Caesarean section – desired rate versus actual need

According to the World Health Organization, governments have expressed interest in the rise in the numbers of caesarean section births and the potential negative consequences for maternal and infant health. If conducted when medically justified, a caesarean section can effectively prevent maternal and perinatal mortality and morbidity. However, there is no evidence showing the benefits of caesarean delivery for women or infants who do not require the procedure. As with any surgical intervention, caesarean sections are associated with short and long-term risk, which can extend many years beyond the current delivery and affect the health of the woman, her child, and future pregnancies. These risks are higher in women with limited access to comprehensive obstetric care. Unequivocally, the potential risks are higher in women with limited access to comprehensive obstetric care, hence the global health concern.Keywords: Caesarean section; Infant morbidity and mortality; Maternal morbidity and mortality; Global trend

Editorial

A Context of Translational Science Researc

Cognitive Impairment in Patients with Type 2 Diabetes Mellitus: Perspectives and Challenges

Type 2 Diabetes Mellitus is associated with elevated blood glucose level, abnormal abdominal fat deposition, insulin resistance and a number of complications including embryopathy, cardiovascular diseases, nephropathy, neuropathy, microangiopathy and retinopathy. Complications extending to the central nervous system may have a deteriorating effect on mental health including a decline in cognitive functioning. This could be a reason for depression, lack of compliance towards medication/treatment, and the inability of patients to meet the day-to-day management demands of the disease. Due to the high metabolic demand for energy in the brain, perturbations in glucose metabolism can noticeably impact cognitive performance. This review discusses and enlightens on the factors contributing to cognitive impairment in Type 2 Diabetes Mellitus. An understanding of the mechanisms of diabetes‐related cognitive impairment and the resulting behaviors of patients can help healthcare professionals implement treatments to significantly improve health status and quality of life of patients with diabetes

Assessing Health Conditions and Medication Use Among the Homeless Community in Long Beach, California

Objective: Persons experiencing homelessness are a vulnerable population and are at increased risk for morbidity and all-cause mortality compared to the general population. This study sought to evaluate medication use, regular physician visits, and identify health conditions among the homeless population of Long Beach, California. Methods: Two brown bag medication review events were held at homeless shelters in the Long Beach area. Demographic information, medication use, and comorbid disease states were obtained through surveys. Findings: Three-fourths of the cohort (95 participants) consisted of males, and the average age of participants was 48 years. Psychiatric disorders and cardiovascular disease were the most common disease states reported at 32% and 46%, respectively and so were medications used in treating these chronic diseases. Medication adherence was found to be a significant problem in this population, where more than 30% of patients were nonadherent to medications for chronic diseases. Furthermore, foot problems, hearing and vision difficulties constitute the most commonly overlooked health problems within the homeless population. Conclusion: Based on this and other similar finding, we must accept that the homeless represent a vulnerable population, and that because of this fact, more programs should be focused at improving availability and access to health care among the homeless. Regarding the high number of reported health problems in the study, more studies are needed and more studies should incorporate screening for foot, hearing, and vision issues, both to increase awareness and to provide an opportunity for devising possible solutions to these highly preventable conditions

Personalized Nutrition: Translating the Science of NutriGenomics Into Practice: Proceedings From the 2018 American College of Nutrition Meeting

Adverse reactions to foods and adverse drug reactions are inherent in product defects, medication errors, and differences in individual drug exposure. Pharmacogenetics is the study of genetic causes of individual variations in drug response and pharmacogenomics more broadly involves genome-wide analysis of the genetic determinants of drug efficacy and toxicity. The similarity of nutritional genomics and pharmacogenomics stems from the innate goal to identify genetic variants associated with metabolism and disease. Thus, nutrigenomics can be thought of as encompassing gene–diet interactions involving diverse compounds that are present in even the simplest foods. The advances in the knowledge base of the complex interactions among genotype, diet, lifestyle, and environment is the cornerstone that continues to elicit changes in current medical practice to ultimately yield personalized nutrition recommendations for health and risk assessment. This information could be used to understand how foods and dietary supplements uniquely affect the health of individuals and, hence, wellness. The individual’s gut microbiota is not only paramount but pivotal in embracing the multiple-functional relationships with complex metabolic mechanisms involved in maintaining cellular homeostasis. The genetic revolution has ushered in an exciting era, one in which many new opportunities are expected for nutrition professionals with expertise in nutritional genomics. The American College of Nutrition’s conference focused on “Personalized Nutrition: Translating the Science of NutriGenomics Into Practice” was designed to help to provide the education needed for the professional engagement of providers in the personalized medicine era.https://doi.org/10.1080/07315724.2019.158298

Clinical Study Effectiveness of Green Tea in a Randomized Human Cohort: Relevance to Diabetes and Its Complications

Epidemiological studies have argued that green tea could mitigate diabetes and its complications. This study investigated the phytophenolic profile of Mauritian green tea and its antioxidant propensity. The effect of green tea on the risk factors: waist-hip ratio, glucose level, arterial pressure, antioxidant status, and alanine aminotransferase (ALT) in prediabetics was assessed. The experimental group consumed 3 cups of green tea daily for 14 weeks followed by a 2-week washout period. The control group followed a water regimen. Green tea contained high level of phenolics related to its antioxidant power. Green tea suppressed waisthip ratio of women from a significant increase and suppressed mean arterial pressure of men and women from a significant decrease after week 14. It reduced ALT level in women by 13.0% ( < 0.1) while increasing the antioxidant potential of men and women sera by 2.7% ( < 0.1) and 5.1% ( < 0.1). The study timescale may have been too short to enable demonstration of effects on fasting plasma glucose and HbA1c outcomes. Green tea regimen could form part of a healthy lifestyle that might ameliorate features of metabolic syndrome and subsequent risks for diabetes and its complications. This trial is registered with ClinicalTrials.gov NCT01248143

Suicide Prevention: does it work?

The risk factors of suicide which occur in people of all genders, ages and ethnicities, although complex to fully understand, share certain characteristics that include depression (other mental disorders, psychosis or substance abuse disorder), a prior suicide attempt, family history of a mental disorder or substance abuse, family history of suicide, family violence (including physical or sexual abuse), having guns or other firearms in the home, incarceration and exposure to others' suicidal behavior (such as that of family members, peers, or media figures). Research suggests that people who attempt suicide differ from others in many aspects of how they think, react to events, and make decisions. This paper reviews the global trends on suicide and the prevention of suicide according to program evaluation, risk and protective factors, type of intervention, level of intervention and the interface between clinical and public health levels. The major interventions for the prevention of suicide are reasonable care and treatment of mental and addictive disorders, restricted access to lethal means of suicide such as firearms, pesticides, etc., improvement of media portrayal of suicide, school-based programs, availability of hotlines and crisis centers, and training of primary health care personnel.Keywords: Suicide; Risk factors; Global trends; Preventio