Issues and Development in Health Research Vol. 2

The re-occurring waves of COVID-19 pandemic has taken so many lives all over the world. Some country has managed it very well whereas some is still struggling to manage it. Along with medications, modification in lifestyle and proper diet may be the two powerful weapons to fight COVID-19 infection. Present paper highlights the management strategy to deal with the COVID-19 pandemic. This strategy is named as Preventive, Curative and Recovery (PCR) strategy which any individual can apply personally to stay safe during such a harsh situation. Preventive strategy includes the actions to be taken to keep the virus away from the internal environment of the body. Curative action begins when the body encounters infection. Recovery is the process of gaining the lost strength by the body. The paper attempts to develop a model for all the three together to be named as PCR Model.

For a long time the assumption has been that, although weight reduction was necessary and desirable, comorbidities were far more important and needed treatment even if weight loss was not a treatment goal, preferably with medication. This controversy leads to postponement of treatment, and later on causes too intensive medical treatment. Thus, raising the health care costs to unacceptable levels, leading to the medicalization of individuals and declining of the own responsibility of patients for their health, leaving it up to individuals when to regard their own weight as a problem that should be dealt with. The aim of this article was to produce evidence to support a shift of paradigm regarding the relationship between body weight and comorbidities. The central problem is insulin resistance which leads to a cascade of health problems. This condition should be diagnosed in primary practice and obesity clinics, to ensure a better tailor-made treatment for patients. Treatment should start at the earliest stage possible, when comorbidities are still reversible and includes a personalized dietary advice and counseling preferably by a dietitian to tackle insulin resistance. An exercise program is part of the treatment.

Background: Obesity is an exaggeration of everyday adiposity. Central weight problems in children has multiplied than standard adiposity now a days, which isn't robotically measured in medical practice. Adipose tissue contributes to the secretion of some of inflammatory cytokines which stimulate the manufacturing of high-touchy C-reactive protein (hs–CRP) via way of means of the liver. The take a look at changed into finished to look the affiliation of hs–CRP degree with crucial weight problems in Bangladeshi children.

Methods: A total of 110 obese children aged between 10 to 18 years with BMI \(\ge\) 95th centile and age and sex matched 55 non-obese children with BMI \(\ge\) 5th to < 85th centile according to Centers for Disease Control and Prevention (CDC) growth chart were selected. A structured questionnaire was prepared taking into account demographic and clinical parameters. The hs-CRP were estimated in study subjects and then correlated to central obesity by waist height ratio (WHtR).

Results: The prevalence central obesity was 45.5% by WHtR and raised hs-CRP levels was 46.4% in obese children. About 62% of obese children had central obesity who had raised hs-CRP level \(\ge\) 2 mg/L (high risk), which showed significant positive correlation with WHtR and was significantly raised in obese children.

Conclusions: A high proportion of central obesity was observed in obese children who had raised hs-CRP level, suggesting that it might be useful to assess future metabolic and cardiovascular complication.

Several studies have shown that life-style changes can help reduce the risk of diabetes. The purpose of this study was to assess the effects of native banana starch (NBS) on glycemic control and insulin resistance in comparison with metformin (MF) in non-diabetic obese women. Forty participants 20-45 years of age, HOMA- IR \(\ge\)2.5 were randomly assigned to two groups of 20 subjects each.  During an eight-week period, one group received NBS 30g/day and the other MF 850 mg/day. Fasting glycemia was reduced by either four weeks NBS or four weeks MF treat-ment (week 0 vs week 4, p<0.05). After NBS and MF treatments, fasting insulin and HOMA-IR values decreased gradually, reaching statistical significance after eight weeks (week 0 vs week 8, p<-0.05). The 30 and 60min insulin AUCs after eight weeks NBS supplementation tended to be lower in comparison to 30 and 60min insulin AUCs at baseline. There were no differences in HOMA-IR response between treatments after four or eight weeks. Data show that NBS supplementation has beneficial effects in reducing fasting glucose and insulin resistance in a group of obese women, and it may represent a low-cost and easily accessible alternative for preventing complications in the obese population.  

Taboos, traditional beliefs and practices can influence the health of the people. Pregnant and lactating women are the most affected by such taboos and cultural beliefs. This has a detrimental effect especially to their nutritional status. The purpose of this chapter is to describe taboos and traditional practices related to pregnancy and childbirth. There was no actual research done, but taboos and traditional practices were identified during rural placement of nursing students in rural health facilities. The results indicated that there are different taboos and traditional practices related to pregnancy and childbirth, some of them are beneficial and others are unfavorable to the health of the mother and the baby. There is a need for health care providers to strengthen health education on the importance of diet and also to educate mothers and community members on the taboos which have negative effect on the mother and babies.

The COVID-19 pandemic affecting planet Earth has had a peculiar development in our country. The objective of the research consisted in modeling by means of the methodology of the Regressive Objective Regression (ROR) a set of parameters (deaths, critical, severe, serious, confirmed and new cases) inherent to the SARS pandemic CoV-2 COVID-19, during the year 2020 in Cuba. The parameters analyzed were: deaths, severe, critical, confirmed and new cases in Santa Clara municipality, Villa Clara province and Cuba. The modeling used was Objective Regressive Regression (ORR), which is based on a combination of Dummy variables with ARIMA modeling. In the ROR methodology, dichotomic variables DS, DI and NoC are created in a first step, and then the module corresponding to the Regression analysis is executed, specifically the ENTER method where the predicted variable and the ERROR are obtained. Mathematical models were obtained by means of the ROR methodology which explain their behavior, depending on 6, 4, 10 and 14 days in advance depending on the variable to be studied, which made it possible to make long-term prognoses, allowing measures to be taken in the clinical services, thus avoiding and reducing the number of deaths and complications in patients with COVID-19. Although COVID-19 is a new disease in the world, it can be followed by means of mathematical ROR modeling, which allows to reduce the number of dead, severe and critical patients for a better management of the pandemic.

All over the world, many of the ART centers, especially those without experience perform Cleavage stage and not blastocyst transfers. Although it has been proved without doubt that Blastocyst transfer is better, the personal experience of failure after shifting to Blastocyst transfer has demotivated many from the shift. The aim of this article is to explain to the reader how we at the University hospital took evidence based decisions and improved our culture conditions while increasing our pregnancy rates. Although the outcome of an ART cycle depends on a multitude of clinical and laboratory factors, this study pursued to critically explore the various advantages and disadvantages of changing the protocol in a German lab to international standards where blastocyst culture is the norm. 1126 ART cycles were performed from 2014 to 2018 in the University Reproductive Medical Unit of UKSH, Kiel. There was an improvement in pregnancy rates from 2014 to 2018 in both cleavage stage transfer (day 3) and blastocyst transfer with a 1.4 time increase every year. Improvement in the lab culture conditions had profound effect in increasing pregnancy rates. The article aims at encouraging the reader to make decisions to improve lab blastocyst culture conditions before shifting to blastocyst culture to improve pregnancy rates and not blindly shift overnight to blastocyst for all.

Women experience various kinds of physical discomforts after childbirth. Abdominal afterpain is one among them, which is an indicator of uterine involution (the process by which reproductive organs revert back into the pre-pregnant state). Afterpain usually goes undetected because of the predominating nature of other forms of pain and discomforts. This chapter is based on an original study aimed to identify the nature and characteristics of afterpain among postnatal mothers. This chapter seeks to identify the factors affecting the afterpain, experience of mothers on the abdominal afterpain and the key strategies in the management of afterpain.

This article is about the therapeutic experience over a period of more than 10 years of a client convicted of murder (Infanticide). My client, for purposes of the article is referred to as “N”, then a young woman aged 19 when found guilty for the murder of her own infant^[1], approximately 3-months old at the time of the murder.  After a plea-bargain, she received a 15-year sentence of imprisonment of which 5 years was suspended for 5 years on condition she not be convicted of murder or any other offence of which violence is an element and for which she is sentenced to direct imprisonment committed in the period of suspension.  Provided here is information pertaining to N’s background, how her case relates to Infanticide, her behaviour during incarceration, the outcome of her incarceration, and her subsequent release back into society.

Objective: To determine if exists relationship between macronutrient intake and overweight/obesity in schoolchildren, from Celaya, Guanajuato, Mexico.

Methods: 225 school-aged children (6 to 13 years) were evaluated in Celaya, Guanajuato. Anthropometric measurements were performed and individual interviews with parents and children were conducted to collect information on the frequency of food consumption using a validated questionnaire (SNUT) from which the intake of macronutrients (carbohydrates, proteins, and fats) and fat subtypes. Chi squared statistic was computed, and its corresponding p-value, to identify the association of macronutrient intake with overweight/obesity in schoolchildren.

Results: There are not relationship between macronutrient intake (proteins, carbohydrates, and lipids) and overweight/obesity in this sample of schoolchildren from Celaya, Guanajuato. Macronutrients with obesity were: carbohydrates with obesity, X² = 3.47, P=.18; proteins X² = 3.36, P=.19; lipids (Z for two proportions) with P>.05.

Conclusion: It is possible that there are other strong factors in relationship with overweight/obesity, such as physical activity.

African Americans suffer depression for a longer period than their White counterparts. Often, African Americans are misdiagnosed and under-treated in the conventional healthcare system. Research studies reported the symptoms of depression among African Americans are inconsistent with the DSM-V. Previous Depression scales have not been culturally competent reflecting the depression symptoms of African Americans. This chapter address the treatment disparities in African Americans and the need for more culturally competent depression scales. The researcher developed a depression scale to reflect the racism and psychosocial factors contributing to depression in African Americans. African Americans are less likely to receive consistent quality care and evidence-based treatment guidelines (i.e., medication therapy or psychotherapy) and less frequently included in research studies. Tools for assessing depression need to be culturally sensitive. Also, healthcare professionals need to be aware of cultural factors when conducting assessments and obtaining a medical history and physical. When prescribing psychotropic medications, clients need adequate assessment and an accurate diagnosis to receive the appropriate medication. Also, clients need an accurate diagnosis when providing culturally competent therapy. If depression is adequately identified in African Americans, health providers will accurately diagnose depression and provide culturally competent treatment.

Non-small-cell lung cancer (NSCLC), a subtype of lung cancer, is one of the leading causes of cancer death in both men and women around the world. Circulating tumour DNA (ctDNA), tyrosine kinase inhibitors (TKIs), and immunotherapy have transformed our understanding of NSCLC and its treatment, from diagnosis to targeted NSCLC therapeutics. Quantifying ctDNA is convenient and precise, making clinical decisions easier. TKI-based targeted therapy and immunotherapy have also enhanced the quality of life of NSCLC patients. This article gives an update on ctDNA technologies and their implications for therapeutic options, including medications targeting the epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) with TKIs such as osimertinib and lorlatinib, the emergence of various resistance mechanisms, the control of programmed cell death-1 (PD- 1), programmed cell death ligand-1 (PD-L1), and cytotoxic T-lymphocyte antigen-4 (CTLA-4) by immune checkpoint inhibitors (ICIs) in immunotherapy and the blood tumor mutational burden (bTMB) calculated by ctDNA assay as a novel biomarker for immunotherapy.  NSCLC patients, on the other hand, nevertheless confront numerous hurdles.  To produce more effective medications or therapies to treat NSCLC, additional research and trials are needed.

Covid-19 has taken a huge toll on health care sector. Many health care workers(HCWs)  fall susceptible to this pandemic infection leading to occupational health hazard. It also has significantly changed the practice of dentistry. Importance of personal protective equipment cannot be enough stressed upon in present scenario due to uncertainity of vaccine availability and efficacy. Major role in protection of health care workers is played by face masks and respirators. Due to crisis in present scenario, there has been an acute shortage of masks though the production has been upregulated. Also due to increased production of masks, it has posed a significant “environmental” hazard. This review aims to summarize different types of masks available, their effectiveness and optimization of usage of masks to derive adequate protection thus preventing occupational health hazard with emphasis on eco-friendly masks for a better environmental safety. 

Coronavirus (COVID-19) pandemic has challenged the health system of various countries with developed technologies and those with little or no technology in medical laboratory services, Nigeria for example. The quest to curb the pandemic is paramount and the inclusion of medical laboratory component is germane toward bringing COVID-19 to a halt. The medical laboratory services has improved from 5 to 78 centers between February, 2020 and April, 2021 which is commendable. This chapter explored the laboratory services in Nigeria in relationship with the population using 2016 National Bureau of Statistics (NBS) population size and Nigeria center for disease control (NCDC) COVID-19 fact sheet of May 2, 2021. The analysis presents federal capital territory (FCT) Abuja as epicenter of COVID-19 and not Lagos as made popular by NCDC in consideration of population, number of testing and COVID-19 cases. The COVID-19 cases in Nigeria may be skewed to the proximity of medical laboratory services. The reality shows that less than 1% of the current population of Nigeria at May 2021, has been tested for COVID-19. Therefore, it is suggestive to expand the medical laboratory services to all local government areas in Nigeria starting with Cross River, Jigawa, Kano and Kogi states that are still lagging behind in their number of testing.

Background: Nursing student incivility has been explicitly described by research, with evidence that nursing students engage in uncivil behaviours on a routine basis. The role of nurse educators has grown to include not only creative classroom and clinical strategies but also strategies for the management of nursing student incivility. The rise in incivility among nursing students is causing great concern for nurse educators and administrators alike. Stress, like incivility, has been connected to the development of negative coping reactions and has an impact on an individual's view of an uncivil interaction.

Methods: A mixed-methods convergent parallel design was used to collect data from 39 nurse educators working at three nursing schools in the southern region of the United States. Creswell [1] described the design as “combining elements of both qualitative and quantitative approaches” (p. 3). The design's convergent method enabled the researcher to collect both quantitative and qualitative data, conduct separate analyses, and compare the results. The method supported the Transactional Model of Stress and Coping [2], which served as the study's foundation. A mixed-methods convergent parallel design was appropriate for this investigation. According to the paradigm, people make an initial assessment of the importance or threat of a stressful situation (e.g., challenging, positive, controllable, stressful, or irrelevant). If the encounter is perceived to be dangerous, a secondary appraisal will occur, activating an individual's coping mechanisms. The design enabled the researcher to identify the coping strategies used by nurse educators, when confronted with uncivil encounters with nursing students.

Setting: Three different nursing schools in the southern region of the United States served as the study's location.

Sample: The sample was a convenience sample of nurse educators employed at the schools of nursing at the selected universities in the southern United States. Selection criteria required participants to be a nurse educator employed by one of the designated universities' schools of nursing in the southern United States.

Procedure for Data Collection: Following receipt of Institutional Review Board approval from all of the selected institutions, a letter was drafted and sent to the deans of the nursing schools at the selected universities, requesting permission to collect data. Following approval from the three study schools, data collection on participants began. Participants were given electronic consent forms and told that completing the surveys meant they were participating voluntarily. Participants were given information about human informed consent and told that there would be no long-term physical effects and minimal (if any) long-term emotional or psychological effects from taking part in the study. When discussing their experiences with nursing student incivility, participants were told that they might experience some emotional distress. The Incivility in Nursing Education Survey-Revised (INE-R) [3], which consists of 24 items on student behaviours, used a Likert-type scale and four open-ended questions to collect data on perceptions of incivility. The participants were not asked for any demographic information. All of the responses were taken in an anonymous manner. The occurrence of themes was examined in the four open-ended questions of the INE-R [3] from the perspective of nurse educators. The themes were then classified into categories, which were then coded to demonstrate the relationship between nurse educators' perceptions of nursing student incivility and their chosen coping responses. Responses from participants were entered into an Excel spreadsheet, which was kept with the researcher and locked in a secure cabinet. Only the researcher had access to the cabinet. The Excel spreadsheet was kept on a password-protected flash drive which was only maintained by the researcher. The Ways of Coping Questionnaire (WCQ) [4] was also linked in the body of an email that was sent to the deans of the three selected universities? schools of nursing for completion by nursing faculty. The questionnaire link was distributed via secure Web-based technology (Survey Monkey). The WCQ [4] used a Likert-type scale to provide responses to 66 items. All responses were collected anonymously, and the information gathered from the respondents was entered into an Excel spreadsheet for compilation. The WCQ [4] data collection process was identical to that of the INE-R [3], and included collecting responses to the 66 items on the questionnaire. All of the responses were entered into an Excel spreadsheet, which was kept with the researcher and locked in a secure cabinet. Only the researcher maintained a key to the cabinet. The Excel spreadsheet was secured on a password protected flash drive maintained only by the researcher.

Results: The top three ways to deal with nursing student incivility were daydreaming, evaluating the topic to better comprehend it, and running or exercising. The most uncivil behaviours were considered to include making condescending remarks, discriminating statements, and cheating on exams.

Conclusions: A critical barrier in less problem-focused coping was identified among nurse educators confronted with incivility. Programs aimed at combating incivility should be revised to provide additional training and support for faculty, and steps should be taken to safeguard the integrity of the nursing profession.