The Impact of Cultural Factors, The Level of Health Education Received by the Caregivers, and Stigma on Asthma Treatment among Children in Southern Jordan

Abstract For asthma treatment in children, caregivers need good knowledge and attitudes regarding the disease and its treatment. This study aimed to determine the impact of cultural factors, the level of health education provided to patients and their families, as well as the impact of stigmatization on the treatment awareness of children with asthma in southern Jordan. A validated questionnaire was used to collect data from a sample of ninety-seven caregivers selected from three hospitals in southern Jordan. Open ended questions were answered after demonstrating the inhaler technique in and evaluated according to the instructions of the National Asthma Education and Prevention Program (NAEPP, 2013). The result revealed moderate knowledge of asthma with a mean score of (22.36/32), as well as moderate knowledge of asthma treatment (24.26/40). A high mean was found for the impact of cultural and environmental factors (22.93/28), whereas low impact was found for stigma with a mean value of (4.73/12). Therefore, to improve future asthma management, additional efforts are required to educate caregivers and improve their asthma awareness and rectify any falsehoods regarding asthma medications by health care providers.

Assessment of Knowledge Among the Physicians Regarding Dental Screening Prior to Chemotherapy and Radiotherapy

ABSTRACT Objective: To evaluate the physicians' knowledge regarding the referral for dental screening prior to chemotherapy and radiotherapy. Material and Methods: We conducted a cross-sectional study using simple random sampling among 468 physicians from various specialties with diverse experience levels from different regions in Saudi Arabia. A self-reporting questionnaire was distributed among the physicians, which consisted of questions assessing the physicians' knowledge about oral health and complications in patients prior to chemotherapy and radiotherapy. Statistical analysis was done after the data was collected employing SPSS, and p<0.05 was taken as significant. Results: Residents were more as expected (39.3%), followed by specialists (2.31%). The majority had a practice experience for more than five years (67.8%).The scores for the knowledge assessment showed that 51.3%, nearly half of the participants, had lower scores. The scores were statistically significant (p<0.05). Conclusion: General physicians and specialists should be aware of the dental complications and associated diseases in patients with malignancies and those undergoing chemo and radiotherapy. It is proposed that more awareness should be raised among physicians to rectify this lapse.

Caminho contra a dengue: relato de experiência de um projeto de extensão universitário / Path against dengue: experience report of a university extension project / El camino contra el dengue: informe de una experiencia de un proyecto de extensión universitaria

dengue é uma doença febril aguda com etiologia viral típica e de evolução benigna que é grave quando se apresenta na forma hemorrágica. Sua transmissão ocorre pela picada do Aedes aegypti, em um ciclo humano-Aedes aegypti-humano. Sendo assim, o cuidado e a prevenção contra a dengue é uma prática que deve ser sempre incentivada, especialmente em áreas de risco, além de buscar incluir a população como partícipes nas ações de prevenção contra essa arbovirose. O artigo trata-se de um relato de experiência cujo objetivo é descrever a experiência desenvolvida e vivenciada pelos acadêmicos do curso de graduação em Medicina da UniFipMoc-Afya durante o projeto de extensão "Caminho Contra a Dengue" que ocorreu em maio de 2022 no Parque Municipal Cândido Canelas, localizado no bairro Canelas, Montes Claros ­ MG. As ações realizadas tinham caráter socioeducativo, tendo como objetivo reconhecer e demarcar os determinantes da dengue dos bairros Canelas e Antônio Canelas, para se realizar uma sensibilização da comunidade local sobre as medidas preventivas contra a proliferação da doença e, dessa forma, contribuir para a integralização da saúde dos moradores. As estratégias empregadas trouxeram a reflexão, a problematização da pauta e a valorização de uma mudança de comportamento visando à diminuição da transmissão da dengue no bairro Antônio Canelas e no Canelas. Logo, esse conjunto de experiências proporcionou a possibilidade de promover um avanço no cuidado e na prevenção da dengue, colocando a própria comunidade como precursora e responsável pelos atos que irão fornecer uma promoção da saúde e melhorias em suas vidas.

Dengue is an acute febrile illness with a typical viral etiology and a benign course that is severe when it presents in the hemorrhagic form. Its transmission occurs through the bite of Aedes aegypti, in a human-Aedes aegypti-human cycle. Therefore, care and prevention against dengue is a practice that should always be encouraged, especially in risk areas, in addition to seeking to include the population as participants in prevention actions against this arbovirus. The article is an experience report whose objective is to describe the experience developed and lived by the academics of the undergraduate course in Medicine at UniFipMoc-Afya during the extension project "Caminho Contra a Dengue" that took place in May 2022 at Parque Municipal Cândido Canelas, located in the Canelas neighborhood, Montes Claros - MG. The actions carried out had a socio-educational character, with the objective of recognizing and demarcating the determinants of dengue in the Canelas and Antônio Canelas neighborhoods, in order to raise the awareness of the local community about preventive measures against the proliferation of the disease and, in this way, contribute to the integralization of the population. residents' health. The strategies used and employed brought reflection, problematization of the agenda and the appreciation of a change in behavior aimed at reducing dengue transmission in the Antônio Canelas and Canelas neighborhoods. Therefore, this set of experiences provided the possibility of promoting progress in the care and prevention of dengue, placing the community itself as a precursor and responsible for the acts that will provide health promotion and improvements in their lives.

El dengue es una enfermedad febril aguda de etiología vírica típica y evolución benigna que es grave cuando se presenta en forma hemorrágica. Su transmisión se produce por la picadura de Aedes aegypti, en un ciclo humano-Aedes aegypti-humano. Así, el cuidado y la prevención contra el dengue es una práctica que siempre debe ser incentivada, especialmente en las zonas de riesgo, y buscar incluir a la población como partícipe de las acciones preventivas contra esta arbovirosis. El artículo es un relato de experiencia cuyo objetivo es describir la experiencia desarrollada y vivida por estudiantes de pregrado de medicina de la UniFipMoc-Afya durante el proyecto de extensión "Camino Contra el Dengue", que tuvo lugar en mayo de 2022 en el Parque Municipal Cândido Canelas, ubicado en Canelas, Montes Claros - MG. Las acciones realizadas tuvieron un carácter socioeducativo, con el objetivo de reconocer y demarcar los determinantes del dengue en los barrios Canelas y Antônio Canelas, a fin de sensibilizar a la comunidad local sobre las medidas preventivas contra la proliferación de la enfermedad y contribuir así a la integralización de la salud de los residentes. Las estrategias empleadas propiciaron la reflexión, la problematización del tema y la valorización de un cambio de comportamiento dirigido a reducir la transmisión del dengue en los barrios Antônio Canelas y Canelas. Así, este conjunto de experiencias proporcionó la posibilidad de promover un avance en la atención y prevención del dengue, colocando a la propia comunidad como precursora y responsable de actos que proporcionarán una promoción de la salud y mejoras en sus vidas.

AVAILABILITY AND STORAGE OF HAZARDOUS PRODUCTS IN HOUSEHOLDS IN THE METROPOLITAN REGION OF MANAUS: A POPULATION-BASED SURVEY, 2015.

OBJECTIVE: The availability of hazardous products in households increases the risks of poisoning. The present study aimed to assess the frequency and associated factors of the availability and storage of hazardous products in residences in the metropolitan region of Manaus. METHODS: Population-based and cross-sectional study conducted in 2015 with adults selected with three-stage probabilistic sampling. Participants were interviewed face-to-face. Prevalence ratio (PR) of the presence of hazardous products (presence of chumbinho [illegal anti-cholinesterase rodenticide], artisanal cleaning products, and unsafe storage of these products and medications) and 95% confidence intervals (95%CI) were calculated with Poisson regression with robust variance, weighted by the complex sampling method adopted. RESULTS: A total of 4,001 participants was included, of which 53.0% (95%CI 51.5-54.6) reported presence of hazardous products in their households, 36.3% (95%CI 34.8-37.8) had unsafe storage, 16.2% (95%CI 15.1-17.4) had artisanal cleaning products, and 8.2% (95%CI 7.4-9.1) had chumbinho. Households with children ≤5 years old had safer storage (PR=0.78; 95%CI 0.71-0.86) and more artisanal products (PR=1.30; 95%CI 1.11-1.51). Presence of artisanal products was higher in lower educational levels (PR=2.20; 95%CI 1.36-3.57) and lower economic classifications (PR=1.63; 95%CI 1.25-2.13). CONCLUSIONS: Over half of the households in the metropolitan region of Manaus kept hazardous products; one-third stored them unsafely. Artisanal cleaning products and chumbinho were frequently present. Households with children had safer storage of products, and socioeconomic factors affected the availability of such hazardous products.

LI-RADS in the year 2020 - Are you already using it or still considering? / LI-RADS im Jahr 2020 ­ Nutzt du es schon oder überlegst du noch?

PURPOSE: The working group for gastrointestinal and abdominal imaging within the German Radiological Society performed a nationwide online survey in order to assess the current status regarding the awareness and application of LI-RADS, a classification for evaluation of liver lesions in patients at risk. MATERIALS AND METHODS: Using the website www.deutsches-krankenhausverzeichnis.de a list of hospitals was generated meeting the criteria internal medicine, gastroenterology, general and visceral surgery and radiology (n = 391). Randomly, 102 department directors were contacted, and asked to name one consultant and one resident from their department in order to participate in the survey. 177 potential participants were invited to fill out an approximately 10-minute online survey in the form of 17 questions regarding the awareness and application of LI-RADS. The results of the survey were analyzed by means of descriptive statistics. RESULTS: 77 participants were registered, which corresponds to a response rate of 43.5 %. 47 % of all participants were radiologists, 30 % surgeons and 23 % internal doctors/gastroenterologists, respectively, many with more than 13 years of professional experience (37.2 %). The majority of participants worked in a hospital with a focus (37.2 %) or a university hospital (29.1 %). Even though the majority of participants knows about or has heard of LI-RADS (73.2 %), only a minority uses the classification themselves (26 %) or within the context of tumor boards (19.2 %). CONCLUSION: The results of our survey demonstrate that LI-RADS is relatively known in Germany, the application however quite sparse. This is in contrast to the general desire and endeavor for more standardized reporting in radiology. KEY POINTS: · LI-RADS is not yet broadly implemented in clinical routine in Germany. · The sparse application is in contrast to the general desire for more standardized reporting in radiology. · Interdisciplinary education may support the propagation and use of the LI-RDAS classification. CITATION FORMAT: · Ringe KI, Gut A, Grenacher L et al. LI-RADS in the year 2020 - Are you already using it or still considering? Fortschr Röntgenstr 2021; 193: 186 - 193.

Availability and storage of hazardous products in households in the metropolitan region of manaus: a population-based survey, 2015 / Disponibilidade e armazenamento de produtos perigosos em domicílios da região metropolitana de manaus: estudo de base populacional, 2015

ABSTRACT Objective: The availability of hazardous products in households increases the risks of poisoning. The present study aimed to assess the frequency and associated factors of the availability and storage of hazardous products in residences in the metropolitan region of Manaus. Methods: Population-based and cross-sectional study conducted in 2015 with adults selected with three-stage probabilistic sampling. Participants were interviewed face-to-face. Prevalence ratio (PR) of the presence of hazardous products (presence of chumbinho [illegal anti-cholinesterase rodenticide], artisanal cleaning products, and unsafe storage of these products and medications) and 95% confidence intervals (95%CI) were calculated with Poisson regression with robust variance, weighted by the complex sampling method adopted. Results: A total of 4,001 participants was included, of which 53.0% (95%CI 51.5-54.6) reported presence of hazardous products in their households, 36.3% (95%CI 34.8-37.8) had unsafe storage, 16.2% (95%CI 15.1-17.4) had artisanal cleaning products, and 8.2% (95%CI 7.4-9.1) had chumbinho. Households with children ≤5 years old had safer storage (PR=0.78; 95%CI 0.71-0.86) and more artisanal products (PR=1.30; 95%CI 1.11-1.51). Presence of artisanal products was higher in lower educational levels (PR=2.20; 95%CI 1.36-3.57) and lower economic classifications (PR=1.63; 95%CI 1.25-2.13). Conclusions: Over half of the households in the metropolitan region of Manaus kept hazardous products; one-third stored them unsafely. Artisanal cleaning products and chumbinho were frequently present. Households with children had safer storage of products, and socioeconomic factors affected the availability of such hazardous products.

RESUMO Objetivo: A disponibilidade de produtos perigosos em domicílios aumenta os riscos de intoxicações. Este estudo objetivou avaliar a frequência e os fatores associados à disponibilidade e armazenamento de produtos perigosos em residências da Região Metropolitana de Manaus. Métodos: Estudo transversal de base populacional realizado em 2015 com adultos selecionados por amostragem probabilística em três estágios. Os participantes foram entrevistados pessoalmente. A razão de prevalência (RP) da presença de produtos perigosos (presença de chumbinho [rodenticida anticolinesterase ilegal], produtos de limpeza artesanais e armazenamento inseguro desses produtos e de medicamentos) e intervalos de confiança de 95% (IC95%) foram calculados por regressão de Poisson com variância robusta, ponderada pela amostragem complexa adotada. Resultados: 4.001 participantes foram incluídos, dos quais 53,0% (IC95% 51,5-54,6) reportaram a presença de produtos perigosos em seus domicílios, 36,3% (IC95% 34,8-37,8) apresentaram armazenamento inseguro, 16,2% (IC95% 15,1-17,4) possuíam produtos de limpeza artesanais e 8,2% (IC95% 7,4-9,1) possuíam chumbinho. Os domicílios com crianças menores de 5 anos apresentaram armazenamento mais seguro (RP=0,78; IC95% 0,71-0,86) e mais produtos artesanais (RP=1,30; IC95% 1,11-1,51). Presença de produtos artesanais foi maior em menores níveis de escolaridade (RP=2,20; IC95% 1,36-3,57) e menores classificações econômicas (RP=1,63; IC95% 1,25-2,13). Conclusões: Mais da metade dos domicílios da Região Metropolitana de Manaus possuía produtos perigosos; um terço os armazenava sem segurança. Produtos de limpeza artesanais e chumbinho estavam frequentemente presentes. Os domicílios com crianças apresentaram armazenamento mais seguro de produtos e fatores socioeconômicos afetaram a disponibilidade de tais produtos perigosos.

A South African perspective on community psychology practice competencies.

The appropriateness of the paradigm underlying competency frameworks and their specific application in the list of definitions developed by a Task Group of Society for Community Research and Action (SCRA) for US community psychologists need further consideration. This paper considers the technicist and behavioural roots of some of these concepts, illustrating tensions when applying them to community psychology. It then proposes a competency perspective from the global South. Drawing from focus group discussions with, and written reflections from, postgraduate Master's students in training as clinical and counselling psychologists, this paper builds inductively from the recorded data. Following a template analysis of the material, four integrating themes were evident. The distinctive nature of community psychology is highlighted through the themes: relational foundations, activity evolution, self-management and the awareness and influences of processes. Proposals for an alternative framework ("RASP") are based on its emergence from the applications of learning to practice, emphasising community-based principles. The importance of reflection as the basis for the learning is highlighted. The imperatives to foreground social justice and to enable reflexive thinking on action are discussed, along with concepts based on Humanist and Social Constructivist paradigms, to lead to more interactive and inclusive processes in work on competencies.

E-cigarette, or Vaping, Product Use-Associated Lung Injury-Lessons Learned: A Case Series.

E-cigarette, or vaping, product use has been declared an epidemic, and a new disease has emerged from their use. We describe 4 patients with significant acute lung injury related to e-cigarette use who underwent bronchoscopy and bronchoalveolar lavage. All cases posed anesthetic challenges, including increased airway reactivity, hypoxia, increasing oxygen requirements, and, in 2 severe cases, the need for continued postprocedural mechanical ventilatory support. It is imperative that all members of the treating team are aware of the disproportionate risk of respiratory complications to anticipate the possible need for increased postprocedural respiratory support.

Subcutaneous desmoplastic small round-cell tumor: An unusual primary location expanding the differential of superficial round-cell tumors.

Desmoplastic small round-cell tumor (DSRCT) is a rare, aggressive malignant tumor, which in the great majority of cases arises at abdominal-pelvic sites. Nevertheless, rare cases of primary extra-abdominal tumors have been reported. In challenging cases, its molecular hallmark, the EWSR1-WT1 reciprocal translocation, can be exploited diagnostically by various molecular techniques. Herein, we report an extremely rare case of primary subcutaneous DSRCT in an effort to raise awareness among our dermatopathology colleagues by expanding the differential of superficial round-cell tumors.

Are There Islands of Awareness?

Ordinary human experience is embedded in a web of causal relations that link the brain to the body and the wider environment. However, there might be conditions in which brain activity supports consciousness even when that activity is fully causally isolated from the body and its environment. Such cases would involve what we call islands of awareness: conscious states that are neither shaped by sensory input nor able to be expressed by motor output. This Opinion paper considers conditions in which such islands might occur, including ex cranio brains, hemispherotomy, and in cerebral organoids. We examine possible methods for detecting islands of awareness, and consider their implications for ethics and for the nature of consciousness.

Assessment of the compliance with minimum acceptable technical parameters proposed by PI-RADS v2 guidelines in multiparametric prostate MRI acquisition in tertiary referral hospitals in the Republic of Turkey.

PURPOSE: Although the clinical use of multiparametric prostate magnetic resonance imaging (mpMRI) is increasing, the adherence to parameters for mpMRI, which had been described in the Prostate Imaging-Reporting and Data System version 2 (PI-RADS v2) for an optimum image acquisition is unknown. In this paper, we aimed to determine the compliance with the minimum acceptable technical parameters for prostate mpMRI defined by PI-RADS v2 in tertiary care centers in Turkey. METHODS: We sent a survey to all radiology departments of tertiary referral hospitals in Turkey (n=120) to evaluate their adherence to PI-RADS v2 technical specifications. Statistical analysis was performed using chi-square, Fisher exact, ANOVA, and the Student t tests. The cutoff values for image acquisition times were also determined with receiver operating characteristics (ROC) analysis. P values <0.05 were considered statistically significant. RESULTS: One hundred and eleven clinics responded to our survey (response rate, 92.5%). Prostate MRI was reported to be performed in 61 centers, of which 26 (42.6%) used 3 T (Tesla) scanner while 35 (57.4%) used 1.5 T. The adherence to slice thickness, in-plane phase and frequency resolutions on T2-weighted imaging were 68.9%, 41%, and 9.8%, respectively. The adherence to the same parameters on diffusion-weighted imaging (DWI) were higher compared with T2-weighted imaging (85.2%, 62.3%, and 78.7%, respectively). In comparative analysis, the adherence to slice thickness, field of view (FOV) and in-plane phase resolution on T2-weighted imaging were higher for 3 T compared with 1.5 T scanners (P = 0.004, P = 0.041, and P = 0.001, respectively). T2-weighted imaging acquisition time was significantly longer for the centers that adhered to FOV (P = 0.034) and in-plane T2-weighted imaging phase resolution (P = 0.028). The DWI scan time was significantly longer when they adhered to DWI-FOV (P = 0.014) and b value ≥1400 s/mm2 (P = 0.008). The calculated cutoff of scan times were 220 s in T2-weighted imaging and 312 s in DWI to ensure the compliance with voxel sizes and b value criteria. CONCLUSION: The tertiary referral centers in Turkey did not meet majority of the technical specifications of PI-RADS v2 during prostate MRI acquisition. Awareness to the minimum acceptable technical parameters of mpMRI should be increased to potentially improve the quality of prostate cancer imaging.

Ethical Awareness Scale: Replication Testing, Invariance Analysis, and Implications.

Background: Ethical awareness (EA) enables nurses to recognize the ethical implications of all practice actions and is an important component of safe and quality nursing care. Evidence suggests that nurses may sometimes feel underprepared to recognize and address ethical issues as they arise in practice. The Ethical Awareness Scale (EAS) presented strong evidence as a psychometrically sound measure of EA in critical care nurses in pilot testing. The present study extends earlier work by (a) expanding the sample, (b) replicating the psychometric analyses, (c) more deeply investigating data-to-model fit, and (d) providing guidelines for the interpretation of EAS scores and subsequent practice-focused and educational interventions. Methods: This study utilized two sets of cross-sectional EAS survey results with ICU nurse respondents from two hospitals in New England. Invariance testing using simple OLS regression was conducted between the item estimates of both samples. The final Rasch analysis utilized a rating scale model. Finally, a score interpretation framework was developed. Results: 240 participants were included in the combined analysis. Nurses were predominantly female (93.1%), aged 25-35 (39.9%), and Bachelor's degree prepared (73.4%). Mean levels of EA were in the low/moderate range (M = 36.2/54). Cronbach's alpha of 0.86 was achieved. The Rasch analysis demonstrated a variable map structure consistent with the hypothesized item order, scoring categories that were sufficiently used by respondents, and adequate model-data fit. Conclusions: This study demonstrates that the EAS is a psychometrically sound and meaningful measure of EA in critical care nurses with item difficulty estimates that are invariant across samples. A raw score on the EAS can be practically interpreted, given the theoretical description of what a nurse at each level of the scale's continuum may "look" like in terms of EA using the diagnostic interpretation table. These findings have implications for nursing education and practice.

Updated hypertension prevalence, awareness, and control rates based on the 2017ACC/AHA high blood pressure guideline.

In 2017, the American College of Cardiology/American Heart Association (ACC/AHA) updated the Guideline of Prevention, Detection, Evaluation and Management and Management of High Blood Pressure (HBP) in Adults. The purpose of the current study was to evaluate the potential impact of the 2017ACC/AHA HBP guideline on hypertension prevalence, awareness, and control rates. The data were collected from Physical Examination Center of the Second Hospital of Hebei Medical University from January 2012 to December 2017 (N = 66 977), including demographic information and risk factors of hypertension. The hypertension prevalence, awareness, and control rates of people were evaluated according to the new guideline. Additionally, the factors related to hypertension prevalence were also assessed. According to previous HBP guideline, hypertension prevalence, awareness, and control rate were 30.54%, 44.33%, and 13.04%, respectively. However, when the 2017 ACC/AHA HBP guideline was introduced, the population with hypertension increased from 20 453 to 34 460, the hypertension prevalence rate increased from 30.54% to 51.45%, the awareness rate decreased from 44.33% to 26.31%, and the control rate declined from 13.04% to 2.72%. The most newly diagnosed hypertension patients were from the low-risk population with young age and without the above histories. The 2017ACC/AHA HBP guideline indicated that high hypertension prevalence rate still existed with a substantial increase, while the awareness and control rates were relatively lowered.

Hepatitis B care pathway in Saudi Arabia: Current situation, gaps and actions.

Hepatitis B virus (HBV) infection remains a public health problem worldwide. In this review, we aim to assess the current situation of the HBV care pathway in the Kingdom of Saudi Arabia (KSA), identify gaps/barriers therein, and recommend initiatives to be taken to improve the management of such patients. Towards this end, a literature search was conducted in PubMed and free Internet searches. Interviews with individuals and focus group discussions were held with HBV experts in KSA. Although significant improvements have been made in the past 30 years in KSA in terms of the decline in prevalence (currently estimated to be around 1.3%), the morbidity and mortality related to the disease have not shown a parallel decline. This makes HBV an important public health concern. Furthermore, poor disease awareness, low diagnosis rates, and nonadherence to therapy amplify the disease burden. There are several mandated national screening structures present; however, established protocols for those who test positive and subsequent linkage-to-care are inadequate. In the absence of a virologic cure, a concerted effort should be made to provide safe and effective lifelong treatment. This review provides recommendations to reduce the HBV disease burden in the Saudi population.

The importance of non-technical skills in modern surgical practice. / Importancia de las habilidades no técnicas en la práctica quirúrgica actual.

The significance of technical skills and manual dexterity for surgeons is an indisputable fact. However, the systematic study of medical errors has revealed that a significant percentage of these errors are caused by factors related to non-technical skills. The review presented in this article intends to describe and explore the relevance of these non-technical skills, including: situational awareness, decision-making, leadership and communication. In conclusion, the authors propose that adequate importance needs to be given to these aptitudes to provide safe clinical care.