BACKGROUND: Protein S deficiency is a common cause of thrombophilia. Free protein S has been suggested as one of the best screening tests for this deficiency. We evaluated an immunoturbidimetric free protein S reagent, INNOVANCE Free Protein S Antigen (Free PS Ag; Siemens Healthcare Diagnostics, Germany), using a CS-5100 coagulation analyzer (Sysmex, Japan). METHODS: The performance of INNOVANCE Free PS Ag was evaluated according to the CLSI guidelines. Precision, linearity, and verification of reference intervals were examined. The INNOVANCE Free PS Ag was also compared by the STA-Liatest Free Protein S immunoturbidimetric assay (Diagnostica Stago, France). RESULTS: The repeatability and within-laboratory imprecision of INNOVANCE Free PS Ag were 0.8% CV and 2.0% CV at the normal level, and 1.3% CV and 2.3% CV at the abnormally low level, respectively. This assay showed linearity from 4.0% to 151.9% (correlation coefficient r=1, P < 0.0001). Reference intervals for males and females were verified as acceptable. INNOVANCE Free PS Ag was comparable with STA-Liatest Free Protein S with a very high correlation (r=0.935, P < 0.0001). The results for the INNOVANCE antigen were higher. CONCLUSIONS: The INNOVANCE Free PS Ag on a Sysmex CS-5100 coagulation analyzer has excellent analytical performance and is comparable with the STA-Liatest Free Protein S assay.
Delivery of Health Care ; Female ; Humans ; Male ; Mass Screening ; Protein S Deficiency ; Protein S* ; Thrombophilia

BACKGROUND AND OBJECTIVE

Public health nurses (PHNs) are vital in the local implementation of the provisions of the Universal Healthcare (UHC) Act of 2019. However, they need adequate competencies in health systems approach to successfully implement the provisions of the law. In response to this, a leadership development course for public health nurses (LDC-PHN), anchored on the building blocks of health systems, was developed and implemented. This paper aims to describe the extent to which training participants have applied the competencies acquired from the LDC-PHN as manifested by the workplace application of their capstone projects.

Following Kirkpatrick’s Model of Evaluation, we used a multi-method study design to evaluate the extent of the participants’ workplace application of acquired competencies. Sources of data included the Workplace Application Plan (WAP) accomplished by each participant, a questionnaire to determine the perceived implementation status of the participants’ capstone project, interviews, and focus group discussions (FGDs) conducted with selected participants and their supervisors, and observation visits. Data were collected from May to December 2022. Data from the semi- structured interviews and FGDs were analyzed through content analysis, while the participants’ perceived status of their capstone project implementation was summarized as frequencies.

Majority of the participants (61.9%) reported partial implementation of their capstone project while 16.77% reported full implementation. Capstone project implementation was facilitated by the support received from their supervisors and local chief executives. Barriers identified included the demands of the COVID-19 pandemic and the challenges imposed by the events before and after the 2022 Philippine National elections. Major themes emerged from the interviews conducted among participants and their supervisors. The workplace application of the training program outcomes, based on participants’ perspectives, yielded increased capacity to lead and innovate, improved ability to advocate for capstone project implementation, transferability of acquired skill sets, and improved population outcomes. From supervisors’ perspectives, workplace application of training program outcomes include increased ability of PHNs to deliver health services, and visible enhancement of leadership and supervision skills among PHNs.

Given ample support and opportunities, and despite the barriers and challenges they faced, LDC-PHN participants, in general, utilized and applied the competencies they gained from the course in their actual work setting. Course graduates participated in health systems strengthening at various capacities by acting upon their capstone projects that addressed UHC challenges within their particular work settings.

The identification of psychosocial burden and general health among women with abnormal Pap smear results was fundamentally important because women play the significant role in the family and community. The purpose of this study was to determine the level of psychosocial burden, level of general health and relationship between psychosocial burden with general health among women with abnormal Pap smear after colposcopy. This crosssectional study was done towards 218 women with abnormal Pap smear after colposcopy. Universal sampling at gynecology clinic from three tertiary hospitals in the East Coast of Malaysia was conducted. Respondents selfanswered the validated Malay version of Psychosocial Effect of Abnormal Pap smear Questionnaire and General Health Questionnaire-12 in Malay version. Data were analyzed by using statistical software IBM-SPSS version 22, descriptive statistical method, Pearson and Spearman Correlation coefficient analysis were used. The results revealed that 43.1% and 16.5% of women with psychosocial burden were having distress due to abnormal Pap smear after colposcopy. The correlation coefficient showed a significant moderate correlation between psychosocial burden and general health (r = 0.41 and p=0.000). The women are facing psychosocial burden and distress in life after being diagnosed with abnormal Pap smear, because it is related to physical and psychological aspects. This shown that psychological aspect is important in health, therefore health care needs to perform the assessment of the psychosocial burden and general health among women with abnormal Pap smear in Malaysia.
women&rsquo ; s health ; psychosocial burden ; abnormal Pap smear ; general health ; distress

Estimating age in women living in rural areas of Papua New Guinea can be inaccurate and subject to observer bias. Parity is often used, but this means that survey results cannot be used to examine the effect of childbearing on nutrition. We describe a method for estimating age in women independent of their parity developed during studies of women's health in the Wosera Subdistrict of Papua New Guinea. The tool, appropriately modified, may be useful to others conducting surveys requiring an estimate of maternal age.
Adolescent ; Adult ; Algorithms ; female ; Maternal Age ; Parity ; Women' ; s Health

Hyperhomocysteinemia is known to be associated with an increased risk of myocardial infarction, stroke, peripheral arterial disease, and venous thrombosis. Gene polymorphisms in methylenetetrahydrofolate reductase (MTHFR) and methionine synthase (MS) may account for reduced enzyme activity and hyperhomocysteinemia. A recent study has documented evidence of polygenic regulation of plasma homocyteine. We report here on a case of occlusive stroke at young age and hyperhomocysteinemia with homozygous VN (677C to T) variant in the MTHFR gene as well as homozygous D/D (2756G to A) variant in the MS gene.
5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase/*genetics ; Adult ; Cerebrovascular Accident/*genetics ; DNA/metabolism ; DNA Restriction Enzymes/metabolism ; Family Health ; Female ; Genotype ; Homocysteine/blood/genetics ; *Homozygote ; Human ; Hyperhomocysteinemia/*genetics ; Male ; Polymorphism (Genetics) ; Tetrahydrofolates/*genetics ; Variation (Genetics)

BACKGROUND: Pulmonary embolism (PE) is a common clinical problem in the West that is associated with substantial morbidity and mortality. The diagnostic modality has been changed since 2001. This study retrospectively reviewed the PE mortality with the aim of identifying the risk factors associated with mortality since the multidetector computed tomography (MDCT) was introduced. METHODS: We analyzed 105 patients with acute PE proven by multidetector CT or ventilation perfusion scan. The primary outcome measure was the all-cause mortality at 3 months. The prognostic effect of the baseline factors on survival was assessed by multivariate analysis. RESULTS: The main risk factors were prolonged immobilization, stroke, cancer and obesity. Forty nine percent of patients had 3 or more risk factors. The overall mortality at 3 months was 18.1%. Multivariate analysis revealed low diastolic blood pressure and the existence of cancer to be independent factors significantly associated with mortality. Forty two PE patients were examined for the coagulation inhibitors. Four of these patients had a protein C deficiency (9.5%), and 11 had a protein S deficiency (26%). CONCLUSION: PE is an important clinical problem with a high mortality rate. Close monitoring may be necessary in patients with the risk factors.
Blood Pressure ; Hospitals, Teaching ; Humans ; Immobilization ; Multidetector Computed Tomography ; Multivariate Analysis ; Obesity ; Outcome Assessment (Health Care) ; Perfusion ; Prognosis ; Protein C Deficiency ; Protein S Deficiency ; Pulmonary Embolism ; Retrospective Studies ; Risk Factors ; Stroke ; Thrombophilia ; Venous Thrombosis ; Ventilation

BACKGROUND: Venous thromboembolism (VTE) is rare in pediatric patients compared to adults, but it's incidence is gradually increasing. The purpose of this study was to analyze the incidence, risk factors, and prognosis of pediatric patients with VTE in Korea. METHODS: Between January 2000 and July 2017, 249,312 medical records of the patients older than 1 year who were hospitalized in the department of pediatrics of 10 university hospitals in Yeungnam region were retrospectively reviewed. RESULTS: The overall incidence of VTE was 4.9 per 10,000 admissions. Of the total 123 patients, 80 (65.0%) were male and the median age was 10.8 years (range, 1.0–23.5 years). Magnetic resonance imaging was performed most frequently to confirm the diagnosis of VTE (43.1%). Thrombosis occurred in the cerebral vessels (46.3%), lower extremities (23.8%), pulmonary (19.5%), abdomen (9.8%), and upper extremities (4.1%). One hundred and six patients had underlying causes such as cancer (27.6%), infection (26.8%), intravenous catheter insertion (17.9%), and surgery (14.6%). Protein C was evaluated in 39 patients (31.7%), protein S in 40 (32.5%), antithrombin (AT) III in 52 (42.3%), and homocysteine in 21 (17.1%). Among them, one patient with a family history of AT III deficiency had SERPINC gene mutation. Seventy-seven patients (62.6%) started anticoagulation treatment. Most (52.0%) were treated for more than 90 days. CONCLUSION: Healthcare providers must be aware of the potential for VTE development in childhood. In the near future, a nationwide survey should be investigated to determine the incidence rate and the trends in VTE among Korean children.
Abdomen ; Adult ; Catheters ; Child ; Diagnosis ; Epidemiology ; Health Personnel ; Homocysteine ; Hospitals, University ; Humans ; Incidence ; Korea* ; Lower Extremity ; Magnetic Resonance Imaging ; Male ; Medical Records ; Pediatrics ; Prognosis ; Protein C ; Protein S ; Retrospective Studies ; Risk Factors ; Thrombosis ; Upper Extremity ; Venous Thromboembolism*