Food safety in the 21st century Fung, Fred; Wang, Huei-Shyong; Menon, Suresh
Biomedical Journal,
04/2018, Volume:
41, Issue:
2
Journal Article
Peer reviewed
Open access
Food is essential to life, hence food safety is a basic human right. Billons of people in the world are at risk of unsafe food. Many millions become sick while hundreds of thousand die yearly. The ...food chain starts from farm to fork/plate while challenges include microbial, chemical, personal and environmental hygiene. Historically, documented human tragedies and economic disasters due to consuming contaminated food occurred as a result of intentional or unintentional personal conduct and governmental failure to safeguard food quality and safety. While earlier incidents were mainly chemical contaminants, more recent outbreaks have been due to microbial agents. The Disability Adjusted Life Years (DALYs) attributed to these agents are most devastating to children younger than 5 years of age, the elderly and the sick. To ensure food safety and to prevent unnecessary foodborne illnesses, rapid and accurate detection of pathogenic agents is essential. Culture-based tests are being substituted by faster and sensitive culture independent diagnostics including antigen-based assays and polymerase chain reaction (PCR) panels. Innovative technology such as Nuclear Magnetic Resonance (NMR) coupled with nanoparticles can detect multiple target microbial pathogens' DNA or proteins using nucleic acids, antibodies and other biomarkers assays analysis. The food producers, distributors, handlers and vendors bear primary responsibility while consumers must remain vigilant and literate. Government agencies must enforce food safety laws to safeguard public and individual health. Medical providers must remain passionate to prevent foodborne illnesses and may consider treating diseases with safe diet therapy under proper medical supervision. The intimate collaboration between all the stakeholders will ultimately ensure food safety in the 21st century.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Aim
To evaluate the effectiveness of a modified four‐session Comprehensive Behavioral Intervention for Tics programme for decreasing tics in children and adolescents with Tourette's syndrome.
...Background
Comprehensive Behavioral Intervention for Tics programme has been shown to decrease tic severity. However, the lack of behaviour therapists in countries, such as in Taiwan, may preclude application of the standard eight‐session, 10‐week programme.
Design
Randomized controlled study.
Methods
Participants aged 6–18 years diagnosed with Tourette's syndrome or chronic tic disorder were recruited from February 2015 through September 2016. Participants in the control and intervention groups (N = 23 each) received the routine care (daily pyridoxine 50 mg and psychoeducation). The intervention group received additional four behavioural intervention sessions over a 3‐month period that included psychoeducation, habit reversal training, relaxation training, and education on tic relapse prevention. The outcome measures, Yale Global Tic Severity Scale scores, were assessed at before and after the completion of programme for both groups and again at 3 months follow‐up for the intervention group. The effect of the intervention on severity scores was assessed using a generalized estimated equation.
Results
Comparison of scores before and after intervention showed that the intervention significantly decreased the severity of total motor tics (B = −3.28, p < .01) and total tics (B = −5.86, p < .01) as compared with control treatment. YGTSS scores for the intervention group were lower at 3‐month follow‐up as compared with before treatment or immediately after treatment completion (total tics, p < .001).
Conclusion
The modified four‐session Comprehensive Behavioral Intervention for Tics programme was more effective than routine care for decreasing tic severity in our cohort of 6‐ to 18‐year olds. This improvement was maintained 3 months after intervention.
Impact
Healthcare providers, including nurses, in countries currently not adopting Comprehensive Behavioral Intervention for Tics programme should be made aware of the positive effects of this modified intervention for Tourette's syndrome.
目的
评价经改良的四期综合性行为干预措施(用于抽动治疗方案)对减轻患有图雷特综合征的儿童和青少年的抽动行为的有效性。
背景
有研究表明,综合性行为干预(用于抽动治疗方案)可降低抽动行为的严重程度。然而,在台湾等地区,行为治疗师人手短缺可能会妨碍八期十周方案的实施效果。
设计
随机对照研究。
方法
2015年2月至2016年9月招募6‐18岁经诊断患有图雷特综合征或慢性抽动障碍的参与者。对照组和干预组(每组N=23人)的参与者均接受了常规护理(每日服用吡哆醇【50毫克】,进行心理教育)。干预组在3个月内还接受了另外4次行为干预治疗,包括心理教育、习惯逆转训练、放松训练和预防抽动搐复发教育。在治疗方案完成前后分别对两组的结果指标——耶鲁综合抽动严重程度量表评分进行评价,并在3个月随访时再次对干预组的结果指标进行评价。同时采用广义估计方程来评估干预措施对严重程度量表评分的影响。
结果
干预前后评分的比较结果表明,与对照治疗相比,干预措施显著降低了整体运动抽动(B = −3.28,p < .01)和整体抽动(B = −5.86,p < .01)的严重程度。与治疗前或治疗完成后相比,干预组在3个月随访时的耶鲁综合抽动严重程度量表评分较低(整体抽动,p<0.001)。
结论
经改良的四期综合性行为干预措施(用于抽动治疗方案)对降低6‐18岁群体的抽动严重程度比常规治疗更有效。这一改善情况可在干预后保持3个月。
影响
针对目前尚未采用综合性行为干预措施(用于抽动治疗方案)的国家,包括护士在内的医疗服务提供者应了解此种改良的干预方案对图雷特综合征的积极治疗效果。
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
4.
Role of vitamins in epilepsy Yang, Ming-Tao; Chou, I-Ching; Wang, Huei-Shyong
Epilepsy & behavior,
February 2023, 2023-02-00, 20230201, Volume:
139
Journal Article
Peer reviewed
Epilepsy is a chronic neurological disorder that presents as recurrent, unprovoked seizures. Pharmacotherapy is the main treatment for epilepsy, but at least 30% of patients with epilepsy have ...pharmacoresistant epilepsy. Therefore, non-pharmacological treatments are still required. In addition to electrophysiological aberrations contributing to epileptogenesis and pathophysiology in epilepsy, neuroinflammation, oxidative stress, and metabolic derangement have been investigated as drug targets in the treatment of epilepsy. Vitamins have antioxidant, anti-inflammatory, and immunomodulatory effects, which can be beneficial for the treatment of epilepsy. Herein, we comprehensively review the role of vitamins in epilepsy. Certain epilepsies are vitamin-dependent or vitamin-responsive. Most studies on vitamins in epilepsy are of low evidence level or limited to animal studies. Nevertheless, vitamin supplementation should be considered in epilepsy therapy. Additionally, certain anti-seizure medications may alter the serum levels of certain vitamins. Monitoring the serum levels of vitamins and supplementing vitamins when needed are suggested during the follow-up of patients with epilepsy.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Suffering from Tourette syndrome (TS) disrupts the daily lives and interpersonal relationships of patients. The psychosocial experiences of young people with TS are not yet clear. The aim of the ...systematic review is to identify and synthesize the psychosocial experiences of young people with TS. A meta-synthesis was conducted. PubMed, EMBASE, Cumulative Index to Nursing and Allied Health Literature, Web of Science, and Chinese Electronic Periodical Services databases were searched for articles published from their inception to February 2023. This review followed the Joanna Briggs Institute's Guidelines for Systematic Reviews according to a previously developed protocol. We used the confidence of synthesized qualitative findings (ConQual) approach to evaluate the credibility and dependability of the synthesized findings. This review included 12 qualitative studies from Western and Asian countries published between 2005 and 2019, representing 190 young people with TS. We identified five synthesized findings: affliction by intractable TS, TS was negatively perceived in the social and cultural context, self-adjustment in response to social interaction, response to receiving various interventions, and positivity in promoting self-acceptance. The ConQual grade for each generated synthesized finding ranged from low to moderate. The psychosocial experiences of youths living with TS are unique and are influenced by their interpersonal relationships, social context, and cultural framework. The findings recommend that healthcare providers assist young people in developing personalized symptom management strategies and provide guidance and care that meets the needs of each individual.
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EMUNI, FIS, FZAB, GEOZS, GIS, IJS, IMTLJ, KILJ, KISLJ, MFDPS, NLZOH, NUK, OBVAL, OILJ, PNG, SAZU, SBCE, SBJE, SBMB, SBNM, UKNU, UL, UM, UPUK, VKSCE, ZAGLJ
Aims and objectives
To explore and describe the experience of social adjustment of adolescents with Tourette syndrome in Taiwan.
Background
Although Tourette syndrome is a non‐life‐threatening ...disease, the inherent difficulties in controlling tics and comorbidities can cause long‐term physical and psychological issues, as well as social maladjustment among adolescents. Good social adjustment can promote mental health among adolescents. Currently, it is not clear how adolescents with Tourette syndrome can self‐adjust and maintain harmonious social interaction with others.
Design
Descriptive phenomenological approach was used in this study. Four criteria were applied to establish the trustworthiness or methodological rigour.
Methods
Sixteen adolescents with Tourette syndrome were recruited by purposive sampling from a medical centre in Northern Taiwan. Semistructured one‐on‐one interviews were performed from March 2014–April 2015 for data collection. Every participant was interviewed once or twice, and each interview lasted for duration of around 60–90 min. Data were analysed with Giorgi's phenomenological method for data analysis.
Results
Three themes were identified from the adolescent’ interviews. The themes were included visible and invisible destitution, moulding a socially acceptable self and coexisting friends and foes.
Conclusions
Adolescents with Tourette syndrome experienced that tics are often not understood nor accepted during social interactions with others. However, with age and autonomy of adolescents, they were able to adjust and develop a socially acceptable body image and maintain amicable social interactions with others. Accompanied by positive thinking, support from friends and families, the adolescents could achieve good social adjustments for living with Tourette syndrome.
Relevance to clinical practice
The experiences and feelings highlighted in this study can bring awareness to nurses and healthcare professionals for developing interventions that promote healthy social adjustment and mental health for adolescents with Tourette syndrome.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK, VSZLJ
In this review, we summarize the general mechanisms of the ketogenic diet, and the application of a ketogenic diet in pediatric intensive care units for the neurological disorders of children and ...young infants. A ketogenic diet is a high-fat, low-carbohydrate, adequate-protein diet. It can alter the primary cerebral energy metabolism from glucose to ketone bodies, which involves multiple mechanisms of antiepileptic action, antiepileptogenic properties, neuro-protection, antioxidant and anti-inflammatory effects, and it is potentially a disease-modifying intervention. Although a ketogenic diet is typically used for the chronic stage of pharmacoresistant of epilepsy, recent studies have shown its efficacy in patients with the acute stage of refractory/super-refractory status epilepticus. The application of a ketogenic diet in pediatric intensive care units is a challenge because of the critical status of the patients, who are often in a coma or have a nothing by mouth order. Moreover, a ketogenic diet needs to be started early and sometimes through parenteral administration in patients with critical conditions such as refractory status epilepticus or febrile infection-related epilepsy syndrome. Animal models and some case reports have shown that the neuro-protective effects of a ketogenic diet can be extended to other emergent neurological diseases, such as traumatic brain injury and ischemic stroke.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Purpose
Our objective was to assess the adverse outcomes during pregnancy, as well as for the fetus and neonates, in women with epilepsy, both with and without the use of antiseizure medications ...(ASMs).
Methods
A cohort of singleton pregnancies between January 1, 2004 and December 31, 2014 was identified using the Taiwan National Health Database. The pregnancies were categorized into ASM exposure, ASM nonexposure, and control (consisting of women without an epilepsy diagnosis) groups. We recorded adverse outcomes in neonates and documented pregnancy complications. The generalized estimating equation with logit link was used to estimate adjusted odds ratios.
Results
There were 629 singleton pregnancies in the group exposed to ASMs, 771 in the epilepsy group without ASM exposure, and 2,004,479 in the control group. Women with epilepsy had a significantly higher risk of puerperal cerebrovascular diseases (adjusted odds ratios in the exposure and nonexposure groups = 54.46 and 20.37, respectively), respiratory distress syndrome (5.1 and 2.99), mortality (3.15 and 3.22), sepsis (2.67 and 2.54), pregnancy‐related hypertension (1.71 and 1.8), preeclampsia (1.87 and 1.79), cesarean delivery (1.72 and 2.15), and preterm labor (1.38 and 1.56). The use of ASMs may increase the risk of eclampsia (adjusted odds ratio = 12.27). Compared to controls, fetuses/neonates born to women with epilepsy had a higher risk of unexplained stillbirth (adjusted odds ratios in the exposure and nonexposure groups = 2.51 and 2.37, respectively), congenital anomaly (1.37 and 1.33), central nervous system malformation (3.57 and 2.25), low birth weight (1.90 and 1.97), and a low Apgar score at 5 min (2.63 and 1.3). The use of ASMs may introduce an additional risk of small for gestational age; the adjusted odds ratio was 1.51.
Conclusion
Women with epilepsy, irrespective of their exposure to ASMs, had a slightly elevated risk of pregnancy and perinatal complications. Puerperal cerebrovascular diseases may be a hidden risk for women with epilepsy.
Comparison of pregnancy outcomes with or without use antiepileptic drugs in pregnant women with epilepsy.
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FZAB, GIS, IJS, IZUM, KILJ, NLZOH, NUK, OILJ, PILJ, PNG, SAZU, SBCE, SBMB, UL, UM, UPUK
Recent studies have shown that tics and related comorbidities can cause poorer social adjustment, lower self-esteem, and higher psychosocial stress among adolescents with Tourette syndrome. This ...study explored the role of self-esteem in mediating the relationship between psychosocial stress and social adjustment among adolescents with Tourette syndrome, and the role of comorbidities in moderating the relationship between self-esteem and social adjustment.
In this descriptive cross-sectional study, 118 Taiwanese adolescents with Tourette syndrome aged between 12 and 20 years old were recruited via convenience sampling. Their demographic information, Yale Global Tic Severity Scale, stress index for children and adolescents with Tourette syndrome, social adjustment scale for adolescents with Tourette syndrome, and Self-Esteem Scale results were collected. Moderated mediation analysis of the study data was performed with the Hayes's PROCESS macro.
Our results revealed that the self-esteem of adolescents with Tourette syndrome fully mediates the relationship between their psychosocial stress and social adjustment (B = −0.0703, 95% CI, −0.0176, −0.001), while comorbidities moderates the relationship between their self-esteem and social adjustment (B = −0.8416, 95% CI, −1.4529, −0.2302). The relationship between self-esteem and social adjustment was more pronounced in adolescents without comorbidities than those with comorbidities.
Psychosocial stress correlates negatively with social adjustment and self-esteem, and indirectly influences social adjustment through self-esteem, while comorbidities (particularly their absence) moderates the relationship between self-esteem and social adjustment.
Different self-esteem strengthening programs to enhance social adjustment for adolescents with Tourette syndrome may be developed in future studies.
•Psychosocial stress is negatively related to social adjustment of adolescents with TS.•Self-esteem fully mediates psychosocial stress and social adjustment.•Comorbidities play a moderating role between self-esteem and social adjustment.•Different self-esteem strengthening plans for TS adolescents with/without comorbidities need to be designed.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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