Search results for: health mental
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9606

Search results for: health mental

6636 DH-Students Promoting Underage Asylum Seekers' Oral Health in Finland

Authors: Eeva Wallenius-Nareneva, Tuula Toivanen-Labiad

Abstract:

Background: Oral health promotion event was organised for forty Afghanistan, Iraqi and Bangladeshi underage asylum seekers in Finland. The invitation to arrange this coaching occasion was accepted in the Degree Programme in Oral Hygiene in Metropolia. The personnel in the reception center found the need to improve oral health among the youngsters. The purpose was to strengthen the health literacy of the boys in their oral self-care and to reduce dental fears. The Finnish studies, especially the terminology of oral health was integrated to coaching with the help of interpreters. Cooperative learning was applied. Methods: Oral health was interactively discussed in four study group sessions: 1. The importance of healthy eating habits; - Good and bad diets, - Regular meals, - Acid attack o Xylitol. 2. Oral diseases − connection to general health; - Aetiology of gingivitis, periodontitis and caries, - Harmfulness of smoking 3. Tools and techniques for oral self-care; - Brushing and inter dental cleaning. 4. Sharing earlier dental care experiences; - Cultural differences, - Dental fear, - Regular check-ups. Results: During coaching deficiencies appeared in brushing and inter dental cleaning techniques. Some boys were used to wash their mouth with salt justifying it by salt’s antiseptic properties. Many brushed their teeth by vertical movements. The boys took feedback positively when a demonstration with model jaws revealed the inefficiency of the technique. The advantages of fluoride tooth paste were advised. Dental care procedures were new and frightening for many boys. Finnish dental care system was clarified. The safety and indolence of the treatments and informed consent were highlighted. Video presentations and the dialog lowered substantially the threshold to visit dental clinic. The occasion gave the students means for meeting patients from different cultural and language backgrounds. The information hidden behind the oral health problems of the asylum seekers was valuable. Conclusions: Learning dental care practices used in different cultures is essential for dental professionals. The project was a good start towards multicultural oral health care. More experiences are needed before graduation. Health education themes should be held simple regardless of the target group. The heterogeneity of the group does not pose a problem. Open discussion with questions leading to the theme works well in clarifying the target group’s knowledge level. Sharing own experiences strengthens the sense of equality among the participants and encourages them to express own opinions. Motivational interview method turned out to be successful. In the future coaching occasions must confirm active participation of everyone. This could be realized by dividing the participants to even smaller groups. The different languages impose challenges but they can be solved by using more interpreters. Their presence ensures that everyone understands the issues properly although the use of plain and sign languages are helpful. In further development, it would be crucial to arrange a rehearsal occasion to the same participants in two/three months’ time. This would strengthen the adaption of self-care practices and give the youngsters opportunity to pose more open questions. The students would gain valuable feedback regarding the effectiveness of their work.

Keywords: cooperative learning, interactive methods, motivational interviewing, oral health promotion, underage asylum seekers

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6635 Health and Climate Changes: "Ippocrate" a New Alert System to Monitor and Identify High Risk

Authors: A. Calabrese, V. F. Uricchio, D. di Noia, S. Favale, C. Caiati, G. P. Maggi, G. Donvito, D. Diacono, S. Tangaro, A. Italiano, E. Riezzo, M. Zippitelli, M. Toriello, E. Celiberti, D. Festa, A. Colaianni

Abstract:

Climate change has a severe impact on human health. There is a vast literature demonstrating temperature increase is causally related to cardiovascular problem and represents a high risk for human health, but there are not study that improve a solution. In this work, it is studied how the clime influenced the human parameter through the analysis of climatic conditions in an area of the Apulia Region: Capurso Municipality. At the same time, medical personnel involved identified a set of variables useful to define an index describing health condition. These scientific studies are the base of an innovative alert system, IPPOCRATE, whose aim is to asses climate risk and share information to population at risk to support prevention and mitigation actions. IPPOCRATE is an e-health system, it is designed to provide technological support to analysis of health risk related to climate and provide tools for prevention and management of critical events. It is the first integrated system of prevention of human risk caused by climate change. IPPOCRATE calculates risk weighting meteorological data with the vulnerability of monitored subjects and uses mobile and cloud technologies to acquire and share information on different data channels. It is composed of four components: Multichannel Hub. Multichannel Hub is the ICT infrastructure used to feed IPPOCRATE cloud with a different type of data coming from remote monitoring devices, or imported from meteorological databases. Such data are ingested, transformed and elaborated in order to be dispatched towards mobile app and VoIP phone systems. IPPOCRATE Multichannel Hub uses open communication protocols to create a set of APIs useful to interface IPPOCRATE with 3rd party applications. Internally, it uses non-relational paradigm to create flexible and highly scalable database. WeHeart and Smart Application The wearable device WeHeart is equipped with sensors designed to measure following biometric variables: heart rate, systolic blood pressure and diastolic blood pressure, blood oxygen saturation, body temperature and blood glucose for diabetic subjects. WeHeart is designed to be easy of use and non-invasive. For data acquisition, users need only to wear it and connect it to Smart Application by Bluetooth protocol. Easy Box was designed to take advantage from new technologies related to e-health care. EasyBox allows user to fully exploit all IPPOCRATE features. Its name, Easy Box, reveals its purpose of container for various devices that may be included depending on user needs. Territorial Registry is the IPPOCRATE web module reserved to medical personnel for monitoring, research and analysis activities. Territorial Registry allows to access to all information gathered by IPPOCRATE using GIS system in order to execute spatial analysis combining geographical data (climatological information and monitored data) with information regarding the clinical history of users and their personal details. Territorial Registry was designed for different type of users: control rooms managed by wide area health facilities, single health care center or single doctor. Territorial registry manages such hierarchy diversifying the access to system functionalities. IPPOCRATE is the first e-Health system focused on climate risk prevention.

Keywords: climate change, health risk, new technological system

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6634 Nine Year Trend Analysis of Malaria in Kahsay Abera General Hospital Humera Town: Western Tigrai, Northern Ethiopia: A Retrospective Study

Authors: Getachew Belay, Getachew Kahsu, Brhane Berhe, Kebede Tesfay, Fitsum Mardu, Nigus Shishay, Hadush Negash, Aster Tsegaye

Abstract:

Background: Malaria kills million people around the world, and it is still a serious public health problem in Ethiopia. Over the past years, the disease has been consistently reported as leading cause of outpatient visits, hospitalization and death in health facilities across the country. This study assessed malaria trend in Humera Town Kahsay Abera Hospital Tigrai region, Northern Ethiopia. Method: A Health facility retrospective cross sectional study was conducted in Kahsay Abera General Hospital from January 2011 to December 2019. Data of Malaria cases were reviewed from Health Management Information System with the help of experts in the office. The nine year data were extracted and analyzed using Excel by excluding those which lack demographic data. Result: A total of 36,604 smear positive malaria cases were confirmed in last nine years in the study area. Plasmodim falcifarum was the most prevalent reported species. Higher number of malaria cases were reported during October season.Males were more infected by the disese (63.1%) than females and males aged 15 years and above were the most iffected ones. The percentage proportion of P.falcifarum and P.vivax were 61.6% to 38.4%, respectively. There was a decreasing trend over the nine years following the peak in 2013. Conclusion: Malaria smear positivity, with highest cases being recorded in October, was declined over the nine years after peaking in 2013. Males aged 15 years and above were more affected, and P falciparum was the predominat species. Strengtheing the prevention and control activities is warranted in the study area.

Keywords: trend, malaria, kahsay abera general hospital, tigray, ethiopia

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6633 Nurture Early for Optimal Nutrition: A Community-Based Randomized Controlled Trial to Improve Infant Feeding and Care Practices Using Participatory Learning and Actions Approach

Authors: Priyanka Patil, Logan Manikam

Abstract:

Background: The first 1000 days of life are a critical window and can result in adverse health consequences due to inadequate nutrition. South-Asian (SA) communities face significant health disparities, particularly in maternal and child health. Community-based interventions, often employing Participatory-Learning and Action (PLA) approaches, have effectively addressed health inequalities in lower-income nations. The aim of this study was to assess the feasibility of implementing a PLA intervention to improve infant feeding and care practices in SA communities living in London. Methods: Comprehensive analyses were conducted to assess the feasibility/fidelity of this pilot randomized controlled trial. Summary statistics were computed to compare key metrics, including participant consent rates, attendance, retention, intervention support, and perceived effectiveness, against predefined progression rules guiding toward a definitive trial. Secondary outcomes were analyzed, drawing insights from multiple sources, such as The Children’s-Eating-Behaviour Questionnaire (CEBQ), Parental-Feeding-Style Questionnaires (PFSQ), Food-diary, and the Equality-Impact-Assessment (EIA) tool. A video analysis of children's mealtime behavior trends was conducted. Feedback interviews were collected from study participants. Results: Process-outcome measures met predefined progression rules for a definitive trial, which deemed the intervention as feasible and acceptable. The secondary outcomes analysis revealed no significant changes in children's BMI z-scores. This could be attributed to the abbreviated follow-up period of 6 months, reduced from 12 months, due to COVID-19-related delays. CEBQ analysis showed increased food responsiveness, along with decreased emotional over/undereating. A similar trend was observed in PFSQ. The EIA tool found no potential discrimination areas, and video analysis revealed a decrease in force-feeding practices. Participant feedback revealed improved awareness and knowledge sharing. Conclusion: This study demonstrates that a co-adapted PLA intervention is feasible and well-received in optimizing infant-care practices among South-Asian community members in a high-income country. These findings highlight the potential of community-based interventions to enhance health outcomes, promoting health equity.

Keywords: child health, childhood obesity, community-based, infant nutrition

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6632 A Unique Immunization Card for Early Detection of Retinoblastoma

Authors: Hiranmoyee Das

Abstract:

Aim. Due to late presentation and delayed diagnosis mortality rate of retinoblastoma is more than 50% in developing counties. So to facilitate the diagnosis, to decrease the disease and treatment burden and to increase the disease survival rate, an attempt was made for early diagnosis of Retinoblastoma by including fundus examination in routine immunization programs. Methods- A unique immunization card is followed in a tertiary health care center where examination of pupillary reflex is made mandatory in each visit of the child for routine immunization. In case of any abnormality, the child is referred to the ophthalmology department. Conclusion- Early detection is the key in the management of retinoblastoma. Every child is brought to the health care system at least five times before the age of 2 years for routine immunization. We should not miss this golden opportunity for early detection of retinoblastoma.

Keywords: retinoblastoma, immunization, unique, early

Procedia PDF Downloads 198
6631 Mechanisms Underlying the Effects of School-Based Internet Intervention for Alcohol Drinking Behaviours among Chinese Adolescent

Authors: Keith T. S. Tung, Frederick K. Ho, Rosa S. Wong, Camilla K. M. Lo, Wilfred H. S. Wong, C. B. Chow, Patrick Ip

Abstract:

Objectives: Underage drinking is an important public health problem both locally and globally. Conventional prevention/intervention relies on unidirectional knowledge transfer such as mail leaflets or health talks which showed mixed results in changing the target behaviour. Previously, we conducted a school internet-based intervention which was found to be effective in reducing alcohol use among adolescents, yet the underlying mechanisms have not been properly investigated. This study, therefore, examined the mechanisms that explain how the intervention produced a change in alcohol drinking behaviours among Chinese adolescent as observed in our previous clustered randomised controlled trial (RCT) study. Methods: This is a cluster randomised controlled trial with parallel group design. Participating schools were randomised to the Internet intervention or the conventional health education group (control) with a 1:1 allocation ratio. Secondary 1–3 students of the participating schools were enrolled in this study. The Internet intervention was a web-based quiz game competition, in which participating students would answer 1,000 alcohol-related multiple-choice quiz questions. Conventional health education group received a promotional package on equivalent alcohol-related knowledge. The participants’ alcohol-related attitude, knowledge, and perceived behavioural control were self-reported before the intervention (baseline) and one month and three months after the intervention. Results: Our RCT results showed that participants in the Internet group were less likely to drink (risk ratio [RR] 0.79, p < 0.01) as well as in lesser amount (β -0.06, p < 0.05) compared to those in the control group at both post-intervention follow-ups. Within the intervention group, regression analyses showed that high quiz scorer had greater improvement in alcohol-related knowledge (β 0.28, p < 0.01) and attitude (β -0.26, p < 0.01) at 1 month after intervention, which in turn increased their perceived behavioural control against alcohol use (β 0.10 and -0.26, both p < 0.01). Attitude, compared to knowledge, was found to be a stronger contributor to the intervention effect on perceived behavioural control. Conclusions: Our internet-based intervention has demonstrated effectiveness in reducing the risk of underage drinking when compared with conventional health education. Our study results further showed an attitude to be a more important factor than knowledge in changing health-related behaviour. This has an important implication for future prevention/intervention on an underage drinking problem.

Keywords: adolescents, internet-based intervention, randomized controlled trial, underage drinking

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6630 Assessing Environmental Psychology and Health Awareness in Delhi: A Fundamental Query for Sustainable Urban Living

Authors: Swati Rajput

Abstract:

Environmental psychology explains that the person is a social agent that seeks to extract meaning from their built and natural environment to behave in a particular manner. It also shows the attachment or detachment of people to their environment. Assessing environmental psychology of people is imperative for planners and policy makers for urban planning. The paper investigates the environmental psychology of people living in nine districts of Delhi by calculating and assessing their Environmental Emotional Quotient (EEQ). Emotional Quotient deals with the ability to sense, understand, attach and respond according to the power of emotions. An Environmental Emotional Quotient has been formulated based upon the inventory administered to them. The respondents were asked questions related to their view and emotions about the green spaces, water resource conservation, air and environmental quality. An effort has been made to assess the feeling of belongingness among the residents. Their views were assessed on green spaces, reuse, and recycling of resources and their participation level. They were also been assessed upon health awareness level by considering both preventive and curative segments of health care. It was found that only 12 percent of the people is emotionally attached to their surroundings in the city. The emotional attachment reduces as we move away from the house to housing complex to neighbouring areas and rest of the city. In fact, the emotional quotient goes lower to lowest from house to other ends of the city. It falls abruptly after the radius of 1 km from the residence. The result also shows that nearly 54% respondents accept that there is environment pollution in their area. Around 47.8% respondents in the survey consider that diseases occur because of green cover depiction in their area. Major diseases are to airborne diseases like asthma and bronchitis. Seasonal disease prevalent, which specially occurred from last 3-4 years are malaria, dengue and chikengunya. Survey also shows that only 31 % of respondents visit government hospitals while 69% respondents visit private hospitals or small clinics for healthcare services. The paper suggests the need for environmental sensitive policies and need for green insurance in mega cities like Delhi.

Keywords: environmental psychology, environmental emotional quotient, preventive health care and curative health care, sustainable living

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6629 The State of Herb Medicine in Oriental Morocco: Cases of Debdou, Taourirt and Guerssif Districts

Authors: Himer Khalid, Alami Ilyass, Kharchoufa Loubna, Elachouri Mostafa

Abstract:

It has been estimated by the World Health Organization that 80% of the world's population relies on traditional medicine to meet their daily health requirements. In Morocco reliance on such medicine is partly owing to the high cost of conventional medicine and the inaccessibility of modern health care facilities. There was high agreement in the use of plants as medicine in Oriental Morocco. Our objective is to evaluate the informant’s knowledge on medicinal plants by the local population and to document the uses of medicinal plants by this community, for the treatment of different illnesses. Using an ethnopharmacological approach, we collected information concerning the traditional medicinal knowledge and the medicinal plants used, by interviewing successfully 458 informants living in oriental Morocco (from Debdou, Taourirt, Guersif a,d Laayoune districts). The data were analyzed by statistical methods (Component Analysis “CA”, Factorial Analysis “FA”) and other methods such as through Informant’s Consensus Factor (ICF) and Use Value (UV). Our results indicate that, more than 60% of the population in these regions relies on medicinal plants for the treatment of different ailments with predominance of women consumers. 135 plant species belonging to 61 families were documented. These plants were used by the population for the treatment of a group of illness (about 14 principal ailments). We conclude that, in oriental Morocco, till now, the population has some traditional knowledge commonly used as medical tradition. These wealthy heritage needs conservation and evaluation.

Keywords: Morocco, medicinal plants, traditional knowledge, wealthy heritage

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6628 Prescribed Organization of Nursing Work and Psychosocial Risks: A Cross-Sectional Study

Authors: Katerine Moraes dos Satons, Gisele Massante Peixoto Tracera, Regina Célia Gollner Zeitoune

Abstract:

To analyze the psychosocial risks related to the organization of nursing work in outpatient clinics of university hospitals. Cross-sectional epidemiological study developed in 11 outpatient units linked to the three public universities of the city of Rio de Janeiro, Brazil. Participants were 388 nursing professionals who worked in patient care at the time of the research. Data were collected from July to December 2018, using a self-applicable instrument. A questionnaire was used for sociodemographic, occupational and health characterization, and the Work Organization Scale. The bivariate analyses were performed using the odds ratio (OR), with a confidence interval of 95%, significance level of 5%. The organization of nursing work received an assessment of medium psychosocial risk by the professionals participating in the research, demanding interventions in the short and medium term. There was no association between sociodemographic, occupational and health characteristics and the organization of outpatient work. Interventional measures should be performed in the psychosocial risk factors presented in this research, with a view to improving the work environment, so that the importance of maintaining satisfactory material conditions is considered, as well as the adequate quantity of human resources. In addition, it aims to expand the spaces of nursing participation in decision- making, strengthening its autonomy as a profession.

Keywords: occupational risks, nursing, nursing team, worker’s health, psychosocial risks

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6627 Global Health, Humanitarian Medical Aid, and the Ethics of Rationing

Authors: N. W. Paul, S. Michl

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In our globalized world we need to appreciate the fact that questions of health and justice need to be addressed on a global scale, too. The way in which diverse governmental and non-governmental initiatives are trying to answer the need for humanitarian medical aid has long since been a visible result of globalized responsibility. While the intention of humanitarian medical aids seems to be evident, the allocation of resources has become more and more an ethical and societal challenge. With a rising number and growing dimension of humanitarian catastrophes around the globe the search for ethically justifiable ways to decide who might benefit from limited resources has become a pressing question. Rooted in theories of justice (Rawls) and concepts of social welfare (Sen) we developed and implemented a model for an ethically sound distribution of a limited annual budget for humanitarian care in one of the largest medical universities of Germany. Based on our long lasting experience with civil casualties of war (Afghanistan) and civil war (Libya) as well as with under- and uninsured and/or stateless patients we are now facing the on-going refugee crisis as our most recent challenge in terms of global health and justice. Against this background, the paper strives to a) explain key issues of humanitarian medical aid in the 21st century, b) explore the problem of rationing from an ethical point of view, c) suggest a tool for the rational allocation of scarce resources in humanitarian medical aid, d) present actual cases of humanitarian care that have been managed with our toolbox, and e) discuss the international applicability of our model beyond local contexts.

Keywords: humanitarian care, medical ethics, allocation, rationing

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6626 The Impact of Multiple Stressors on the Functioning and Resilience of Model Freshwater Ecosystems

Authors: Sajida Saqira, Anthony Chariton, Grant C. Hose

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The Anthropocene has seen dramatic environmental changes which are affecting every ecosystem on earth. Freshwater ecosystems are particularly vulnerable as they are at risk from the many activities that go on and contaminants that are released in catchments. They are thus subject to many stressors simultaneously. Freshwater ecosystems respond to stress at all levels of biological organization, from subcellular to community structure and ecosystem functioning. The aim of this study was to examine the resistance and resilience of freshwater ecosystems to multiple stressors. Here we explored the individual and combined effects of copper as a chemical stressor and common carp (Cyprinus carpio) as a biological stressor on the health, functioning, and recovery of outdoor experimental pond ecosystems in a long-term, controlled, factorial experiment. Primary productivity, decomposition, and water and sediment quality were analysed at regular intervals for one year to understand the health and functioning of the ecosystems. Changes to benthic biota were quantified using DNA-based and traditional microscopy-based counts of invertebrates. Carp were added to the ponds to copper contaminated sediments (with controls) to explore the combined effects of copper and carp and removed after six months to explore the resilience and recovery of the system. The outcomes of this study will advance our understanding of the impacts of multiple stressors on freshwater ecosystems, and the resilience of these systems to copper and C. carpio, which are both globally significant stressors in freshwater systems.

Keywords: carp, copper, ecosystem health, freshwater ecosystem, multiple stressors

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6625 The Advancement of Smart Cushion Product and System Design Enhancing Public Health and Well-Being at Workplace

Authors: Dosun Shin, Assegid Kidane, Pavan Turaga

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According to the National Institute of Health, living a sedentary lifestyle leads to a number of health issues, including increased risk of cardiovascular dis-ease, type 2 diabetes, obesity, and certain types of cancers. This project brings together experts in multiple disciplines to bring product design, sensor design, algorithms, and health intervention studies to develop a product and system that helps reduce the amount of time sitting at the workplace. This paper illustrates ongoing improvements to prototypes the research team developed in initial research; including working prototypes with a software application, which were developed and demonstrated for users. Additional modifications were made to improve functionality, aesthetics, and ease of use, which will be discussed in this paper. Extending on the foundations created in the initial phase, our approach sought to further improve the product by conducting additional human factor research, studying deficiencies in competitive products, testing various materials/forms, developing working prototypes, and obtaining feedback from additional potential users. The solution consisted of an aesthetically pleasing seat cover cushion that easily attaches to common office chairs found in most workplaces, ensuring a wide variety of people can use the product. The product discreetly contains sensors that track when the user sits on their chair, sending information to a phone app that triggers reminders for users to stand up and move around after sitting for a set amount of time. This paper also presents the analyzed typical office aesthetics and selected materials, colors, and forms that complimented the working environment. Comfort and ease of use remained a high priority as the design team sought to provide a product and system that integrated into the workplace. As the research team continues to test, improve, and implement this solution for the sedentary workplace, the team seeks to create a viable product that acts as an impetus for a more active workday and lifestyle, further decreasing the proliferation of chronic disease and health issues for sedentary working people. This paper illustrates in detail the processes of engineering, product design, methodology, and testing results.

Keywords: anti-sedentary work behavior, new product development, sensor design, health intervention studies

Procedia PDF Downloads 158
6624 2016 Taiwan's 'Health and Physical Education Field of 12-Year Basic Education Curriculum Outline (Draft)' Reform and Its Implications

Authors: Hai Zeng, Yisheng Li, Jincheng Huang, Chenghui Huang, Ying Zhang

Abstract:

Children are strong; the country strong, the development of children Basketball is a strategic advantage. Common forms of basketball equipment has been difficult to meet the needs of young children teaching the game of basketball, basketball development for 3-6 years old children in the form of appropriate teaching aids is a breakthrough basketball game teaching children bottlenecks, improve teaching critical path pleasure, but also the development of early childhood basketball a necessary requirement. In this study, literature, questionnaires, focus group interviews, comparative analysis, for domestic and foreign use of 12 kinds of basketball teaching aids (cloud computing MINI basketball, adjustable basketball MINI, MINI basketball court, shooting assist paw print ball, dribble goggles, dribbling machine, machine cartoon shooting, rebounding machine, against the mat, elastic belt, ladder, fitness ball), from fun and improve early childhood shooting technique, dribbling technology, as well as offensive and defensive rebounding against technology conduct research on conversion technology. The results show that by using appropriate forms of teaching children basketball aids, can effectively improve children's fun basketball game, targeted to improve a technology, different types of aids from different perspectives enrich the connotation of children basketball game. Recommended for children of color psychology, cartoon and environmentally friendly material production aids, and increase research efforts basketball aids children, encourage children to sports teachers aids applications.

Keywords: health and physical education field of curriculum outline, health fitness, sports and health curriculum reform, Taiwan, twelve years basic education

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6623 Development of Ready Reckoner Charts for Easy, Convenient, and Widespread Use of Horrock’s Apparatus by Field Level Health Functionaries in India

Authors: Gumashta Raghvendra, Gumashta Jyotsna

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Aim and Objective of Study : The use of Horrock’s Apparatus by health care worker requires onsite mathematical calculations for estimation of ‘volume of water’ and ‘amount of bleaching powder’ necessary as per the serial number of first cup showing blue coloration after adding freshly prepared starch-iodide indicator solution. In view of the difficulties of two simultaneous calculations required to be done, the use of Horrock’s Apparatus is not routinely done by health care workers because it is impractical and inconvenient Material and Methods: Arbitrary use of bleaching powder in wells results in hyper-chlorination or hypo-chlorination of well defying the purpose of adequate chlorination or non-usage of well water due to hyper-chlorination. Keeping this in mind two nomograms have been developed, one to assess the volume of well using depth and diameter of well and the other to know the quantity of bleaching powder to b added using the number of the cup of Horrock’s apparatus which shows the colour indication. Result & Conclusion: Out of thus developed two self-speaking interlinked easy charts, first chart will facilitate bypassing requirement of formulae ‘πr2h’ for water volume (ready reckoner table with depth of water shown on ‘X’ axis and ‘diameter of well’ on ‘Y’ axis) and second chart will facilitate bypassing requirement formulae ‘2ab/455’ (where ‘a’ is for ‘serial number of cup’ and ‘b’ is for ‘water volume’, while ready reckoner table showing ‘water volume’ shown on ‘X’ axis and ‘serial number of cup’ on ‘Y’ axis). The use of these two charts will help health care worker to immediately known, by referring the two charts, about the exact requirement of bleaching powder. Thus, developed ready reckoner charts will be easy and convenient to use for ensuring prevention of water-borne diseases occurring due to hypo-chlorination, especially in rural India and other developing countries.

Keywords: apparatus, bleaching, chlorination, Horrock’s, nomogram

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6622 Navigating States of Emergency: A Preliminary Comparison of Online Public Reaction to COVID-19 and Monkeypox on Twitter

Authors: Antonia Egli, Theo Lynn, Pierangelo Rosati, Gary Sinclair

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The World Health Organization (WHO) defines vaccine hesitancy as the postponement or complete denial of vaccines and estimates a direct linkage to approximately 1.5 million avoidable deaths annually. This figure is not immune to public health developments, as has become evident since the global spread of COVID-19 from Wuhan, China in early 2020. Since then, the proliferation of influential, but oftentimes inaccurate, outdated, incomplete, or false vaccine-related information on social media has impacted hesitancy levels to a degree described by the WHO as an infodemic. The COVID-19 pandemic and related vaccine hesitancy levels have in 2022 resulted in the largest drop in childhood vaccinations of the 21st century, while the prevalence of online stigma towards vaccine hesitant consumers continues to grow. Simultaneously, a second disease has risen to global importance: Monkeypox is an infection originating from west and central Africa and, due to racially motivated online hate, was in August 2022 set to be renamed by the WHO. To better understand public reactions towards two viral infections that became global threats to public health no two years apart, this research examines user replies to threads published by the WHO on Twitter. Replies to two Tweets from the @WHO account declaring COVID-19 and Monkeypox as ‘public health emergencies of international concern’ on January 30, 2020, and July 23, 2022, are gathered using the Twitter application programming interface and user mention timeline endpoint. Research methodology is unique in its analysis of stigmatizing, racist, and hateful content shared on social media within the vaccine discourse over the course of two disease outbreaks. Three distinct analyses are conducted to provide insight into (i) the most prevalent topics and sub-topics among user reactions, (ii) changes in sentiment towards the spread of the two diseases, and (iii) the presence of stigma, racism, and online hate. Findings indicate an increase in hesitancy to accept further vaccines and social distancing measures, the presence of stigmatizing content aimed primarily at anti-vaccine cohorts and racially motivated abusive messages, and a prevalent fatigue towards disease-related news overall. This research provides value to non-profit organizations or government agencies associated with vaccines and vaccination programs in emphasizing the need for public health communication fitted to consumers' vaccine sentiments, levels of health information literacy, and degrees of trust towards public health institutions. Considering the importance of addressing fears among the vaccine hesitant, findings also illustrate the risk of alienation through stigmatization, lead future research in probing the relatively underexamined field of online, vaccine-related stigma, and discuss the potential effects of stigma towards vaccine hesitant Twitter users in their decisions to vaccinate.

Keywords: social marketing, social media, public health communication, vaccines

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6621 Predictors of Motor and Cognitive Domains of Functional Performance after Rehabilitation of Individuals with Acute Stroke

Authors: A. F. Jaber, E. Dean, M. Liu, J. He, D. Sabata, J. Radel

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Background: Stroke is a serious health care concern and a major cause of disability in the United States. This condition impacts the individual’s functional ability to perform daily activities. Predicting functional performance of people with stroke assists health care professionals in optimizing the delivery of health services to the affected individuals. The purpose of this study was to identify significant predictors of Motor FIM and of Cognitive FIM subscores among individuals with stroke after discharge from inpatient rehabilitation (typically 4-6 weeks after stroke onset). A second purpose is to explore the relation among personal characteristics, health status, and functional performance of daily activities within 2 weeks of stroke onset. Methods: This study used a retrospective chart review to conduct a secondary analysis of data obtained from the Healthcare Enterprise Repository for Ontological Narration (HERON) database. The HERON database integrates de-identified clinical data from seven different regional sources including hospital electronic medical record systems of the University of Kansas Health System. The initial HERON data extract encompassed 1192 records and the final sample consisted of 207 participants who were mostly white (74%) males (55%) with a diagnosis of ischemic stroke (77%). The outcome measures collected from HERON included performance scores on the National Institute of Health Stroke Scale (NIHSS), the Glasgow Coma Scale (GCS), and the Functional Independence Measure (FIM). The data analysis plan included descriptive statistics, Pearson correlation analysis, and Stepwise regression analysis. Results: significant predictors of discharge Motor FIM subscores included age, baseline Motor FIM subscores, discharge NIHSS scores, and comorbid electrolyte disorder (R2 = 0.57, p <0.026). Significant predictors of discharge Cognitive FIM subscores were age, baseline cognitive FIM subscores, client cooperative behavior, comorbid obesity, and the total number of comorbidities (R2 = 0.67, p <0.020). Functional performance on admission was significantly associated with age (p < 0.01), stroke severity (p < 0.01), and length of hospital stay (p < 0.05). Conclusions: our findings show that younger age, good motor and cognitive abilities on admission, mild stroke severity, fewer comorbidities, and positive client attitude all predict favorable functional outcomes after inpatient stroke rehabilitation. This study provides health care professionals with evidence to evaluate predictors of favorable functional outcomes early at stroke rehabilitation, to tailor individualized interventions based on their client’s anticipated prognosis, and to educate clients about the benefits of making lifestyle changes to improve their anticipated rate of functional recovery.

Keywords: functional performance, predictors, stroke, recovery

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6620 The Specificity of Mother's Attitude to a Preschool Child Having Complex Disorders: The Key to Adaptive Functioning

Authors: Alla Tvardovskaya

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The family of a child with disabilities is an important mechanism of socialization. The relationship of mother and child with developmental difficulties is a significant predictor of the emergence, development and interiorization of various forms of mental activity. Complex impairments of the child form nonconstructive maternal attitude and destructive behavior strategies that complicate the dyadic relationship ‘mother-child’. The study of psychological characteristics of mother's personality was conducted within four years, and adaptive abilities of a child with a complex disorder were evaluated as well. 25 diads (25 mothers and 25 preschool children aged between 4-7 years with complex developmental disorders) took part in the study. Typological features of mothers rearing deafblind preschoolers are described. Constructive and non-constructive types of mothers’ attitude to a pre-school child with complex disorders are specified. The research shows that mothers of deafblind children are more depressed, they are engaged in children’s rearing more, and at the same time they experience difficulties to control negative emotions towards children or demonstrate impulsive behavior with a high level of anxiety. The correlation analysis of relationships between Vineland scales and the dominant type of mothers’ attitude to a child shows the presence of both general and specific links. Adaptive profile analysis of a child with complex disabilities allows to plan specific ways to increase their adaptation by developing a dyadic constructive relationship system. Techniques to develop constructive parental attitudes toward the child are proposed.

Keywords: adaptive behavior, complex disorder, constructive maternal attitude, deaf-blindness, pre-school child

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6619 Educational Attainment Inequalities in Depressive Symptoms in More Than 100 000 Individuals in Europe

Authors: Adam Chlapecka, Anna Kagstrom, Pavla Cermakova

Abstract:

Background: Increasing educational attainment (EA) could decrease the occurrence of depression. We investigated the relationship between EA and depressive symptoms in older individuals across four European regions. Methods: We studied 108 315 Europeans (54 % women, median age 63 years old) from the Survey on Health, Ageing and Retirement in Europe assessing EA (7 educational levels based on ISCED classification); and depressive symptoms (≥ 4 points on EURO-D scale). Logistic regression estimated the association between EA and depressive symptoms, adjusting for sociodemographic and health-related factors; testing for sex/age/region and education interactions. Results: Higher EA was associated with lower odds of depressive symptoms, independent of sociodemographic and health-related factors. A threshold of the lowest odds of depressive symptoms was detected at the first stage of tertiary education (OR 0.60; 95% CI 0.55-0.65; p<0.001; relative to no education). Central and Eastern Europe showed the strongest association (OR for high vs. low education 0.37; 95% CI 0.33-0.40; p<0.001) and Scandinavia the weakest (OR for high vs. low education 0.69; 95% CI 0.60-0.80; p<0.001). The association was strongest amongst younger individuals. There was a sex and education interaction only within Central and Eastern Europe. Conclusion: The level of EA is reflected in later-life depressive symptoms, suggesting that supporting individuals in achieving EA, and considering those with lower EA at increased risk for depression, could lead to the decreased burden of depression across the life course. Further educational support in Central and Eastern Europe may decrease the higher burden of depressive symptoms in women.

Keywords: depression, education, epidemiology, Europe

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6618 Investigate the Movement of Salt-Wedge at Co Chien Estuary, Vietnam in the Context of Climate Change and Reduce Upstream Flow Using 3D Model

Authors: Hieu Duy Nguyen, Chitsan Lin Jr., Dung Duc Tran

Abstract:

Nowadays, drought and salinity intrusion becomes a severe problem in the Lower Mekong region due to climate change, especially in coastal provinces. Freshwater resources are decreased due to sea-level rise and the decline in water flow from upstream in the dry season. The combination of the above issues can lead to many effects on the environment and human health in affected areas such as the pathological of digestive or decreased the immune system. Tidal cycle and upstream flows are the two main factors affecting the saline intrusion process and the former salt-wedge in the estuary. Under suitable conditions, salt-wedge can be going further upstream under the water surface and affected groundwater. In order to have a proper plan for the mitigation of the above adverse effects, we need to understand the characteristics of this process. In this study, 3D model is used to investigate the movement of salt-wedge under different conditions of tidal and flow discharge. The salinity in the vertical profile is also measured in the dry season of 2017 and 2018 for model calibrating. The data has proved that there is the presence of salt-wedge in the study area. The obtained results will help strategic planners to use and preserve water resources more effectively and serve as a basis for new research directions on saline intrusion and human health.

Keywords: salt-wedge, salinity intrusion, human health, 3D model

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6617 Leveraging Artificial Intelligence to Analyze the Interplay between Social Vulnerability Index and Mobility Dynamics in Pandemics

Authors: Joshua Harrell, Gideon Osei Bonsu, Susan Garza, Clarence Conner, Da’Neisha Harris, Emma Bukoswki, Zohreh Safari

Abstract:

The Social Vulnerability Index (SVI) stands as a pivotal tool for gauging community resilience amidst diverse stressors, including pandemics like COVID-19. This paper synthesizes recent research and underscores the significance of SVI in elucidating the differential impacts of crises on communities. Drawing on studies by Fox et al. (2023) and Mah et al. (2023), we delve into the application of SVI alongside emerging data sources to uncover nuanced insights into community vulnerability. Specifically, we explore the utilization of SVI in conjunction with mobility data from platforms like SafeGraph to probe the intricate relationship between social vulnerability and mobility dynamics during the COVID-19 pandemic. By leveraging 16 community variables derived from the American Community Survey, including socioeconomic status and demographic characteristics, SVI offers actionable intelligence for guiding targeted interventions and resource allocation. Building upon recent advancements, this paper contributes to the discourse on harnessing AI techniques to mitigate health disparities and fortify public health resilience in the face of pandemics and other crises.

Keywords: social vulnerability index, mobility dynamics, data analytics, health equity, pandemic preparedness, targeted interventions, data integration

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6616 Depression in Non Hospitalized Jordanian Patients with Coronary Artery Disease

Authors: Ibtisam Al-Zaru

Abstract:

Background: Worldwide, depression among coronary artery disease (CAD) patients is considered a serious problem that may cause many complications and negative consequences; particularly serious being increased mortality and morbidity rate. Studying depression among CAD patients in Jordan has not been investigated thoroughly and thus a need for further studies has been a priority. Aims: To assess depression in non-hospitalized Jordanian patients with CAD; to describe the relationship between socio-demographic data, health related factors, and depression; and to examine the best predictors of depression in non-hospitalized Jordanian patients with CAD. Method: A cross-sectional-descriptive design was used to collect data from 174 non-hospitalized Jordanian patients diagnosed with CAD in outpatients’ cardiac clinics, using a self- administered questionnaires and Cardiac Depression Scale. Results: 53.4% of CAD patients reported mild/moderate, and severe depressive symptoms. Significant relationships between depressive symptoms and some demo-clinical characteristics (i.e. being female gender; having of chronic disease and surgical history; being physically inactive, and perceived their sexual activity, physical and psychological as poor). The preceding factors are also found to be statistically significant predictors for depression among this patients’ group. Conclusion: Jordanian patients with CAD had various levels of severity regarding their depressive symptoms. Therefore, health care providers need to introduce depression assessment and treatment in cardiac rehabilitation to control depression and its impact on the patient. Consequently, such control will reduce co-morbidity, mortality, complications and health costs among CAD patients and enhance the quality of their lives.

Keywords: coronary artery disease, predictors, depression, prevalence

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6615 Potential Risk Assessment Due to Groundwater Quality Deterioration and Quantifying the Major Influencing Factors Using Geographical Detectors in the Gunabay Watershed of Ethiopia

Authors: Asnakew Mulualem Tegegne, Tarun Kumar Lohani, , Abunu Atlabachew Eshete

Abstract:

Groundwater quality has become deteriorated due to natural and anthropogenic activities. Poor water quality has a potential risk to human health and the environment. Therefore, the study aimed to assess the potential risk of groundwater quality contamination levels and public health risks in the Gunabay watershed. For this task, seventy-eight groundwater samples were collected from thirty-nine locations in the dry and wet seasons during 2022. The ground water contamination index was applied to assess the overall quality of groundwater. Six major driving forces (temperature, population density, soil, land cover, recharge, and geology) and their quantitative impact of each factor on groundwater quality deterioration were demonstrated using Geodetector. The results showed that low groundwater quality was detected in urban and agricultural land. Especially nitrate contamination was highly linked to groundwater quality deterioration and public health risks, and a medium contamination level was observed in the area. This indicates that the inappropriate application of fertilizer on agricultural land and wastewater from urban areas has a great impact on shallow aquifers in the study area. Furthermore, the major influencing factors are ranked as soil type (0.33–0.31)>recharge (0.17–0.15)>temperature (0.13–0.08)>population density (0.1–0.08)>land cover types (0.07– 0.04)>lithology (0.05–0.04). The interaction detector revealed that the interaction between soil ∩ recharge, soil ∩ temperature, and soil ∩ land cover, temperature ∩ recharge is more influential to deteriorate groundwater quality in both seasons. Identification and quantification of the major influencing factors may provide new insight into groundwater resource management.

Keywords: groundwater contamination index, geographical detectors, public health · influencing factors, and water resources management

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6614 Inducing Flow Experience in Mobile Learning: An Experiment Using a Spanish Learning Mobile Application

Authors: S. Jonsson, D. Millard, C. Bokhove

Abstract:

Smartphones are ubiquitous and frequently used as learning tools, which makes the design of educational apps an important area of research. A key issue is designing apps to encourage engagement while maintaining a focus on the educational aspects of the app. Flow experience is a promising method for addressing this issue, which refers to a mental state of cognitive absorption and positive emotion. Flow experience has been shown to be associated with positive emotion and increased learning performance. Studies have shown that immediate feedback is an antecedent to Flow. This experiment investigates the effect of immediate feedback on Flow experience. An app teaching Spanish phrases was developed, and 30 participants completed both a 10min session with immediate feedback and a 10min session with delayed feedback. The app contained a task where the user assembles Spanish phrases by pressing bricks with Spanish words. Immediate feedback was implemented by incorrect bricks recoiling, while correct brick moved to form part of the finished phrase. In the delayed feedback condition, the user did not know if the bricks they pressed were correct until the phrase was complete. The level of Flow experienced by the participants was measured after each session using the Flow Short Scale. The results showed that higher levels of Flow were experienced in the immediate feedback session. It was also found that 14 of the participants indicated that the demands of the task were ‘just right’ in the immediate feedback session, while only one did in the delayed feedback session. These results have implications for how to design educational technology and opens up questions for how Flow experience can be used to increase performance and engagement.

Keywords: feedback timing, flow experience, L2 language learning, mobile learning

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6613 Preparing Undergraduate Nursing and Midwifery Students for Culturally Competent Health Care: A Qualitative Study

Authors: Olayide Ogunsiji, Glenda McDonald

Abstract:

Engendering cultural competence in nursing and midwifery students is germane to reducing disparities in contemporary health care settings, increasingly patronized by people from diverse background. Professional standards for registration in Australia require nurses and midwives to be culturally competent. Nursing and midwifery academics worldwide are responsible for preparing students for clinical practice, yet limited attention is paid to exploring how students are being prepared to care for a culturally diverse population. This paper provides insight into the perceptions of academics about how they are preparing undergraduate nursing and midwifery students for culturally competent health care. Academics were drawn from a tertiary educational institution in metropolitan Australia. They responded to a generic email indicating their interest in participating in the study. A total of nine academics who have taught undergraduate nursing and midwifery students in a unit that focused on health and illness perspectives for culturally diverse communities; and provided written consent to participate were included. These academics were engaged in a qualitative digitally-recorded semi-structured face-to-face or telephone interviews which lasted for about 45-60 minutes. Interview data were transcribed verbatim. Through constant comparison, three themes emerged: experiences of the teachers, strategies used for preparing students and challenges in preparing students. The participants spoke about their experiences of teaching in the unit and with the students. They faced challenges related to physical and relational space. They utilised a number of didactic approaches in teaching the unit and critiqued the adequacy of the content in preparing students for practice. This study demonstrated that didactic classroom approaches need to be supported with clinical practice and cultural immersion for a meaningful preparation of nursing and midwifery students to care for culturally diverse populations.

Keywords: cultural competence, nursing students, preparation, undergraduate

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6612 Identifying Knowledge Gaps in Incorporating Toxicity of Particulate Matter Constituents for Developing Regulatory Limits on Particulate Matter

Authors: Ananya Das, Arun Kumar, Gazala Habib, Vivekanandan Perumal

Abstract:

Regulatory bodies has proposed limits on Particulate Matter (PM) concentration in air; however, it does not explicitly indicate the incorporation of effects of toxicities of constituents of PM in developing regulatory limits. This study aimed to provide a structured approach to incorporate toxic effects of components in developing regulatory limits on PM. A four-step human health risk assessment framework consists of - (1) hazard identification (parameters: PM and its constituents and their associated toxic effects on health), (2) exposure assessment (parameters: concentrations of PM and constituents, information on size and shape of PM; fate and transport of PM and constituents in respiratory system), (3) dose-response assessment (parameters: reference dose or target toxicity dose of PM and its constituents), and (4) risk estimation (metric: hazard quotient and/or lifetime incremental risk of cancer as applicable). Then parameters required at every step were obtained from literature. Using this information, an attempt has been made to determine limits on PM using component-specific information. An example calculation was conducted for exposures of PM2.5 and its metal constituents from Indian ambient environment to determine limit on PM values. Identified data gaps were: (1) concentrations of PM and its constituents and their relationship with sampling regions, (2) relationship of toxicity of PM with its components.

Keywords: air, component-specific toxicity, human health risks, particulate matter

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6611 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships

Authors: Shelley Y. Hawkins

Abstract:

Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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6610 Minimizing thought Communication Gap between Designer and Client Using the Projective Personality Tests

Authors: Hira, Nisar Bhatti, Ezza

Abstract:

Contemporary studies support the strong co-relation between psychology and design. This study elaborates how different psychological personality test can help a fashion designer to judge the needs of their clients with respect to the customized clothing. This study will also help the designer to improve the lacking in the personality and will enable him to put his effort in required areas for grooming the customer. The use of psychology test to support the choice of certain design strategies that how the right clothing can make client a better intellectual with enhanced self-esteem and confidence. Different projective personality test are being used to suggest to evaluate personality traits. The Rorschach Inkblot Test is projective mental comprising of 10 ink-blots synonymous with the clinical brain research. Lüsher Color Diagnostics measures a person’s psycho physical state, his or her ability to withstand stress to perform and communicate. HTP is a projective responsibility test measuring self-perception, attitudes. The TAT test intend to evaluate a person’s patterns of thoughts, attitudes, observation, capacity and emotional response to this ambiguous test materials. No doubt designers are already crucially redesigning the individuals by their attires, but to expose the behavioral mechanism of the customer, designers should be able to recognize the hidden complexity behind his client by using the above mentioned methods. The study positively finds the design and psychology need to become substantially contacted in order to create a new regime of norms to groom a personality under the concentration and services of a fashion designer in terms of clothing.

Keywords: projective personality tests, customized clothing, Rorschach Inkblot Test, TAT, HTP, Lüsher Color Diagnostics

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6609 A Linear Regression Model for Estimating Anxiety Index Using Wide Area Frontal Lobe Brain Blood Volume

Authors: Takashi Kaburagi, Masashi Takenaka, Yosuke Kurihara, Takashi Matsumoto

Abstract:

Major depressive disorder (MDD) is one of the most common mental illnesses today. It is believed to be caused by a combination of several factors, including stress. Stress can be quantitatively evaluated using the State-Trait Anxiety Inventory (STAI), one of the best indices to evaluate anxiety. Although STAI scores are widely used in applications ranging from clinical diagnosis to basic research, the scores are calculated based on a self-reported questionnaire. An objective evaluation is required because the subject may intentionally change his/her answers if multiple tests are carried out. In this article, we present a modified index called the “multi-channel Laterality Index at Rest (mc-LIR)” by recording the brain activity from a wider area of the frontal lobe using multi-channel functional near-infrared spectroscopy (fNIRS). The presented index aims to measure multiple positions near the Fpz defined by the international 10-20 system positioning. Using 24 subjects, the dependencies on the number of measuring points used to calculate the mc-LIR and its correlation coefficients with the STAI scores are reported. Furthermore, a simple linear regression was performed to estimate the STAI scores from mc-LIR. The cross-validation error is also reported. The experimental results show that using multiple positions near the Fpz will improve the correlation coefficients and estimation than those using only two positions.

Keywords: frontal lobe, functional near-infrared spectroscopy, state-trait anxiety inventory score, stress

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6608 Rabies Free Pakistan - Eliminating Rabies Through One Health Approach

Authors: Anzal Abbas Jaffari, Wajiha Javed, Naseem Salahuddin

Abstract:

Rationale: Rabies, a vaccine preventable disease, continues to be a critical public health issue as it kills around 2000-5000 people annually in Pakistan. Along with the disease spread among animals, the dog population remains a victim of brutal culling practices by the local authorities, which adversely affects ecosystem (sinking of poison in the soil – affecting vegetation & contaminating water) and the disease spread. The dog population has been exponentially rising primarily because a lack of a consolidated nationwide Animal Birth Control program and awareness among the local communities in general and children in particular. This is reflected in Pakistan’s low SARE score - 1.5, which makes the country trails behind other developing countries like Bangladesh (2.5) and Philippines (3.5).According to an estimate, the province of Sindh alone is home to almost 2.5 million dogs. The clustering of dogs in Peri-Urban areas and inner cities localities leads to an increase of reported dog bite cases in these areas specifically. Objective: Rabies Free Pakistan (RFP), which is a joint venture of Getz Pharma Private Limited and Indus Hospital & Health Network (IHHN); it was established in 2018 to eliminate Rabies from Pakistan by 2030 using the One Health Approach. Methodology: The RFP team is actively working on advocacy and policy front with both the Federal & Provincial government to ensure that all stakeholders currently involved in dog culling in Pakistan have a paradigm shift towards humane methods of vaccination and ABC. Along with the federal government, RFP aims to declare Rabies as a notifiable disease. Whereas RFP closely works with the provincial government of Sindh to initiate a province wide Rabies Control Program.RFP program follows international standards and WHO approved protocols for this program in Pakistan.RFP team has achieved various milestones in the fight against Rabies after successfully scaling up project operations and has vaccinated more than 30,000 dogs and neutered around 7,000 dogs since 2018. Recommendations: Effective implementation of Rabies program (MDV and ABC) requires a concentrated effort to address a variety of structural and policy challenges. This essentially demands a massive shift in the attitude of individuals towards rabies. The two most significant challenges in implementing a standard policy at the structural level are lack of institutional capacity, shortage of vaccine, and absence of inter-departmental coordination among major stakeholders: federal government, provincial ministry of health, livestock, and local bodies (including local councils). The lack of capacity in health care workers to treat dog bite cases emerges as a critical challenge at the clinical level. Conclusion: Pakistan can learn from the successful international models of Sri Lanka and Mexico as they adopted the One Health Approach to eliminate rabies like RFP. The WHO advised One Health approach provides the policymakers with an interactive and cross-sectoral guide, which involves all the essential elements of the eco system (including animals, humans, and other components).

Keywords: animal birth control, dog population, mass dog vaccination, one health, rabies elimination

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6607 Lessons Learned from Implementation of Remote Pregnant and Newborn Care Service for Vulnerable Women and Children During COVID-19 and Political Crisis in Myanmar

Authors: Wint Wint Thu, Htet Ko Ko Win, Myat Mon San, Zaw Lin Tun, Nandar Than Aye, Khin Nyein Myat, Hayman Nyo Oo, Nay Aung Lin, Kusum Thapa, Kyaw Htet Aung

Abstract:

Background: In Myanmar, the intense political instability happened to start in Feb-2021, while the COVID-19 pandemic waves are also threatening the public health system, which subsequently led to severe health sector crisis, including difficulties in accessing maternal and newborn health care for vulnerable women and children. The Remote Pregnant and Newborn Care (RPNC) uses a telehealth approach United States Agency for International Development (USAID)-funded Essential Health Project. Implementation: The Remote Pregnant and Newborn Care (RPNC) service has adapted to the MNCH needs of vulnerable pregnant women and was implemented to mitigate the risk of limited access to essential quality MNH care in Yangon, Myanmar, under women, and the project trained 13 service providers on a telehealth care package for pregnancy and newborn developed Jhpiego to ensure understanding of evidence-based MNCH care practices. The phone numbers of the pregnant women were gathered through the preexisting and functioning community volunteers, who reach the most vulnerable pregnant women in the project's targeted area. A total of 212 pregnant women have been reached by service providers for RPNC during the implementation period. The trained service providers offer quality antenatal and postnatal care, including newborn care, via telephone calls. It includes 24/7 incoming calls and time-allotted outgoing calls to the pregnant women during antenatal and postnatal periods, including the newborn care. The required data were collected daily in time with the calls, and the quality of the medical services is made assured with the track of the calls, ensuring data privacy and patient confidentiality. Lessons learned: The key lessons are 1) cost-effectiveness: RPNC service could reduce out of pocket expenditure of pregnant women as it only costs 1.6 United States dollars (USD) per one telehealth call while it costs 8 to 10 USD per one time in-person care service at private service providers, including transportation cost, 2) network of care: telehealth call could not replace the in-person antenatal and postnatal care services, and integration of telehealth calls with in-person care by local healthcare providers with the support of the community is crucial for accessibility to essential MNH services by poor and vulnerable women, and 3) sharing information on health access points: most of the women seem to have financial barriers in accessing private health facilities while public health system collapse and telehealthcare could provide information on low-cost facilities and connect women to relevant health facilities. These key lessons are important for future efforts regarding the implementation of remote pregnancy and newborn care in Myanmar, especially during the political crisis and COVID-19 pandemic situation.

Keywords: telehealth, accessibility, maternal care, newborn care

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