Journal of Health Scope
Volume:14 Issue: 1, Feb 2025

Context:

 Migration and addressing the medical needs of migrants is a complex issue in the field of international health that requires an integrated, evidence-based, and human rights-focused response. The aim of this article is to investigate migration in Latin America and its implications for health and the evaluation of infectious diseases.

The scope of this systematic review is to explore the health implications of migration in Latin America regarding human immunodeficiency virus (HIV) and other infections. Data Sources: Keyword combinations were searched through the PubMed/MEDLINE database as of February 26, 2023. Study Selection: The selection of publications was performed in a two-step process and followed the inclusion/exclusion criteria of the study.

Data Extraction: 

The validity and authenticity of this study were optimized by adhering to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) checklist.

Out of 102 initial articles, only 8 articles met the eligibility criteria. In total, 1,904,387 people were included in this systematic study, and the average age across all studies was 31.10 years. The main countries of origin were Mexico (n = 3) and El Salvador (n = 3). Chile (n = 2), Mexico (n = 2), Peru (n = 2), and the USA (n = 2) were the most frequent destinations. Human immunodeficiency virus infection, mental health issues, tuberculosis (TB), and diabetes mellitus (DM) were the main surveyed diseases, with the highest prevalence among migrants from Brazil, Peru, and Tapachula. In general, economic, social, and health system crises were among the reasons for migration identified in this study.

The findings emphasize the need for more attention and prioritization of resources to improve the health outcomes of migrants in Latin America, particularly concerning infectious diseases like HIV. The findings also underscore the importance of addressing the underlying social and economic factors that drive migration in the region. Further research is required to investigate the health implications of migration in this region and to identify effective strategies to mitigate these challenges.

Context: 

The increasing prevalence of non-communicable diseases in low- and middle-income countries (LMICs) has prompted governments to consider levying taxes on sugar-sweetened beverages (SSBs) to reduce consumption and improve public health.

This review aims to provide evidence-based insights to policymakers on implementing SSBs taxes to enhance health outcomes.

A comprehensive analysis of data from seven databases was conducted to evaluate the effects of SSBs taxes on pricing, consumption, substitution patterns, health outcomes, unintended consequences, and tax revenue. The review included systematic reviews and meta-analyses, following the Joanna Briggs Institute (JBI) format for data extraction and synthesizing existing research findings relevant to these outcomes.

Of the 938 studies reviewed, five met the inclusion criteria, providing detailed explanations for most quality benchmarks, though certain challenges were noted. The findings indicated that SSBs taxes often result in reduced consumption of sugary beverages, increased consumption of substitutions, and are associated with decreases in diabetes, strokes, heart attacks, and overall mortality. However, there was limited evidence regarding unintended consequences of SSB taxation in LMICs. Additionally, studies highlighted increased revenue generation through sin taxes.

Taxing SSBs can effectively reduce consumption, improve health outcomes, and generate revenue. However, the impact on healthcare funding depends on factors such as the type of tax, consumer behavior, income levels, and political agreement on public expenditure priorities. To maximize benefits, revenue from SSBs taxes could be allocated to health programs targeting low-income communities. Policymakers are encouraged to design tax mechanisms thoughtfully, monitor and evaluate their policies regularly, and address the financial impact on low-income households. This approach could help mitigate health disparities and enhance the overall effectiveness of SSBs taxation.

Context: 

Some researchers proved new and persistent symptoms lasting for weeks and even months after COVID that is named “long-COVID” or “post-COVID syndrome.” It appears that occupational therapists (OTs) have a significant role in managing the symptoms of long COVID, with the aim of enhancing patients' ability to perform daily activities and improving their overall well-being. The objective of this study was to conduct a scoping review study of reputable databases to identify the various ways in which OTs can manage long COVID from the onset of symptoms.

Evidence Acquisition: 

To identify relevant documents, the following databases and search engine were searched from 2019 to 2023 in the English language: PubMed, Scopus, ISI, and Google Scholar. Keywords used for search include (("occupational therapy") AND (("post-COVID") OR ("long-COVID"))) AND ((intervention) OR (exercise)), of which 45 articles were found, and a total of 22 were chosen according to the predetermined criteria.

A diverse array of interventions in OT can be useful for the management of post-COVID symptoms, as mentioned in the 22 studies found as the search result, including energy management education, pulmonary rehabilitation, sleep hygiene, stress and fatigue management, and work simplification.

Occupational Therapist offers a distinctive viewpoint on health conditions that arise in human life, and its interventions can be utilized to enhance health, self-management, and quality of life (QOL).

Following the COVID-19 pandemic, the significant vulnerability of healthcare facilities, particularly hospitals, in the context of acute respiratory syndrome outbreaks has been highlighted. Given the critical role of hospital services, it is essential to assess the preparedness of hospitals to manage the spread of pathogens. Isolation rooms represent one of the most critical areas in hospitals for infection control.

This study aimed to evaluate hospital isolation rooms and compare their conditions with established standards.

In this cross-sectional study, 33 isolation rooms across 13 different hospitals in Mashhad were examined in 2020. The degree of compliance with standard conditions was assessed using a checklist based on regulatory standards for isolation rooms. The checklist included items related to room sealing, air inlet and outlet conditions, pressure warning systems, and the pressure differential between the isolation room and adjacent areas. Additionally, the proper use of HEPA filters was evaluated.

The findings indicated that in 81.8% of cases, there was no evidence of air recirculation to the isolation rooms, meeting the relevant standard. However, the required configuration of the air inlet positioned above the patient’s head and the air outlet at the foot of the bed was not observed in 72.8% of the rooms. All rooms met the standards regarding door width and the minimum distance between beds.

This study revealed that a substantial proportion of isolation rooms do not meet standard conditions in several critical areas. Such deficiencies pose significant risks during outbreaks of infectious diseases like COVID-19, potentially endangering both healthcare providers and immunocompromised patients.

Radiation therapy-induced oral mucositis is a significant acute side effect in patients with head and neck cancer. Severe mucositis can negatively impact the patient's treatment plan and decrease survival rates.

This study aimed to evaluate the effect of educational and care interventions on the severity of oral mucositis in patients undergoing radiation therapy for head and neck cancer.

This study was conducted on head and neck cancer patients referred to the chemotherapy and radiotherapy departments of Khatam Al-Anbia and Ali Ibn Abi Talib Hospitals, affiliated with Zahedan University of Medical Sciences, in 2023. A total of 60 participants were selected through convenience sampling and randomly divided into intervention and control groups. Initially, patients in both groups were examined for oral and dental conditions. Oral health was assessed using the Decayed, Missing, and Filled Teeth (DMFT) Index and the Community Periodontal Index of Treatment Needs (CPITN), based on the global WHO standard. The condition of oral mucositis was evaluated upon entry into the study to confirm eligibility. The intervention group received a comprehensive oral and dental care program during their chemotherapy sessions, which consisted of three 45 - 60-minute sessions. In contrast, the control group received routine training. Recognizing the importance of dental health, dental check-ups were performed again before radiotherapy using the DMFT Index, followed by continued monitoring during the radiotherapy period and at the end of radiotherapy to ensure the patients' teeth remained in good condition. At the conclusion of the radiotherapy, the severity of oral mucositis was assessed. Data analysis was performed using SPSS version 27 software, employing paired t -tests, independent t -tests, Fisher’s exact test, Mann-Whitney U, and chi-square tests. A significance level of less than 0.05 was considered statistically significant.

An initial examination of oral and dental conditions was conducted using the DMFT Index (Tooth Decay Index) and CPITN Index (Gingival Inflammation Index). Analysis with the independent t -test and Fisher's exact test showed no statistically significant differences between the intervention and control groups (P > 0.46 and P > 0.31, respectively). At the start of radiotherapy, the mean ± standard deviation of the DMFT Index was 16.53 ± 7.56 in the intervention group and 15.13 ± 7.07 in the control group. The independent t -test revealed no significant statistical difference between the two groups (P > 0.46). However, by the end of radiotherapy, a significant difference in the severity of mucositis was observed between the two groups, as determined by the Mann–Whitney U test (P < 0.001).

This study underscores the critical role of a collaborative treatment team, including dentists, nurses, and oncologists, in the prevention and management of oral mucositis in patients. By fostering a multidisciplinary approach to patient care, treatment effectiveness, survival rates, and the quality of life for patients can be significantly improved.

The rapid advancement of robotics and artificial intelligence is poised to revolutionize industrial settings through widespread automation. This study investigates the impact of robotic assistance on human operator mental workload (MWL) within a simulated industrial environment. Utilizing electroencephalography (EEG) to measure changes in alpha and theta band power, we aim to identify the cognitive challenges associated with human-robot collaboration (HRC) and inform the design of safer and more efficient collaborative systems.

The main objective of the current study was to assess the MWL in a simulated industrial human-robot interaction (HRI) task.

The EEG data were collected from 17 participants (aged 25 - 35 years) using a 64-channel system while they engaged in an ecologically valid robotic task that induced three distinct levels of cognitive load: Low, medium, and high. Subsequent analysis focused on EEG power within the alpha and theta frequency bands, employing repeated-measures ANOVA to assess the impact of cognitive load on brain activity.

A repeated-measures ANOVA revealed significant changes in EEG power across different task difficulty levels. The theta and alpha bands in F 3 , F 4 , and F z , as well as the alpha, beta, and gamma bands in P 3 , P 4 , and P z , emerged as promising indicators for differentiating between varying levels of cognitive load in human-robot tasks.

Electroencephalography spectral power, particularly within the alpha and theta frequency bands, is a reliable indicator of human MWL. These frequency bands exhibit dynamic changes in response to fluctuating cognitive demands, especially in human-robotic interaction tasks.

To evaluate the outcomes of using intraoperative optical coherence tomography (OCT) during retinal detachment surgeries and to determine whether it influenced surgical outcomes.

A case series of fifteen patients underwent retinal detachment surgery utilizing the Leica Enfocus microscope with integrated intraoperative optical coherence tomography (IOCT). The study assessed the impact of IOCT on surgical decision-making. It was conducted at the Layton Rahmatullah Benevolent Trust (LRBT) Eye Hospital, Lahore, Pakistan. Data were collected using a questionnaire as a tool for analysis.

Fifteen patients with a mean age of 35.33 ± 8.27 years (95% confidence interval) underwent retinal detachment surgery and were included in the study. The questionnaire revealed that the surgeon altered their decisions in four cases (26%). Intraoperative OCT was instrumental in identifying critical structures such as sites of vitreomacular traction, thick epiretinal membranes, and various interfaces.

The application of intraoperative OCT proved to be highly beneficial in retinal procedures. Its use enhanced the surgeon's confidence and influenced decision-making in specific cases, demonstrating its value in improving surgical outcomes.

General practitioners (GPs) play a crucial role in providing primary healthcare services. However, there is limited understanding of the specific roles and responsibilities of GPs in Iran's healthcare system. The objective of this qualitative study is to explore the various roles and responsibilities of GPs in Iran's healthcare system by gathering insights from different stakeholders.

Semi-structured interviews were conducted with 32 health policymakers and GPs in Iran between April and December 2021. Participants were selected using a purposive sampling method. The interviews, conducted in Persian, were transcribed verbatim. Data analysis was performed using both deductive and inductive content analysis. Initially, deductive coding was applied based on the research questions, followed by inductive coding to allow new concepts to emerge from the interview data. Qualitative analysis was conducted using MAXQDA 22.

The study included a diverse group of participants in terms of age, gender, experience, and workplace. During data analysis, 173 primary codes were identified, which were categorized into four themes: "The evolving role of GPs," "rhe skills and competencies of GPs," "GPs' perspectives on their role," and "requirements for general practitioner reinforcement."

Recognizing GPs as gatekeepers within Iran's healthcare system requires significant measures in both health policy and public attitudes. It is crucial to shift public perception so that individuals rely more on GPs as their first point of contact in the healthcare system, using secondary services only through referrals. This shift should be accompanied by a greater emphasis on strengthening primary care and the role of family physicians in service delivery.

Despite technological advancements, heavy metal concentrations in water sources remain above the safe limits set by regulatory standards worldwide. Contaminated drinking water containing heavy metals poses significant public health concerns globally.

This study aims to examine the non-carcinogenic and carcinogenic risks for adults and children exposed to chromium (Cr) in drinking water through ingestion and dermal pathways.

Health risk assessments were conducted on 60 samples collected from ten active wells and ten stations within the drinking water distribution network sections in Fariman, Iran. The Superfund risk assessment model from the US Environmental Protection Agency (EPA) was employed to evaluate health risks. Crystal Ball software was used to perform Monte Carlo simulations and sensitivity analyses to reduce uncertainties and assess the impact of each variable on the risk assessment results.

The hazard quotient (HQ) values for Cr from ingestion pathways exceeded the safety level threshold (HQ > 1) for both adults and children in all sampling sites, while for dermal exposure, the HQ was lower than the safe limit for both populations. The mean cancer risk (CR) values for children and adults via ingestion were 4.58 × 10 -4 and 7.9 × 10 -5 , respectively. However, the CR associated with dermal exposure for both groups was deemed negligible.

The health risk of Cr exposure from drinking water exceeds the acceptable safety level for children and adults. This indicates that drinking water is the primary source of Cr exposure for residents in Fariman. It is essential to implement more control measures and suitable purification systems to reduce Cr levels in the water supply in Fariman.

Dental diseases and disorders are reported to affect specific ages, genders, and races of patients. Therefore, epidemiological investigations are necessary for understanding dental diseases and disorders.

This cross-sectional study aims to determine the prevalence and potential risk factors of chronic pulpitis, dental caries, and periapical disease in adults seeking treatment at the Tianjin Stomatological Hospital, Tianjin, a major referral center in the Northern region of China.

A total of 3,245 males and females visited the Department of Adult Dentistry and the Department of Endodontics of the Tianjin Stomatological Hospital, Tianjin, China, for oral health concerns from January 17, 2020, to November 18, 2023. Among these patients, 615 (19%) were receiving treatment for chronic pulpitis, dental caries, and/or periapical diseases at the institute. Demographic parameters and clinical examination results of 496 patients (119 patients were excluded due to missing information) who were being treated for chronic pulpitis (long-term inflammation of the dental pulp), dental caries (a biofilm-mediated, sugar-driven, multifactorial, dynamic disease), and/or periapical disease (inflammation around the tooth root) with varying severity (moderate or severe) were included in the study.

Of the 496 patients, 300 (60%) were females, 328 (66%) were aged 60 years or older, and 295 (59%) had issues with mandibular teeth. Among the patients, 250 (50%), 301 (61%), and 151 (30%) were diagnosed with dental caries, chronic pulpitis, and periapical disease(s), respectively. Female gender (P = 0.041), age ≥ 60 years (P = 0.045), and issues with mandibular teeth (P = 0.046) were found to be associated with chronic pulpitis, dental caries, and periapical diseases in the patients.

The prevalence of dental diseases and disorders in Han Chinese adults is 19% in the Northern regions of China. Chronic pulpitis and dental caries are the most prevalent dental diseases, while periapical diseases occur less frequently among Han Chinese adults in the Northern regions of China. Females, individuals aged ≥ 60 years, and issues with mandibular teeth are independent risk factors for the development of chronic pulpitis, dental caries, and periapical disease in adult patients in Northern regions of China. Policymakers in China should consider the findings of this study to reduce dental diseases and disorders in Chinese adults, especially in the Northern regions of China.

Stroke is the leading cause of disability in adults. The most prevalent disorder following a stroke is a balance disorder, and the primary goal of rehabilitation treatment in these patients is to improve balance.

This study aims to compare the effects of various balance therapy exercises on balance performance and balance confidence in individuals with stroke.

In this double-blind clinical trial, 30 individuals with stroke were randomly assigned to one of three groups: Control, reactive, and proactive. Of these, 27 patients completed the study. Participants underwent 12 treatment sessions over four weeks. The control group received conventional exercises, the reactive group received conventional exercises plus reactive exercises, and the proactive group received conventional exercises plus proactive exercises. Balance performance was evaluated using the Mini-BESTest and the activities-specific balance confidence (ABC) questionnaire at three stages: Before treatment, after treatment, and during a two-month follow-up period. Data analysis was conducted using SPSS version 20.

Intra-group analysis indicated significant improvements in balance (F = 64.694; P < 0.001; ηp 2 = 0.729) and balance confidence (F = 76.002; P < 0.001; ηp 2 = 0.760). At the end of the treatment, the proactive group exhibited better balance performance compared to the reactive group, while the reactive group demonstrated higher balance confidence than the proactive group. However, these differences were not statistically significant (P > 0.05).

Balance performance and balance confidence improved significantly in all three treatment groups. However, the differences between the groups were not statistically significant. This study concludes that exercise therapy is an integral component of rehabilitation treatment for stroke patients.

Staphylococcus epidermidis contaminates medical devices and produces biofilm, complicating antibiotic treatment for its elimination and causing a nosocomial health issue. The sdr genes ( sdrG , sdrF , and sdrH ) are involved in bacterial adhesion to the surface of medical devices for biofilm formation.

To compare the presence and expression of the sdr gene in S. epidermidis from infectious and commensal isolates to propose them as a therapeutic target.

This is a descriptive, observational, and retrospective study. Infected ocular (n = 64), healthy conjunctiva (n = 46), and healthy skin (n = 53) isolates were genotyped using the Staphylococcal Chromosome mec (SCC mec ) cassette to avoid clonality. Different genotypes representative of each isolation source selected isolates. In the selected isolates, sdr genes were determined by PCR, and RT-qPCR determined their expression.

The sdrG , sdrF , and sdrH genes were present in the genome of all selected isolates. The expression level of the sdr genes was low in all isolates and there was no significant difference between different isolation sources.

The presence and expression of sdrG , sdrF , and sdrH genes are independent of the genotype and isolation source; this suggests that these proteins could be therapeutic targets to prevent the contamination of medical devices by S. epidermidis .