir square (center of Baghdad, Iraq) was included in this study. The collective action offers participants a place to reassess their perception. The changes might affect relationships, work-life, extended involvement, consumer behavior, radicalization / politicization, legitimacy, self- assessment / self-confidence, well-being, knowledge, level of activity …etc., which in turn affect positively mental health.

The aim of this chapter is to provide evidence-based recommendations for the SLE health care providers working with this cohort. This cross-sectional study evaluates 378 SLE patients to identify the psychosocial experiences and which ethnicities may be at risk for which psychosocial stressors. Depression and anxiety cause severe loss of quality of life for patients with systemic lupus erythematosus. The causes and factors that contribute to these psychological manifestations in lupus are difficult to disentangle.

In addition to sociodemographic variables, the instrument consisted of two scales: (A) the Systemic Lupus Erythematosus Needs Questionnaire (SLENQ) and the (B) Multidimensional Health Locus of Control Scale, as well as questions regarding the subjective perceptions of their SLE medication side effects.

The highest general cause of self-reported depressive and anxious feelings regarded: Over sixty percent (60.58%, n=228) of respondents indicated that their SLE was marked by a chronic set of symptoms. Another 16.23% (n= 61) had frequent flares while 19.13% (n=72) reported infrequent flares. Joint aches, fatigue and muscle pain were present for two-thirds or more of the respondents. Respondents reporting chronic symptoms or frequent flares had higher psychosocial needs as determined by their mean scores: depression 3.8 ±1.1, p = .000, anxiety 3.7 ± 1.1, p = .000 and SEC 3.3 ±1.2 (p = .043) as compared to those with infrequent flares.  Compared to patients of other ethnicities, African-American and Hispanic SLE patients reported a higher degree of unmet psychological needs as a result of their disease. The most likely adverse effects of the medications, and the most likely causes of the anxiety and despair associated with SLE, were weight increase and hair loss. The medical staffs who are caring for this group of people need to be aware of the possible psychological effects of SLE, including anxiety and sadness. To address the emotional effects of having SLE, health care practitioners should, if feasible, conduct thorough biopsychosocial screening and assessment, make referrals when necessary, and offer complete treatment. 

Introduction: Health issues during pregnancy have been associated with a decrease in the incidence of uncomplicated deliveries in expectant mothers. To address this concern, the World Health Organization advocates for supplementing pregnant women with essential nutrients such as folic acid, iron, and a range of micronutrients. This study, conducted at Semen Padang Hospital in Padang, aimed to evaluate the impact of Multiple Micronutrient (MMN) supplementation on the mode of delivery.

Methods: Employing a retrospective descriptive research design, data was collected from pregnant women who underwent prenatal care and delivered at Semen Padang Hospital between January and December 2021.

Results: The study encompassed 201 pregnant participants, with 73 experiencing normal vaginal deliveries and 128 undergoing cesarean sections. The statistical analysis yielded a p-value of 0.767 (p>0.05), signifying that the effectiveness of Iron and Folic Acid (IFA) supplementation did not significantly differ from that of MMN in promoting normal deliveries.

Discussion: This study contributes valuable insights into the realm of maternal healthcare, shedding light on the comparable effectiveness of IFA and MMN in influencing the mode of delivery. The findings underscore the importance of providing expectant mothers with appropriate micronutrient supplementation, which may potentially contribute to improved maternal and neonatal outcomes.

Conclusion: These results advocate for continued research and implementation of targeted nutrient interventions during pregnancy to enhance overall maternal health and well-being.