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Tobacco Control Law Enforcement and Compliance in Odisha, India - Implications for Tobacco Control Policy and Practice

  • Panda, Bhuputra;Rout, Anita;Pati, Sanghamitra;Chauhan, Abhimanyu Singh;Tripathy, Asima;Shrivastava, Radhika;Bassi, Abhinav
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4631-4637
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    • 2012
  • Introduction: Tobacco use is a leading cause of deaths and disabilities in India, killing about 1.2 lakh people in 2010. About 29% of adults use tobacco on a daily basis and an additional 5% use it occasionally. In Odisha, non-smoking forms are more prevalent than smoking forms. The habit has very high opportunity cost as it reduces the capacity to seek better nutrition, medical care and education. In line with the WHO Framework Convention on Tobacco Control (FCTC), the Cigarettes and Other Tobacco Products Act (COTPA) is a powerful Indian national law on tobacco control. The Government of Odisha has shown its commitment towards enforcement and compliance of COTPA provisions. In order to gauge the perceptions and practices related to tobacco control efforts and level of enforcement of COTPA in the State, this cross-sectional study was carried out in seven selected districts. Materials and methods: A semi-structured interview schedule was developed, translated into Odiya and field-tested for data collection. It mainly contained questions related to knowledge on provisions of section 4-7 of COTPA 2003, perception about smoking, chewing tobacco and practices with respect to compliance of selected provisions of the Act. 1414 samples were interviewed. Results: The highest percentage of respondents was from the government departments. 73% of the illiterates consumed tobacco as compared to 34% post graduates. 52.1% of the respondents were aware of Indian tobacco control laws, while 80.8% had knowledge about the provision of the law prohibiting smoking in public places. However, 36.6% of the respondents reported that they had 'very often' seen tobacco products being sold 'to a minor', while 31.2% had seen tobacco products being sold 'by a minor'. In addition, 24.8% had 'very often' seen tobacco products being sold within a radius of 100 yards of educational institutions.

Toxicities Demonstrated in Dams and Neonates following Intragastric Intubation of Polyethylene Microplastics to Pregnant Mice (폴리에틸렌 미세플라스틱의 임신 마우스 위내투여에 따른 모체 및 신생자 독성평가)

  • Song, YoungMin;Kim, ChangYul
    • Journal of Environmental Health Sciences
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    • v.47 no.5
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    • pp.446-453
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    • 2021
  • Background: Plastic particles less than 5 mm in diameter (microplastics) are well-known for causing various toxicities such as lung inflammation, oxidative stress, genotoxicity, and reproductive toxicity. As microplastics become smaller, they can move across cell membranes, the placenta, and the blood-brain barrier. Objectives: We evaluated the toxicities of polyethylene microplastics (PE-PMs) in dams and neonates through intragastric intubation of pregnant ICR mice. Methods: Low concentrations (0.01 mg/mouse/day) and high concentrations (0.1 mg/mouse/day) of polyethylene microplastics were administered from the ninth day of pregnancy to postnatal day seven. The control group was administered with distilled water. On the day of sacrifice, the weight of dams and neonates and the organ weight of neonates was measured. Further, acetylcholinesterase levels and glutathione peroxidase levels were evaluated by using a blood sample obtained on the sacrifice day. Results: No significant difference in the number of neonates was found, but the body weight gain of dams was seen to be lower in the low-dose group. On the other hand, we observed a consecutively declining trend in the weight gain and organ weight of neonates among the high-, control, and low-dose groups. Meanwhile, the serum acetylcholinesterase and glutathione peroxidase level were higher in the low-dose group compared to the control group. Further, the dose-dependent accumulation of microplastics in the organs of neonates revealed the transport of plastic particles from dams to their offspring. Conclusions: Although the exact mechanism of toxicity caused by microplastics could not be confirmed, it was validated that exposure to microplastics during pregnancy and lactation causes its migration between generations and accumulation throughout the body. Hence, it is necessary to evaluate the systemic toxicity of microplastics and assessment of co-morbidities such as second-generation toxicity, neurotoxicity, and depression following long-term exposure.

Associations between body dysmorphic disorder (BDD) with the dental health component of the index of orthodontic treatment need (IOTN-DHC) and other BDD risk factors in orthodontic patients: A preliminary study

  • Farhad Sobouti;Foruzan Elyasi;Reza Alizadeh Navaei;Farbod Rayatnia;Nika Rezaei Kalantari;Sepideh Dadgar;Vahid Rakhshan
    • The korean journal of orthodontics
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    • v.53 no.1
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    • pp.3-15
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    • 2023
  • Objective: Body dysmorphic disorder (BDD) is a form of obsessive-compulsive disorder that may be negatively associated with the self-image. It might be associated with orthodontic treatment demand and outcome, and therefore is important. Thus, this study was conducted. Methods: The Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS) questionnaire was used in 699 orthodontic patients above 12 years of age (222 males, 477 females), at seven clinics in two cities (2020-2021). BDD diagnosis and severity were calculated based on the first 3 items and all 12 items of the questionnaire. The dental health component of the index of orthodontic treatment need (IOTN-DHC) was assessed by orthodontists. Multivariable and bivariable statistical analyses were performed on ordinal and dichotomized BDD diagnoses to assess potentially associated factors (IOTN-DHC, age, sex, marital status, education level, and previous orthodontic consultation) (α = 0.05). Results: IOTN-DHC scores 1-5 were seen in 13.0%, 39.9%, 29.8%, 12.4%, and 4.9% of patients. Age/sex/marital status/education were not associated with IOTN-DHC (p > 0.05). Based on 3-item questionnaire, 17.02% of patients had BDD (14.02% mild). Based on 12-item questionnaire, 2.86% had BDD. BDD was more prevalent or severer in females, married patients, patients with a previous history of orthodontic consultation, and patients with milder IOTN-DHCs (p < 0.05). Conclusions: IOTNDHC was negatively/slightly associated with BDD in orthodontic patients. Being female and married may increase BDD risk.

Systematic review on interprofessional education for pre-licensure nursing student in East Asia (예비 간호인력 대상 다학제 전문직 간 교육 중재 연구의 체계적 문헌고찰: 동아시아권 국가 연구를 중심으로)

  • Heejin Lim;Hwa In Kim;Minji Kim;Seung Eun Lee
    • Quality Improvement in Health Care
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    • v.30 no.1
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    • pp.132-152
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    • 2024
  • Purpose: This study aimed to identify and evaluate interprofessional education (IPE) interventions for healthcare professional students in East Asian countries. Methods: The reporting of this study followed the Preferred Reporting Items of Systematic Reviews and Meta-Analysis guidelines. A literature search was conducted using seven electronic databases: PubMed, EMBASE, CINAHL, Scopus, Web of Science, ERIC, and ProQuest Dissertations & Theses Global. Joanna Briggs Institute Critical Appraisal Checklists were also used to appraise the quality of the included studies. The outcomes of IPE interventions were classified based on a modified Kirkpatrick model. Results: This review included 30 studies predominantly conducted in Singapore, South Korea, and Taiwan. The prevalent research design was a one-group pre-posttest design, and most IPE interventions occurred as single events. Approximately 70% of the studies involved students from two healthcare professions, mainly nursing and medicine. Simulations, group discussions, and lectures have emerged as the most common teaching methodologies, with almost half of the studies leveraging a combination of these techniques. The IPE content primarily focused on interprofessional teamwork, communication, and clinical patient care situations; these included the management of septic shock. The effectiveness of the IPE interventions was mainly evaluated through self-reported measures, indicating improvements in attitudes, perceptions, knowledge, and skills, aligning with Level 2 of the modified Kirkpatrick model. Nonetheless, the reviewed studies did not assess changes in the participants' behavior and patient results. Conclusion: IPE interventions promise to enhance interprofessional collaboration and communication skills among health professional students. Future studies should implement rigorous designs to assess the effectiveness of IPE interventions. Moreover, when designing IPE interventions, researchers and educators should consider the role of cultural characteristics in East Asian countries.

Relationship between the Occurrence of Thromboembolism and INR Measurement Interval in Low Intensity Anticoagulation after Aortic Mechanical Valve Replacement

  • Rhie, Sang-Ho;Choi, Jun-Young;Jang, In-Seok;Kim, Jong-Woo;Lee, Chung-Eun;Park, Hyun-Oh
    • Journal of Chest Surgery
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    • v.44 no.3
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    • pp.220-224
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    • 2011
  • Background: We investigated changes in the International Normalized Ratio (INR) and its measurement interval in patients with thromboembolic events who were treated by low intensity anticoagulation therapy after isolated mechanical aortic valve replacement. Materials and Methods: Seventy-seven patients who underwent surgery from June 1990 to September 2006 were enrolled in the study and observed until August 2008. The patients were followed up at 4~8 week intervals and their warfarin (Coumadin)$^{(R)}$ dosage was adjusted aiming for a target range of INR 1.5~2.5. The rate of thromboembolic events was obtained. Changes in the mean INR and INR measurement interval were comparatively analyzed between the normal group (event free group, N=52) who had no anticoagulation-related complications and the thromboembolic group (N=10). Hospital records were reviewed retrospectively. Results: The observation period was 666.75 patient-years. Thromboembolic events occurred in 10 patients. The linearized occurrence rate of thromboembolism was 1.50%/patient-years. Actuarial thromboembolism-free rates were $97.10{\pm}2.02%$ at 5 years, $84.30{\pm}5.22%$ at 10 years, and $67.44{\pm}12.14%$ at 15 years. The percentages of INR within the target range and mean INR were not statistically significantly different for the normal and thromboembolic groups. However, the mean INR during the segmented period just before the events showed a significantly lower level in the thromboembolic group (during a 4 month period: normal group, $1.86{\pm}0.14$ vs. thromboembolic group, $1.50{\pm}0.28$, p<0.001). The mean intervals of INR measurement during the whole observation period showed no significant differences between groups, but in the segmented period just before the events, the interval was significantly longer in thromboembolic group (during a 6 month period: normal group, $49.04{\pm}9.47$ days vs. thromboembolic group, $65.89{\pm}44.88$ days, p<0.01). Conclusion: To prevent the occurrence of thromboembolic events in patients who receive isolated aortic valve replacement and low intensity anticoagulation therapy, we suggest that it would be safe to maintain an INR level above 1.8 and to measure the INR at least every 7~8 weeks.

The Effect of Sport Drink Ingestion on the Physical Fatigue Level and Heart Rate during Prolonged Exposure in Hot Ambient Temperature in Professional Golfers (장시간 고온 환경 노출시 수분의 섭취가 프로골프선수들의 신체피로도 및 심박수에 미치는 영향)

  • Kim Seung-Kon;Cho In-Ho;Park Soo-Yeon;Lee Jong-Sam
    • Journal of Nutrition and Health
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    • v.38 no.2
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    • pp.117-124
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    • 2005
  • We investigated the effects of prolonged exposure in hot environmental condition and ingestion of fluid on various physiological variables including plasma glucose, lactate, the rating of perceived exertion (RPE), and heart rate as well as golf putting performance. Six male professional golfers were voluntarily participated in three different putting trials which were separated by seven days of time interval period. Three different putting trials were conducted at either 20℃ or 32℃, or 32℃ + Fluid ingestion. Performing 32℃ + Fluid ingestion trial, all subject ingested sport drink as much as their body mass was decreased. For each experiment, all subjects were undertaken total 48 putting, which separated by four x 12 putting in four different time points (i.e., Rest, 1 hr, 2 hr, and 3 hr). Plasma glucose concentration was significantly decreased with hot ambient condition but it was almost fully recovered by fluid ingestion. Plasma lactate concentration was significantly higher when subjects were exposed in hot environmental condition, and it did not change with fluid ingestion. There was a no different in putting performance and psychological fatigue level (performed by GRID test) at any environmental conditions. The RPE, commonly used for evaluating of physical fatigue level, was significantly dropped by fluid ingestion which indicates lower physical fatigue level. In addition to this, heart rate (HR) was also significantly decreased after fluid ingestion. Based on these results, it was concluded that the ingestion of fluid during prolonged exposure in hot ambient condition decrease the degree of physical fatigue levels and heart rate, which will possibly improve the golf performance when exposed in extreme weather condition in summer. (Korean J Nutrition 38(2): 117~124, 2005)

The Effect of Aerobic Dancing on Lipid and Ca Metabolism in College Women (에어로빅 운동이 여대생의 체내지질 및 Ca 대사에 미치는 영향)

  • 김희선
    • Journal of Nutrition and Health
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    • v.21 no.1
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    • pp.23-35
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    • 1988
  • This study was designed to find out the effects of aerobic exercise on lipid and Ca metabolism in seven healthy college women, aged 20 to 22 years. Metabolic studies were conducted before and after a 10-weeks exercise period, during which subjects participated in the planned aerobic dance program every day except Sunday. The initial mean time engaged in the exercise was 28 minutes and it was gradually increased up to 45 minutes around the middle point of the exercise period. During both of metabolic study periods, the subjects ate experimental diets which supplied about 120g of protein and 600mg of Ca daily and during the rest of the experimental period they ate their usual diets. The use of alcoholic beverages and drugs were prohibited. The results were summarized as follows. 1) The effect of exercise on lipid metabolism. (1) Mean body weight decreased significantly after exercise(p<0.01) and it did not show a significant decline in skinfold thickness and total body fat contents. (2) Serum total cholesterol level decreased significantly after exercise(p<0.05) and TG level also tended to be lower than that of pre-exercise period. Exercise did not exert any influence on the level of serum HDL-cholesterol in this study. (3) Exercise did not alter total lipid content in feces and apparent lipid absorption rate. 2) The effect of exercise on Ca and P metabolism. (1) After exercise, focal Ca excretion was slightly reduced, however, urinary Ca excretion was not significantly changed. In the results, a slight increase was shown in body Ca retention after exercise. (2) Exercise tended to increase urinary P excretion, but neither P balance nor fecal excretion was significantly changed after exercise. (3) Bone mineral content was not affected by exercise. In summary, aerobic exercise decreased total cholesterol and TG level in serum and tended to increase body Ca retention. With the results, it can be concluded that the additional physical activities beyond the normal daily life in college women might prevent some degenerative diseases-suchas atherosclerosis and osteoporosis.

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Microbiological Hazard Analysis of Cooked Foods Donated to Foodbank (II) (푸드뱅크 기탁 조리식품의 미생물학적 위해분석 (II))

  • Park, Hyeong-Su;Ryu, Gyeong
    • Journal of the Korean Dietetic Association
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    • v.13 no.4
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    • pp.389-406
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    • 2007
  • This study was conducted to estimate the safety level of non-cooking and cooking processed foods to propose the sanitary management of foods donated to foodbanks. The time and temperature were measured and the microbial levels of aerobic plate counts (APC), coliforms, E. coli, Salmonella spp., S. aureus, B. cereus, and E. coli O157:H7 were analyzed on ten food items donated to seven foodbanks. The amount of cooked foods donated to each foodbank was about 10 to 40 servings. All foodbanks hired a supervisor and had at least one refrigerator/freezer and one temperature-controlled vehicle, but only four foodbanks had the separate offices to manage the foodbank operation. The flow of donated foods was gone through the steps; production, meal service and holding at donator, collection by foodbank, transport (or holding after transport) and distribution to recipients. After production, the levels of APC of both non-cooking and cooking processed foods were complied with the standards by Ministry of Education & Human Resources Development, and were not increased till distribution. Only the level of coliforms in dried squid & cucumber salad (1.5×$10^3$ CFU/g) was not met the standards. E. coli and other pathogens were not detected in all tested samples. The microbial levels of delivery vessels and work tables were satisfactory, but the APC levels of two of four tested serving tables (6.9×$10^3$ and 5.3×$10^3$ CFU/100$cm^2$) and the coliforms level of one (1.1×$10^3$ CFU/100$cm^2$) were over the standards. The air-borne microflora level in serving room was estimated as satisfactory. It took about 3.0 to 6.5 hours from after-production to distribution and the temperatures of donated foods were exposed mostly to temperature danger zone, which had a high potential of microbial growth. These results imply that a checklist to monitor time and temperature in each step should be provided and the employees involving foodbank operation should be properly educated to ensure the safety of donated foods.

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Optimal Target Low-density Lipoprotein Level for Reducing the Risk of Atherosclerotic Cardiovascular Diseases: A Systematic Review and Meta-analysis

  • Min-Gyo Jang;Yeung-Eun Son;Hye Duck Choi;Junwoo Kim;Tae-Eun Kim;Kwang-Hee Shin
    • Korean Journal of Clinical Pharmacy
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    • v.33 no.4
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    • pp.270-277
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    • 2023
  • Background: As per guidelines for treating dyslipidemia, the recommended low-density lipoprotein cholesterol (LDL-C) level in extremely high-risk patients, including those with coronary artery diseases is <55 mg/dL. Although this recommendation has been adopted in the guidelines for dyslipidemia in various countries, there is limited evidence of its efficacy in reducing cardiovascular diseases (CVDs), especially among East Asian patients. This study aimed to investigate whether an LDL-C value below 55 mg/dL is associated with decreased risk of CVDs. Methods: Seven clinical trials including 50,970 patients that compared intensive lipid-lowering therapy with less therapy or placebo in patients who had >6 months of follow-up, those with a sample size of ≥150 were selected as the final literature for analysis. Risk ratios (RR) using random effects were represented with 95% confidence intervals (CI) for the reliability of the results. Results: An LDL-C level of <55 mg/dL was related to significantly reduced events of major CVDs (RR: 0.88; 95% CI: 0.80-0.98) and myocardial infarction (RR: 0.81; 95% CI: 0.73-0.90) and a reduced risk of ischemic stroke (RR 0.79; 95% CI 0.69-0.89, mean follow-up=2 years). However, an LDL-C level below 55 mg/dL did not reduce the incidence of CVD in intensive therapy in East Asian patients. Conclusions: A goal LDL-C value below 55 mg/dL was identified to be related to a decreased risk of developing CVD. However, the relation to LDL-C below 55 mg/dL with a decreased risk of CVD was not observed in East Asian patients.

The Associations of Empowerment and Social Capital with Self-Rated Health in Communities with Poor Health (사망률이 높은 지역사회에서 임파워먼트 및 사회적 자본과 주관적 건강수준의 연관성)

  • Kim, Jang-Rak;Jeong, Baek-Geun;Park, Ki-Soo;Kang, Yune-Sik
    • Journal of agricultural medicine and community health
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    • v.37 no.3
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    • pp.131-144
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    • 2012
  • Objectives: This study was performed to identify the associations of empowerment and social capital (such as social participation and trust) with self-rated health in Korean communities with poor health. Methods: This study used the data from community health interviews conducted at 29 administrative sections (dong, eup, or myeon) with high mortality from August to October in both 2010 and 2011 as part of the Health Plus Happiness Plus Projects in Gyeongsangnam-do Province. The study subjects comprised 6,383 individuals composed of approximately 220 adults randomly sampled from each administrative section. The empowerment was measured with five-point Likert scale responses to seven perceived control questions (two at the individual level, five at the community level). The social participation was measured with 'participation in formal and/or informal group' and trust using responses to three questions about trust of others. Results: The high empowerment scores at both individual and community levels, social participation in informal groups, and high trust level had independent and significant associations with good self-rated health after adjusting for socio-demographic factors (sex, age, marital status, occupation, and food affordability) and health behaviors (smoking, alcohol drinking, and exercise) in the logistic regressions. There were weak but significant associations among empowerment, social participation, and trust levels. Conclusions: Empowerment, social participation, and trust were weakly inter-related and significantly associated with self-rated health. More studies are warranted for empowerment and other social capital indices in health promotion.