Comparative Management Methods for Adolescents With Polycystic Ovarian Syndrome: A Systemic Review.

Polycystic ovarian syndrome (PCOS) is a common endocrinological disorder affecting many adolescents and women of reproductive age worldwide. A diagnosis of PCOS in adolescence relies upon investigating each medical history independently and noting commonly associated symptoms, including obesity, insulin resistance, acne, menstrual abnormalities, and hirsutism. Many researchers are aiming to discover a methodology to help manage the symptoms associated with PCOS, especially in adolescents. This review will investigate management methods possible for adolescents with PCOS. Although the most preferred way to help reduce symptoms is through lifestyle modifications such as vigorous exercise and dietary regimens low in carbohydrates, pharmaceuticals are also offering promising results to adolescents with PCOS. Metformin, oral contraceptives, gonadotropin-releasing hormone (GnRH) antagonists, and other alternatives, including finasteride, eflornithine, fibroblast growth factors (FGFs), and vitamin D, are all shown to help improve insulin sensitivity and regulate menstrual cycles and reduce hirsutism. Epilatory and surgical measurements are also available; however, they are reserved for when all other methods fail and once adulthood or an appropriate age is reached. Although there are many pharmaceuticals available, it is necessary to evaluate each adolescent with PCOS uniquely and prescribe the appropriate pharmacotherapy regarding their symptoms.

Increasing the Awareness of Stroke Among Canadian Women.

Previous studies have shown that there is increased mortality of cerebrovascular diseases such as stroke among Canadian women. The morbidity of stroke is also higher among Canadian women because they are less likely to recover from stroke, and they generally tend to have a greater disability from a stroke when compared to men. In order to help minimize these issues, six interventional strategies were evaluated using four criteria: 1) the evidence-based criterion, 2) the socioeconomic-based criterion, 3) the ethics-based criterion, and 4) the sustainable-based criterion. Upon analysis, two alternative interventional strategies were recommended: increased public awareness of stroke symptoms and increased public awareness of stroke risk factors among Canadian women.

Improving Child Mental Health Policy in Canada.

Evergreen is Canada's first official national mental health framework for children that was developed by the Mental Health Commission of Canada in 2010. The program is primarily an online consultation service, which is a beneficial aspect since it provides widespread access for those seeking mental health services for children, especially those in rural and underserved areas. Despite the program's benefits and high ratings, Canada still lacks an adequate mental health framework for children because not all provinces and territories fulfilled the World Health Organization (WHO) criteria for child mental health, which shows that Evergreen has not been effective. As summarized in this review article, out of the 13 provinces and territories, the four provinces that met the minimum criteria for the WHO guidelines for child mental health policies were Ontario (ON), Alberta (AB), Saskatchewan (SK), and British Columbia (BC), with British Columbia being the leader in child mental health policies in Canada. For those that met the guideline, many performed poorly or failed to meet some of the WHO evaluation criteria for child mental health policies. For future progress, Canada should assess and evaluate its child mental health policies and incorporate that into a new and improved national standard and framework. Mental health data from Canada should also be analyzed to either implement an improved system or to fix old systems such as Evergreen that are currently in place. Finally, child mental health policy for Canada should constantly be reevaluated and improved to compensate for changes over time.

Knowledge, attitudes, and practices regarding rabies in Grenada.

OBJECTIVE: While Grenada attained a zero-human-rabies case status since 1970, the authors conducted the first study to assess knowledge, attitudes, and practices that may contribute to this status as well as to receive feedback on the rabies control program in Grenada. METHODOLOGY: A cross-sectional survey was conducted in July, 2017 with 996 households on the mainland. A questionnaire was administered to collect information on knowledge of rabies and prevention, vaccination practices, perception of institutional responsibilities for rabies control, and evaluation of the anti-rabies program. RESULTS: Of the 996 households, 617 (62%) had owners of animals that can be infected with rabies and were included in the analysis. Respondents were very aware of rabies as a disease that can infect animals and humans. The rate of participation in the vaccination program was 51.6% for pets and 38.0% for livestock. About 40% of respondents were knowledgeable about the extent of protection from the rabies vaccine. Respondents did not demonstrate exceptionally high levels of knowledge about animals that were likely to be infected with rabies, neither the anti-rabies programs that were conducted in Grenada. The three most frequent recommendations made to improve the rabies-control programs were: increase education programs, control the mongoose population, and expand the vaccination period each year. CONCLUSIONS: Conducting a comprehensive national rabies education program, expanding the vaccination program, and increasing the rate of animal vaccination are important steps that need to be taken to maintain the current zero-human-case status.

Prevalence and patterns of self-reported animal-related injury among veterinarians in metropolitan Kampala.

To establish the prevalence, patterns and risk factors of animal-related injuries among veterinarians, self-administered questionnaires were given to 60 veterinarians practicing in metropolitan Kampala. The prevalence of animal-related injuries in metropolitan Kampala was 72% (95%CI, 57~84). Some veterinarians (34%) suffered multiple injuries with a mean and median of 2.1 and 2.0 injuries per veterinarian, respectively. Of a total of 70 self-reported animal related injuries, cattle accounted for 72%, cats for 25%, dogs for 23%, self inoculation for 15% and birds for 13%. Injuries associated with poultry did not require hospital treatment. The upper limb was the most the frequently (68%) injured anatomical body part of veterinarians, and vaccination of animals (25%) was the major activity associated with injury. Animal-related injuries are common among practicing veterinarians in metropolitan Kampala; however, they did not differ significantly based on the veterinarian's gender, experience or risk awareness.

Cardiovascular disease event classification in the Jackson Heart Study: methods and procedures.

OBJECTIVE: The process of identifying, abstracting, and classifying cardiovascular disease (CVD) endpoints in the Jackson Heart Study (JHS) is described. METHOD: Trained interviewers conduct telephone annual followup interviews on or near the JHS exam 1 anniversary to ascertain any significant health events since the last JHS contact, including diagnostic tests, hospitalizations, or death. Information on cohort hospitalizations and deaths is transmitted to the medical record abstraction (MRA) unit who review death certificates and hospital records to identify CVD events in the cohort. Interviews with the next of kin and completed questionnaires by physicians and medical examiners or coroners are used to obtain information on deaths in the cohort. A computer-generated diagnosis with follow-up review and adjudication by trained medical personnel completes final, disease-specific event classification of hospitalized and fatal coronary heart disease (CHD), stroke, and congestive heart failure (CHF) events. DISCUSSION: Surveillance of this well-characterized group of African Americans for CVD events as well as sub- and preclinical manifestations of disease is a central aspect of the JHS. Particular focus is placed on the leading causes of CVD illness and death, including fatal and nonfatal CHD, stroke, and CHF.