Coping Strategies versus Health-Related Quality of Life among Hepatitis C Patients

This study aiming at describe overall health related  quality of life and preferred coping  strategies among  hepatitis's c patients  and correlate between health related  quality  of life and coping   strategies.  The study was conducted in two outpatient clinics 1st outpatient clinic for hepatic disease affiliated to Ain shams university .2nd outpatient clinic affiliated to Theodor Bilharz research institute. The samples of this study consist of 106 hepatitis c patients. Data were collected  through three tools .First tool:- A structured interviewing questionnaire developed by researchers for collecting data related to: Socio-demographic characteristics of patients such as age – sex –education  ,Questions about parameters of quality of life which are most commonly affected and behavioral changes following diagnosis .Second tool:- The Hepatitis Quality of Life Questionnaire version 2.( HQLQv2). Third tool :- Coping strategies inventory. The main results revealed that a significant   reduction in the patient quality of life and there was   significant positive associations between Overall (HRQoL) versus coping strategies. The present study recommended that providing counseling intervention to hepatitis c patients   for evaluating patient psychological condition and provision of psychological support to patients during different stage of treatment. And implementing educational intervention for the patients to educate them     to promote the use of appropriate coping strategies to enhance quality of life. Keywords: hepatitis c- quality of life – coping strategies

Effect of Psycho-Educational Training Program for Parent's Having Child with Leukemia on Their Experience and Psychological Wellbeing

Leukemia is a significant public health and life-threatening problem for pediatric cancer patients. Family caregivers of cancer patients receive little preparation, information, or support to perform their care giving role. This study aims to assess the effect of psycho-educational training program to enhancing practice and psychosocial adaptation for parents caring child with leukemia. the study  was conducted at day care and out patient clinic in pediatric hospital of Ain Shams University  .the sample of this study consist of of 60 parents and their children  attended day care and out patient clinic in pediatric Hospital of Ain Shams University. Data were collected through three tool first tool .,Interview questionnairesheet: it is developed by the researchers to collecting data regarding socio-demographic  characteristics about  patients and family caregivers , family knowledge about leukemia and family practice regarding care child with leukemia 2nd toolis Ryff’spsychological Well-Being Scales (PWB).third tools is Caregiver  strain Index (CSI).the  results reveleaved that was significant improvement in  familyknowedge  and  practice ,as wellas were significant decrease in the stress level after Pogrom intervention andthere was a siginificant difference .Regarding psychological wellbeingbefore and after program intervention.thepresent recommended that Further research is necessary to   understand the mechanisms    through which parents cope with the strain of parenting a cancer survivor and how parenting stress in this parents  influences both physical and mental health. Keywords : leukemia -parent – stressors – adjustment – psychological wellbein

Impact of Lifestyle Modification Program on Quality of Life, and Psychological Wellbeing among Elderly Women with Urinary Incontinence

Background: urinary incontinence has a major impact on physical, quality of life, emotional and social health and wellbeing. Objective: Our study aimed to   evaluate the efficacy of the lifestyle modification program on quality of life, and psychological well-being of women with urinary incontinence, Methods: an Experimental study carried out  at 6 health center on 190  women with urinary incontinence. Tools of data collection: interview questionnaire, the incontinence impact questionnaire , the Urogenital distress inventory, and psychological well-being index. Results: More half of women in age more than fifty years and were married, and have duration of incontinence from one to less two years.   Urinary incontinence has a moderate impact on the women life.  There was highly significant difference in the quality of life score and psychological wellbeing after program implementation Conclusion: Lifestyle modification has a positive impact on quality of life and psychological wellbeing in women with urinary incontinence in present study so recommended that providing counseling services in clinic to counsel women on how to best incorporate lifestyle modification into their lives in order to manage incontinence Keywords: urinary incontinence -quality of life – psychological well-being – lifestyl

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49\ub74% (95% uncertainty interval [UI] 46\ub74–52\ub70). The TFR decreased from 4\ub77 livebirths (4\ub75–4\ub79) to 2\ub74 livebirths (2\ub72–2\ub75), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83\ub78 million people per year since 1985. The global population increased by 197\ub72% (193\ub73–200\ub78) since 1950, from 2\ub76 billion (2\ub75–2\ub76) to 7\ub76 billion (7\ub74–7\ub79) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2\ub70%; this rate then remained nearly constant until 1970 and then decreased to 1\ub71% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2\ub75% in 1963 to 0\ub77% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2\ub77%. The global average age increased from 26\ub76 years in 1950 to 32\ub71 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59\ub79% to 65\ub73%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1\ub70 livebirths (95% UI 0\ub79–1\ub72) in Cyprus to a high of 7\ub71 livebirths (6\ub78–7\ub74) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0\ub708 livebirths (0\ub707–0\ub709) in South Korea to 2\ub74 livebirths (2\ub72–2\ub76) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0\ub73 livebirths (0\ub73–0\ub74) in Puerto Rico to a high of 3\ub71 livebirths (3\ub70–3\ub72) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2\ub70% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress. Funding: Bill & Melinda Gates Foundation

Population and fertility by age and sex for 195 countries and territories, 1950–2017: a systematic analysis for the Global Burden of Disease Study 2017

Background: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. Methods: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10–54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10–14 years and 50–54 years was estimated from data on fertility in women aged 15–19 years and 45–49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories. Findings: From 1950 to 2017, TFRs decreased by 49·4% (95% uncertainty interval [UI] 46·4–52·0). The TFR decreased from 4·7 livebirths (4·5–4·9) to 2·4 livebirths (2·2–2·5), and the ASFR of mothers aged 10–19 years decreased from 37 livebirths (34–40) to 22 livebirths (19–24) per 1000 women. Despite reductions in the TFR, the global population has been increasing by an average of 83·8 million people per year since 1985. The global population increased by 197·2% (193·3–200·8) since 1950, from 2·6 billion (2·5–2·6) to 7·6 billion (7·4–7·9) people in 2017; much of this increase was in the proportion of the global population in south Asia and sub-Saharan Africa. The global annual rate of population growth increased between 1950 and 1964, when it peaked at 2·0%; this rate then remained nearly constant until 1970 and then decreased to 1·1% in 2017. Population growth rates in the southeast Asia, east Asia, and Oceania GBD super-region decreased from 2·5% in 1963 to 0·7% in 2017, whereas in sub-Saharan Africa, population growth rates were almost at the highest reported levels ever in 2017, when they were at 2·7%. The global average age increased from 26·6 years in 1950 to 32·1 years in 2017, and the proportion of the population that is of working age (age 15–64 years) increased from 59·9% to 65·3%. At the national level, the TFR decreased in all countries and territories between 1950 and 2017; in 2017, TFRs ranged from a low of 1·0 livebirths (95% UI 0·9–1·2) in Cyprus to a high of 7·1 livebirths (6·8–7·4) in Niger. The TFR under age 25 years (TFU25; number of livebirths expected by age 25 years for a hypothetical woman who survived the age group and was exposed to current ASFRs) in 2017 ranged from 0·08 livebirths (0·07–0·09) in South Korea to 2·4 livebirths (2·2–2·6) in Niger, and the TFR over age 30 years (TFO30; number of livebirths expected for a hypothetical woman ageing from 30 to 54 years who survived the age group and was exposed to current ASFRs) ranged from a low of 0·3 livebirths (0·3–0·4) in Puerto Rico to a high of 3·1 livebirths (3·0–3·2) in Niger. TFO30 was higher than TFU25 in 145 countries and territories in 2017. 33 countries had a negative population growth rate from 2010 to 2017, most of which were located in central, eastern, and western Europe, whereas population growth rates of more than 2·0% were seen in 33 of 46 countries in sub-Saharan Africa. In 2017, less than 65% of the national population was of working age in 12 of 34 high-income countries, and less than 50% of the national population was of working age in Mali, Chad, and Niger. Interpretation: Population trends create demographic dividends and headwinds (ie, economic benefits and detriments) that affect national economies and determine national planning needs. Although TFRs are decreasing, the global population continues to grow as mortality declines, with diverse patterns at the national level and across age groups. To our knowledge, this is the first study to provide transparent and replicable estimates of population and fertility, which can be used to inform decision making and to monitor progress

Population and fertility by age and sex for 195 countries and territories, 1950-2017: a systematic analysis for the Global Burden of Disease Study 2017

BACKGROUND: Population estimates underpin demographic and epidemiological research and are used to track progress on numerous international indicators of health and development. To date, internationally available estimates of population and fertility, although useful, have not been produced with transparent and replicable methods and do not use standardised estimates of mortality. We present single-calendar year and single-year of age estimates of fertility and population by sex with standardised and replicable methods. METHODS: We estimated population in 195 locations by single year of age and single calendar year from 1950 to 2017 with standardised and replicable methods. We based the estimates on the demographic balancing equation, with inputs of fertility, mortality, population, and migration data. Fertility data came from 7817 location-years of vital registration data, 429 surveys reporting complete birth histories, and 977 surveys and censuses reporting summary birth histories. We estimated age-specific fertility rates (ASFRs; the annual number of livebirths to women of a specified age group per 1000 women in that age group) by use of spatiotemporal Gaussian process regression and used the ASFRs to estimate total fertility rates (TFRs; the average number of children a woman would bear if she survived through the end of the reproductive age span [age 10-54 years] and experienced at each age a particular set of ASFRs observed in the year of interest). Because of sparse data, fertility at ages 10-14 years and 50-54 years was estimated from data on fertility in women aged 15-19 years and 45-49 years, through use of linear regression. Age-specific mortality data came from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2017 estimates. Data on population came from 1257 censuses and 761 population registry location-years and were adjusted for underenumeration and age misreporting with standard demographic methods. Migration was estimated with the GBD Bayesian demographic balancing model, after incorporating information about refugee migration into the model prior. Final population estimates used the cohort-component method of population projection, with inputs of fertility, mortality, and migration data. Population uncertainty was estimated by use of out-of-sample predictive validity testing. With these data, we estimated the trends in population by age and sex and in fertility by age between 1950 and 2017 in 195 countries and territories

CD 160 molecules and IL28 B genotypes in diabetic and non diabetic chronic hepatitis C patients

Abstract Background and Aim: Despite the close relationship between hepatitis C viral infection (HCV) and diabetes mellitus type 2 (DM2), the underlying mechanism that links diabetes and HCV infection remains conjectural. During chronic hepatitis C disease, key inhibitory molecules including CD160 are up-regulated with different kinetics on CD8 cytotoxic T lymphocytes. There are two different opinions regarding the function of CD160 molecules, the first opinion suggested that the expression of CD160 on CD8 cytotoxic T cell contribute to the exhaustion and failure of immune responses, whereas the other opinion defined CD160 molecule as modulators and regulators of immune responses. Thus, we aimed to assess the pattern of expression and the role of CD160 molecules in the development and controlling of HCV associated diabetes. Also, a little of known about the genetic control of CD160 signaling pathway between T lymphocytes and antigen presenting cells. Recently, IL-28B gene polymorphisms were identified as a genetic predictor for progression of HCV and the effectiveness of antiviral therapy. IL28B polymorphisms include C/C, C/T and T/T genotypes, C/C genotype is considered as a good predictor of disease progression and therapy responses while T alleles groups were associated with bad prognosis and less response to therapy. We aimed to clarify the link between a triad, CD160 molecules, T lymphocytes immune responses and IL28B genotypes during HCV associated diabetes. Patients & Methods: This cross sectional study was conducted at Al-Zahraa University Hospital from June 2011 to January 2012. An informed consent was obtained from patients. The study included fourteen diabetic chronic hepatitis C (HCV) patients, fourteen non-diabetic HCV patients (without decompensated liver or hepatocellular carcinoma) and twelve healthy control subjects. The selection of HCV patients depends upon seropositive anti-HCV confirmed by positive HCV-RNA-PCR. Also, the exclusion of patients with decompensated liver disease or hepatocellular carcinoma was achieved via questionnaire, clinical examination, pelviabdominal ultrasonography and routine laboratory investigations. The diabetic HCV patients were identified in the presence of documented hypoglycemic medications or fasting blood sugar greater than 140 mg/dL on two occasions. Using flow cytometry, the patients and control groups were investigated for the expression of CD160 molecules on CD8 T lymphocytes. Using real time PCR, the diabetic and non-diabetic HCV patients were evaluated for the frequency of IL-28B genotypes. In addition, the diabetic HCV patients were estimated for glycosylated hemoglobin (Hb A1C) using high performance liquid chromatography (HPLC). Results: The diabetic and non-diabetic HCV patients showed statistically significant increase in CD160% as matched to control group. Importantly, theCD8 cytotoxic T cells of diabetic HCV group displayed higher expression of CD160% as compared to non-diabetic group. Also, we observed significant negative correlation between the frequency of CD160 molecules and the mean value of HbA1C in diabetic HCV group. As regard IL-28B polymorphisms, our result showed higher frequency of C/C genotype in diabetic HCV patients, whereas non-diabetic HCV group showed higher frequency of C/T genotype. Interestingly, our data showed an association of favorable genotype C/C with higher frequency of CD160 molecules as matched to both T alleles genotypes groups. Conclusion: we concluded that CD 160 molecules up regulation on cytotoxic CD8 T cells occur as a consequence of exaggerated immune responses and vigorous secretion of proinflammatory cytokines. Also, we clarified that the over expression of CD160 in tandem with IL28B C/C genotype is considered as a good predictor of disease progression and antiviral treatment response. In addition, we suggested the involvement of IL28 B gene in controlling T cell immune responses including CD160 signaling via HLA class-1 gene. Importantly, we confirmed the modulatory and regulatory role of CD160 molecules in controlling of HCV associated diabetes