Search results for: public health · influencing factors

Authors: Kiran Bala

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Health, education and employment opportunities available for a common citizen reflect the development status of a country. Health of an individual affects the growth of a country in every aspect. According to a study by WHO, India is estimated to lose more than $237 billion of its GDP over the period 2006-15 on account of premature death and morbidity from Non-communicable diseases alone. Each year 37 million people fall below poverty line due to high expenditure on health services they have to incur. Falling sick puts a double burden on them in terms of loss of income and expenditure on health care which pushes them further into debt and poverty. Adding to the gravity of situation, public spending on health in India has itself declined after liberalization from 1.3% of GDP in 1990 to 0.9% in 1999. The Approach Paper of the Government of India to the Twelfth Five Year Plan indicated that health expenditure alone as a per cent of GDP was about 1.4 per cent (B.E.) in 2011-12. It also mentioned that if one included expenditure on rural water supply and sanitation, the figure would be about 1.8 per cent. Given the abysmally low level of priority accorded to health in Indian economic policy, it becomes rather important to study the representation of health in the Indian public sphere. To this end, this study examines the prioritization of health in the public policy agenda of the national/regional political parties as evidenced in their election manifestos at a time when the nation is poised to go for the General Elections. The paper also focuses attention on the prioritization of health in the public perception as evidenced in their reasons for their preferences for a particular party or individual contestant. To arrive at the reasons for the priority level accorded by the political actors and the citizens, the study uses Focus groups of health policy makers, media persons, medical practitioners and voters. Collected data will be analysed in the theoretical framework of spiral of silence and agenda setting theory.

Keywords: health, election manifestos, public perception, policies

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Authors: Amenawo I. Offiong, Hodo B. Riman

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Public debt profile of Nigeria has continuously been on the increase over the years. The drop in international crude oil prices has further worsened revenue position of the country, thus, necessitating further acquisition of public debt to bridge the gap in revenue deficit. Yet, when we look back at the increasing public sector spending, there are concerns that the government spending do not amount to increase in public goods provided for the country. Using data from 1980 to 2014 the study therefore seeks to investigate the factors responsible for the poor provision of public goods in the face of increasing public debt profile. Using the unrestricted VAR model Governance and Tax revenue were introduced into the model as structural variables. The result suggested that governance and tax revenue were structural determinants of the effectiveness of public goods provisioning in Nigeria. The study therefore identified weak governance as the major reason for the non-provision of public goods in Nigeria. While tax revenue exerted positive influence on the provisions of public goods, weak/poor governance was observed to crowd the benefits from increase tax revenue. The study therefore recommends reappraisal of the governance system in Nigeria. Elected officers in governance should be more transparent and accountable to the electorates they represent. Furthermore, the study advocates for an annual auditing of all government MDAs accounts by external auditors to ensure (a) accountability of public debts utilization, (b) transparent in implementation of program support funds, (c) integrity of agencies responsible for program management, and (d) measuring program effectiveness with amount of funds expended.

Keywords: impulse response function, public debt shocks, governance, public goods, tax revenue, vector auto-regression

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Authors: Hamid Vahidkia

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The International Health Regulations (IHR), the sole worldwide regulations for managing infectious diseases, have remained largely unchanged since their initial release in 1951. The WHO is currently involved in updating the IHR. This article evaluates WHO's updated IHR draft and suggests enhancements to enhance global health, such as a strong focus on the organization's fundamental public health goals, activities, and crucial services; wide-reaching coverage for various health risks; establishing global monitoring through official and unofficial data networks; setting benchmarks for national public health systems, evaluating results, and ensuring accountability from countries; safeguarding human rights by implementing evidence-based guidelines and just processes; and promoting good governance by embracing fairness, impartiality, and openness. The World Health Organization needs to guarantee that countries follow health regulations and provide ample economic and technical support to less privileged nations. A crucial concern for the global community is how independent nations can collaborate to ensure that global health benefits all individuals, regardless of their economic status.

Keywords: IHR, law, health, international, WHO

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Authors: Tya M. Arthur

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Purpose: BIPOC (Black, Indigenous, and People of Color) adolescents face racism and discrimination at a young age. These early experiences have short- and long-term impacts on their health and overall well-being. The purpose of this study was to determine the relationships between perceived racial discrimination at school and health risk behaviors and experiences of BIPOC adolescents. Methods: Data from the 2021 Adolescent Behaviors and Experiences Survey (ABES) were analyzed. All demographic data were summarized using frequencies and chi-squared tests. A univariate and multivariate logistic regression model was used to test the relationship between perceived racial discrimination and selected health risk factors. All analyses were conducted using STATA SE 18. Results: A total of 42.2% of the BIPOC adolescents in the study indicated being treated unfairly at school due to their race. The majority of those who reported being discriminated against were Black/African American or Multiple Race-Hispanic. Asian adolescents were almost 5 times more likely to face racial discrimination at school compared to their American Indian/Alaska Native counterparts (OR = 4.86, 95% CI [2.69-8.77], p < 0.001). Other risk predictors of racial discrimination included being female (OR = 1.38, 95% CI [1.13-1.68], p = 0.002) and feeling disconnected at school (OR = 1.76, 95% CI [1.30-2.38], p < 0.001). After adjustment for health risk behaviors and experiences, BIPOC adolescents were still more likely to face racial discrimination with even higher odds. Conclusions: The results of this study highlight the depth of racial discrimination faced by BIPOC adolescents at school. Greater attention should be placed on racial discrimination as a social determinant of health and a public health crisis.

Keywords: racial discrimination, adolescents, heath risk factors, BIPOC

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Authors: Gil Soriano, Aubreyrose Casilang

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Soil-transmitted helminth infection remains to be one of the leading public health problem worldwide, which is common in the rural developing regions especially among children. This study aimed to detect the presence of soil transmitted helminths among children and its associated transmission factors. Descriptive cross sectional research was the design used in the study and questionnaires were administered. Stool samples were collected among the samples (n=108) and were analyzed using kato thick method. Results showed that 61 out of 108 respondents are infected by soil transmitted helminth infection with A. lumbricoides the highest, followed by hookworm and T. trichuria. Parent's educational attainment, hand washing practices, and water sources were found to be associated with presence of Soil Transmitted Helminth infection.

Keywords: associated risk factors, barangay, school children, soil transmitted helminth infection

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Authors: Helen Nelly Naiga, Christopher Garimoi Orach

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Introduction: Long-acting reversible contraceptive (LARC) methods are highly effective. However, LARC use in Uganda is low (13%). We assessed the factors associated with the use of long-acting reversible contraceptives among women of reproductive age (15-49 yrs) in Jinja District. Methods: We conducted a facility-based cross-sectional study. A total of 314 women aged 15–49 years attending public health facilities (1 hospital and 3 health center IV) in Jinja district, were randomly selected. A total of 6 key informants and 6 in-depth interviews were conducted. Logistic regression analysis was conducted using Stata version 14. Qualitative data were analysed using thematic analysis. Results: The study found that 40.45% of the respondents had ever used LARC. The commonest LARC method used was implanting (38.22%). The factors significantly associated with use of LARC were employment (AOR =2.91; 95% CI (1.05-8.08), access to LARC methods (AOR =4.48; 95% CI (1.24-16.21), husband support (AOR =4.90; 95% CI (1.56-15.41), and experience of no side effects (AOR =3.48; 95% CI (1.00-12.19). Conclusion and recommendations: The study showed that 4 in 10 women of reproductive age in Jinja District were using LARC. The factors associated with LARC use were employment, husband support, access to LARC methods, and the lack of side effects. There is a need to strengthen client education, improve accessibility to LARC methods at all levels of health centers, improve male partner’s decision-making in LARC use and manage the side effects effectively.

Keywords: family planning, implants, intrauterine device, long-acting reversible contraceptives (LARC)

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Authors: N. R. N. Mendis, S. N. Silva

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Introduction: Patient satisfaction of services provided by primary care health services depends on many factors. One key factor in this depends on is the nursing services received in primary care. Since majority of the primary care in Sri Lanka is provided by the private sector, it is important to assess patient satisfaction on this. Objective: To assess the satisfaction among the public on nurses working in dispensaries in Sri Lanka. Methods: A descriptive study was done on 200 individual selected using convenient sampling among dispensaries in Gampaha district, Sri Lanka. Results: 59.3% of the sample had long term illnesses or disabilities and all of them preferred speaking to a nurse. 70.9% of the sample used to make appointments with nurses while 57.8% out of them were comfortable in discussing their health concerns. 98.9 % agreed that they get individual attention by the nurses. Majority of the sample that is 34.2% spends around 20 minutes with the nurse without even making any pay. Significantly, the whole sample believes that the nurses are professional and admits that the care given is of high quality. All 100% of the sample said that the nurses could understand their concerns while 93.5% admitted that it was very useful in their recovery. Conclusions: Majority of the public were very much satisfied with the nurses and their practice at the dispensaries.

Keywords: health education, nurses practices, patient satisfaction, primary care

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Authors: Engida Yisma, Berhanu Dessalegn, Ayalew Astatkie, Nebreed Fesseha

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Background: The World Health Organization (WHO) recommends using the partograph to follow labour and delivery, with the objective to improve health care and reduce maternal and foetal morbidity and death. Methods: A retrospective document review was undertaken to assess the completion of the modified WHO partograph during labour in public health institutions of Addis Ababa, Ethiopia. A total of 420 of the modified WHO partographs used to monitor mothers in labour from five public health institutions that provide maternity care were reviewed. A structured checklist was used to gather the required data. The collected data were analyzed using SPSS version 16.0. Frequency distributions, cross-tabulations and a graph were used to describe the results of the study. Results: All facilities were using the modified WHO partograph. The correct completion of the partograph was very low. From 420 partographs reviewed across all the five health facilities, foetal heart rate was recorded into the recommended standard in 129(30.7%) of the partographs, while 138 (32.9%) of cervical dilatation and 87 (20.70%) of uterine contractions were recorded to the recommended standard. The study did not document descent of the presenting part in 353 (84%). Moulding in 364 (86.7%) of the partographs reviewed was not recorded. Documentation of state of the liquor was 113(26.9%), while the maternal blood pressure was recorded to standard only in 78(18.6%) of the partographs reviewed. Conclusions: This study showed a poor completion of the modified WHO partographs during labour in public health institutions of Addis Ababa, Ethiopia. The findings may reflect poor management of labour and indicate the need for pre-service and periodic on-job training of health workers on the proper completion of the partograph. Regular supportive supervision, provision of guidelines and mandatory health facility policy are also needed in support of a collaborative effort to reduce maternal and perinatal deaths.

Keywords: modified WHO partograph, completion, public health institutions, Addis Ababa, Ethiopia

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Authors: Maciej Kozlowski, Agnieszka Piotrowska-Piatek

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Purpose: This article analyses the most important financial participation programmes (FPP) in Poland to show the relationship between the programmes applied and the socio-economic results of enterprises and assesses the impact of participation on these results and the impact of selected factors on the introduction of FPP. Methodology: The research has been based on a questionnaire answered by senior management of listed Polish companies that had at least one out of three major FPPs in operation, namely share ownership, profit-sharing, or a stock option scheme. Findings: The results of the empirical study conducted indicate the existence of some peculiar relationships. The vast majority of schemes in Polish public companies are aimed at the participation of the management personnel; these programmes are narrow-based (only for management) and rather hermetic, with a high concentration of stocks or shares in the hands of the management. Conclusion: FPPs generally have a positive influence on enterprise functioning. However, the effects are more social than economic (no significant economic improvement after programme implementation). The paper contributes to the debate about financial participation and suggests actions to popularize these programmes on a wider scale.

Keywords: financial participation, profit sharing, stock options, worker attitude, worker ownership

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Authors: Orathai Srithongtham, Ploypailin Mekathepakorn, Tossaphong Buraman, Pontida Moonpradap, Rungrueng Kitpati, Chulapon Kratet, Worayuth Nak-ai, Suwaree Charoenmukkayanan, Peeranuch Keawkanya

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The COVID-19 pandemic was effect to the health security of the Thai people. The PHEM principle was essential to the surveillance, prevention, and control of COVID-19. This study aimed to present the process of prevention and control of COVID-19 from February 29, 2021- April 30, 2022, and the factors and conditions influent the successful outcome. The study areas were three provinces. The target group was 37 people, composed of public health personnel. The data was collected in-depth, and group interviews followed the non-structure interview guide and were analyzed by content analysis. The components of COVID-19 prevention and control were found in the process of PHEM as follows; 1) Emergency Operation Center (EOC) with an incidence command system (ICS) from the district to provincial level and to propose the provincial measure, 2) Provincial Communicable Disease Committee (PCDC) to decide the provincial measure 3) The measure for surveillance, prevention, control, and treatment of COVID-19, and 4) outcomes and best practices for surveillance and control of COVID-19. The success factors of 4S and EC were as follows; Space: prepare the quarantine (HQ, LQ), Cohort Ward (CW), field hospital, and community isolation and home isolation to face with the patient and risky group, Staff network from various organization and group cover the community leader and Health Volunteer (HV), Stuff the management and sharing of the medical and non-medical equipment, System of Covid-19 respond were EOC, ICS, Joint Investigation Team (JIT) and Communicable Disease Control Unit (CDCU) for monitoring the real-time of surveillance and control of COVID-19 output, Environment management in hospital and the community with Infections Control (IC) principle, and Culture in term of social capital on “the relationship of Isan people” supported the patient provide the good care and support. The structure of PHEM, Isan’s Culture, and good preparation was a significant factor in the three provinces.

Keywords: public health, emergency management, covid-19, pandemic

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Authors: Yang Wenjuan, Xu Yilun

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Based on the comparative analysis of the relevant evaluation methods of walking environment, this paper selects the combined evaluation method of macro urban morphology analysis and micro urban design quality survey, then investigates and analyzes the walking environment of three rail transit station area in Nanjing to explore the influence factor and internal relation of walkability of rail transit station area. Analysis shows that micro urban design factors have greater impact on the walkability of rail transit station area compared with macro urban morphology factors, the convenience is the key factor in the four aspects of convenience, security, identity and comfortability of the urban design factors, the convenience is not only affected by the block network form, but also related to the quality of the street space. The overall evaluation of walkability comes from the overlapping and regrouping of the walking environment at different levels, but some environmental factors play a leading role. The social attributes of pedestrians also partly influence their walking perception and evaluation.

Keywords: rail transit station area, walkability, evaluation, influence factors

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Authors: Marwa Mamdouh Shaban, Nagat Saied Habib, Shireen Ezz El-Din Taha, Eman Mahmoud Seif El-Naser

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Background: Dental nurses and dentists were constantly exposed to a number of specific work related health risk factors which develop and intensify with years. Awareness regarding these work-related health risk factors and implementation of preventive health care measures could provide a safe work environment for all dental nurses and dentists. Aim of the study: to assess the work-related health risk factors among dental nurses and dentists and preventive health care measures applied among dental nurses and dentists. Research design: A descriptive design was utilized. Sample: Convenience sample of 50 dental nurses and 150 dentists were included in the current study. Setting: This study was conducted at the dental clinics at faculty of oral and dental medicine, Al-Kasr Al Ainy Hospital. Tools of data collection: Three tools were developed, tested for clarity, and feasibility: a-Socio-demographic data sheet, b-Work-related health risk factors questionnaire, and c-structured observational checklist. Results: The most common work risk factors prevailing among dental nurses were emotional exhaustion (82%), low back pain (76%) and latex allergy (62%) and the most common work risk factors prevailing among dentists were percutaneous exposure incident (100%), emotional exhaustion (100%) and low back pain (93.3%). Also, statistically significant negative correlation (r=-0.274, at p = 0.045) between the incidence of chemical health risk factors and application of chemical preventive measures among dental nurses. A statistically significant negative correlation (r=-0.177, at p = 0.030) between the incidences of mechanical health risk factors among dentists and application of mechanical preventive measures. Conclusion: The studied dental nurses and dentists exposed to many work related health risk factors as latex allergy, percutaneous exposure incidents, low back pain and emotional exhaustion related to inappropriate application of preventive health care measures. Recommendation: Raise awareness of dental nurses and dentists about work-related health risk factors, design and implement health education program for preventive health care measures.

Keywords: work-related risk factors, preventive measures, nurses, dentists

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Authors: Gizachew Assefa Tessema, Mohammad Afzal Mahmood, Judith Streak Gomersall, Caroline O. Laurence

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Introduction: Improving access to quality family planning services is the key to improving health of women and children. However, there is currently little evidence on the quality and scope of family planning services provided by private facilities, and this compares to the services provided in public facilities in Ethiopia. This is important, particularly in determining whether the government should further expand the roles of the private sector in the delivery of family planning facility. Methods: This study used the 2014 Ethiopian Services Provision Assessment Plus (ESPA+) survey dataset for comparing the structural aspects of quality of care in family planning services. The present analysis used a weighted sample of 1093 primary health care facilities (955 public and 138 private). This study employed logistic regression analysis to compare key structural variables between public and private facilities. While taking the structural variables as an outcome for comparison, the facility type (public vs private) were used as the key exposure of interest. Results: When comparing availability of basic amenities (infrastructure), public facilities were less likely to have functional cell phones (AOR=0.12; 95% CI: 0.07-0.21), and water supply (AOR=0.29; 95% CI: 0.15-0.58) than private facilities. However, public facilities were more likely to have staff available 24 hours in the facility (AOR=0.12; 95% CI: 0.07-0.21), providers having family planning related training in the past 24 months (AOR=4.4; 95% CI: 2.51, 7.64) and possessing guidelines/protocols (AOR= 3.1 95% CI: 1.87, 5.24) than private facilities. Moreover, comparing the availability of equipment, public facilities had higher odds of having pelvic model for IUD demonstration (AOR=2.60; 95% CI: 1.35, 5.01) and penile model for condom demonstration (AOR=2.51; 95% CI: 1.32, 4.78) than private facilities. Conclusion: The present study suggests that Ethiopian government needs to provide emphasis towards the private sector in terms of providing family planning guidelines and training on family planning services for their staff. It is also worthwhile for the public health facilities to allocate funding for improving the availability of basic amenities. Implications for policy and/ or practice: This study calls policy makers to design appropriate strategies in providing opportunities for training a health care providers working in private health facility.

Keywords: quality of care, family planning, public-private, Ethiopia

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Authors: Farnoosh Faal

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The excessive reliance on private cars has led to a range of problems, such as traffic congestion, air pollution, and carbon emissions, which have significant impacts on public health and the environment. Public open spaces have the potential to promote sustainable transportation and reduce dependence on cars by providing alternative mobility options, including walking, cycling, and public transit. This paper examines the existing research on the relationship between public open spaces and sustainable transportation. It discusses the key design principles and planning strategies that can enhance the accessibility and safety of public open spaces, particularly for pedestrians and cyclists. The paper also explores the role of public open spaces in promoting active mobility and reducing car use in urban and suburban contexts. Finally, the paper highlights the policy and institutional barriers that hinder the integration of public open spaces with sustainable transportation systems and suggests some potential solutions to overcome these barriers. Overall, the paper argues that public open spaces have immense potential to facilitate sustainable transportation and reduce car dependence, and therefore, it is important to prioritize the development and maintenance of public open spaces as a key component of sustainable urban and regional planning.

Keywords: public open space, sustainable transportation, active mobility, car dependence, urban and regional planning, traffic congestion

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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: Marwah Mohsin, Thomas Beach, Alan Kwan, Mahdi Ismail

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This paper describes the differences in views on sustainable development between the general public and experts in a developing country, Iraq. This paper will answer the question: How do the views of the public differ from the generally accepted view of experts in the context of sustainable urban development in Iraq? In order to answer this question, the views of both the public and the experts will be analysed. These results are taken from a public survey and a Delphi questionnaire. These will be analysed using statistical methods in order to identify the significant differences. This will enable investigation of the different perceptions between the public perceptions and the experts’ views towards urban sustainable development factors. This is important due to the fact that different viewpoints between policy-makers and the public will impact on the acceptance by the public of any future sustainable development work that is undertaken. The brief findings of the statistical analysis show that the views of both the public and the experts are considered different in most of the variables except six variables show no differences. Those variables are ‘The importance of establishing sustainable cities in Iraq’, ‘Mitigate traffic congestion’, ‘Waste recycling and separating’, ‘Use wastewater recycling’, ‘Parks and green spaces’, and ‘Promote investment’.

Keywords: urban sustainability, experts views, public views, principle component analysis, PCA

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Authors: Thomas Suarez, Anne-Sophie Grenouilleau, Erwan Autin, Alexandre Biosse-Duplan, Emmanuelle Blondet, Laurence Chazalette, Marie Coniel, Agnes Dessaigne, Sylvie Lascols, Andrea Lasserre, Candice Legris, Pierre Liot, Aline Metais, Karine Petitprez, Christophe Varlet, Christian Saout

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Background: The role of biological sex and gender identity -whether assigned or chosen- as health determinants are far from a recent discovery: several reports have stressed out how being a woman or a man could affect health on various scales. However, taking it into consideration beyond stereotypes and rigid binary assumptions still seems to be a work in progress. Method: The report is a synthesis on a variety of specific topics, each of which was studied by a specialist from the French National Authority for Health (HAS), through an analysis of existing literature on both healthcare policy construction process and instruments (norms, data analysis, clinical trials, guidelines, and professional practices). This work also implied a policy analysis of French recent public health laws and a retrospective study of guidelines with a gender mainstreaming approach. Results: The analysis showed that though sex and gender were well-known determinants of health, their consideration by both public policy and health operators was often incomplete, as it does not incorporate how sex and gender interact, as well as how they interact with other factors. As a result, the health and social care systems and their professionals tend to reproduce some stereotypical and inadequate habits. Though the data available often allows to take sex and gender into consideration, such data is often underused in practice guidelines and policy formulation. Another consequence is a lack of inclusiveness towards transgender or intersex persons. Conclusions: This report first urges for raising awareness of all the actors of health, in its broadest definition, that sex and gender matter beyond first-look conclusions. It makes a series of recommendations in order to reshape policy construction in the health sector on the one hand and to design public health instruments to make them more inclusive regarding sex and gender on the other hand. The HAS finally committed to integrate sex and gender preoccupations in its workings methods, to be a driving force in the spread of these concerns.

Keywords: biological sex, determinants of health, gender, healthcare policy instruments, social accompaniment

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Authors: Ahmed Sami Hammami, Mohamed Jellazi

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Background: The aim of the study is to evaluate the magnitude of different psychological outcomes among Tunisian health care professionals (HCP) during the COVID-19 pandemic and to identify the associated factors. Methods: HCP completed a cross-sectional questionnaire from April 4th to April, 28th 2020. The survey collected demographic information, factors that may interfere with the psychological outcomes, behavior changes and mental health measurements. The latter was assessed through 3 scales; the 7-item questions Insomnia Severity Index, the 2-item Patient Health Questionnaire and the 2-item Generalized Anxiety Disorder. Multivariable logistic regression was conducted to identify factors associated with psychological outcomes. Results: A total of 503 HCP successfully completed the survey; among those, n=493 consented to enroll in the study, 411 [83.4%] were physicians, 323 [64.2%] were women and 271 [55%] had a second-line working position. A significant proportion of HCP had anxiety 35.7%, depression 35.1% and insomnia 23.7%. Females, those with psychiatric history and those using public transport exhibited the highest proportions for overall symptoms compared to other groups e.g., depression among females vs. males: 44,9% vs. 18,2%, P=0.00. Those with a previous medical history and nurses, had more anxiety and insomnia compared to other groups e.g. anxiety among nurses vs. interns/residents vs. attending 45,1% vs 36,1% vs 27,5%; p=0.04. Multivariable logistic regression showed that female gender was a risk factor for all psychological outcomes e.g. female sex increased the odds of anxiety by 2.86; 95% confidence interval [CI], 1, 78-4, 60; P=0.00, whereas having a psychiatric history was a risk factor for both anxiety and insomnia. (e.g. for insomnia OR=2,86; 95% [CI], 1,78-4,60; P=0.00), Having protective equipment was associated with lower risk for depression (OR=0,41; 95% CI, 0,27-0,62; P=0.00) and anxiety. Physical activity was also protective against depression and anxiety (OR=0,41, 95% CI, 0,25-0,67, P=0.00). Conclusion: Psychological symptoms are usually undervalued among HCP, though the COVID-19 pandemic played a major role in exacerbating this burden. Prompt psychological support should be endorsed and simple measures such as physical activity and ensuring the necessary protection are paramount to improve mental health outcomes and the quality of care provided to patients.

Keywords: COVID-19 pandemic, health care professionals, mental health, protective factors, psychological symptoms, risk factors

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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: Zeinab Aliyas, Diba Mahboubi

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Leisure walking is known as one of the most common types of physical activity that perform in purpose of recreation or health, which in turn may affect resident’s health. In the recent years, promoting leisure walking activity in neighborhood areas become as one of the important issues regarding promoting mental and physical health, however; the level of physical inactivity is rising in many societies including Iran. As it was proven that the tendency to walk out of choice is not encouraging among Iranian people. Hence; understanding the main concern of residents regarding walking activity in their neighborhoods can help in increasing the tendency to do leisure activity among residents. Built environment, social and individual factors are known as the main factors that affect decision to walk, in this regard, the study aimed to investigate the influence of personal and social factors that prevent residents to walk for recreation or exercise in their neighborhoods. Hence the fear of crime and personal barriers were examined in the current research as social and personal factors respectively. To collect the required data, 500 questionnaires by using systematic sampling were distributed from March to May 2016 in four residential neighborhoods of Bandar Abbas in Iran out which 411 questionnaire turned out to be qualified to be used in the study. The Smart-PLS was used to analyze the data. The findings of the study revealed that personal and fear of crime both have significant influence on the level of recreation and exercise walking in the neighborhood areas. The study found that fear of crime has the higher influence on exercise and recreational walking behavior in comparison to individual factors. It was revealed that social factors such as fear of crime in the neighborhoods might be more important than the personal reason for walking optionally in the surrounding environment. The finding of this study can help urban and health researcher to know the significant influence of fear of crime and individual attitudes on the level of leisure walking activity, in addition, the findings of the study suggest that urban planners and designers, as well as public health promoters, need to highly consider the contribution of neighborhoods' social environment variables as well as individual variables to promote walking behavior changes among adult population.

Keywords: exercise walking, fear of crime, neighborhood, personal barriers, recreation walking

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Authors: Anatoly Krivinsh

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The results of dissertation research "Preventing and combating corruption in public procurement" are presented in this publication. The study was conducted 2011 till 2013 in a Member State of the European Union, in the Republic of Latvia. Goal of the thesis is to explore corruption prevention and combating issues in public procurement sphere, to identify the prevalence rates, determinants and contributing factors and prevention opportunities in Latvia. In the first chapter the author analyses theoretical aspects of understanding corruption in public procurement, with particular emphasis on corruption definition problem, its nature, causes and consequences. A separate section is dedicated to the public procurement concept, mechanism and legal framework. In the first part of this work the author presents cognitive methodology of corruption in public procurement field, based on which the author has carried out an analysis of corruption situation in public procurement in Republic of Latvia. In the second chapter of the thesis, the author analyzes the problem of corruption in public procurement, including its historical aspects, typology and classification of corruption subjects involved, corruption risk elements in public procurement and their identification. During the development of the second chapter author's practical experience in public procurements was widely used. The third and fourth chapter deals with issues related to the prevention and combating corruption in public procurement, namely the operation of the concept, principles, methods and techniques, subjects in Republic of Latvia, as well as an analysis of foreign experience in preventing and combating corruption. The fifth chapter is devoted to the corruption prevention and combating perspectives and their assessment. In this chapter the author has made the evaluation of corruption prevention and combating measures efficiency in Republic of Latvia, assessment of anti-corruption legislation development stage in public procurement field in Latvia.

Keywords: prevention of corruption, public purchases, good governance, human rights

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Authors: Fujia Yang

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Alongside technological innovation, the current “double reduction” policy and English Curriculum Standards for Compulsory Education in China both emphasise and encourage appropriately integrating educational technologies into the classroom. Therefore, schools are increasingly using digital means to engage students in English reading, but the impact of such technologies on Chinese pupils’ reading achievement remains unclear. To serve as a reference for reforming English reading education in primary schools under the double reduction policy, this study investigates the effects and primary influencing factors of a specific reading programme, Accelerated Reader (AR), on Chinese primary school students’ reading achievement. A quantitative online survey was used to collect 37 valid questionnaires from teachers, and the results demonstrate that, from teachers’ perspectives, the AR program seemed to positively affect students’ reading achievement by recommending material at the appropriate reading levels and developing students’ reading habits. Although the reading enjoyment derived from the AR program does not directly influence students’ reading achievement, these factors are strongly correlated. This can be explained by the self-paced, independent learning AR format, its high accuracy in predicting reading level, the quiz format and external motivation, and the importance of examinations and resource limitations in China. The results of this study may support reforming English reading education in Chinese primary schools.

Keywords: educational technology, reading programme, primary students, accelerated reader, reading effects

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

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Groundwater potential delineation is essential for efficient water resource utilization and long-term development. The scarcity of potable and irrigation water has become a critical issue due to natural and anthropogenic activities in meeting the demands of human survival and productivity. With these constraints, groundwater resources are now being used extensively in Ethiopia. Therefore, an innovative convolutional neural network (CNN) is successfully applied in the Gunabay watershed to delineate groundwater potential based on the selected major influencing factors. Groundwater recharge, lithology, drainage density, lineament density, transmissivity, and geomorphology were selected as major influencing factors during the groundwater potential of the study area. For dataset training, 70% of samples were selected and 30% were used for serving out of the total 128 samples. The spatial distribution of groundwater potential has been classified into five groups: very low (10.72%), low (25.67%), moderate (31.62%), high (19.93%), and very high (12.06%). The area obtains high rainfall but has a very low amount of recharge due to a lack of proper soil and water conservation structures. The major outcome of the study showed that moderate and low potential is dominant. Geodetoctor results revealed that the magnitude influences on groundwater potential have been ranked as transmissivity (0.48), recharge (0.26), lineament density (0.26), lithology (0.13), drainage density (0.12), and geomorphology (0.06). The model results showed that using a convolutional neural network (CNN), groundwater potentiality can be delineated with higher predictive capability and accuracy. CNN-based AUC validation platform showed that 81.58% and 86.84% were accrued from the accuracy of training and testing values, respectively. Based on the findings, the local government can receive technical assistance for groundwater exploration and sustainable water resource development in the Gunabay watershed. Finally, the use of a detector-based deep learning algorithm can provide a new platform for industrial sectors, groundwater experts, scholars, and decision-makers.

Keywords: CNN, geodetector, groundwater influencing factors, Groundwater potential, Gunabay watershed

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Authors: Yamam Abuzinadah

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Mental health literacy has become a very influential topic around the world due to the increase of mental health issues that have been reported through national research and surveys. Mental health literacy refers to the awareness, attitudes, beliefs, knowledge and skills when dealing with mental illness. This research explores mental health literacy in the Arabic and the ways culture informs perceptions of mental health in general. Also, the impact of mental health literacy on: help-seeking attitudes, relationships and community interactions. The outcomes of this research will contribute to raising mental health awareness among the Arabic community, develop and enhance mental health service provision and explore new ideas in regards to elevating mental health literacy in the Arabic community. This research aims to explore attitudes, beliefs, perspective, values and perceptions toward mental health in general among the Arabic community. It will also aim to highlight the factors contributing to theses beliefs, perspective, value and perception and accordingly the role these factors play in regards to awareness, services access, recovery and care provided from the family and the community. This thesis will aim to reflect a detailed theorisation and exploration of: (1) The impact of cultural factors on mental health literacy ie. attitudes, beliefs, knowledge and skills. (2) The ways culture informs perceptions of mental health literacy. (3) The impact of mental health literacy on: help-seeking behaviors, and relationships and community interactions.

Keywords: Arab, mental health, literacy, awareness

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Authors: A. Al-Wandi, A. Al-Ali, R. Dali, Y. Al-Karaghouli

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Background: Non-communicable diseases (NCDs) have become an alarming health problem across the globe. The risk of developing those diseases begins in childhood and develops gradually under the influence of risk factors including obesity, hypertension, dyslipidemia, cigarette smoking and decreased physical activity. Therefore, this study aims to determine the level of knowledge, attitudes, and practices of the risk factors of lifestyle induced chronic diseases (non-communicable diseases) among secondary school students in Sharjah city. Methods: Five hundred and ninety-one school children, from grades 10 to 12, formed the study sample, using the multistage stratified cluster sampling method. Four governmental schools were chosen, for each gender. Data was collected through a pretested, close-ended questionnaire consisting of five sections; demographics, physical activity, diet, smoking and sleeping patterns. Frequencies and descriptive statistics were used to analyze data through SPSS 23. Results: The data showed 64.6% of students had low knowledge of risk factors of non-communicable diseases. Concerning physical activity, 58.2 % were physically inactive and females being less active than males. More than 2/3 of students didn’t fulfill the recommended daily intake of fruits and vegetables (75.9%). 8% reported to be smokers with cigarettes being the most encountered tobacco product. Conclusion: Our study has demonstrated a low level of knowledge and practices yet, positive attitudes towards risk factors of chronic diseases. We recommend implementation of thorough awareness campaigns through public health education about the risk factors of non-communicable diseases.

Keywords: non-communicable diseases, physical activity, diet, knowledge, attitudes, practices, smoking

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Authors: Izani Uzair Zubair, Mohd Ismail Ibrahim, Mohd Nazri Shafei, Hassan Merican Omar Naina Merican, Mohamad Sabri Othman, Mohd Izmi Ahmad Ibrahim, Rasilah Ramli, Rajpal Singh Karam Singh

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Nurses experience a higher prevalence of low back pain (LBP) and musculoskeletal complaints as compared to other hospital workers. Due to no proper policy related to LBP, the job has exposed them to the problem. Thus, the current study aims to look at the intensity of the problem and factors associated with development of LBP. Method and Tools: A cross sectional study was carried out among 1292 nurses from six public hospitals in Penang. They were randomly selected and those who were pregnant and have been diagnosed to have LBP were excluded. A Malay validated BACK Questionnaire was used. The associated factors were determined by using multiple logistic regression from SPSS version 20.0. Result: Most of the respondents were at mean age 30 years old and had mean working experience 86 months. The prevalence of LBP was identified as 76% (95% CI 74, 82). Factors that were associated with LBP among nurses include lifting a heavy object (OR2.626 (95% CI 1.978, 3.486) p =0.001 and the estimation weight of the lifted object (OR1.443 (95% CI 1.056, 1.970) p =0.021. Conclusion: Nurses who practice lifting heavy object and weight of the object lifted give a significant contribution to the development of LBP. The prevalence of the problem is significantly high. Thus, a proper no weight lifting policy should be considered.

Keywords: low back pain, nurses, Penang public hospital, Penang

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Authors: Samia Jamshed Nauman Majeed

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Purpose: Globally, the pandemic of COVID -19 has created a massive distraction for educational reforms influencing learning options, education access, and outcomes of students in more than 190 countries which has carved marks in history. To explore the challenges and complications confronted by students and faculty members while ensuring access to online education, qualitative research was conducted. Methodology: For this purpose, a series of focus group discussions were conducted in different regions of Pakistan, which revealed interesting findings shared by Panelists, which include Vice-Chancellors, Rectors, and Deans of different private and public sector universities of Pakistan. The qualitative research aims to explore the challenges and success factors of online educations by students with diverse backgrounds of higher education institutions to maximize student educational outcomes. Findings: The findings revealed several challenges and opportunities when it comes to online education for students of higher education institutions. Simultaneously, the researchers discovered the key success factors necessary for online education. Lastly, the paper presents the research limitations and future research recommendations to streamline online education in a better way ensuring the students' success. Originality: The pandemic has forced the closure of social, business, and educational activities, which has drastically influence the quality of education with its subsequent impact on the economy. In response, numerous universities across the globe are forced to suspend their educational activities by closing the universities. Though online education has been adopted worldwide by the universities, which brought numerous issues for academia, particularly for underdeveloped countries, and Pakistani higher education reforms are no exception to this.

Keywords: online education, higher education institutions, COVID-19, challenges, key success factors

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Authors: Ulysse Lecomte, Maryline Thenot

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For a long time, disabled people lived in isolation within the family environment, with little interaction with the outside world and a high risk of social exclusion. However, in a number of countries, progress has been made thanks to changes in legislation on the social integration of disabled people, a significant change in attitudes, and the development of CSR. But the problem of their social, economic, and professional exclusion persists and has been further exacerbated by the COVID-19 pandemic. This societal phenomenon is sufficiently important to be the subject of management science research. We have therefore focused our work on society's current perception of people with disabilities and their possible integration. Our aim is to find out what levers could be put in place to bring about positive change in the situation. We have chosen to focus on the perception of young people in France, who are the new generation responsible for the future of our society and from whom tomorrow's decisionmakers, future employers, and stakeholders who can influence the living conditions of disabled people will be drawn. Our study sample corresponds to the 18-30 age group, which is the population of young adults likely to have sufficient experience and maturity. The aim of this study is not only to find out how this population currently perceives disability but also to identify the factors influencing this perception and the most effective levers for action to act positively on this phenomenon and thus promote better social integration of people with disabilities in the future. The methodology is based on theoretical and empirical research. The literature review includes a historical and etymological approach to disability, a definition of the different concepts of disability, an approach to disability as a vector of social exclusion, and the role of perception and representations in defining the social image of disability. This literature review is followed by an empirical part carried out by means of a questionnaire administered to 110 young people aged 18 to 30. Analysis of our results suggests that, despite a recent improvement, disabled people are still perceived as vulnerable and socially marginalised. The following factors stand out as having a significant influence (positive or negative) on the perception of disability: the individual's familiarity with the 'world of disability', cultural factors, the degree of 'visibility' of the disability and the empathy level of the disabled person him/herself. Others, on the other hand, such as socio-political and economic factors, have little impact on this perception. In addition, it is possible to classify the various levers of action likely to improve the social perception of disability according to their degree of effectiveness. Our study population prioritised training initiatives for the various players and stakeholders (teachers, students, disabled people themselves, companies, sports clubs, etc.). This was followed by communication, ecommunication and media campaigns in favour of disability. Lastly, the sample was judged as 'less effective' positive discrimination actions such as setting a minimum percentage for the representation of disabled people in various fields (studies, employment, politics ...).

Keywords: disability, perception, social image, young people, influencing factors, levers for action

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Authors: Vivian Khamis

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Exposure to war and forced migration have been widely linked to child subsequent adaptation. What remains sparse is research spanning multiple risk and protective factors and examining their unique and relative implications to difficulties in mental health among refugee girls. This study investigated the mechanisms through which posttraumatic stress disorder (PTSD), emotion dysregulation , neuroticism, and behavioral and emotional disorders in Syrian refugee girls is impacted by exposure to war traumas, age, and other risk and protective factors such as coping styles, family relationships, and school environment. The sample consisted of 539 Syrian refugee girls who ranged in age from 7 to 18 years attending public schools in various governorates in Lebanon and Jordan. Two school counselors carried out the interviews with children at school. Results indicated that war trauma, older age, and a combination of negative copying style associated with conflict in the family could lead to an overall state of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD in refugee girls. On the other hand, lapse of time since resettlement in host country, positive copying style, cohesion, and expressiveness in the family would lead to more positive mental health status, including lower levels of emotion dysregulation, neuroticism, behavioral and emotional disorders, and PTSD . Enhanced understanding of the mechanistic role of risk and protective factors in contributing to difficulties in mental health in refugee girls may contribute to the development of effective interventions to target the psychological effects of the refugee experience.

Keywords: refugee girls, PTSD, emotion dysregulation, neuroticism, behavioral and emotional disorders

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Authors: A. Rezazadeh, B Damari, S. Riazi-Esfahani, M. Hajian

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The consumption of junk food in Iran is alarmingly increasing. This study aimed to investigate the influencing factors of junk food consumption and amendable interventions that are criticized and approved by stakeholders, in order to presented to health policy makers. The articles and documents related to the content of study were collected by using the appropriate key words such as junk food, carbonated beverage, chocolate, candy, sweets, industrial fruit juices, potato chips, French fries, puffed corn, cakes, biscuits, sandwiches, prepared foods and popsicles, ice cream, bar, chewing gum, pastilles and snack, in scholar.google.com, pubmed.com, eric.ed.gov, cochrane.org, magiran.com, medlib.ir, irandoc.ac.ir, who.int, iranmedex.com, sid.ir, pubmed.org and sciencedirect.com databases. The main key points were extracted and included in a checklist and qualitatively analyzed. Then a summarized abstract was prepared in a format of a questionnaire to be presented to stakeholders. The design of this was qualitative (Delphi). According to this method, a questionnaire was prepared based on reviewing the articles and documents and it was emailed to stakeholders, who were asked to prioritize and choose the main problems and effective interventions. After three rounds, consensus was obtained.            Studies revealed high consumption of junk foods in the Iranian population, especially in children and adolescents. The most important affecting factors include availability, low price, media advertisements, preference of fast foods taste, the variety of the packages and their attractiveness, low awareness and changing in lifestyle. Main interventions recommended by stakeholders include developing a protective environment, educational interventions, increasing healthy food access and controlling media advertisements and putting pressure from the Industry and Mining Ministry on producers to produce healthy snacks. According to the findings, the results of this study may be proposed to public health policymakers as an advocacy paper and to be integrated in the interventional programs of Health and Education ministries and the media. Also, implementation of supportive meetings with the producers of alternative healthy products is suggested.

Keywords: junk foods, situation, qualitative study, Iran

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