Determinants and pathways of healthcare-seeking behaviours in under-5 children for common childhood illnesses and antibiotic prescribing: a cohort study in rural India

ObjectivesTo explore the healthcare-seeking pathways, antibiotic prescribing and determine the sociodemographic factors associated with healthcare-seeking behaviour (HSB) of caregivers for common illnesses in under-5 (U-5) children in rural Ujjain, India.Study designProspective cohort study.Study setting and study sampleThe cohort included 270 U-5 children from selected six villages in rural demographic surveillance site, of the R.D. Gardi Medical College, Ujjain, Madhya Pradesh, India. A community-based cohort was visited two times weekly for over 113 weeks (August 2014 to October 2016) to record the HSB of caregivers using HSB diaries. Sociodemographic information was also solicited.Primary and secondary outcome measuresPrimary outcomes: first point of care, healthcare-seeking pathway and quantify antibiotic prescribing for the common acute illnesses.Secondary outcomeHSB risk factors were determined using mixed-effects multinomial logistic regression.ResultsA total of 60 228 HSB follow-up time points for 270 children were recorded with a total of 2161 acute illness episodes. The most common illnesses found were respiratory tract infections (RTI) (69%) and gastrointestinal tract infections (8%). No healthcare was sought in 33% of illness episodes, mostly for RTIs. The most common healthcare-seeking pathway was to informal healthcare providers (IHCPs, 49% of illness episodes). The adjusted relative risk for obtaining no treatment, home treatment and treatment by IHCPs was higher for RTIs (aRR=11.54, 1.82 and 1.29, respectively), illiterate mothers (aRR=2.86, 2.38 and 1.93, respectively), and mothers who were homemakers (aRR=2.90, 4.17 and 2.10, respectively). Socioeconomic status was associated with HSB, with the highest aRR for no treatment in the lowest two socioeconomic quintiles (aRR=6.59 and 6.39, respectively). Antibiotics were prescribed in 46% (n=670/1450) illness episodes and the majority (85%, n=572/670) were broad spectrum.ConclusionIn our rural cohort for many acute episodes of illnesses, no treatment or home treatment was done, which resulted in overall reduced antibiotic prescribing. The most common healthcare-seeking pathway was to visit IHCPs, which indicates that they are major healthcare providers in rural areas. Most of the antibiotics were prescribed by IHCPs and were commonly prescribed for illnesses where they were not indicated.

Different Extracting Methods of Medicinal Herbs

Salvia officinalis L. is well known as an aromatic and medicinal plant in Albania. Several studies suggest that Salvia officinalis L., in addition to treating minor common illnesses, might potentially provide novel natural treatments for the relief or cure of many serious and life-threatening diseases such as depression, dementia, obesity, diabetes, lupus, heart disease, cancer or antibacterial treatments. The most common methods used for obtaining extracts of essential oils are water distillation, distillation with organic solvents such as hexane, ethanol, methanol and extraction with liquid CO2 under pressure as well. The extracts fractions obtained by these methods are of interest especially in the fields of pharmacology, cosmetic, medicine, food chemistry etc. In this study the extraction of essential oil from Salvia officinalis L is carried out by using an organic solvent (hexane) and liquid CO2 solvent under pressure at 40 0 C. The essential oil extracts are analyzed by thin layer chromatography. The amount of essential oil and the overall yield obtained by hexane distillation method is lower than that obtained by CO2 extraction method. These findings demonstrated that the amount of S. Officinalis oils obtained by CO2 extraction method is optimal, making that suitable for a possible use in pharmaceutical purposes.

Indonesian indigenous plants as a source of antioxidants to treat gastrointestinal disorders

Gastrointestinal disorders are the most common illnesses that affect people nowadays. Its prevalence and incidence have increased over the last decades. The majority of the people in Indonesia are still using indigenous plants as medicine to treat these infections or diseases. This study was aimed to determine the potential of Indonesian indigenous plants in treating gastrointestinal disorders. The plants were inventoried through searching articles such as Google Scholar, PubMed, ScienceDirect and Indonesian medicinal plants books. The keyword search term used was “gastrointestinal,” “Indonesian,” “medicinal plants,” “antioxidant activity,” and “phenolic compound,”. A total of fifty-one species of indigenous Indonesian plants of 32 families were recorded as being used by the Indonesian population to treat gastrointestinal disorders. Gastrointestinal disorders that heavily utilize indigenous plants are diarrhoea, constipation, gastric ulcer and gastritis. Indonesian indigenous plants containing bioactive compounds such as alkaloids, flavonoids, saponins, tannins, steroids, terpenoids and phenolics that can serve as a source of antioxidants to treat gastrointestinal disorders. There were five Indonesian indigenous plants with the most potential as a source of antioxidants to cope with gastrointestinal disorders: Zingiber officinale L, Annona muricata, Phyllanthus niruri, Curcuma longa and Curcuma xanthorrizha.

Understanding Traditional Healing Practices and the Categories of Practices from Fijian iTaukei’s Perspectives

This study takes an in-depth look at how traditional healing practices (THPs) are perceived by the iTaukei people living in villages and periurban areas in Fiji Islands. The research used both qualitative and quantitative knowledge/data gathered from six villages in Viti Levu, Fiji Islands, to determine, first, the perception(s) of THPs among the iTaukei; second, what THPs successfully survive and are still important to the iTaukei way of life; and third, what factors influence the iTaukei’s health-seeking behavior or choices between Western and traditional medical systems in their villages. Results confirm that the knowledge healers used to hold to cure common illnesses is now more dispersed and shared with community members; healers/elders’ roles in iTaukei villages are important for cultural–spiritual–social causes of illnesses, and for more complex cases, there are specialized iTaukei healers. Recommendations in the form of categories of practices are offered for practitioners to work more effectively and affectively with the iTaukei.

Disease Diagnosis System using Machine Learning

The efficient use of data mining in virtual sectors such as e-соmmerсe, and соmmerсe has led to its use in other industries. The mediсаl environment is still rich but weaker in technical analysis field. There is а lot of information that саn оссur within mediсаl systems. Using powerful analytics tооls to identify the hidden relationships with the current data trends. Disease is а term that provides а large number of соnditiоns connected to the heath care. These mediсаl соnditiоns describe unexpected health соnditiоns that directly соntrоl all the оrgаns of the body. Mediсаl data mining methods such as соrроrаte management mines, сlаssifiсаtiоn, integration is used to аnаlyze various types of соmmоn рhysiсаl problems. Seраrаtiоn is an imроrtаnt рrоblem in data mining. Many рорulаr сliрs make decision trees to рrоduсe саtegоry models. Data сlаssifiсаtiоn is based on the ID3 decision tree algorithm that leads to ассurасy, data are estimated to use entrорy verifiсаtiоn methods based on сrоss-seсtiоnаl and segmentation and results are соmраred. The database used for mасhine learning is divided into 3 parts - training, testing, and finally validation. This approach uses а training set to train а model and define its аррrорriаte раrаmeters. А test set is required to test а professional model and its standard performance. It is estimated that 70% of people in India can catch common illnesses such as viruses, flu, coughs, colds etc. every two months. Because most people do not realize that common allergies can be symptoms of something very serious, 25% of people suddenly die from ignoring the first normal symptoms. Therefore, identifying or predicting the disease early using machine learning (ML) is very important to avoid any unwanted injuries.

Having a Positive Relationship to Physical Activity: Basic Psychological Need Satisfaction and Age as Predictors for Students’ Enjoyment in Physical Education

Physical activity is fundamental to prevent common illnesses in youth and research shows that students who perceive enjoyment in physical education (PE) have a more physically active lifestyle. This study aims to identify psychological antecedents of student enjoyment in PE. We addressed this by assessing aspects of self-determination theory (SDT), including the extent of autonomy-supportive teaching in PE (reported by teachers), the satisfaction of students’ basic psychological needs, and student age (reported by students), via questionnaires. Correlational and multiple linear regression analyses of the collected data of N = 170 students (M = 14.3 ± 2.20, 10–19 years of age) and N = 10 teachers show that autonomy support is related to autonomy satisfaction in students (r = 0.20, p < 0.01). In turn, student perception of autonomy correlates with competence (r = 0.64, p < 0.001) and belonging (r = 0.37, p < 0.001). All three basic psychological needs predict enjoyment in PE (F(1, 163) = 19.59, R2 = 0.68, p < 0.01). Additional analyses show that higher student age predicts a decrease in enjoyment (ΔR2 = 0.04, B = −0.73, β = −0.21, p < 0.01). Thus, student enjoyment in PE, as a foundation for a physically active lifestyle, can help to prevent common illnesses by satisfying basic psychological needs in PE.

Revisiting the primary bias: the role of innumeracy in the misperception of prevalence of common illnesses

Although people have been repeatedly found to underestimate frequencies of common illnesses and overestimate those of rare illnesses, not much is known about this consistent bias in risk perception, termed “primary bias” in the literature, as well as the origin of its variations among different subpopulations. To fill this gap, we designed and implemented a national survey to compare the perceived and actual prevalence of common illnesses, and to test the hypothesis that numeracy may play an important role in the accuracy of judgments of risk frequencies. Our data were collected through a large online survey conducted in France among a representative sample of the adult population (n = 3,245). The participants were asked to complete a 10-items numeracy scale and to estimate the prevalence of a variety of social conditions and common illnesses such as cancers or heart diseases in the French population by using a percentage scale. The analyses show that (1) participants tend to greatly overestimate the prevalence of conditions affecting small percentages of people, and underestimate those affecting a large percentage of them, (2) the Tversky and Kahneman’s probability weighting function provides an adequate model to represent the discrepancy between the perceived and actual prevalence of these illnesses, and (3) the magnitude of the primary bias varies principally as a function of the respondents’ numeracy. These results suggest that the primary bias that affects perceptions of prevalence of chronic diseases is not fundamentally different from those characterizing other types of probabilistic judgments investigated in the field of psychological and behavioral sciences. They also confirm that numeracy plays a considerable role in people’s ability to transform epidemiological observations from their social environment into more accurate estimates.

Contribution of Community Health Workers to the treatment of common illnesses among under 5-year-olds in rural Uganda.

Introduction The control of malaria, pneumonia, and diarrhea is important for the reduction in morbidity and mortality among children under five years. Uganda has adopted the Integrated Community Case Management strategy using Community Health Workers to address this challenge. The extent and trend of these three conditions managed by the Community Health Workers are not well documented. This study was done to document Community Health Workers’ contribution towards treatment and the trends of the three common illnesses in Bugoye Sub-County in rural Uganda.

Facilitating the gut brain axis by probiotic bacteria to modulate neuroimmune response on lead exposed zebra fish models

Unravelling the efficacy of gut biome has a major impact on health. An unbalanced microbiome composition is linked to many common illnesses such as gut dysbiosis, mental deformities and immunological imbalance. An optimistic influence on the gut biome can be made by consuming probiotics. This would stimulate neuroprotection and immunomodulation intended by heavy metals pollution. Lead is a major source of neurotoxin that can induce neural deformities. Lactobacillus species isolated from curd were characterized to confirm its specificity. Zebra fish was reared at standard conditions and preclinical assessment on the intensity of induced neurotoxin lead was performed. The embryo toxic assay, immunomodulation effects and animal behavioural models endorsed the consequence of neurotoxicity. Different concentrations of bacterial isolate with standard antidepressant was considered for analysing the vigour of toxicity and its influence on cognitive behaviour by novel tank diving method. The restrain in the animal behaviour was also conferred by all the test samples with a decreased bottom dwelling time which was authenticated with haematology and histopathological studies. The alterations in morphology of the lymphocytes were balanced by the treated test samples. This study paves a twofold potential of probiotic as neuroprotectant and immune modulator against heavy metal toxicity.

Military healthcare challenges: deployed Role 1 healthcare delivery on Operation TRENTON. A personal view

Op TRENTON is the UK response to support the United Nations Mission in South Sudan. This article documents a 5-month Engineering deployment after the UK Hospital had ended their mission and some of the medical challenges encountered. During this time, there were 2104 individual patient interactions recorded, with the main common illnesses being musculoskeletal injuries, gastrointestinal infection and dermatology. Given the nature of the tour, there were no battlefield-related injuries and trauma was limited to a handful of minor cases related to physical training or construction work. Recommendations for future deployments would include careful consideration of the required clinical skillsets, particularly identifying individuals who can undertake multiple secondary functions such as Primary Care Nurses, capable of patient care, ward management and Healthcare Governance.