International Journal of Pharmaceutical Science Invention (IJPSI) is an international journal intended for professionals and researchers in all fields of Pahrmaceutical Science. IJPSI publishes research articles and reviews within the whole field Pharmacy and Pharmaceutical Science, new teaching methods, assessment, validation and the impact of new technologies and it will continue to provide information on the latest trends and developments in this ever-expanding subject. The publications of papers are selected through double peer reviewed to ensure originality, relevance, and readability. The articles published in our journal can be accessed online.
Introduction-The Work Ability Index (WAI) is a valuable used tool in occupational health to identify and avoid early retirement and work related disability. Purpose-To assess the work ability of construction workers of West Bengal and its relationship with risk factors. Methods-A cross sectional study was carried out among 25construction workers of semi urban area of Hooghly district of West Bengal by simple random sampling method. Body composition parameters and demographic details were recorded. Work ability and work ability index were measured by questionnaire. Results-4% Construction workers have poor WAI, 88% have moderate and 8% have good WAI. None was present in excellent category of WAI. The average WAI was 32.92. There was a negative correlation between WAI and body composition parameters like height, weight, percentage of body fat. In the present study effects of hypertension and Musculo-skeletal disorder on WAI have also been found. Conclusion-According to the results of this present study aging, year of service, illiteracy, smoking habit decline the health status of construction workers thereby increasing the risk of presenting moderate or poor work ability.
American Research Journal of Humanities & Social Science (ARJHSS) is a double blind peer reviewed, open access journal published by (ARJHSS).
The main objective of ARJHSS is to provide an intellectual platform for the international scholars. ARJHSS aims to promote interdisciplinary studies in Humanities & Social Science and become the leading journal in Humanities & Social Science in the world.
The Link between Health Condition Costs and Standard of Living Through Out-of...Economic Research Forum
Eleftherios Giovanis - University of Verona
Oznur Ozdamar - Bologna University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
Background; Social Class has shown relation with admissions at Emergency Departments. To assess whether there is a relationship between the level of triage and the social class of patients who attend the emergency department and whether there are other variables that can modulate this association. Methods Observational study with 1000 patients was carried out between May and July 2018 in the Emergency Department of the University Hospital Arnau de Vilanova in Lleida. Sociodemographic variables such as age, gender, country of origin and marital status were analyzed. The triage level and the main explanatory variable was social class. Social class was calculated based on the CSO-SEE 2012 scale. Results 49.4% were male and the average age was 51.7 years. Most of the patients (66.6%) attended the emergency department under their own volition and the most common triage levels were level III or Emergency (45%). There is a significant relationship between age and triage level. The younger patients had a lower triage level (p <0.001). The percentage of patients with lower social class who attended the emergency department for minor reasons was 42% higher compared to the rest of the patients (RR = 1.42; 1.21-1.67 95% CI, p <0.001). Conclusions; Patients with a lower socioeconomic class go to the Emergency Department for less serious pathologies.
This document summarizes a study that used classical and Bayesian structural equation modeling to analyze factors influencing an individual's health index. The study used data from a health survey of over 5,000 individuals in Malaysia. It identified socio-demographic factors, lifestyle factors, and mental health as latent variables potentially influencing the health index. Both classical and Bayesian SEM were used to model relationships between these latent variables and manifest variables measuring them, like employment, exercise, and stress levels. Both approaches found socio-demographic status and lifestyle were significantly related to health index, but mental health was not. The Bayesian approach allowed incorporating prior information into the analysis.
Work-related Musculoskeletal Disorders (MSD) are one of the most common occupational diseases of offi ce workers. The aim of this study is investigating the prevalence of these disorders, determining the risk factors of occupational diseases and providing control strategies. The aim of this study is evaluating the prevalence of these symptoms among oil refinery staff. The studies conducted 200 administrative staff, 150 were male and 50 were female. It was observed that most musculoskeletal symptoms were in the neck (50%),knee (42.5%), shoulders (38.5%), the hip (10%) and lower arm (8.5%). To investigate the risk factors of musculoskeletal symptoms, we use the new methods of RULA and REBA so that we can take the necessary action to reduce the musculoskeletal symptoms and prevent potential dangers.
Practitioner Summary: This study was conducted to evaluate the prevalence of musculoskeletal disorders among one company of Iran’s oil refineries staff. Basically, because refinery workers need to do a lot of technical and physical work, therefore they have many musculoskeletal disorders. This study suggests that, with these disorders, there should be some necessary measures.
Abstract— Elderly population is increasing due to demographic shift in favor of geriatric population. This age group is susceptible for many acute and chronic health problems which may lead to limitation daily activities of life. Study of acute and chronic health problems with limitation daily activities of life of this population is required to frame comprehensive policies to make ageing a comfortable experience. So this cross-sectional period prevalence study was carried out from September 2009 to August 2010 on 1620 elderly residing in Municipal corporation area of Jaipur city with the aim to study episodes of acute health problems within last one month and limitation daily activities of life within last years of this population of elderly population. Study population consist of 1620 elderly with M:F ratio 0.95. Mean age of elderly was 66.08 years with slight female predominance i.e. 1048 females for 1000 males in Jaipur city. It can be concluded from 41.6% of elderly were having difficulty in performing activity of daily living and this difficulty was found more in females that males and in older ages. It was also revealed that 44.37 of elderly had one or more episodes of acute illness in last one month. These number of episodes of acute illness in last one month was found more in males and in older age groups.
Presentation given by Mauro Vigani at the recent ICAE conference in Milan.
The aim of the work is to provide a comprehensive analysis on the impact of maize technologies at household level in Tanzania, disentangling the effect of improved maize seeds and inorganic fertilizers on each of the four dimensions of food security
Introduction-The Work Ability Index (WAI) is a valuable used tool in occupational health to identify and avoid early retirement and work related disability. Purpose-To assess the work ability of construction workers of West Bengal and its relationship with risk factors. Methods-A cross sectional study was carried out among 25construction workers of semi urban area of Hooghly district of West Bengal by simple random sampling method. Body composition parameters and demographic details were recorded. Work ability and work ability index were measured by questionnaire. Results-4% Construction workers have poor WAI, 88% have moderate and 8% have good WAI. None was present in excellent category of WAI. The average WAI was 32.92. There was a negative correlation between WAI and body composition parameters like height, weight, percentage of body fat. In the present study effects of hypertension and Musculo-skeletal disorder on WAI have also been found. Conclusion-According to the results of this present study aging, year of service, illiteracy, smoking habit decline the health status of construction workers thereby increasing the risk of presenting moderate or poor work ability.
American Research Journal of Humanities & Social Science (ARJHSS) is a double blind peer reviewed, open access journal published by (ARJHSS).
The main objective of ARJHSS is to provide an intellectual platform for the international scholars. ARJHSS aims to promote interdisciplinary studies in Humanities & Social Science and become the leading journal in Humanities & Social Science in the world.
The Link between Health Condition Costs and Standard of Living Through Out-of...Economic Research Forum
Eleftherios Giovanis - University of Verona
Oznur Ozdamar - Bologna University
ERF Workshop on The Economics of Healthcare in the ERF Region
Cairo, Egypt - May 23, 2016
www.erf.org.eg
Background; Social Class has shown relation with admissions at Emergency Departments. To assess whether there is a relationship between the level of triage and the social class of patients who attend the emergency department and whether there are other variables that can modulate this association. Methods Observational study with 1000 patients was carried out between May and July 2018 in the Emergency Department of the University Hospital Arnau de Vilanova in Lleida. Sociodemographic variables such as age, gender, country of origin and marital status were analyzed. The triage level and the main explanatory variable was social class. Social class was calculated based on the CSO-SEE 2012 scale. Results 49.4% were male and the average age was 51.7 years. Most of the patients (66.6%) attended the emergency department under their own volition and the most common triage levels were level III or Emergency (45%). There is a significant relationship between age and triage level. The younger patients had a lower triage level (p <0.001). The percentage of patients with lower social class who attended the emergency department for minor reasons was 42% higher compared to the rest of the patients (RR = 1.42; 1.21-1.67 95% CI, p <0.001). Conclusions; Patients with a lower socioeconomic class go to the Emergency Department for less serious pathologies.
This document summarizes a study that used classical and Bayesian structural equation modeling to analyze factors influencing an individual's health index. The study used data from a health survey of over 5,000 individuals in Malaysia. It identified socio-demographic factors, lifestyle factors, and mental health as latent variables potentially influencing the health index. Both classical and Bayesian SEM were used to model relationships between these latent variables and manifest variables measuring them, like employment, exercise, and stress levels. Both approaches found socio-demographic status and lifestyle were significantly related to health index, but mental health was not. The Bayesian approach allowed incorporating prior information into the analysis.
Work-related Musculoskeletal Disorders (MSD) are one of the most common occupational diseases of offi ce workers. The aim of this study is investigating the prevalence of these disorders, determining the risk factors of occupational diseases and providing control strategies. The aim of this study is evaluating the prevalence of these symptoms among oil refinery staff. The studies conducted 200 administrative staff, 150 were male and 50 were female. It was observed that most musculoskeletal symptoms were in the neck (50%),knee (42.5%), shoulders (38.5%), the hip (10%) and lower arm (8.5%). To investigate the risk factors of musculoskeletal symptoms, we use the new methods of RULA and REBA so that we can take the necessary action to reduce the musculoskeletal symptoms and prevent potential dangers.
Practitioner Summary: This study was conducted to evaluate the prevalence of musculoskeletal disorders among one company of Iran’s oil refineries staff. Basically, because refinery workers need to do a lot of technical and physical work, therefore they have many musculoskeletal disorders. This study suggests that, with these disorders, there should be some necessary measures.
Abstract— Elderly population is increasing due to demographic shift in favor of geriatric population. This age group is susceptible for many acute and chronic health problems which may lead to limitation daily activities of life. Study of acute and chronic health problems with limitation daily activities of life of this population is required to frame comprehensive policies to make ageing a comfortable experience. So this cross-sectional period prevalence study was carried out from September 2009 to August 2010 on 1620 elderly residing in Municipal corporation area of Jaipur city with the aim to study episodes of acute health problems within last one month and limitation daily activities of life within last years of this population of elderly population. Study population consist of 1620 elderly with M:F ratio 0.95. Mean age of elderly was 66.08 years with slight female predominance i.e. 1048 females for 1000 males in Jaipur city. It can be concluded from 41.6% of elderly were having difficulty in performing activity of daily living and this difficulty was found more in females that males and in older ages. It was also revealed that 44.37 of elderly had one or more episodes of acute illness in last one month. These number of episodes of acute illness in last one month was found more in males and in older age groups.
Presentation given by Mauro Vigani at the recent ICAE conference in Milan.
The aim of the work is to provide a comprehensive analysis on the impact of maize technologies at household level in Tanzania, disentangling the effect of improved maize seeds and inorganic fertilizers on each of the four dimensions of food security
Summarization Techniques in Association Rule Data Mining For Risk Assessment ...IJTET Journal
Abstract— At Early exposure of patients with dignified risk of developing diabetes mellitus is so hyper critical to the bettered prevention and global clinical management of these patients. In an existing system, apriori algorithm is used to find the itemsets for association rules but it is not efficient in finding itemsets and it uses only four association rules for finding the risk of diabetes mellitus so it have low precision. In this paper we are focusing to implement association rule mining to electronic medical records to detect set of danger factors and their equivalent or identical subpopulations that indicates patients at especially steep risk of progressing diabetes. Association rule mining accomplishes a very bulky set of rules for summarizing the EMR with huge dimensionability. We proposed a system in enlargement to combine risk of diabetes for the purpose of finding an suitable summary for this we use ten association rule and using the reorder algorithm for finding the itemsets and rules. For identifying the risk we considered four association rule set summarization techniques and organised a related calculation to support counselling with respect to their applicability merits and demerits and provide solutions to reduce the risk of diabetes. The above four methods having its fair strength but the bus algorithm developed the best acceptable summary.
Estimating the Survival Function of HIV AIDS Patients using Weibull Modelijtsrd
This work provides information on the survival times of a cohort of infected individuals. The mean survival time was obtained as 22.579 months from the resultant estimate of the shape parameter =1.156 and scale parameter =0.0256 from Weibull 7 simulation of n = 500. Confidence intervals were also obtained for the two parameters at = 0.05 and it was found that the estimates are highly reliable. R. A. Adeleke | O. D. Ogunwale "Estimating the Survival Function of HIV/AIDS Patients using Weibull Model" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30636.pdf Paper Url :https://www.ijtsrd.com/mathemetics/statistics/30636/estimating-the-survival-function-of-hivaids-patients-using-weibull-model/r-a-adeleke
ABSTRACT- Introduction: Low back pain (LBP) is an important clinical, social, economic, and public health problem
affecting the population indiscriminately. It is a disorder with many possible etiologies, occurring in many groups of the
population, and with many definitions. Nearly everyone will experience some form of back pain in his or her lifetime.
Materials ans& Methods: The current study is a cross sectional study undertaken at Lord Buddha Koshi Medical
College, Saharsa, Bihar, India from Aug 2015 to Dec 2015. The objective of this study was to see the age specific
prevalence of low back pain among 400 subjects visiting the Orthopedics OPD of the hospital. The age range of the study
participants were 25 years to 65 years. The national guidelines of LBP diagnosis is used as diagnostic criteria.
Results: Overall prevalence of LBP was found as 31.25%. The highest prevalence was seen in 55-65 years age group.
Age had positive association & important risk factors of increasing burden of LBP.
Conclusion: LBP is an important health problem & affecting all age groups and it is responsible for a great economic loss
of any country.
Key-words- Low Back Pain, Prevalence, Public Health
The job satisfaction of physicians is an important factor that influences their motivation for work and the quality of the provided health services. The aim of the study is to evaluate the job satisfaction of General Practitioners in Bulgaria and to explore some of the factors which influence this satisfaction.
This document discusses key data sources and methods used in public health. It outlines several main sources of raw health data including births, deaths, hospital admissions, and prescriptions. These data are aggregated and linked to geography to measure population health indicators like mortality rates, life expectancy, and birth rates. Determinants of health like deprivation, lifestyle factors, and environment are also examined using surveys. The document explains methods like incidence, prevalence, crude rates, and age standardization used to analyze health data and measure the health of populations.
This document analyzes the costs and benefits of screening and treatment programs for non-communicable diseases in Rajasthan, India. It finds that screening 50-70% of people aged 30-69 for cardiovascular disease, diabetes, cervical cancer and breast cancer could avert many deaths from these diseases in a cost-effective manner. The interventions would have benefit-cost ratios ranging from 11.9 to 28.8 depending on the disease and discount rate. While start-up costs are substantial, early detection and treatment of non-communicable diseases reduces long-term health costs. Increased funding for primary care screening and management of non-communicable diseases is needed.
This document discusses several socioeconomic status (SES) scales used in India to measure and classify families based on income, education, occupation, and other factors. It describes the Kuppuswamy scale from 1976, which uses composite scores of education, occupation, and monthly income to classify SES into high, middle, and low. It also discusses modifying the Kuppuswamy scale using consumer price index data to account for inflation over time. Several other SES scales developed for India are briefly outlined, including the B.G. Prasad scale, Udai Pareek scale from 1964, and scales developed by Agarwal, Rahudkar, Shirpurkar, Jalota, Kulshreshta, and
The document discusses social stratification and different stratification systems such as caste systems, class systems, and estate systems. It provides details on key characteristics of each system, including that caste systems are based on ascribed status at birth and largely determine occupation, mandate endogamy, limit social contacts, and are underpinned by powerful beliefs. Class systems involve achievement in addition to ascribed status and have lower status consistency. Estate systems divided societies into hereditary groups tied to land ownership and services.
The impact of innovation on travel and tourism industries (World Travel Marke...Brian Solis
From the impact of Pokemon Go on Silicon Valley to artificial intelligence, futurist Brian Solis talks to Mathew Parsons of World Travel Market about the future of travel, tourism and hospitality.
We’re all trying to find that idea or spark that will turn a good project into a great project. Creativity plays a huge role in the outcome of our work. Harnessing the power of collaboration and open source, we can make great strides towards excellence. Not just for designers, this talk can be applicable to many different roles – even development. In this talk, Seasoned Creative Director Sara Cannon is going to share some secrets about creative methodology, collaboration, and the strong role that open source can play in our work.
Reuters: Pictures of the Year 2016 (Part 2)maditabalnco
This document contains 20 photos from news events around the world between January and November 2016. The photos show international events like the US presidential election, the conflict in Ukraine, the migrant crisis in Europe, the Rio Olympics, and more. They also depict human interest stories and natural phenomena from various countries.
The Six Highest Performing B2B Blog Post FormatsBarry Feldman
If your B2B blogging goals include earning social media shares and backlinks to boost your search rankings, this infographic lists the size best approaches.
1) The document discusses the opportunity for technology to improve organizational efficiency and transition economies into a "smart and clean world."
2) It argues that aggregate efficiency has stalled at around 22% for 30 years due to limitations of the Second Industrial Revolution, but that digitizing transport, energy, and communication through technologies like blockchain can help manage resources and increase efficiency.
3) Technologies like precision agriculture, cloud computing, robotics, and autonomous vehicles may allow for "dematerialization" and do more with fewer physical resources through effects like reduced waste and need for transportation/logistics infrastructure.
International Journal of Caring Sciences September-December 2020 Volume 13 | Issue 3| Page 2131
www.internationaljournalofcaringsciences.org
Original Article
Effects of Low Back Pain on Functional Disability Level and Quality of Life
in Nurses Working in a University Hospital
Ipek Kose Tosunoz, MSc
Lecturer, Hatay Mustafa Kemal University, Hatay School of Health, Nursing Department, Hatay, Turkey
Gursel Oztunc, PhD
Professor, University of Kyrenia, Faculty of Health Sciences, Nursing Department, Kyrenia, Cyprus
Correspondence: Ipek Kose Tosunoz, MSc, Lecturer, Hatay Mustafa Kemal University, Hatay School of Health,
Nursing Department, Hatay, Turkey E-mail address: [email protected]
Abstract
Background: The nurses are under a greater risk in terms of Low Back Pain (LBP) and LBP can affect the nurses’
quality of life adversely and result in disability. This study aims at analysing the effects of LBP on functional
disability level and quality of life in nurses.
Methods: This is a descriptive study. The population consisted of all the nurses working at a university hospital. The
whole population was included in the sampling. 514 nurses participated in the study. The confirmation of the ethics
committee and permission of the institution were obtained prior to the study. The data were collected via Personal
Information Form, Quality of Life Scale Short Form 36 (SF-36) and Oswestry Disability Index (ODI).
Objectives: This study aims at exploring the effects of Low Back Pain (LBP) on functional disability level and
quality of life in nurses.
Material and Methods: This is a descriptive study. The population consisted of all the nurses working at a
university hospital. The whole population was included in the sampling. 514 nurses participated in the study. The
confirmation of the ethics committee and permission of the institution were obtained prior to the study. The data
were collected via Personal Information Form, Quality of Life Scale Short Form 36 (SF-36) and Oswestry Disability
Index (ODI).
Results: It was found that 85.4% of the nurses had low back pain at any stage of their life and 57.8% had continuing
back pain. Nurses’ average scores are lower for each subscale of the SF-36 except for Emotional Role when
compared with other nurses who do not suffer from LBP. The mean score that the nurses with low back pain
obtained from the ODI was 11.09 ± 6.18 and majority of the nurses experiences mild disability. It was indicated that
there is a negative correlation between nurses’ average scores for all subscales of SF-36 and ODI (p<.05).
Conclusion: The results of this study revealed that LBP is a common health problem among working nurse. LBP
affects the nurses’ quality of life adversely and results in disability. Taking necessary precautions for the prevention
of LBP in nurses would provide positive effects on nurses’ quality of life and functional levels.
Keywords: Lo ...
In India, Reproductive Tract Infection (RTI) including Sexually transmitted Diseases (STDs) produce a huge disease burden. Nursing staff plays a major role in prevention of STI/RTIs. So this study was conducted aimed to know the knowledge about STIs/RTIs of nursing personnel of a tertiary care hospital of Rajasthan. 100 nursing professionals were supervised for practice and interrogated for attitude and knowledge as per a semi- structured schedule. It was found that overall mean score of nurses was 56% and only 52% had scores passing marks (>50%). Although this knowledge about STI/RTI was not found to be associated religion, caste, type of family and socio-economic status but it was found to be associated with sex, marital status and education of nurses. It was also found in this study that gap of training decreases the knowledge and number of training increases the knowledge. It was found to be associated with department where the nurses were working. So all the nurses irrespective of place of posting should be given refresher trainings at regular intervals.
Impact of Spinal Cord Injury on Patients Social Integration in Ibn- Al-kuff M...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
(03) Occupational Exposure to Blood and Body Fluids.pdfHLeyva1
This study examined occupational exposure to blood and body fluids among healthcare workers in Gondar, Ethiopia. A cross-sectional study design was used with 286 randomly selected participants. The main outcome of interest was occupational exposure to blood/body fluids in the past 12 months, defined as skin, eye, or mucous membrane contact with blood/body fluids. Key findings included:
1) The prevalence of occupational exposure was 65.3%.
2) Factors significantly associated with increased risk of exposure included lack of personal protective equipment, lack of training, khat chewing, and being a medical doctor.
3) The study aimed to determine the current prevalence and risk factors of occupational exposure to blood and body fluids among healthcare
This study examined the psychiatric morbidity profile of 1,620 elderly people residing in Jaipur, India. The researchers found that over half (54.32%) of the elderly population had at least one psychiatric illness. Depression was the most common psychiatric problem, affecting 40.93% of participants. Other frequent issues included sleep disorders, anxiety, and psychosis. Females had significantly higher rates of depression, sleep disorders, psychosis, and phobias compared to males. The results suggest that the elderly population requires increased attention and support from policymakers to address their high burden of psychiatric illnesses.
Factors that affect the Quality of Life of Patients with Behcet's DiseaseMinistry of Health
Objective: To assess the quality of life in patients with Behçet's disease, and to address the factors impact the domains of Quality of Life.
Methods: We surveyed101 patients with Behcet's disease no less than 3 months before the study. Data were collected using Short Form 36 Quality of life Scale. Results: The quality of life scores in patients with Behçet's disease were low and were adversely influenced by socio-demographic characteristics such as gender, age, work status and education status. Furthermore, disease manifestations such as oral and genital ulcerations, arthritis, and skin lesions affected the quality of life scores. Moreover, patients who experienced pain, poor sleep and fatigue lower the quality of life scale and patients whose social relations were influenced by the disease had significantly lower the quality of life scores. Conclusion: Patients with Behcet's disease reported a low level of quality of life.
Keywords: Behcet's disease, Factors affecting, Quality of life, Jordan.
A study on patients care quality in public district hospitals in tamilnaduIAEME Publication
This document summarizes a study on patient care quality in public district hospitals in Tamil Nadu, India. The study examined 34 variables related to patient care quality as perceived by patients. It found that patients' expectations generally exceeded their perceptions of quality. Some key findings:
- Rural patients gave higher ratings than urban patients for doctors' knowledge, analytical nature, and test performance ability.
- There were significant perception differences between urban and rural patients for 14 of the 34 variables.
- Factor analysis identified five important factors of patient care quality: empathy, patients' needs, relationship, professionalism, and responsiveness.
The study suggests that while Tamil Nadu has invested in healthcare, public hospitals need more autonomy
Summarization Techniques in Association Rule Data Mining For Risk Assessment ...IJTET Journal
Abstract— At Early exposure of patients with dignified risk of developing diabetes mellitus is so hyper critical to the bettered prevention and global clinical management of these patients. In an existing system, apriori algorithm is used to find the itemsets for association rules but it is not efficient in finding itemsets and it uses only four association rules for finding the risk of diabetes mellitus so it have low precision. In this paper we are focusing to implement association rule mining to electronic medical records to detect set of danger factors and their equivalent or identical subpopulations that indicates patients at especially steep risk of progressing diabetes. Association rule mining accomplishes a very bulky set of rules for summarizing the EMR with huge dimensionability. We proposed a system in enlargement to combine risk of diabetes for the purpose of finding an suitable summary for this we use ten association rule and using the reorder algorithm for finding the itemsets and rules. For identifying the risk we considered four association rule set summarization techniques and organised a related calculation to support counselling with respect to their applicability merits and demerits and provide solutions to reduce the risk of diabetes. The above four methods having its fair strength but the bus algorithm developed the best acceptable summary.
Estimating the Survival Function of HIV AIDS Patients using Weibull Modelijtsrd
This work provides information on the survival times of a cohort of infected individuals. The mean survival time was obtained as 22.579 months from the resultant estimate of the shape parameter =1.156 and scale parameter =0.0256 from Weibull 7 simulation of n = 500. Confidence intervals were also obtained for the two parameters at = 0.05 and it was found that the estimates are highly reliable. R. A. Adeleke | O. D. Ogunwale "Estimating the Survival Function of HIV/AIDS Patients using Weibull Model" Published in International Journal of Trend in Scientific Research and Development (ijtsrd), ISSN: 2456-6470, Volume-4 | Issue-4 , June 2020, URL: https://www.ijtsrd.com/papers/ijtsrd30636.pdf Paper Url :https://www.ijtsrd.com/mathemetics/statistics/30636/estimating-the-survival-function-of-hivaids-patients-using-weibull-model/r-a-adeleke
ABSTRACT- Introduction: Low back pain (LBP) is an important clinical, social, economic, and public health problem
affecting the population indiscriminately. It is a disorder with many possible etiologies, occurring in many groups of the
population, and with many definitions. Nearly everyone will experience some form of back pain in his or her lifetime.
Materials ans& Methods: The current study is a cross sectional study undertaken at Lord Buddha Koshi Medical
College, Saharsa, Bihar, India from Aug 2015 to Dec 2015. The objective of this study was to see the age specific
prevalence of low back pain among 400 subjects visiting the Orthopedics OPD of the hospital. The age range of the study
participants were 25 years to 65 years. The national guidelines of LBP diagnosis is used as diagnostic criteria.
Results: Overall prevalence of LBP was found as 31.25%. The highest prevalence was seen in 55-65 years age group.
Age had positive association & important risk factors of increasing burden of LBP.
Conclusion: LBP is an important health problem & affecting all age groups and it is responsible for a great economic loss
of any country.
Key-words- Low Back Pain, Prevalence, Public Health
The job satisfaction of physicians is an important factor that influences their motivation for work and the quality of the provided health services. The aim of the study is to evaluate the job satisfaction of General Practitioners in Bulgaria and to explore some of the factors which influence this satisfaction.
This document discusses key data sources and methods used in public health. It outlines several main sources of raw health data including births, deaths, hospital admissions, and prescriptions. These data are aggregated and linked to geography to measure population health indicators like mortality rates, life expectancy, and birth rates. Determinants of health like deprivation, lifestyle factors, and environment are also examined using surveys. The document explains methods like incidence, prevalence, crude rates, and age standardization used to analyze health data and measure the health of populations.
This document analyzes the costs and benefits of screening and treatment programs for non-communicable diseases in Rajasthan, India. It finds that screening 50-70% of people aged 30-69 for cardiovascular disease, diabetes, cervical cancer and breast cancer could avert many deaths from these diseases in a cost-effective manner. The interventions would have benefit-cost ratios ranging from 11.9 to 28.8 depending on the disease and discount rate. While start-up costs are substantial, early detection and treatment of non-communicable diseases reduces long-term health costs. Increased funding for primary care screening and management of non-communicable diseases is needed.
This document discusses several socioeconomic status (SES) scales used in India to measure and classify families based on income, education, occupation, and other factors. It describes the Kuppuswamy scale from 1976, which uses composite scores of education, occupation, and monthly income to classify SES into high, middle, and low. It also discusses modifying the Kuppuswamy scale using consumer price index data to account for inflation over time. Several other SES scales developed for India are briefly outlined, including the B.G. Prasad scale, Udai Pareek scale from 1964, and scales developed by Agarwal, Rahudkar, Shirpurkar, Jalota, Kulshreshta, and
The document discusses social stratification and different stratification systems such as caste systems, class systems, and estate systems. It provides details on key characteristics of each system, including that caste systems are based on ascribed status at birth and largely determine occupation, mandate endogamy, limit social contacts, and are underpinned by powerful beliefs. Class systems involve achievement in addition to ascribed status and have lower status consistency. Estate systems divided societies into hereditary groups tied to land ownership and services.
The impact of innovation on travel and tourism industries (World Travel Marke...Brian Solis
From the impact of Pokemon Go on Silicon Valley to artificial intelligence, futurist Brian Solis talks to Mathew Parsons of World Travel Market about the future of travel, tourism and hospitality.
We’re all trying to find that idea or spark that will turn a good project into a great project. Creativity plays a huge role in the outcome of our work. Harnessing the power of collaboration and open source, we can make great strides towards excellence. Not just for designers, this talk can be applicable to many different roles – even development. In this talk, Seasoned Creative Director Sara Cannon is going to share some secrets about creative methodology, collaboration, and the strong role that open source can play in our work.
Reuters: Pictures of the Year 2016 (Part 2)maditabalnco
This document contains 20 photos from news events around the world between January and November 2016. The photos show international events like the US presidential election, the conflict in Ukraine, the migrant crisis in Europe, the Rio Olympics, and more. They also depict human interest stories and natural phenomena from various countries.
The Six Highest Performing B2B Blog Post FormatsBarry Feldman
If your B2B blogging goals include earning social media shares and backlinks to boost your search rankings, this infographic lists the size best approaches.
1) The document discusses the opportunity for technology to improve organizational efficiency and transition economies into a "smart and clean world."
2) It argues that aggregate efficiency has stalled at around 22% for 30 years due to limitations of the Second Industrial Revolution, but that digitizing transport, energy, and communication through technologies like blockchain can help manage resources and increase efficiency.
3) Technologies like precision agriculture, cloud computing, robotics, and autonomous vehicles may allow for "dematerialization" and do more with fewer physical resources through effects like reduced waste and need for transportation/logistics infrastructure.
International Journal of Caring Sciences September-December 2020 Volume 13 | Issue 3| Page 2131
www.internationaljournalofcaringsciences.org
Original Article
Effects of Low Back Pain on Functional Disability Level and Quality of Life
in Nurses Working in a University Hospital
Ipek Kose Tosunoz, MSc
Lecturer, Hatay Mustafa Kemal University, Hatay School of Health, Nursing Department, Hatay, Turkey
Gursel Oztunc, PhD
Professor, University of Kyrenia, Faculty of Health Sciences, Nursing Department, Kyrenia, Cyprus
Correspondence: Ipek Kose Tosunoz, MSc, Lecturer, Hatay Mustafa Kemal University, Hatay School of Health,
Nursing Department, Hatay, Turkey E-mail address: [email protected]
Abstract
Background: The nurses are under a greater risk in terms of Low Back Pain (LBP) and LBP can affect the nurses’
quality of life adversely and result in disability. This study aims at analysing the effects of LBP on functional
disability level and quality of life in nurses.
Methods: This is a descriptive study. The population consisted of all the nurses working at a university hospital. The
whole population was included in the sampling. 514 nurses participated in the study. The confirmation of the ethics
committee and permission of the institution were obtained prior to the study. The data were collected via Personal
Information Form, Quality of Life Scale Short Form 36 (SF-36) and Oswestry Disability Index (ODI).
Objectives: This study aims at exploring the effects of Low Back Pain (LBP) on functional disability level and
quality of life in nurses.
Material and Methods: This is a descriptive study. The population consisted of all the nurses working at a
university hospital. The whole population was included in the sampling. 514 nurses participated in the study. The
confirmation of the ethics committee and permission of the institution were obtained prior to the study. The data
were collected via Personal Information Form, Quality of Life Scale Short Form 36 (SF-36) and Oswestry Disability
Index (ODI).
Results: It was found that 85.4% of the nurses had low back pain at any stage of their life and 57.8% had continuing
back pain. Nurses’ average scores are lower for each subscale of the SF-36 except for Emotional Role when
compared with other nurses who do not suffer from LBP. The mean score that the nurses with low back pain
obtained from the ODI was 11.09 ± 6.18 and majority of the nurses experiences mild disability. It was indicated that
there is a negative correlation between nurses’ average scores for all subscales of SF-36 and ODI (p<.05).
Conclusion: The results of this study revealed that LBP is a common health problem among working nurse. LBP
affects the nurses’ quality of life adversely and results in disability. Taking necessary precautions for the prevention
of LBP in nurses would provide positive effects on nurses’ quality of life and functional levels.
Keywords: Lo ...
In India, Reproductive Tract Infection (RTI) including Sexually transmitted Diseases (STDs) produce a huge disease burden. Nursing staff plays a major role in prevention of STI/RTIs. So this study was conducted aimed to know the knowledge about STIs/RTIs of nursing personnel of a tertiary care hospital of Rajasthan. 100 nursing professionals were supervised for practice and interrogated for attitude and knowledge as per a semi- structured schedule. It was found that overall mean score of nurses was 56% and only 52% had scores passing marks (>50%). Although this knowledge about STI/RTI was not found to be associated religion, caste, type of family and socio-economic status but it was found to be associated with sex, marital status and education of nurses. It was also found in this study that gap of training decreases the knowledge and number of training increases the knowledge. It was found to be associated with department where the nurses were working. So all the nurses irrespective of place of posting should be given refresher trainings at regular intervals.
Impact of Spinal Cord Injury on Patients Social Integration in Ibn- Al-kuff M...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
(03) Occupational Exposure to Blood and Body Fluids.pdfHLeyva1
This study examined occupational exposure to blood and body fluids among healthcare workers in Gondar, Ethiopia. A cross-sectional study design was used with 286 randomly selected participants. The main outcome of interest was occupational exposure to blood/body fluids in the past 12 months, defined as skin, eye, or mucous membrane contact with blood/body fluids. Key findings included:
1) The prevalence of occupational exposure was 65.3%.
2) Factors significantly associated with increased risk of exposure included lack of personal protective equipment, lack of training, khat chewing, and being a medical doctor.
3) The study aimed to determine the current prevalence and risk factors of occupational exposure to blood and body fluids among healthcare
This study examined the psychiatric morbidity profile of 1,620 elderly people residing in Jaipur, India. The researchers found that over half (54.32%) of the elderly population had at least one psychiatric illness. Depression was the most common psychiatric problem, affecting 40.93% of participants. Other frequent issues included sleep disorders, anxiety, and psychosis. Females had significantly higher rates of depression, sleep disorders, psychosis, and phobias compared to males. The results suggest that the elderly population requires increased attention and support from policymakers to address their high burden of psychiatric illnesses.
Factors that affect the Quality of Life of Patients with Behcet's DiseaseMinistry of Health
Objective: To assess the quality of life in patients with Behçet's disease, and to address the factors impact the domains of Quality of Life.
Methods: We surveyed101 patients with Behcet's disease no less than 3 months before the study. Data were collected using Short Form 36 Quality of life Scale. Results: The quality of life scores in patients with Behçet's disease were low and were adversely influenced by socio-demographic characteristics such as gender, age, work status and education status. Furthermore, disease manifestations such as oral and genital ulcerations, arthritis, and skin lesions affected the quality of life scores. Moreover, patients who experienced pain, poor sleep and fatigue lower the quality of life scale and patients whose social relations were influenced by the disease had significantly lower the quality of life scores. Conclusion: Patients with Behcet's disease reported a low level of quality of life.
Keywords: Behcet's disease, Factors affecting, Quality of life, Jordan.
A study on patients care quality in public district hospitals in tamilnaduIAEME Publication
This document summarizes a study on patient care quality in public district hospitals in Tamil Nadu, India. The study examined 34 variables related to patient care quality as perceived by patients. It found that patients' expectations generally exceeded their perceptions of quality. Some key findings:
- Rural patients gave higher ratings than urban patients for doctors' knowledge, analytical nature, and test performance ability.
- There were significant perception differences between urban and rural patients for 14 of the 34 variables.
- Factor analysis identified five important factors of patient care quality: empathy, patients' needs, relationship, professionalism, and responsiveness.
The study suggests that while Tamil Nadu has invested in healthcare, public hospitals need more autonomy
Abstract: Geriatric population is increasing as life expectancy is increasing. This population is susceptible for many health problems which have a significant impact on their quality of life. So this cross-sectional study was carried out from September 2009 to August 2010 on 1620 elderly residing in Municipal corporation area of Jaipur city with the aim to study the heart diseases and its associated factors in geriatric population. Mean age of elderly was 66.08 years with slight female predominance i.e. 1048 females for 1000 males in Jaipur city. Only 285 (17.59%) elderly who were not having and type of morbidity otherwise a sizable count i.e. 573 (35.36%) were having even 4 or more type of co morbidity. Out of total 1620 elderly 544 (33.58%) were having Hypertension and 88 (5.43%) of elderly were having other heart diseases. It was found that all other heart diseases were having hypertension. Obesity was maximal co-morbidly with heart disease followed by Diabetes. Heart diseases were found significantly more in males. Likewise it was also observed that elderly who were doing exercise were having significantly less heart diseases. Hypertension was observed significantly more in elderly who were smoking followed by elderly who were taking alcohol and chewing tobacco. But proportion of heart diseases (other than hypertension) found significantly more in elderly who were taking alcohol than who were smoking.
Work-related Musculoskeletal Disorders (MSD) are one of the most common occupational diseases of offi ce workers. The aim of this study is investigating the prevalence of these disorders, de termining the risk factors of occupational diseases and providing control strategies. The aim of this study is evaluating the prevalence of these symptoms among oil refi nery staff. The studies conducted 200 administrative staff, 150 were male and 50 were female. It was observed that most musculoskeletal symptoms were in the neck (50%), knee (42.5%), shoulders (38.5%), the hip (10%) and lower arm (8.5%). To investigate the risk factors of musculoskeletal symptoms, we use the new methods of RULA and REBA so that we can take the necessary action to reduce the musculoskeletal symptoms and prevent
potential dangers.
Work–related Musculoskeletal Disorders Among Healthcare Workers in a General ...CSCJournals
Background. Musculoskeletal disorders is the most common disease among healthcare workers. Which affects not only the quality of life but also the income, the health, the economy. In Vietnam, there are some research about the MSDs among healthcare workers and the factors affect this problem, especially, the ergonomic factors. Objective. To assess the prevalence of musculoskeletal disorders among healthcare workers in Cao Bang General Provincial Hospital, Vietnam and determine risk factors associated with musculoskeletal disorders. Material and methods. A cross-sectional study was conducted among 85 healthcare workers in a general provincial hospital in Vietnam using the Nordic questionnaire and questionnaire. Results. High prevalence of musculoskeletal among healthcare workers during the past 12 months (62.4%) and last 7 days (45.9%), with the two most common sites being low back pain (48.2%) and neck (40%). Gender, work experience, total working hours, night shift work, and stress level showed the association with the MSDs in the past 12 months. Conclusion. Due to the high prevalence of MSDs among healthcare workers in a general provincial hospital, preventive actions are needed to improve the working conditions and to raise the awareness of healthcare workers about MSDs prevention.
Determinants of Socio-Economic Condition of the Nurses at Sylhet in BangladeshBRNSSPublicationHubI
This document summarizes a study on the socio-economic conditions of nurses in Sylhet, Bangladesh. 151 nurses were surveyed using a structured questionnaire. The results showed that most nurses were young, female, married, and had nursing diplomas. The average monthly income was 27,843 Taka. Multiple linear regression analysis found that nurse satisfaction levels and length of service were significantly associated with higher income. Most nurses were satisfied with their work but few had received additional training. This study provides insight into the demographic characteristics and economic factors affecting nurses in Sylhet, Bangladesh.
Elderly population is increasing due to demographic shift in favor of geriatric population. This age group is susceptible for many health problems. So this cross-sectional study was carried out from September 2009 to August 2010 on 1620 elderly residing in Municipal corporation area of Jaipur city with the aim to study episodes of acute illness and its associating factors. Study population consist of 1620 elderly with M:F ratio 0.95. Mean age of elderly was 66.08 years with slight female predominance i.e. 1048 females for 1000 males in Jaipur city. It can be concluded from this study that 44.37% of elderly had one or more episodes of acute illness in last one month. These numbers of episodes of acute illness in last one month was found more in males and in older age groups.
Burnout among Health Workers: Case of the Military Hospital of Ouakam, Senegalinventionjournals
This study assessed burnout among workers at the Military Hospital of Ouakam in Senegal. A survey was conducted using the Maslach Burnout Inventory tool, involving 66 hospital employees. The results found that 68.2% of workers showed signs of burnout, with 46.9% experiencing mild burnout and 21.2% moderate burnout. Emotional exhaustion was observed in 30.3% of participants, depersonalization in 21.2%, and reduced personal achievement in 36.3%. Burnout was more common among older workers and paramedics. The high prevalence of burnout indicates the need for measures to improve workers' social and professional environments.
This study assessed the costs and effects of different degrees of task shifting for anti-retroviral therapy (ART) from physicians to other health professionals in Ethiopia. The study found that (1) facilities with maximal task shifting, where non-physicians performed most ART tasks, had similar patient outcomes and costs as facilities with minimal/moderate task shifting; (2) over 88% of patients remained active on ART after two years across all facility types; and (3) maximal task shifting cost $36 more per patient over two years but resulted in 0.4% fewer patients remaining active, though this difference was not statistically significant.
This study examined musculoskeletal disorders (MSDs) among 100 medical care professionals working in two hospitals in Lorestan, Iran. The most common areas of pain reported were back pain (26% of participants at the first hospital and 20% at the second) and neck pain (20% at both hospitals). The majority (87-88%) of participants stated they did not receive treatment or pain management for their MSDs. While most (64%) felt stress was not associated with their pain, 36% reported their pain worsened with increased stress. The high rates of MSDs among these medical professionals suggests preventative measures are needed to address causes like improper posture and mechanics.
Attitudes toward interprofessional education and collaborative practices in M...SubmissionResearchpa
From the perspective of activity theory, it can be argued that the major challenge in relation to implementing interprofessional education (IPE) could be embraced as contradictions that may lead to change. Patients have complex health needs and typically require insight from more than one discipline to address issues regarding their health status (Lumague et al. 2006). The World Health Organization (WHO) recommends that institutions engaged in health professional education and training consider implementing IPE in both undergraduate and postgraduate programs (WHO, 2010). The purpose of this study was to identify the needs of IPECP for health care professionals, faculty members, and students. Methods: The survey instrument contained four scales to evaluate faculty attitudes toward IPE and teamwork, adapted from the methods of Curran et al. (2007). Each scale asked respondents to rate their attitudes toward statements on a 5-point Likert scale (1=strongly disagree; 2=disagree; 3=neutral; 4=agree; 5=strongly agree). The initial factor extractions were performed by means of principal components analysis. To define the model structure more clearly, an exploratory factor analysis using varimax rotation was conducted. The level of significance was p<.0001 for all tests. Results: As shown in Table 2, the Kaiser–Meyer-Olkin index was 0.902, indicating sampling adequacy, and the Bartlett Sphericity Chi-Square index was 2246.5 (p <0.0001). Cronbach’s alpha for the 14 items was 0.731, revealing a high rate of internal consistency. The modified Attitude toward health care team scores (ATHCTS) questionnaire was categorized into four factors: “Quality of care,” “Team efficiency,” “Patient-centered care,” and “Negative factors.” Conclusion: Findings suggest that the positive attitude of health care professionals, faculty members and students towards IPE indicates the need for IPE training by Azjargal Baatar, Sumberzul Nyamjav and Oyuntsetseg Sandag 2020. Attitudes toward interprofessional education and collaborative practices in Mongolia. International Journal on Integrated Education. 3, 8 (Aug. 2020), 48-52. DOI:https://doi.org/10.31149/ijie.v3i8.536 https://journals.researchparks.org/index.php/IJIE/article/view/536/512 https://journals.researchparks.org/index.php/IJIE/article/view/536
This study examined aspects of sustainability among Swiss psychiatrists by assessing levels of cooperation, job satisfaction, and burnout. The researchers surveyed 352 psychiatrists. They found that cooperation was highest with general practitioners and lowest with community mental health providers. Overall job satisfaction was assessed as high, while burnout rates were below concerning thresholds. Both job satisfaction and burnout correlated inversely, with higher satisfaction associated with lower burnout. Cooperation was positively associated with job satisfaction and inversely with burnout. The study concludes that fostering sustainability in outpatient psychiatric care requires considering personal, organizational, and supportive factors that can influence cooperation, satisfaction, and burnout.
Out of Pocket Expenditure on Non-Communicable Diseases among Households: Evid...Premier Publishers
The document summarizes a study on out-of-pocket expenditures for non-communicable diseases (NCDs) among households in the Indian state of Punjab. Key findings include:
- Punjab has higher prevalence of NCDs than the national average in India.
- Households in Punjab incurred higher out-of-pocket expenditures for NCD treatment and hospitalization than the all India levels.
- The poorest households in Punjab spent the highest share of their total consumption on out-of-pocket health expenditures for NCDs.
- The results indicate that due to high out-of-pocket costs, NCDs place a large economic burden on households in Punjab
share - Lions, tigers, AI and health misinformation, oh my!.pptxTina Purnat
• Pitfalls and pivots needed to use AI effectively in public health
• Evidence-based strategies to address health misinformation effectively
• Building trust with communities online and offline
• Equipping health professionals to address questions, concerns and health misinformation
• Assessing risk and mitigating harm from adverse health narratives in communities, health workforce and health system
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Kat...rightmanforbloodline
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
TEST BANK For Basic and Clinical Pharmacology, 14th Edition by Bertram G. Katzung, Verified Chapters 1 - 66, Complete Newest Version.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
Does Over-Masturbation Contribute to Chronic Prostatitis.pptxwalterHu5
In some case, your chronic prostatitis may be related to over-masturbation. Generally, natural medicine Diuretic and Anti-inflammatory Pill can help mee get a cure.
1. International Journal of Pharmaceutical Science Invention
ISSN (Online): 2319 – 6718, ISSN (Print): 2319 – 670X
www.ijpsi.org Volume 3 Issue 4‖ April 2014 ‖ PP.27-36
www.ijpsi.org 27 | P a g e
The Association Between Socioeconomic Status and the Incidence of
Osteoarthritis in Mumbai and Its Rural Periphery
Lena Röbbel2
, Prof. Dr. Dnyanesh Limaye1
, Prof. Dr. Vaidehi Limaye1
, Prof. Dr.
Gerhard Fortwengel2
1
University of Mumbai, India, 2
University of Applied Sciences and Arts Hannover, Germany
ABSTRACT:
OBJECTIVE: This case study was set up to investigate if there is an association between the socioeconomic
status and the incidence of osteoarthritis in Mumbai and it’s rural periphery.
METHODS: A regional exploratory case study was conducted with 19 Indian physicians working in
orthopedic practice based in government hospital or private clinics. They were interviewed to collect data about
their osteoarthritis patients. Information regarding patients’ socioeconomic status, incidence of osteoarthritis
as well as demographic data were documented in a case report form. The socioeconomic status was calculated
based on a modified version of Kuppuswamy’s socioeconomic scale.
RESULTS: The results showed a higher average incidence of osteoarthritis in rural areas (53.8%) compared
to urban Mumbai (20.8%). The socioeconomic status was lower in rural Raigad (12.8 points) compared to
urban Mumbai (18.3 points). On average, women were more often affected than men. The highest incidence of
osteoarthritis was found in women from rural areas (39.4%). Conclusion: Findings of the case study indicated
association between high incidence of osteoarthritis and low socioeconomic status. Thus, the findings of this
case study offer a solid template for future research.
KEY WORDS: Socioeconomic status, osteoarthritis, incidence, prevalence, risk factors, health insurance,
Mumbai, Raigad, India
I. INTRODUCTION:
Osteoarthritis (OA) has a high prevalence in industrialized nations and is the most frequently occurring
musculoskeletal disease (1). The prevalence of OA increases with age. At age < 45 men are more often affected
than women, whereas above 55 women are more frequently affected. Approximately, worldwide 9.6% of men
and 18% of women 60 years suffer from OA. As life expectancy grows, the prevalence of OA is very likely to
increase. In 2020 OA is expected to be the fourth leading cause of disability (2), (3). It will not only cause more
expenses for health care but also produce high indirect costs, since people affected by symptomatic OA are not
able to add to the economic performance of a country, causing a loss of productivity and profits (2). In the past,
studies on OA and its risk factors primarily focused on physical risk factors, e.g. obesity, old age, female
gender, or joint injury (4). Nonetheless, recent studies have indicated that there is an association between the
socioeconomic status (SES) and the incidence and prevalence of OA. SES, is categorized as low, middle and
high (9). SES can be measured in terms of income, wealth, poverty, education, occupation, and area level
measures (10), (11), (12).A study by Callahan et al. found that both education and SES were independently
associated with knee OA (5). Two large surveys conducted in India by Chopra et al. focusing on Western India
and the Pune region revealed a significantly higher prevalence of knee pain in the rural compared with the urban
community (13.7% vs. 6.0%) in the adjusted comparison (6), (7). Studies by Joshi et al. basically focused on the
rural-urban divide and did not collect data on the SES of its subjects. In summary, there is very little data on the
correlation between the SES and the incidence of OA in modern India (7). Since the study by Joshi et al. is
based on data of 2001 it may also be of interest to investigate the incidence and prevalence of OA nowadays,
with India’s economy and society developing rapidly and life expectancy rising.
II. MATERIALS AND METHODS:
Doctors from government hospital or private clinic from Mumbai or periphery (Raigad) were selected
randomly based on their professional qualification. Data acquisition was based on the interview technique and
documented on a paper based case report form. Queries were resolved immediately, if any. Data were entered in
study specific Microsoft Excel sheet and analyzed by
2. The Association Between Socioeconomic…
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Microsoft Excel as well as Graph Pad Prism™. In order to evaluate the SES of patients a modified version of
Kuppuswamy’s SES scale was developed. Kuppuswamy’s SES scale is a composite measure based on the
subject’s occupation, education and income. In order to calculate the final modified version of SES score based
on Kuppuswamy’s SES scale, scores for occupation, education, and income had to be calculated in the first
place. It was calculated as follows:Beginning with occupation, all values of single subdivisions of this category,
which comprise ‘unemployed’, ‘unskilled worker’, ‘semi-skilled worker’, ‘skilled worker’, ‘clerical/shop-
owner/farmer’, ‘semi-professional’, and ‘professional’ in terms of percent were converted to absolute numbers,
which were equivalent to the number of patients. Then, absolute numbers were multiplied by Kuppuswamy’s
point score to calculate the total score. Total score values of the separate subdivisions were added and divided
by the sum of all absolute numbers (patients) in order to obtain the occupation score. The same calculation was
done for education and income. After calculating scores for education, occupation, and income, all three scores
were added to get a final composite modified version of SES score based on Kuppuswamy’s SES scale for each
doctor’s patient pool.
Table 1: Calculation of modified version of Kuppuswamy’s socioeconomic score
(Example no° 1 - Occupation)
Example calculation of the occupation scale based on data of one participating doctor from Mumbai:
First, percentage values for each occupational subdivision were converted into absolute numbers (see
column 2 and 3). Then, absolute numbers (see column 3) were multiplied by Kuppuswamy’s point score (see
column 4) to calculate the total score (see column 5). Altogether, the sum of all total scores (see bold number in
column 5) was divided by the total absolute number of all patients (see bold number in column 3) to obtain the
final occupation score (see column 6). In this example, the occupation score was 3.65 points.The same
procedure was repeated using correspondent data to obtain values for an education and income score. In this
example, the education score amounted to 6.0 points, and the income score was 10.2 points (see appendix Table
15 and Table 16). To obtain the final modified SES score the sum of the three previously calculated values was
used, which made a final SES of 19.85 points. The average patient in this setting has a modified SES score of
19.85 points, which means the patient belongs to the upper middle class (9).
CRF no° 2 Number of OA patients in this facility: 300
Occupation
scale:
Numbers [%] Absolute numbers
(patients)
Kuppuswamy’s
point score
Total
score
Occupation
score
Unemployed: 50 150 1 150
Unskilled
worker:
0 0 2 0
Semi-skilled
worker:
5 15 3 45
Skilled worker: 10 30 4 120
Clerical, shop
owner,farmer
10 30 5 150
Semi-
Professional
10 30 6 180
Professional 15 45 10 450
Total: 100 300 1095 3.65
3. The Association Between Socioeconomic…
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Incidence and prevalence were calculated using following formulas:
Calculation of Incidence and Prevalence
Incidence Rate = (Naïve patients with OA) / (Patients with Musculoskeletal Disease – Patients with
known OA) Prevalence Rate = (Number of patients with OA / Number of patients with Musculoskeletal
Disease) x 100
III. RESULTS:
In total 19 doctors were interviewed out of which ten were from Mumbai and nine were rural Raigad
district.
Table 2: Overview of patients with OA and musculoskeletal disorders
Total [numbers] Mumbai [numbers] Raigad [numbers]
Number of patients with OA 4804 1254 3550
Number of patients with
musculoskeletal disorders
9447 3647 5800
Figure 1: Gender distribution of all OA patients
29.20% M ale
70.80% F em ale
A ll P atients
31.00% M ale
69.00% F em ale
U rban Patients
27.20% M ale
72.80% F em ale
R ural P atients
On average, 70.8% of all OA patients were female, whereas only 29.2% of all OA patients were male. In
Mumbai, 69% of OA patients were female compared to 31% male OA patients. In Raigad (Rural), 72.8% of OA
patients were male and 27.2% were female. The average age of all patients was 57.5 years (60.0 years in males
and 55.0 years in females).
4. The Association Between Socioeconomic…
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Table 3: Overview of average number of naive and repeat patients
57.2% of all patients were naïve and 42.8% were repeat patients. In Mumbai the number of naïve patients was
lower (42.6%) as compared to Raigad (73.3%). The number of repeat patients was 57.4% in Mumbai and 26.7%
in Raigad.
Total [%] Mumbai [%] Raigad [%]
All naïve patients 57.2 42.6 73.3
All repeat patients 42.8 57.4 26.7
Female naïve patients 71.1 69.5 72.8
Male naïve patients 29.0 30.5 27.2
Female repeat patients 71.6 70.5 72.8
Male repeat patients 28.4 29.5 27.2
Figure 2: Overview of average patients’ occupational status
On Average, 8.1% of the total number of patients were unemployed. In Mumbai 15.3% of patients were
unemployed. The results showed that in Raigad no patients were unemployed. On average, 13.4% of all patients
were unskilled. Numbers of unskilled workers in Mumbai (12.5%) and Raigad (14.4%) were similar. The total
number of semi-skilled workers was 16.2%. There were more semi-skilled workers in Raigad compared to
Mumbai (23.3% vs. 9.8%). 11.4% of all patients of the case study were classified as skilled. In Mumbai 10.1%
were skilled workers and 12.8% of rural patients were said to be skilled. On average, 19.7% of total patients
belonged to the group of clericals, shop owners or farmers. In urban areas only 8.5% of patients were counted in
this group in comparison to 32.2% of rural patients. 14.0% of all patients were semi-professional. In Mumbai
11.5% patients were semi-professional, whereas in Raigad 16.7% were semi-professional. Furthermore, 17.3%
of all patients were declared as professional. In Mumbai 32.3% of patients were professionals, whereas 0.6% of
Raigad patients belonged to this group.
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
0
10
20
30
40
Unskilled
Semi-skilled
Skilled
Clerical,shop-owner,farmer
Semi-professional
Professional
Unemployed
Occupation[%]
Figure 3: Overview of average patients' educational status
5. The Association Between Socioeconomic…
www.ijpsi.org 31 | P a g e
Regarding education status, 3.7% of all patients were illiterate, 21.8% of all patients finished education
with a primary school diploma, 20.5% with a middle school diploma, and 20.8% with an intermediate or post
high school diploma. 22.1% of the total number of patients were classified as graduates, whereas 11.1% were
said to have a professional education. In Mumbai, 6.5% of their patients were illiterate. 11.5% had a primary
school diploma, 19.0% a middle school diploma, and 15.5% had an intermediate or post high school diploma.
27.0% were assessed to be graduates, who thus constitute the biggest subgroup in the urban arm. 20.1% of
Mumbai patients were professionals, thus forming the second largest subgroup. In Raigad only 0.6% as
illiterate. 33.3% finished primary school, thus forming the biggest subgroup in the rural arm. 22.2% of Raigad
patients had a middle school diploma and 26.7% had an intermediate or post high school diploma. 16.7% of
Raigad patients were graduates and only 0.6% were assessed to be professionals.
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
0
10
20
30
40
Primary school
Middle school
Intermediate/post high school
Graduate
Profession or honours
Illiterate
Education[%]
Figure 4: Overview of average patients' income status
In terms of income only 1.8% of the total number of patients earned less than 1600 rupees per months.
4.7% earned 1601-4809 rupees, 19% between 4810-8009 rupees, 19.2% earned up to 8010-12019 rupees, and
17.9% earned between 12020-16019 rupees. 16.6% of all patients were rewarded for their work with 16020-
32049 rupees, and 20.8% were paid more than 32050 rupees per month. In Mumbai average salaries were higher
compared to salaries in Raigad. In Mumbai only 3.5% of urban patients earned less than 1600 rupees per month,
2.0% earned between 1601-4809 rupees and 5.0% were paid 4810-8009 rupees. 16.5% of patients from Mumbai
were paid 8010-12019 rupees, 19.0% earned up to 12020-16019 rupees, and 14.5% were paid 16020-32049
rupees per month. The biggest subgroup of urban patients, amounting up to 39.5%, was paid more than 32050
rupees per month. Neither did any of the patients from Raigad earn less than 1600 rupees, nor did any of them
earn more than 32050 rupees per month. 7.8% were paid between 1601-4809 rupees per month. Most of the
rural patients (34.4%) earned between 4810-8009 rupees per month. 22.2% were paid 8010-12019 rupees,
16.7% were rewarded with 12020-16019 rupees, and 18.9% earned up to 16020-32049 rupees per month.
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Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
Total
Urban
Rural
0
10
20
30
40
1601-4809 Rs
4810-8009 Rs
8010-12019 Rs
12020-16019 Rs
16020-32049 Rs
>32050 Rs
< 1600 Rs
Income[%]
On average, the SES of all patients was 15.8 points. The average SES score in urban areas was 18.4 points,
which means that urban patients belonged mostly to the upper middle class.
Table 4: Overview of average patients’ socioeconomic status (SES)
Total [points] Urban [points] Rural [points]
Patients 15.8 18.4 12.8
Patients treated by eight out of ten urban doctors were classified to belong to the upper middle class and the
patients of the two remaining doctors belonged to the middle/ lower middle class according to the modified
version of Kuppuswamy’s SES scale. The average rural SES score counted 12.8 points, thus on average rural
patients belonged to the middle/lower middle class. Regarding patients from rural Raigad, two doctors primarily
treated patients belonging to the upper middle class, four doctors dealt with patients counted to the middle/lower
middle class, and three doctors primarily helped patients who belonged to the lower/upper lower class on
average.
Table 5: Overview of patients’ socioeconomic class
Socioeconomic Class Total Socioeconomic Class Urban Socioeconomic Class Rural
N= 19 (Doctors) N= 10 (Doctors) N= 9 (Doctors)
Upper middle (II): 10 Upper middle (II): 8 Upper middle (II): 2
Middle /Lower middle III: 6 Middle/Lower middle III: 2 Middle/Lower middle III: 4
Lower/Upper lower IV: 3 - Lower/Upper lower IV: 3
Average SES Score and Class Average Rural SES Score and Class Average Rural SES Score and Class
15.8 points:
Upper middle (II)
18.4 points:
Upper middle (II)
12.8 points:
Middle/Lower middle (III)
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The prevalence of OA among all patients with musculoskeletal diseases being treated by doctors participating in
the study was 50.9% on doctors’ level. On average, in urban Mumbai the prevalence amounted to 34.4%. In
rural Raigad, prevalence of OA was almost double as high, amounting to 61.2%. In all female OA patients
prevalence was 72.4%. In male OA patients the prevalence was 27.6%. In Mumbai, prevalence of OA in
females was 69.7%, compared to rural areas where it was 73.3%. In male patients prevalence of OA was 30.3%
in urban and 26.7% in rural areas as seen in Table 6.
Table 5: Overview of average prevalence of OA
Total [%] Urban [%] Rural [%]
All patients 50.9 34.4 61.2
Female patients 72.4 69.7 73.3
Male patients 27.6 30.3 26.7
Generally, the average incidence of OA among all OA patients from both Mumbai and Raigad was
41.1% on doctors’ level. In Mumbai the average incidence of OA was 20.8%, whereas it was higher in Raigad.
(53.8%). The calculated incidence of OA was highest in female patients from rural areas, amounting 39.4%. In
contrast, female patients from Mumbai had an incidence of 14.6%. Regarding male patients, the incidence of
OA was generally lower compared to female patients. In rural areas the incidence was 14.3% and in urban areas
it was only 6.1% as shown in Table 7.
Table 6: Overview of average incidence of OA
Total [%] Urban [%] Rural [%]
All patients 41.1 20.8 53.8
Female patients 29.9 14.6 39.4
Male patients 11.2 6.1 14.3
Table 7: Overview of treatment of patients subdivided by Gender and Origin
84.1% of patients were treated with drugs and 15.9% was treated surgically as seen in the Table 8.
Total [%] Urban [%] Rural [%]
All patients treated on drugs 84.1 86.8 81.1
All patients treated on surgery 15.9 13.2 18.9
Male patients treated on drugs 31.6 35.5 27.2
Female patients treated on drugs 68.4 64.5 72.8
Male patients treated on surgery 26.1 25.0 27.2
Female patients treated on surgery 73.9 75.0 72.8
On average, 23.7% of all patients were obese. In Mumbai, 38.0% of all patients were obese, whereas only 7.8%
of patients consulting a doctor in rural areas were obese.
Table 8: Overview of average patients’ obesity
Total [%] Urban [%] Rural [%]
Obesity (all patients) 23.7 38.0 7.8
Obesity (male patients) 28.1 33.1 23.1
Obesity (female patients) 71.9 66.9 76.9
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Table 9: Overview of average number of patients doing moderate exercise
Results showed that 22.6% of male and 16.6% of all female OA patients were doing moderate exercise.
Total [%] Urban [%] Rural [%]
Male patients doing moderate exercise 22.6 33.5 10.6
Female patients doing moderate exercise 16.6 23.0 9.4
Moreover, in urban areas 31.6% of all OA patients had comorbidites, in comparison to only 11.0% of all OA
patients from rural areas. Also, it was seen that average consultation time in urban areas was 14 minutes. In rural
areas consultation time was shorter, lasting only five minutes. Average consultation fees were 585 rupees in
Mumbai and 77.8 rupees in Raigad. All in all, on average, 83.8% of all patients did not have any health
insurance. 13.8% were insured by a private health insurance and 1.8% were insured by the RSBY program.
IV. DISCUSSION:
Based on the study results there is a strong evidence indicating an association between the incidence of
OA and the SES. The average incidence of recently diagnosed OA of all patients treated by doctors participating
in the study was 41.1%. In Mumbai, the average incidence of OA was only 20.8% compared to an incidence
more than twice as high, amounting to 53.8%, in Raigad rural orthopedic hospitals or practices.
Correspondingly, the average prevalence of OA was also higher in rural Raigad compared to urban Mumbai
(61.2% in Raigad vs. 34.4% in Mumbai). Overall, OA patients from urban Mumbai had a better education,
higher income, and worked in more professionalized jobs. Consequently, the SES score calculated with the
modified version of Kuppuswamy’s SES scale was higher in urban patients. On average, in urban Mumbai OA
patients belonged to the upper middle class, with a SES score of 18.4 points. Thus, this score was higher than
the rural score, which counted only 12.8 points. Thus, on average OA patients from rural areas belonged to the
middle/lower middle class. In 2009, Joshi et al. asked if there is a rural-urban divide regarding the prevalence of
musculoskeletal diseases. Also dealing with OA, they found that OA had a lower prevalence in urban compared
to rural communities, a fact which supports the finding of a lower incidence and prevalence of OA in urban
Mumbai compared to rural Raigad. Yet, Joshi and his team did not look for the SES (7). This study shows that a
lower SES correlates with a higher incidence of OA and may pose an additional risk factor for the development
of OA. Besides investigating the association between the incidence of OA and the SES, this study also included
questions on gender, age, obesity, moderate exercise and comorbidities as well as treatment of patients both in
rural and urban areas.
Generally, the incidence of OA was higher in women than in men both in Mumbai and Raigad, with
female patients from rural areas showing the highest incidence counting 39.4%. On average, 70.8% of all OA
patients were female, whereas only 29.2% of all OA patients were male. However, research has shown that the
disease generally appears more often in women than in men, a fact that is attributed to female biology, female
hormones, and a certain genetic risk (15). Regarding the patients’ age of average onset of the disease, the
average age was 60 years in male and 55.0 years in female patients. It is worth mentioning that in Raigad male
patients were diagnosed with OA aged 58.3 in comparison to male patients from urban Mumbai, where onset of
OA seems to be later in life as on average they were diagnosed with OA aged 61.5. Possibly, increased physical
labor in rural areas may pose an explanation to this finding.On average, 23.7% of all patients were obese. But
obesity was a bigger problem in Mumbai, as 38% of all OA patients from the city were overweight, whereas on
average only 7.8% of rural OA patients were obese. Regarding gender distribution, the majority of obese OA
patients were female (28.1% of all male OA patients vs. 71.9% of all female OA patients). In contrast to
industrialized countries, where people with a low SES are more often overweight. India shows higher
prevalence of obesity in people living in cities, having a higher educational attainment and being affluent (16).
According to the National Family Health Survey, women are more often overweight than men (17). As
mentioned before, obesity is one of the major risk factors for the development of OA (18), (19). Nevertheless,
incidence of OA was higher in OA patients from rural Raigad, where obesity was less prevalent than in
Mumbai. As analysis of the case report forms revealed, in rural areas the majority of OA patients worked in jobs
associated with physical labor, with only 17.3% of patients being professionals and semi-professionals.
Basically, working on a farm for 1-9 years increases the risk of OA about 4.5 times. Farming 10 or even more
years will lead to a 9.3 elevated risk to suffer from OA (3). The Framingham OA study named physical labor
and heavy lifting as main risk factors for OA (19).
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Physical labor seems to be a great risk factor for OA and may actually outweigh obesity as a main risk
factor for OA in this case study. Thus, people from rural areas, especially women, being at higher risk for the
development of OA should be the central target for primary, secondary, and tertiary prevention. Primary
prevention includes prevention strategies for the development of OA. In Raigad people working in jobs
demanding physical labor could be educated how to do physical labor the best way and the work environment
could be adjusted to prevent OA from occurring. Secondary prevention comprises early diagnosis of OA to
intervene as early as possible. Tertiary prevention is designed to prevent progress of the disease and to improve
quality of life by reducing pain and disability caused by OA (20). It is also interesting to note that urban OA
patients, who on average had a higher SES than rural OA patients, were said to suffer from comorbidities such
as diabetes or arterial hypertension more often than rural OA patients. In urban areas 31.6% of all OA patients
suffered from comorbidities in contrast to 11.0% of OA patients from rural areas (figure 11). These findings
were coherent to a recent study by Corsi and Subramanian conducted in India in 2012. They found that groups
with the highest SES had the biggest risk for type 2 diabetes (21). Moderate exercise is known to decrease the
risk of cardiovascular comorbidities like diabetes type 2 (22). But even though OA patients from Mumbai were
more likely to do moderate exercise (33.5% of male patients and 23.0% of female patients) than rural patients
(10.6% of male patients and 9.4% of female patients) they had a higher rate of cardiovascular comorbidities
(please compare table 12 and figure 11).
According to the results regarding the treatment of OA patients there was no obvious evidence for
differences in the treatment of patients from urban and rural areas. All in all, the majority of patients (84.1% in
urban and 81.1% in rural areas) was treated on drugs and only a small percentage (15.9% in urban and 18.9% in
rural areas) was treated on surgery (please view table 10). Furthermore, inferences on the Indian health care
system can be drawn. As results of the study reveal, most of OA patients both from urban and rural areas did not
have any kind of health insurance (83.6% of all patients). Alarmingly, doctors participating in the survey from
Raigad declared 100% of their patients to not have any kind of health insurance. As mentioned before, the
Indian health care system has many problems that remain to be solved in order to achieve adequate health care
for the Indian people. It is commonly known to burden patients with high out of pocket expenditures (8).
Consequently, findings of this study reflect deficits of the Indian health care system. Furthermore, the poorest of
the poor do not seek doctoral help when in need since they cannot afford the costs and the majority of them do
not have any kind of health insurance. Thus, these patients are underrepresented in this case study. One may
hypothesize that the incidence of OA may be even higher in groups with a very low SES, which remains to be
proved in future studies. Once again, it becomes obvious that many steps need to be taken to improve health
care in India.
V. CONCLUSION:
This case-study was done to determine if there is an association between the SES and the incidence of
OA in Mumbai and its rural periphery as well as to identify new risk factors for the development of OA.
Previous studies have indicated that there is a strong association between the SES and health (13), (1). This
exploratory case study, was conducted to investigate the association between the incidence of OA and the SES.
Results indicated that there is an association between low SES and high incidence of OA. Additionally, the
study implies that a low SES comprising low educational attainment, a low occupational status, and a low
income may pose an additional risk factor for the development of OA. In order to prove the association between
the SES and the incidence of OA a confirmatory case-control study would be appropriate. A nationally
representative cross-sectional household survey could be an alternative study design. Even though more OA
patients from Mumbai were obese compared to rural OA patients, the incidence of OA was higher in rural
Raigad, indicating that heavy physical labor is even a stronger risk factor for OA than obesity. Findings of this
study yield strong evidence that there is an association between a high incidence of OA and a low SES and thus
offer a template for future research.
Limitations of the study:Limitations of this study include that there was no randomization of participating
doctors. Another limitation is the recall bias as doctors answered questions only based on their memories. It is
likely that certain groups of patients are overrepresented and others are underrepresented due to recall bias (23).
Furthermore, the case study only represents OA patients seeking help from an orthopedic specialist. Patients not
affluent enough to afford medical help were not represented in the case study, thus the poorest of the poor are
underrepresented. The study is also limited in terms of different methods regarding questioning of doctors.
Doctors from Mumbai were questioned in interviews. In contrast, doctors from rural areas were sent the CRF
via email and were not interviewed directly. In future studies one standardized interview technique should be
chosen to ensure complete comparability. In some cases, certain questions may not have been answered
correctly due to a lack of understanding the meaning of the question. Thus, certain results may be distorted.
Furthermore, the CRF has certain weaknesses. The modified version of Kuppuswamy’s SES scale in the CRF
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lacked one sub-division regarding the patients’ average educational attainment. OA patients having achieved a
high school certificate were not listed in the modified version of Kuppuswamy’s scale being part of the CRF.
Two scores were on the verge of falling into another category (CRF no°18, SES amounting to 9.9 points in rural
areas, and CRF no° 9, SES amounting to 14.5 points in urban areas). However, in order to change the final SES
score of the two concerned CRFs doctors’ statements on education would have needed to deviate dramatically
from their original statements.
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