Qualitative analysis of Amazon customer reviews of penile clamps for male urinary incontinence.

AIMS: Penile clamps offer an alternative to manage male urinary incontinence in patients who are unfit for surgery. Patient experience with penile clamps is poorly understood. Our study elucidates patient opinions on commercially available penile clamps and the factors that associate with favorable and unfavorable opinions. METHODS: We collected Amazon reviews of all penile clamps marketed for male urinary incontinence from November 2011 to January 2020 and qualitatively assessed the overall sentiment towards penile clamps, key praises and key complaints. Covariates such as designated Amazon star rating were further explored for association with coding patterns. RESULTS: Amazon reviews of penile clamps were found to be more positive (n = 425) in overall sentiment than negative (n = 294). The most frequent praise was effective incontinence control (n = 334) and the most frequent complaint was bad design or material (n = 166). The majority of reviews were for lower priced penile clamps, had higher Amazon star ratings, were written for Wiesner-produced clamps, and were written more recently (i.e., 2015-2020). Penile clamps with higher Amazon star ratings were more often coded positive and with a praise compared to lower rated penile clamps. CONCLUSIONS: Penile clamps are seen favorably by users as an effective treatment modality for male urinary incontinence. User reviews suggest opportunities for improvement in penile clamp design. The most frequently reviewed clamp seen positively is the Wiesner Incontinence Clamp Penile Clamp whereas the most frequently reviewed clamp seen negatively is the Pacey Cuff Male Incontinence Device.

Economic performance and cost-effectiveness of using a DEC-salt social enterprise for eliminating the major neglected tropical disease, lymphatic filariasis.

BACKGROUND: Salt fortified with the drug, diethylcarbamazine (DEC), and introduced into a competitive market has the potential to overcome the obstacles associated with tablet-based Lymphatic Filariasis (LF) elimination programs. Questions remain, however, regarding the economic viability, production capacity, and effectiveness of this strategy as a sustainable means to bring about LF elimination in resource poor settings. METHODOLOGY AND PRINCIPAL FINDINGS: We evaluated the performance and effectiveness of a novel social enterprise-based approach developed and tested in Léogâne, Haiti, as a strategy to sustainably and cost-efficiently distribute DEC-medicated salt into a competitive market at quantities sufficient to bring about the elimination of LF. We undertook a cost-revenue analysis to evaluate the production capability and financial feasibility of the developed DEC salt social enterprise, and a modeling study centered on applying a dynamic mathematical model localized to reflect local LF transmission dynamics to evaluate the cost-effectiveness of using this intervention versus standard annual Mass Drug Administration (MDA) for eliminating LF in Léogâne. We show that the salt enterprise because of its mixed product business strategy may have already reached the production capacity for delivering sufficient quantities of edible DEC-medicated salt to bring about LF transmission in the Léogâne study setting. Due to increasing revenues obtained from the sale of DEC salt over time, expansion of its delivery in the population, and greater cumulative impact on the survival of worms leading to shorter timelines to extinction, this strategy could also represent a significantly more cost-effective option than annual DEC tablet-based MDA for accomplishing LF elimination. SIGNIFICANCE: A social enterprise approach can offer an innovative market-based strategy by which edible salt fortified with DEC could be distributed to communities both on a financially sustainable basis and at sufficient quantity to eliminate LF. Deployment of similarly fashioned intervention strategies would improve current efforts to successfully accomplish the goal of LF elimination, particularly in difficult-to-control settings.

SOSAS Study in Rural India: Using Accredited Social Health Activists as Enumerators.

BACKGROUND: Global estimates show five billion people lack access to safe, quality, and timely surgical care. The wealthiest third of the world's population receives approximately 73.6% of the world's total surgical procedures while the poorest third receives only 3.5%. This pilot study aimed to assess the local burden of surgical disease in a rural region of India through the Surgeons OverSeas Assessment of Surgical Need (SOSAS) survey and the feasibility of using Accredited Social Health Activists (ASHAs) as enumerators. MATERIAL AND METHODS: Data were collected in June and July 2015 in Nanakpur, Haryana from 50 households with the support of Indian community health workers, known as ASHAs. The head of household provided demographic data; two household members provided personal surgical histories. Current surgical need was defined as a self-reported surgical problem present at the time of the interview, and unmet surgical need as a surgical problem in which the respondent did not access care. RESULTS: One hundred percent of selected households participated, totaling 93 individuals. Twenty-eight people (30.1%; 95% CI 21.0-40.5) indicated they had a current surgical need in the following body regions: 2 face, 1 chest/breast, 1 back, 3 abdomen, 4 groin/genitalia, and 17 extremities. Six individuals had an unmet surgical need (6.5%; 95% CI 2.45%-13.5%). CONCLUSIONS: This pilot study in Nanakpur is the first implementation of the SOSAS survey in India and suggests a significant burden of surgical disease. The feasibility of employing ASHAs to administer the survey is demonstrated, providing a potential use of the ASHA program for a future countrywide survey. These data are useful preliminary evidence that emphasize the need to further evaluate interventions for strengthening surgical systems in rural India.

COPD Guidelines: A Review of the 2018 GOLD Report.

Global Strategy for the Diagnosis, Management, and Prevention of COPD 2018 is a consensus report published periodically since 2001 by an international panel of health professionals from respiratory medicine, socioeconomics, public health, and education comprising the Global Initiative for Chronic Obstructive Lung Disease (GOLD). The GOLD documents endeavor to incorporate latest evidence and expert consensus and are intended for use as "strategy documents" for implementation of effective care for chronic obstructive lung disease (COPD) on a global level. The GOLD 2018 report defines COPD as a "common, preventable and treatable disease that is characterized by persistent respiratory symptoms and airflow limitation that is due to airway and/or alveolar abnormalities, usually caused by significant exposure to noxious particles or gases," with the criteria of "persistent respiratory symptoms" being a new and controversial inclusion since 2017. With the availability of newer pharmacotherapy options, treatment recommendations are made on the basis of a review of the latest literature and directed by symptom burden and health care utilization. Apart from the change in definition, a major shift in the recommendations is the exclusion of severity of airflow limitation as one of the major factors in guiding therapy. We review the salient features of the GOLD 2018 document and provide commentary on features that merit further discussion based on our clinical experience and practice as well as literature review current as of February 2018.

Proceso de trabajo y salud docente. Un abordaje socio-antropológico de las relaciones entre los riesgos organizacionales y psicosociales del trabajo en contextos de pobreza urbana de Rosario (Argentina) / Work process and teacher's health. A socio-anthropological approach to the relationship between the organizational and psychosocial workplace risk factors in the context of urban poverty in Rosario (Argentina)

El presente escrito aborda las relaciones entre el proceso de trabajo y los procesos de salud-enfermedad de docentes de Nivel Medio de la ciudad de Rosario (Argentina), en el contexto de las reformas educativas de la denominada posconvertibilidad. El objetivo específico de este artículo es analizar los riesgos organizacionales y psicosociales presentes en una escuela secundaria ubicada en un contexto barrial de creciente fragmentación, diferenciación socioeconómica y pobreza. El estudio se realiza a partir de un enfoque propio de la Antropología del Trabajo y retoma asimismo los aportes de la Medicina Social. En este sentido, entendemos los procesos productivos a partir de su condición sociohistórica y a los procesos de salud-enfermedad a estos asociados como expresión del conflicto entre capital y trabajo (Grimberg, 1991). Se privilegió el desarrollo del denominado enfoque etnográfico, el cual implicó optar por estrategias intensivas de construcción de la información, tales como la observación participante y las entrevistas semiestructuradas. A partir de un referente empírico acotado se identificaron riesgos psicosociales vinculados con la condición social de los alumnos y sus familias, los cuales forman parte de la dinámica escolar en el contexto específico. Asimismo, se profundizó la identificación y análisis de los riesgos organizacionales vinculados a las formas de contratación; tiempo de trabajo, salario y exigencias de capacitación. El enfoque propuesto que vincula analíticamente los riesgos psicosociales y organizacionales es plausible de ser retomado para abordar la relación trabajo-salud de docentes en otros contextos escolares similares(AU)

In this article, we analyze the relationships between the work process, psychosocial risk factors and the health-disease processes of secondary level school teachers in Rosario (Argentina), in the context of the so-called "postconvertibility educational reforms". The main objective was to analyze organizational and psychosocial risk factors, based on a case study of a school located in an urban area affected by increasing fragmentation, socioeconomic differentiation and poverty. We used an approach based on the anthropology of work, with some contributions from the field of social medicine. In this sense, we understand productive processes as based on their socio-historical condition, and the associated health-disease processes as the expression of the conflict between capital and work. We prioritized the implementation of the ethnographic approach, which led us to select intensive strategies to construct the information, such as participant observation and semi-structured surveys. Based on a limited empirical reference, we were able to identify psychological risks attached to the students and the social conditions of their family. These risks reflect the different dimensions of school dynamics within this general context. Moreover, we went further by identifying and analyzing the organizational risks connected to hiring, working time, wages and training demands. We consider that this approach, which connects psychological and the organizational risk factors, has been scarcely researched in studies in this area. Thus, it is plausible that it can be used to further investigate relationships between work and health among teachers in similar school contexts(AU)

Social and population health science approaches to understand the human microbiome.

The microbiome is now considered our 'second genome' with potentially comparable importance to the genome in determining human health. There is, however, a relatively limited understanding of the broader environmental factors, particularly social conditions, that shape variation in human microbial communities. Fulfilling the promise of microbiome research - particularly the microbiome's potential for modification - will require collaboration between biologists and social and population scientists. For life scientists, the plasticity and adaptiveness of the microbiome calls for an agenda to understand the sensitivity of the microbiome to broader social environments already known to be powerful predictors of morbidity and mortality. For social and population scientists, attention to the microbiome may help answer nagging questions about the underlying biological mechanisms that link social conditions to health. We outline key substantive and methodological advances that can be made if collaborations between social and population health scientists and life scientists are strategically pursued.

Pediatric Firearm-Related Injuries in the United States.

Pediatric firearm-related deaths and injuries are a national public health crisis. In this Special Review Article, we characterize the epidemiology of firearm-related injuries in the United States and discuss public health programs, the role of pediatricians, and legislative efforts to address this health crisis. Firearm-related injuries are leading causes of unintentional injury deaths in children and adolescents. Children are more likely to be victims of unintentional injuries, the majority of which occur in the home, and adolescents are more likely to suffer from intentional injuries due to either assault or suicide attempts. Guns are present in 18% to 64% of US households, with significant variability by geographic region. Almost 40% of parents erroneously believe their children are unaware of the storage location of household guns, and 22% of parents wrongly believe that their children have never handled household guns. Public health interventions to increase firearm safety have demonstrated varying results, but the most effective programs have provided free gun safety devices to families. Pediatricians should continue working to reduce gun violence by asking patients and their families about firearm access, encouraging safe storage, and supporting firearm-related injury prevention research. Pediatricians should also play a role in educating trainees about gun violence. From a legislative perspective, universal background checks have been shown to decrease firearm homicides across all ages, and child safety laws have been shown to decrease unintentional firearm deaths and suicide deaths in youth. A collective, data-driven public health approach is crucial to halt the epidemic of pediatric firearm-related injury.

[Social medical/public health assessment of the ability to work regarding urological and urooncological diseases]. / Sozialmedizinische Begutachtung der Arbeits- und Erwerbsfähigkeit bei urologischen/uroonkologischen Erkrankungen.

The primary objectives of modern urooncological treatment concepts are quality of life, reintegration and participation. Urological rehabilitation supports the overcoming of side effects of disease and treatment, which is necessary for the timely return to work life. Social medical assessment reflects the individual overall results of the entire treatment process concerning oncological prognosis, physical and mental capacity and resilience.

[Social medicine, public health and governance for health]. / Sociální lékarství, verejné zdravotnictví a rízení péce o zdraví.

Social medicine, public health and governance for health have a long tradition in the Czech Republic but some problems persist. Possible solutions are reliable information, research, education and training. Action plans for Health 2020 implementation are appreciated as well as a valuable help of the WHO Country Office, Czech Republic.Key words: social medicine, public health, health, health governance, governance for health, Health 2020, World Health Organization.

[Social medical/public health assessment of bladder cancer after curative and adjuvant therapy]. / Sozialmedizinische Begutachtung nach kurativer und adjuvanter Therapie des Harnblasenkarzinoms.

Radical cystectomy and urinary diversion are a challenge for patients. Requirements for the successful participation of the patient are sufficient urinary diversion management and recuperation/recovery as the result of urological rehabilitation. A social medical assessment reviews the individual oncological prognosis and the rehabilitation results to determine the return to work.

[Social medicine assessment of patients with prostate cancer]. / Sozialmedizinische Begutachtung bei Patienten mit Prostatakarzinom.

Due to the increasing incidence of prostate cancer in social-medicine-relevant age groups, a correct subject-specific evaluation of the professional capacity of these patients with all stages of disease is required. A concluding assessment is only significant when based on concrete functional deficits.

[Actual problems of social gerontology at the present stage of development of Russia].

The basic medico-demographic indices of aging population for Russia were identified in this article. Special attention was given to the examination of the demographic risks of a reduction in the population at the working ages, to an increase in the demographic load on the labor forces. The «Strategy for Action for the elderly persons until 2025¼, prepared by the Interdepartmental Working Group at the Ministry of Labour and Social Protection of the Russian Federation, was analyzed. The development and implementation of the professional longevity management system is one of the timely and comprehensive solutions to the problem of employment in the elderly. The need for further studies was proven, dedicated to the use of innovative gerontotechnologies in order to prevent the premature workability reduction, retarding of the aging processes, the level of mortality decrease and the professional longevity increase, especially in the elderly.

[Parkinson syndromes: aspects of social medical care]. / Parkinson-Syndrome: Aspekte der sozialmedizinischen Versorgung.

Parkinson syndromes (PS) represent frequent neurodegenerative disorders. The demographic change suggests an increasing prevalence of PS in the near future. Treatment expenses, early retirement and need of long-term care result in rising public health care expenditures. Standardised concepts of care do not only improve the quality of patient-centered care, but also help to minimize its consequential costs. Their implementation requires profound knowledge of therapeutic strategies and sociomedical regulations. Medical treatment and sociomedical care have to be regularly reevaluated and adapted to the patient's needs and disease severity. An optimal therapy concept guarantees the patient's long term social integration and improves the compliance.

[The social role of the faculties of medicine: physicians' perception of the dominant orientation of their medical studies and social involvement].

BACKGROUND: Medical education, based on the principles of social medicine, has the ability to contribute to reducing health disparities through the "creation" of doctors who are more involved in community programs. AIMS: To compare the social and community orientation of graduates from the various medical schools. METHODS: An online cross-sectional survey among 12,000 physicians who are graduates of Israeli medical schools was conducted in May 2011. RESULTS: The study encompassed 1,050 physicians, Israeli medical school graduates living in Israel and practicing medicine: 36% were Hebrew University graduates, 26% were Tel Aviv University graduates, 22% were Technion graduates and 16% were Ben-Gurion University (BGU) graduates. Higher rates of physicians who studied at the Technion and BGU are working or have worked in the periphery (approximately 50% vs. approximately 30% average of Hebrew and Tel-Aviv University schools). Among BGU graduates, 47% are active in community programs vs. 34-38% in other schools. Among physicians active in community programs, 32% of BGU alumni estimated that their medical education greatly influenced their community involvement vs. 8-15% in other schools. Hebrew University alumni graded their studies as having a higher research orientation. In contrast, BGU graduates graded their studies as having a higher social orientation, and had more positive attitudes on the role of the physician in reducing health disparities. DISCUSSION: Medical education with a social orientation will induce a socialization process that reinforces human values regarding the doctor-patient relationship and produce positive attitudes among future doctors regarding their social involvement. The findings emphasize the need to develop educational programs with a social orientation and to strengthen medical schools in the periphery.

Sanitary conditions of abattoirs in Ibadan, Southwest Nigeria.

BACKGROUND: The environment in the abattoir is of public health concern because of its implications on the quality of meat sold in the markets. The poor sanitary states of abattoirs have been reported in the literature. Very few studies have provided a comprehensive assessment of the sanitary conditions in the abattoir premises. This study sought to assess the compliance of abattoirs in Ibadan, Southwest Nigeria with standards set by Federal Ministry of Environment. METHODOLOGY: A descriptive cross-sectional study was conducted in Ibadan using an observational checklist adapted from Policy guidelines on market and abattoir sanitation by the Federal Ministry of Environment. Twelve (12) abattoirs in Ibadan metropolis were assessed. Data obtained were analyzed using descriptive statistics. RESULTS: Concerning general inspection, only one (8.3%) of the abattoirs had adequate access route, potable water supply and functional drainage system. Many had poor solid waste management practices as heaps of refuse littered the surroundings. Internal inspection of the abattoirs revealed that two (16.7%) had adequate space and facilities. Ten (83.3%) had first aid posts even though they were not equipped with materials. Eleven (91.7%) abattoirs had toilet facilities that were either poorly kept or abandoned. CONCLUSION: This study showed that most of the abattoirs in Ibadan metropolis were operating under unhygienic and sub-standard conditions and lacked basic requirements for a good abattoir as stipulated in the Policy Guidelines on Market and Abattoir Sanitation. There is an urgent need to enforce the minimum standards as stipulated in the policy guidelines.

Randomized trial of the Availability, Responsiveness and Continuity (ARC) organizational intervention for improving youth outcomes in community mental health programs.

OBJECTIVES: The primary objective of the study was to assess whether the Availability, Responsiveness and Continuity (ARC) organizational intervention improved youth outcomes in community based mental health programs. The second objective was to assess whether programs with more improved organizational social contexts following the 18-month ARC intervention had better youth outcomes than programs with less improved social contexts. METHOD: Eighteen community mental health programs that serve youth between the ages of 5 and 18 were randomly assigned to ARC or control conditions. Clinicians (n = 154) in the participating programs completed the Organizational Social Context (OSC) measure at baseline and following the 18-month ARC organizational intervention. Caregivers of 393 youth who were served by the 18 programs (9 in ARC and 9 in control) completed the Shortform Assessment for Children (SAC) once a month for six months beginning at intake. RESULTS: Hierarchical linear models (HLM) analyses indicated that youth outcomes were significantly better in the programs that completed the 18 month ARC intervention. HLM analyses also showed that youth outcomes were best in the programs with the most improved organizational social contexts following the 18 month ARC intervention. CONCLUSIONS: Youth outcomes in community mental health programs can be improved with the ARC organizational intervention and outcomes are best in programs that make the most improvements in organizational social context. The relationships linking ARC, organizational social context, and youth outcomes suggest that service improvement efforts will be more successful if those efforts include strategies to improve the organizational social contexts in which the services are embedded.