Mohammad Hossein Imani, Amir Hossein Imani, Amirhossein Saem
et al.
Abstract Background Falls are a leading cause of injury, hospitalization, and mortality among older adults. Sedative-hypnotic medications, especially benzodiazepines and Z-drugs, have been implicated as potential contributors to fall risk and fracture. This study investigated the prevalence of sedative-hypnotic drug use in elderly patients with falls and its association with fracture outcomes. Methods A cross-sectional study was conducted on 200 patients aged ≥ 60 years presenting with falls to Rasool Akram Hospital, Tehran (2023–2024). Demographics, comorbidities, and medication history were extracted from medical records. Sedative-hypnotic use was recorded, and outcomes included fracture occurrence confirmed by imaging. Statistical analyses included chi-square tests and multivariate logistic regression. Results Among 200 patients (mean age 73 ± 8 years; 65.5% female), 55.5% sustained a fracture. Sedative-hypnotic use was identified in 15.5% (n = 31). Fracture prevalence was higher in sedative users compared to non-users (74% vs. 52%), but the difference was not statistically significant (p = 0.08). Benzodiazepines were the most commonly used class (15.5%). Losartan use was more frequent in fracture patients (29.7% vs. 12.4%) and showed a significant association in logistic regression (OR 3.28; 95% CI: 1.48–7.26; p = 0.003). Conclusions Sedative-hypnotic use was common among elderly patients presenting with falls; although fracture risk was higher in users, the association did not reach statistical significance, likely due to limited sample size. The observed link between losartan and fractures should be interpreted cautiously and warrants further investigation. Medication review remains a critical component of fall-prevention strategies in geriatric care.
Guillaume Barbalat, Ariane Guilbert, Lucie Adelaïde
et al.
Abstract Background A number of negative developmental outcomes in response to extreme temperature have been documented. Yet, to our knowledge, environmental research has left the question of the effect of temperature on human neurodevelopment largely unexplored. Here, we aimed to investigate the effect of ambient temperature on linguistic development at the age of 2 years-old. Methods We used data from the prospective national French birth cohort ELFE (N = 12,163) and highly-resolved exposure models with daily temporal resolution and 200 m to 1 km spatial resolution. We investigated the effect of weekly averages of overall, daytime and night-time temperature in the prenatal (first 30 weeks of gestation) and postnatal (91 weeks after birth) period on vocabulary production scores from the MacArthur-Bates Communicative Development Inventories (MB-CDI) at 2 years-old. Exposure-response and lag-response relationships were modeled with confounder-adjusted distributed lag non-linear models. Results Scores at the MB-CDI decreased by 3.2% (relative risk (RR) 0.968, 95% confidence interval (CI): 0.939–0.998) following exposure to severe night-time heat of 15.6 °C (95th percentile) vs. 8.3 °C (median) throughout gestational weeks 14 to 19. In the postnatal period, scores at the MB-CDI decreased by 14.8% (RR 0.852; 95% CI: [0.756–0.96]) for severe overall heat of 21.9 °C (95th percentile) vs. 11.5 °C (median) throughout weeks 1 to 28. Consistent results were found for daytime and night-time heat. We observed positive effects of overall and night-time heat in the first few weeks of pregnancy. Night-time cold in the pre-natal period also resulted in improved scores at the MB-CDI. Adjusting our models for air pollutants (PM2.5, PM10 and NO2) tended to confirm these observations. Finally, there were no significant differences in temperature effects between boys and girls. Conclusion In this large cohort study, we showed a negative impact of hot temperatures during pregnancy and after birth on language acquisition. Positive associations observed in the first few weeks of pregnancy are likely the results of methodological artifacts. Positive associations with night-time cold during the prenatal period are likely truly protective, as colder temperatures may encourage staying indoors at a comfortable temperature. Policymakers should consider neurodevelopment impairments as a deleterious effect of climate change.
Industrial medicine. Industrial hygiene, Public aspects of medicine
Ioana R. Preston, Luke S. Howard, D. Langleben
et al.
Care of pulmonary hypertension (PH) patients in special situations requires insightful knowledge of the pathophysiology of the cardiopulmonary system and close interaction with different specialists, depending on the situation. The role of this task force was to gather knowledge about five conditions that PH patients may be faced with. These conditions are 1) perioperative care; 2) management of pregnancy; 3) medication adherence; 4) palliative care; and 5) the influence of climate on PH. Many of these aspects have not been covered by previous World Symposia on Pulmonary Hypertension. All of the above conditions are highly affected by psychological, geographical and socioeconomic factors, and share the need for adequate healthcare provision. The task force identified significant gaps in information and research in these areas. The current recommendations are based on detailed literature search and expert opinion. The task force calls for further studies and research to better understand and address the special circumstances that PH patients may encounter. Shareable abstract The aim of this task force was to gather information on several complex and special conditions in PH, including perioperative care; management of pregnancy; medication adherence; palliative care; and the influence of climate on PH. https://bit.ly/3VLgNZy
The article considers the results of the study of psychological preparation of students — extreme profile psychologists for situations of special risk through special organized training using virtual reality. Subjects: 38 students aged 20 to 24 years, including 29 females. The subjects were randomly divided into control and experimental groups. Research methods: method “Forecast”, method of differential diagnostics of depressive states by V.A. Zhmurov, method “Assessment of neuropsychic stress”, diagnostics of slowing down of biological aging using the program “Anti-aging XXI” (T.N. Berezina). Methods of mathematical statistics: calculation of descriptive statistics, calculation of the Mann-Whitney U criterion, calculation of the Spearman correlation coefficient. Methods of experimental influence: seven VR simulators of different influences (flight simulator, depth, altitude, speed, darkness, etc.). Results. There is a relationship between motivation for activity in extreme conditions and personal resources: a direct relationship with the “achievement” resource and an inverse relationship with the risk level. The VR training we developed actualizes these resources. Increased achievements are ensured by the fact that respondents successfully complete tasks in extreme situations simulated in VR. Risk reduction is ensured by adaptation to extreme situations during the training. After the training, the subjects of the experimental group showed a significant decrease in the level of depression and an increase in the motivational and emotional components of readiness for action in an extreme situation. Conclusion: to increase motivation for activity in an extreme environment, it is necessary to increase the “achievement” resource, and for the “risk” resource, it is necessary to achieve its replacement with a conscious attitude to the situation. Virtual reality technologies have proven their effectiveness in increasing personal resources and preparing psychology students for activity in extreme conditions.
Abstract Objectives Surrogate decision-making by family caregivers for patients with severe brain injury is influenced by the availability and understanding of relevant information and expectations for future rehabilitation. We aimed to compare the consistency of family caregivers’ perceptions with clinical diagnoses and to inform their expectation of prognosis in the future. Methods The Coma Recovery Scale-Revised was used to assess the diagnosis of inpatients with severe brain injury between February 2019 and February 2020. A main family caregiver was included per patient. The family caregiver’s perception of the patient’s consciousness and expectations of future recovery were collected through questionnaires and compared consistently with the clinical diagnosis. Results The final sample included 101 main family caregivers of patients (57 UWS, unresponsive wakefulness syndrome, 37 MCS, minimally conscious state, 7 EMCS, emergence from MCS) with severe brain injury. Only 57 family caregivers correctly assessed the level of consciousness as indicated by the CRS-R, showing weak consistency (Kappa = 0.217, P = 0.002). Family caregivers’ demographic characteristics and CRS-R diagnosis influenced the consistency between perception and clinical diagnosis. Family caregivers who provided hands-on care to patients showed higher levels of consistent perception (AOR = 12.24, 95% CI = 2.06-73.00, P = 0.006). Compared to UWS, the family caregivers of MCS patients were more likely to have a correct perception (OR = 7.68, 95% CI = 1.34–44.06). Family caregivers had positive expectations for patients’ recovery in terms of both communication and returning to normal life. Conclusion Nearly half of family caregivers have inadequate understanding of their relative’s level of consciousness, and most of them report overly optimistic expectations that do not align with clinical diagnosis. Providing more medical information to family caregivers to support their surrogate decision-making process is essential.
Background. People live in a technological world, where social media is used very commonly. Social media has effects on eating behaviors, as in other aspects. For this reason, it is important to measure social media effect.
Objective. This study aimed to adapt the Scale of Effects of Social Media on Eating Behaviour (SESMEB) that examines the effect of social media on eating behavior in Hungarian university students.
Material and methods. The SESMEB was translated into the target language by taking various stages. The online questionnaire including general information, social media use, and the eighteen-item SESMEB was used to collect data. The scale was administered to the study group consisting of 213 Hungarian university students, and data from 203 of them were analyzed. Confirmatory factor analyses were performed to test construct validity, and the Cronbach alpha coefficient was calculated for the reliability of the scale in Hungarian.
Results. Total correlation value was higher than 0.50 for all items of the scale. The fit indices were at an acceptable level or had a perfect fit. The t-values were significant at the level of 0.1 and ranged between 2.927 and 5.706. The Spearman–Brown coefficient was calculated at 0.894. The reliability coefficient of the scale was calculated to be 0.866. SESMEB scores were different according to spending time daily, sharing content, and using filters or Photoshop on social media (p < 0.05).
Conclusions. Higher than 0.80 Cronbach’s alpha coefficient and other results show that Hungarian SESMEB is a valid and reliable tool. Therefore, Hungarian SESMEB will be useful for further studies to determine the impact of social media on eating behaviors.
Nutrition. Foods and food supply, Industrial medicine. Industrial hygiene
Community identity is understood as a multilevel systemic construct formed as a result of a person’s awareness of belonging to a certain community and subjective attitude to this belonging based on a strong emotional connection, as well as inclusion in one’s inner world and perception of the norms and values of the community as one’s own, which is manifested in the behavioural practices of representatives of certain communities (a citizen of the state, a resident of a certain territorial community, a representative of a certain property or linguistic and cultural community, etc.) A community is defined on the basis of common interests of its members, common actions, place, territory, common practices and circumstances. The key feature of defining a community and distinguishing it from a social group is the subjective significance of belonging to it for the community members. In the context of emergency situations and social transformations, such as the Russian-Ukrainian war, there is a reconstruction, a special way and unique configurations of interaction between community identities, including territorial ones: local, regional, national, global; linguistic, cultural, ethnic, civic, religious, etc. Interaction between these identities occurs in such a way that some become more dominant, manifested, actualised, and they, in turn, can suppress others, enter into competitive interaction with them, or, conversely, highlight, emphasise others, or at least coexist harmoniously. A shared identity can be spontaneously actualised or de-actualised during emergencies. However, it is often based on pre-existing identities and values in society. In times of war, there is a tendency for society to consolidate around a common, clearly defined enemy, a common problem, a common misfortune, a common future, a leader, a territory, etc. through the actualisation of certain community identities. At the same time, this creates threats of internal confrontation, which makes Ukrainian society to a certain extent vulnerable and susceptible to the actions of hostile propaganda. The formulated provisions can serve as a basis for developing practical recommendations for local and state authorities, which will help to strengthen the consolidation of society and overcome the consequences of polarisation and socio-political confrontation. This will ultimately have a positive impact on the national security of the country
The article is devoted to the expansion of functional devices of the Internet of Things (IoT) in order to increase the safety of the population in emergency situations, in particular in the context of natural disasters and military threats. After analyzing the latest research and publications, a conclusion was made about the relevance of the development of IoT technologies in the context of modern challenges for the safety of citizens. Special emphasis is placed on the use of innovative approaches to solving public safety problems, particularly for persons with disabilities, such as the hearing impaired or the elderly. The article describes the implementation of software in the Python programming language to visually display the status of a missile threat or artillery fire using Yeelight smart lamps, which use colored light to convey information about the presence or absence of danger messages. The proposed solutions include synchronous operation of devices in real time, connection to reliable sources of messages and provision of stable communication between devices and the server. The project demonstrated an innovative approach to solving security problems in crisis situations, in particular martial law, promoting a quick and accurate response to valuable threats and protecting the population.
Sue Ann Costa Clemens, Gustavo Mendes Lima Santos, Isabela Gonzalez
et al.
Poliovirus infection causes paralysis in up to 1 in 200 infected persons. The use of safe and effective inactivated poliovirus vaccines and live attenuated oral poliovirus vaccines (OPVs) means that only two pockets of wildtype poliovirus type 1 remain, in Afghanistan and Pakistan. However, OPVs can revert to virulence, causing outbreaks of circulating vaccine-derived poliovirus (cVDPV). During 2020–2022, cVDPV type 2 (cVDPV2) was responsible for 97–99% of poliomyelitis cases, mainly in Africa. Between January and August 2022, cVDPV2 was detected in sewage samples in Israel, the United Kingdom and the United States of America, where a case of acute flaccid paralysis caused by cVDPV2 also occurred. The Pan American Health Organization has warned that Brazil, the Dominican Republic, Haiti and Peru are at very high risk for the reintroduction of poliovirus and an additional eight countries in Latin America are at high risk, following dropping vaccination rates (average 80% coverage in 2022). Sabin type 2 monovalent OPV has been used to control VDPV2 outbreaks, but its use could also lead to outbreaks. To address this issue, a more genetically stable, novel OPV2 (nOPV2) was developed against cVDPV2 and in 2020 was granted World Health Organization Emergency Use Listing. Rolling out a novel vaccine under the Emergency Use Listing in mass settings to contain outbreaks requires unique local regulatory and operational preparedness.
Stéphanie Watier-Grillot, Damien Costa, Cédric Petit
et al.
<h4>Introduction</h4>Contaminated drinking and recreational waters account for most of the reported Cryptosporidium spp. exposures in high-income countries. In June 2017, two successive cryptosporidiosis outbreaks occurred among service members in a military training camp located in Southwest France. Several other gastroenteritis outbreaks were previously reported in this camp, all among trainees in the days following their arrival, without any causative pathogen identification. Epidemiological, microbiological and environmental investigations were carried out to explain theses outbreaks.<h4>Material and methods</h4>Syndromic diagnosis using multiplex PCR was used for stool testing. Water samples (100 L) were collected at 10 points of the drinking water installations and enumeration of Cryptosporidium oocysts performed. The identification of Cryptosporidium species was performed using real-time 18S SSU rRNA PCR and confirmed by GP60 sequencing.<h4>Results</h4>A total of 100 human cases were reported with a global attack rate of 27.8%. Cryptosporidium spp. was identified in 93% of stool samples with syndromic multiplex PCR. The entire drinking water network was contaminated with Cryptosporidium spp. The highest level of contamination was found in groundwater and in the water leaving the treatment plant, with >1,000 oocysts per 100 L. The same Cryptosporidium hominis isolate subtype IbA10G2 was identified in patients' stool and water samples. Several polluting activities were identified within the protection perimeters of the water resource. An additional ultrafiltration module was installed at the outlet of the water treatment plant. After several weeks, no Cryptosporidium oocysts were found in the public water supply.<h4>Conclusions</h4>After successive and unexplained gastroenteritis outbreaks, this investigation confirmed a waterborne outbreak due to Cryptosporidium hominis subtype IbA10G2. Our study demonstrates the value of syndromic diagnosis for gastroenteritis outbreak investigation. Our results also highlight the importance of better assessing the microbiological risk associated with raw water and the need for sensitive and easy-to-implement tools for parasite detection.
Arctic medicine. Tropical medicine, Public aspects of medicine
The organizational, legal and marketing characteristics of domestically produced medicines for pharmaceutical provision of affected persons in emergency situations in Ukraine have been studied. The results of the study can be used to approve and further improve the National List of domestic drugs for pharmaceutical provision of various contingents of affected persons during special period. The necessity of further researches in the direction of pharmaceutical maintenance of victims in the conditions of the special period in Ukraine was substantiated.
Studied the pharmaceutical support of affected individuals in the conditions of special period. The meaningful meaning is determined: special period; affected individuals and their close relatives. Particularities of the pharmaceutical provision of affected contingents of the population in the conditions of special period were studied. Proved that the analysis of the experience of economically developed countries is useful for the formation of a powerful and effective healthcare system in Ukraine for the pharmaceutical provision of affected and privileged categories of citizens in emergency situations. The necessity of further researches in the field of pharmaceutical provision of persons who suffered in the conditions of the special period is substantiated.
Most prospective coaches are not fully ready to manage sports teams under extreme conditions and cannot make quick decisions in difficult situations. The article aims to develop students’ psychological readiness to make decisions in extreme coaching situations. The formative experiment involved 50 students (25 respondents in the experimental group; 25 respondents in the control group). It became possible to develop operational readiness in prospective coaches by conducting special classes on the development of decision-making skills, self-reflection, self-regulation (theoretical classes and a set of exercises aimed at developing the necessary qualities). The final stage of the experiment shows that the number of EG students with a high level of anxiety has decreased by 16%. At the same time, the expert assessment shows that their capacity for self-regulation in extremely competitive situations has increased by 20%. The group of students’ leading motives includes the following: to achieve the set goals; to win; to enjoy the team’s victory; to prove oneself and test one’s abilities as a coach in extreme situations. In extreme professional situations, the leading motives behind coaches’ decisions involve achieving the set goals and enjoying the team’s victory. There were no significant differences in decision-making motivation among students (both males and females). However, almost every third student has a low level of motivation for competition.
Andrew D. Williams, Sandie Ha, Edmond Shenassa
et al.
Abstract Background Asian/Pacific Islander (API) communities in the United States often reside in metropolitan areas with distinct social and environmental attributes. Residence in an ethnic enclave, a socially distinct area, is associated with lower gestational diabetes mellitus (GDM) risk, yet exposure to high levels of air pollution, including volatile organic compounds (VOCS), is associated with increased GDM risk. We examined the joint effects of ethnic enclaves and VOCs to better understand GDM risk among API women, the group with the highest prevalence of GDM. Methods We examined 9069 API births in the Consortium on Safe Labor (19 hospitals, 2002–2008). API ethnic enclaves were defined as areas ≥66th percentile for percent API residents, dissimilarity (geographic dispersal of API and White residents), and isolation (degree that API individuals interact with another API individual). High levels of 14 volatile organic compounds (VOC) were defined as ≥75th percentile. Four joint categories were created for each VOC: Low VOC/Enclave (reference group), Low VOC/No Enclave, High VOC/Enclave, High VOC/No Enclave. GDM was reported in medical records. Hierarchical logistic regression estimated odds ratios (OR) and 95% confidence intervals (95%CI) between joint exposures and GDM, adjusted for maternal factors and area-level poverty. Risk was estimated for 3-months preconception and first trimester exposures. Results Enclave residence was associated with lower GDM risk regardless of VOC exposure. Preconception benzene exposure was associated with increased risk when women resided outside enclaves [High VOC/No Enclave (OR:3.45, 95%CI:1.77,6.72)], and the effect was somewhat mitigated within enclaves, [High VOC/Enclave (OR:2.07, 95%:1.09,3.94)]. Risks were similar for 12 of 14 VOCs during preconception and 10 of 14 during the first trimester. Conclusions API residence in non-enclave areas is associated with higher GDM risk, regardless of VOC level. Ethnic enclave residence may mitigate effects of VOC exposure, perhaps due to lower stress levels. The potential benefit of ethnic enclaves warrants further study.
Industrial medicine. Industrial hygiene, Public aspects of medicine
V. P. Romaguera, J. Sancho-Muriel, Eduardo Alvarez-Sarrdo
et al.
BACKGROUND Hemorrhoidal disease is still one of the most prevalent proctological diseases. Pain is the most common complication after surgery, but bleeding, urinary retention and perianal infection are also frequent. There is also an important group of patients, such as those with inflammatory bowel disease, pregnancy or immunosuppression, who can present an increased rate or more severe complications. OBJECTIVE To describe the complications following different surgical and instrumental techniques for hemorrhoids in a literature review. Special situations were reviewed to determine how they affect the management of the disease. METHODS During August 2019 a narrative review of hemorrhoid surgery complications and special situations was performed using the Pubmed MESH DATABASE. CONCLUSIONS Pain, urinary retention and bleeding remain the most frequent complications after surgery for hemorrhoids; however, special situations must be taken into account in order to choose the best technique to prevent more severe complications.
J. Fernández-Candil, L. Castelltort Mascó, N. Fábregas Juliá
et al.
OBJECTIVES Electroconvulsive therapy (ECT) is one of the main techniques available for the treatment of such serious mental illnesses as schizophrenia and drug-resistant depression. The pre-anaesthetic assessment appropriate for patients with various mental disorders or pathologies does not differ substantially from that of any patient prior to undergoing anaesthesia for a surgical procedure. The present review aims to propose guidelines to achieve a higher level of safety and effectiveness during ECT in the most frequent situations, in accordance with the current literature. METHODS We conducted a search on the role of anaesthesia in ECT in the Ovid MEDLINE, PubMed, and SciELO (Scientific Electronic Library Online) databases, with special attention to the populations undergoing this type of therapy. The search was carried out between 1978 and December 2016. RESULTS We included the 96 articles that contained the most important recommendations for the preparation of this guide. CONCLUSIONS We propose these guidelines in order to achieve a higher level of safety and effectiveness during ECT in special conditions. We also summarize the most important attitude to be taken into account by the anaesthesiologist in these cases.