Search results for: health tourism

Authors: KangQi Jin

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School-Related Gender-Based Violence (SRGBV) seriously impacts the victim's physical and mental health and academic and employment prospects. Due to the lack of protective policies for sexual minority students in mainland China at present, the well-being of those students in China is seriously endangered by SRGBV, and their physical and mental health is at great risk. By analyzing the current situation of stigmatization of sexual minority students and the harm brought to them by gender violence, this study proposes some strategies to reduce SRGBV on sexual minorities. First, the nation should set laws to protect the rights and interests of sexual minorities, and second, universities should make multifaceted efforts to reduce these violent phenomena. The violence experienced by students of sexual minorities has a crucial impact on their future physiology and psychology, and through the research, in this paper, the author hope can provide suggestions for scholars who try to study related fields in the future.

Keywords: sexual minority, school-related gender-based violence, response, strategies

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Authors: Ryeong-Hyeon Kim, Ah-Reum Lee, Seong-Soo Roh, Gyo-Nam Kim

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Appropriate regulation of melanogenesis is important for the management of skin pigmentation-related disease. Although several beneficial effects of fisetin (3,7,3’,4’-tetrahydroxyflavone) have been reported, the precise role and molecular mechanisms of fisetin in skin health both remain unclear. Here, we induced melanogenesis of HRM2 mice (n=7/group) by UVB irradiation for 20 days. UVB-induced HRM2 mice showed that the significantly increased melanin accumulation, however, fisetin treatment (25mg and 50mg/kg of body weight) dose-dependently and significantly inhibits UVB-induced melanogenesis. In line with this, fisetin treatment effectively down-regulated m RNA and expression levels of tyrosinase, TRP2, and MITF. In addition, our inhibitor assay revealed the down-regulated melanogenic marker genes by fisetin treatment were mediated with connective tissue growth factor (CCN2)/TGF-β signaling pathway. Useful information is provided for development of functional foods using fisetin for skin health.

Keywords: connective tissue growth factor, fisetin, melanogenesis, skin, TGF-beta

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Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

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Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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Authors: Elena Cangelosi, Wayne Beyea

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This research expands the resilience planning literature by exploring the barriers and enablers to climate and health adaptation planning for small urban, coastal Great Lakes communities. With funding from the United States Centers for Disease Control and Prevention (CDC) Climate Ready City and States Initiative, this research took place during a 3-year pilot intervention project which integrates urban planning and public health. The project used the CDC’s Building Resilience Against Climate Effects (BRACE) framework to prevent or reduce the human health impacts from climate change in Marquette County, Michigan. Using a deliberation with the analysis planning process, interviews, focus groups, and community meetings with over 25 stakeholder groups and over 100 participants identified the area’s climate-related health concerns and adaptation interventions to address those concerns. Marquette County, on the shores of Lake Superior, the largest of the Great Lakes, was selected for the project based on their existing adaptive capacity and proactive approach to climate adaptation planning. With Marquette County as the context, this study fills a gap in the adaptation literature, which currently heavily emphasizes large-urban or agriculturally-based rural areas, and largely neglects small urban areas. This research builds on the qualitative case-study, survey, and interview approach established by previous researchers on contextual barriers and enablers for adaptation planning. This research uses a case study approach, including surveys and interviews of public officials, to identify the barriers and enablers for climate and health adaptation planning for small-urban areas within a large, non-agricultural, Great Lakes county. The researchers hypothesize that the barriers and enablers will, in some cases, overlap those found in other contexts, but in many cases, will be unique to a rural setting. The study reveals that funding, staff capacity, and communication across a large, rural geography act as the main barriers, while strong networks and collaboration, interested leaders, and community interest through a strong human-land connection act as the primary enablers. Challenges unique to rural areas are revealed, including weak opportunities for grant funding, large geographical distances, communication challenges with an aging and remote population, and the out-migration of education residents. Enablers that may be unique to rural contexts include strong collaborative relationships across jurisdictions for regional work and strong connections between residents and the land. As the factors that enable and prevent climate change planning are highly contextual, understanding, and appropriately addressing the unique factors at play for small-urban communities is key for effective planning in those areas. By identifying and addressing the barriers and enablers to climate and health adaptation planning for small-urban, coastal areas, this study can help Great Lakes communities appropriately build resilience to the adverse impacts of climate change. In addition, this research expands the breadth of research and understanding of the challenges and opportunities planners confront in the face of climate change.

Keywords: climate adaptation and resilience, climate change adaptation, climate change and urban resilience, governance and urban resilience

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Authors: Ayomi Indika Irugalbandara

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Reproductive Health (RE) education among Sri Lankan Adolescents (comprising one fifth inner population) remains unsatisfactory despite 91.8% of them completing primary education & 56.2 % receiving post secondary level education. The main reason for this large population not receiving satisfactory RH education is traditional values and longstanding taboos surrounding sexuality. The current study was undertaken with there objectives. The relevance of achieving them being to formulate RH educational policies and programs that address a sizable and sensitive chunk of the population thereby achieving the goal of mental and social well being and not merely the absence of reproductive disease or infirmity. This research was a descriptive study, using random sampling technique, sample of the study consisting of 160 adolescent in the age group of 16-19, studying in government schools in Sri Lanka. Questionnaire was the main instrument of data collection, qualitative and quantitative techniques were used in data analysis. According to the data it was revealed that a majority has some idea about RH education. While this awareness had been provided by the school, the source of information had been Health and Physical Education. The entire sample mentioned that more RH information, than was provided, should be given and everybody wanted further knowledge regarding sexuality, and in depth information on it was essential. About 96 adolescents were of the opinion that their behavior was respectful to elders and 64 felt embarrassed while communicating with elders regarding RH issues. About their preferred sources of information, both genders named health providers as their first choice, followed by family members and friends. The internet was cited by a few boys; less than 5 percent cited religious figures. More than 50% of respondents had no knowledge about abortion and they were unaware of dangerous abortion. The practice of abortion was reported among zero percent. Although every member of the sample did not possess knowledge of the scientific process involved in abortion, all of them totally rejected the idea of destroying a foetus. Adolescence is a critical period in the life of girls and boys and sexuality education empowers young people to protect their health and well-being. Schools have the proper staff, and environment for learning. It might be stated that the greater segment of individuals entering adolescents and going through their adolescence are still in the school. This becomes the reason why it is mandatory that the school should be geared to handle this critical stage of the students. Adolescents or those approaching adolescence are best educated by the relevant parents, but this being quite a sensitive issue in the socio cultural context, it is somewhat doubtful whether all parents are prepared to handle this candidly, due either to lack of knowledge or absence of the appropriate state of mind. As such it is best that seminars/workshops be conducted to enlighten parents on handling HR issues related to their adolescent children. Apart from the awareness on HR provided through the school curriculum a greater impact can be brought about through street dramas, exhibitions etc. specific to HR. Finally the researcher would like to suggest that Sunday schools be harnessed for the provision of HR education linked with cultural values, ethics, and social well-being.

Keywords: reproductive health, awareness, perception, school curriculum

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Authors: J. Al-Dmour, A. Sagahyroon, A. Al-Ali, S. Abusnana

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Radio Frequency Based Identification Systems have emerged as one of the possible valuable solutions that can be utilized in healthcare systems. Nowadays, RFID tags are available with built-in human vital signs sensors such as Body Temperature, Blood Pressure, Heart Rate, Blood Sugar level and Oxygen Saturation in Blood. This work proposes the design, implementation, and testing of an integrated mobile RFID-based health care system. The system consists of a wireless mobile vital signs data acquisition unit (RFID-DAQ) integrated with a fuzzy-logic–based software algorithm to monitor and assess patients conditions. The system is implemented and tested in ‘Rashid Center for Diabetes and Research’, Ajman, UAE. System testing results are compared with the Modified Early Warning System (MEWS) that is currently used in practice. We demonstrate that the proposed and implemented system exhibits an accuracy level that is comparable and sometimes better than the widely adopted MEWS system.

Keywords: healthcare, fuzzy logic, MEWS, RFID

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Authors: Vasuki Rayapati, Bhanu Duggal

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Trans catheter aortic valve replacement (TAVR) is the recommended treatment over surgical aortic valve replacement (SAVR) for high-risk groups, patients >75 years of age with severe symptomatic Aortic stenosis (AS). In high income countries TAVR is more cost effective because of – i) Reduction in total length of stay including less number of days in ICU ii) Non-procedural costs like cost of general anaesthesia are higher for SAVR. In India, there are two kinds of hospitals – Public and Private. Most patients visit public sector hospitals than private sector hospitals. In a LMIC like India, especially in the Public health sector cost of TAVR is prohibitive. In a small study from three (public) hospitals in India, it was envisaged that cost of TAVR should decrease at least by 2/3 to be a cost effective option in Public health sector for severe AS.

Keywords: cost effectiveness, TAVR vs SAVR, LMIC, HTA

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Authors: Dhriti Kirpalani

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The survey aims to explore the impact of Instagram on the perception of lifestyle aspirations (such as social life, fitness, trends followed in fashion, etc.) and perception of self in relation to an idealized lifestyle: Amidst today's media-saturated environment, university students are constantly exposed to idealized portrayals of lifestyles, often leading to unrealistic expectations and dissatisfaction with their own lives. This study investigates the impact of media on university students' perceptions of their own lifestyle, the discrepancy between their self-perception and idealized lifestyle, and their mental health. Employing a mixed-methods approach, the study combines quantitative and qualitative data collection methods to understand the issue comprehensively. A literature review was conducted in order to determine the effects of idealized lifestyle portrayal on Instagram; however, less attention has been received in the Indian setting. The researchers wish to employ a convenience sampling method among undergraduate students from India. The surveys that would be employed for quantitative analysis are Negative Social Media Comparison (NSMCS), Lifestyle Satisfaction Scale (LSS), Psychological Well-being Scale (PWB), and Self-Perception Profile for Adolescents (SPPA). The qualitative aspect would include in-depth interviews to provide deeper insights into participants' experiences and the mechanisms by which media influences their lifestyle aspirations and mental health. With the aim of being an exploratory study, the basis of the idea is found in the social comparison theory described by Leon Festinger. The findings aim to inform interventions to promote realistic expectations about lifestyle, reduce the negative effects of media on university students, and improve their mental health and well-being.

Keywords: declined self-perception, idealized lifestyle, Instagram, Indian university students, social comparison

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Authors: Niranjana Soperna, Shivangi Nigam

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Violence against women is linked to their disadvantageous position in the society. It is rooted in unequal power relationships between men and women in society and is a global problem which is not limited to a specific group of women in society. An adolescent girl’s life is often accustomed to the likelihood of violence, and acts of violence exert additional power over girls because the stigma of violence often attaches more to a girl than to her doer. The experience of violence is distressing at the individual emotional and physical level. The field of research and programs for adolescent girls has traditionally focused on sexuality, reproductive health, and behavior, neglecting the broader social issues that underpin adolescent girls’ human rights, overall development, health, and well-being. This paper is an endeavor to address the understated or disguised form of violence which the adolescent girls experience within the social contexts. The parameters exposed under this research had been ignored to a large extent when it came to studying the dimension of violence under the social domain. Hence, the researchers attempted to explore this camouflaged form of violence and discovered some specific parameters such as: Diminished Self Worth and Esteem, Verbal Abuse, Menstruation Taboo and Social Rigidity, Negligence of Medical and Health Facilities and Complexion- A Prime Parameter for Judging Beauty. The study was conducted in the districts of Haryana where personal interviews were taken from both urban and rural adolescent girls (aged 13 to 19 years) based on structured interview schedule. The results revealed that the adolescent girls, both in urban as well as rural areas were quite affected with the above mentioned issues. In urban areas, however, due to the higher literacy rate, which resulted in more rational thinking, the magnitude was comparatively smaller, but the difference was still negligible.

Keywords: adolescent girls, education, social contexts, understated violence

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Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Mustafa Jahanara

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The aim of present research was to study of the relationship between emotional intelligence, perceived stress, positive religious coping with psychological distress to in a sample of undergraduate students in Polytechnic University in Kabul. One hundred and fifty-tow students (102 male, 50 female) were included in this study. All participants completed the Emotional Intelligence Scale (EIS), General Health Questionnaire (GHQ 12), Perceived Stress Scale (PSS-10), and the Brief RCOPE. The results revealed that EI was negatively associated with perceived stress and psychological distress. Also emotional intelligence was positively correlated with positive religious coping. Perceived stress was positive related with psychological distress and negatively correlated with positive religious coping. Eventually positive religious coping was significantly and negatively correlated with psychological distress. However, emotional intelligence and positive religious coping could influence on mental health.

Keywords: emotional intelligence, perceived stress, positive religious coping, psychological distress

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Authors: Rachel Dolan

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Background: Over two thirds of women in prison in England are mothers, and estimates suggest between 100 and 200 women per year give birth during imprisonment. There are currently six mother and baby units (MBUs) in prisons in England which admit women and babies up to the age of 18 months. Although there are only 65 places available, and despite positive impacts, they are rarely full. Mental illness may influence the number of admissions, as may interpretation of admission criteria. They are the only current alternative to separation for imprisoned mothers and their babies. Aims: To identify the factors that affect the decision to apply for/be offered a place in a prison MBU; to measure the impact of a placement upon maternal mental health and wellbeing; To measure the Initial outcomes for mother and child. Methods: A mixed methods approach - 100 pregnant women in English prisons are currently being recruited from prisons in England. Quantitative measures will establish the prevalence of mental disorder, personality disorder, substance misuse and quality of life. Qualitative interviews will document the experiences of pregnancy and motherhood in prison. Results: Preliminary quantitative findings suggest the most prevalent mental disorders are anxiety and depression and approximately half the participants meet the criteria for one or more personality disorders. The majority of participants to date have been offered a place in a prison MBU, and those in a prison with an MBU prior to applying are more likely to be admitted. Those with a previous history of childcare issues, who are known to social services are less likely to be offered a place. Qualitative findings suggest that many women are often hungry and uncomfortable during pregnancy, many have feelings of guilt about having a child in prison and that feelings of anxiety and worry are exacerbated by lack of information.

Keywords: mothers, prison, mother and baby units, mental health

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Authors: Klara Strecker

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During times of globalization, socioeconomic systems have become connected across the world through global supply chains. As a result, consumption and production locations have increasingly become spatially decoupled. This decoupling leads to complex entanglements of systems and sustainability challenges across distances -entanglements which can be conceptualized as telecouplings. Through telecouplings, people and environments across the world have become closely connected, bringing challenges as well as opportunities. Some argue that telecoupling dynamics started taking shape during times of colonization when resources were first traded across the world. An example of such a telecoupling is that of the rose. Every third rose sold in Europe is grown in Kenya and enters the European market through the Dutch flower auction system. Many Kenyan farms are Dutch-owned, closely entangling Kenya and the Netherlands through the trade of roses. Furthermore, the globalization of the flower industry and the resulting shift of production away from the Netherlands and towards Kenya has led to significant changes in the Dutch horticulture sector. However, the sustainability effects of this rose telecoupling is limited neither to the horticulture sector nor to the Netherlands and Kenya. Alongside the flow of roses between these countries come complex financial, knowledge-based, and regulatory flows. The rose telecoupling also creates spillover effects to other countries, such as Ethiopia, and other industries, such as Kenyan tourism. Therefore, telecoupling dynamics create complex entanglements that cut across sectors, environments, communities, and countries, which makes effectively governing and managing telecouplings and their sustainability implications challenging. Indeed, sustainability can no longer be studied in spatial and temporal isolation. This paper aims to map the rose telecoupling’s complex environmental and social interactions to identify points of tension guiding sustainability-targeted interventions. Mapping these interactions will provide a more holistic understanding of the sustainability challenges involved in the Dutch-Kenyan rose trade. This interdisciplinary telecoupling approach reframes and integrates interdisciplinary knowledge about the rose trade between the Netherlands, Kenya, and beyond.

Keywords: Dutch-Kenyan rose trade, globalization, socio-ecological system, sustainability, telecoupling

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Authors: Mary-Luz Olivares-Tenorio, Ruud Verkerk, Matthijs Dekker, Martinus A. J. S. van Boekel

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Cape gooseberry, the fruit of the plant Physalis peruviana L. has gained interest in research given its contents of promising health-promoting compounds like contents. The presence of carotenoids, ascorbic acid, minerals, polyphenols, vitamins and antioxidants. This project aims to study thermal stability of β-carotene, ascorbic acid, catechin and epicatechin and antioxidant activity in the matrix of the Cape Gooseberry. Fruits were obtained from a Colombian field in Cundinamarca. Ripeness stage was 4 (According to NTC 4580, corresponding to mature stage) at the moment of the experiment. The fruits have been subjected to temperatures of 40, 60, 80, 100 and 120°C for several times. β-Carotene, ascorbic acid, catechin and epicatechin content were assessed with HPLC and antioxidant activity with the DPPH method. β-Carotene was stable upon 100°C, and showed some degradation at 120°C. The same behavior was observed for epicatechin. Catechin increased during treatment at 40°C, at 60°C it remained stable and it showed degradation at 80°C, 100°C and 120°C that could be described by a second order kinetic model. Ascorbic acid was the most heat-sensitive of the analyzed compounds. It showed degradation at all studied temperatures, and could be described by a first order model. The activation energy for ascorbic acid degradation in cape gooseberry was 46.0 kJ/mol and its degradation rate coefficient at 100 °C was 6.53 x 10-3 s-1. The antioxidant activity declined for all studied temperatures. Results from this study showed that cape gooseberry is an important source of different health-promoting compounds and some of them are stable to heat. That makes this fruit a suitable raw material for processed products such as jam, juices and dehydrated fruit, giving the consumer a good intake of these compounds.

Keywords: goldenberry, health-promoting compounds, phytochemical, processing, heat treatment

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Authors: S. Ramteke, K. S. Patel

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Aerosols are complex mixture of particulate matters (PM) inclusive of carbons, silica, elements, various salts, etc. Aerosols get deep into the human lungs and cause a broad range of health effects, in particular, respiratory and cardiovascular illnesses. They are one of the major culprits for the climate change. They are emitted by the high thermal processes i.e. vehicles, steel, sponge, cement, thermal power plants, etc. Raipur (22˚33'N to 21˚14'N and 82˚6'E) to 81˚38'E) is a growing industrial city in central India with population of two million. In this work, the distribution of inorganics (i.e. Cl⁻, NO³⁻, SO₄²⁻, NH₄⁺, Na⁺, K⁺, Mg²⁺, Ca²⁺, Al, Cr, Mn, Fe, Ni, Cu, Zn, and Pb) associated to the PM in the ambient air is described. The PM₁₀ in ambient air of Raipur city was collected for duration of one year (December 2014 - December 2015). The PM₁₀ was segregated into nine modes i.e. PM₁₀.₀₋₉.₀, PM₉.₀₋₅.₈, PM₅.₈₋₄.₇, PM₄.₇₋₃.₃, PM₃.₃₋₂.₁, PM₂.₁₋₁.₁, PM₁.₁₋₀.₇, PM₀.₇₋₀.₄ and PM₀.₄ to know their emission sources and health hazards. The analysis of ions and metals was carried out by techniques i.e. ion chromatography and TXRF. The PM₁₀ concentration (n=48) was ranged from 100-450 µg/m³ with mean value of 73.57±20.82 µg/m³. The highest concentration of PM₄.₇₋₃.₃, PM₂.₁₋₁.₁, PM₁.₁₋₀.₇ was observed in the commercial, residential and industrial area, respectively. The effect of meteorology i.e. temperature, humidity, wind speed and wind direction in the PM₁₀ and associated elemental concentration in the air is discussed.

Keywords: ambient aerosol, ions, metals, segregation

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Authors: Purna Prasad Acharya, Madhav Karki, Sunta B. Tamang, Uttam Basnet, Chhatra Katwal

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The paper outlines the idea behind achieving sustainable lifestyles based on the spiritual values and teachings of Lord Buddha. This objective is to be achieved by spreading the tenets and teachings of Buddhism throughout the Asia Pacific region and the world from the sacred birth place of Buddha - Lumbini, Nepal. There is an urgent need to advance the relevance of Buddhist philosophy in tackling the triple planetary crisis of climate change, nature’s decline, and pollution. Today, the world is facing an existential crisis due to the above crises, exasperated by hunger, poverty and armed conflict. To address multi-dimensional impacts, the global communities have to adopt simple life styles that respect nature and universal human values. These were the basic teachings of Gautam Buddha. Lumbini, Nepal has the moral obligation to widely disseminate Buddha’s teaching to the world and receive constant feedback and learning to develop human and ecosystem resilience by molding the lifestyles of current and future generations through adaptive learning and simplicity across the geography and nationality based on spirituality and environmental stewardship. By promoting Buddhism, Nepal has developed a pro-nature tourism industry that focuses on both its spiritual and bio-cultural heritage. Nepal is a country rich in ancient wisdom, where sages have sought knowledge, practiced meditation, and followed spiritual paths for thousands of years. It can spread the teachings of Buddha in a way people can search for and adopt ways to live, creating harmony with nature. Using tools of natural sciences and social sciences, the team will package knowledge and share the idea of community well-being within the framework of environmental sustainability, social harmony and universal respect for nature and people in a more holistic manner. This notion takes into account key elements of sustainable development such as food-energy-water-biodiversity interconnections, environmental conservation, ecological integrity, ecosystem health, community resiliency, adaptation capacity, and indigenous culture, knowledge and values. This inclusive concept has garnered a strong network of supporters locally, regionally, and internationally. The key objectives behind this concept are: a) to leverage expertise and passion of a network of global collaborators to advance research, education, and policy outreach in the areas of human sustainability based on lifestyle change using the power of spirituality and Buddha’s teaching, resilient lifestyles, and adaptive living; b) help develop creative short courses for multi-disciplinary teaching in educational institutions worldwide in collaboration with Lumbini Buddha University and other relevant partners in Nepal; c) help build local and regional intellectual and cultural teaching and learning capacity by improving professional collaborations to promote nature based and Buddhist value-based lifestyles by connecting Lumbini to Nepal’s rich nature; d) promote research avenues to provide policy relevant knowledge that is creative, innovative, as well as practical and locally viable; and e) connect local research and outreach work with academic and cultural partners in South Korea so as to open up Lumbini based Buddhist heritage and Nepal’s Karnali River basin’s unique natural landscape to Korean scholars and students to promote sustainable lifestyles leading to human living in harmony with nature.

Keywords: triple planetary crisis, spirituality, sustainable lifestyles, living in harmony with nature, resilience

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Authors: Binh Thanh Ta, Elizabeth Sturgiss

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Central to patient-centered care is the idea of treating a patient as a person and understanding their perspectives regarding their health conditions and care preferences. Surprisingly, little is known about how GPs can understand their patients’ perspectives. This paper addresses the challenge of understanding patient perspectives in behavior change consultations by adopting Conversation Analysis (CA), which is an empirical research approach that allows both researchers and the audience to examine patients’ perspectives as displayed in GP-patient interaction. To understand people’s perspectives, CA researchers do not rely on what they say but instead on how they demonstrate their endogenous orientations to social norms when they interact with each other. Underlying CA is the notion that social interaction is orderly by all means. (It is important to note that social orders should not be treated as exogenous sets of rules that predetermine human behaviors. Rather social orders are constructed and oriented by social members through their interactional practices. Also, note that these interactional practices are the resources shared by all social members). As CA offers tools to uncover the orderliness of interactional practices, it not only allows us to understand the perspective of a particular patient in a particular medical encounter but, more importantly, enables us to recognise the shared interactional practice for signifying a particular perspective. Drawing on the 10 video-recorded consultations on behavior change in primary care, we have discovered the orderliness of patient laughter when reporting health behaviors, which signifies their orientation to the problematic nature of the reported behaviors. Among 24 cases where patients reported their health behaviors, we found 19 cases in which they laughed while speaking. In the five cases where patients did not laugh, we found that they explicitly framed their behavior as unproblematic. This finding echoes the CA body research on laughter, which suggests that laughter produced by first speakers (as opposed to laughing in response to what has been said earlier) normally indicates some sort of problems oriented to the self (e.g. self-tease, self-depreciation, etc.). This finding points to the significance of understanding when and why patients laugh; such understanding would assist GPs to recognise whether patients treat their behavior as problematic or not, thereby producing responses sensitive to patient perspectives.

Keywords: patient centered care, laughter, conversation analysis, primary care, behaviour change consultations

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Authors: Lutaf Ali, Haris Ahmed, Hina Najmi

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Background: Access, better counseling and quality in the provision of family planning services remain big challenges. Sukh Initiative (a project of three different foundations) is a multi-pronged approach, working in one million underserved population residing peri urban slums in Karachi and providing door to door services by lady health workers (LHWs) and community health workers (CHWs) linked with quality family planning and reproductive (FP/RH) services both at public and private health care facilities. Objective: To assess the improvement in family planning and reproductive health behavior among MWRAs by improving access in peri-urban-underserved population of Karachi. Methodology: Using cross sectional study design 3866 married women with reproductive age (MWRAs) were interviewed in peri urban region of Karachi during November 2016 to January 2017. All face to face structured interviews were conducted with women aged 15-49 currently living with their husbands. Based on the project intervention question on reproductive health were developed and questions on contraceptive use were adopted from PDHS- Pakistan 2013. Descriptive and inferential analysis was performed on SPSS version 22. Results: 65% of population sample are literate, 51% women were in young age group- 15–29. On the poverty index, 6% of the population sample living at national poverty line 1.25$ and 52% at 2.50$. During the project years 79% women opted for facility based delivery; private facilities are the priority choice. 61.7% women initiated the contraceptive use in last two years (after the project).Use of family planning was increased irrespective of education level and poverty index- about 55.5% women with no formal education are using any form of contraception and trend of current modern contraceptives across poverty scores strata equally distributed amongst all groups. Age specific modern contraceptive prevalence rate (mCPR)(between 25-34) was found to be 43.8%. About 23% of this contraceptive ascertained from door to door services- short acting, (pills and condoms) are common, 29.5% from public facilities and 47.6% are from public facilities in which long acting and permanent method most received methods. Conclusion: Strategy of expanding access and choice in the form of providing family planning information and supplies at door step and availability of quality family planning services in the peripheries of underserved may improve the behavior of women regarding FP/RH.

Keywords: access, family planning, underserved population, socio-demographic facts

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Authors: Soualem Mami Zoubida, Brixi Nassima, Beghdad Choukri, Belarbi Meriem

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Cereals are the most important source of dietary fiber in the Nordic diet. The fiber in cereals is located mainly in the outer layers of the kernel; particularly in the bran. Improved diet can help unlock the door to good health. Whole grains are an important source of nutrients that are in short supply in our diet, including digestible carbohydrates, dietary fiber, trace minerals, and other compounds of interest in disease prevention, including phytoestrogens and antioxidants (1). The objective of this study is to know the composition of whole grain cereals (rye, millet, white, and red sorghum) which a majority pushes in the south of Algeria. This shows that the millet has a high rate of the sugar estimated at 67.6%. The high proportion of proteins has been found in the two varieties of sorghum and rye. The millet presents the great percentage in lipids compared with the others cereals. And at the last, a red sorghum has the highest rate of fiber(2). These nutrients, as well as other components of whole grain cereals, have, in terms of health, an increased effect if they are consumed together.

Keywords: chemical composition, miller, Secale cereal, Sorghum bicolor

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Authors: Saman Kumara, Duminda Guruge, Krishani Jayasinghe

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Introduction: Nutrition strongly influences good health and development in early life. This study, based on a health promotion approach, used a community-based intervention to improve child nutrition. The approach provides the community with control of interventions, thereby building its capacity and empowering individuals and communities. The aim of this research was to reduce stunting, low birth weight and underweight in communities from Anuradhapura District in Sri Lanka, by identifying and addressing the underlying determinants of under-nutrition and strengthening families and communities to address them. Methods: A health promotion intervention was designed and implemented-based on a logical framework developed in collaboration with members of targeted community. Community members’ implements action, so they fully own the process. Members of the community identify and address the most crucial determinants of health including child health and development and monitor the initial results of their action and modify action to optimize outcomes as well as future goals. Group Discussion, group activities, awareness programs, cluster meetings, community tools and sharing success stories were major activities to address determinants. Continuous data collection was planned at different levels. Priority was given to strengthening the ability of families and groups or communities to collect meaningful data and analyze these themselves. Results: Enthusiasm and interest of the mother, happiness of the child/ family, dietary habits, money management, tobacco and alcohol use of fathers, media influences, illnesses in the child or others, hygiene and sanitary practices, community sensitiveness and domestic violence were the major perceived determinants elicited from the study. There were around 1000 well-functioning mothers groups in this district. ‘Happiness calendar’, ‘brain calendar’, ‘money tool’ and ‘stimulation books’ were created by the community members, to address determinants and measure the process. Evaluation of the process has shown positive early results, such as improvement of feeding habits among mothers, innovative ways of providing early stimulation and responsive care, greater involvement of fathers in childcare and responsive feeding. There is a positive movement of communities around child well-being through interactive play areas. Family functioning and community functioning improved. Use of alcohol and tobacco declined. Community money management improved. Underweight was reduced by 40%. Stunting and low birth weight among under-fives also declined within one year. Conclusion: The health promotion intervention was effective in changing the determinants of under-nutrition in early childhood. Addressing the underlying determinants of under-nutrition in early childhood can be recommended for similar contexts.

Keywords: birth-weight, community, determinants, stunting, underweight

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Authors: Anna Guitart Atienza, Ana Fernández del Río, Madhav Nekkar, Jelena Ljubicic, África Periáñez, Eura Shin, Lauren Bellhouse

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The use of digital devices in healthcare or mobile health (mHealth) has increased in recent years due to the advances in digital technology, making it possible to nudge healthy behaviors through individual interventions. In addition, mHealth is becoming essential in poor-resource settings due to the widespread use of smartphones in areas where access to professional healthcare is limited. In this work, we evaluate mHealth interventions in low-income countries with a focus on causal inference. Counterfactuals estimation and other causal computations are key to determining intervention success and assisting in empirical decision-making. Our main purpose is to personalize treatment recommendations and triage patients at the individual level in order to maximize the entire intervention's impact on the desired outcome. For this study, collected data includes mHealth individual logs from front-line healthcare workers, electronic health records (EHR), and external variables data such as environmental, demographic, and geolocation information.

Keywords: causal inference, mHealth, intervention, personalization

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Authors: Fabiane Alves Farias Guimarães, Rodrigo Otávio Moretti-Pires, Ana Lúcia Schaefer Ferreira de Mello

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Introduction: Considering the last changes in Brazilian Health and Higher Educational Systems, the production of scientific knowledge regarding dental education and training has been increasing. The National Curriculum Guidelines for undergraduate courses in Dentistry established in 2002 the principles and procedures to perform a more generalist dental professional profile. Objectives: To perform a systematic review of the Brazilian scientific literature about dental education and training. Methods: The systematic review was conducted considering the Lilacs - Latin American Literature in Health Sciences and SciELO - Scientific Electronic Library Online data bases, using the combination of key words dentistry, education, teaching or training. It was select original research articles, published between 2010 and 2013, in Portuguese. Results: Based on the selection criteria, it was found 23 articles. In order to organize the outcomes, the analysis was separated in three themes: Ethical aspects of education (3 articles), integrating dental service with training (10 articles) and Dental education and the Brazilian curriculum guidelines (10 articles). Most of the studies were published between 2011 and 2012 (35% each) and were held in public universities. The studied populations included dental students, teachers, universities directors, health managers and dentists. The qualitative methodological approach was predominant. Conclusion: It was possible to identify a transience time in Brazilian undergraduate courses in Dentistry after curricular changes. The produced literature shows some advances, as the incorporation of ethical values on dental education and the inclusion of new practices environments for students by integrating education and training in diversified dental services scenarios.

Keywords: Teaching, Dental Students, Human resources in dentistry

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Authors: Elizabeth M. Seabrook, Nikki S. Rickard

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Examining time-dependent measures of emotion such as variability, instability, and inertia, provide critical and complementary insights into mental health status. Observing changes in the pattern of emotional expression over time could act as a tool to identify meaningful shifts between psychological well- and ill-being. From a practical standpoint, however, examining emotion dynamics day-to-day is likely to be burdensome and invasive. Utilizing social media data as a facet of lived experience can provide real-world, temporally specific access to emotional expression. Emotional language on social media may provide accurate and sensitive insights into individual and community mental health and well-being, particularly with focus placed on the within-person dynamics of online emotion expression. The objective of the current study was to examine the dynamics of emotional expression on the social network platform Facebook for active users and their relationship with psychological well- and ill-being. It was expected that greater positive and negative emotion variability, instability, and inertia would be associated with poorer psychological well-being and greater depression symptoms. Data were collected using a smartphone app, MoodPrism, which delivered demographic questionnaires, psychological inventories assessing depression symptoms and psychological well-being, and collected the Status Updates of consenting participants. MoodPrism also delivered an experience sampling methodology where participants completed items assessing positive affect, negative affect, and arousal, daily for a 30-day period. The number of positive and negative words in posts was extracted and automatically collated by MoodPrism. The relative proportion of positive and negative words from the total words written in posts was then calculated. Preliminary analyses have been conducted with the data of 9 participants. While these analyses are underpowered due to sample size, they have revealed trends that greater variability in the emotion valence expressed in posts is positively associated with greater depression symptoms (r(9) = .56, p = .12), as is greater instability in emotion valence (r(9) = .58, p = .099). Full data analysis utilizing time-series techniques to explore the Facebook data set will be presented at the conference. Identifying the features of emotion dynamics (variability, instability, inertia) that are relevant to mental health in social media emotional expression is a fundamental step in creating automated screening tools for mental health that are temporally sensitive, unobtrusive, and accurate. The current findings show how monitoring basic social network characteristics over time can provide greater depth in predicting risk and changes in depression and positive well-being.

Keywords: emotion, experience sampling methods, mental health, social media

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Authors: Susan Scott, Dina Hanna, Bassel Zebian, Gary Ruiz, Sreena Das

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Although the number of cases of TB in England has fallen over the last 4 years, it remains an important public health burden with 1 in 20 cases dying annually. The vast majority of cases present in non-UK born individuals with social risk factors. We present a case of non-pulmonary TB presenting in a healthy child born in the UK to professional parents. We present a case of a healthy 10 year old boy who developed acute back pain during school PE. Over the next 5 months, he was seen by various health and allied professionals with worsening back pain and kyphosis. He became increasing unsteady and for the 10 days prior to admission to our hospital, he developed fevers. He was admitted to his local hospital for tonsillitis where he suffered two falls on account of his leg weakness. A spinal X-ray revealed a pathological fracture and gibbus formation. He was transferred to our unit for further management. On arrival, the patient had lower motor neurone signs of his left leg. He underwent spinal fixture, laminectomy and decompression. Microbiology samples taken intra-operatively confirmed Mycobacterium Tuberculosis. He had a positive Mantoux and T-spot and treatment were commenced. There was no evidence of immune compromise. The patient was born in the UK, had a BCG scar and his only travel history had been two years prior to presentation when he travelled to the Phillipines for a short holiday. The patient continues to have issues around neuropathic pain, mobility, pill burden and mild liver side effects from treatment. Discussion: There is a paucity of case reports on spinal TB in paediatrics and diagnosis is often difficult due to the non-specific symptomatology. Although prognosis on treatment is good, a delayed diagnosis can have devastating consequences. This case highlights the continued need for higher index of suspicion and diagnosis in a world with changing patterns of migration and increase global travel. Surgical intervention is limited to the most serious cases to minimise further neurological damage and improve prognosis. There remains the need for a multi-disciplinary approach to deal with challenges of treatment and rehabilitation.

Keywords: tuberculosis, non-pulmonary TB, public health burden, diagnostic challenge

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Authors: Khadije Khazaeli, Farzane Saberi

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Spinal cord injury is one of the traumatic events which has a great impact on the quality of life. spirituality has been used to improve many disorders and abnormalities in recent years and positive results have been seen; accordingly, the present study investigated the relationship between spirituality and quality of life in these patients. This study is a cross-sectional study of the correlation type was conducted on 100 people with spinal cord injury in Isfahan province in 2016 by the available sample method. Spirituality was assessed through the Spiritual Attitude Questionnaire and quality of life through the World Health Organization Quality of Life Questionnaire. Pearson correlation and regression tests were used to analyze the data. The results of this study showed that spirituality has a significant relationship with the quality of life of patients with spinal cord injury. It was also proved that all sub-units of spirituality, including attitude and spiritual ability, can affect all components of quality of life. The findings suggest that spirituality, along with other factors, can lead to a significant improvement in quality of life and, ultimately, general health of patients with SCI.

Keywords: spinal cord injury, quality of life, spirituality, patients

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Authors: Amina Salem Attia

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This east project consists in studying The child's mental health is the medium through which he expresses his thoughts, so pay attention to it because it is an essential building block in the process of building the child's future personality, where it gives him a balance between feelings and mental thoughts, and since the family is the child's first guardian, it greatly affects his personality and psychological development. As the disturbed environment contributes to behavioral deviations and mental disorders, unlike the stable environment, which plays a major role in developing the child's abilities and forming his psychologically sound attitudes, this should not be forgotten about the role of the school, it is also the second social institution after the family and has a major impact on the child's mental health as it contributes It is important in forming the child's personality and developing his skills and achieving his healthy psychological development, by providing him with psychological care and helping him to solve his problems by using models that are valid for the behavior that is taught to him or that the teachers present in their daily behavior with him.

Keywords: psychological, behavioral problems, children, school education

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Authors: Cait M. Henry, Sarah Jackson

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Abstract-This study is built from the culmination of four years of research into the cultural interpretation of Civil War heritage at a National Park Service (NPS) site, namely the Manassas National Battlefield Park, within an increasingly contentious political landscape surrounding the U.S. Civil War. Originating as questions regarding the relevancy of historic battlefields to the current culture within the United States soon evolved into more philosophical questions about what it means to feel welcome at a battlefield site, and what are considered appropriate actions and behaviors at what was once a mass gravesite. In trying to answer these questions, this work aims to critically analyze the confluence between the cultural authority of the NPS and collective memories of the U.S. Civil War. Operationalizing trauma as repeated violent acts within public spaces, the authors posit that the normalization of violence from white or white-passing men partially stems from the glorification of heroic white masculinity at National Park Service Civil War battlefield sites—especially those which also commemorate Confederate military strategy and prowess. From here the study moves outward to focus on the prevalence of heroic white masculinity within the nation’s current social zeitgeist, and particularly the notion that to take back masculinity one must utilize violence as a means of symbolic restoration from perceptions of white victimhood. The study ends with case studies of dark tourism framing at international battlefields as models for expanding heritage interpretation at the NPS site to foster narratives of empathy and responsibility within an increasingly contentious political landscape within the United States of America. Visitors do not leave Manassas National Battlefield Park with answers about the social and moral implications of the U.S. Civil War, but the tools for championing their own (predominantly white) heroic masculinity. As such, it is only logical that one common reaction when masculinity is symbolically threatened is to enact violence against Others as a restorative force within the United States.

Keywords: confederate heritage, military history, national park service, trauma, United States civil war

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Authors: Rama Krishna Supramanian, Marzuki Isahak, Noran Naqiah Hairi

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Noise-induced hearing loss (NIHL) is one of the highest recorded occupational diseases, despite being preventable. Hearing Conservation Program (HCP) is designed to protect workers hearing and prevent them from developing hearing impairment due to occupational noise exposures. However, there is still a lack of evidence regarding the effectiveness of this program. The purpose of this study was to determine the effectiveness of a Hearing Conservation Program (HCP) in preventing or reducing audiometric threshold changes among vector control workers. This study adopts a cluster randomized controlled trial study design, with district health offices as the unit of randomization. Nine district health offices were randomly selected and 183 vector control workers were randomized to intervention or control group. The intervention included a safety and health policy, noise exposure assessment, noise control, distribution of appropriate hearing protection devices, training and education program and audiometric testing. The control group only underwent audiometric testing. Audiometric threshold changes observed in the intervention group showed improvement in the hearing threshold level for all frequencies except 500 Hz and 8000 Hz for the left ear. The hearing threshold changes range from 1.4 dB to 5.2 dB with largest improvement at higher frequencies mainly 4000 Hz and 6000 Hz. Meanwhile for the right ear, the mean hearing threshold level remained similar at 4000 Hz and 6000 Hz after 3 months of intervention. The Hearing Conservation Program (HCP) is effective in preserving the hearing of vector control workers involved in fogging activity as well as increasing their knowledge, attitude and practice towards noise-induced hearing loss (NIHL).

Keywords: adult, hearing conservation program, noise-induced hearing loss, vector control worker

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Authors: H. Chabalala, A. Grootboom, M. Tang

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The innovative development, production, and clinical utilisation of African natural medicines requires frameworks from systematisation, innovation, registration. Afrika faces challenges when it comes to these sectors. The opposite is the case as is is evident in ancient Asian (Traditional Chinese Medicine and Indian Ayurveda and Siddha) medical systems, which are interfaced into their respective national health and educational systems. Afrikan Natural Medicines (ANMs) are yet to develop systematisation frameworks, i.e. disease characterisation and medicines classification. This paper explores classical medical systems drawn from Afrikan and Chinese experts in natural medicines. An Afrikological research methodology was used to conduct in-depth interviews with 20 key respondents selected through purposeful sampling technique. Data was summarised into systematisation frameworks for classical disease theories, patient categorisation, medicine classification, aetiology and pathogenesis of disease, diagnosis and prognosis techniques and treatment methods. It was discovered that ancient Afrika had systematic medical cosmologies, remnants of which are evident in most Afrikan cultural health practices. Parallels could be drawn from classical medical concepts of antiquity, like Chinese Taoist and Indian tantric health systems. Data revealed that both the ancient and contemporary ANM systems were based on living medical cosmologies. The study showed that African Natural Healing Systems have etiological systems, general pathogenesis knowledge, differential diagnostic techniques, comprehensive prognosis and holistic treatment regimes. Systematisation models were developed out of these frameworks, and this could be used for evaluation of clinical research, medical application including development of curriculum for high-education. It was envisaged that frameworks will pave way towards the development, production and commercialisation of ANMs. This was piloted in inclusive innovation, technology transfer and commercialisation of South African natural medicines, cosmeceuticals, nutraceuticals and health infusions. The central model presented here in will assist in curriculum development and establishment of Afrikan Medicines Hospitals and Pharmaceutical Industries.

Keywords: African Natural Medicines, Indigenous Knowledge Systems, Medical Cosmology, Clinical Application

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Authors: Lydia Booney Jyrwa, Rabindra Nath Bhuyan

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Chocolate Mahseer (Neolissochilus hexagonolepis) is one of the Mahseer species inhabiting the North-eastern region of India and is a native species to the state of Meghalaya since it can adapt and grow well under the agro climatic conditions of the region. The natural population of this fish has been declining over the years from this part of the country. The natural population of this fish has been declining over the years from this part of the country. The fish is considered as one of the endangered species of the Mahseer group, which is having tremendous scope for culture, sports and tourism. But non-availability of quality seed is a hindrance for the culture of this fish. Thus induced breeding of the fish by hormonal administration with pituitary gland and synthetic hormones is the only reliable method to procure the pure seed of the fish. Chocolate Mahseer was successfully bred at the Hatchery Complex, St. Anthony’s College, Shillong, Meghalaya by using pituitary extract and synthetic hormone viz. ovaprim, ovatide and gonopro-FH. The dose standardized is @ 4mg/kg body weight to both male and female as 1st dose and @ 7.9 mg/kg body weight only to female as 2nd dose for pituitary extract and single dose @ 0.8 ml/kg body weight to female and @ 0.3 ml/kg body weight to male of both ovaprim and ovatide, while a single dose @ 0.9 ml/kg body weight to female and @ 0.3 ml/kg body weight to male of gonopro-FH. The doses are standardized after a series of trial and error experiment performed. The fecundity of the fish was 3500 eggs/ kg body weight. The final hatching percentage achieved was 60%. The survival rate of hatchling was 50% up to fry stage. The use of synthetic hormone and positive response of the fish to the hormone will go in long way for production of quality seed of the fish which in turn help in culture of the species as the fish can be a very good candidate species for the culture in the state. This study will also help in the ranching of the fish in the natural habitat leading to conservation of the species. However, the study should be continued further for the large scale production of seeds.

Keywords: chocolate mahseer, induced breeding, pituitary extract, synthetic hormone

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