Search results for: intestinal health

Authors: Kanda Janyam, Piyaporn Vijit

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Background: As a consequence of sustained declines in fertility and mortality during the last three decades of the 20th century, Thailand faces a rapidly growing population of older persons. This demographic change directly affect Thailand workforce. Therefore, the study of health promotion behaviour of the older employees will benefit the employers as they can then develop the preparation for promoting well-being in older persons. Purpose: The current study aims to investigate health promotion behaviour and factors related to health promotion behaviour of older employees in factory. Methodology: The research instrument was questionnaire on health promotion behaviour and semi-structured interviews. The questionnaire was launched with 326 employees aged between 45-59 years in three factories in Songkhla Province, southern Thailand. The data collection started in December 2011. The data were analysed with mean, standard deviation, and correlation. Results: The results revealed that overall health promotion behaviour of the older employees in factory was at a high level. Moreover, when considered by aspect, it was found that their responsibility for health, nutrition, success in life, interpersonal relationship were at a high level while stress management, and exercise were at a moderate level. The results from correlation analysis indicated that the overall health promotion behaviour was positively related to knowledge of health promotion behaviour, attitude toward health promotion behaviour, health perception, the policy of health promotion, participation in health promotion activities, convenience in obtaining health promotion services, health resources, advice from people supporting health, and information received from the media. In addition, the results of the interviews with four key informants helped to confirm the factors related to health promotion behaviour of older employees in factory. Therefore, health promotion for elderly employees in factory is likely to be successful, if the support is given to the four health promotion factors that are divided into: leading factors consisting of attitude toward health promotion behaviour, and health perception, and supporting factors consisting of advice from other people, and information on health from various media. Practical implications: The results of the study identified the factors related to health promotion behaviour of older employees in factory. Such information will benefit employers as they can then develop specific strategies to increase their staffs’ well-being and, hence, presumably enhance the organization productivity.

Keywords: health promotion behavior, older, employee, factory

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Authors: Rudra Vaghela, P. K. Kulkarni

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The aim of the present research was to develop oral Amphotericin B (AmB) nanocrystals (Nc) grafted with suitable ligand in order to enhance drug transport across the intestinal epithelial barrier and subsequently, active uptake by macrophages. AmB Nc were prepared by liquid anti-solvent precipitation technique (LAS). Poloxamer 188 was used to stabilize the prepared AmB Nc and grafted with mannose for actively targeting M cells in Peyer’s patches. To prevent shedding of the stabilizer and ligand, N,N’-Dicyclohexylcarbodiimide (DCC) was used as a cross-linker. The prepared AmB Nc were characterized for particle size, PDI, zeta potential, X-ray diffraction (XRD) and surface morphology using scanning electron microscope (SEM) and evaluated for drug content, in vitro drug release and cell uptake studies using caco-2 cells. The particle size of stabilized AmB Nc grafted with WGA was in the range of 287-417 nm with negative zeta potential between -18 to -25 mV. XRD studies revealed crystalline nature of AmB Nc. SEM studies revealed that ungrafted AmB Nc were irregular in shape with rough surface whereas, grafted AmB Nc were found to be rod-shaped with smooth surface. In vitro drug release of AmB Nc was found to be 86% at the end of one hour. Cellular studies revealed higher invasion and uptake of AmB Nc towards caco-2 cell membrane when compared to ungrafted AmB Nc. Our findings emphasize scope on developing oral delivery system for passively targeting M cells in Peyer’s patches.

Keywords: leishmaniasis, amphotericin b nanocrystals, macrophage targeting, LAS technique

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Authors: Sandip Shrestha, Ann M. Donoghue, Komala Arsi, Basanta R. Wagle, Abhinav Upadhyay, Dan J. Donoghue

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Campylobacter, one of the major cause of foodborne illness worldwide, is commonly present in the intestinal tract of poultry. Many strategies are currently being investigated to reduce Campylobacter counts on commercial poultry during processing with limited success. This study investigated the efficacy of the generally recognized as safe compound, carvacrol (CR), a component of wild oregano oil as a wash treatment for reducing C. jejuni and aerobic bacteria on chicken skin. A total of two trials were conducted, and in each trial, a total of 75 skin samples (4cm × 4cm each) were randomly allocated into 5 treatment groups (0%, 0.25%, 0.5%, 1% and 2% CR). Skin samples were inoculated with a cocktail of four wild strains of C. jejuni (~ 8 log10 CFU/skin). After 30 min of attachment, inoculated skin samples were dipped in the respective treatment solution for 1 min, allowed to drip dry for 2 min and processed at 0, 8, 24 h post treatment for enumeration of C. jejuni and aerobic bacterial counts (n=5/treatment/time point). The data were analyzed by ANOVA using PROC GLM procedure of SAS 9.3. All the tested doses of CR suspension consistently reduced C. jejuni counts across all time points. The 2% CR wash was the most effective treatment and reduced C. jejuni counts by ~4 log₁₀ CFU/sample (P < 0.05). Aerobic counts were reduced for the 0.5% CR dose at 0 and 24h in Trial 1 and at 0, 8 and 24h in Trial 2. The 1 and 2% CR doses consistently reduced aerobic counts in both trials up to 2 log₁₀ CFU/skin.

Keywords: Campylobacter jejuni, carvcrol, chicken skin, postharvest

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Authors: Marina Kartseva, Polina Kuznetsova

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In our work, we estimate the contribution of inequality of opportunity to inequality in the health of the Russian population aged 25 to 74 years. The empirical basis of the study is the nationally representative data of the RLMS for 2018. Individual health is measured using a self-reported status on five-point scale. The startconditions are characterized by parental education and place of birth (country, type of settlement). Personal efforts to maintain health include the level of education, smoking status, and physical activity. To understand how start opportunities affect an individual's health, we use the methodology proposed in (Trannoy et al., 2010), which takes into account both direct and indirect (through the influence on efforts) effects. Regression analysis shows that all other things being equal, the starting capabilities of individuals have a significant impact on their health. In particular, parental education has a positive effect on self-reported health. Birth in another country, in another settlement, and in an urban area, on the contrary, reduceself-reported health. This allows to conclude that there exists an unfair inequality in health, namely inequality caused by factors that are independent of a person's own efforts. We estimate the contribution of inequality of opportunity to inequality in health using a nonparametric approach (Checchi, Peragine, 2010; Lazar, 2013). According to the obtained results, the contribution of unfair inequality as 72-74% for the population as a whole, being slightly higher for women (62-74% and 60-69% for men and women, respectively) and for older age (59- 62% and 67-75% for groups 25-44 years old and 45-74 years old, respectively). The obtained estimates are comparable with the results for other countries and indicate the importance of the problem of inequality of opportunities in health in Russia.

Keywords: inequality of opportunity, inequality in health, self-reported health, efforts, health-related lifestyle, Russia, RLMS

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Authors: Vera Lúcia Raposo

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The right to health care – usually known as the right to health – is recognized in many national laws and Constitutions, as well as in international human rights documents. The kind of health care that citizens are entitled to receive, especially in the framework of the National Health Service, is usually identified with conventional medicine. However, since ancient times that a different form of medicine – alternative, traditional or nonconventional medicine – exists. In recent times it is attracting increasing interest, as it is demonstrated by the use of its specific knowledge either by pharmaceutical companies either by modern health technologies. Alternative medicine refers to a holistic approach to body and mind using herbal products, animal parts and minerals instead of technology and pharmaceutical drugs. These notes contributed to a sense of distrust towards it, accusing alternative medicine of being based on superstition and ignorance. However, and without denying that some particular practices lack indeed any kind of evidence or scientific grounds, the fact is that a substantial part of alternative medicine can actually produce satisfactory results. The paper will not advocate the substitution of conventional medicine by alternative medicine, but the complementation between the two and their specific knowledge. In terms of the right to health, as a fundamental right and a human right, this thesis leads to the implementation of a wider range of therapeutic choices for patients, who should be entitled to receive different forms of health care that complement one another, both in public and private health facilities. This scenario would demand a proper regulation for alternative medicine, which nowadays does not exist in most countries, but it is essential to protect patients and public health in general and to reinforce confidence in alternative medicine.

Keywords: alternative medicine, conventional medicine, patient’s rights, right to health

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Authors: Pedro G. Rodrigues, Maria J. Bárrios, Sara A. Ambrósio

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The digitalisation of health is a profoundly transformative economic, political, and social process. As is often the case, such processes need to be carefully managed if misunderstandings, policy misalignments, or outright conflicts between the government and a wide gamut of stakeholders with competing interests are to be avoided. Thus, ensuring open lines of communication where all parties know what each other’s concerns are is key to good governance, as well as efficient and effective policymaking. This project aims to make a small but still significant contribution in this regard in that we seek to determine the extent to which health managers’ perceptions of what is a priority for digital health in Portugal are aligned with official policy perspectives. By applying state-of-the-art artificial intelligence technology first to the indexed literature on digital health and then to a set of official policy documents on the same topic, followed by a survey directed at health managers working in public and private hospitals in Portugal, we obtain two priority rankings that, when compared, will allow us to produce a synthesis and toolkit on digital health policy in Portugal, with a view to identifying areas of policy convergence and divergence. This project is also particularly peculiar in the sense that sophisticated digital methods related to text analytics are employed to study good governance aspects of digitalisation applied to health care.

Keywords: digital health, health informatics, text analytics, governance, natural language understanding

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Authors: Saqib Amina, Waqas Mehmoodb, Iftikhar Yasinc

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This study analyzes the robust association between ethnic violence and mental health from a global perspective (201-countries across the world) by using the panel data for the period 1970 to 2020. Mental health has been determined through various dimensions such as mental disorders, anxiety disorder, depressive disorder, schizophrenia, and bipolar disorder. The empirical findings show that ethnic violence has a significant positive association with all types of mental health indicators, including mental disorders, anxiety disorder, depressive disorder, schizophrenia, and bipolar disorder. The study also reveals that institutional quality may reduce the effect of mental health disorders in a better way than promoting democracy. This study suggests the non-stigmatizing social form of community-based support services instead of a stigmatizing the concept of mental illnesses that promotes hospitalization and drug treatment.

Keywords: ethnic violence, unemployment, mental health, violence

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Authors: Dipendra Kumar Yadav, Rajani Ghimire, Saroj Yadav

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Background: The concern about adolescent on reproductive health has grown due to unprecedented increasing rates of early pregnancies and sexually transmitted Infections and they do not have adequate awareness and knowledge about it. Access to these services as well as information about them is, therefore, crucial for adolescents to utilize and benefit from sexual and reproductive health services. The objective of the study was to assess the reproductive health knowledge, attitude and health services utilization among adolescents in rural and urban areas of Kaski district. Materials and Methods: A community-based descriptive cross-sectional study was conducted among adolescents (10-19 years of age) in rural and urban areas of Kaski district, Nepal. The period of data collection was October to November, 2014. Altogether 419 participants were taken for the study. Results: The mean age of the respondents was 15.86 and standard deviation was ±2.305. More than half (58.7 %) of the respondents were females and 41.3 % were males. Out of 419, majority (78.8%) of the respondents were known about family planning, among them only 70 % of respondents were aware about family planning methods. Fifty-one percentages of the respondents were aware about the sexually transmitted diseases. Before giving a birth there is need to consult with partner with this fact 68.7 % of the respondents were agree, 23.6 % of them were neutral and very few (7.6%) of them were disagree. Nearly twenty six percentage of the respondents were faced the reproductive health problems within one month. Out of 107 respondents, 57.9 % did not utilize reproductive health services because of different reasons. Conclusions: The overall level of knowledge towards reproductive health among adolescents was found low. However, levels of attitude towards different reproductive health components were found favorable. Only 42.1% of the respondents were utilized reproductive health services among those who was faced the reproductive health problems within one month which was low coverage of reproductive health services utilization.

Keywords: reproductive health knowledge, reproductive health attitudes, adolescent, service utilization

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Authors: Cindy de Frias, Erum Whyne

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Objectives: The current study examined whether the link between stress and health-related quality of life was buffered by protective factors, namely mindfulness, in a sample of middle-aged and older adults. Method: In this cross-sectional study, 134 healthy, community-dwelling adults (aged 50–85 years) were recruited from Dallas, Texas. The participants were screened for depressive symptoms and severity (using the Patient Health Questionnaire [PHQ-9]). All participants completed measures of self-reported health status (i.e., SF-36v2: mental and physical health composites), life stress (using the Elder’s Life Stress Inventory [ELSI]), and trait mindfulness (i.e., Mindful Attention Awareness Scale). Results: Hierarchical regressions (covarying for age, gender, and education) showed that life stress was inversely related to physical and mental health. Mindfulness was positively related to mental health. The negative effect of life stress on mental health was weakened for those individuals with greater trait mindfulness. Discussion: The results suggest that mindfulness is a powerful, adaptive strategy that may protect middle-aged and older adults from the well-known harmful effects of stress on healthy aging.

Keywords: health, stress, mindfulness, aging

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Authors: K. M. G. T. R. Waidyarathna, S. M. Vidanagamachchi

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Public Health System exists in Sri Lanka has a satisfactory complete information flow when compared to other systems in developing countries. The availability of a good health information system contributed immensely to achieve health indices that are in line with the developed countries like US and UK. The health information flow at the moment is completely paper based. In Sri Lanka, the fields like banking, accounting and engineering have incorporated information and communication technology to the same extent that can be observed in any other country. The field of medicine has behind those fields throughout the world mainly due to its complexity, issues like privacy, confidentially and lack of people with knowledge in both fields of Information Technology (IT) and Medicine. Sri Lanka’s situation is much worse and the gap is rapidly increasing with huge IT initiatives by private-public partnerships in all other countries. The major goal of the framework is to support minimizing the spreading diseases. To achieve that a web based framework should be implemented for this application domain with web mapping. The aim of this GIS based public health system is a secure, flexible, easy to maintain environment for creating and maintaining public health records and easy to interact with relevant parties.

Keywords: DHIS2, GIS, public health, Sri Lanka

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Authors: Mohammed-Hareef Asunramu, Sana Hashemi, Raja Ohri, Luc Worthington, Nadia Zaman, Junkai Zhu

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Background: The 2012 Health and Social Care Act committed to a ‘parity of esteem between mental and physical health services. Although this investment, aimed to both increase the quality of services and ensure the retention of mental health staff, questions remained regarding its ability to prevent mental health problems. One possible solution is a focus on the social determinants of health which have been shown to impact mental health. Aim: To examine the relationship between the index of multiple deprivations (IMD) and the prevalence of common mental health disorders (CMD) for CCGs in NHS England between 2019 and 2020. Design and setting: Cross-sectional analysis of 189 CCGs in NHS England. Methods: A multivariate linear regression model was utilized with CMD as outcome variable and IMD, age and ethnicity as explanatory variables. Datasets were obtained from Public Health England and the latest UK Census. Results: CCG IMD was found to have a significantly positive relationship with CMD. For every 1-point increase in IMD, CMD increases by 0.25%. Ethnicity had a significantly positive relationship with CMD. For every 1% increase in the population that identifies as BME, there is a 0.03% increase in CMD. Age had a significantly negative relationship with CMD. For every 1% increase in the population aged 60+, there is a 0.11% decrease in CMD. Conclusion: This study demonstrates that addressing mental health issues may require a multi-pronged approach. Beyond budget increases, it is essential to prioritize health equity, with careful considerations towards ethnic minorities and different age brackets.

Keywords: deprivation, health inequality, mental health, social determinants

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Authors: Swati Naruka

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"Looking after one’s mind is as important as looking after one’s body". As part of one’s overall health, mental and emotional health or well being is a necessary condition to enable one to manage one’s life successfully. Mental health is the capacity of an individual to form harmonious adjustments to one’s social and physical environments. Universities and colleges are dealing with substantial challenges posed by the changing mental health needs of today’s college students. It is important for administrators, faculty, and staff to understand the profound impact that mental health problems can have on all aspects of campus life, and to treat mental health issues as an institutional responsibility and priority. Counselling centres can respond effectively to the current challenges if they have the support and commitment of the administration; and if they take steps to balance the demand for services with existing resources by reviewing priorities, establishing appropriate limits, employing innovative strategies, and practicing good self-care to minimize stress and burnout. The need for counselling centres has never been greater. They will continue to play an important role in supporting the mission of higher education institutions by providing counselling for students who are experiencing problems and assisting them in achieving their educational and personal goals.

Keywords: mental health, well being, India, college students

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Authors: Ming Ma, Rui Li

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In the highly urbanized district, green open space is playing an important role in human’s health and wellbeing as a physical, aesthetic and natural environment resources. The aim of this paper is to close this gap through providing a comprehensive, qualitative meta-analysis of existing studies related to this issue. A systematic scoping of current quantitative research is conducted which mostly focused on cross-sectional survey and experimental studies. Health benefits from contact with green open space could be categorized into physical health, psychological health and social wellbeing. Mechanism for the health related to green open space could be clearly identified with the regard to natural restoration, physical activities and social capital. These results indicate a multiple pathways framework between the health benefits and mechanism. In order to support design and planning, the most evident relationship was picked up that people could psychologically benefit from green open space through outdoors physical activities. Additionally, three design and planning strategies are put forward. Various and multi-level contacts with green open space would be considered as an explanation of the pathway results and tie to bridge the health to design and planning. There is a need to carry out long-term research emphasizing on causal relationship between health and green open space through excluding cofounding factors such as self-selection.

Keywords: urban green open space, planning and design, health benefit, mechanism, pathway framework

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Authors: Erol Karaca

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This study aims to analyze ceramic employees’ occupational health and safety training expectations. To that general objective, the study tries to examine whether occupational health and safety training expectations of ceramic employees meaningfully differentiate depending on demographic features and professional, social and economic conditions. For this purpose, the research data was collected through “Questionnaire of Occupational Health and Safety Training Expectation” (QSOHSTE) consisting of 25 open and close-ended questions developed by the researcher on the base of the literature review. QSOHSTE was applied to 125 ceramic employees working in Kutahya, Turkey. Data obtained from questionnaires were analyzed via SPSS 21. The findings, obtained from the study, revealed that employees’ agreement level to occupational health and safety training expectation statements is generally high-level. These findings also reveals that employees have various expectations about occupational health and safety training. These expectations are increasing sensitivity towards occupational health and safety training about the prevention of occupational accidents and diseases, contributing occupational health and safety training in establishing healthy and safe working environment, requiring occupational health and safety training before starting work, in case of changing working equipment and new technological applications, necessity of measurement and evaluation after occupational health and safety training. Besides these findings, employees’ agreement level to occupational health and safety training expectation statements also varies in terms of educational level, professional seniority, income level and perception of economic condition.

Keywords: occupational health and safety, occupational training, occupational expectation, professional seniority

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Authors: Manisha Singh, Padam Simkhada

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Background: Although mental health policy has been adapted in Nepal since 1997, the implementation of the policy framework is yet to happen. The fact that mental health services are largely concentrated in urban areas more specific to treatment only provides a clear picture of the scarcity of mental health services in the country. The shreds of evidence from around the world, along with WHO’s (World Health Organization) Mental Health Gap Action Program (mhGAP) suggest that effective mental health services can be provided from Primary Health Care (PHC) centers through community-based programs without having to place a specialized health worker. However, the country is still facing the same challenges to date with very few psychiatrists and psychologists, but they are largely based in cities. Objectives: The main objectives of this study are; (a) to understand the perception of health workers at PHC on maternal mental health, and (b) to assess the availability of the mental health services at PHC to address maternal mental health. Methods: This study used a qualitative approach where an in-depth interview was conducted with the health workers at the primary level. “Mayadevi” rural municipality in Rupendehi District that comprised of 13 small villages, was chosen as the study site. A total 8 health institutions which covered all 13 sites were included where either the health post in- charge or health worker working in maternal and child health care was interviewed for the study. All the health posts in the study area were included in the study. The interviews were conducted in Nepali; later, they were translated in English, transcribed, and triangulated. NViVO was used for the analysis. Results: The findings show that most of the health workers understood what maternal mental health was and deemed it as a public health issue. They could explain the symptoms and knew what medication to prescribe if need be. However, the majority of them failed to name the screening tools in place for maternal mental health. Moreover, they hadn’t even seen one. None of the health care centers had any provision for screening mental health status. However, one of the centers prescribed medication when the patients displayed symptoms of depression. But they believed there were a significant number of hidden cases in the community due to the stigma around mental health and being a woman with mental health problem makes the situation even difficult. Nonetheless, the health workers understood the importance of having screening tools and acknowledged the need of training and support in order to provide the services from PHC. Conclusion: Community health workers can identify cases with mental health problems and prevent them from deteriorating further. But there is a need for robust training and support to build the capacity of the health workers. The screening tools on mental health needs to be encouraged to be used in the PHC levels. Furthermore, community-based culture-sensitive programs need to be initiated and implemented to mitigate the stigma related issues around mental health.

Keywords: maternal mental health, health care providers, screening, Nepal

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Authors: Michelle E. Taylor, Clare E. Morrall

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Microplastics are small particles produced for industrial purposes or formed by breakdown of anthropogenic debris. Caribbean nations import large quantities of plastic products. The Caribbean region is vulnerable to natural disasters and Climate Change is predicted to bring multiple additional challenges to island nations. Microplastics have been found in an array of marine environments and in a diversity of marine species. Occurrence of microplastic in the intestinal tracts of marine fish is a concern to human and ecosystem health as pollutants and pathogens can associate with plastics. Studies have shown that the incidence of microplastics in marine fish varies with species and location. Prevalence of microplastics (≤ 5 mm) in fish species from Grenadian waters (representing pelagic, semi-pelagic and demersal lifestyles) harvested for human consumption have been investigated via gut analysis. Harvested tissue was digested in 10% KOH and particles retained on a 0.177 mm sieve were examined. Microplastics identified have been classified according to type, colour and size. Over 97% of fish examined thus far (n=34) contained microplastics. Current and future work includes examining the invasive Lionfish (Pterois spp.) for microplastics, investigating marine invertebrate species as well as examining environmental sources of microplastics (i.e. rivers, coastal waters and sand). Owing to concerns of pollutant accumulation on microplastics and potential migration into organismal tissues, we plan to analyse fish tissue for mercury and other persistent pollutants. Despite having ~110,000 inhabitants, the island nation of Grenada imported approximately 33 million plastic bottles in 2013, of which it is estimated less than 5% were recycled. Over 30% of the imported bottles were ‘unmanaged’, and as such are potential litter/marine debris. A revised Litter Abatement Act passed into law in Grenada in 2015, but little enforcement of the law is evident to date. A local Non-governmental organization (NGO) ‘The Grenada Green Group’ (G3) is focused on reducing litter in Grenada through lobbying government to implement the revised act and running sessions in schools, community groups and on local media and social media to raise awareness of the problems associated with plastics. A local private company has indicated willingness to support an Anti-Litter Campaign in 2018 and local awareness of the need for a reduction of single use plastic use and litter seems to be high. The Government of Grenada have called for a Sustainable Waste Management Strategy and a ban on both Styrofoam and plastic grocery bags are among recommendations recently submitted. A Styrofoam ban will be in place at the St. George’s University campus from January 1st, 2018 and many local businesses have already voluntarily moved away from Styrofoam. Our findings underscore the importance of continuing investigations into microplastics in marine life; this will contribute to understanding the associated health risks. Furthermore, our findings support action to mitigate the volume of plastics entering the world’s oceans. We hope that Grenada’s future will involve a lot less plastic. This research was supported by the Caribbean Node of the Global Partnership on Marine Litter.

Keywords: Caribbean, microplastics, pollution, small island developing nation

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Authors: Denise F. Brown

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This proposal provides an explanation of the content for a Special Topics Course to be offered Spring of 2022. The course will be titled, Creative means to address mental health in the African American Community: Arts, Advocacy, and Awareness. Research shows that African Americans are less likely to seek treatment for mental illnesses. The stigma around mental illness influences negative ideas about having psychological problems within the African American community. Assessments of how African Americans perceive mental illness will also be provided. Current research suggests that understanding mental health is just as important as understanding mental illness. The distinguishment between mental illness and mental health provides a way to not negatively point out mental illness but to better understand that psychological and emotional well-being can be achieved whether a mental illness is present or not. The course will consist of defining mental health and mental illness and then what it means to utilize creative means to become a mental health advocate within the African American community.

Keywords: arts, advocacy, black mental health, mental illness

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Authors: M. Ahmadi, Sh. Damanabi, F. Sadoughi

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National Health Information System plays an important role in ensuring timely and reliable access to Health information which is essential for strategic and operational decisions that improve health, quality and effectiveness of health care. In other words, by using the National Health information system you can improve the quality of health data, information and knowledge used to support decision making at all levels and areas of the health sector. Since full identification of the components of this system for better planning and management influential factors of performance seems necessary, therefore, in this study, different attitudes towards components of this system are explored comparatively. Methods: This is a descriptive and comparative kind of study. The society includes printed and electronic documents containing components of the national health information system in three parts: input, process, and output. In this context, search for information using library resources and internet search were conducted and data analysis was expressed using comparative tables and qualitative data. Results: The findings showed that there are three different perspectives presenting the components of national health information system, Lippeveld, Sauerborn, and Bodart Model in 2000, Health Metrics Network (HMN) model from World Health Organization in 2008 and Gattini’s 2009 model. All three models outlined above in the input (resources and structure) require components of management and leadership, planning and design programs, supply of staff, software and hardware facilities, and equipment. In addition, in the ‘process’ section from three models, we pointed up the actions ensuring the quality of health information system and in output section, except Lippeveld Model, two other models consider information products, usage and distribution of information as components of the national health information system. Conclusion: The results showed that all the three models have had a brief discussion about the components of health information in input section. However, Lippeveld model has overlooked the components of national health information in process and output sections. Therefore, it seems that the health measurement model of network has a comprehensive presentation for the components of health system in all three sections-input, process, and output.

Keywords: National Health Information System, components of the NHIS, Lippeveld Model

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Authors: Restuning Widiasih, Katherine Nelson, Joan Skinner

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Muslim husbands have significant roles in the family including their roles in women’s health and illness. However, studies that explore Muslim husbands’ participation in women’s health is limited. The objective of this study was to uncover Muslim husbands’ participation in women’ health and illness including cancer prevention and screening. A descriptive exploratory approach was used involving 20 Muslim women from urban and rural areas of West Java Province, Indonesia. Muslim women shared experience related to their husbands support and activities in women’s health and illness. The data from the interviews were analyzed using the Comparative Analysis for Interview (CAI). Women perceived that husbands fully supported their health by providing opportunities for activities, and reminding them about healthy food, their workloads, and family planning. Husbands actively involved when women faced health issues including sharing knowledge and experience, discussing any health problems, advising for medical check-ups, and accompanying them for treatments. The analysis also found that husbands were less active and offered less advice regarding prevention and early detection of cancer. This study highlights the significant involvement of Muslim husbands in women’s health and illness, yet a lack of support from husbands related to screening and cancer prevention. This condition could be a burden for Muslim women to participate in health programs related to cancer prevention and early detection. Health education programs to improve Muslim husbands’ understanding of women’s health is needed.

Keywords: descriptive exploratory study, Muslim husbands, Muslim women, women's health and illness

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Authors: Kirubasankar, Sanjeevkumar, Aravindh Nagappan

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This paper addresses a system for monitoring patients using biomedical sensors and displaying it in a remote place. The main challenges in present health monitoring devices are lack of remote monitoring and logging for future evaluation. Typical instruments used for health parameter measurement provide basic information regarding health status. This paper identifies a set of design principles to address these challenges. This system includes continuous measurement of health parameters such as Heart rate, electrocardiogram, SpO2 level and Body temperature. The accumulated sensor data is relayed to a processing device using a transceiver and viewed by the implementation of cloud services.

Keywords: bio-medical sensors, monitoring, logging, cloud service

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Authors: S. V. Patil, P. S. Dounde, S. S. Patil

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Emulgels have emerged as one of the most interesting topical delivery system as it has dual release control system that is gel and emulsion. The major objective behind this formulation is delivery of hydrophobic drugs to systemic circulation via skin. In fact presence of a gelling agent in water phase converts a classical emulsion in to emulgel. The emulgel for dermatological use has several favorable properties such as being thixotropic, greaseless, easily spreadable, easily removable, emollient, non-staining, water-soluble, longer shelf life, bio-friendly, transparent and pleasing appearance. Various penetration enhancers can potentiate the effect. So this can be used as better topical drug delivery systems over present conventional systems available in market. Piroxicam is a non-steroidal anti-inflammatory drug that has major problems when administered orally; it is an insoluble drug and has irritant effect on gastro intestinal tract lead to ulceration and bleeding. The aim of this study was to overcoming these problems through preparation of topical emulgel of this drug. Emulgel of Piroxicam was prepared using Carbopol 940 along with mentha oil and clove oil as permeation enhancer. The prepared emulgel were evaluated for their physical appearance, pH determination, viscosity, spreadability, in vitro drug release, ex vivo permeation studies. All the prepared formulations showed acceptable physical properties, homogeneity, consistency, spreadability, viscosity and pH value. The emulgel was found to be stable with respect to physical appearance, pH, rheological properties and drug content at all temperature and conditions for three month.

Keywords: emulgel, piroxicam, menthe oil, clove oil

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Authors: Amna Beshir Medani Ahmed, Samia Mohammed Ali El Badwi, Ahmed El Amin Mohammed

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This work has been managed to yield toxicity information on water treatment agents in the Sudan namely polyDADMAC, using New Zealand rabbits at multiple daily oral doses for a period of 10 weeks. Thirty-three heads of New Zealand rabbits were divided into 11 groups, each of three. Group 1 animals were the undosed controls. Test groups of either species were given polyDADMAC at similar dose rates of 0.5, 2.5, 4.5, 10, 15, 20, 25, 50, 100 and 150 mg/kg body weight respectively for groups 2,3,4,5,6,7,8,9,10 and 11. Clinical signs were closely observed with postmortem and histopathological examinations. Chemical investigations included enzymatic concentrations of ALP, GOT, CK, GPT and LDH together with hematological changes in Hb, PCV, RBCs and WBCs. Mortalities occurred to variable degrees irrespective of the dose level. On polyDADMAC challenge, the test species showed clinical signs of dullness, loss of weight, anorexia, diarrhea, difficulty in respiration, hind limb paralysis and recumbency. Notably oral dosing with polyDADMAC caused lung emphysema, hepatic and renal dysfunctions, irregularity in enzymatic activities and serum metabolites, sloughing of intestinal epithelium, decreased electrolytes in serum, and splenic haemosiderosis. On evaluation of the above results, polyDADMAC was considered toxic to New Zealand rabbits at all dose rates tried. Practical implications of the results were highlighted and suggestions for future work were put forward.

Keywords: polydiallyldiethylaluminiumchloride (polyDADMAC), nubian goats, toxicity of drinking water, treatment of drinking water using chemicals

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Authors: Jamie R. Chua, Christina Irene D. Mejia, Regina P. Berba

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Disseminated tuberculosis is an infectious disease caused by Mycobacterium tuberculosis involving two or more non-contiguous sites identified through bacteriologic confirmation or clinical diagnosis. Over the five year period included in the study, the UP-PGH TB DOTS clinic had total of 3,967 referrals, and the prevalence of disseminated tuberculosis is 1% (68/3967). The mean age was 33.9 years (range 19-64 years) with a male: female ratio of 1:1. 67% (52 patients) had no predisposing comorbid illness or immune disorder. The most common presenting symptoms were abdominal pain (19%), back pain (13%), abdominal enlargement (11%) and mass (10.2%). Anemia, leukocytosis, hypoalbuminemia, and high-normal serum calcium were common biochemical and hematologic findings. Around 36% (25) of patients were diagnosed clinically with disseminated tuberculosis despite lacking bacteriologic evidence of multi-organ involvement. The lungs (86%) is still the most commonly involved site, followed by intestinal (22%), vertebral/Pott’s (27%), and pelvic/genital (19%). The mean time from presentation to initiation of therapy was 22 days (SD 32.7). Only 18 patients (29.3%) were properly recorded to have been referred to local TB DOTs facilities. Of the 68 patients, only 16% (11 patients) continued follow-up at PGH, and all had documented treatment completion. Treatment outcomes of the remaining were unknown. Due to the variety of involved sites, a high index of suspicion is required. Knowledge on clinical features, common radiographic findings, and histopathologic characteristics of disseminated TB is important as bacteriologic evidence of infection is not always apparent.

Keywords: disseminated tuberculosis, Mycobacterium tuberculosis, miliary tuberculosis, tuberculosis

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Authors: Harinder Singh

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The paper sheds light on the perceptions of the uninsured workers employed in the urban informal sector of India, towards the health insurance. In addition to this, it also explores the association of the identified perceptions with household decisions to enroll for health insurance schemes in India. Firstly the data taken from the primary survey of the uninsured workers employed in the urban informal sector was analyzed using exploratory factor analysis to evaluate the perceptions. Thereafter, logistic regression was employed to determine the association of the identified perceptions regarding the enrollment. Our study identifies twelve perceptions related to the health insurance enrollment of the uninsured workers employed in the urban informal sector of India. The study demonstrates that perceptions have the strongest association with the voluntary enrollment. These specifically relate to the lack of awareness about the need to buy health insurance; comprehensive coverage; income constraint; future contingencies and social obligations; lack of information; availability of subsidized government health care; linkage with government hospitals and preference for government schemes. Conclusions: Along with the food security, health security has become a crying need of the workers employed in the informal sector and the time has come to scale up the health insurance schemes for them in the country. Policy makers or marketers of health insurance policies should recognize the household perceptions as a potential barrier and try to develop a health insurance package as per the actual needs of the informal sector (low income) in India.

Keywords: association, enrollment, health insurance, informal sector, perceptions, uninsured

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Authors: Harjyot Khosa

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In India and south Asia, stigma and discrimination against transgender community remain disproportionately high. Lack of mental health care restricts effective treatment and care for both physical and mental health. Knowledge assessment of 80 counsellors across India reflected that only 28% counsellors knew about the transgender community. Whereas, only 6% of them felt, that transgender community require a specific mental health support, considering the stigma they face in day to day life. Lastly, 62% did agree that they require specific training to address unmet needs of transgender community. A robust counselling module was developed with focus on technical counselling skills and strategies, specific counselling issues, identity and sexuality, disclosure, hormone therapy and sex reassignment surgery. Mental health related support should be an integral part of government and non-government programs for the overall well-being of transgender community who face stigma and discrimination at every level. Needs based capacity building and technical assistance is required towards providing mental health support for transgender populations and their partners.

Keywords: identity and sexuality, mental health, stigma, transgender

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Authors: Windy Rakhmawati, Suryani Suryani, Sri Hendrawati, Nenden Nur Asriyani Maryam

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Tuberculosis (TB) is one of the leading causes of death in the world. Fear of COVID-19 has made people reluctant to visit health facilities, leading to disruptions to childhood TB control programs, which may increase household transmission and delay diagnosis and treatment. This study aimed to describe parents' knowledge, attitudes, and health-seeking behaviour towards childhood TB during the COVID-19 pandemic. This cross-sectional study was performed on 392 parents with TB children in three provinces with the highest proportion of TB cases in Indonesia. This study was conducted from February to December 2022. The inclusion criteria of respondents were parents with a child aged 0-14 years old with TB diagnosis who live with their parents. Data were collected using the Knowledge, Attitude, and Practice (KAP) survey guidelines from the World Health Organization and analyzed descriptively, as well as Spearman’s correlation. Overall, 392 parents of children with TB had poor knowledge (51.8%) including about causes, risk factors, transmission, symptoms, treatment, and prevention, which about 52.3%, 55.1%, 61.2%, 69.6%, 100%, 59.2%, respectively. Parents' health service-seeking behaviour towards Child TB was not normally distributed (P < 0.05) with knowledge test results (.000) and Seeking Health Services (.000). Health-seeking behaviour of parents in pediatric TB care was self-medication or self-treatment (86.2%), Traditional health seeking behaviour (4.8%), and modern health seeking behaviour (8.9%). The correlation between knowledge and seeking health services (Sig= .609) means there is no correlation between knowledge about TB and parents' health-seeking behaviour. Furthermore, 60.2% of the respondents would be shocked if their child had TB. More than half of the families in this study have poor knowledge and did self-medication or self-treatment regarding health-seeking behaviour for TB disease. Therefore, health workers, especially nurses, must provide TB-related education and health promotion and emphasize the importance of early detection. Health workers can also optimize their role in caring for and providing care to patients by increasing their trust in health workers, which will impact health-seeking behaviour in the future.

Keywords: attitude, child, health seeking behaviour, knowledge, tuberculosis

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Authors: Shantol McIntosh

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Due to environmental and underlying health disparities, the COVID-19 pandemic has caused an added set of economic implications worldwide. Black and Hispanic individuals are more susceptible to contract COVID-19, and if they do, they are more likely to have a severe case that necessitates hospitalization or results in death (Altarum et al., 2020). The literature shows that disparities in health and health treatment are nothing new as they have been recorded for decades and indicate systemic and structural imbalances rooted in racism and discrimination. The purpose of this study is to determine the frequency with which these populations have access to healthcare and treatment. The study will also highlight the key drivers of health disparities. Findings and implications for research and policy will be discussed.

Keywords: COVID-19, racial and ethnic disparities, discrimination, policy

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Authors: Anny Retnowati, Elisabeth Sundari

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This research aims to elaborate the meaning of personal data protection principles on patient access to health data in medical records in Indonesia and its implications. The method uses normative legal research by examining health law in Indonesia regarding the patient's right to access their health data in medical records. The data will be analysed qualitatively using the interpretation method to elaborate on the limitation of the meaning of personal data protection principles on patients' access to their data in medical records. The results show that patients only have the right to obtain copies of their health data in medical records. There is no right to inspect directly at any time. Indonesian health law limits the principle of patients' right to broad access to their health data in medical records. This restriction has implications for the reduction of personal data protection as part of human rights. This research contribute to show that a limitaion of personal data protection may abuse the human rights.

Keywords: access, health data, medical records, personal data, protection

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Authors: Andreas Aceranti, Sergio Romanò, Simonetta Vernocchi, Silvia Arnaboldi, Emilio Mazza

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As a result of the Sars-Cov2 pandemic, the incidence of thymism disorders has significantly increased and, often, patients are reluctant to want to take drugs aimed at stabilizing mood. In order to provide an alternative approach to drug therapies, we have prepared a study in order to evaluate the possibility of improving the quality of life of these subjects through osteopathic treatment. Patients were divided into visceral and fascial manual treatment with the aim of increasing serotonin levels and stimulating the vagus nerve through validated techniques. The results were evaluated through the administration of targeted questionnaires in order to assess quality of life, mood, sleep and intestinal functioning. At a first endpoint we found, in patients undergoing fascial treatment, an increase in quality of life and sleep: in fact, they report a decrease in the number of nocturnal awakenings; a reduction in falling asleep times and greater rest upon waking. In contrast, patients undergoing visceral treatment, as well as those included in the control group, did not show significant improvements. Patients in the fascial group have, in fact, reported an improvement in thymism and subjective quality of life with a generalized improvement in function. Although the study is still ongoing, based on the results of the first endpoint we can hypothesize that fascial stimulation of the vagus nerve with manual and osteopathic techniques may be a valid alternative to pharmacological treatments in mood and sleep disorders.

Keywords: ostheopathy, insomnia, noctural awakening, thymism

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Authors: E. M. Mhlongo, E. Lutge

Abstract:

In 2010, South Africa’s National Department of Health (NDoH) launched national primary health care (PHC) initiative to strengthen health promotion, disease prevention, and early disease detection. The strategy, called Re-engineering Primary Health Care (rPHC), aims to support a preventive and health-promoting community-based PHC model by using community-based outreach teams (known in South Africa as Ward-based Primary Health Care Outreach teams or WBPHCOTs). These teams provide health education, promote healthy behaviors, assess community health needs, manage minor health problems, and support linkages to health services and health facilities. Ward based primary health care outreach teams are supervised by a professional nurse who is the outreach team leader. In South Africa, the WBPHCOTs have been established, registered, and are reporting their activities in the District Health Information System (DHIS). This study explored and described the challenges faced by outreach team leaders in supporting and supervising the WBPHCOTs. Qualitative data were obtained through interviews conducted with the outreach team leaders at a sub-district level. Thematic analysis of data was done. Findings revealed some challenges faced by team leaders in day to day execution of their duties. Issues such as staff shortages, inadequate resources to carry out health promotion activities, and lack of co-operation from team members may undermine the capacity of team leaders to support and supervise the WBPHCOTs. Many community members are under the impression that the outreach team is responsible for bringing the clinic to the community while the outreach teams do not carry any medication/treatment with them when doing home visits. The study further highlights issues around the challenges of WBPHCOTs at a household level. In conclusion, the WBPHCOTs are an important component of National Health Insurance (NHI), and in order for NHI to be optimally implemented, the issues raised in this research should be addressed with some urgency.

Keywords: community health worker, national health insurance, primary health care, ward-based primary health care outreach teams

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