Abstract Objective: To investigate the correlation between 5-HTTLPR (5-and seroto nin transporter linked polymer region) gene polymorphism and BDNF (brain derived neural factor) gene polymorphism and PTSD (post traumatic stress disorders) in Li and Han nationalities in Hainan Province. Methods: 167 Hainan Li PTSD patients, 141 Hainan Han PTSD patients and 158 healthy volunteers (control group) were investigated by ETI, caps, Toh, WCST, TMT and WAIS-RC. The polymorphisms of rs6265 locus of 5-HTTLPR and BDNF genes were detected by PCR (polymerase chain reaction) and page (polycy lamide gel electrophoresis), and the correlation with PTSD was analyzed. Lo gistic regression analysis was used to analyze the influencing factors of PTSD. Results: The ETI score, total PTSD score and TMT time of Li PTSD patients were significantly higher than those of Han PTSD patients (P < 0.01). The comprehension, picture filling, picture arrangement, operation IQ and total IQ of WAIS-RC were significantly lower than those of Han PTSD patients (P < 0.01); The numbers of errors, TMT and Toh in WCST were significantly lower than those in Han PTSD patients (P < 0.01). There was no significant difference in the distribution of 5-HTTLPR genotype and allele between Li PTSD patients and control group (P > 0.05). SS genotype of 5-HTTLPR and (GA + AA) genotype of rs6265 locus may increase the risk of PTSD in Hai nan Han population. AA and GA + AA genotypes at rs6265 locus may in crease the risk of PTSD in Li population (P < 0.05). Among Li PTSD patients, the ETI score, PTSD total score, TMT time, Toh planning time and execution time of AA genotype at rs6265 locus were significantly higher than those of GG genotype; the total scores of comprehension and operation IQ, and Tohin WAIS-RC were significantly lower than those in GG genotype (P < 0.05). Among Han PTSD patients, the ETI score, PTSD total score and TMT time of SS genotype of 5-HTTLPR were significantly higher than those of LL geno type, and the comprehension, arithmetic and block diagram in WAIS-RC were significantly lower than those of LL genotype; The ETI score, PTSD total score and TMT time of patients with (GA + AA) genotype at rs6265 locus were also significantly higher than those of patients with GG genotype. The compre hension and block diagram in WAIS-RC were significantly lower than those of patients with GG genotype. The number of WCST errors in patients with AA genotype was significantly higher than those of patients with GG geno type, and the operational IQ in WAIS-RC was significantly lower than those of patients with GG genotype (P < 0.05). Conclusion: The LL genotype of 5-HTTLPR and the GG genotype of rs6265 locus are related to PTSD of Li and Han nationalities in Hainan, which are important protective factors for PTSD of Li and Han nationalities in Hainan.

Abstract Introduction: The COVID-19 Pandemic has affected critical sectors of hu man development. To curtail these effects, vaccines are being approved for human trials. It is, therefore, important to know the possible vaccine coverage expected in each country. This study determined the willingness of Nigerians to accept and pay for COVID-19 vaccine. Methods: A cross-sectional web based survey across all states of Nigeria was conducted via a structured e questionnaire. Descriptive statistics, ANOVA and multinomial logistic regres sion were conducted. Result: A total of 502 responses were obtained from all six geopolitical zones of Nigeria, comprising 67.3% males (n = 338) and 32.7% females (n = 164). The results indicated that 34.7% (n = 167) are will ing to accept the vaccine when given for free, 33.9% (n = 163) are not willing, and up to 31.4% (n = 151) are indifferent in their decision. Univariate analy sis indicated the likelihood that education level could influence willingness to accept the vaccine (F = 2.408, p = 0.049). Rollout strategies may have an im pact (p < 0.0001) on the willingness to accept the vaccine. These strategies in clude providing incentives, making it compulsory and paying for the vaccine with F = 186.983 and eta = 0.657, F =71.620 and Eta = 0.476, F = 108.696 and Eta = 0.552, respectively. Conclusion: The study revealed a possibility of the low willingness of Nigerians to accept COVID-19 vaccine. Providing incen tives is likely to improve coverage, while making the vaccine compulsory may increase rejection. This study, therefore, serves as a gateway for government and policymakers on how best to prime and penetrate the society to achieve massive COVID-19 vaccine coverage in Nigeria.

Abstract In March 2020, the first cases of SARS-CoV-2 were reported in Accra, Ghana. These initial cases were diagnosed at the Advanced Research Laboratories (ARL) of the Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana. The ARL which hitherto was used for routine clinical research in viral, bacteria and immunological studies has since been the facil ity of choice for testing for all suspected cases of COVID-19 submitted from across Ghana and beyond. The success of testing at the ARL hinged on the availability of several laboratory spaces furnished with state-of-the-art diag nostic equipment and working aids. During the “peak season” where over whelming numbers of clinical specimens were received, the ARL processed and got results for close to four thousand samples daily. After general disin fection and re-bagging into smaller numbers, at the entrance of the ARL, the samples are taken to a central receiving laboratory, where they are received and entered in a database with accompanying case investigation forms. All samples that are successfully sorted and matched are sent to general laborato ries for nucleic acid extraction and then referred to the Instrumentation la boratory for real time reverse-transcription polymerase chain reaction (RT PCR). When the RT-PCRs were completed, results were analysed and trans mitted via email and/or local network to the data reporting office. The data managers then reported results to the investigators and the Ghana Health Service (GHS). Additionally, the ARL provided a next-generation Genome Sequencing platform in partnership with the West African Centre for Cell Bi ology of Infectious Pathogens at the University of Ghana, which was essential in reporting the genome data of the circulating variants of SARS-CoV-2 in Ghana. Conclusively, it is worth noting, that the NMIMR fulfilled its mandate of supporting the country with specialized diagnostics through the judicious use of the ARL for SARS-CoV-2 testing, from sample receipt to data report ing. The ARL facility and the research faculty have trained and continue to train budding laboratories on biosafety, biosecurity, best practices and testing protocols. It is obvious that the success story of SARS-CoV-2 testing in Gha na, cannot be complete without the mention of the ARL at NMIMR.

Abstract Background: Many studies examined and reported oral and general health inequalities in clinical health, SROH and SRH. Objectives: The study aims to explore the social influences, gradients and predictors of self-rated oral health (SROH) and self-rated health (SRH) and wellbeing in Greek adults. Methods: Cross-sectional study, of men and women, aged 65 years and over (N = 743) in Greece. Descriptive and statistical analyses were performed for dentate and edentulous participants. For the association between socioeconomic expo sures and binary outcomes, logistic regression was performed to estimate Odds Ratios and 95% Confidence Intervals (OR, 95% CI); levels of associa tion and Cramer’s V were applied to calculate associations and p-values. Re sults: The objective socioeconomic measures, such as household income, education level and last main occupation were significant predictors and de terminants of both SROH and self-rated health (SRH). For Satisfaction with life (SWL), there was a diversity in the results analogous to the dental status of the participants. Household income and SSS were predictors of SWL in dentate participants. In the total sample Household income, occupation and SSS, were predictors of SWL, while in edentulous participants only occupa tion and SSS were statistically significant (p < 0.05). Subjective social status was statistically significant for SROH, SRH and SWL (p < 0.01). More men than women reported their SROH and SRH as good. Household income and SSS were predictors of SWL, in dentate participants, thus the better the in come and the higher the relative social status, the higher feeling of SWL was recorded. Place of residence had significant associations only with SWL. Household income, education, occupation and SSS had significant levels of association with SROH and SRH in dentate participants (p < 0.05). Conclu sion: There are socioeconomic gradient inequalities in SROH and SRH in Greek adults living in Attica area. Subjective social status is a predictor of SROH, SRH and SWL. The need to prioritize interventions to eliminate dis parities and inequalities in oral and general health and wellbeing of elders is evident.

Abstract Diet remains a key factor that significantly influences the outcomes of the disease. There are some factors that place one at a higher risk of morbidity from the disease, with the common ones being elderly age and coexistent comor bidities. The dietary consumption of the patient is vital since some Western Diets that are largely refined predispose one to cardio-metabolic diseases. In addition to that, the consumption of such diets largely influences the immun ity of the individual, whereby it reduces the disease-fighting capability of the immune system. The health education on the patient with the condition has largely widened to encompass the healthy eating habits that one should emu late to reduce the disease severity. Further, in an attempt to promote the awareness of the importance of healthy eating, Eat Well Saskatchewan (EWS) has formulated some social media outreach to ensure that the importance of healthy eating reaches a larger population.

Abstract Background: Recently, abuse, assault, and harassment in pediatric medical settings have become more serious. We extracted typical problems from a na tionwide simultaneous survey on abuse in the pediatric medical field and de veloped a training textbook to simulate or discuss these issues with col leagues. This study aimed to confirm the validity and usability of the contents of this training textbook. Methods: The textbook was mailed to the heads of 51 medical institutions affiliated with the Society of Ambulatory and General Pediatrics of Japan (SAGPJ) and the participants of the SAGPJ online work shop, who were asked to evaluate the textbook using a three-point scale to answer the following questions and provide opinions and impressions about the textbook. Q1. Do you think the whole content and structure of this text book are useful? Q2. Would you use this textbook as a training textbook for all staff at your facility? A simple tabulation was performed on the evaluation using a three-point scale, while content analysis was performed on the opi nions and impressions of the participants. Results: In response to Q1 and Q2, all 63 staff members from 55 facilities answered “3: Yes.” Opinions and im pressions on the training textbook included “I think it can be used for work place training” and “it is useful for exchanging various opinions among staff members and gaining a common opinion.” Conclusion: We developed a training textbook on abuse, assault, and harassment in pediatric medical set tings based on a nationwide survey and confirmed the validity and usability of its contents.

Abstract Background: Immune checkpoints inhibitors (ICIs) are widely used in vari ous therapy of tumors. With the increasing usage of them, immune-related adverse events (irAEs) have been known and become common events, espe cially in the dermatologic system. However, the rare and severe immune-re lated cutaneous adverse events (irCAEs) still lack enough knowledge. Case presentation: We described a rare case of Steven-Johnson syndrome (SJS) in duced by pembrolizumab in an advanced squamous non-small cell lung can cer (NSCLC) patient. SJS is a rare irCAE that could happen at any time after immunotherapy while this case happened from the 3rd day. The patient had influence-like symptoms and several mucous lesions including oral, eye, and skin. With a gradually severer condition, a stoss therapy of intravenous im munoglobulin (IVIG) had a mild effect. It was a long process and failed to respond to usual dermatologic treatment. Conclusion: We share this case in order to enhance clinicians’ ability to early recognition and diagnosis in se vere irCAEs. Early recognition and appropriate management are important to evade the termination of immunotherapy. Such severe irCAE should be paid more attention to in clinical medicine when using ICIs.

Abstract This study aimed to clarify the amount of physical activity, lifestyle, and self esteem of elementary school students living in Aomori Prefecture Japan. The subjects were ninety-one elementary school students in the 4th to 6th grades who live in A town. The subjects were asked to fill out a questionnaire about lifestyles and self-esteem and to wear the lifestyle-related recorder Life Coder GS® (Suzuken, Japan) for a total of four days, two weekdays and two holidays. The results showed the amount of exercise such as the number of steps taken was significantly higher on weekdays than on holidays. There was no differ ence by gender or classification of obesity. In addition, when they go to school on foot, the number of steps and fast walking time was significantly higher than when using the bus. Screen times of holidays were significantly longer than those of weekdays. The number of steps on holidays was negatively cor related with screen time, and positively correlated with the factor of “self-as sertion/self-determination” of self-esteem scale. Health promotion is needed so that the entire community, including family and friends, can develop daily physical activities.

Abstract The aim of the study was to examine some overlooked individual difference (demography, ideology, ability) correlates of attitudes to being vaccinated with the Covid-19 vaccine. Six hundred and sixteen adults were asked about re ceiving the COVID-19 vaccine. The relationship between demographic (age, sex, education), ideology (political and religious beliefs), intelligence (cogni tive ability) and attitudes to vaccination (acceptance, hesitancy, rejection) was examined. Correlations and regressions indicated that vaccine hesitancy and rejection were associated primarily with intelligence and political beliefs as well as mental illness history, as well as religious beliefs. Effect sizes were however small. Limitations are acknowledged.

Abstract Background: Clinical judgment is a specific role that establishes a profes sional identity. The purpose of this paper is to prepare nursing students to make better judgments in the clinical setting and realign learning and teach ing. Methods: We used six steps to arrive at a competent clinical judgment suggested by the National Council State Board of Nursing (NSCBN) as a clini cal judgment model 1) recognizing cues, 2) analyzing cues, 3) prioritizing hy potheses, 4) generating solutions, 5) taking an action, and 6) evaluating out comes during the head-to-toe examination of the patient. Results: The pri mary outcomes are stabilization of the hemodynamics of the patient and pre vention of further blood loss. Fluids are being given to help keep the vascular volume from being depleted, but they cannot solve the underlying problem. Continued assessment, intervention, and monitoring of vital signs through the course of the hospital stay ending with the patient’s discharge. Discus sion: Survivors of sexual assault are unique for a nurse to provide care. The nurse needs to assess, intervene, monitor, and pay attention to detail of the 6 steps to clinical judgment, resulting in positive outcomes for their patient. Conclusions: Forensic nursing is a field of nursing that focuses on sexual as sault survivor care and works to make the aftermath of their tragic situation easier to cope with. Strengthening clinical judgment skills could remedy sig nificant mistakes made by novice forensic nurses. Critical thinking and clini cal ethical reasoning are the building blocks of clinical judgment.

Abstract Purpose: The purpose of this study was to prepare a self-assessment ques tionnaire for nurses’ risk-taking behavior (RTB) in medication and to develop a reliable and valid questionnaire. Method: In the first study, a draft of the self-evaluation questionnaire for nurses’ RTB in medication was prepared based on the literature study and qualitative analysis of important case infor mation included in the Project to Collect Medical Near-miss/Adverse Event Information Annual Report of the Ministry of Health, Labor and Welfare. Following the studies, face validity was confirmed, and a questionnaire survey was conducted for nurses who oversee medication nationwide to verify the reliability and validity. Result: The number of subjects was 586 (valid re sponse rate: 94.1%). Item analysis and exploratory factor analysis showed that 4 factors and 12 items for the RTBs in daily life and 4 factors and 20 items for RTBs in medication could be extracted. Confirmatory factor analysis con firmed the fit of the hypothetical model obtained by exploratory factor analy sis. In addition, Cronbach’s α coefficient was 0.888. Thus, high reliability and validity were obtained. A correlation was found by comparing the total scores of each RTB factor with the incident/accident group, and a standard for self-evaluation value could be established (p < 0.01). Conclusions: We were able to develop a self-assessment questionnaire for nurses’ risk-taking beha vior in medication. This questionnaire will be used by nurses to find out their trends.