Search results for: medical and health sciences
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 11484

Search results for: medical and health sciences

8304 Factors Associated with Suicidal Ideation among Undergraduate College Students

Authors: Samantha Vennice G. Sarcia

Abstract:

A person dies every 40 seconds throughout the world due to suicide-related behaviors. Suicidal ideation is a strong precursor to suicide completion. It is one of the major health challenges faced by the world today thus, it is highly substantial. The present study investigated the influence of personality traits and socio-demographic characteristics in predicting suicidal ideation. Using the Suicide Behaviors Questionnaire-Revised and the Big Five Inventory, the degree of suicidal ideation and the associated personality traits were identified. Out of 194 students from the allied health courses, the findings suggest that the college students are at-risk and have passive thoughts about suicide. Using multiple regression analysis, there was an identified significant relationship among the factors associated with suicidal ideation, particularly the number of persons in the household, living arrangement, attendance in church activities, agreeableness, conscientiousness, and neuroticism. Findings can help in the development of campus-based suicide prevention programs.

Keywords: depression, personality traits, suicidal ideation, suicide

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8303 Prevalence of Common Mental Disorders and Its Correlation with Mental Toughness among Professional South African Rugby Players

Authors: H. B. Grobler, K. Du Plooy, P. Kruger, S. Ellis

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Objectives: The primary objective of the study was to determine the common mental disorders (CMD) identified by professional South African rugby players and its correlation with their mental toughness, as a first step towards developing such a programme within a larger research project. Design: Survey research, within the theoretical perspective of field theory, was conducted, utilising an adaptation of an already existing mental health questionnaire. The aim was to obtain feedback from as many possible professional South African rugby players in order to make certain generalizations and come to conclusions with regard to the current mental health experiences of these rugby players. Methods: Non-randomized sampling was done, linking it with internet research in the form of the online completion of a questionnaire. A sample of 215 rugby players participated and completed the online questionnaire. Permission was obtained to make use of an existing questionnaire, previously used by the specific authors with retired professional rugby players. A section on mental toughness was added. Data were descriptively analysed by means of the SPSS software platform. Results: Results indicated that the most significant problem that the players are experiencing, is a problem with alcohol (47.9%). Other problems that featured are distress (16.3%), sleep disturbances (7%), as well as anxiety and depression (4.2%). 4.7% of the players indicated that they smoke. 3.3% of the players experience themselves as not being mentally tough. A positive correlation between mental toughness and sound sleep (0.262) was found while a negative correlation was found between mental toughness and the following: anxiety/depression (-0.401), anxiety/depression positive (-0.423), distress (-0.259) and common mental disorder problems in general (-0.220). Conclusions: Although the presence of CMD at first glance do not seem significantly high amongst all the players, it must be considered that if one player in a team experiences the presence of CMD, it will have an impact on his mental toughness and most likely on his performance, as well as on the performance of the whole team. It is therefore important to ensure mental health in the whole team, by addressing individual CMD problems. A mental health support programme is therefore needed to be implemented to the benefit of these players within the South African context.

Keywords: common mental disorders, mental toughness, professional athletes, rugby players

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8302 Case Report: A Case of Confusion with Review of Sedative-Hypnotic Alprazolam Use

Authors: Agnes Simone

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A 52-year-old male with unknown psychiatric and medical history was brought to the Psychiatric Emergency Room by ambulance directly from jail. He had been detained for three weeks for possession of a firearm while intoxicated. On initial evaluation, the patient was unable to provide a reliable history. He presented with odd jerking movements of his extremities and catatonic features, including mutism and stupor. His vital signs were stable. Patient was transferred to the medical emergency department for work-up of altered mental status. Due to suspicion for opioid overdose, the patient was given naloxone (Narcan) with no improvement. Laboratory work-up included complete blood count, comprehensive metabolic panel, thyroid stimulating hormone, vitamin B12, folate, magnesium, rapid plasma reagin, HIV, blood alcohol level, aspirin, and Tylenol blood levels, urine drug screen, and urinalysis, which were all negative. CT head and chest X-Ray were also negative. With this negative work-up, the medical team concluded there was no organic etiology and requested inpatient psychiatric admission. Upon re-evaluation by psychiatry, it was evident that the patient continued to have an altered mental status. Of note, the medical team did not include substance withdrawal in the differential diagnosis due to stable vital signs and a negative urine drug screen. The psychiatry team decided to check California's prescription drug monitoring program (CURES) and discovered that the patient was prescribed benzodiazepine alprazolam (Xanax) 2mg BID, a sedative-hypnotic, and hydrocodone/acetaminophen 10mg/325mg (Norco) QID, an opioid. After a thorough chart review, his daughter's contact information was found, and she confirmed his benzodiazepine and opioid use, with recent escalation and misuse. It was determined that the patient was experiencing alprazolam withdrawal, given this collateral information, his current symptoms, negative urine drug screen, and recent abrupt discontinuation of medications while incarcerated. After admission to the medical unit and two doses of alprazolam 2mg, the patient's mental status, alertness, and orientation improved, but he had no memory of the events that led to his hospitalization. He was discharged with a limited supply of alprazolam and a close follow-up to arrange a taper. Accompanying this case report, a qualitative review of presentations with alprazolam withdrawal was completed. This case and the review highlights: (1) Alprazolam withdrawal can occur at low doses and within just one week of use. (2) Alprazolam withdrawal can present without any vital sign instability. (3) Alprazolam withdrawal does not respond to short-acting benzodiazepines but does respond to certain long-acting benzodiazepines due to its unique chemical structure. (4) Alprazolam withdrawal is distinct from and more severe than other benzodiazepine withdrawals. This case highlights (1) the importance of physician utilization of drug-monitoring programs. This case, in particular, relied on California's drug monitoring program. (2) The importance of obtaining collateral information, especially in cases in which the patient is unable to provide a reliable history. (3) The importance of including substance intoxication and withdrawal in the differential diagnosis even when there is a negative urine drug screen. Toxidrome of withdrawal can be delayed. (4) The importance of discussing addiction and withdrawal risks of medications with patients.

Keywords: addiction risk of benzodiazepines, alprazolam withdrawal, altered mental status, benzodiazepines, drug monitoring programs, sedative-hypnotics, substance use disorder

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8301 A Review of Critical Framework Assessment Matrices for Data Analysis on Overheating in Buildings Impact

Authors: Martin Adlington, Boris Ceranic, Sally Shazhad

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In an effort to reduce carbon emissions, changes in UK regulations, such as Part L Conservation of heat and power, dictates improved thermal insulation and enhanced air tightness. These changes were a direct response to the UK Government being fully committed to achieving its carbon targets under the Climate Change Act 2008. The goal is to reduce emissions by at least 80% by 2050. Factors such as climate change are likely to exacerbate the problem of overheating, as this phenomenon expects to increase the frequency of extreme heat events exemplified by stagnant air masses and successive high minimum overnight temperatures. However, climate change is not the only concern relevant to overheating, as research signifies, location, design, and occupation; construction type and layout can also play a part. Because of this growing problem, research shows the possibility of health effects on occupants of buildings could be an issue. Increases in temperature can perhaps have a direct impact on the human body’s ability to retain thermoregulation and therefore the effects of heat-related illnesses such as heat stroke, heat exhaustion, heat syncope and even death can be imminent. This review paper presents a comprehensive evaluation of the current literature on the causes and health effects of overheating in buildings and has examined the differing applied assessment approaches used to measure the concept. Firstly, an overview of the topic was presented followed by an examination of overheating research work from the last decade. These papers form the body of the article and are grouped into a framework matrix summarizing the source material identifying the differing methods of analysis of overheating. Cross case evaluation has identified systematic relationships between different variables within the matrix. Key areas focused on include, building types and country, occupants behavior, health effects, simulation tools, computational methods.

Keywords: overheating, climate change, thermal comfort, health

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8300 Cardiovascular Disease Prediction Using Machine Learning Approaches

Authors: P. Halder, A. Zaman

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It is estimated that heart disease accounts for one in ten deaths worldwide. United States deaths due to heart disease are among the leading causes of death according to the World Health Organization. Cardiovascular diseases (CVDs) account for one in four U.S. deaths, according to the Centers for Disease Control and Prevention (CDC). According to statistics, women are more likely than men to die from heart disease as a result of strokes. A 50% increase in men's mortality was reported by the World Health Organization in 2009. The consequences of cardiovascular disease are severe. The causes of heart disease include diabetes, high blood pressure, high cholesterol, abnormal pulse rates, etc. Machine learning (ML) can be used to make predictions and decisions in the healthcare industry. Thus, scientists have turned to modern technologies like Machine Learning and Data Mining to predict diseases. The disease prediction is based on four algorithms. Compared to other boosts, the Ada boost is much more accurate.

Keywords: heart disease, cardiovascular disease, coronary artery disease, feature selection, random forest, AdaBoost, SVM, decision tree

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8299 Effective Microorganisms as a Sustainable Environment Product and Their Application: A Study in Pakistan

Authors: Jaffar Hussain, Farman Ali Shah

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As we know that Pakistan is the developing country so it adopts new technologies for progress. In last three decays, some new technologies were introduced in the world in which Effective Microorganism was one of them. Microorganisms are one of the most power full living forces on earth. Originally, EM was developed as an odor control, farm, and animal health, human health many industrial treatments. Effective Microorganism is an organic fertilizer that contains a mixture of co-existing valuable microorganism composed from the environment. There are vast application of the EM in the world in which the researchers are explained in literature .In Pakistan work on EM technologies are under process, researcher are doing work to make them most valuable. At that time the application of EM are in agriculture, water treatment, to increase Cement strength, improving saline soil etc. Effective microorganisms are environmentally friendly , not-naturally organized, not chemically synthesized, not dangerous and not pathogenic.

Keywords: developing country, technologies, effective microorganism, researchers, Pakistan, agriculture

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8298 The Visually Impaired Jogger: Enhancing Interaction and Fitness through the Fun Run

Authors: Zasha Romero, Joe Paschall

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This poster will detail the importance of physical activity for the Visually Impaired students and how to promote inclusion in fitness through way of social gatherings and jogging. Furthermore, it will demonstrate how a Health & Kinesiology University Club cooperated in the journey of visually impaired students from participating in physical activity to completing their first 10K fun run. Purpose: The poster will detail how a university’s Health & Kinesiology Club developed a program to promote participation in fitness activities for visually impaired individuals. Also, it will detail their journey from participation in physical activity to completing a 10K fun run. Methods: In an effort to promote inclusion of all into physical activity, a university’s Health & Kinesiology Club developed a non-profit program to challenge visually impaired students to train and complete a 10 kilometer fun run in a South Texas town. The idea was to promote physical fitness through way of social interaction. In order to maintain runners interested, Club students developed training plans and strategies to be able to navigate in a race that was attended by over 18,000 runners. The idea was to promote interaction and life-long fitness amongst participants. Implications: This strategy was done in collaboration with different non-profit institutions to create awareness and provide opportunities for physical fitness, social interaction and life-long fitness skills associated with the jogging. The workshop provided collaboration amongst different entities and novel ideas to create opportunities for a typically underserved population.

Keywords: inclusion, participation, management, disability, fitness

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8297 The Effect of a Multidisciplinary Spine Clinic on Treatment Rates and Lead Times to Care

Authors: Ishan Naidu, Jessica Ryvlin, Devin Videlefsky

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Introduction: Back pain is a leading cause of years lived with disability and economic burden, exceeding over $20 billion in healthcare costs not including indirect costs such as absence from work and caregiving. The multifactorial nature of back pain leads to treatment modalities administered by a variety of specialists, which are often disjointed. Multiple studies have found that patients receiving delayed physical therapy for lower back pain had higher medical-related costs from increased health service utilization as well as a reduced improvement in pain severity compared to early management. Uncoordinated health care delivery can exacerbate the physical and economic toll of the chronic condition, thus improvements in interdisciplinary, shared decision-making may improve outcomes. Objective: To assess whether a multidisciplinary spine clinic (MSC), consisting of orthopedic surgery, neurosurgery, pain medicine, and physiatry, alters interventional and non-interventional planning and treatment compared to a traditional unidisciplinary spine clinic (USC) including only orthopedic surgery. Methods: We conducted a retrospective cohort study with patients initially presenting for spine care to orthopedic surgeons between July 1, 2018 to June 30, 2019. Time to treatment recommendation, time to treatment and rates of treatment recommendations were assessed, including physical therapy, injections and surgery. Treatment rates were compared between MSC and USC using Pearson’s chi-square test logistic regression. Time to treatment recommendation and time to treatment were compared using log-rank test and Cox proportional hazard regression. All analyses were repeated for the propensity score (PS) matched subsample. Results: This study included 1,764 patients, with 692 at MSC and 1,072 at USC. Patients in MSC were more likely to be recommended injection when compared to USC (8.5% vs. 5.4%, p=0.01). When adjusted for confounders, the likelihood of injection recommendation remained greater in MSC than USC (Odds ratio [OR]=2.22, 95% CI: (1.39, 3.53), p=0.001). MSC was also associated with a shorter time to receiving injection recommendation versus USC (median: 21 vs. 32 days, log-rank: p<0.001; hazard ratio [HR]=1.90, 95% CI: (1.25, 2.90), p=0.003). MSC was associated with a higher likelihood of injection treatment (OR=2.27, 95% CI: (1.39, 3.73), p=0.001) and shorter lead time (HR=1.98, 95% CI: (1.27, 3.09), p=0.003). PS-matched analyses yielded similar conclusions. Conclusions: Care delivered at a multidisciplinary spine clinic was associated with a higher likelihood of recommending injection and a shorter lead time to injection administration when compared to a traditional unidisciplinary spine surgery clinic. Multidisciplinary clinics may facilitate coordinated care amongst different specialties resulting in increased utilization of less invasive treatment modalities while also improving care efficiency. The multidisciplinary clinic model is an important advancement in care delivery and communication, which can be used as a powerful method of improving patient outcomes as treatment guidelines evolve.

Keywords: coordinated care, epidural steroid injection, multi-disciplinary, non-invasive

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8296 Acute Respiratory Infections in a Rural Area of the Southwestern Region of Bangladesh: Perceptions, Practices and the Role of First-Time Mothers

Authors: Sonia Mannan

Abstract:

A qualitative study was conducted in a rural area of the southwestern region of Bangladesh to identify perceptions, practices, and the role of first-time mothers surrounding acute respiratory infections (ARI) in infants and children aged under four years. The study reveals that all mothers had knowledge of ARI and were able to identify a number of signs and symptoms. They also recognized pneumonia and thought it to be caused by exposure to cold or weather change, supernatural causes, evil influences, mothers’ negligence, and failure to observe ‘purdah’. They were able to identify chest retractions, difficult breathing, and inability to feed as signs of severe disease needing treatment outside the home. In these cases, spiritual healers were sought, and allopathic treatment was delayed or avoided. Home care practices involved massaging the child with oil and avoiding 'cooling' foods, including water. With the presence of fever and breathing difficulty, mothers tended to increase the number and diversity of medicines, although more concern was expressed about fever than about breathing difficulty. Effective medical care was more likely to be delayed for infants than for older children (they often waited 2-5 days after signs of illness appeared); infants were also more likely to be taken to a spiritual healer as the first-choice provider. The reasons for these perceptions and practices and their implications on the ARI of infants and young children are discussed. Community intervention is identified as viable, effective, and practical to address the body of local socio-cultural knowledge about family practices and the role of the mother regarding the mitigation of ARI in infants and young children.

Keywords: acute respiratory infections , public health, pneumonia, Bangladesh

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8295 Identification of Knee Dynamic Profiles in High Performance Athletes with the Use of Motion Tracking

Authors: G. Espriú-Pérez, F. A. Vargas-Oviedo, I. Zenteno-Aguirrezábal, M. D. Moya-Bencomo

Abstract:

One of the injuries with a higher incidence among university-level athletes in the North of Mexico is presented in the knee. This injury generates absenteeism in training and competitions for at least 8 weeks. There is no active quantitative methodology, or protocol, that directly contributes to the clinical evaluation performed by the medical personnel at the prevalence of knee injuries. The main objective is to contribute with a quantitative tool that allows further development of preventive and corrective measures to these injuries. The study analyzed 55 athletes for 6 weeks, belonging to the disciplines of basketball, volleyball, soccer and swimming. Using a motion capture system (Nexus®, Vicon®), a three-dimensional analysis was developed that allows the measurement of the range of movement of the joint. To focus on the performance of the lower limb, eleven different movements were chosen from the Functional Performance Test, Functional Movement Screen, and the Cincinnati Jump Test. The research identifies the profile of the natural movement of a healthy knee, with the use of medical guidance, and its differences between each sport. The data recovered by the single-leg crossover hop managed to differentiate the type of knee movement among athletes. A maximum difference of 60° of offset was found in the adduction movement between male and female athletes of the same discipline. The research also seeks to serve as a guideline for the implementation of protocols that help identify the recovery level of such injuries.

Keywords: Cincinnati jump test, functional movement screen, functional performance test, knee, motion capture system

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8294 Impact of Transportation on Access to Reproductive and Maternal Health Services in Northeast Cambodia: A Policy Brief

Authors: Zaman Jawahar, Anne Rouve-Khiev, Elizabeth Hoban, Joanne Williams

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Ensuring access to timely obstetric care is essential to prevent maternal deaths. Geographical barriers pose significant challenges for women accessing quality reproductive and maternal health services in rural Cambodia. This policy brief affirms the need to address the issue of transportation and cost (direct and indirect) as critical barriers to accessing reproductive and maternal health (RMH) services in four provinces in Northeast Cambodia (Kratie, Ratanak Kiri, Mondul Kiri, Stung Treng). A systemic search of the literature identified 1,116 articles, and only ten articles from low-and-middle-income countries met the inclusion criteria. The ten articles reported on transportation and cost related to accessing RMH services. In addition, research findings from Partnering to Save Lives (PSL) studies in the four provinces were included in the analysis. Thematic data analysis using the information in the ten articles and PSL research findings was conducted, and the findings are presented in this paper. The key findings are the critical barriers to accessing RMH services in the four provinces because women experience: 1) difficulties finding affordable transportation; 2) lack of available and accessible transportation; 3) greater distance and traveling time to services; 4) poor geographical terrain and; 5) higher opportunity costs. Distance and poverty pose a double burden for the women accessing RMH services making a facility-based delivery less feasible compared to home delivery. Furthermore, indirect and hidden costs associated with institutional delivery may have an impact on women’s decision to seek RMH care. Existing health financing schemes in Cambodia such as the Health Equity Fund (HEF) and the Voucher Scheme contributed to the solution but have also shown some limitations. These schemes contribute to improving access to RMH services for the poorest group, but the barrier of transportation costs remains. In conclusion, initiatives that are proven to be effective in the Cambodian context should continue or be expanded in conjunction with the HEF, and special consideration should be given to communities living in geographically remote regions and difficult to access areas. The following strategies are recommended: 1) maintain and further strengthen transportation support in the HEF scheme; 2) expand community-based initiatives such as Community Managed Health Equity Funds and Village Saving Loans Associations; 3) establish maternity waiting homes; and 4) include antenatal and postnatal care in the provision of integrated outreach services. This policy brief can be used to inform key policymakers and provide evidence that can assist them to develop strategies to increase poor women’s access to RMH services in low-income settings, taking into consideration the geographic distance and other indirect costs associated with a facility-based delivery.

Keywords: access, barriers, northeast Cambodia, reproductive and maternal health service, transportation and cost

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8293 The Utilization of Banana Leaves as a Substitute for Synthetic Mosquito Repellant

Authors: Beryl Apondi Obola

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Introduction: Mosquitoes are known to transmit various diseases such as malaria, dengue fever, and Zika virus. Mosquito repellents are commonly used to prevent mosquito bites. However, some of these repellents contain chemicals that can be harmful to human health and the environment. Therefore, there is a need to find alternative mosquito repellents that are safe and effective. Objective: The objective of this research is to investigate the effectiveness of banana leaves as an alternative mosquito repellent on Plasmodium falciparum and Plasmodium vivax. Methodology: The research will be conducted in two phases. In the first phase, the repellent properties of banana leaves will be tested in a laboratory setting. The leaves will be crushed and mixed with water to extract the active ingredients. The extract will be tested against mosquitoes in a controlled environment. The number of mosquitoes that are repelled by the extract will be recorded. In the second phase, the effectiveness of the banana leaf extract will be tested in the field. The extract will be applied to the skin of human volunteers, and the number of mosquito bites will be recorded. The results will be compared to a commercially available mosquito repellent. Expected Outcomes: The expected outcome of this research is to determine whether banana leaves can be used as an effective mosquito repellent. If the results are positive, banana leaves could be used as an alternative to chemical-based mosquito repellents. Conclusion: Banana leaves have been used for various purposes in traditional medicine. This research aims to investigate the potential of banana leaves as an alternative mosquito repellent. The results of this research could have significant implications for public health and the environment

Keywords: banana leaf extract, mosquito repellant, plasmodium falciparum, public health

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8292 Physiotherapy Program for Frozen Shoulder Related to Onset of Symptom, Range of Motions and Obtaining Modalities

Authors: Narupon Kunbootsri, P. Sirasaporn

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Frozen shoulder is a common problem present by pain and limit range of motion. The prevalence of frozen shoulder showed 18-31% of population. The effect of frozen shoulder lead to limit activities daily living life, high medical care cost and so on. Physiotherapy is one of the treatments for frozen shoulder but there was no data about the treatment of physiotherapy. Moreover, it is question about onset of symptom relate to physiotherapy program and obtaining physical modalities and delayed start physiotherapy program lead to delayed improvement. Thus the aim of this study was to investigate physiotherapy program for frozen shoulder relate to onset of symptom, range of motion and obtaining physical modalities. A retrospective study design was conducted. 182 medical records of patients with frozen shoulder were reviewed. These frozen shoulders were treated at physiotherapy unit, department of Rehabilitation last 3 years (January, 2014- December, 2016). The data consist of onset of symptom, range of motion and obtaining physical modalities were recorded. There was a statistically significant increase in shoulder flexion [mean difference 38.88 with 95%CI were [16.00-61.77], shoulder abduction [mean difference 48.47 with 95%CI were 16.07-90.59], shoulder internal rotation [mean difference 22.36 with 95%CI were 2.81-37.18] and shoulder external rotation [mean difference 32.12 with 95%CI were [(-2.47)-(46.91)]. In addition, the onset of symptom was 76.42±46.90 days. And the physical modalities used frequently were hot pack 14.8% and ultrasound diathermy 13.7%. In conclusion, the physiotherapy program including, hot pack and ultrasound diathermy seem to be useful for frozen shoulder. But onset of symptom is too long to start physiotherapy programs.

Keywords: frozen shoulder, range of motions, onset of symptom, physiotherapy, physical modality

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8291 Job Satisfaction among Brigadista in Nicaragua: A Lesson to Be Considered for Task-Shifting

Authors: Rashed Shah, Jeanne Koepsell, Dixmer Rivera, Eric Swedberg, David Marsh

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Success of primary health care goals of health promotion and disease prevention may well be determined by community based health workers’ overall job satisfaction. It is also important to understand the ways community health workers perceive their jobs and the importance they give to the various factors influencing their job satisfaction, which is critical before making a decision for task-shifting and for expanding their scope of work. Although brigadistas are unpaid volunteers, they are formally recognized and receive support and supervision from the Ministry of Health in Nicaragua. Brigadistas are responsible for classifying and diagnosing illnesses, administering treatment, counseling mothers and care givers within the community, encouraging referral in case of serious illness and making follow-up visits at home. Some brigadistas provide more technically advanced services, including treatment for pneumonia, diarrhea, malaria and tuberculosis and/or distribution of contraceptives. Expanding brigadistas’ duties could threaten their heretofore ‘job satisfaction’. This study primarily aims to report on job satisfaction of brigadistas in Nicaragua before expanding the scope of their work by adding more responsibilities. The study was guided by the following research questions: 1) What aspects of their job made the brigadistas satisfied or dissatisfied? 2) What is the job satisfaction level of brigadistas in Nicaragua? This cross-sectional study was conducted during March – July 2014, to assess brigadistas’ job satisfaction, prior to deciding on inclusion of care for sick newborns and young infants (<2 months of age) to brigadistas’ existing service package of community case management for children of 2-59 months of age. Following stratified random sampling strategy, 15 brigadistas were randomly selected from each of the following four strata: [(1) females under 25 years of age, (2) females over 30 years of age, (3) males under 25 years of age, and (4) males over 30 years of age. Out of 45 completed in-person interview with eligible and available brigadistas, 20 (44.4%) were with female and 25 (55.6%) were with male respondents; the mean age (±sd) was found as 32.0 (±3.2) years. About 53% (24/45) brigadista mentioned “Training” as the most helpful for performing their job. Another 31% (14/45) mentioned that “feeling of doing good, supporting community, women and children” was helpful to perform their job well. When asked about difficulty, about 35.5% (16/45) brigadistas mentioned about “Lack of time” due to their responsibilities in family, farm, other work places, study and such time constraint made their job performance difficult. Measured on a 0-5 scale, estimated average job satisfaction was 4.2. Current trends in task-shifting and integrated program delivery require community health workers (like the brigadistas) to deliver several essential services, including maternal, newborn and child health, and family planning, and thereby increasing their responsibilities. Given the reported level of job satisfaction among brigadistas (4.2 out of 5), and the mentioned difficulty in performing their current job (as ‘Lack of Time’) in this study results, the policy makers and program managers in MOH should be cautious enough before making a decision to expand current scope of work for brigadistas in Nicaragua.

Keywords: Brigadisata, job satisfaction, Nicaragua, task-shifting

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8290 Effects of Animal Metaphor on Consumer Response to Product Advertising

Authors: Wen-Hsien Huang, Hsu-Ting Hsu

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While advertisers often use animal metaphors to promote product performance, representing through the use of a product image together with an animal-like messenger to imply the undesirable health states of not using the product, the effect of such metaphors on persuasion remains unclear. The current research addresses this issue by investigating how consumers perceive and react to animal metaphor advertising in the context of product promotion. Three studies are carried out using field and experimental data. The findings demonstrate that animal metaphor ads are less persuasive than non-metaphor ads and that ads with animal-like messengers (as opposed to human messengers) activate stronger dehumanization perceptions, which in turn lead to lower product choice, product evaluation and purchase intention, regardless of whether the animal metaphors are presented visually in the picture or verbally in the headline. Furthermore, when the metaphorical pairing includes a more disliked animal, consumer reaction was less favorable. The implications of the findings for advertisers considering the use of animalized messengers are discussed.

Keywords: animal metaphor, dehumanization, product evaluation, health communication

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8289 Co-Factors of Hypertension and Decomposition of Inequalities in Its Prevalence in India: Evidence from NFHS-4

Authors: Ayantika Biswas

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Hypertension still remains one of the most important preventable contributors to adult mortality and morbidity and a major public health challenge worldwide. Studying regional and rural-urban differences in prevalence and assessment of the contributions of different indicators is essential in determining the drivers of this condition. The 2015-16 National Family Health Survey data has been used for the study. Bivariate analysis, multinomial regression analysis, concentration indices and decomposition of concentration indices assessing contribution of factors has been undertaken in the present study. An overall concentration index of 0.003 has been found for hypertensive population, which shows its concentration among the richer wealth quintiles. The contribution of factors like age 45 to 49 years, years of schooling between 5 to 9 years are factors that are important contributors to inequality in hypertension occurrence. Studies should be conducted to find approaches to prevent or delay the onset of the condition.

Keywords: hypertension, decomposition, inequalities, India

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8288 Vaccination against Hepatitis B in Tunisian Health Care Workers

Authors: Asma Ammar, Nabiha Bouafia , Asma BenCheikh, Mohamed Mahjoub, Olfa Ezzi, Wadiaa Bannour, Radhia Helali, Mansour Njah

Abstract:

Background: The objective of the present study was to identify factors associated with vaccination against Hepatitis B virus (HBV) among healthcare workers (HWs) in the University Hospital Center (UHC) Farhat Hached Sousse, Tunisia. Methods: We conducted a descriptive cross-sectional study all licensed physicians (n= 206) and a representative sample of paramedical staff (n= 372) exercising at UHC Hached Sousse (Tunisia) during two months (January and February 2014). Data were collected using a self-administered and pre-tested questionnaire, which composed by 21 questions. In order to determinate factors associated with vaccination against hepatitis B among HWs, this questionnaire was based on the Health Belief Model, one of the most classical behavior theories. Logistic regression with the stepwise method of Hosmer and Lemeshow was used to identify the determinants of the use of vaccination against HBV. Results: The response rates were 79.8%. Fifty two percent believe that HBV is frequent in our healthcare units and 60.6% consider it a severe infection. The prevalence of HWs vaccination was 39%, 95% CI [34.49%; 43.5%]. In multivariate analysis, determinants of the use of vaccination against HBV among HWs were young age (p=10-4), male gender (p = 0. 006), high or very high importance accorded to health (p = 0.035), perception membership in a risk group for HBV infection (p = 0.038) and very favorable or favorable opinion about vaccination against HVB (p=10-4). Conclusion: The results of our study should be considered in any strategy for preventing VHB infection in HWs. In the mean time, coverage with standard vaccines should be improved also by supplying complete information on the risks of VHB infection and on the safety and efficacy of vaccination.

Keywords: Hepatitis B virus, healthcare workers, prevalence, vaccination

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8287 Prevalence and Risk Factors of Musculoskeletal Disorders among School Teachers in Mangalore: A Cross Sectional Study

Authors: Junaid Hamid Bhat

Abstract:

Background: Musculoskeletal disorders are one of the main causes of occupational illness. Mechanisms and the factors like repetitive work, physical effort and posture, endangering the risk of musculoskeletal disorders would now appear to have been properly identified. Teacher’s exposure to work-related musculoskeletal disorders appears to be insufficiently described in the literature. Little research has investigated the prevalence and risk factors of musculoskeletal disorders in teaching profession. Very few studies are available in this regard and there are no studies evident in India. Purpose: To determine the prevalence of musculoskeletal disorders and to identify and measure the association of such risk factors responsible for developing musculoskeletal disorders among school teachers. Methodology: An observational cross sectional study was carried out. 500 school teachers from primary, middle, high and secondary schools were selected, based on eligibility criteria. A signed consent was obtained and a self-administered, validated questionnaire was used. Descriptive statistics was used to compute the statistical mean and standard deviation, frequency and percentage to estimate the prevalence of musculoskeletal disorders among school teachers. The data analysis was done by using SPSS version 16.0. Results: Results indicated higher pain prevalence (99.6%) among school teachers during the past 12 months. Neck pain (66.1%), low back pain (61.8%) and knee pain (32.0%) were the most prevalent musculoskeletal complaints of the subjects. Prevalence of shoulder pain was also found to be high among school teachers (25.9%). 52.0% subjects reported pain as disabling in nature, causing sleep disturbance (44.8%) and pain was found to be associated with work (87.5%). A significant association was found between musculoskeletal disorders and sick leaves/absenteeism. Conclusion: Work-related musculoskeletal disorders particularly neck pain, low back pain, and knee pain, is highly prevalent and risk factors are responsible for the development of same in school teachers. There is little awareness of musculoskeletal disorders among school teachers, due to work load and prolonged/static postures. Further research should concentrate on specific risk factors like repetitive movements, psychological stress, and ergonomic factors and should be carried out all over the country and the school teachers should be studied carefully over a period of time. Also, an ergonomic investigation is needed to decrease the work-related musculoskeletal disorder problems. Implication: Recall bias and self-reporting can be considered as limitations. Also, cause and effect inferences cannot be ascertained. Based on these results, it is important to disseminate general recommendations for prevention of work-related musculoskeletal disorders with regards to the suitability of furniture, equipment and work tools, environmental conditions, work organization and rest time to school teachers. School teachers in the early stage of their careers should try to adapt the ergonomically favorable position whilst performing their work for a safe and healthy life later. Employers should be educated on practical aspects of prevention to reduce musculoskeletal disorders, since changes in workplace and work organization and physical/recreational activities are required.

Keywords: work related musculoskeletal disorders, school teachers, risk factors funding, medical and health sciences

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8286 Changes in the Quality of Life of Turkish Patients with Trauma-Related Phthisis Bulbi

Authors: Titap Yazicioglu

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Purpose: Losing an eye due to trauma is a challenging situation that reduces the quality of life by causing physical, cosmetic, and serious psychological problems. This study aimed to evaluate the effect of aesthetic rehabilitation on the change in psychological status and quality of life of patients with eye loss resulting in phthisis bulbi. Materials and Methods: The files of 25 males and 15 females with an average age of 27.5 years who had trauma-related phthisic eye and had applied to the Department of Ophthalmology at the Dr. Lütfi Kırdar Kartal Education and Research Hospital, Istanbul, Turkey, for aesthetic rehabilitation during the years 2015-19 were retrospectively analyzed. The Beck Depression Inventory (BDI), Beck Anxiety Scale(BAS), and Short Form 36 quality-of-life survey (SF-36) were used to collect data on admission and one-year follow-up. Results: Of the patients reviewed, 65% stated that eye loss had caused their avoidance of family and social environments; 30% had moderate anxiety and depression. The post-operative sub-dimension scores of general health, emotional role function, and physical and social functions were statistically significant (p = 0.001; p<0.01), but the variations in the sub-dimension scores of vitality, mental health, and total physical health were not (p>0.05). Conclusion: Lossing an eye is a traumatic event that can affect all aspects of a person’s social and professional life. A patient who has suffered from the psychological damage of physical loss of eye needs a prosthesis that can give the desired function and appearance in different aspects of life.

Keywords: eye loss, phthisis bulbi, quality of life, psychological trauma

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8285 An Ethnographic Study of Workforce Integration of Health Care Workers with Refugee Backgrounds in Ageing Citizens in Germany

Authors: A. Ham, A. Kuckert-Wostheinrich

Abstract:

Demographic changes, like the ageing population in European countries and shortage of nursing staff, the increasing number of people with severe cognitive impairment, and elderly socially isolated people raise important questions about who will provide long-term care for ageing citizens. Due to the so-called refugee crisis in 2015, some health care institutions for ageing citizens in Europe invited first generation immigrants to start a nursing career and providing them language skills, nursing training, and internships. The aim of this ethnographic research was to explore the social processes affecting workforce integration and how newcomers enact good care in ageing citizens in a German nursing home. By ethnographic fieldwork, 200 hours of participant observations, 25 in-depth interviews with immigrants and established staff, 2 focus groups with 6 immigrants, and 6 established staff members, data were analysed. The health care institution provided the newcomers a nursing program on psychogeriatric theory and nursing skills in the psychogeriatric field and professional oriented language skills. Courses of health prevention and theater plays accompanied the training. The knowledge learned in education could be applied in internships on the wards. Additionally, diversity and inclusivity courses were given to established personal for cultural awareness and sensitivity. They learned to develop a collegial attitude of respect and appreciation, regardless of gender, nationality, ethnicity, religion or belief, age sexual orientation, or disability and identity. The qualitative data has shown that social processes affected workforce integration, like organizational constraints, staff shortages, and a demanding workload. However, zooming in on the interactions between newcomers and residents, we noticed how they tinkered to enact good care by embodied caring, playing games, singing and dancing. By situational acting and practical wisdom in nursing care, the newcomers could meet the needs of ageing residents. Thus, when health care institutions open up nursing programs for newcomers with refugees’ backgrounds and focus on talent instead of shortcomings, we might as well stimulate the unknown competencies, attitudes, skills, and expertise of newcomers and create excellent nurses for excellent care.

Keywords: established staff, Germany, nursing, refugees

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8284 Health Outcomes from Multidrug-Resistant Salmonella in High-Income Countries: A Systematic Review and Meta-Analysis

Authors: Andrea Parisi, Samantha Vilkins, Luis Furuya-Kanamori, John A. Crump, Benjamin P. Howden, Darren Gray, Kathryn Glass, Martyn Kirk

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Objectives: Salmonella is a leading cause of foodborne enterocolitis worldwide. Nontyphoidal Salmonella (NTS) infections that are Multi-Drug Resistant (MDR) (non-susceptible to ≥1 agent in ≥3 antimicrobial categories) may result in more severe outcomes, although these effects have not been systematically examined. We conducted a systematic review and meta-analysis to examine impacts of MDR NTS on health in high-income settings. Methods: We systematically reviewed the literature from scientific databases, including PubMed, Scopus and grey literature sources, using PRISMA guidelines. We searched for data from case-control studies, cohorts, outbreaks, reports and theses, imposing no language restriction. We included only publications from January 1990 to September 2016 from high income countries as classified by World Bank. We extracted data from papers on duration of illness, hospitalisation rates, morbidity and mortality for MDR and non-MDR NTS strains. Results: After removing duplicates, the initial search revealed 4258 articles. After further screening, we identified 16 eligible studies for the systematic review, and 9 of these were included in meta-analysis. NTS serotypes differed among the reported studies but serotype Typhimurium, Enteritidis, Newport and Heidelberg were among the most often reported as MDR pathogens. Salmonella infections that were MDR were associated with excess bloodstream infections (OR 1.63; 95%CI 1.18-2.26), excess hospitalisations (OR 2.77; 95%CI 1.47-5.21) and higher mortality (OR 3.54; 95%CI 1.10-11.40). Conclusions: MDR NTS infections are a serious public health concern. With the emergence of MDR Salmonella strains in the high-income countries, it is crucial to restrict the use of antimicrobials both in animals and humans, and intervene to prevent foodborne infections.

Keywords: Antimicrobial Resistance, Bloodstream Infection, Health Outcomes, Hospitalisation, Invasive Disease, Multi-Drug Resistance (MDR), Mortality, Nontyphoidal Salmonella

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8283 Permeodynamic Particulate Matter Filtration for Improved Air Quality

Authors: Hamad M. Alnagran, Mohammed S. Imbabi

Abstract:

Particulate matter (PM) in the air we breathe is detrimental to health. Overcoming this problem has attracted interest and prompted research on the use of PM filtration in commercial buildings and homes to be carried out. The consensus is that tangible health benefits can result from the use of PM filters in most urban environments, to clean up the building’s fresh air supply and thereby reduce exposure of residents to airborne PM. The authors have investigated and are developing a new large-scale Permeodynamic Filtration Technology (PFT) capable of permanently filtering and removing airborne PMs from outdoor spaces, thus also benefiting internal spaces such as the interiors of buildings. Theoretical models were developed, and laboratory trials carried out to determine, and validate through measurement permeodynamic filtration efficiency and pressure drop as functions of PM particle size distributions. The conclusion is that PFT offers a potentially viable, cost effective end of pipe solution to the problem of airborne PM.

Keywords: air filtration, particulate matter, particle size distribution, permeodynamic

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8282 Computer Countenanced Diagnosis of Skin Nodule Detection and Histogram Augmentation: Extracting System for Skin Cancer

Authors: S. Zith Dey Babu, S. Kour, S. Verma, C. Verma, V. Pathania, A. Agrawal, V. Chaudhary, A. Manoj Puthur, R. Goyal, A. Pal, T. Danti Dey, A. Kumar, K. Wadhwa, O. Ved

Abstract:

Background: Skin cancer is now is the buzzing button in the field of medical science. The cyst's pandemic is drastically calibrating the body and well-being of the global village. Methods: The extracted image of the skin tumor cannot be used in one way for diagnosis. The stored image contains anarchies like the center. This approach will locate the forepart of an extracted appearance of skin. Partitioning image models has been presented to sort out the disturbance in the picture. Results: After completing partitioning, feature extraction has been formed by using genetic algorithm and finally, classification can be performed between the trained and test data to evaluate a large scale of an image that helps the doctors for the right prediction. To bring the improvisation of the existing system, we have set our objectives with an analysis. The efficiency of the natural selection process and the enriching histogram is essential in that respect. To reduce the false-positive rate or output, GA is performed with its accuracy. Conclusions: The objective of this task is to bring improvisation of effectiveness. GA is accomplishing its task with perfection to bring down the invalid-positive rate or outcome. The paper's mergeable portion conflicts with the composition of deep learning and medical image processing, which provides superior accuracy. Proportional types of handling create the reusability without any errors.

Keywords: computer-aided system, detection, image segmentation, morphology

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8281 Older Adults’ Coping during a Pandemic

Authors: Aditya Jayadas

Abstract:

During a pandemic like the one we are in with COVID-19, older adults, especially those who live in a senior retirement facility, experience even bigger challenges as they are often dependent on other individuals for care. Many older adults are dependent on caregivers to assist with their instrumented activities of daily living (IADL). With travel restrictions imposed during a pandemic, there is a critical need to ensure that older adults who are homebound continue to be able to participate in physical exercise, cognitive exercise, and social interaction programs. The objective of this study was to better understand the challenges that older adults faced during the pandemic and what they were doing specifically to cope with the pandemic physically, mentally, and through social interaction. A focus group was conducted with ten older adults (age: 82.70 ± 7.81 years; nine female and one male) who resided in a senior retirement facility. During the course of one hour, seven open-ended questions were posed to the participants: a) What has changed in your life since the start of the pandemic, b) What has been most challenging for you, c) What are you doing to take care of yourself, d) Are you doing anything specifically as it relates to your physical health, e) Are you doing anything specifically as it relates to your mental health, f) What did you do for social interaction during the pandemic, g) Is there anything else you would like to share as it relates to your experience during the pandemic. The focus group session was audio-taped, and verbatim transcripts were created to evaluate the responses of the participants. The transcript consisted of 4,698 words and 293 lines of text. The data was analyzed using content analysis. The unit of analysis was the text from the audio recordings that were transcribed. From the review of the transcribed text, themes and sub-themes were identified, along with salient quotes under each sub-theme. The major themes that emerged from the data were: having a routine, engaging in activities, attending exercise classes, use of technology, family, community, and prayer. The quotes under the sub-themes provided compelling evidence of how older adults coped during the pandemic while addressing the challenges they faced and developing strategies to address their physical and mental health while interacting with others. Lessons learned from this focus group can be used to develop specific physical exercise, cognitive exercise, and social interaction programs that benefit the health and well-being of older adults.

Keywords: cognitive exercise, pandemic, physical exercise, social interaction

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8280 A Paradox in the Issue of Sexual Violence: A Study on Sexual Violence Perpetrated against Men and Boys by Women: A Case Study of the Municipality of Ibanda, Town of Bukavu, Province of South Kivu, Democratic Republic of Congo, Africa

Authors: Sylvie Ekanga Lumumba

Abstract:

Background and Significance of the Study: Over the past three decades, the perception of sexual violence has changed significantly, it is now recognized that men and boys are victims of sexual violence. However, the body of research on male victims and particularly on their attackers is much more limited. Research on the above is thus more than required. To contribute to the above quest for further studies, the researcher conducted this study on sexual violence perpetrated against men and boys by women, in the Municipality of Ibanda, Town of Bukavu, Province of South Kivu, Democratic Republic of Congo. The main study objectives were the following: to investigate on the statement of sexual violence perpetrated against men and boys in the Municipality of Ibanda, to investigate into its consequences and the statement of medical and psycho-social care given to victims. Methodology: Data were collected using valid and reliable Survey Questionnaire and Interview Schedule. Study population: the 85,882 men and boys from the Municipality of Ibanda. Sampling: led to 150 men and boys, received discreetly by the researcher during November-December 2015. Major findings: First, findings related to sexual abuse and its procedure: 74.2% of men and boys were victims of sexual violence perpetrated by a woman, more than a year ago. 13.3% however, were victims for less than a year now. 79.7% of victims have experienced sexual violence by a sexual act; 3.9% through the intention of the woman to cause the death of the victim, by serious injury to the genitals. The Second group of findings related to the consequences of sexual violence revealed that HIV/AIDS is the most important physical consequence experienced by 77.3 % of victims. Physical psychological consequences are: urinary or defecation problems (72.7%); while key psycho-emotional and behavioral consequence is: living a state of deep shame and humiliation: 68.8%. As for sexual consequences: 71.1% indicated a chronic avoidance of sexual activity and 57% reported sexual dysfunctions. The third group of findings is related to medical and psycho-social care: repetitively, more than 80% of male victims affirmed that with the help of friends and traditional healers, they took care of themselves for all the eight WHO phases of clinical care of rape victims, this was hence not effectively done. Concluding Statement: for this study, the statement of sexual violence of men and boys by women in the Eastern Congo and its consequences are not researched upon and are underestimated; the study also revealed that the care of male victims is grossly ill-conducted, as opposed to female victims care. It therefore calls for further research and further vulgarization of the research results, to convince other stakeholders (politicians for example) to immediately take action.

Keywords: sexual violence, men and boys, medical care, psycho-social care

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8279 Clothing as Cure: Dress as Moral Treatment in Psychiatry

Authors: Dorothy Chyung

Abstract:

In the psychiatric interview, the mental status exam begins with an assessment of the patient's appearance, noting aspects such as grooming and hygiene. However, it is not well established whether further examination of a patient's attire can provide further useful information. The popular assumption is that those who are mentally unwell will manifest this in unusual clothing. In the moral treatment of the 19th century, proper clothing was also seen as a pivotal therapeutic concern. This project examines assumptions about clothing, both as a reflection of and treatment for psychopathology. The methodology considers the opinions expressed in 19th century art and journals, as well as asylum rules, in comparison to contemporary psychiatric practice and research evidence. Per moral treatment in the 19th century, self-discipline and a proper environment would cure insanity. Madness was evident in the opposite of these ideals—such as ragged or ‘improper’ clothing—and rules about attire delineated the most correct (i.e. sane) ways to dress. These rules applied not only for the patients but also for staff. Despite these ideals, accusations were made that asylums, in fact, dressed patients to look more mentally unwell and further removed patients’ agency. Current practice in psychiatric hospitals retains remnants of moral treatment. Patients are expected to dress ‘appropriately’ while retaining some choice to build self-esteem, with arguments about safety being used to justify the removal of choice. Meanwhile, staff is expected to dress professionally and as role models, based on the assumption that conservative dress is least pathological. Research on this subject is limited, and there is little evidence that discrete psychiatric diagnoses manifest in the particular dress, nor that conservative dress would result in a reduction in pathology. Dressing unusually has become a privilege granted only to those without association with mental illness.

Keywords: fashion, history of psychiatry, medical humanities, mental health treatment

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8278 Antimicrobial and Aroma Finishing of Organic Cotton Knits Using Vetiver Oil Microcapsules for Health Care Textiles

Authors: K. J. Sannapapamma, H. Malligawad Lokanath, Sakeena Naikwadi

Abstract:

Eco-friendly textiles are gaining importance among the consumers and textile manufacturers in the healthcare sector due to increased environmental pollution which leads to several health and environmental hazards. Hence, the research was designed to cultivate and develop the organic cotton knit, to prepare and characterize the Vetiver oil microcapsules for textile finishing and to access the wash durability of finished knits. The cotton SAHANA variety grown under organic production systems was processed and spun into 30 single yarn dyed with four natural colorants (Arecanut slurry, Eucalyptus leaves, Pomegranate rind and Indigo) and eco dyed yarn was further used for development of single jersy knitted fabric. Vetiveria zizanioides is an aromatic grass which is being traditionally used in medicine and perfumery. Vetiver essential oil was used for preparation of microcapsules by interfacial polymerization technique subjected to Gas Chromatography Mass Spectrometry (GCMS), Fourier Transform Infrared Spectroscopy (FTIR), Thermo Gravimetric Analyzer (TGA) and Scanning Electron Microscope (SEM) for characterization of microcapsules. The knitted fabric was finished with vetiver oil microcapsules by exhaust and pad dry cure methods. The finished organic knit was assessed for laundering on antimicrobial efficiency and aroma intensity. GCMS spectral analysis showed that, diethyl phthalate (28%) was the major compound found in vetiver oil followed by isoaromadendrene epoxide (7.72%), beta-vetivenene (6.92%), solavetivone (5.58%), aromadenderene, azulene and khusimol. Bioassay explained that, the vetiver oil and diluted vetiver oil possessed greater zone of inhibition against S. aureus and E. coli than the coconut oil. FTRI spectra of vetiver oil and microcapsules possessed similar peaks viz., C-H, C=C & C꞊O stretching and additionally oil microcapsules possessed the peak of 3331.24 cm-1 at 91.14 transmittance was attributed to N-H stretches. TGA of oil microcapsules revealed that, there was a minimum weight loss (5.835%) recorded at 467.09°C compared to vetiver oil i.e., -3.026% at the temperature of 396.24°C. The shape of the microcapsules was regular and round, some were spherical in shape and few were rounded by small aggregates. Irrespective of methods of application, organic cotton knits finished with microcapsules by pad dry cure method showed maximum zone of inhibition compared to knits finished by exhaust method against S. aureus and E. coli. The antimicrobial activity of the finished samples was subjected to multiple washing which indicated that knits finished with pad dry cure method showed a zone of inhibition even after 20th wash and better aroma retention compared to knits finished with the exhaust method of application. Further, the group of respondents rated that the 5th washed samples had the greater aroma intensity in both the methods than the other samples. Thus, the vetiver microencapsulated organic cotton knits are free from hazardous chemicals and have multi-functional properties that can be suitable for medical and healthcare textiles.

Keywords: exhaust and pad dry cure finishing, interfacial polymerization, organic cotton knits, vetiver oil microcapsules

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8277 Applying Multivariate and Univariate Analysis of Variance on Socioeconomic, Health, and Security Variables in Jordan

Authors: Faisal G. Khamis, Ghaleb A. El-Refae

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Many researchers have studied socioeconomic, health, and security variables in the developed countries; however, very few studies used multivariate analysis in developing countries. The current study contributes to the scarce literature about the determinants of the variance in socioeconomic, health, and security factors. Questions raised were whether the independent variables (IVs) of governorate and year impact the socioeconomic, health, and security dependent variables (DVs) in Jordan, whether the marginal mean of each DV in each governorate and in each year is significant, which governorates are similar in difference means of each DV, and whether these DVs vary. The main objectives were to determine the source of variances in DVs, collectively and separately, testing which governorates are similar and which diverge for each DV. The research design was time series and cross-sectional analysis. The main hypotheses are that IVs affect DVs collectively and separately. Multivariate and univariate analyses of variance were carried out to test these hypotheses. The population of 12 governorates in Jordan and the available data of 15 years (2000–2015) accrued from several Jordanian statistical yearbooks. We investigated the effect of two factors of governorate and year on the four DVs of divorce rate, mortality rate, unemployment percentage, and crime rate. All DVs were transformed to multivariate normal distribution. We calculated descriptive statistics for each DV. Based on the multivariate analysis of variance, we found a significant effect in IVs on DVs with p < .001. Based on the univariate analysis, we found a significant effect of IVs on each DV with p < .001, except the effect of the year factor on unemployment was not significant with p = .642. The grand and marginal means of each DV in each governorate and each year were significant based on a 95% confidence interval. Most governorates are not similar in DVs with p < .001. We concluded that the two factors produce significant effects on DVs, collectively and separately. Based on these findings, the government can distribute its financial and physical resources to governorates more efficiently. By identifying the sources of variance that contribute to the variation in DVs, insights can help inform focused variation prevention efforts.

Keywords: ANOVA, crime, divorce, governorate, hypothesis test, Jordan, MANOVA, means, mortality, unemployment, year

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8276 Concurrent Validity of Synchronous Tele-Audiology Hearing Screening

Authors: Thidilweli Denga, Bessie Malila, Lucretia Petersen

Abstract:

The Coronavirus Disease of 2019 (COVID-19) pandemic should be taken as a wake-up call on the importance of hearing health care considering amongst other things the electronic methods of communication used. The World Health Organization (WHO) estimated that by 2050, there will be more than 2.5 billion people living with hearing loss. These numbers show that more people will need rehabilitation services. Studies have shown that most people living with hearing loss reside in Low-Middle Income Countries (LIMC). Innovative technological solutions such as digital health interventions that can be used to deliver hearing health services to remote areas now exist. Tele-audiology implementation can potentially enable the delivery of hearing loss services to rural and remote areas. This study aimed to establish the concurrent validity of the tele-audiology practice in school-based hearing screening. The study employed a cross-sectional design with a within-group comparison. The portable KUDUwave Audiometer was used to conduct hearing screening from 50 participants (n=50). In phase I of the study, the audiologist conducted on-site hearing screening, while the synchronous remote hearing screening (tele-audiology) using a 5G network was done in phase II. On-site hearing screening results were obtained for the first 25 participants (aged between 5-6 years). The second half started with the synchronous tele-audiology model to avoid order-effect. Repeated sample t-tests compared threshold results obtained in the left and right ears for onsite and remote screening. There was a good correspondence between the two methods with a threshold average within ±5 dB (decibels). The synchronous tele-audiology model has the potential to reduce the audiologists' case overload, while at the same time reaching populations that lack access due to distance, and shortage of hearing professionals in their areas of reach. With reliable and broadband connectivity, tele-audiology delivers the same service quality as the conventional method while reducing the travel costs of audiologists.

Keywords: hearing screening, low-resource communities, portable audiometer, tele-audiology

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8275 Body Weight Variation in Indian Heterogeneous Group-An Analytical Study

Authors: A. K. Srivastva

Abstract:

Body weight is considered as an important factor in health and fitness. It is an index of one's health. Considering significance of body weight and its wider application in various fields in general and sports in particular, it is made a point of enquiry in the present study. The purpose of the study to observe over all weight pattern of Indian youths in the age group of 15 through 20 years. Total 7500 samples pooled from ten Indian states ranging in their age 15 to 20 years were examined in six age categories. Conclusion: 1. The period between 15 to 20 year of age is a growing period and that body weight is gained during this period. 2. Statewise difference is observed in body-weight during the period, which is significant. 3. PRG indicated by higher rate of weight gain varies from state to state. 4. Sportsman possess comparatively higer level of body-weight than other student of same age group. 5. Tribal youths show comparatively better status in their weight gain than the untrained uraban dwellers.

Keywords: PRG (period of rapid growth), HG (heterogeneous group), WP (weight pattern), MBW (mean body weight)

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