Intestinal microbiota composition of children with glycogen storage Type I patients.

AIM: Dietary therapy of glycogen storage disease I (GSD I) is based on frequent feeding, with a high intake of complex carbohydrates (supplied by uncooked cornstarch), restriction of sugars, and a lower amount of lipids. There is limited information about the dietary regimen in patients with GSD, which might affect the intestinal luminal pH and microbiota composition. The aim of this study to investigate the intestinal microbiota composition in patients with GSD receiving diet treatment. METHOD: Twelve patients who were followed up with GSD I after the diagnosis receiving diet therapy and 11 healthy children have been enrolled. Intestinal microbiota composition was evaluated by 16 s rRNA gene sequencing. RESULTS: A significant difference was found for beta-diversity between the GSD group and controls. A significantly lower abundance of Firmicutes and higher abundance of Actinobacteria was found in GSD group compared to the controls. Akkermansia, Pseudoalteromonas, Uruburella, and Castellaniella were dominant in the GSD patients at the genus level, while Faecalibacterium, Bacterioides, Gemmiger, Parabacteroides in the control group. At species level, Faecalibacterium prausnitzii decreased, and Akkermansia muciniphila were dominant in children with GSD. DISCUSSION: There is a substantial change in the composition of the gut microbiota, reduction of F. prausnitzii and an increase of A. muciniphila in children with GSD receiving consumption of uncooked cornstarch. Alterations of the intestinal microbiota might be related with the disease itself or dietary restrictions in patients with GSD, however, in certain condition, dysbiosis can negatively affect the course and make it difficult to control the disease.

Using the Omaha System to Determine Health and Social Problems of Roma Population in Istanbul: Secondary Data Analysis.

The aim of this study was to determine the health and social problems and related behaviors of the Roma population by using the Omaha System. The data were collected from 650 Roma individuals. This study was a cross-sectional secondary data analysis and the data were collected in two stages. First, the "Technical Assistance for Promoting Social Inclusion in Densely Roman Populated Areas Project (SIROMA)" Act team evaluated health problems among Roma individuals. Second, data were reanalyzed using the Omaha System. When sociodemographic and economic characteristics were evaluated, low education level, adolescent marriages, a high number of live births, soiled living areas, unemployment, and substance use were found in the Roma population. In this context, using the Omaha System, the frequently diagnosed health and social problems were Sanitation (13.5%), Healthcare supervision (11.8%), Nutrition (11.0%), Income (9.8%), Respiration (8.3%), Substance use (7.3%), and Neighborhood/workplace safety (6.0%). This study results found out that the Roma population is less prone than natives to have healthy lifestyle behaviors and more prone to experience a deterioration in both their general and mental health. The Omaha System is a valid method used to collect and analyze data for a vulnerable population in the community. Also, it has been proven that the Omaha System Problem Classification Scheme can provide a more detailed and comprehensive assessment.

Migrant workers occupational health research: an OMEGA-NET working group position paper.

OBJECTIVE: The aims of the study were: (1) to clarify the definitions of "migrant" used in occupational health research; (2) to summarize migrant workers' industry sectors, occupations and employment conditions; (3) to identify the occupational health and safety services available to migrant workers; (4) to summarize work-related health problems found among migrant workers; (5) to identify the methodological challenges to research into occupational health of migrant workers; and (6) to recommend improvements in migrant occupational health research. METHODS: This position paper was prepared by researchers from several European countries and Australia, working within the EU COST Action OMEGA-NET. The paper drew on two recent systematic reviews on the occupational health of international migrant workers and other literature, and also identified uncertainties and gaps in the research literature. Migrants may, for example, be temporary or permanent, moving for specific jobs migrants or other reasons. Their ethnicity and language capabilities will affect their work opportunities. RESULTS: The occupational health literature seldom adequately identifies the heterogeneity or characteristics of the migrant group being studied. Migrants tend to work in more physically and mentally demanding environments with higher exposures than native workers. Migrants tend to have an increased risk of physical and mental ill health, but less access to health care services. This has been demonstrated recently by high rates of COVID-19 and less access to health care. There have been a number of cross-sectional studies of migrant health but few long-term cohort studies were identified. Other study designs, such as registry-based studies, surveys and qualitative studies may complement cross-sectional studies. Mixed-methodology studies would be valuable in research on migrants' occupational health. Language and lack of trust are barriers to migrant research participation. CONCLUSION: Targeted research, especially longitudinal, identifying how these economically important but often-vulnerable workers can be best assisted is needed. Researchers should identify the characteristics of the migrant workers that they are studying including visa/migration circumstances (temporary, permanent, undocumented), racial and ethnic characteristics, existing skills and language abilities.

A mixed method study on global warming, climate change and the role of public health nurses from the perspective of nursing students.

AIM: This study aims to evaluate the knowledge and awareness of the nursing students taking the Public Health Nursing course about global warming, climate change, the impact on health and the role of the public health nurse. DESIGN: The study is a mixed method study that includes descriptive data and focus group discussions on global warming, the effects of climate change and the role of the public health nurse. METHODS: The data were collected from the nursing faculty of a university located in the Central Anatolia region, where agricultural lands are widespread and climate change effects are most commonly observed. The data were collected from 154 undergraduate senior nursing students between February 2020 and May 2020. Firstly, the students completed the Global Warming Questionnaire that includes 26 items about global warming, climate change, their effects and the role of the public health nurse. Secondly, some students (n = 19) selected through the purposive sampling method participated in online focus group meetings. RESULTS: Our study revealed that 87.7% of the students know the main cause of climate change. The mean scale scores of the students who watch documentaries on the environment, who participate in activities related to the environment, and who know that climate change, sustainable development and health services are closely related were found to be statistically significantly higher (p ≤ 0.005). The views of the students on global warming and the environment were analyzed in focus group interviews according to five themes (global warming perception; the impact of global warming on health; methods of protection; roles of nurses; nursing education). CONCLUSION: Global warming and climate change are sensitive and important issues that cannot be evaluated considering only knowledge level. IMPACT: Global warming, climate change, their effects on health and the roles and responsibilities of nurses need to be included in the nursing curricula so that health professionals who can take measures against global warming, climate change and their health effects can be educated.

The first case with FBXL4 mutation successfully treated with a parenteral ketogenic diet for lactic acidosis.

BACKGROUND: The ketogenic diet (KD) is a low-carbohydrate, high-fat diet that has been used as an effective nonpharmacological treatment in many neurological and metabolic disorders for a long time. The effectiveness of the KD is revealed in mitochondrial disorders, mainly in pyruvate dehydrogenase deficiency. CASE REPORT: A 4-year-old girl who was diagnosed with an F-box and leucine-rich repeat protein 4 (FBXL4) gene mutation was hospitalized with sepsis. She was first given standard parenteral nutrition (PN) because of gastrointestinal problems. During the disease course, lactic acidosis became prominent and did not respond to pharmacological treatment; standard PN was gradually switched to parenteral KD, and lactate levels decreased after parenteral KD. The patient was discharged with an enteral KD. CONCLUSION: This is the first case of mitochondrial depletion syndrome effectively treated with parenteral KD for lactic acidosis.

Beneficial Effects of Modified Atkins Diet in Glycogen Storage Disease Type IIIa.

INTRODUCTION: Glycogen storage disease Type III (GSD III) is an autosomal recessive disease caused by the deficiency of glycogen debranching enzyme, encoded by the AGL gene. Two clinical types of the disease are most prevalent: GSD IIIa involves the liver and muscle, whereas IIIb affects only the liver. The classical dietetic management of GSD IIIa involves prevention of fasting, frequent feeds with high complex carbohydrates in small children, and a low-carb-high-protein diet in older children and adults. Recently, diets containing high amount of fat, including ketogenic and modified Atkins diet (MAD), have been suggested to have favorable outcome in GSD IIIa. METHODS: Six patients, aged 3-31 years, with GSD IIIa received MAD for a duration of 3-7 months. Serum glucose, transaminases, creatine kinase (CK) levels, capillary ketone levels, and cardiac parameters were followed-up. RESULTS: In all patients, transaminase levels dropped in response to MAD. Decrease in CK levels were detected in 5 out of 6 patients. Hypoglycemia was evident in 2 patients but was resolved by adding uncooked cornstarch to diet. CONCLUSION: Our study demonstrates that GSD IIIa may benefit from MAD both clinically and biochemically.

Skin disease symptoms and related risk factors among young workers in high-risk jobs.

BACKGROUND: Occupational skin diseases are the one of the most frequent diseases in many industrialized countries. The studies about skin disease (SD) on young workers were limited. OBJECTIVES: In this study, we aim to evaluate the prevalence of SD symptoms and related risk factors among young workers in high-risk occupations. METHODS: This cross-sectional study was undertaken between 2011 and 2012 in two vocational training centres. We included 455 young workers who were working as hairdressers, jewellers, or car mechanics. Data were collected with the Nordic Occupational Skin Questionnaire, which was adapted to Turkish for young workers. RESULTS: The average age of the young workers was 17.9 ± 1.7 years. Of the 455 young workers, 52.7% were female and 47.3% were male. During the previous 12 months, the prevalences of the total SD symptoms, hand/forearm eczema symptoms and urticaria symptoms were 49.7%, 44.4%, and 13.4%, respectively. Those who worked as car mechanics were 5.8 times more likely [odds ratio (OR) 5.81, 95%CI: 2.58-13.10) to have a dry skin type, 2.9 times more likely (OR 2.86, 95%CI: 1.72-4.75) to work for >12 h daily, 2.6 times more likely (OR 2.59, 95%CI: 1.25-5.35) to have worked for >5 years, and 3.0 times more likely (OR 3.05, 95%CI: 1.14-8.14) to have SD symptoms. CONCLUSION: The results indicate that young workers in high-risk jobs have a high frequency of skin symptoms. These results could provide a basis for occupational health professionals to plan prevention programmes for young workers.

A Turkish translation of the Nordic Occupational Skin Questionnaire (NOSQ-2002/LONG) adapted for young workers in high-risk jobs.

BACKGROUND: Occupational skin diseases (OSDs) represent 10-40% of all occupational diseases in many industrialized countries. Young workers are frequently exposed to toxic substances and chemicals in the workplace. The occupational conditions of young workers can impose a high level of risk for the occurrence of OSDs. The Nordic Occupational Skin Questionnaire (NOSQ-2002) was developed in English as a new, comprehensive, standardized tool with which to screen for OSDs. OBJECTIVES: The purpose of this study was to translate the NOSQ-2002 into Turkish and to culturally adapt the long version of the instrument for use with young workers in jobs with high risk for the occurrence of OSDs. METHODS: Forward and back translations were carried out. Problematic items were modified until the Turkish-language version achieved a satisfactory consensus with the original version of the NOSQ-2002. The final Turkish version was tested in 40 randomly selected young workers with and without OSDs who were studying in the fields of hairdressing, jewelry making, and car mechanics at vocational training schools run by the National Education Ministry. RESULTS: When the original questionnaire had been translated into the target language, a first consensus version was evaluated by an expert panel. The expert panel determined that 36 questions (63.2%) in the Turkish version required some level of modification in order to facilitate clear understanding. Cognitive interviews were then performed. After some modification, the final Turkish version was established and tested among young workers. CONCLUSIONS: The new Turkish version of the NOSQ is a comprehensible, reliable, and useful tool that can be applied to young workers in specific occupations.

Using the Omaha System to describe health problems, interventions, and outcomes in home care in Istanbul, Turkey: a student informatics research experience.

Preparing nursing students to achieve informatics competencies is essential in today's information-intensive healthcare delivery systems. This study aimed to provide hands-on informatics experience to nursing students and to identify the frequency and type of home care clients' health problems, nursing interventions, and outcomes using a standardized nursing terminology, the Omaha System. Data were collected by 159 nursing students on home visits to 598 clients, who received 8657 interventions from students and faculty for 2267 problems, in addition to the services provided by the home care centers. Skin, neuromusculoskelatal function, personal care, nutrition, and urinary function were the most common problems. The most common intervention category was teaching, guidance, and counseling (47%), followed by treatments and procedures (22%), surveillance (22%), and case management (9%). Outcomes evaluation showed significant improvement in 97.5% of the identified problems. Students gained informatics experience in the use of a standardized nursing language in electronic health records, data management, and use of nursing data at the basic practice level. This study demonstrated that the Omaha System was a useful data collection tool for evaluating problems, interventions, and outcomes in home care and a positive teaching and learning tool for baccalaureate nursing education.