Introduction: Devices for Magnetic Resonance Imaging (MRI) represent the specific conditions for disinfection. Among the relevant facts include the presence of electronic equipment in a single device that limits the possibility of selecting the appropriate biocide to disinfect the device. Disinfectants of choice are therefore expected to possess properties such as rapid, residue-free action without any damaging effect on the sensitive electronic equipment. The purpose of this study was to determine the reliability of Neutral Electrolyzed Oxidizing Water (NEOW) using two different methods of disinfection on 3.0 T MRI Scanner.

Materials and Methods: The MRI room disinfection was completed by using the sprayer and the method of cold fogging. The presence of micro-organisms before and after the aerosolization was recorded with the help of sedimentation andanalyse the total number of Colony-Forming Units CFU. The CFU was evaluated in absolute and log values.

Results: After disinfection we found reduction of microbial NEOW over 90% or more than 1log10 CFU/ cm2. With cold fogging disinfection, we found a reduction in the number of microorganisms by an average of 3.32 log10 CFU/cm2. Based on the results of the experiment we can conclude that with the model of NEOW Steriplant®N in practical terms we can see over 90% reduction of microorganisms (> 1log10 CFU/cm2) on MRI. The use of NEOW proved to be efficient and safe in all applied ways. Also, no eventual damage to exposed devices or staff was recorded.

Discussion: The use of the biocide aerosol Steriplant®N in practical terms in prepared space in which substantially reduces the burden of microorganisms. We believe that this helps to establish a bio-security between operational and diagnostic interventions. Considering the fact that the biocide aerosolization needs 6-8 ml of biocide solution / 1m3 can reach very small amounts of disinfectant effects on equipment.

Background: Earlier examinations of mortality patterns in West Virginia found higher total mortality in coal mining compared to non-coal mining counties. The objective is to further explore these findings and determine whether heart disease mortality in West Virginia is associated with coal mining or other factors.

Methods: West Virginia county Specific Standardized Mortality Ratios (SMRs) were calculated and base (sex, age group and time period-adjusted) and covariate-adjusted (base + income, smoking, and obesity) SMR models were computed for cumulative total, surface, and underground coal production. Models were also stratified by dichotomous versions of income, smoking, and obesity.

Results: Median income, obesity, and smoking were all found to be statistically significant predictors of heart disease SMRs and were also found to have statistically significant interactions with coal production. Specifically, SMRs generally increased as median income decreased in mining counties, and SMRs generally increased as obesity increased in mining counties. The same relationships were not evident in non-mining counties. Additionally, SMRs were elevated in the highest two quartiles of coal production in counties with high smoking prevalence.

Conclusion: SMRs for heart disease were elevated in the highest levels of total, surface and underground coal production compared to the state population. Further research should examine the relationship between coal-mining and heart disease at the individual level.

Objective: To estimate the prevalence of falls in a group of older women and to measure the influence of risk factors associated with age.

Methods: Longitudinal study with a representative probability sample of the AGEQOL study (Aging, Gender and Quality of Life). This article is based on 1226 older Brazilian community-dwelling women. Participants were interviewed on falls in past 12 months, demographic and socioeconomic characteristics, health status, functional ability and access to and use of health services. Poisson regression was used to confirm the association of decline in women with possible determinants, separated by age (60-74 years and ≥75 years).

Results: Overall, 250 women (54.2%) had a single fall, and the prevalence of falls was significantly different between age groups (p<0.001). Women aged less than 75 years old who smoked, drank, and reported nausea and imbalance had a higher prevalence of falls. Among the oldest women, a dose-response relationship was present between falls and functional capacity of ADL.

Conclusions: The prevalence of falls differed in each age group of women. For older women aged 60-74 years, the prevalence of falls was associated with self-reported health status and the type of health services used. In addition to performing ADL, worse health conditions, surgeries, and higher education were risk factors associated with a higher prevalence of falls in older women.

Whenever patients are involved in research, the occurrence of missing information is inevitable. Examples of missing data include missing data points, as in incomplete forms, or loss of entire follow-ups due to patient attrition

Background: Information Communication Technologies (ICTs) play vital roles to enhance the effectiveness and efficiency of healthcare industries worldwide. However, its utilization in developing countries is very limited. This study was aimed to identify challenges of ICTs utilization among health professionals working in hospitals, Addis Ababa, Ethiopia.

Methods: A cross-sectional quantitative study was done among 320 health professionals in February 2015. Health professionals were selected systematically from the alphabetical lists/ registration book/of health professionals in each hospital. Trained data collectors used a pretested self-administered questionnaire to collect data on different variables. Epi Info version 3.5.4 and SPSS version 20 were used to edit and analyze data respectively. Descriptive statistics to describe study subjects and bi/multi variable regression analysis to identify ICTs utilization factors were used. Odds ratio at 95% Confidence Interval (CI) was used to describe the association between dependent and independent variables.

Result: A total of 312 (97.5%) health professionals responded to the questionnaire. More than half of health professionals (58.0%) aged between 25-30 years. Only 141 (45.0%) and 135 (43.0%) were computer literate and had computer access respectively. For those who had computer access, 115 (85.0%) used it in their daily activities. Of 123 (39.0%) respondents who have printer/photocopy services, 68 (55.0%) used printers to assist their work. Nearly two-third, 197 (63.0%) of health professionals accessed the internet using mobile/computer. Less than half, 148 (47.0%) of health professionals have awareness on the application of ICTs in the health system. Age, educational status, computer access, personal initiation, infrastructure, computer literacy, poor internet connection, budget shortage and management style were significant factors to health professionals’ ICTs utilization in the study area.

Conclusion: Health professionals accessed and utilized ICTs inadequately to manage their patients. Personal (age, education level, computer skills, initiation/awareness), management style, infrastructure and resource shortage were factors for limited ICTs access and utilization. Improving ICTs access, computer literacy, internet connection, personal ICTs awareness and management are important to improve ICTs access and utilization among health professionals working in hospitals, Addis Ababa, Ethiopia.

T he sentence “inadvertently coming to rest on the ground, floor or other lower level, excluding intentional change in position to rest in furniture, wall or other objects” defines accidental falls

Objective: This research was conducted with the aim of determining the possible effects of physical activity levels on quality of life in health care workers who are employed in a Training and Research Hospital.

Materials and Methods: This descriptive study was performed on 120 personnel consisting of physician, allied health and administrative personnel who employed and had no any chronic illness in GATF Training and Research Hospital. The life qualities of 30 health care employees who go to the gym regularly and whose physical activities were observed as being high, according to the results of the International Physical Activity Assessment Questionnaire-Short Form; and the life qualities of 90 employees whose socio-demographic characteristics and work places are similar to the first group were evaluated by using the SF-36 Life Quality Questionnaire. The Statistical Package for Social Sciences (SPSS) version 22.0 was used in the statistical analysis of data. p

Result: The mean age of the participants was 36.09 ± 4.89 years. There was no statistically significant difference between the groups for age, sex, education, occupation, body mass index and sitting time. Total Physical Health Score and Mental Health Score which is SF-36 subscales were found to be statistically higher in the group with high physical activity (p<0.001). Although mental health, pain and energy/fatigue scores did not make a statistically significant difference, they were found to be higher in HPA group.

Discussion: According to the results obtained from this study; quality of life has been found to be affected positively in health care workers with high physical activity. The development by encouraging action and opportunities should be provided for increasing the physical activity levels of health care workers who are role models in the community.

The limited number of tools and resources available to guide emergency response in conflict settings is particularly grim. In order to improve response in areas impacted by emergencies, responders need new frameworks to guide the inclusion of wider macro-level determinants such as conflict throughout the program cycle. The Conflict Determinant Model (CDM) provides a theoretical base for emergency responders, public health professionals, and social scientists to include the social determinants of health in their programming and for analysis of the impact of conflict on health status. By considering conflict as a macro-level determinant of health, responders and agencies can design high quality contextually relevant programming that identifies and responds to the wider social inequalities that create conflict. We propose five uses of the CDM: Health disparity analysis, community engagement, program design, impact measurement, and monitoring and evaluation tool development. When applied in the program cycle for emergency programs, CDM improves the understanding, application, and analysis of conflict as a determinant of health. CDM informs the evidence base needed for effective and efficient response in conflict settings.

Background: Debate about the influence of costs of seeking Antenatal Care (ANC) on the maternal health service utilization in Africa has remained controversial and generally inconclusive, calling for more systematic, robust and reliable evidence. A study was done to assess the influence of real and perceived costs of ANC seeking on pregnant women’s access to Intermittent Preventive Treatment in Pregnancy (IPTp) against malaria in two rural districts in Tanzania.

Methods: Exist interviews were administered to 823 pregnant women leaving ANC clinics, among which 417 and 406 came from Mkuranga and Mufindi districts, respectively. Data analysis was executed using STATA 8 statistical software.

Result: Of all interviewees, 66.2% and 89.3% of respondents in Mkuranga and Mufindi, respectively, previously contacted government clinics during their current pregnancies; less than 20% and 15% of these districts, respectively, had contacted private clinics. Respondents reporting to have paid user-fees on the study day accounted for 36.7% and 7.0% in both districts, respectively. Few (<2%) of the respondents in each district reported unofficial payments asked of them by clinic staff for the services sought. In both districts, long travel distance was identified as the main disappointing factor against ANC seeks, followed by health care user-fees. Apparently, perceived low quality of care at particular clinics had more influenced the respondents found in public clinics to visit private clinics than it had influenced those found at private clinics to contact public ones. Respondents from wealthier families and those with decision-making autonomy for spending family income were less likely to have faced user-fee payment hardship than those without such opportunities. Lack of money for user-fees or transport delayed 12.6% and 12.4% of the respondents in Mkuranga and Mufindi, respectively to register for the ANC and receive IPTp during the recommended period.

Conclusion: Evidently, real and perceived costs together with perceived quality of care influence rural women to seek ANC and determine their chance to access malaria IPTp in Tanzania.

Background: Evidence indicating that sexual behaviors are the leading mode of acquisition and transmission of Human-Immunodeficiency Virus (HIV) responsible for causing the Acquired Immune-Deficiency Syndrome (AIDS) in a majority of countries in the world remains. However, knowledge about the disease and methods for its control varies across socio-economic groups as well as between and within countries. This paper reports and discusses the findings from a study done to assess the perceptions of secondary school students and their teachers on the importance of voluntary counseling and testing (VCT) for HIV among students in Tanzania.

Methodology: The study was conducted in two regions – Iringa and Mtwara using a questionnaire designed with closed and open-ended questions seeking opinions from 125 secondary school teachers and 2,060 students. Two districts from each region were covered. While the teachers were identified using a convenient sampling strategy, a random sampling strategy was employed to identify students from forms I-VI, excluding Form Fours who had left the school. The students were asked to state whether they personally participated in sexual relationships involving sexual intercourses with fellow students or other people, their knowledge of other students who behaved in the latter way, and views regarding the need for VCT services for students, teaching staff and other members within school compounds, Teachers were asked the same questions except their own participation in sexual affairs. Data analysis was aided by the use of the Stata 10 software.

Result: Admission of either personal or fellow students’ recent participation in premarital sex relationships was expressed by students in all districts, although a relatively larger number reported the behavior of fellow students than the respondents stating their own sexual behavior. Possessing multiple sexual partners were claimed as being a common behavior of sexual active students, although most of the respondents in this case also were referring to their peer students. While many students responding appreciated that secondary school students were also at risk of facing HIV, most of the teachers in all districts shied away to confirm this or show their belief in this, and denied to know students who engaged themselves in sexual love relationships. The Majority of teachers did not find it needful for suggesting schools as appropriate centers for delivering VCT services for HIV. Variations in the perceptions about the readiness of the students to undergo VCT were noted between male and female students; female and male teachers, and between the two study regions and districts of the same region. However, the difference was significant statistically for selected cases only.

Conclusion: To attain their goals, HIV/AIDS Control Programs in Tanzania need to address the challenges faced in their quest for enhancing knowledge about HIV/AIDS and encouraging behavior change attitudes towards HIV/AIDS related VCT services.

Background: In Italy cardiovascular diseases are the leading cause of death. Percutaneous Transluminal Coronary Angioplasty (PTCA) reduces short-term deaths in patients with Acute Myocardial Infarction (AMI). We evaluated inequalities in accessing PTCA among AMI patients.

Methods: This is a retrospective cohort study on 9894 Italian patients hospitalized for AMI in 2003-2007. Generalized linear models were estimated for the probability of PTCA and for time between hospital admission and intervention.

Result: Gender was the most relevant factor in the probability of intervention. Patients ≥75 years and those with higher Charlson index had lower probability. The presence of a coronary unit was associated with greater probability. Surgical intervention within 24 hours from admission was more likely with increasing age and Charlson index and less likely for patients living near a coronary unit. Days between admission and intervention resulted affected by all covariates and deprivation index.

Conclusion: Consistently with literature, we pointed out the role of gender and age on the likelihood of PTCA. Additional factors affecting time to intervention (coronary units and deprivation index) were also identified.

Background: Alanine Aminotransferase (ALT) is an enzyme released for the liver pathology. Growing studies have proposed the association between ALT and Type 2 Diabetes Mellitus (T2DM). Current literatures lack data of ALT in newly diagnosed T2DM patients in Chinese population. We therefore, conducted this cohort study to determine whether elevated serum ALT levels contributed to Insulin Resistance (IR), Impaired Fasting Glucose (IFG), and T2DM simultaneously.

Methods: We combined a cross-sectional and cohort design together in this research. In the cross-sectional study, data was collected from 2423 men at Fangchenggang Area Males Health and Examination Survey (FAMHES). The participants were categorized into three groups, including normal (n=1794), IFG (n=556) and T2DM (n=73) in light of fasting glucose and history of diabetes. Besides, the subjects were divided into non insulin resistance (Non-IR) (n=1947) and IR (n=403) groups. Moreover, in the longitudinal analysis, 2819 men without T2DM underwent 4-year follow-up examination in the study of observing for the T2DM development.

Results: We observed a significant distinction of ALT between normal, IFG and T2DM groups (38.00(27.00 49.00) U/L, 43.00(30.50-55.50) U/L, and 45.00(32.00-58.00) U/L, respectively, P=0.024). After multiple adjustment, the Odds Ratios (ORs) were substantially higher for IFG [OR=1.73, 95% Confidence Interval (CI) =1.33-2.26)], T2DM [OR=2.05, 95% CI=1.05-3.97] and HOMA-IR [OR=3.12, 95% CI=2.18-4.47] in the highest ALT tertile comparing with those in the lowest tertile. In the longitudinal analysis, 99 individuals had developed T2DM and there were 28 (2.99%), 33 (3.51%) and 38 (4.03%) new cases from the first tertile to the last tertile. Individuals with the highest tertile of ALT were at significantly increased the incidence of T2DM compared with those in the lowest [HR=1.67, 95% CI=1.00-2.75].

Conclusion: Serum ALT concentrations were associated with prediabetes and increased ALT predicted a high risk for T2DM development.

During the last two decades or so, groups of immigrant patients in Western mental hospitals have challenged traditional psychiatry and questioned the ways immigrant patients have been treated.

Background: Nearly 1.3 million people die each year as a result of Road Traffic Accidents (RTAs). More than nine in every ten (91%) of the world’s RTA fatalities were from low and middle income countries such as Nepal. This study aimed to describe epidemiology of RTAs and reasons for delayed post-crash response in one of the major highways in Nepal.

Methods: This study employed a cross-sectional design including both quantitative and qualitative techniques of data collection. The study area was Nagdhunga to Narayangadh road segment of Prithvi Highway. Data collection included key informant interviews, observation of the sites and inventory of road traffic accidents for the years 2011 and 2012. Qualitative data were analyzed through content analysis while quantitative data were analyzed using MS Excel software.

Results: One thousand and twelve accidents were reported over the study period involving a total of 1,383 vehicles. Among the vehicles involved in accidents, truck and tripper were at the top position (27%), followed by two wheelers (25%). Highest number of accidents occurred during the month of October coinciding with the higher traffic during because of major national festivals. Inadequate communication immediately after the crash and narrow and steeper roads delayed post-crash response. Additionally, scarcity of rescue teams and ambulance posed serious barriers in timely hospitalization of the victims.

Conclusion: Truck, trippers and scooters were vehicles involved in majority of accidents. Roads with severe turning, lack of adequate street lighting and the festival seasons were main reasons for RTAs. Establishing trauma centres and strengthening trauma units of tertiary care hospitals, establishing rescue teams at every 10-kilometer long road segment of the highway and formation of effective coordination committees at local level would strengthen post-crash response.

Valid quality metrics, and more importantly, improvement in healthcare delivery, depend on frontline provider engagement. We explore a pilot for using a familiar technology model, customized to the needs of frontline users, to foster a culture of teamwork, accountability, and improve patient care. Pre-intervention surveys measured awareness of quality indicators and their importance among frontline staff of a Mayo Clinic cardiovascular unit. Post-intervention surveys indicated substantial to significant increases in awareness of three critical metrics and two related best practices. We conclude with qualitative remarks on attitudinal changes that resulted from participation in the pilot.

Aim: To investigate prevalence of Escherichia coli in drinking water samples collected from municipal and local water supply in the period January 2013 to December 2013 in Zenica-Doboj Canton, Bosnia and Herzegovina.

Methods: A total of 1080 and 2206 water samples from municipal and local water supply were taken over one year from the Protocols of the Laboratory for Sanitary and Clinical Microbiology (Cantonal Public Health Institute of Zenica-Doboj Canton). Membrane filtration method was used for the analysis the samples of drinking water, according to International standards.

Results: Among total of 1080 water samples from municipal water supply, 59 (5.5%) were positive for Escherichia coli, while from local water supply, 560 (25.4%; out of 2206) were positive on E. coli. Fourty-five samples from municipal water supply (4.2%; out of 1080) were positive on coliforms, and 724 from local water supply (32.8%; out of 2206) were positive on other organisms.

The highest number of positive samples on E. coli from municipal and local water supply were from the municipality of Olovo, 30 (27.8%; out of 108), and the lowest was from the municipalities of Doboj-Jug and Usora, in each 12%, respectively.

Conclusion: Monitoring the microbiological quality of drinking water relies largely on examination of indicator bacteria such as coliforms, Escherichia coli, and Pseudomonas aeruginosa. Preventive activities and more frequent water sampling are necessary measures.

Background: Diabetes mellitus has been associated with an increased risk of hospital malnutrition.

Objective: The aim of this study was to estimate the prevalence of hospital malnutrition and its related costs in hospitalized diabetic patients in Spain.

Methods: We evaluated the prevalence of hospital malnutrition, length of hospital stay and related costs in the subset of patients from PREDyCES® study with diabetes mellitus. PREDyCES® study was a nationwide, cross-sectional, observational, multicentre study in routine clinical practice. Prevalence of hospital malnutrition was assessed both at patient admission and discharge using NRS-2002®

Results: 387 patients were included, of whom 53.7% were males. Mean age was 69.9 ± 12 y/o. Mean weight and mean body mass index were 69.8 ± 18.3 kg and 26.3 ± 6.9 kg/m2, respectively. 30.1% patients were malnourished (NRS®-2002 ≥ 3) at admission and 29.3% were malnourished at discharge. Prevalence of malnutrition was significantly higher in women than in men (36.9% vs. 24.2%; p < 0.01), in ≥ 70 than in < 70 y/o (41.2% vs. 15.2%; p < 0.001) and in urgent vs. programmed admissions (32.7% vs. 21.7%; p < 0.05). Weight loss during hospitalization was significant in 9.5% of patients and severe in 33.3%. Length of hospital stay and costs were significantly higher in malnourished patients than in patients who were not malnourished (12.3 ± 8.3 vs. 8.4 ± 5.5 days; p < 0.001; €8 911.3 ± 6 755 vs €5 965.1 ± 4 654; p = 0.001). 73.3% of patients who were malnourished did not receive nutritional support.

Conclusion: A third of diabetic patients admitted at Spanish hospitals are malnourished. Malnourished diabetic patients have longer hospitalizations and higher costs than those at no nutritional risk.

I summarize our work over the past decade to illustrate how improper management of heavy metal in manufacturing has caused pollution to the environment and as a result, has negatively influenced the health of local people in Changhua, a county in central Taiwan. Our study found a frightening 5.3-fold increase in the incidence of male oral cancer from 1982 to 2001 in Taiwan. Changhua, one of the 23 counties in Taiwan, ranked first in the list of oral cancer incidence. The incidence of male oral cancer in Changhua was also leading in the world (45.07/100,000/year in 2001). Heavy metal contained in waste water from electroplating factories was released into the environment and polluted farm soil. The incidence and prognosis of oral cancer in Changhua was strongly correlated with the densities of electroplating factories and the levels of heavy metal in the farm soil. In addition, the levels of heavy metal in the blood from the patients correlated strongly with the levels in the farm soil of their residence areas. Moreover, the patients had higher levels of heavy metal in their blood, compared with the blood levels in controls. Evidence shows that the detrimental effects from the environmental pollution can persist for generations.

Almost every statistical test generates a P value (or several). Yet, many physicians don’t really understand what P values are. It is mentioned that P value is probably the most ubiquitous and at the same time, misunderstood, misinterpreted, and occasionally miscalculated index