Conceptual substantiation of priority criteria of quality of life and health in assessing the effectiveness of health care, social and environmental programs

 

 

Conceptual substantiation of priority criteria of quality of life and health in assessing the effectiveness of health care, social and environmental programs

 

Luchkevich V.S., Shakirov A.M., Marinicheva G.N., Samodova I.L.,

 

Russia, Saint-Petersburg

 

International University of Fundamental Science

 

International Academy of Ecology and Human and Natural Security

 

North-Western Public Medical I. I.  Mechnikov University

 

Factors of health and disease risk existing in the world civilization, problems of ecological safety and unmet subsistence needs –they are on one side, and measures of active preventive health conservation, increase in life expectancy and optimal living conditions – are on another shore.A connecting bridge, ensuring the unity and the ability to implement socially -oriented state policy priority of health and ideological activities, protection of the rights and well-being, is to optimize the quality of life of the population as the main criterion for the effectiveness of social and environmental programs .

 

I, as a public health and health professional, am particularly pleased to present here at the European headquarters of the United Nations Organization (UNO Headquarters), an example of use of the main criteria for health -related quality of life - HRQOL.

 

We believe that the methodological basis for the prevention included in the Concept of health-medicine and quality of life, as one of the leading methods for assessing their effectiveness, needs to be updated with the definition of health indicators that can be measured, establishing reference standards, determining the risk groups.

 

A person has a right for health, a right for a healthy environment, a right for affordable and quality health care. Therefore, health should not be seen as a result, but as a basis for the development of health state policy. 
However, even the definition of the World Health Organization (even in 1948) : «Health is the complete physical, mental and social well-being and not merely the absence of disease», does not contain the active preventive directive and there is no methodological basis for a complete understanding of the quality of life , so we propose to add that «Health is  a condition that allows the optimal interaction with the environment , quality of life and the safe implementation of the basic kinds of life , with full physical, psychological and social functioning of human». Integrative and systemic approach to assessing the health and quality of life suggests that the body is a functioning biological system in time. Therefore, health promotion and improved quality of life are the functional concept and it is necessary to assess their dynamics and stages of life. It should be taken into account that the body's ability to adapt is a measure of independence from the device and changing conditions of internal and external environment.Only on this basis can be developed the concept of Health promotion, as a health-medicine and the concept of a healthy lifestyle.

 

Changing the biomedical model of health and illness and biopsychosocial model of health has led to the need to consider the subjective opinion of the person about his well-being and health. He introduced concept does not oppose health-active prevention of high-quality curative medicine. The unifying integrative criterion for health prevention and for treatment and rehabilitation programs is a criterion of the quality of life, testifying to the subjective evaluation of a man of his status as a consumer of health services. The study of quality of life is generally accepted in international practice, a highly sensitive and cost-effective method of assessment of the relative health. The concept, based on the principles of this methodology allows the most important principle of the treatment process: not to treat the disease, but the patient, to take into account the peculiarities of his way of life.

 

According to the WHO definition of "Quality of life  is the perception of individuals of their position in life in the context of the values of the environment in which they live, in close connection with their goals, expectations, standards and concerns". The most often the following meaning is given to the quality of life in Russia: "Quality of life is an integral characteristic of the physical, psychological, emotional and social functioning of a person based on his subjective perception". However, the existing quality of life characteristics do not sufficiently reflect the interests and human rights as a consumer of health services, taking into account the peculiarities of its social and hygienic operation and its lifestyle in certain socio-economic conditions and the environment that has an impact on his health in the amount of more than 75.0%.

 

Therefore, from our point of view, we have ntroduced the concept of "quality of life related to health that is an integral, subjective satisfaction characteristic of life conditions, habitat and adaptive abilities of the body, providing physical, psychological and social well-being".

 

Up to nowerdays there are various criteria for measuring quality of life. UN experts have developed a generalized structure of the components of quality of life, including health, education, social security, rights and the human condition. HDI (Human Development Index) was developed as an "expansion of human capabilities for a long and healthy life". WHO coined the medical practice standardized index (QOL-Index). It reflects the quality of life in the aspects such as: overall physical activity, psychological condition, the patient's independence in daily life, health, the availability of support from other people, the possibility of restoring full life. A composite index is the "quality of life index". So far, despite the international practice, the problem of the quality of life study remains underestimated.

 

Possible indicators of quality of life as a criterion for the effectiveness of therapeutic interventions were limited in clinical trials. The main problem is the lack of common technical approaches, not to compare the scientific and practical studies in different countries and regions.

 

We have developed and tested a universal multidimensional questionnaire study of quality of life as an integrated criterion of health assessments and the effectiveness of medical and preventive, treatment and rehabilitation, and environmental programs. 15 kinds of scales on the functioning of the signs and symptoms gradations are presented in the structure of the proposed questionnaire to produce quantitative and qualitative indicators. The model scales and the total number of measurements of features were developed for the assessment of quality of life. The study determined the level of informative significance scales by type of operation and group features. The method of calculation and evaluation of the outcomes of quality of life and health allows to modify presented in the questionnaire scale and gradation attributes given the specificity of the studied contingent (children, working-age population, the elderly, people with disabilities, migrants and others) and the clinical condition of the patient (including prenosological states specific symptoms, painful manifestations characteristic for different nosologic forms of diseases). In this case both general and specific marker of the formation of pathology in the early stages may serve as indicators of structural and functional changes in various systems of the body that can be measured and assessed in dynamics. Subjective data (in the Quality of Life Research) in addition to objective indicators to assess the dynamics of clinical and functional conditions (changes) is based on screening and diagnostic programs. Therefore, it is advisable to develop individual programs of medical prophylactic and therapeutic effects of rehabilitation to improve the quality of life of patients.

 

We have developed a special research program "Quality of life as a criterion for assessing the health and effectiveness of health care systems to ensure ecological, sanitary and epidemiological safety". The results of the study among urban residents of St. Petersburgmade possible to determine the priority of life indicators and characteristics of quality of life (social and hygienic operation, the socio-economic well-being, the level of hygiene and environmental well-being of the community). We have identified 3 risk groups of urban residents on the basic health and social and hygienic characteristics of life (the optimal conditions, the relative and absolute risk).

 

 According to the generalized indicator of socio-hygienic operation urban residents can be attributed to the relative risk (73 points). In this set, taking into account the type of family only 44% of urban households can be attributed to the healthy, and 56% of residents are in different groups of risk. This single-parent families, divorced, single, and others. Up to 12% of workers speak about the impact of adverse factors of work, and for 7% of the work performed does not correspond to a state of health. Proportion of completely satisfied with living conditions of the total number surveyed for economic and household activities (Group optimal conditions) is only 24%. More than half of residents (69%) are satisfied with the regime and not enough food quality (risk group).
According to their subjective estimations, women are more demanding in the assessment of the socio-hygienic operation and although they have objectively more favorable characteristics of quality of life that according to their subjective indicators, they evaluate worse.
There is a high proportion (82 %) of persons who wish to improve their socio-economic status (overall quality of life - 67 points, the relative risk). With women, these figures are much worse. Important informative measure of quality of life is social and psychological well-being in the workplace and at home (72 points), and 27% of residents have noted the need for psychological correction. This recreational activity in order to restore physical strength and to promote health is carried out regularly or occasionally only by 66% of urban residents.

 

On the basis of preclinical subjective diagnosis and screening questionnaire we assessed the presence and dynamics of changes in the severity of symptoms and early clinical manifestations that characterize the quality, timeliness and effectiveness of preventive and therapeutic measures. The results indicate the presence of symptoms and expressed prenosological states in such nosologic forms of diseases such as diseases of the musculoskeletal system (56%), digestive system (57%), circulatory system (40%), and others.

 

In the transition from a healthy state to disease, the quality of life is deteriorating mainly due to the physical component (symptoms, pain, feeling of general health). Overall health is most negatively evaluated in the presence of concomitant chronic diseases. General health indicators are related to the degree of exposure to the life factors such as: satisfaction with living conditions; the type and conditions of employment; quality of food; the level of health awareness and prevention activities. On a scale of subjective health assessments all urban residents evaluate on average about 70%.

 

The migrants (mostly younger) have very unfavorable indicators of the quality of life in almost all the characteristics of social and hygienic operation (group relative and absolute risk), socio-economic (absolute risk), social and psychological state (up 30.0% absolute risk group), the level of medical awareness, preventive and medical- social activity (to 36.3% - an absolute risk group).

 

Women are at risk to a greater extent than men, on grounds such as: type of family, family environment, socio-economic status, the quality of food, conditions and nature of the professional activity.

 

More important ranking places are occupied by socio-economic, psychological and hygienic problem indicators in the formation of the quality of life related to health. Total index of quality of life was 65 points, with a strong correlation found between indicators of social and hygienic operation, socio-economic status, physical functioning and health. Evidence suggests that a group of healthy urban population is 30%, relative risk group is 54%, and the absolute risk group (with various forms of chronic diseases) is 16%. However, the analysis of additional data on the presence of the expressed prenosological conditions, signs and symptoms indicates the projected increase in the absolute risk especially in diseases of the circulatory system, respiratory diseases and diseases of the musculoskeletal system.

 

Successfully, reliably and objectively is used the complex method of evaluating the quality of life in the evaluation of the effectiveness of treatment and rehabilitationwith the analysis of the dynamics of species in the functioning of the rehabilitation stage in forecasting distant treatment results in the post-hospital stage.

 

The results of the analysis of quality of life with personalized state monitoring methods allow to optimize and correct some types of life, management of employment (especially for people with disabilities or at risk).

 

Studies suggest that the process of studying and optimizing the quality of life necessitates the use of a process approach with the definition of the governing bodies, the presence of regulatory support, the definition of objects, identification of life risk factors, habitat forming diseases, clinical and functional states, identifying rank the importance of risk factors and optimizing the role of participants in the process of correction of living conditions and quality of life.

 

Thus, the proposed conceptual model allows not only to assess the effectiveness of implementation of social, health, environmental programs and support systems, but can also be used for monitoring of clinical and functional conditions of different population groups (patients and healthy), in the extreme situations (natural and manmade), during the examination of new methods of treatment and prevention, in the economic rationale for regional projects.

 


Microwave based cancer cell screening with no marker

 

 

Microwave based cancer cell screening with no marker

 

The aging of the population associated with the increase demand of higher quality of life at old age has set a significant demand for higher quality medical care with faster, more accurate and minimal invasive assays. The advancements in the early detection of specific medical conditions are further required to understand or early prevent diseases. Most of the assays used blood, urine, saliva and tissue cells to detect and screen important clues related with patient medical condition. The outcome of these assays was reflected in the medical data which further emerged in better treatments and more effective drugs. Most of the present assays require high qualified personnel to prepare, analyze and perform the interpretation of the results as well as sophisticated and expensive equipment and long period of analysis time. The emergence of new technologies such as MEMS (Micro Electro Mechanical Systems) with microfluidics and Lab-on-a-chip (LOC) concept, bring new type of available tools with the possibility to perform efficient fast tests and assays with very little help of the human operator and at relatively low associated costs. The ultimate aim is to reproduce the same laboratory biological assays with miniaturized Bio MEMS devices to acceptable specific and sensitive results. For the last decade, several researchers investigated and used different cell detection techniques such as optical cytometry, impedance spectroscopy and electromagnetic spectroscopy with cancer cell attached to markers. The amount of literature on Circulating Tumor Cells (CTC) has exponentially grown over past ten years. As the possibility to separate and count CTC after cancer therapy was approved by FDA in 2005 for Veridex of Johnson and Johnson, the idea of “catching” the cells by bonding magnetic ferrofluid on the markers specific to three types of cancer. These commercially available kits are made to find and count CTC of epithelial origin from breast, colon and prostate cancers after therapy (chemotherapy). The method is based on bounding magnetic micro particles to specific over-expressed proteins (markers) in cancer cells in whole blood and counting them after attracted by magnetic field - The CellSearch®. Although the desire to identify other type of cells is extremely high, the presently used method is limited to detection of cancer cells of known origin. Finding cancer cells of unknown origin based on the bio-chemical reaction between proteins requires an omni-binding protein which at the present time is unknown.
At the present time there are more than 30 research groups that direct their interest towards cancer cell separation. The technologies used by the research groups are either filtering based on size or magnetic marking and separation in magnetic field. The technologies targeted by the research groups are mainly focusing on specific CTC separation, detection or counting. According to the last 10 years information acquisitions, the interest in cancer research is expanded towards cancer detection through single cell analysis. Any of such technologies would require an accurate cell separation system and an integrated system would be preferred when automation of detection is intended.
The proposed enabling technology research represents one of the potential key in any future single cell analysis devices based on microwave screening. Both modeling and experimental work carried out so far point towards the possibility to enhance the efficiency of the method through 3 dimensional configurations of electrodes in a microfluidic channel. The ultimate objective of this research is to develop a miniaturized system to screen cancer cells from the blood taken from the patient without the use of marker.

 

This research is based on the characterization of different cancer cell’s dielectric properties at low and high frequencies for cell separation from blood by Dielectrophoresis (DEP) and microwave cell screening without the use of markers. The cell screening to count, to differentiate different type of cancer cell and to identify the signature of each single cell or CTC uses microwave measurements on single CTC with no marker.

 

ANALYSIS OF THE EFFECT OF GINGER ON REDUCING COX-2 GENE EXPRESSION IN “HT-29” COLON CANCER STEM CELLS

 

Haghighi, A.1, Zia Jahromi, N.2, Hejazi, S.H.3

1-       MSc. In Biochemistry, School of Basic Sciences, Islamic Azad University/Shahrekord Branch

2-       Assistant Professor in Biology group, School of Basic Sciences, Islamic Azad University/Shahrekord Branch

3-       Professor in the Sedigheh Tahereh Skin Diseases and Leishmaniasis Center, Parasitology and Mycology Group, School of Medicine, Esfahan University of Medical Sciences

 * Correspondance: This email address is being protected from spambots. You need JavaScript enabled to view it. (+98933146504)

 

ABSTRACT:

Introduction and objective:Colon cancer is the second reason of mortality caused by cancer in the world, after lung cancer, and it is the third prevalent gastrointestinal cancer after gastric and esophageal cancers in Iran. Environmental and genetic factors have important roles in the emergence of this cancer. One of the important factors in creation of this type of cancer is chronic inflammations of colon. Ginger has anti-inflammatory properties due to its content of [6]-gingerol and, hence, it can play a role in the prevention of colon cancer. COX-2 gene expression is increased in colon cancer, causing intestinal inflammation. The effect of ginger extract on reducing COX-2 gene expression in colon cancer HT-29 cells was investigated in this study.

Methodology: In this laboratory research, HT-29 cells of colon cancer were cultured in a 75 ml flask. The cells were trypsinated at the third passage and 5000 of them were cultured in the wells of 96-well plates. Ginger extract at four concentrations (10, 20, 30, and 40 mg/mL) was added to the wells, and the plates were incubated at 37˚C for 24, 48, and 72 hours in a 5% Co2 atmosphere. To study the effects of ginger extract on the cells, the MTT test was performed and the densities of the plates were read using an ELISA instrument. Total cellular RNA was extracted and expression of the COX-2 gene was investigated using the RT-PCR method. A sample not treated with the ginger extract was used as the positive control and GAPDH as the internal control.

Results: The measured IC50 concentration of the ginger extract was 20 mg/ml. Determination of the expression of the COX-2 gene using the RT-PCR method indicated that the ginger extract at 20 mg/ml reduced expression of the COX-2 gene compared to using Aspirin. Therefore, ginger extract could be used as an anti-inflammatory drug against the HT-29 cells of colon cancer. 

 

Read more...

CONCEPTUAL SUBSTANTIATION OF PRIORITY CRITERIA OF QUALITY OF LIFE AND HEALTH

Conceptual substantiation of priority criteria of quality of life and health in assessing the effectiveness of health care, social and environmental programs

 

Luchkevich V.S., Shakirov  A.M., Marinicheva G.N., Samodova I.L.,

                              Russia, Saint-Petersburg

 

International University of Fundamental Science

 

International Academy of Ecology and Human and Natural Security

 

North-Western Public Medical I. I.  Mechnikov University

 

Factors of health and disease risk existing in the world civilization, problems of ecological safety and unmet subsistence needs –they are on one side, and measures of active preventive health conservation, increase in life expectancy and optimal living conditions – are on another shore.A connecting bridge, ensuring the unity and the ability to implement socially -oriented state policy priority of health and ideological activities, protection of the rights and well-being, is to optimize the quality of life of the population as the main criterion for the effectiveness of social and environmental programs .

 

Read more...

PREHENSIVE HEALTHY NOOSPHERIC TECHNOLOGIES

COMPREHENSIVE HEALTHY NOOSPHERIC TECHNOLOGIES

 

PhD in energo-informational technologies, the correspondent participant of the Internatonal Academy  of Ecology and Life Safety -

Dr. Sergey Yurievich Tulsky (PhD).

 

    In 1990 the author put forward a hypothesis that all the biological forms of life in total form are some kinds of a rational substance in the form of energo-informational field. Such a hypothesis emerged on the basis of the analysis of the reasonable behavior of birds in flock, bees, ants, locusts, fish and other biological poulation.  This hypothesis corresponded to the doctrine by V.I.Vernadsky about the transition of biosphere into noosphere, that is reasonable sphere. There was the opinion that all the people living on the planet and that is 7, 5 billion people, in total, form the united energo-informational field that has reasonable characteristics.  Such field according to the author’s opinion has to exist according to the law of transition from quantity to quality and the law of conservation of energy. If we turn to Pierre Teilhard de Chardin, co-author of the term “noosphere”, then his term is put down to the collective consciousness. The hypothesis now has to be approved or disapproved.  Due to the biolocation, the means of connection to the different objects on the big distances, the attempt of connection to the supposed egergoinformational field was made.  This attempt turned to be successful. The dialog with energo-informational field took place, that is, Noosphere. In the result of the dialog the information in the form of knowledge about the appearance of biological life forms on the planet was gained, also about the mechanisms of matter motion and the harmonious human development. The author called the knowledge gained in this way: “Noospheric studies” The main postulate of the noospheric studies sounds: “All the processes in the Universe, evident or latent” happen due to the information on the basis of what the matter is constructed, and it moves.

 

Read more...

ABOUT THE UNCERTAIN CONSEQUENCES OF NUCLERA EXPLOSIONS IMPACT ON THE BIOSPERE OF THE EARTH

ABOUT THE UNCERTAIN CONSEQUENCES OF NUCLERA EXPLOSIONS IMPACT ON THE BIOSPERE OF THE EARTH

Grand Ph. D. V.A.Shemchyk

Today eight nuclear powers have in total nuclear weapons in trinitrotoluol equivalent 320 thousand of megatons in store. If,  in case of war between Europe, Russia, the USA, at least 10 % of these recourses were used, after a month of the start of the war 1300 million of the world population of 1400 would die. From the rest 100 million 70 million would be seriously wounded, and 30 million slightly injured people would be obliged to solve the problems, which occurred because of the total destruction of the civilization.

 

Read more...