Lifestyle Factors and Symptoms of Gastroesophageal Reflux Disease: A Cross-sectional Study

Background and Objectives: Gastroesophageal Reflux Disease (GERD) is a condition characterized by heartburn and acid regurgitation without signs of oesophagal mucosal injury on one hand, and erosive oesophagitis and Barrett's oesophagus consequences like oesophagal cancer on the other. The aim of this study was to explore the involvement of different lifestyle-related factors in the aetiology of symptomatic GERD. Methods: In this cross-sectional study, 79 patients (28 men and 51 women) aged between 20-68 years old were recruited randomly through a direct interview between January to October 2021, and they were prescribed Proton Pump Inhibitors. Prior to starting this study, the approvals had been granted by the ethics committee and oral consent was gained from the participants. A questionnaire was designed and consisted of demographic and clinical characteristics regarding GERD. Statistical analysis was done using SPSS version 25 for describing frequencies and percentages, followed by Chi-square and Fisher’s Exact tests as inferential statistical analysis for finding associations between variables. Results: Among the total of 79 patients with gastroesophageal reflux disease, the findings indicated that more than half of the study sample (58.2%) were overweight and obese (26.6% and 31.6% respectively), and the heavy smokers made the highest percentage among smokers (19%). There was a statistically significant association between gender and smoking and BMI among GERD patients (P-value = 0.001 and < 0.001 respectively). There was a very highly significant association between BMI and heartburn and nausea and vomiting (P-value = 0.001 for both), while there was a non-significant association between BMI and chest pain, cough, and sleep pattern disturbance (P-value = 0.324, 0.558, and 0.907 respectively). Conclusion: A higher BMI and smoking are associated with a higher likelihood of GERD symptoms

A randomized controlled trial of mental health interventions for survivors of systematic violence in Kurdistan, Northern Iraq

BACKGROUND: Experiencing systematic violence and trauma increases the risk of poor mental health outcomes; few interventions for these types of exposures have been evaluated in low resource contexts. The objective of this randomized controlled trial was to assess the effectiveness of two psychotherapeutic interventions, Behavioral Activation Treatment for Depression (BATD) and Cognitive Processing Therapy (CPT), in reducing depression symptoms using a locally adapted and validated version of the Hopkins Symptom Checklist and dysfunction measured with a locally developed scale. Secondary outcomes included posttraumatic stress, anxiety, and traumatic grief symptoms. METHODS: Twenty community mental health workers, working in rural health clinics, were randomly assigned to training in one of the two interventions. The community mental health workers conducted baseline assessments, enrolled survivors of systematic violence based on severity of depression symptoms, and randomly assigned them to treatment or waitlist-control. Blinded community mental health workers conducted post-intervention assessments on average five months later. RESULTS: Adult survivors of systematic violence were screened (N = 732) with 281 enrolled in the trial; 215 randomized to an intervention (114 to BATD; 101 to CPT) and 66 to waitlist-control (33 to BATD; 33 to CPT). Nearly 70% (n = 149) of the intervention participants completed treatment and post-intervention assessments; 53 (80%) waitlist-controls completed post-intervention assessments. Estimated effect sizes for depression and dysfunction were 0.60 and 0.55 respectively, comparing BATD participants to all controls and 0.84 and 0.79 respectively, compared to BATD controls only. Estimated effect sizes for depression and dysfunction were 0.70 and 0.90 respectively comparing CPT participants to all controls and 0.44 and 0.63 respectively compared to CPT controls only. Using a permutation-based hypothesis test that is robust to the model assumptions implicit in regression models, BATD had significant effects on depression (p = .003) and dysfunction (p = .007), while CPT had a significant effect on dysfunction only (p = .004). CONCLUSIONS: Both interventions showed moderate to strong effects on most outcomes. This study demonstrates effectiveness of these interventions in low resource environments by mental health workers with limited prior experience. TRIAL REGISTRATION: ClinicalTrials.Gov NCT00925262. Registered June 3, 2009

The Diamond STING server

Diamond STING is a new version of the STING suite of programs for a comprehensive analysis of a relationship between protein sequence, structure, function and stability. We have added a number of new functionalities by both providing more structure parameters to the STING Database and by improving/expanding the interface for enhanced data handling. The integration among the STING components has also been improved. A new key feature is the ability of the STING server to handle local files containing protein structures (either modeled or not yet deposited to the Protein Data Bank) so that they can be used by the principal STING components: (Java)Protein Dossier ((J)PD) and STING Report. The current capabilities of the new STING version and a couple of biologically relevant applications are described here. We have provided an example where Diamond STING identifies the active site amino acids and folding essential amino acids (both previously determined by experiments) by filtering out all but those residues by selecting the numerical values/ranges for a set of corresponding parameters. This is the fundamental step toward a more interesting endeavor—the prediction of such residues. Diamond STING is freely accessible at and

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection are often non-specific, and there is no definitive test for the accurate diagnosis of infection. The 'omics' approaches to identifying biomarkers from the host-response to bacterial infection are promising. In this study, lipidomic analysis was carried out with plasma samples obtained from febrile children with confirmed bacterial infection (n = 20) and confirmed viral infection (n = 20). We show for the first time that bacterial and viral infection produces distinct profile in the host lipidome. Some species of glycerophosphoinositol, sphingomyelin, lysophosphatidylcholine and cholesterol sulfate were higher in the confirmed virus infected group, while some species of fatty acids, glycerophosphocholine, glycerophosphoserine, lactosylceramide and bilirubin were lower in the confirmed virus infected group when compared with confirmed bacterial infected group. A combination of three lipids achieved an area under the receiver operating characteristic (ROC) curve of 0.911 (95% CI 0.81 to 0.98). This pilot study demonstrates the potential of metabolic biomarkers to assist clinicians in distinguishing bacterial from viral infection in febrile children, to facilitate effective clinical management and to the limit inappropriate use of antibiotics

Plasma lipid profiles discriminate bacterial from viral infection in febrile children

Fever is the most common reason that children present to Emergency Departments. Clinical signs and symptoms suggestive of bacterial infection ar

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Understanding Iraq’s basic health services package: examining the domestic and external politics of post-conflict health policy

Background: Iraq is a higher middle-income country with a GDP of $223.5 billion (as of 2014). In the 1970s and 1980s, an extensive network of primary, secondary and tertiary health facilities was built, and the country recorded some of the best health indicators in the Middle East. However, two decades of conflict (both inter- and intra-state), sanctions and poor planning have reversed many of the previous gains. In the aftermath of the 2003 war, the government of Iraq introduced a Basic Health Services Package (BHSP) with a user fee component. International actors often advocate BHSPs as a means of rapidly scaling-up services in health systems that are devastated by conflict. User fees have also been promoted as a way of raising revenue to enhance the financial sustainability of healthcare systems in such contexts. While Iraq is a conflict-affected state, it has retained an extensive healthcare infrastructure and has a ministry of health with considerable financial and administrative capacity. In such a context, the introduction of a BHSP is a notable and distinctive feature of health policy in this setting, and the process through which this occurred have not yet been examined. Aim: To explore the processes through which the BHSP was conceived and designed in Iraq. It compares Iraq’s BHSP with similar policies in other post-conflict settings. It examines the roles of domestic and external actors and models in the policy’s conception and design. It explores the preferences of internal and external actors about the financing of service delivery through user fees. The study also examines the extent of policy transfer in the formulation of Iraq’s BHSP. Methodology: The thesis utilises a qualitative case study approach, incorporating analysis of semi-structured elite interviews and documents. Twenty Skype, phone, and face-to- face interviews were conducted between January 2013 and August 2014. Interviewees included former ministers of health, directors of departments of health, academics and officials at donor agencies, bilateral and multi-lateral bodies and consultancies. Documents included 47 official government publications, evaluations, reports, policy briefs and assessments. Literature review: A search of the literature on health policy making in post-conflict and fragile settings identified three key gaps in existing evidence; first, there is a dearth of published work examining health policy in post-conflict Iraq. Second, the literature focuses mainly on the impact of policy action in post-conflict contexts, largely neglecting the processes through which those policies are introduced. Third, while the literature concentrates on the roles of external actors, it pays limited attention to the role of domestic actors and politics. Results: Iraq’s BHSP shares commonalities with the other selected countries (Uganda, Afghanistan, and Liberia) in its primary aims, influential actors, interventions included or excluded, and financing principles. However, Iraq’s BHSP also aims at broader, and longer-term, structural reform, while the BHSP in other countries is often motivated by short-term objectives. The MoH in Iraq also appears to assume a prominent role in this case relative to others. Also, Iraq’s BHSP includes a greater number of interventions compared to the other countries. The Iraq war of 2003 offered the opportunity for wide-ranging structural change in the healthcare system. External actors, especially the WHO, were influential in advocating for a BHSP drawing on the recent experience of a similar initiative in what was in some ways the similar context of Afghanistan. However, the removal of former politicians and the emergence of internal policy actors with considerable technical and financial capacity allowed the domestic authorities to debate, dispute and challenge the recommendations of external actors. Relatedly, some of the internationally distinctive features of the BHSP in Iraq, including user fees, are similar to those that exist elsewhere in the health system. Most interviewees agreed that the BHSP was a means of enhancing financial sustainability and that it would help to enhance efficiency by targeting resources at population health need. The BHSP, according to some, represented the categories of healthcare that the government should finance, while allowing the private sector to meet demand for other services. However, many domestic actors supported the introduction of user fees as part of the BHSP. Several external actors either distanced themselves from this decision or declared no position, claiming that this was properly a matter for the government of Iraq. Discussion: While the BHSP’s ‘label’ is new in the context of Iraq, its substantive content is not. The BHSP can be seen as the outcome of the combination of old (existing) technologies and instruments presented in new (and introduced) ways. The existing health system offered ideas, techniques and processes that were maintained and reproduced even if these were packaged in new ways, to create a policy framework which is genuinely novel. External experts highlighted the idea of the BHSP and provided models (such as Afghanistan) on which the policy could be based. Internal decision-makers, however, were active players in policy formulation, not passive recipients who did not question or modify the policy during the process of transfer. On the contrary, it seems that the latter exerted considerable influence. User fees represent one aspect of that continuity. Ownership of policies by ministries of health in post-conflict is often advocated. However, such involvement introduces the potential for replicating old structures and policies, and may result in a degree of policy incoherence. Policy ideas are likely to change significantly where there is considerable local engagement in policy design and implementation

Human Resource Management Practices and Its Effects on Job Satisfaction Levels of Employees: An Analysis on the Selected SMEs in the Iron & Steel Industry of Erbil KRI

This study aims to investigate the impact of HRM practices and its effect on employee’s job satisfaction in the iron and steel sector of Erbil, KRI. The objectives of the study are three fold, first to measure the degree of association between HR practices and job satisfaction. Second, to find out the impact of HR practices on job satisfaction and at last to propose some measures in order to enhance the job satisfaction level of the employees concerned to the selected iron &amp; steel enterprises. A structured questionnaire was developed and distributed among 70 employees of three firms in Erbil, whereas 50 employees answered rightly. Most of the employees showed positive answers toward HR practices on them. This thing leads toward rejection of our Ho and acceptance of&nbsp; H1. Those who left behind with less positive answers&nbsp; main reason were found during survey that was they are with less education so that’s why they get less opportunities in order to develop themselves. Related to future research other authors can consider other variables that are not coved by this research such as staffing and package because human practices coves various range.&nbsp;&nbsp