Recent Articles

Background: The individual level of health literacy directly affects the health outcomes of any people. Older adult people are more vulnerable to chronic diseases than other groups of people. Also they have low health literacy and poor understanding of diseases than any other age group of people. Aim: This study aim is to explore older adult perspectives towards health literacy and knowledge of chronic diseases. Methods: The study was taken during December 2019 in the Budhanilkantha Municipality of Kathmandu district of Nepal. Semi-structured interview was conducted in four older adult participants with chronic diseases. It included health knowledge, level of understanding of chronic disease conditions, and the use of health services. Inductive analysis was followed for the patterns, themes, and categories of analysis to emerge. Results: Health literacy and knowledge of chronic diseases, health belief system, and experience of health problems were the emerging themes included here. The study results finds that lack of disease knowledge, low health literacy, health belief system, socio-economic, and cultural factors were influencing factors to chronic diseases among older adults. Participants had a minor knowledge of chronic diseases; they had lack in knowledge regarding their own chronic diseases. Conclusion: Health literacy is an important factor of understanding, accessing and utilizing health knowledge and health services. It is most important that the health literacy of the people is necessary to improve for positive health and gaining the knowledge of chronic diseases. To overcome the chronic health problems it is most important to improve the health knowledge, understanding of chronic diseases, and literacy level to the older adult people.

Here, we report a case of hepatic sinusoidal obstruction syndrome(HSOS) of a 30 years old female patient with Ulcerative colitis(UC) who was being treated by mesalazine. The patient was admitted to the emergency unit by harsh and cramping abdominal pain, she had increased AST-ALT-Bilirubine and GGT levels in the blood laboratory analysis. In the Portal venous Doppler US; Splenomegaly and coarse granular appearance in liver parenchymal echogenecity were observed. In the abdominal CT, Splenomegaly was confirmed. In the Dynamic Abdominal MRI, pathognomonic liver finding which was the patchy contrast-enhancing reticular appearance, was visualized and the exact diagnosis was handled by true-cut biopsy. The aid of Dynamic Abdominal MRI to the early diagnosis of HSOS was also demonstrated in this case.

Previous research presents extensive conclusive results regarding the association between firm performance and CEO turnover. However, the issue of CEO turnover is still rarely investigated with regard to the usefulness Initial Public Offerings (IPOs) performance in the topic of Chief Executives Officers (CEOs) turnovers. The principle objective of this study is to investigate whether the likelihood of the CEOs turnover is inversely correlated with the IPO performance of the firm. This study is conducted by employing the U.S. sample data consists of 462 firms including 173 CEO turnover events within 5 years after the IPO offering during the period between 2003 and 2013, and it is mainly concluded that CEO turnover matters with respect to firm IPO performance, however, only for IPO long-term performance, rather than short-term performance.

As time goes on, sentiments change. This statement is perhaps best observed in the mercurial nature of the fashion industry, where styles and brands are constantly evolving. These changes may seem random, or simply a product of what celebrities enjoy at the moment. However, upon closer investigation, an interesting trend appears: the movement of designer brands towards smaller and more simplistic logos. These changes are by no means insignificant; advertising is one of the most important aspects of a brand, and its costs are substantial. Because of these costs, brands only aim to change logos when they feel they need to match a change in fashion or a cultural shift. Thus, by analyzing when and how brands change their logos, researchers can predict and capitalize upon trends in the fashion industry. However, it is still unclear as to why brands have specifically moved to more simplistic appearances. What is the appeal for newer styles to be more discreet, humble, and less ostentatious? To understand this phenomenon, we propose a model that analyzes the change in preferences and motivations in both fashion and culture across generations. Using this model, we achieve results that give further insight into how this knowledge can be used to predict and capitalize upon future trends.

Background: Although multiple reports exist in the literature of patients with 15q11.2 deletion syndrome, the variability of the phenotype has made clinical delineation difficult. Neuro-developmental scores have not been previously reported. We present clinical findings in a group of 16 patients referred to our center for evaluation and management of neurodevelopmental difficulties. Methods: All patients were seen in our center between 2005 and 2016. They were seen by a clinical geneticist and their diagnosis of 15q11.2 deletion syndrome was confirmed by a microarray analysis. Bayley Scales of Infant Development was done and provided a mental developmental index and a motor developmental index. The data collected was then compared to previous reports in the literature of patients with 15q11.2 deletion syndrome. Results: The reviewed group consisted of 10 males and 6 female patients between the ages of 3 and 15 years. The most common clinical findings included developmental delay (94%), hypotonia (88%), ADHD (75%), anxiety (50%), feeding difficulties (44%), autism (31%), dolichocephaly (25%), 2-3 toe syndactyly (19%), seizure activity (19%), and congenital heart disease (13%). Additional findings included prominence of the metopic suture, epicanthal folds, micrognathia, ankle torsion, incontinence, and sleeping difficulties. Our developmental evaluation by the Bayley Scales of Infant Development indicated an average Mental Developmental Index of 75 (NL = >85) and Motor Developmental Index of 75 (NL = >85) in the patients less than 3 years old. Close to 43% of patients had an occipitofrontal circumference (OFC) greater than or equal to the 97th. Conclusion: The data provided here intends to expand the phenotype of the 15q11.2 deletion syndrome. Neurodevelopmental scores have not been previously reported in 15q11.2 del syndrome which were found to be in the mild developmental delay range.

Poultry feathers are rich in amino acids and keratin resources, which is a kind of protein feed raw materials with high nutritional value. A twin-screw extruder was designed to deal with the environmental damage caused by the shortage of rapidly developing protein feed and the large amount of feather waste in China’s livestock breeding industry. The bulking machine can break the disulfide bond and hydrogen bond in feather keratin to form crude protein which can be absorbed by livestock. A kind of high-protein feed feather powder was developed while protecting the environment. The combination mode and rotation direction between two screws are discussed, the relationship between the key basic parameters of the twin screw is derived by combining the motion principle of the twin screw and the relative geometric position. It provides theoretical basis for determining screw parameters and working condition parameters in the following experimental research.

Mental illnesses represent a challenge for healthcare worldwide. In Brazil, this reality is not different, with the Unified Health System (SUS) providing or improving the therapeutic treatment of patients assisted by public health policies, through the implementation of integrative and complementary practices in mental health patient therapy. Drug therapy associated with the increase in integrative practices contributes to improvements in the patient, in addition to promoting updates to the protocols and clinical guidelines that address pathologies of the mental nature. In this context, this chapter should analyze the main mental disorders, such as drug therapies used to treat these patients, as well as the use of integrative practices that complement the use of medications.

The term “autism spectrum disorder” (ASD) describes today a heterogeneous group of neurodevelopmental disorders with diverse etiologies. Autism spectrum disorder is obviously a neurodevelopmental disorder that seems to be a big challenge today for both: the family doctor and the pediatrician. The core of this disorder is mainly integrated by the patient’s communication and social interaction difficulties and by the presence of repetitive or restricted behaviors and / or interests. (AUGUSTYN, PATTERSON, TORCHIA, 2019 p. 1)1-10 Autistic Spectrum Disorder is a pervasive and permanent disorder. It has no cure, no especific treatment, and this must be clarified from the begining, however, early intervention can drastically alter prognosis and soften symptoms (SOCIEDADE BRASILEIRA DE PEDIATRIA, 2019) 1-10. To benefit from early intervention, the patient with autistic spectrum disorder needs an early diagnosis. The key to their better social integration is the time. It is obvious that children identified with risk for autism spectrum disorder should be referred to a specialist with the purpose to establishing the diagnosis. However, it is primarily up to the primary-care physician to identify children at risk through developmental follow-up, behavioral follow-up and eventually through a valid screening and clinical judgment. In fact, early, accurate and appropriate diagnosis usually requires a clinician with experience in diagnosis and treatment. However, the contribution of a multiprofessional team to assess key symptoms, functional impairment, severity, and comorbid conditions is very important. The management of this patient should be individualized according to the child’s age and specific needs. The primary care provider can refer the child to local consultants or the public school system for ancillary evaluations (speech language, cognitive and adaptive testing, psychoeducational testing) (AUGUSTYN, PATTERSON, TORCHIA, 2019 p. 2)1-10 The key to our attitude as professionals is continuous follow-up. And it needs to be done together with an expert…

Psychoanalysis and its application in the biological area. The area of Psychology already presents a lot of research in the context, looking for artificial and laboratory situations; however, the importance of contextual analysis of the individual as a whole, of their daily activities and, from this, the understanding of their perceptions. Through psychoanalysis it is possible to observe widely the subject as a whole, not focusing on the presence of organic or genetic disorders, Ansermet (2003) addresses this problem by stating that “We cannot see the subject only as someone who manifests an organic or mental defect, according to the logic of disability”. The systems that compose and organize the environment, according to Bronfenbrenner (1996), are constituted by the fitting of concentric structures called microsystem, what presents itself as the most active and direct contact environments, such as family, school or social work relationships; mesosystem referring to two or more environments of active social participation; exosystem, understood as environments that influence events that take place in the immediate environment of social relationship; and macrosystem, which comprise, in addition to the behavior of individuals, the connections between other people, the nature of bonds and the direct or indirect influence on the developing individual in the contexts in which they live and act actively. The use of psychoanalysis as a tool to decipher possible mental disorders has become essential, since it is intrinsically linked to the biological look for the diagnosis of a patient. Autism, attention deficit disorder, depression and hyperactivity (ADHD), among other diseases that can be diagnosed during childhood or late they are psychosocial disorders that have their diagnoses complemented by psychoanalysis. In this way, it is possible to perceive the challenges that psychoanalysis faces in terms of complementing the diagnosis of mental disorders in children, as well as the…

Acute generalized exanthematous pustulosis (AGEP) and toxic epidermal necrolysis (TEN) are adverse cutaneous reactions. Despite the fact that these 2 cutaneous reactions differ in presentation, prognosis, pathologic features, and treatment, overlap can exist between them, creating a diagnostic challenge. It has rarely been reported that AGEP overlaps or mimics TEN, while TEN which starting by multıple pustules like AGEP has not been reported. The present study reports a rare case of a 14-year-old male patient with the clinical manifestations of multiple purulent bullae caused by amoxycillin ingestion. On 3. day dermatological examination revealed flaccid bullae and epidermal splitting with positive Nikolsky’s sign on right pectoral area, erosions on oral and anogenital mucosa. Histopathologic examination showed a massive inflammatory infiltration and epidermal necrosis indicated Steven Johnson syndrome. Later on added systemic symptoms with haemodynamic, respiratory imbalance and the patient was exitus. The case is discussed to reveal whether a new clinical pattern of drug eruption has been identified. We describe a patient with TEN who presented initially with clinical features of acute generalized exanthematous pustulosis (AGEP). To the best of our knowledge, one report drug eruption with purulent bulla and epidermal necrolysis has previously been documented, and therefore the present study is the second case report of its kind. Because the initial presentation of such adverse drug reactions may vary, diagnosis is difficult and dermatologists must careful the possibility of mimics among adverse cutaneous reactions.