The effect of educational- counseling program on general health of women as caregivers of patient, with Alzheimerdisease

زمینه و هدف: ارائه مراقبت طولانی مدت به بیماران مبتلا به آلزایمر، با افزایش خطرات ابتلا به بیماری جسمی و روانی برای مراقبین همراه است و فقدان تعلیمات لازم نیز مشکلات سلامتی آنها را دو چندان نموده است. این مطالعه با هدف تعیین تاثیر برنامه آموزشی- مشاوره ای بر سلامت عمومی زنان مراقبت کننده از سالمندان مبتلا به آلزایمر انجام شده است. روش بررسی: در این پژوهش تجربی، 150 زن 18 تا 60 ساله که از وابستگان درجه یک سالمندان مبتلا به آلزایمر بوده و مراقبت مستقیم از آنها را به مدت حداقل 6 ماه به عهده داشتند، با روش نمونه گیری آسان انتخاب شدند و پس از انجام پیش آزمون شامل پرسشنامه اطلاعات دموگرافیک و سلامت عمومی گلدبرگ، با روش تصادفی بلوکه شده، به شکل تصادفی در دو گروه آزمون و کنترل قرار گرفتند. گروه آزمون در یک برنامه آموزشی – مشاوره ای شامل یک جلسه بحث گروهی، دریافت یک پمفلت آموزشی و دو مشاوره تلفنی شرکت نمودند. 6 هفته پس از مداخله، پس آزمون برای هر دو گروه انجام گرفت. برای مقایسه متغیرها از آزمون های آماری t زوجی، t مستقل، کای اسکوئر و آنالیز واریانس یک طرفه استفاده شد. یافته ها: نتایج نشان داد که قبل از برنامه آموزشی- مشاوره ای 3/17 از نمونه های مورد پژوهش سلامت عمومی نامطلوب داشتند. پس از انجام برنامه آموزشی- مشاوره ای میانگین سلامت عمومی در گروه آزمون از 3/15±68/39 به 03/10±09/19 تقلیل یافت (001/0

Inverse Protein Folding Using Deep Bayesian Optimization

Inverse protein folding -- the task of predicting a protein sequence from its backbone atom coordinates -- has surfaced as an important problem in the "top down", de novo design of proteins. Contemporary approaches have cast this problem as a conditional generative modelling problem, where a large generative model over protein sequences is conditioned on the backbone. While these generative models very rapidly produce promising sequences, independent draws from generative models may fail to produce sequences that reliably fold to the correct backbone. Furthermore, it is challenging to adapt pure generative approaches to other settings, e.g., when constraints exist. In this paper, we cast the problem of improving generated inverse folds as an optimization problem that we solve using recent advances in "deep" or "latent space" Bayesian optimization. Our approach consistently produces protein sequences with greatly reduced structural error to the target backbone structure as measured by TM score and RMSD while using fewer computational resources. Additionally, we demonstrate other advantages of an optimization-based approach to the problem, such as the ability to handle constraints

Peer navigation improves diagnostic follow-up after breast cancer screening among Korean American women: results of a randomized trial

To test an intervention to increase adherence to diagnostic follow-up tests among Asian American women. Korean American women who were referred for a diagnostic follow-up test (mainly diagnostic mammograms) and who had missed their follow-up appointment were eligible to participate in the study. Women from two clinics (n = 176) were randomly allocated to a usual care control arm or a peer navigator intervention arm. A 20-min telephone survey was administered to women in both study arms six months after they were identified to assess demographic and socio-economic characteristics and the primary outcome, self-reported completion of the recommended follow-up exam. Among women who completed the survey at six-month follow-up, self-reported completion of follow-up procedures was 97% in the intervention arm and 67% in the control arm (p < 0.001). Based on an intent-to-treat analysis of all women who were randomized and an assumption of no completion of follow-up exam for women with missing outcome data, self-reported completion of follow-up was 61% in the intervention arm and 46% in the usual care control arm (p < 0.069). Our results suggest that a peer navigator intervention to assist Korean American women to obtain follow-up diagnostic tests after an abnormal breast cancer screening test is efficacious

Equity in healthcare financing: A case of Iran

Background: Fair financial contribution in healthcare financing is one of the main goals and challengeable subjects in the evaluation of world health system functions. This study aimed to investigate the equity in healthcare financing in Shiraz, Iran in 2018. Materials and methods: This was a cross- sectional survey conducted on the Shiraz, Iran households. A sample of 740 households (2357 persons) was selected from 11 municipal districts using the multi-stage sampling method (stratified sampling method proportional to size, cluster sampling and systematic random sampling methods). The required data were collected using the Persian format of "World Health Survey" questionnaire. The collected data were analyzed using Stata14.0 and Excel 2007. The Gini coefficient and concentration and Kakwani indices were calculated for health insurance premiums (basic and complementary), inpatient and outpatient services costs, out of pocket payments and, totally, health expenses. Results: The Gini coefficient was obtained based on the studied population incomes equal to 0.297. Also, the results revealed that the concentration index and Kakwani index were, respectively, 0.171 and - 0.125 for basic health insurance premiums, 0.259 and - 0.038 for health insurance complementary premiums, 0.198 and - 0.099 for total health insurance premiums, 0.126 and - 0.170 for outpatient services costs, 0.236 and - 0.061 for inpatient services costs, 0.174 and - 0.123 for out of pocket payments (including the sum of costs related to the inpatient and outpatient services) and 0.185 and - 0.112 for the health expenses (including the sum of out of pocket payments and health insurance premiums). Conclusion: The results showed that the healthcare financing in Shiraz, Iran was regressive and there was vertical inequity and, accordingly, it is essential to making more efforts in order to implement universal insurance coverage, redistribute incomes in the health sector to support low-income people, strengthening the health insurance schemes, etc. © 2019 The Author(s)

Knowledge, attitudes and practice of breast cancer screening among female health workers in a Nigerian urban city

<p>Abstract</p> <p>Background</p> <p>Late presentation has been observed as the hallmark of breast cancer in Nigerian women and an earlier onset has been reported in this population. This study was designed to assess the awareness of female health workers about risk factors and screening methods for early detection of breast cancer.</p> <p>Methods</p> <p>A cross-sectional descriptive study was carried out among female health workers in the two major government health institutions in Benin City, Edo State capital in Nigeria.</p> <p>Data analysis was by SPSS version 10 and test of significance was done with differences considered significant at p < 0.05.</p> <p>Results</p> <p>Three hundred and ninety-three (393) female health workers out of five hundred and five eligible subjects completed and returned the questionnaires, giving a response rate of 77.8%. One hundred and two (26%) were Doctors, two hundred and fifty-four (64.6%) Nurses, and thirty-seven (9.4%) were Radiographers, Laboratory Scientists and Pharmacists. A high proportion of our respondents had very poor knowledge about risk factors for breast cancer (55%). The awareness of mammography as a diagnostic method was very high (80.7%), but an extremely low knowledge of mammography as a screening method was found. Mammography practice of only 3.1% was found among those above 40 years of age who qualify for routine annual screening. Relatively low knowledge (45.5%) about Breast Self Examination (BSE) as a screening method was found.</p> <p>Conclusion</p> <p>These female health workers who are expected to act as role models and educate the public had poor knowledge of risk factors for breast cancer and practice of breast cancer screening. There is very urgent need for regular update courses for health workers concerning breast cancer education including screening methods.</p

Various indicators for the assessment of hospitals' performance status: Differences and similarities

Background: Hospitals are the most costly operational and really important units of health system because they consume about 50-89 of total health resources. Therefore efficient use of resources could help in saving and reallocating the financial and physical resources. Objectives: The aim of this study was to obtain an overview of hospitals' performance status by applying different techniques, to compare similarities and differences between these methods and suggest the most comprehensive and practical method of appraisal for managers and policy makers. Patients and Methods: This is a cross sectional study conducted in all hospitals of Ahvaz (eight hospitals affiliated with Jundishapur University of Medical Sciences and eight non-affiliated hospitals) during 2007 to 2011. Two kinds of data were collected through separate special checklists. Excel 2007 and Windeap 2.1 software were applied for data analysis. Results: The present findings show that the average of bed occupancy rate (BOR) in the studied hospitals was about 65.91 ± 1.16. The maximum number of inefficient hospitals in the present study happened in the years 2007, 2008 and 2010 (four hospitals) but there were two hospitals in the third part of the present graph which had maximum level of efficiency and optimal level of productivity in the years 2007 and 2009. Data Envelopment Analysis (DEA) showed that the mean score of technical efficiency for the studied hospitals is 0.924 ± 0.105 with the minimum of 0.585 ± 0.905 for hospital number 1. Furthermore It shows that only five hospitals (31.25) reach complete technical efficiency (TE) scores across all five years of 2007-11 (TE = 1). Conclusions: Results of the present and similar studies should be considered for the future planning and resource allocation of Iranian public hospitals. At the same time it is very important to consider need assessment results for each region according to its potentials, population under the coverage and other geographical and cultural indices. Furthermore because of potential limitations of each of the above models it is highly recommended to apply different methods of performance evaluation to reach a complete and real status view of the hospitals for future planning. © 2014, Iranian Red Crescent Medical Journal; Published by Kowsar Corp

Illness perceptions and explanatory models of viral hepatitis B & C among immigrants and refugees: a narrative systematic review.

© 2015 Owiti et al.; licensee BioMed Central. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.BACKGROUND: Hepatitis B and C (HBV, HCV) infections are associated with high morbidity and mortality. Many countries with traditionally low prevalence (such as UK) are now planning interventions (screening, vaccination, and treatment) of high-risk immigrants from countries with high prevalence. This review aimed to synthesise the evidence on immigrants' knowledge of HBV and HCV that might influence the uptake of clinical interventions. The review was also used to inform the design and successful delivery of a randomised controlled trial of targeted screening and treatment. METHODS: Five databases (PubMed, CINHAL, SOCIOFILE, PsycINFO & Web of Science) were systematically searched, supplemented by reference tracking, searches of selected journals, and of relevant websites. We aimed to identify qualitative and quantitative studies that investigated knowledge of HBV and HCV among immigrants from high endemic areas to low endemic areas. Evidence, extracted according to a conceptual framework of Kleinman's explanatory model, was subjected to narrative synthesis. We adapted the PEN-3 model to categorise and analyse themes, and recommend strategies for interventions to influence help-seeking behaviour. RESULTS: We identified 51 publications including quantitative (n = 39), qualitative (n = 11), and mixed methods (n = 1) designs. Most of the quantitative studies included small samples and had heterogeneous methods and outcomes. The studies mainly concentrated on hepatitis B and ethnic groups of South East Asian immigrants residing in USA, Canada, and Australia. Many immigrants lacked adequate knowledge of aetiology, symptoms, transmission risk factors, prevention strategies, and treatment, of hepatitis HBV and HCV. Ethnicity, gender, better education, higher income, and English proficiency influenced variations in levels and forms of knowledge. CONCLUSION: Immigrants are vulnerable to HBV and HCV, and risk life-threatening complications from these infections because of poor knowledge and help-seeking behaviour. Primary studies in this area are extremely diverse and of variable quality precluding meta-analysis. Further research is needed outside North America and Australia

Conducting Health Research in Korean American Churches: Perspectives from Church Leaders

Korean Americans experience many challenges to obtaining adequate health care coverage and access to needed services. Because a large proportion of Korean Americans attend churches on a regular basis, churches may be a promising venue where health programs can be delivered. In order to gain an in-depth understanding of Korean American churches with respect to conducting future health intervention research, we conducted exploratory interviews and focus groups with 58 leaders from 23 Korean American churches and three community organizations. From these interviews and focus groups, we found that Korean churches and church leaders seek to meet a variety of social and health needs of their congregation and their surrounding community. Several leaders have stated that assisting with social and medical needs of their members is an important component of their current ministry. They described profound health needs of their congregations and have suggested various ways in which the university can partner with the local churches to help address these needs through research. Additionally, they described various resources churches can provide to researchers such as: their personal assistance, church volunteer base, church facility, and church network and contacts. Our findings suggest that Korean churches have a high potential to serve an important role in the health of Korean Americans. On the basis of the promising results of the present study, we are planning to conduct a cross sectional survey of Korean church leaders and members in Los Angeles County to substantiate our findings in a larger representative sample