Sexually Transmitted Infections: Educational Settings

Background: Sexually transmitted infections (STIs) are a major public health concern in Canada and worldwide. Nearly two-thirds of STIs are seen among youth. Therefore, it is crucial to provide effective STI interventions to youth. Substance use is an important factor for STI acquisition among youth because of high prevalence and its ability to link proximal sexual risk behaviors and distal contextual factors. STI preventive behavioral interventions remain the gold standard due to the limitations in biomedical interventions. Educational institutions are recognized as ideal settings to target youth. Thus, it is essential to assess whether integrating substance use into STI prevention programs at educational settings is worthwhile as well as whether STI preventive interventions at educational settings are effective and how can they be improved. Objectives and Methods: The objectives and methodologies of this thesis include 1) determine the prevalence and association between substance use and STIs among Canadian post-secondary students (descriptive analysis and logistic regression of the ACHA-NCHA II Spring 2016 survey data and 2) assess the efficacy and effectiveness of STI preventive intervention programs at educational settings (a systematic review and meta-analysis). Results: Positive association exists between current cannabis use or other drug use and STIs among Canadian post secondary students. STI preventive interventions at educational institutions in developed countries show effectiveness. Interventions are more effective in promoting knowledge compared to enhancing motivational factors, behavioral skills and behaviors, and for female students. No significant difference in effectiveness is seen based on the type of provider (peer-involved and non-peer-involved) and type of intervention (face-to-face and technology-based). Recommendations: Based on our findings, it is recommended to integrate substance use preventive interventions into STI preventive interventions at Canadian post-secondary institutions. A potential framework for effective STI preventive interventions at educational settings which can possibly be inferred to the Canadian post-secondary institutions is presented based on our results. This thesis will help inform, evaluate and guide STI preventive interventions at educational settings to effectively reduce the burden of STIs among Canadian youth. Future research with more rigorous methodology should be undertaken to provide conclusive evidence

ミャンマー国に於けるＣ型肝炎ウイルス陽性肝癌での鉄沈着と細胞増殖活性動態に関する研究

長崎大学学位論文 学位記番号:博（医歯薬）甲第89号 学位授与年月日:平成19年3月20

A Modular design framework for Lab-On-a-Chips

This research discusses the modular design framework for designing Lab-On-a-Chip (LoC) devices. This work will help researchers to be able to focus on their research strengths, without needing to learn details of LoCs design, and they can reuse existing LoC designs

Novel disease severity factors in systemic lupus erythematosus: A profile of mannose binding lectin gene polymorphisms, nephrin autoantibodies and brain-reactive autoantibodies

Ph.DDOCTOR OF PHILOSOPH

A Systematic Review on the Effectiveness of Different Functional Treatments for Acute Ankle Sprains

Background: An ankle sprain is a very common sport-related injury and can reduce participation in sports and employment. It can also create further complications in the function of the joint. Purpose: To evaluate the effectiveness of different functional treatments and to ascertain which functional treatment is the most effective method for acute ankle sprains. Study Design: Systematic review. Methods: The design of this systematic review was developed in accordance with PRISMA-P 2015 statement and performed according to its guidelines. A computerized literature search was performed from PubMed Central, MEDLINE via OVID and Cochrane library. Randomized controlled trials or quasi-experimental studies, published within a ten-year period (2007 to 2017), in peer-reviewed journals, with full-text articles and written in English were included in this study. Any type of functional treatments being applied to treat acute ankle sprains were considered as an intervention and only adult participants were included in this review. Surgical methods, unpublished trials, not written in the English language or not experimental research were excluded. Results: From the pooled data of this review, the stocking was more effective at improving pain, swelling, functional outcomes, range of motion, and return to sport/work, and had higher patient satisfaction than the bandage. There was no evidence that the taping and lace-up brace were more effective than other functional interventions in the treatment of acute ankle sprains. Furthermore, the prevalence of complications was greatest for the taping and lace-up brace interventions. The semi-rigid or posterior rigid support group had a better functional recovery and higher patient satisfaction, but some complications were present. Conclusion: The semi-rigid or posterior rigid support group and stocking were the most effective functional interventions for acute ankle sprain treatment. What is known about this subject: The functional treatments are becoming popular due to being effective, inexpensive and simplistic to apply. Different types of functional interventions have been used according to the choice of clinicians and patients in the treatment of ankle sprains. According to the previous researches, semi-rigid support, ankle braces, bandage and lace-up supports have greater advantages than other functional treatments from different perspectives (Example. the elastic bandage had a slower recovery rate than semi-rigid brace but less complications than taping, the lace-up support was better in swelling management than other functional treatments). What this study adds to existing knowledge: This study found that the stocking is an effective treatment for managing acute ankle sprains. It is valuable for the patient because the cost of the stocking is considerably cheaper than other functional treatments and it is very easy to wear. Some popular functional treatments like lace-up support; taping and semi-rigid braces were shown to have some complications

Factors associated with psychological distress among Myanmar residents during COVID-19 pandemic crises

Background: COVID-19 pandemic reached a public health emergency status of international concern. The impacts and events associated with this were associated with adverse psychological impacts among the general public globally. This study aimed to determine the prevalence of psychological distress and to identify predictors associated with psychological distress due to the COVID-19 pandemic among the population in Myanmar. Design and Methods: A cross-sectional survey was conducted from March to April 2020 among adults, 18 years old and above, who reside in Myanmar through a structured questionnaire distributed in social media platforms. Univariate and Bivariate analyses were used to estimate the prevalence of COVID-19 Peritraumatic Distress Index (CPDI) symptoms and to test the associations between CPDI and the exposure variables. Logistic Regression Analysis was done to identify significant predictors of distress. Results: There were 530 participants in this study.37.4% of them did not have psychological distress,55.6% experienced mild to moderate psychological distress, and 7% experienced severe psychological distress due to COVID-19 pandemic. Simple and Multiple Logistic Regression Analyses were performed to determine the factors associated with psychological distress due to COVID-19. Conclusions: It was shown that the self-employed group and age group older than 45 years old had more psychological distress than others. However, Buddhists and people from the capital city had less distress than other religions and districts. This study recommends the government to develop better strategies for self-employed groups, elders, and the poor for a support, relief, and resettlement of their ruined status

The Relationship Between Husband Support and Behavior of Pregnant Teenagers to Face Pregnancy During the Covid-19 Pandemic in Gombong, Kebumen, Indonesia

Background: Age influences pregnancy and childbirth. Pregnant women aged less than 20 years old or pregnant adolescents are not physically and mentally ready to cope with pregnancy or childbirth. The husband's support highly determines the health status of the mother. This research aimed to determine the relationship between husband support and the behavior of pregnant adolescents to face pregnancy during the COVID-19 pandemic in the Gombong District, Kebumen Regency. Methods: This study used a cross-sectional approach. The population was all pregnant women aged less than 20 years in the Gombong District, Kebumen Regency. It used a saturated sampling technique involving 256 people. Data were analyzed using univariate and bivariate analysis to answer the percentage and the Chi-Square test to answer the research hypothesis. Results: The study showed that 130 (50.8%) husbands did not support the mothers, and 126 (49.2%) husbands supported the mothers. The result also showed that 116 (45.3%) of the pregnant women showed positive behavior, while140 (54.7%) pregnant women showed negative behavior. The chi-square test found a p-value of 0.005, which proved a significant relationship between the husband's support and the behavior of pregnant adolescents to overcome pregnancy during the covid-19 pandemic. Conclusion: Pregnant teenagers with husband support will prepare for pregnancy and childbirth programs more maturely to ensure the safety of both mother and fetus

Factors Associated With Age of Diagnosis Among Myanmar Children with Autism Spectrum Disorders

This study aimed to find out the average age of diagnosis, and factors associated with the age of diagnosis, among Myanmar children with Autism Spectrum Disorders. A cross-sectional descriptive study involving 84 children from two private special schools, namely New World and Light House. All children who were diagnosed as ASD, according to DSM-IV criteria, were involved in this study. Data was collected from the caregivers by face-to-face interviewing. Physical examinations and investigations were done as necessary. Results: A total of 84 children with ASD were included in this study. The mean age of diagnosis was 3.5 years old. The minimum age of diagnosis was 1 year old and the maximum was 6 years old. There were significant findings regarding factors associated with the age of diagnosis. A higher educational standard of the child’s father, and some autism specific signs such as lack of pointing out objects of interest, and poor response to name being called, were associated with an earlier age of diagnosis of autism spectrum disorders. The presence of persistent preoccupation with parts of objects, the presence of selective eating habits and comorbid conditions like epilepsy and global delay, had been found to delay the age of diagnosis of ASDs. This study revealed information regarding the age of diagnosis among Myanmar children with ASD, and factors associated with the age of diag-nosis. Although this study could not represent the whole population, due to its limitation in sampling size and study area, the findings will contribute to future research being done in different places, including urban, as well as rural areas, with larger populations, which would result in a later age of diagnosis. Identified discrepancies in the age of diagnosis based on certain socio-demographic and clinical variables highlight the need for coordinated strategies for early detection of autism spectrum disorders

Advanced abdominal pregnancy with dead foetus: a case report

Abdominal pregnancy is a rare form of ectopic pregnancy in which the zygote implanted within the peritoneal cavity exception at ovaries, fallopian tubes and intra ligament spaces. The diagnosis is challenging and can be missed especially when the imaging facilities are not available in remote areas.A 35 years old, G3P2+0 was admitted to the hospital at 38+2 weeks of pregnancy with the chief complaint of reduced foetal movement for three days. She was taking regular antenatal care with the midwife at the rural health centre and uneventful until 37 weeks of pregnancy. On physical examination, the abdomen was distended, the foetal parts were easily palpable, no visible foetal movement and the foetal heart sound was not audible. Abdominal ultrasound scan identified the term foetus of abdominal pregnancy without foetal cardiac activity. The patient underwent laparotomy and dead, male foetus was extracted uneventfully. The placenta was attached to intestines and mesentery so that which was removed with great caution and secured haemostasis. The mother’s condition was stable throughout the operation and did not need to give the blood transfusion. The sutures were removed after 7 days and the healthy patient discharged from the hospital.Abdominal pregnancy is a rare condition and the diagnosis can be missed during the antenatal period and hence it is crucial to raise the awareness of health care personals especially in remote areas. The suspicious case of abdominal pregnancy should be referred to the experienced clinicians in the centres with diagnosis facilities