Background: The number of childhood cancer survivors (CCSs) is increasing due to improved survival. Most suffer at least one treatment-related late effect, even decades after treatment, thus lifelong long-term follow-up (LTFU) care is a necessity. Currently no standardized LTFU programme for CCSs exists in South Africa. Study purpose: This study investigated current LTFU care of CCSs in South Africa. Methods: A survey was conducted amongst 31 South African paediatric oncologists using the SurveyMonkeyTM online tool. Information obtained included: training/experience, LTFU practices, late effects knowledge and opinion regarding the importance of a standardized LTFU programme. Results: The response rate was 74% (23/31). Respondents had an average of 9 years’ experience. All (22/23; 96%) regarded LTFU as important. Only half (12/23; 52%) discussed late effects at diagnosis. Infertility and second malignancy risks were discussed by a third. Less than half (48%) used LTFU guidelines; the majority (9/11; 82%) adjusted them to the local context. Most survivors were followed by a paediatric oncologist (17/23; 74%). About half of respondents (47.8%) shared LTFU with colleagues in private practice (50%), secondary (66.7%) or primary care facilities (25%). Almost half of respondents (10/23; 43.5%) regarded their late effects knowledge and LTFU experience as good, 8/23 (34.8%) as adequate and 3/23 (13%) as inadequate. All agreed that a national LTFU programme would be very important (87%) or important (13%). Almost half of the respondents (48%) understood what a Survivorship Passport was. Conclusion: It is essential to develop a national standardized LTFU programme for CCSs in South Africa to ensure appropriate care for all survivors.

In development of movement apparatus in small children, youth and – if not cured – in adults play the role two factors. First is connected with small disorders in brain – and in Pediatrics Orthopedic Departments we see very often children with the symptoms of Minimal Brain Dysfunctions [MBD]. The second is connected with asymmetries in anatomy and in function of movement apparatus in “Syndrome of Contracture and Deformities” described by Professor Hans Mau (Tübingen, Germany). These second problems are the subject of this paper

Child neglect is a global problem that involves large costs for both the individual and for society. This article is based on published reviews and meta-analyses in the field of child neglect between 1980 and 2018. Of a total of 433 articles, 13 was included, main Data bases has been PubMed, Scopus, Web of Science, Psych Info, ERIC, CINAHL. The prevalence in the normal population was found to be between 16% and 26%, while the prevalence in clinical groups seem to be significantly higher. For example, was the prevalence of neglect 50% among patients with eating disorder. It is especially important to know who is reporting neglect. Research shows that neglect is strongly associated with among other things, depression, one of the most common illnesses among the general public. The theoretical models that are used are ecological. Risk factors can be found at all levels when using ecological models. Research shows that factors involving the relationship parent-child are among the most important. Neglect is more common in low-income countries than in high income countries. Most studies point to the importance of prevention. Existing preventive programs are most often of family and parental character. More research is needed, especially as concerns the development of preventive programs that can identify specific types of neglect and present suitable preventive measures, both at the societal and family level. Key points 1. Neglect is a global problem. 2. Prevalence depends on the measurement method and can vary between about 16% and 76%. 3. Prevalence is higher when negligence is self-reported than when reported by professionals. 4. The most common and most serious risk factors are present in the microsystem. Parenting and interactions between child and parent are considered important. 5. There is a link between neglect and, above all, depression, but also anxiety, self-harm and eating disorders.

Objective: To examine the association between adverse social determinants of health (SDH) and missed well-child visits and the interaction with the level of caregiver social support. Methods: This is a secondary data analysis of data collected from a SDH screening program conducted during well-child visits with referral, navigation and follow-up services for patients. We included 573 adult caregivers who accompanied patients aged 0-5 years to well-child visits and completed the screening from August 2017 to May 2018. The caregivers reported financial hardship, food insecurity, housing challenges, childcare difficulty, transportation issues, insurance difficulty, job difficulty, and education needs. Our primary outcome was a no-show (i.e., missed) to a well-child visit. Social support was dichotomized as low or high. Results: Among 573 patients who completed the screening, 335 patients (76.4%) had at least one social need. Financial hardship (p = 0.006), housing instability (p = 0.002), and no/poor childcare (p = 0.03) were associated with missed well-child visits. In multivariable regression analysis, having Medicaid (aOR = 1.91 [1.17-3.10]) and unstable housing (aOR = 6.79 [1.35-34.70]) were both associated with missed well-child visits. However, when social support was added to the multivariable logistic model, both Medicaid and unstable housing were no longer associated with missed well-child visits. Conclusion: Adverse SDH such as financial hardship, housing instability, and childcare difficulty were associated with missed well-child visits. However, with the addition of social support, this association was no longer significant. This study supports the hypothesis that high social support may mitigate the association between well-child visits among families experiencing adverse SDH.

Type 2 diabetes is a common disease in these days and day by day it is arising. The main focus of the study was to investigate association of packed cell volume (PCV), Mean Corpuscular Volume (MPV), Mean Corpuscular Hemoglobin Concentration (MCHC), Red Cell Distribution Width (RDW) with glycemic marker HbA1c. So that PCV, MPV, MCHC, RDW could be used as a predictor of glucoregulation in type 2 diabetes instead of HbA1c value. This study included 87 DMT2 patients, which divided into two groups, A (n=41, presence in diabetics≤6.5-6.9%) and B (n=46, target in diabetes≥7.0%), according to HbA1c values. Spearsman correlation co-efficients were calculated to evaluate the relationship between RBC count, MCHC, RDW with random blood sugar (RBS) and PCV, MCV, MCHC with HbA1c value. Binominal logistic regression analysis was performed to estimate the relationship between glycemic control, as dichotomous outcome of MCHC, RDW, PCV, and MCV as the main prognosticator. MCHC and RDW were significantly higher in the group B compared to the group A. RDW and MCHC may be applied as the auxiliary indicators of deterioration of glucoregulation.

High blood pressure (HBP) is a strong, independent and etiologically relevant risk factor for cardiovascular and therefore, the leading cause of preventable deaths worldwide. Hypertension has high medical and social costs. Due to its many associated complications, the use of medical services create high costs with medications which represent almost half of the estimated direct expenses. Free distribution of more than 15 medications for HyPERtension and DIAbetes (HIPERDIA program) clearly shows the important role of drugs in the Brazilian Government’s effort to tackle these two diseases. Notwithstanding, the prevalence of HBP is rising in parallel with other NCDs. It is known that HBP results from environmental and genetic factors, and interactions among them. Our ancestors were often faced with survival stresses, including famine, water and sodium deprivation. As results of natural selection, the survival pressures drove our evolution to shape a thrifty genotype, which favored/promoted energy-saving and sodium/water preservation. However, with the switch to a sodium- and energy-rich diets and sedentary lifestyle, the thrifty genotype and ancient frugal alleles, are no longer advantageous, and may be maladaptive to disease phenotype, resulting in hypertension, obesity and insulin resistance syndrome. Low-grade chronic inflammation and oxidative stress would be the underlying mechanisms for these diseases. HBP is often associated with unhealthy lifestyles such as consumption of high fat and/or high-salt diets and physical inactivity. Therefore, alternatively to medicine drugs, lifestyle and behavioral modifications are stressed for the prevention, treatment, and control of hypertension. A lifestyle modification program (LSM) involving dietary counseling and regularly supervised physical activity (“Move for Health”) has been used for decades, in our group, for NCDs primary care. Retrospective (2006-2016) data from 1317 subjects have shown the top quartile of blood pressure(142.2/88.5mmHg) differing from the lower quartile (120.6/69.2mmHg) by being older, with lower schooling, lower income and, lower physical activity and aerobic capacity. Additionally, the P75 showed higher intake of CHO, saturated fat and sodium along with lower-diet quality score with a more processed foods. They showed higher body fatness and prevalence of metabolic syndrome along with higher pro-inflammatory and peroxidative activities and insulin resistance. In this free-demand sample, the HBP rate was 51.2% for SBP and 42.7% for DBP. The rate of undiagnosed HBP was 9.8% and only 1/3 of medicated patients were controlled for HBP. After 10 weeks of LSM the HBP normalization achieved 17.8% for SBP and 9.3% for DBP with a net effectiveness of 8.5% and 2.4%, respectively. The reduction of HBP by LSM was followed by increased aerobic conditioning and reduced intake of processed foods along with decreased values of BMI, abdominal fatness, insulin resistance, pro-inflammatory and peroxydative activities. Importantly, once applied nationwide this LSM would save HBP medication for 3.1 million of hypertensives at an economic saving costs of US$ 1.47 billion a year!

NAFLD is characterized by accumulation of fat in the liver that can lead to health complications. Previous studies have found the obesity phenotype and its components to be risk factors for the development of NAFLD. This study aims to examine the relationship between the obesity phenotype and NAFLD among each racial-ethnic group. We analyzed data from the NHANES III survey (1988-1994). The obesity phenotype was defined based on BMI and metabolic syndrome. NAFLD was defined by abdominal ultrasounds among non-alcoholics with no infection or taking drugs affecting the liver. A higher prevalence of NAFLD was found among the metabolically unhealthy obese group (43.1%) and the metabolically unhealthy overweight (29.4%) than the metabolically unhealthy normal weight (11.8%). Mexicans-Americans had higher odds of NAFLD relative to whites (adjusted odds ratio (AOR) = 1.3, 95% confidence interval (CI) = 1.01-1.9, p = 0.04). The metabolically healthy obese phenotype was associated with NAFLD (p > 0.05) in the overall sample and in Whites. The metabolically healthy overweight was associated with NAFLD only among Mexican-American (p < 0.05). Metabolically unhealthy overweight or obese had higher odds of NAFLD relative to the metabolically healthy normal weight and this relation is consistent in all the racial/ethnic groups (p < 0.05). Metabolically healthy overweight and obese individuals had a high chance of NAFLD and it varied by race/ethnicity. Healthcare providers should pay more attention to care for those who are part of the metabolically healthy overweight or obese group especially among the Mexican-American population.

Thermal stress of a continuous rigid frame bridge, based on the temperature gradient in Chinese bridge gauge, using a finite element analysis (FEA) method was investigated. First of all, the temperature effect of the whole bridge was analyzed, and the correlation of the improved amplitude of temperature gradient and temperature effect were studied. It was found that there was a linear relationship with temperature stress and improved temperature. And then, the temperature effect of zero block was analyzed and the details of box girder temperature stress distribution investigated by utilizing the FEA method. It was concluded that temperature stress mainly distributed in the body surface; under the condition of the improvement of temperature field, the center temperature stress of zero block was improved about 60% and the end temperature stress of zero block was improved about 75%.

Introduction: Obesity defined as increased fatty mass is progressively rising in recently, even though its affects begins to all systems in childhood and adolescence periods, the most important morbidity and mortality reason of obesity is its effects on the cardiovascular system. Researches point out endothelial dysfunction and atherosclerosis as the reason of the cardiovascular system disease in obesity. The studies conducted on childhood period related to this subject are highly limited and the results of these are also controversial. Therefore in our study the effects of obesity on endothelial functions in children and adolescents was assessed by flow mediated dilation (FMD) method. In addition to that, effects of epidemiological, biochemical, hormonal and clinical features of cases to FMD were investigated. Material and method: A total number of 104 cases were cover in this study. Obese group (group 1) was consisted of 59 children whose body mass index (BMI) was ≥ 95th percentile and mean age was 12 ± 2.8 years old. The control group (group 2) consisted of 45 children whose body mass index (BMI) was between 25th -84th percentil and mean age was 11.4 ± 2.9 years old. The detailed history, epidemiological data and physical examination were performed. The population classified three groups according to sport activities. 97th percentile and higher values were accepted as morbid obesity. The blood pressure was measured with a mercury sphygmomanometer with utilizing the proper size cuff in compliance with the criterion used by the “National High Blood Pressure Education Program Working Group”. The complete blood count and biochemistry tests (renal and liver function tests, electrolytes, lipids, hsCRP) of the cases were analysed with biochemistry Roche Cobas Integra 800 and hormon assays of the cases (thyroid function tests, diurnal cortisol, ACTH, 17 OHP, prolactin, DHEA-S) were analysed by ECLIA method on Roche Elecsys 2010 device in the laboratory of our hospital. IR-HOMA values > 2.5 in prepuberal and > 4 in pubertal were defined as the insulin resistance. Bone ages of cases were evaluated with left hand wrist X-ray by using Greulich and Pyle Bone Age Atlas. flow mediated dilation (FMD) was used to assess the endothelial functions of all cases. The brachial artery was evaluated with SPG 12 MHz surface probes by using GE voluson ultrasound system in this method. FMD was expresses as percent (%) increase according to the basal vein dimension. 7% mean value was taken as the limit in the comparisons. Results: The ratio of male and female was 20/39 in group 1 and 14/31 in group 2. 32.3% of the cases in group 1 and 47.6% of the cases in group 2 were prepubertal. The waist and hip circumferences ratio of the group 1 (0.86 ± 0.05) was significantly higher than group 2 (0.80 ± 0.07). While there was no difference between groups 1 and 2 in terms of the birth weight, using duration period of vitamin D and beginning time to additional nutrition, breastfeeding duration of group 1 (10.6 ± 7.8 months) was significantly shorter than group 2 (14 ± 7.4 months). BMIs of the mothers in group 1 were statistically higher than the mothers in group 2 (27.5 ± 4.8 kg/m² and 24.3 ± 3.2 kg/m² respectively. The mean of IR-HOMA was 4 ± 2.9 in group 1 and 1.9 ± 0.8 in group 2 and there was the insulin resistance in 51% of the obese cases. The dyslipidemia was diagnosed in 38.5% of the cases in group 1. The systolic and diastolic blood pressures in group 1 (117 ± 12.2 mmHg and 73.7 ± 9.4 mmHg respectively) were significantly higher than in group 2 (107.5 ± 9.1 mmHg and 68.2 ± 7.1 mmHg respectively). Hypertension was determined in 25% of the cases included in group 1. The minimum values of FMD in groups 1 and 2 were 1.01% and 3.1% respectively. The maximum values of FMD in groups 1 and 2 were 9.7% and 15% respectively. The mean values of FMD was %5 ± 2.3 in group 1 and %8.1 ± 3.5 in group 2. Compared with group 2, group 1 demonstrated significantly impaired FMD. There was no association between FMD and the birth weight, breastfeeding duration, physical exercises in two groups. A negative correlation was found between FMD and BMI (p < 0.01, r = -0.402). The correlation was determined between FMD and BMI of the mother (p = 0.017, r = -0.305) and the presence of obese individuals in the family (p = 0.021, r =-0.413). It was found that a significant negative correlation between FMD and waist-hip circumference ratio (p = 0.003, r = -0.421). When each groups were assessed in terms of biochemical and hormonal characteristics, there was low negative correlation between FMD and uric acid level and strong negative correlation between FMD and ALT level were determined in group 1. Conclusion: In our study showed that the obesity begins in the childhood period may cause to the endothelial dysfunction. For this reason, according to our opinion, recognition prior indicators of endothelial dysfunction in early time may be helpful both to take the precautions required and to prevent cardiovascular complications in childhood and influences to the adult period. The rising sizes of the waist and hip circumferences, positive family history for obesity and obesity of the parents were determined as the most important parameters negative affecting FMD. Unlike the literature, the association between endothelial dysfunction and GGT level the indicator of the hepatosteatosis in obese children was also found as well as FMD and ALT have also a close association independent from BMI in this study. Thus, a different point of view was formed since ALT may possibly have a predictor value in the assessment of the endothelial functions and it is also found as a highlighted risk factors for the endothelial dysfunction in this study. Because of this reason, it can be recommended that when the liver function tests carry out in obese children it does not show only hepatosteatosis but also can be used as an early indicator of the cardiovascular complications of obesity. Another important subject to be emphasize that the ALT level in the childhood period may be an early cardiovascular risk indicator in both obese and nonobese children.

Nanocontainers of the type CuO, ZnO and CeMo were developed in the present work and incorporated into commercial paints. The nanocontainers were filled with bromosphaerol (CuO and ZnO), SeaNineTM 211 (CuO and ZnO), and 8Hydroxyquinoline (CeMo). The new resulting paints were tested in the lab and in the sea via painting a fraction of two ships. The outcome of this work is encouraging demonstrating that the new nanotechnology-based paints yield to superior commercial paints that may present a major milestone in the new generation of marine paints

Background: NSU is generally caused by right cerebral hemisphere lesions with a preeminent localization on the frontoparietal lobe. Aim: To assess the correlation between the typology and the brain lesion site and the consensual consent modality of body image modification after an integrated rehabilitative and neuropsychological treatment. Setting: A rehabilitation institute for the treatment of neurological gait disorders and neuropsichological failures. methods: Patients recruited were divided according to the brain lesion site into 3 groups (IG = ischemic group = 5 patients; HG = hemorrhagic group = 4 patients; IG + HG = ischemic + hemorrhagic group = 3 patients) based on CT brain performed in the post-acute phase. At time T0, the patients recruited underwent a systematic review of their current neuroradiological profile (location delineation and type of brain injury) compared with a consensual framing of the neuromotor and neuropsychological profile acquired at the time of taking charge in the ward. At time T1 and after the drafting and implementation of the rehabilitation treatment plan foreseen in the study (1 to 4 months after T0), the patients in our sample underwent a re-evaluation of their neuromotor and neuropsychological profile with controls of the same outcome parameters considered at time T0. Results: A parametrically but not statistically significant modification of the results obtained was observed by measuring the MI ULl, MI LLl and TCT scales in the group with hemorrhagic brain injury; the analysis of variance did not show any statistical significance in the relationship between the type of stroke (ischemic, hemorrhagic or both) and the motor impairment passing from time T0 to time T1. The analysis of variance did not reveal a statistically or parametrically significant relationship between the type (ischemic, hemorrhagic and ischemic + hemorrhagic) of cerebral stroke and the variations of the neuropsychological profile. The T-Student test showed statistically significant changes in the importance of the lesion site in defining the degree of motor disability. In particular, we observed, about the presence of frontal lobe lesions, a statistically significant variation passing from the T0 time to the T1 time for the following motor scales in 9 of 12 recruited patients: MI LLl (26.4 vs. 62, with p < 0.05), TCT (43.6 vs. 80.6, with p < 0.01 for equal variance assumed and p < 0.05 for equal variance not assumed), FAC (0.8 vs. 2.3 with p < 0,01 for equal variance assumed and p < 0.05 for equal variance not assumed). Conclusion: We have confirmed the importance of the anatomical-dysfunctional correlation as a key concept from which to start in any neurorehabilitative treatment approach. Our work has highlighted the basic role of the right frontal lobe in the programming and execution of the gesture and its kinesthetic control as regards the left lower limb and the trunk.

The demand for materials and devices that are capable of controlling heat flux has attracted many interests due to desire to attain new sources of energy and on-chip cooling. Excellent properties of DNA make it as an interesting nanomaterial in future technologies. In this paper, we aim to investigate the thermal flow through two sequence combinations of DNA, e.g, (AT)4 (CG)4 (AT)4 (CG)4 and (CG)8 (AT)8. Two interesting phenomena have been observed respectively. In the first configuration, an oscillatory thermal flux is observed. In this way, an oscillating heat flux from a stationary spatial thermal gradient is provided by varying the gate temperature. In the second configuration, the system behaves as a constant heat current source. The physical mechanism behind each phenomenon is identified. In the first case, it was shown that the transition between thermal positive conductance and negative differential conductance implies oscillatory heat current. In the latter, the discordance between the phonon bands of the two coupled sequences results in constant thermal flow despite of increasing in temperature gradient.

The purpose of this study was to differentiate between muscular activity of three different types of belt squats (SquatMax-MD, Pit Shark and Monster Rhino) and the muscle activation of the rectus femoris, vastus medialis oblique, gluteus maximus, and gluteus medius. Fourteen healthy, male athletes, over the age of 18 years, performed 2 sets of 5 repetitions on each of the three belt squat machines with a weight equivalent to each participant’s body weight. Athletes were given at least 2 minutes of rest between each set and condition. Electromyographic data were collected from four muscles: rectus femoris, vastus medialis oblique, gluteus maximus, and gluteus medius muscles. ANOVA revealed the SquatMax-MD belt squat resulted in the highest muscle activation in every muscle, with significantly higher activity in the rectus femoris, vastus medialis oblique, and gluteus medius muscles. The Monster Rhino belt squat produced the second highest muscle activation with the Pit Shark belt squat creating the lowest muscle activation. In totality, the SquatMax-MD produced 38.7% greater muscle activation than the Monster Rhino and 12.2% greater activation than the Pit Shark. The belt squat can be an advantageous exercise because it can effectively load the lower body while de-loading the spine and upper body. The difference in activation between the SquatMax-MD and other belt squats may be due, in part, to the design of the machines. The additional activation produced by the SquatMax-MD belt squat may be useful for individuals seeking hypertrophy, strength, or a reduction in injury risk.

Introduction: Physical activity (PA) directly affects Health-related quality of life. The aim of the study was to establish the relationship between physical activity levels of physiotherapists and their physical activity promotion strategies. in Hebron/West Bank. Method: The study relied on cross-section, which included 150 PTs distributed over 42 centers of Hebron areas in Palestine country. The questionnaire is based on Likert scale items pentagonal level, which included several aspects of Health-related quality of life. Statistical analysis was used to test the associations between different categorical variables (p < 0.05). Results: of total 150 participants, most of them were male 56%, their ages ranged from 25-30 years (46%), and holding bachelor’s degrees 78%. About 60% of them are in good physical health. Most participants feel vitality, depression, quit, have energy, and are happy in the most of the time. In addition, most of them believe their health is similar to that of the members of the surrounding community. The study showed there is no relationship between general health and age except in the age group over 40 years, and females are the most exposed group. In addition, there is an influence relationship between physical and psychological with age, and this effect also includes females more than males. Conclusion: Physical functioning of most of the participants was good, while most of the participants had problems with their work and the major effect was on the female category.

Introduction: There is increasing published evidence confirming the long-term adult mental and physical health impact of childhood exposure to adverse events including different forms of abuse and family dysfunction. Looked-after Children and young people (LACYP) living in public care are known to be a highly vulnerable group, who have often experienced several pre-care poor socio-economic and family circumstances with subsequent placement instability, as well as inadequate compensatory care within the social care system. We aimed to evaluate the relationship between the adverse socio-emotional risk factors experienced by a cohort of LACYP and their emotional, behavioural and physical health needs within a South-West England Local Authority between Jan and Dec 2018. Methods: We carried out a retrospective review of the medical records of all looked-after children and young people (LACYP) within one year (Jan to Dec 2018) at the North Somerset Local Authority (NSLA). This was an audit project of the LAC Health team completed as part of the Clinical Governance strategies of the NSLA. Results: 93% (89/96) of the LACYP experienced at least one or more socio-emotional adverse risk factors. The commonest socio-emotional risk factors recorded were parent-related including poor mental health (67%), neglectful parenting (59%), drugs/alcohol abuse (45%) and domestic violence (47%). Forty-six (48%) of the LACYP had at least one or more emotional problems, 48 (50%) had neurodevelopmental conditions, while 63 (66%) had at least one or more physical problems. The most common emotional needs were behavioural problems (35%), anxiety/ depression (17%), nicotine/substance misuse (10%) and self-harm (6%). Conclusion: High levels of physical, emotional, behavioral, developmental and neurodisability disorders are prevalent among LACYP due to their high vulnerabilities to adverse life experiences and trauma while living within their biological families. Present and future clinical implications of the socio-emotional risk factors and the need for more integrated multi-agency services for addressing the diverse health needs of the LACYP were discussed. What is known? • There is increasing awareness of the relationship between childhood exposure to adverse events and long-term adult mental and physical health • Looked after children and young people (LACYP) are highly vulnerable to early traumatic and poor socio-economic circumstances exposure What this study adds: • Over 90% of LACYP experienced at least one ACE which disproportionately affected the youngest age-group • Parental factors such as childhood abuse, alcohol/substance abuse and mental health problems were the most common adverse factors experienced by the LACYP

Objective: In primary care, during treatments, nurses may need to wear surgical masks, namely for control of infection contamination, or to minimize unpleasant odors. The goal of this study is to inspect the effect of nurses wearing the mask on patient perception of the nurse-patient relation. Methods: A pre-post-test, control-experimental group design was employed with 60 patients treated in family health units. Patients responded to the Patient Satisfaction Questionnaire III (PSQ-III) regarding nurses’ communication, interpersonal manner, technical quality, as well regarding general satisfaction with the encounter. An additional question asked both patients and nurses how long they felt that the visit lasted. Results: Results show that nurses wearing the surgical mask had significantly negative effects in all dimensions of PSQ-III and increased the perceived visit duration among both nurses and patients. Conclusion: When a previous relationship exists, nurses wearing the surgical mask in primary care in Portugal negatively affects patient satisfaction with both the patient-nurse relation and the nurses’ technical quality. Practice implications: Is important the nurse understand this impact to discuss with the colleagues the best strategy to minimize the negative impact to the patient- family nurse relation and manager this situation in the best way to the patient. 

Multiple studies have investigated the relationship between androgenetic alopecia and cardiovascular disease, including studies that have identified elevated rates of cardiovascular disease in patients with vertex hair loss, vertex and frontal hair loss, early onset hair loss and rapidly progressive hair loss. In addition, increased risks for hypertension, excess weight, abnormal lipids, insulin resistance, carotid atheromatosis and death from diabetes or heart disease have been reported in this population. Studies investigating an association between androgenetic alopecia and metabolic syndrome have yielded conflicting findings. Distinct guidelines for the detection and prevention of cardiovascular disease in individuals with androgenetic alopecia have not been established. In addition to the traditional risk factors for developing cardiovascular disease, included in the definition of the metabolic syndrome, several skin diseases have recently been shown to be markers of conditions relating to the patient’s overall health. Physicians should be aware of the possible connection between relatively frequent skin diseases, such as psoriasis and hair growth disruptions, including androgenetic alopecia and female pattern hair loss and cardiovascular disease. This review is concentrated on the association between insulin resistance, type 2 diabetes, abdominal fat, cardiovascular disease and hair growth disruptions as an early indicator of these underlying conditions. We have investigated the importance of robust primary clinical treatment measures to address the manifestation of hair loss due to a disruption caused by metabolic syndrome as an effective means to alleviate further stress induced hair loss, which can exacerbate the underlying cause.

Purpose: In an aspect of qualitative treatment, this research gathered lung cancer patients’ actual experiences to understand deeply, such as their expectation for treatment results, their difficulties during treatment, and their various requests to their family and medical teams. Methods: From May to June 2013, semi-structured interviews were conducted with 9 lung cancer patients. Data were collected through a tape-recorded in-depth interview. The analysis of the data was made through the qualitative method. Results: 124 themes regarding the experience were found. From these 35 concepts, 24 subcategories were emerged. The core category was enduring hardship of the treatment with the hope for full recovery. Six categories included ‘Wishing to be cured but concern about recurrence’, ‘Receiving radiation treatment with pleasure and difficult at the same time’. ‘Being sorry for their family’s full support and trying to stand alone‘, ‘Having confidence in their medical team’, ‘regretting for their old days’, and ‘Wanting to live a long life without illness and pain’. Conclusion: The results of this study would help oncology nurses to understand the lung cancer patients receiving concurrent chemo-radiotherapy (CCRT) and to develop a quality of life improvement program for physical, psychosocial, and spiritual aspects of nursing.

Knowing the possible origin of sexist attitudes in adolescents is essential when educating them to avoid gender violence derived from them. Nurses have an important role in education for the health of children and adolescents, so we must study the risk factors that lead to these attitudes and how to prevent them. Some studies such as Landripet, et al. have undertaken to study the association between frequency of pornography use and preference for violent and coercive content in male adolescents. Sexism and pornography use have been associated by various authors. Hostile sexism is the most obvious and traditional form, based on the supposed inferiority or difference of women as a group. According to benevolent sexism, women are understood as deserving of affection, respect and protection, as long as they are limited to certain traditional feminine roles. The second is even more difficult to detect. Our aim in this work is to evaluate ambivalent sexist attitudes in young adolescents in the province of Jaén and check whether there is a relationship between use of pornography and sexual content, and the kinds of sexism studied, in order to be able to prevent these attitudes as nurses through health education. The final sample was made up of 150 participants from all school years, belonging to the same secondary school, 74 male and 76 female. They were aged between 12 and 18 years old. One of the conclusions of this work has been that the use of new technologies is in addition starting at even younger ages due to the situation of online teaching due to the pandemic, and it has been observed that age at first use is a determining factor.

Alopecia is associated with an increased risk of coronary heart disease, and it appears that there is a relationship between the degree of hair loss and the risk of coronary heart disease, meaning, the greater the severity of alopecia, the greater the risk of coronary heart disease. Alopecia is also associated with an increased risk of hypertension, hyperinsulinemia, insulin resistance, metabolic syndrome as well as elevated serum total cholesterol and triglyceride levels. It has not been definitively established whether patients with androgenetic alopecia have a higher cardiovascular risk or prevalence of metabolic syndrome, and results of recent studies indicate that androgenetic alopecia patients do not show differences in insulin resistance or the prevalence of metabolic syndrome. However, androgenetic alopecia patients do show a higher cardiovascular risk, characterised by increased inflammatory parameters and Lp(a) levels. Data collected from female populations are scarce, but it would be interesting to extend our clinical knowledge with this type of data to further our understanding of the connection between androgenetic alopecia, metabolic syndrome and cardiovascular risk. The divergence in results from different studies done in this context may simply be a result of the composition of the study populations with respect to age, gender, severity of alopecia, sample size and perhaps ethnicity. In this connection, a large group of androgenetic alopecia patients is necessary, including different representative groups and varying severities of alopecia. Furthermore, it is recommended that all women and men with androgenetic alopecia be thoroughly examined and that lifestyle changes are made early on to reduce the risk of various problems associated with metabolic syndrome, since androgenetic alopecia can be considered an early marker of metabolic syndrome.