Journal of Preventive Medicine and Hygiene (JPMH)
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A Snapshot Investigation on Assessment of Role of Dietary Diversity in Healthy Ageing among Elderly Living at Ahmedabad City, India: Role of Dietary Diversity in Healthy Ageing among Elderly
No full textBackground: Dietary Diversity (DD) is one of the crucial determinants to address Healthy ageing among elderly people. Objectives: To estimate prevalence with concerned determinants of Dietary Diversity, to assess intake-pattern of various nutrients and correlation of dietary diversity with healthy ageing among study participants. Methodology: A cross-sectional study was conducted among 192 Elderly people (≥ 60 years of age) residing at Ahmedabad city, India, selected by two-stage Cluster sampling [As per Rapid Assessment Method for Older People (RAM-OP) survey sampling technique]. A pretested, semi-structured questionnaire including Socio-Demographic and Dietary-Diversity related details was utilised as survey-instrument. Healthy ageing was assessed with selected General Health status using two domains of total five; namely general Activity of Daily Living and Instrumental Activity of Daily Living (IADL) were applied to collect relevant data. Results: Prevalence of Dietary-Diversity was 44.27% among study-participants. Various determinants such as living alone, socio-economic-class, co-morbidities, type of diet, oral health and meal-frequency revealed statistically significant association with Dietary Diversity. Cereals (96.9%), roots and tubers (91.7%), and condiments and mushrooms (90.1%) were the most common food-groups consumed by study participants. Of 85 participants with positive dietary diversity, more than two-thirds (67, 78.82%) were able to manage activities of daily living independently whereas approximately three-fifth (66, 61.68%) of sub-cohort of counterpart could manage the same independently. Predictors of IADL like use of telephone, practice of taking medications and managing their own money showed statistically significant association with presence of dietary-diversity. Conclusion: Dietary diversity was prevalent among less than half of study-participants. A diverse diet showed statistical significant role in ensuring independence in general activities of daily living while gender-specific variations for instrumental activities of daily living
Delivering physical rehabilitation services during the COVID-19 pandemic in Iran: Common challenges and potential solutions for future pandemics: Physical rehabilitation services during the COVID-19 pandemic in Iran
No full textThe COVID-19 pandemic affected people with disabilities in different aspects, including their access to rehabilitation. Despite a significant global surge in the need for physical rehabilitation, it has not been prioritized and is under-resourced, even in the non-COVID era, in many countries. This study aimed to explore the challenges of delivering physical rehabilitation services during the COVID-19 pandemic in Iran and potential solutions to these challenges. This qualitative study was done using a thematic approach from November 2023 to March 2024 in Iran. 45 rehabilitation professionals and faculty members from three fields—physiotherapy, occupational therapy, and orthotics and prosthetics—were interviewed in a semi-structured fashion. Data analysis was done using Braun and Clarke’s thematic analysis approach. The five control knobs (organization, regulation, financing, payment, and behavior) were used to study the challenges and proposed solutions. The main identified challenges included Iran\u27s healthcare system\u27s lack of preparedness, deficient infrastructure, limited remote rehabilitation options, restriction of in-person visits, lack of clinical guidelines, ambiguous pricing for telerehabilitation, financial hardships stemming from the pandemic, insufficient government support, reliance on out-of-pocket, patients\u27 reluctance to pay for online services, delayed compensation for rehabilitation professionals, mental distress experienced by patients and service providers, resistance to new service modalities, and inadequate digital literacy. The key solutions included strengthening telerehabilitation infrastructure, developing clear clinical guidelines, increasing government financial support, improving payment structures, and fostering behavioral changes through increased awareness. The findings of this study underscore the importance of proactive planning, intersectoral collaboration, and the integration of rehabilitation services within the healthcare framework. The suggested solutions can inform policymakers to enhance the preparedness and responsiveness of health systems to future crises
Zika Virus Disease in India: Zika Virus Disease in India
No full textIn 2024, a total of 151 Zika virus disease (ZVD) cases were reported in India (from Maharashtra, Karnataka, and Gujarat States). Maharashtra reported 140 cases (125 cases from Pune), Karnataka 10 cases (7 cases from Bengaluru) and Gujarat 1 case (1 case from Gandhinagar) respectively. No case of microcephaly or Guillain-Barre syndrome (GBS) associated with this outbreak was reported.1
India reported its first Zika case from Gujarat State in 2016. Since then, many other States namely Tamil Nadu, Madhya Pradesh, Rajasthan, Kerala, Maharashtra, Uttar Pradesh, Delhi, and Karnataka have reported cases subsequently, but no ZIKV-associated microcephaly has been reported. Aedes mosquito density in India varies by season and location, with the highest densities occurring during the monsoon and post-monsoon seasons.1
The Zika virus disease is usually mild and requires no specific treatment. The most common symptoms are mild fever, skin rash, headache, muscle and joint pain and inflammation of the underside of the eyelid. These symptoms normally last for 2-7 days.2
In India, Zika outbreak occurred in 2017 and in July 2021 one laboratory-confirmed case was also reported in Kerala state. One study was conducted to assess any positivity in field-collected mosquitoes for ZIKV and DENV during 2016–2021. Mosquito samples were received from 4 Zika affected citites, whereas samples were collected from Delhi. Out of 2346 pools, 4 pools for ZIKV, and 23 pools for DENV were found positive. ZIKV positive pools were from Jaipur (3 pools) and Kanpur (1 pool). 10 localities of Delhi were found positive for DENV. It was observed that the maximum positivity rate for both viruses were found in September–October.3
Another study showed that the lower attack rate of ZIKV in children than in adults will hasten the emergence of a population that will be fully susceptible to infection. Even with lifelong immunity, children aged 0–14 years will become entirely susceptible by 2031 and 15–29 year olds by 2046. In future outbreaks, the attack rate will then be highest amongst 15–29 year olds, including women who will be at risk of ZIKV infection in pregnancy.4
With the limited data available, it is seen that ZVD cases are rising and vary regionally across different states. The difference can be due to variation in number of tests done in all regions (state and city) due to different reasons. Hence, samples should be homogenously taken from different region including from hard to reach areas for understanding better picture. The case load appears to be underreported because asymptomatic infection and unreported illness are generally not taken into consideration, overlapping symptomatology of ZVD with dengue and chikungunya, and different level of health care providers’ awareness about the disease. Rising number of ZVD in India and future possibility of increased susceptibility among children and young adults mandates continuous monitoring, surveillance and use of preventive measures
Comparing vape use and perceptions among pharmacy and non-pharmacy students from two universities in the US and UK
Full text linkIntroduction: Little research exists regarding pharmacy student vaping habits or differences among students from different countries.
Methods: A novel 19-item questionnaire was distributed in November 2023 to students at The University of Bath (United Kingdom) and The University of Texas at Austin (United States) to compare vape use and perceptions among pharmacy and non-pharmacy students from the two universities. All pharmacy students at both institutions were invited to complete the survey. A non-pharmacy student control group was identified through snowball sampling (i.e., the survey was distributed to a convenience sample of non-pharmacy students at each school, asking them to complete and distribute to peers). To incentivize participation, one respondent received a $100 reward. Data was analyzed using descriptive statistics. Chi-square and Wilcoxon Rank Sum tests were used to compare answers between pharmacy and non-pharmacy and UK and US participants. A p-value <0.05 was deemed significant.
Results: Overall, 372 students completed the survey (25% pharmacy student response rate). Vape use significantly differed between pharmacy and non-pharmacy students (p=0.03). Among 212 pharmacy students, 49% reported vape ever-use versus 59% of the 158 non-pharmacy students. Significant differences were found in harm perceptions; more pharmacy students believed vapes are cancer-causing, affect the health of others nearby, should be banned in public, and are ineffective for quitting cigarettes. Few differences were observed between UK and US students.
Conclusion: Pharmacy students were less likely to vape and exhibited heightened awareness of associated risks than non-pharmacy students. Few differences were observed between UK and US students surveyed
Final Heights in Patients with Congenital Adrenal Hyperplasia: A Retrospective Cohort Study
Full text linkIntroduction
Congenital adrenal hyperplasia (CAH) attributed to 21-OHD is one of the most common genetic endocrine disorders that occurs due to the disruption and defects in the steroidogenic enzymes involved in the production of cortisol. The current study aims to assess the final height of patients with classic CAH forms in Iran.
Methods
The retrospective cohort study was conducted on 30 patients with classic type CAH who were followed up and treated in the endocrinology clinic of Ali Asghar Hospital during the 2000-2022 years. The history of the patients at the time of diagnosis was extracted from the patient\u27s files and recorded in the checklist. All data was analyzed using IBM SPSS Statistics version 22 software.
Results
In the SV group, the target and final height for females was 162 and 159.2 cm, and for males was 173 and 171 cm. In the SW group, the target and final height for females was 164 and 163.2 cm, and for males was 171.7 and 173.1 cm. There was a significant and reverse correlation between the mean age at the time of diagnosis and the Final Height percentile among all cases (r: -0.55, p: 0.02) and the SW group (r: -0.75, p: 0.002). A positive and significant correlation was seen between the bone age advanced and final height percentile in the SV group (r: 0.04, p: 0.03). The final height percentile increased significantly with an increase in the Duration of treatment regardless of CAH type (r: -0.67, p: 0.009). Also, there was a positive and significant correlation between hydrocortisone dose and final height percentile in the SV group (r: 0.24, p: 0.04).
Conclusion
The results of the present study showed that early diagnosis of the disease at a young age, lower bone age of patients, preventing the increase of obesity in children with CAH, and receiving appropriate drugs with standard doses can play an effective role in increasing the final height of CAH patients
What strategic actions may be implemented to reach high immunisation coverage for clinically vulnerable individuals? A process for achieving regional consensus using World Cafè methods
No full textBackground and Study Design: Clinically vulnerable individuals, including the elderly, are at increased risk of adverse health outcomes following infections, due to immunosenescence, chronic inflammation, or underlying medical conditions. Despite measures such as the National Immunisation Prevention Plan and Regional Laws, immunisation coverage for herpes zoster, pneumococcus, and COVID-19 in the Apulia Region has declined in recent years. This study outlines strategic actions to improve vaccination coverage for clinically vulnerable individuals s in the region, using methods like the World Café (WoCa) to achieve regional consensus. Methods: On 31st May 2023, a working group of Apulian researchers and healthcare workers, supported by the Regional Immunisation Committee, conducted a workshop. The WoCa method facilitated structured discussions across five thematic domains to generate innovative solutions for enhancing immunisation rates. Results: Key actions included active vaccination reminders in all formats of informed consent and during healthcare visits; improved training for healthcare workers conducting outreach; involving pharmacies in patient guidance alongside general practicioners (GPs) and SHPH operators; establishing vaccination clinics near specialist centres and employing mobile units; launching media campaigns to counteract misinformation using authoritative voices; providing vaccinology and scientific communication training for professionals; implementing a hub-and-spoke logistics system under the governance by the Department of Prevention (DP); and ensuring seamless communication between digital platforms for vaccine data reporting and monitoring. Conclusions: The findings demonstrate the value of WoCa in achieving regional consensus to enhance immunisation for frail individuals . Collaboration among healthcare professionals, institutions, and the public is vital to raise awareness, improve accessibility, and address logistical challenges, ensuring equitable access to vaccination for vulnerable populations
Pneumococcal Vaccination of Adults in Italy: What Strategies?
Full text linkS. pneumoniae has been classified by the World Health Organization (WHO) as one of the 12 priority pathogens with the greatest global health impact. Although many individuals (approximately 20–30% of adults and nearly 40–50% of children) may carry the bacterium asymptomatically, certain groups are considered at higher risk of disease (non-invasive illnesses and invasive diseases). These include young children, the elderly and individuals who are immunocompromised or affected by pre-existing medical conditions.
Italian surveillance data show a significant increase in Invasive Pneumococcal Disease (IPD) incidence in 2023 in comparison with 2021 and 2022, rising from 0.84 cases per 100,000 population in 2021 to 3.02 in 2023. The highest rates were observed in children under 1 year of age [10.41/100,000 (2023)] and in adults aged 65 and over (7.45/100,000 in 2023 compared with 2.11 in 2021 and 4.49 in 2022).
Surveillance systems and epidemiological studies on the global distribution of the different pneumococcal serotypes associated with disease continue to be essential to determining which serotypes to include in new vaccines, in order to produce preparations capable of preventing an increasing number of cases, hospitalizations, sequelae and deaths.
A milestone in pneumococcal vaccination was the development of conjugate vaccines (PCVs), which started in the 2000s. The first PCV, which covered seven serotypes (PCV7: 4, 6B, 9V, 14, 18C, 19F, and 23F), was introduced in Italy in 2005 for the pediatric population. The introduction of this vaccination strategy leading to a significant reduction in disease among children and an overall decline in the pneumococcal disease burden across all age-groups. However, an increase in disease caused by serotypes not included in PCV7 was observed. This phenomenon, named serotype replacement, led to the development of higher-valency conjugate vaccines. In 2010, the 13-valent pneumococcal vaccine (PCV13) and 10-valent pneumococcal vaccine (PCV10) were approved. However, the phenomenon of serotype replacement continued to be observed, and consequently, the need for broader-spectrum vaccines remained a public health priority.
In 2021 and 2022 PCV15 (serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 9V, 14, 18C, 19A, 19F, 22F, 23F and 33F) and PCV20 (serotypes: 1, 3, 4, 5, 6A, 6B, 7F, 8, 9V, 10A, 11A, 12F, 14, 15B, 18C, 19A, 19F, 22F, 23F and 33F) were authorized for immunization in individuals aged ≥18 years, respectively. In March 2025, the use of a new 21-valent pneumococcal vaccine was approved (serotypes: 3, 6A, 7F, 19A, 22F, 33F, 8, 10A, 11A, 12F, 9N, 17F, 20, 15A, 15C, 16F, 23A, 23B, 24F, 31 and 35B) and it included some serotypes particularly aggressive or emerging.
Maximizing the effectiveness of a vaccination program in combating diseases related to S. pneumoniae is based on the integration of three key elements: epidemiological need, immunological need and vaccine compliance.
From an epidemiological perspective, the 2023 specific data analysis reveals that, out of 1,783 cases, 734 involved individuals over the age of 64 (41.2%). The estimated coverage with the PCV20 vaccine would be 63.6%, while with the PCV21 vaccine it would be 76.4%. The specific analysis of the most recent available data (1st half of 2024) reveals that a total of 1,152 cases were reported, 58.4% of which occurred in individuals over 64. If only the data referring to subjects over the age of 64 are analyzed, the estimated coverage becomes 72.1% for PCV20 and 79.2% for PCV21.
From an immunological standpoint, the vaccine should induce an immune response that is at least non-inferior to the comparator, and ideally, robust and long-lasting.
Regarding compliance, all possible strategies must be activated in order to raise awareness of the risks of pneumococcal disease and the benefits of vaccination, so as to increase coverage rates.
A thorough analysis of epidemiological and clinical data, combined with an assessment of the economic and social impact, is crucial to guiding vaccination policies and supporting efficient decision-making in order to protect the health of the entire population
Quality of Life and non-motor symptoms Improvement in Parkinson\u27s Disease through Nutritional Intervention: A Case Study : Weancare Parkinson
No full textSummary of the paper: The text discusses the significant impact of non-motor symptoms on the quality of life (QoL) of patients with Parkinson’s disease (PD), emphasizing the role of nutritional status. The Non-Motor Symptoms Scale (NNMS) evaluates QoL across various domains, including nutrition, which is crucial due to common issues like dysphagia leading to malnutrition and sarcopenia. These nutritional problems exacerbate motor deficits by reducing muscle mass and energy levels. Addressing dysphagia through targeted nutritional programs is essential for improving clinical outcomes and patients\u27 QoL. A case study involving an 84-year-old PD patient with dysphagia and the Tower of Pisa Syndrome demonstrated the effectiveness of the \u27Weancare\u27 program. Initial assessments indicated poor nutritional status. Post-intervention, the program showed significant improvement in the patient’s non-motor symptoms and overall QoL, highlighting a better mealtime experience and clinical healt
The influencing factors of nurses’ well-being in critical care during pandemic era: a systematic review protocol
Full text linkABSTRACT
Purpose: To review, identify and disclose predictive and protective factors of critical care nurse well-being in the COVID-19 era.
Design: Systematic review protocol based on the Joanna Briggs Institute (JBI) guidelines.
Review Methods: All quantitative primary studies focused on factors influencing the well-being of critical care nurses and the relationships among these factors will be included. Based on the review question, six databases will be searched: MEDLINE, The Cochrane Library, SCOPUS, CINAHL, Web on Science, PsycINFO. Time limits will be set according to the COVID-19 pandemic era. To establish the quality of studies JBI tools will be used. Where possible, data will be summarised quantitatively through meta-analysis.
Expected Results: We anticipate that this systematic review will provide an overview of the factors that impacted the professional well-being of critical care nurses during the pandemic period from Covid-19.
Conclusions:
This study will be the first to reveal which are the factors that play an important role in impacting intensive care nurses in covid-19 pandemic era. Furthermore, it will provide updated and valid evidence of which factors should be considered protective of intensive care nurses\u27 well-being and which are to be considered hindering.
Implication for the profession: Enhancing the professional well-being of nurses is crucial in addressing the growing trend of their intention to leave the profession. Understanding the factors that positively or negatively impact the well-being of critical care nurses during the pandemic is key to developing effective retention strategies within the nursing field. The results of the review will support managers and leaders in direct health policies toward the implementation of interventions to promote the well-being of healthcare workers and to contrast the intention to leave.
KEYWORDS: intensive care nurses, well-being, systematic review protocol, nursin
Estimation of Dental Caries in Adults coming to a Dental College in Himachal Pradesh (North West India) using CAST Index: a Cross-Sectional Study
Full text linkBackground: Decayed Missing Filled Index is the universal index of choice to record dental caries however, it is unable to estimate the severity of dental caries. The Caries Assessment Spectrum and treatment (CAST) Index is a new index which can be used to distinguish the intensity of caries.
Aim: To ascertain dental caries using CAST index and to compare the association of CAST index with DMF Index values attained using CAST index in adults.
Materials and Methods: The cross-sectional survey recorded dental caries using CAST index in adults.30.6% of adults experienced tooth loss and 32.3% recorded caries lesion advancing to dentin. 29.5% of adults had lesion attacking pulp but the gender predilection was insignificant. Caries severity in adults worsened with increasing age with significant association (p< 0.00). Scarcely 7.3% had undergone restorative care owing to dental caries.
Conclusion: The CAST index provides all-inclusive knowledge with regard to caries severity and transient shift in oral health in adult