Social and Economic Factors that Influence Health Outcomes in Family Medicine

Over the last twenty years, the social determinants of health (SDOH) have gained more and more attention in the public health community. SDOH are non-medical elements that may be significantly impacted by social policies and have an impact on health. The increasing variety that exists within our societies makes it absolutely necessary for us to incorporate into undergraduate medical education social determinants of health such as racial factors, financial instability, partner violence, insufficient accessibility to transportation, and inadequate social supports, as well as the crucial role of health education.  Nonetheless, a growing body of research indicates that a variety of health outcomes are fundamentally caused by socioeconomic variables including wealth, income, and education together. In this review we highlight the influence of socio-economic factors on health outcomes, approaches to incorporate social determinants of health in family medicine practice, and we also talk about challenges and solutions in addressing social determinants in family medicine. The objective of this research was to assess the impact of social determinants of health on family medicine practice in which socioeconomic determinants of health might have an effect on health outcomes and healthcare delivery within the context of a family medicine clinical environment

Healthcare Administration Facilitating Neonatal Resuscitation Program Role Of Nursing, Midwifery, Clinical Laboratory And Radiological Teams In NRP

The purpose of this review was to investigate the level of knowledge that nurses and midwives, as well as the clinical laboratory and radiology team, have regarding neonatal resuscitation. Additionally, the review aimed to investigate the effect that education has on knowledge levels, as well as the role that healthcare administration plays in making the program accessible to healthcare providers. Based on the timing of events, data from real-life instances reveal that main resuscitation events, as recommended by the guidelines of the Neonatal Resuscitation Program, are frequently severely delayed. Taking into consideration the fact that the individuals who participated in the NRP practitioner-training course had completed the course within the past four to five years, it was seen that the knowledge points were pretty satisfactory

Prevalence of internalized stigma in patients with psychiatric illness in Abha, Southern Region, Saudi Arabia

BACKGROUND: Mental stigma occurs when patients with various mental disorders are labeled by their disorders. Little is known about the burden of mental stigma on patients with mental disorders. The aim of this study was to evaluate the incidence of mental stigma on patients with psychiatric disorder in Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study was conducted among previously diagnosed patients with any psychiatric disorder attending King Khalid Hospital, Abha, Saudi Arabia. The patients were interviewed with a sociodemographic questionnaire and a validated Arabic version of the Internalized Stigma of Mental Illness (ISMI-29) scale. Chi-square test and t-test were used to assess the association between various demographic characteristics and presence of stigma. RESULTS: The study included 489 patients with different psychiatric disorders. The mean age of the participants was 32.8 years and 54.6% were females. About 39% participants showed no to minimal internalized stigma, 37.4% of total sample had mild stigma, 20% had moderate stigma, and 3.7% had severe stigma. A signficantly higher proportion (71.4%) of widowed patients had stigma (P = 0.032). CONCLUSION: Self-stigma is prevalent among patients with psychiatric disorders in Abha, Saudi Arabia, but lower than the prevalence in developing countries. Marital status has a significant impact on the prevalence and severity of the self-stigma of patients. There is a need for awareness program to reduce self-stigma. Psychiatric institutions should also focus on promotion of patients' social life and increase patient's awareness of certain issues that could prevent stigma

Postprandial Antioxidative Response to Ingestion of Formulated Date- and Fruit-Based Nutritional Bars by Healthy Individuals

Nutritional bars (NBs) are gaining popularity among healthy and athletic individuals, but postprandial antioxidative response has not been investigated. Therefore, the current study examined the postprandial alterations in total phenolic content (TPC), total antioxidant capacity (T-AOC), malondialdehyde (MDA), and Superoxide dismutase (SOD) in the plasma of healthy individuals after the ingestion of 140 g (510 Kcal) from formulated date-based bars (DBBs) or fruit-based bars (FBBs). Firstly, the free and bound phenolic contents (PCs) were determined to be 10.15 and 12.98 and 6.19 and 3.57 mg GAE g−1, respectively. FBBs were significantly higher in free PC than DBBs, while DBBs were considerably higher in bound PC than FBBs. Secondly, twenty participants with age, height, weight, body mass index (BMI), fat mass, and fat-free mass averages of 21.4 years, 170.0 cm, 66.3 kg, 22.9 kg m2, 14.5, and 29.2 kg, respectively, were subjected to metabolic experiments (ISRCTN19386758). Ingestion of 140 g of FBB or DBB resulted in 288.50 or 302.14 µg TPC mL−1 blood, respectively. Postprandial TPC content increased with time progression and peaked after 120 min. T-AOC contents averaged 22.63 and 23.61 U mL−1 before ingestion of FBBs or DBBs, respectively. The T-AOC content increased significantly 120 and 180 min after ingestion of DBBs, while no significant change was noted after consuming FBBs. A significant decrease in MDA content was observed 180 min after consuming DBBs, while no significant change was noted after consuming FBBs. SOD concentrations ranged from 193.99 to 201.07 U L−1 in FBBs and DBBs, respectively. No considerable response was noted up to 3 h after ingestion of FBBs. On the contrary, a significant response was found 120 min after consuming DBBs. Pearson’s correlation coefficient indicated a highly significant positive correlation coefficient (p p > 0.05) differ between DBBs and FBBs, except for TPC (p = 0.04, paired t-test) and SOD (p = 0.003, paired t-test). Further studies with an extended experimental time are needed to confirm the current findings

Integrating technology acceptance model with innovation diffusion theory: an empirical investigation on students' intention to use e-learning systems

This paper aims to explore and investigate the potential factors influencing students' behavioral intentions to use the e-learning system. This paper proposes an extended technology acceptance model (TAM) that has been tested and examined through the use of both innovation diffusion theory (IDT) and integrating TAM. This paper was conducted on 1286 students utilizing systems of e-learning in Malaysia. The findings were obtained via a quantitative research method. The findings illustrate that six perceptions of innovation characteristics, in particular, have impacts on students' e-learning system behavioral intention. The influences of the relative advantages, observability, trialability, perceived compatibility, complexity, and perceived enjoyment on the perceived ease of use is noteworthy. Moreover, the effects of the relative advantages, complexity, trialability, observability, perceived compatibility, and perceived enjoyment on the perceived usefulness have a strong impact. Therefore, the empirical results provide strong backing to the integrative approach between TAM and IDT. The findings suggest an extended model of TAM with IDT for the acceptance of the e-learning system used to improve the students' learning performance, which can help decision makers in higher education, universities, as well as colleges to evaluate, plan and execute the use of e-learning systems

Ranitidine Impairs Bone Healing and Implant Osseointegration in Rats' Tibiae

Purpose: Ranitidine has been found to have an impact on bone metabolism by suppressing osteoclastogenesis. We hypothesized that the use of ranitidine would impair bone healing and implant osseointegration. This study investigated the effect of postoperative administration of ranitidine on bone healing and osseointegration in rats. Materials and Methods: Twenty-two Sprague-Dawley rats underwent surgery to create a unicortical bone defect in each tibia. A titanium implant was placed on the right tibial defect, whereas the contralateral defect was left unfilled. After surgery, the rats were randomly divided into 2 groups receiving a daily dose of ranitidine or saline solution for 14 days and then euthanized for assessment of bone healing and osseointegration using micro?computed tomography (CT) and histomorphometry. Results: Micro-CT analysis of the bone defect showed a larger bone defect volume in the ranitidine group (0.82 � 0.13 ?L vs 0.66 � 0.16 ?L, P = .034), thinner cortical thickness (0.54 � 0.07 mm vs 0.63 � 0.11 mm, P = .026), and less bone regeneration at the defect site (40% � 12% vs 57% � 11%, P = .003). Implant-site micro-CT analysis showed less osseointegration in the ranitidine group (34.1% � 2.7% vs 43.5% � 2.1%, P = .014), and implant-site histologic analysis showed less medullary (P = .021), cortical (P = .001), and total (P = .003) bone-implant contact and less peri-implant bone volume?tissue volume (P = .002) in the ranitidine group. Histologic analysis for osteoclastic activity showed a lower number of osteoclasts in the ranitidine group (4.8 � 2.4 mm?2 vs 9.1 � 2.1 mm?2, P = .026). Conclusions: The postoperative use of ranitidine impaired bone healing and osseointegration. ? 2020 American Association of Oral and Maxillofacial SurgeonsScopu

Normative and Equated Data of the Original and Basic Versions of the Montreal Cognitive Assessment among Community Dwelling Saudi Arabians

Introduction. Currently, there are standard and basic versions of the MoCA, the latter designed for those with lower educational achievements. Community-based normative data on these versions of the MoCA from Arabic populations are deficient, and there is little data demonstrating how both scales perform in comparison. We aim to obtain normative performances from both versions and equate the measures of both scales. Methods. Community-based recruitment of healthy volunteers≥18 years of age. Participants underwent testing with both versions. Demographic data was collected with regard to age, gender, years of education, diabetes, and hypertension. Regression analysis was performed to determine significance of variables, and the circle-arc equating method was used to equate the two scores from each scale. Results. 311 participants were included in the study. The mean (sd) age was 45.8 (15.96), females were 184 (59.16%), and the duration of education was 12.7 (5.67) years. The mean scores on the MoCA-A and MoCA-B were 21.47 (4.53) and 24.37 (4.71) (P<0.0001), respectively. Multivariate regression showed significance of age and years of education in both versions (both variables with P<0.0001). Correlation coefficient between the two scales was 0.77 (P<0.0001). The largest equated difference between both MoCA versions was four points in those scoring from 10-20 on the MoCA-A. Conclusion. We present normative data from a large Saudi Arabian community-based sample with two different MoCA tests, and an equating graph is presented to determine the corresponding expected performance between the two scales

Prevalence, Predictors, and Awareness of Coffee Consumption and Its Trend among Saudi Female Students

This study aimed to investigate the prevalence, trends, and predictors of coffee consumption among Saudi female students and its association with anthropometric and demographic variables. A survey-based study using a face-to-face interview was designed, and 930 (aged 21.5 &plusmn; 2.1 years) apparently healthy female students from different departments of King Saud University participated. The prevalence of coffee consumption was significantly higher (88.2%, p &lt; 0.03) in the central Riyadh region. Coffee consumers had significantly higher prevalence of being overweight than non-consumers (p = 0.02). The frequency of coffee consumption was significantly higher (p &lt; 0.02) in students who were single and belonged to families with a moderate income level. Coffee consumption was significantly higher among first-year students with a high-scale grade point average (GPA) (p &lt; 0.001 and p = 0.03, respectively). Increased coffee consumption during exam and stress conditions was associated with unhealthy dietary habits such as using more sugar and spices. The prevalence of coffee consumption was high among Saudi females. High body mass index (BMI) and increased family income level were strong determinants for coffee consumption. Continued nutritional education and awareness about the potential positive and negative health effects of coffee consumption and the importance of food label use should be provided to younger generations in order to correct the wrong perceptions

Therapeutic Switching of Rafoxanide: a New Approach To Fighting Drug-Resistant Bacteria and Fungi

ABSTRACT Control and management of life-threatening bacterial and fungal infections are a global health challenge. Despite advances in antimicrobial therapies, treatment failures for resistant bacterial and fungal infections continue to increase. We aimed to repurpose the anthelmintic drug rafoxanide for use with existing therapeutic drugs to increase the possibility of better managing infection and decrease treatment failures. For this purpose, we evaluated the antibacterial and antifungal potential of rafoxanide. Notably, 70% (70/100) of bacterial isolates showed multidrug resistance (MDR) patterns, with higher prevalence among human isolates (73.5% [50/68]) than animal ones (62.5% [20/32]). Moreover, 22 fungal isolates (88%) were MDR and were more prevalent among animal (88.9%) than human (87.5%) sources. We observed alarming MDR patterns among bacterial isolates, i.e., Klebsiella pneumoniae (75% [30/40; 8 animal and 22 human]) and Escherichia coli (66% [40/60; 12 animal and 28 human]), and fungal isolates, i.e., Candida albicans (86.7% [13/15; 4 animal and 9 human]) and Aspergillus fumigatus (90% [9/10; 4 animal and 5 human]), that were resistant to at least one agent in three or more different antimicrobial classes. Rafoxanide had antibacterial and antifungal activities, with minimal inhibitory concentration (MICs) ranging from 2 to 128 μg/mL. Rafoxanide at sub-MICs downregulated the mRNA expression of resistance genes, including E. coli and K. pneumoniae blaCTX-M-1, blaTEM-1, blaSHV, MOX, and DHA, C. albicans ERG11, and A. fumigatus cyp51A. We noted the improvement in the activity of β-lactam and antifungal drugs upon combination with rafoxanide. This was apparent in the reduction in the MICs of cefotaxime and fluconazole when these drugs were combined with sub-MIC levels of rafoxanide. There was obvious synergism between rafoxanide and cefotaxime against all E. coli and K. pneumoniae isolates (fractional inhibitory concentration index [FICI] values ≤ 0.5). Accordingly, there was a shift in the patterns of resistance of 16.7% of E. coli and 22.5% of K. pneumoniae isolates to cefotaxime and those of 63.2% of C. albicans and A. fumigatus isolates to fluconazole when the isolates were treated with sub-MICs of rafoxanide. These results were confirmed by in silico and mouse protection assays. Based on the in silico study, one possible explanation for how rafoxanide reduced bacterial resistance is through its inhibitory effects on bacterial and fungal histidine kinase enzymes. In short, rafoxanide exhibited promising results in overcoming bacterial and fungal drug resistance. IMPORTANCE The drug repurposing strategy is an alternative approach to reducing drug development timelines with low cost, especially during outbreaks of disease caused by drug-resistant pathogens. Rafoxanide can disrupt the abilities of bacterial and fungal cells to adapt to stress conditions. The coadministration of antibiotics with rafoxanide can prevent the failure of treatment of both resistant bacteria and fungi, as the resistant pathogens could be made sensitive upon treatment with rafoxanide. From our findings, we anticipate that pharmaceutical companies will be able to utilize new combinations against resistant pathogens