A Systematic Literature Review on Health Information Sharing Among Older Adults

The purpose of this research is to synthesize the findings of existing studies on the sharing of health information among older adults. This SLR follows the PRISMA model to provide an extensive analysis of the practices of health information sharing among older adults. This review synthesizes the results of the searches in Google Scholar, Web of Science (WoS), and Scopus databases that investigated the purpose to share health related information, technologies used, and challenges faced by older adults in sharing their health information. Most of the studies emphasize that the elderly use computers, mobile phones, and social media apps to discuss their health issues with doctors and families. However, there are challenges like technology constraints, people’s resistance to technology, and lack of funds that hinder information sharing. Moreover, the study shows the variety of technologies used by older people, indicating the necessity for more individualized approaches to the development of interventions. Subsequent studies should focus on tackling these barriers with the help of specific interventions and creating effective technology designs that would enhance the accessibility of healthcare services for elderly people. By bridging the digital divide and enhancing access to technology, stakeholders can foster a more equitable healthcare system that empowers older adults to actively engage in health information sharing, ultimately improving their health outcomes and overall well-being

A phenomenological investigation on ethical leadership and workplace engagement from a multi-cultural perspective

Despite continuous attempts to introduce employee engagement measures, leaders worldwide have been increasingly concerned about diminishing employee engagement levels. The issue of workplace engagement continues to be a source of contention for academics and practitioners alike. There is still a need to comprehend this phenomenon since previous research lacks a thorough understanding of employee work engagement concerning ethical leadership. This qualitative study explores the perceptions of the leaders working in service organizations regarding ethical leadership on employee work engagement in three countries, i.e., Malaysia, Turkey, and Pakistan. The phenomenon of work engagement was explored in this study. The theory of self-determination supports the proposed theoretical framework of the current study. Purposive sampling was applied to select 28 leaders in the service sector. Semi-structured interviews were performed to understand employee engagement better using participant observations, opinions, strategic perspectives, and the employee handbook and recordings of interviews and meetings with service sector leaders. The findings highlighted eight major ethical leadership themes suggested by 28 managers in the interviews. Eight themes of ethical leadership are (1) Role Modeling, (2) Trust, (3 Honesty, (4) Integrity, (5) Justice, (6) Religiosity, (7) Responsibility, (8) Intellectual competence. The present study found that leaders applying different strategies and understanding the importance of employee engagement could improve employee engagement and have a more robust workforce and beneficial organization. (C) CIKD Publishing

Higher scrotal uptake ratio of (99m)Tc-MDP on bone scans in newly diagnosed prostate cancer : a reliable indicator of pelvic node metastasis.

Abstract OBJECTIVE: Pelvic lymph node dissection (PLND) is the gold standard procedure for nodal staging in prostate cancer (PC) but less commonly used due to its invasiveness. More commonly computerized tomography (CT) and magnetic resonance imaging (MRI) are used although these have limited sensitivities and specificities. The aim of this study was to find out the correlation between higher scrotal uptake ratio (SUR) of (99m)Tc-methylene diphosphonate (MDP) on bone scan and pelvic nodemetastasis in patients with PC at high risk for nodal metastasis. METHODS: This was a retrospective study which included 68 biopsy proven newly diagnosed PC patients who had bone scan from January 2008 till January 2012. MRI of the pelvis, prostate specific antigen (PSA) and Gleason\u27s score were available in all patients. Whole body bone scan was performed in all patients and SUR was calculated by dividing mean counts over scrotum and soft tissue over lateral aspect of right thigh. PLND was carried out within 2-3 weeks of MRI study in these patients. RESULTS: Mean age of studied males was 71 ± 07 years with a mean PSA level of 65 ± 162 ng/ml. Prostate biopsy revealed adenocarcinoma in all patients with mean Gleason\u27s score 7 ± 1. Mean SUR was 2.786 ± 0.496. MRI was positive for pelvic lymphadenopathy in 32/68 (47 %). PLND revealed evidence of nodal metastasis in 16/68 (24 %) patients. Receiver operating characteristic analysis revealed good diagnostic strength of SUR for nodal metastasis with a cut off value of \u3e2.99 with an area under curve (AUC) 0.708 (95 % CI 0.533-0.847, p value \u3c0.05) and a mean sensitivity of 68.75 % and mean specificity of 80 %. Diagnostic strength of MRI for nodal metastasis was found to be low (AUC 0.566, 95 % CI 0.047-0.657, non-significant p value). No significant correlation was found between SUR and PSA in nodes positive and nodes negative patients. CONCLUSION: We conclude that in newly diagnosed PC patients, higher SUR on bone scan has a high diagnostic accuracy for pelvic node metastasis. Furthermore, a bone scan with a SUR \u3c2.99 and negative for bone metastasis can stratify newlydiagnosed PC patients as low risk

Comparative effects of mulligan’s mobilization and proprioceptive neuromuscular facilitation technique on pain and disability in patients with sacroiliac joint dysfunction

Purpose: To evaluate the efficacy of Mulligan’s Movement of Mobilization and contract- relax technique on pain and disability in patients suffering from sacroiliac joint Dysfunction. Method: A randomized clinical trial was done at DHQ hospital Jhang. 38 persons including both genders old enough 20-35 years were associated with this review who meet the inclusion criteria were recruited by consecutive sampling technique and allocated to the groups by simple random sampling process and by sealed opaque enveloped labeled as 0 for group A and 1 for group B and indiscriminately allocated into two sets. One set A was specified to mulligan mobilization technique and the second set B was specified to contract-relax technique for 6 weeks as three sessions per week. Baseline treatment of hot pack and ultrasound was given to both groups. All the patients were assessed for pain with NPRS and for disability with MOPDQ before and after treatment. Data was analyzed using SPSS 22. Results: After treatment, both groups significantly improved in terms of pain and disability. Mean value of NPRS was reduced from 6.89±1.15 to 1.68±.58 in MWM Group while in Contract-Relax from 6.78±1.18 to 2.57±.90. Mean Value of MOPDQ improved from 31.00±6.24 to 2.95±.911 and 32.26±7.14 to 4.31±1.20 in MWM and Contract-Relax group. However, group that received mulligan technique had significantly better improved NPRS and MOPDQ values than contract-relax group in patients with Sacro-iliac dysfunction (p<0.05). Conclusion: In the management of sacroiliac joint dysfunction, Mulligan mobilization is more efficient than contract-relax approach

Trends in antimicrobial susceptibility patterns of bacterial isolates in Lahore, Pakistan

BackgroundAntimicrobial resistance (AMR) has provoked a global health issue. Antimicrobial stewardship programs should be implemented to overcome this issue. The aim of this study was to determine the sensitivity patterns of the WHO Access, Watch, Reserve (AWaRe) group of antibiotics that assists in the selection of appropriate empiric antibiotic therapies.MethodA descriptive, cross-sectional study was conducted for 6 months, in which 422 culture sensitivity sample reports from the Ghurki Trust Teaching Hospital’s laboratory were obtained through a convenience sampling technique, and the sensitivity patterns of nine offending bacteria to the WHO AWaRe group antibiotics were determined. Descriptive statistics and differences in frequency distribution among the categorical variables were obtained using the Statistical Package for Social Sciences (SPSS) software, version 21.ResultsAmong 422 culture sensitivity sample reports, Escherichia coli (16.1%) was the most common Gram-negative pathogen. Acinetobacter, E. coli, Klebsiella, and Pseudomonas showed 100% sensitivity to polymyxin-b and colistin. Proteus showed the highest sensitivity to meropenem (90%), Staphylococcus aureus showed a 98% sensitivity to linezolid, Staphylococcus epidermidis was 100% sensitive to vancomycin and linezolid, and Streptococcus showed the highest sensitivity to penicillin (100%) and vancomycin (94.7%). Polymyxin b and colistin were found to be the most effective antibiotics against Gram-negative bacteria (100%). Gram-positive bacteria were highly sensitive to linezolid (99.4%), vancomycin (98.2%), chloramphenicol (89.5%), and tigecycline (82.6%).ConclusionCulture sensitivity reports help to rationalize the empirical use of antibiotics in clinical practice in addressing the challenge of antimicrobial resistance. This study showed that polymyxin-b and colistin were the most effective antibiotics against Gram-negative isolates and that Gram-positive bacteria were highly susceptible to linezolid. Updated antibiograms should be used by clinicians to evaluate bacterial susceptibility patterns and rationalize antibiotic empiric therapy

A non-injected opioid analgesia protocol for acute pain crisis in adolescents and adults with sickle cell disease

Initial management of the acute pain crisis (APC) of sickle cell disease (SCD) is often unsatisfactory, and might be improved by developing a standardised analgesia protocol. Here, we report the first stages in developing a standard oral protocol for adolescents and adults. Initially, we performed a dose finding study to determine the maximal tolerated dose of sublingual fentanyl (MTD SLF) given on arrival in the acute care facility, when combined with repeated doses of oral oxycodone. We used a dose escalation algorithm with two dosing ranges based on patient’s weight (50 kg). We also made a preliminary evaluation of the safety and efficacy of the protocol. The study took place in a large tertiary centre in London, UK. Ninety patients in the age range 14–60 years were pre-consented and 31 treatment episodes were evaluated. The first 21 episodes constituted the dose escalation study, establishing the MTD SLF at 600 mcg (>50 kg) or 400 mcg (<50 kg). Further evaluation of the protocol indicated no evidence of severe opioid toxicity, nor increased incidence of acute chest syndrome (ACS). Between 0 and 6 hours, the overall gradient of reduction of visual analogue pain score (visual analogue scale (VAS)) was 0.32 centimetres (cm) per hour (95% confidence interval (CI) = 0.20 to 0.44, p < 0.001). For episodes on MTD SLF, there was median (interquartile range (IQR)) reduction in VAS score of 2.8 cm (0–4.2) and 59% had at least a 2.6-cm reduction. These results are supportive of further evaluation of this protocol for acute analgesia of APC in a hospital setting and potentially for supervised home management.The trial was funded by a grant from the Barts Charity (reference no. 1704), the National Institute for Health Research North Thames Clinical Research Network Divisional Contingency Funding, and unrestricted grants from Kyowa Kirin and Napp Pharmaceuticals

An Overview of Functional Food

Functional foods are responsible for the improvement of human health and can significantly reduce the probability of disease in the host body. Functional foods are directly or indirectly part of different food ingredients and can induce functional activities in the host biological system. Functional foods are present in fruits, vegetables, dairy, bakery, cereals and meat products. Functional foods are not additional food supplements, drugs or antibiotics, they are the main component of a normal human and animal diet. Functional foods are cost-effective and easily available in the market. Daily consumption of functional foods can prevent the gastrointestinal diseases and also provide ease against different acute and chronic diseases. Adequate administration of probiotics in a human food can convert a normal food into functional food. This chapter will highlight the effective role of functional food in an individual’s daily life

Neutralising antibody potency against SARS-CoV-2 wild-type and omicron BA.1 and BA.4/5 variants in patients with inflammatory bowel disease treated with infliximab and vedolizumab after three doses of COVID-19 vaccine (CLARITY IBD):an analysis of a prospective multicentre cohort study

Background: Anti-TNF drugs, such as infliximab, are associated with attenuated antibody responses after SARS-CoV-2 vaccination. We aimed to determine how the anti-TNF drug infliximab and the anti-integrin drug vedolizumab affect vaccine-induced neutralising antibodies against highly transmissible omicron (B.1.1.529) BA.1, and BA.4 and BA.5 (hereafter BA.4/5) SARS-CoV-2 variants, which possess the ability to evade host immunity and, together with emerging sublineages, are now the dominating variants causing current waves of infection. Methods: CLARITY IBD is a prospective, multicentre, observational cohort study investigating the effect of infliximab and vedolizumab on SARS-CoV-2 infection and vaccination in patients with inflammatory bowel disease (IBD). Patients aged 5 years and older with a diagnosis of IBD and being treated with infliximab or vedolizumab for 6 weeks or longer were recruited from infusion units at 92 hospitals in the UK. In this analysis, we included participants who had received uninterrupted biological therapy since recruitment and without a previous SARS-CoV-2 infection. The primary outcome was neutralising antibody responses against SARS-CoV-2 wild-type and omicron subvariants BA.1 and BA.4/5 after three doses of SARS-CoV-2 vaccine. We constructed Cox proportional hazards models to investigate the risk of breakthrough infection in relation to neutralising antibody titres. The study is registered with the ISRCTN registry, ISRCTN45176516, and is closed to accrual. Findings: Between Sept 22 and Dec 23, 2020, 7224 patients with IBD were recruited to the CLARITY IBD study, of whom 1288 had no previous SARS-CoV-2 infection after three doses of SARS-CoV-2 vaccine and were established on either infliximab (n=871) or vedolizumab (n=417) and included in this study (median age was 46·1 years [IQR 33·6–58·2], 610 [47·4%] were female, 671 [52·1%] were male, 1209 [93·9%] were White, and 46 [3·6%] were Asian). After three doses of SARS-CoV-2 vaccine, 50% neutralising titres (NT50s) were significantly lower in patients treated with infliximab than in those treated with vedolizumab, against wild-type (geometric mean 2062 [95% CI 1720–2473] vs 3440 [2939–4026]; p&lt;0·0001), BA.1 (107·3 [86·40–133·2] vs 648·9 [523·5–804·5]; p&lt;0·0001), and BA.4/5 (40·63 [31·99–51·60] vs 223·0 [183·1–271·4]; p&lt;0·0001) variants. Breakthrough infection was significantly more frequent in patients treated with infliximab (119 [13·7%; 95% CI 11·5–16·2] of 871) than in those treated with vedolizumab (29 [7·0% [4·8–10·0] of 417; p=0·00040). Cox proportional hazards models of time to breakthrough infection after the third dose of vaccine showed infliximab treatment to be associated with a higher hazard risk than treatment with vedolizumab (hazard ratio [HR] 1·71 [95% CI 1·08–2·71]; p=0·022). Among participants who had a breakthrough infection, we found that higher neutralising antibody titres against BA.4/5 were associated with a lower hazard risk and, hence, a longer time to breakthrough infection (HR 0·87 [0·79–0·95]; p=0·0028). Interpretation: Our findings underline the importance of continued SARS-CoV-2 vaccination programmes, including second-generation bivalent vaccines, especially in patient subgroups where vaccine immunogenicity and efficacy might be reduced, such as those on anti-TNF therapies. Funding: Royal Devon University Healthcare NHS Foundation Trust; Hull University Teaching Hospital NHS Trust; NIHR Imperial Biomedical Research Centre; Crohn's and Colitis UK; Guts UK; National Core Studies Immunity Programme, UK Research and Innovation; and unrestricted educational grants from F Hoffmann-La Roche, Biogen, Celltrion Healthcare, Takeda, and Galapagos.</p

Genomic investigations of unexplained acute hepatitis in children

Since its first identification in Scotland, over 1,000 cases of unexplained paediatric hepatitis in children have been reported worldwide, including 278 cases in the UK1. Here we report an investigation of 38 cases, 66 age-matched immunocompetent controls and 21 immunocompromised comparator participants, using a combination of genomic, transcriptomic, proteomic and immunohistochemical methods. We detected high levels of adeno-associated virus 2 (AAV2) DNA in the liver, blood, plasma or stool from 27 of 28 cases. We found low levels of adenovirus (HAdV) and human herpesvirus 6B (HHV-6B) in 23 of 31 and 16 of 23, respectively, of the cases tested. By contrast, AAV2 was infrequently detected and at low titre in the blood or the liver from control children with HAdV, even when profoundly immunosuppressed. AAV2, HAdV and HHV-6 phylogeny excluded the emergence of novel strains in cases. Histological analyses of explanted livers showed enrichment for T cells and B lineage cells. Proteomic comparison of liver tissue from cases and healthy controls identified increased expression of HLA class 2, immunoglobulin variable regions and complement proteins. HAdV and AAV2 proteins were not detected in the livers. Instead, we identified AAV2 DNA complexes reflecting both HAdV-mediated and HHV-6B-mediated replication. We hypothesize that high levels of abnormal AAV2 replication products aided by HAdV and, in severe cases, HHV-6B may have triggered immune-mediated hepatic disease in genetically and immunologically predisposed children