Search results for: health care

Authors: A. L. Verret, N. Prince, Y. Jerome, A. Bras

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The effects of housing design on the health and well-being of populations are quite intangible. In fact, healthy housing parameters are generally difficult to establish scientifically. It is often unclear the direction of a cause-and-effect relationship between health variables and housing. However, the lack of clear and definite measurements does not entail the absence of relationship between housing, health, and well-being. Research has thus been conducted. It has mostly aimed the physical rather than the psychological or social well-being of a population, given the difficulties to establish cause-effect relationships because of the subjectivity of the psychological symptoms and of the challenge in determining the influence of other factors. That said, a strong relationship has been exposed between light and physiology. Both the nervous and endocrine systems, amongst others, are affected by different wavelengths of natural light within a building. Daylight in the workplace is indeed associated to decreased absenteeism, errors and product defects, fatigue, eyestrain, increased productivity and positive attitude. Similar associations can also be made to residential housing. Lower levels of sunlight within the home have been proven to result in impaired cognition in depressed participants of a cross-sectional case study. Moreover, minimum space (area and volume) has been linked to healthy housing and quality of life, resulting in norms and regulations for such parameters for home constructions. As a matter of fact, it is estimated that people spend the two-thirds of their lives within the home and its immediate environment. Therefore, it is possible to deduct that the health and well-being of the occupants are potentially at risk in an unhealthy housing situation. While the impact of architecture on health and well-being is acknowledged and considered somewhat crucial in various countries of the north and the south, this issue is barely raised in Haiti. In fact, little importance is given to architecture for many reasons (lack of information, lack of means, societal reflex, poverty…). However, the middle-class is known for its residential strategies and trajectories in search of better-quality homes and environments. For this reason, it would be pertinent to use this group and its strategies and trajectories to isolate the impact of housing design on the overall health and well-being. This research aims to analyze the impact of housing architecture on the health and well-being of middle-class families in the metropolitan region of Port-au-Prince. It is a case study which uses semi-structured interviews and observations as research methods. Although at an early stage, this research anticipates that homes affect their occupants both psychologically and physiologically, and consequently, public policies and the population should take into account the architectural design in the planning and construction of housing and, furthermore, cities.

Keywords: architectural design, health and well-being, middle-class housing, Port-au-Prince, Haiti

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Authors: Hamda Ajmal, Karen Young, Ruth Melia, John Bogue, Mary O'Sullivan, Jim Duggan, Hannah Wood

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The Covid-19 pandemic led to a range of public health mitigation strategies in order to suppress the SARS-CoV-2 virus. The drastic changes in everyday life due to lockdowns had the potential for a significant negative impact on public mental health, and a key public health goal is to now assess the evidence from available Irish datasets to provide useful insights on this issue. Text-50808 is an online text-based mental health support service, established in Ireland in 2020, and can provide a measure of revealed distress and mental health concerns across the population. The aim of this study is to explore statistical associations between public mental health in Ireland and the Covid-19 pandemic. Uniquely, this study combines two measures of emotional wellbeing in Ireland: (1) weekly text volume at Text-50808, and (2) emotional wellbeing indicators reported by respondents of the Amárach public opinion survey, carried out on behalf of the Department of Health, Ireland. For this analysis, a multivariate graphical exploratory data analysis (EDA) was performed on the Text-50808 dataset dated from 15th June 2020 to 30th June 2021. This was followed by time-series analysis of key mental health indicators including: (1) the percentage of daily/weekly texts at Text-50808 that mention Covid-19 related issues; (2) the weekly percentage of people experiencing anxiety, boredom, enjoyment, happiness, worry, fear and stress in Amárach survey; and Covid-19 related factors: (3) daily new Covid-19 case numbers; (4) daily stringency index capturing the effect of government non-pharmaceutical interventions (NPIs) in Ireland. The cross-correlation function was applied to measure the relationship between the different time series. EDA of the Text-50808 dataset reveals significant peaks in the volume of texts on days prior to level 3 lockdown and level 5 lockdown in October 2020, and full level 5 lockdown in December 2020. A significantly high positive correlation was observed between the percentage of texts at Text-50808 that reported Covid-19 related issues and the percentage of respondents experiencing anxiety, worry and boredom (at a lag of 1 week) in Amárach survey data. There is a significant negative correlation between percentage of texts with Covid-19 related issues and percentage of respondents experiencing happiness in Amárach survey. Daily percentage of texts at Text-50808 that reported Covid-19 related issues to have a weak positive correlation with daily new Covid-19 cases in Ireland at a lag of 10 days and with daily stringency index of NPIs in Ireland at a lag of 2 days. The sudden peaks in text volume at Text-50808 immediately prior to new restrictions in Ireland indicate an association between a rise in mental health concerns following the announcement of new restrictions. There is also a high correlation between emotional wellbeing variables in the Amárach dataset and the number of weekly texts at Text-50808, and this confirms that Text-50808 reflects overall public sentiment. This analysis confirms the benefits of the texting service as a community surveillance tool for mental health in the population. This initial EDA will be extended to use multivariate modeling to predict the effect of additional Covid-19 related factors on public mental health in Ireland.

Keywords: COVID-19 pandemic, data analysis, digital health, mental health, public health, digital health

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Authors: Wegene Demeke

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Background: The demand for healthcare services is growing in developing and developed countries. Information and communication technology is used to facilitate healthcare services. In the case of developing countries, implementing telemedicine is aimed at providing healthcare for people living in remote areas where health service is not accessible. The implementations of telemedicine in developing countries are unsuccessful. For example, the recent study indicates that 90% of telemedicine projects are abandoned or failed in developing countries. Several researchers reported the technological challenges as the main factor for the non-adoption of telemedicine. However, this research reports the health professionals’ perspectives arising from technical, social and organizational factors that are considered as key elements for the setting and running of telemedicine in Ethiopia. The importance and significance of telemedicine for healthcare is growing. For example, the use of telemedicine in the current pandemic situation becomes an essential strategic element in providing healthcare services in developed countries. Method: Qualitative and quantitative exploratory research methods used to collect data to find factors affecting the adoption of Information and communication technologies for telemedicine use. The survey was distributed using emails and Google forms. The email addresses were collected from personal contact and publicly available websites in Ethiopia. The thematic analysis used to build the barriers and facilitators factors for establishing telemedicine services. A survey questionnaire with open-and-close questions was used to collect data from 175 health professionals. Outcome: The result of this research will contribute to building the key barriers and facilitators factors of telemedicine from the health professional perspectives in developing countries. The thematic analysis provides barriers and facilitators factors arising from technical, organizational, and social sources.

Keywords: telemedicine, ICT, developing country, Ethiopia, health service

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Authors: Anamika A. Sharma, Arezou Ahmadi R. A., Narendra B. Parihar, Manjusha Sajith

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Introduction: Hemodialysis is the most effective therapeutic technique for patient with ESRD second to renal transplantation. However it is a lifelong therapy which requires frequent hospital, or dialysis centers visits mainly twice and thrice weekly, thus considerably changes the normal way of patient’s living. So this study aimed to Assess Health-Related Quality of life in End-Stage Renal Disease (ESRD) Undergoing Twice and Thrice weekly Hemodialysis. Method: A prospective observational, cross-sectional study was carried out from September 2016 to April 2017 in end-stage renal disease patients undergoing hemodialysis. Socio-demographic and clinical details of patients were obtained from the medical records. WHOQOL-BREF questionnaire was used to Access Health-Related Quality Of Life. Quality of Life scores of Twice weekly and Thrice weekly hemodialysis was analyzed by Kruskal Wallis Test. Results: Majority of respondents were male (72.55%), married (89.31%), employed (58.02%), belong to middle class (71.00%) and resides in rural area (58.78%). The mean ages in the patient undergoing twice weekly and thrice weekly hemodialysis were 51.89 ± 15.64 years and 51.33 ± 15.70 years respectively. Average Quality of Life scores observed in twice weekly and thrice weekly hemodialysis was 52.07 ± 13.30 (p=0.0037) and 52.87 ± 13.47 (p=0.0004) respectively. The hemoglobin of thrice weekly dialysis patients (10.28 gm/dL) was high as compared to twice weekly dialysis (9.23 gm/dL). Patients undergoing thrice weekly dialysis had improved serum urea, serum creatinine values (95.85 mg/dL, 8.32 mg/dL) as compared to twice weekly hemodialysis ( 104.94 mg/dL, 8.68 mg/dL). Conclusion: Our study concluded that there was no significant difference between overall Health-Related Quality Of Life in twice weekly and thrice weekly hemodialysis. Frequent hemodialysis was associated with improved control of hypertension, serum urea, serum creatinine levels.

Keywords: end stage renal disease, health related quality of life, twice weekly hemodialysis, thrice weekly hemodialysis

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Authors: Aratrika Sarkar, Jayita Guha Niyogi

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This paper focuses on the application of general healing design theories to modulate them into case-specific and contextual design considerations. Existing literature focuses on the relationship between architecture and mental health. Primary case studies are selected in India to focus on the effect of a specific location on design considerations. They are qualitatively analysed to further contextualise the inferences from the literature study. An academic project is cited as an example to apply the learnings from the study and understand the influence of various parameters on the design process for further conclusion. Literature studies, case studies and hypothetical design applications helped in finding the different ways of achieving the similar goal of a sensitive approach toward mental health. Along with salutogenic parameters, category of establishment, age group, location of the site and user preference plays a crucial role in the design process. Design of mental health establishments, especially in India, has to involve transparency between stakeholders and users. Owing to different climatic zones and diverse sociocultural traditions, the approach toward healing should adapt accordingly. It should be an effort towards striking a balance between contradictory elements of healing design and resolving the dilemmas with sensitivity and consensus. Lastly, the design should not force a person towards communication or companionship but rather let the person realise that naturally through the healing process.

Keywords: contextual healing design, deinstitutionalisation, Indian mental healthcare establishments, environmental psychology, salutogenesis, therapeutic design

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Authors: María José López Rey, Mar Chaves Carrillo, Manuela Caballero Guisado

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The data presented here are part of a broader investigation on active population aging. The work was carried out in November 2020 in Extremadura, a region of southern Spain. This R + D + I project, called "Active aging scenarios in Extremadura: intervention proposals," was carried out by a team of professors, researchers from the University of Extremadura. The project has been financed by the European Regional Development Funds and the Government of Extremadura. Here, we focus on aspects that have to do with the experience of health, especially during the COVID-19 pandemic, and how this has affected the population related to the main sociodemographic variables. In an exercise of methodological triangulation, thus providing robustness to the analysis, primary data, obtained from the survey designed ad hoc, are combined with other secondary data from various sources and studies carried out in Spain (Sociological Research Centre, and National Institute of Statistics). The survey was carried out on a representative sample of the population over 55 years old, coming from Extremadura. Among the findings, we must highlight the practical invariability of perceptions based on the main sociodemographic variables, as well as some differences indicated by the variables sex and age.

Keywords: aging, health, COVID-19, perceptions

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Authors: Kevin Montanez, Patricia Garcia

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The confinement and restrictions adopted to avoid an exponential spread of the COVID-19 have negatively impacted the Peruvian economy. In this context, Industries offering essential products could continue operating, but they have to follow safety protocols and implement strategies to ensure employee health. In view of the increasing internet access and mobile phone ownership, “Alerta Temprana”, a mobile app, was developed to self-report COVID-19 symptoms in the work context. In this study, the usability of the mobile app “Alerta Temprana” was evaluated from the perspective of health monitors and workers. In addition to reporting the metrics related to the usability of the application, the utility of the system is also evaluated from the monitors' perspective. In this descriptive study, the participants used the mobile app for two months. Afterwards, System Usability Scale (SUS) questionnaire was answered by the workers and monitors. A Usefulness questionnaire with open questions was also used for the monitors. The data related to the use of the application was collected during one month. Furthermore, descriptive statistics and bivariate analysis were used. The workers rated the application as good (70.39). In the case of the monitors, usability was excellent (83.0). The most important feature for the monitors were the emails generated by the application. The average interaction per user was 30 seconds and a total of 6172 self-reports were sent. Finally, a statistically significant association was found between the acceptability scale and the work area. The results of this study suggest that Alerta Temprana has the potential to be used for surveillance and health monitoring in any context of face-to-face modality. Participants reported a high degree of ease of use. However, from the perspective of workers, SUS cannot diagnose usability issues and we suggest we use another standard usability questionnaire to improve "Alerta Temprana" for future use.

Keywords: public health in informatics, mobile app, usability, self-report

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Authors: Abdel-Samad M. Ali, Ali A. Hadi Al-Shawi

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Discrimination against women and girls impairs progress in all domains of development articulated either in the framework of Millennium Development Goals (MDGs) or in the Post-2015 Development Agenda. Paper aspires to create greater awareness among researchers and policy makers of the challenges posed by gender gaps and the opportunities created by reducing them within the Arab region. The study reveals how Arab countries are closing in on gender-oriented targets of the third and fifth MDGs. While some countries can claim remarkable achievements particularly in girls’ equality in education, there is still a long way to go to keep Arab’s commitments to current and future generations in other countries and subregions especially in the economic participation or in the political empowerment of women. No country has closed or even expected to close the economic participation gap or the political empowerment gap. This should provide the incentive to keep moving forward in the Post-2015 Agenda. Findings of the study prove that while Arab states have uneven achievements in reducing maternal mortality, Arab women remain at a disadvantage in the labour market. For Arab region especially LDCs, improving maternal health is part of the unmet agenda for the post-2015 period and still calls for intensified efforts and procedures. While antenatal care coverage is improving across the Arab region, progress is marginal in LDCs. To achieve proper realization of gender equality and empowerment of women in the Arab region in the post-2015 agenda, the study presents critical key challenges to be addressed. These challenges include: Negative cultural norms and stereotypes; violence against women and girls; early marriage and child labour; women’s limited control over their own bodies; limited ability of women to generate their own income and control assets and property; gender-based discrimination in law and in practice; women’s unequal participation in private and public decision making autonomy; and limitations in data. However, in all Arab states, gender equality must be integrated as a goal across all issues, particularly those that affect the future of a country.

Keywords: gender, equity, millennium development goals, post-2015 development agenda

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Authors: Kanchan Negi

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Background: Modern and urban occupational culture have driven demands for people to work long hours and weekends and take work to home at times. Research on the health effects of these exhaustive temporal work patterns is scant or contradictory. This study examines the relationship between work patterns and wellbeing in a sample of women living in the metropolitan hub of Delhi. Method: This study is based on the data collected from 360 currently married women between age 29 and 49 years, working in the urban capital hub of India, i.e., Delhi. The women interviewed were professionals from the education, health, banking and information and technology (IT) sector. Bivariate analysis was done to study the characteristics of the sample. Logistic regression analysis was used to estimate the physical and psychological wellbeing across occupational characteristics. Results: Most of the working women were below age 35 years; around 30% of women worked in the education sector, 23% in health, 21% in banking and 26% in the IT sector. Over 55% of women were employed in the private sector and only 36% were permanent employees. Nearly 30% of women worked for more than the standard 8 hours a day. The findings from logistic regression showed that compared to women working in the education sector, those who worked in the banking and IT sector more likely to have physical and psychological health issues (OR 2.07-4.37, CI 1.17-4.37); women who bear dual burden of responsibilities had higher odds of physical and psychological health issues than women who did not (OR 1.19-1.85 CI 0.96-2.92). Women who worked for more than 8 hours a day (OR 1.15, CI 1.01-1.30) and those who worked for more than five days a week (OR 1.25, CI 1.05-1.35) were more likely to have physical health issues than women who worked for 6-8 hours a day and five days e week, respectively. Also, not having flexible work timings and compensatory holidays increased the odds of having physical and psychological health issues among working women (OR 1.17-1.29, CI 1.01-1.47). Women who worked in the private sector, those employed temporarily and who worked in the non-conducive environments were more likely to have psychological health issues as compared to women in the public sector, permanent employees and those who worked in a conducive environment, respectively (OR 1.33-1.67, CI 1.09-2.91). Women who did not have poor work-life balance had reduced the odds of psychological health issues than women with poor work-life balance (OR 0.46, CI 0.25-0.84). Conclusion: Poor wellbeing significantly linked to strenuous and rigid work patterns, suggesting that modern and urban work culture may contribute to the poor wellbeing of working women. Noticing the recent decline in female workforce participation in Delhi, schemes like Flexi-timings, compensatory holidays, work-from-home and daycare facilities for young ones must be welcomed; these policies already exist in some private sector firms, and the public sectors companies should also adopt such changes to ease the dual burden as homemaker and career maker. This could encourage women in the urban areas to readily take up the jobs with less juggle to manage home and work.

Keywords: occupational characteristics, urban India, well-being, working women

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Authors: Abimbola Motunrayo Folami, Ibironke Titilayo Enitan, Feroz Mohomed Swalaha

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Water is a vital resource that is important in ensuring the growth and development of any country. To sustain the basic human needs and the demands for agriculture, industry, conservational and ecosystem, enough quality and quantity water is needed. Contamination of water resources is now a global and public health concern. Hence, this study assessed the water quality of Ndawuse River by measuring the physicochemical parameters and heavy metals concentrations of the river using standard methods. In total, 16 surface water samples were obtained from five locations along the river, from upstream to downstream as well as samples from the dumpsite. The results obtained were compared with the standard limits set by both the World Health Organization and the Federal Environmental Protection Agency for domestic purposes. The results of the measured parameters indicated that biological oxygen demand (85.88 mg/L), turbidity (44.51 NTU), Iron (0.014 - 3.511 mg /L) and chromium (0.078 - 0.14 mg /L) were all above the standard limits. The results further showed that the quality of surface water is being significantly affected by human activities around the Ndawuse River which could pose an adverse health risk to several communities that rely on this river as their primary source of water. Therefore, there is a need for strict enforcement of environmental laws to protect the aquatic ecosystem and to avoid long term cumulative exposure risk that heavy metals may pose on human health.

Keywords: Abuja, contaminants, heavy metals, Ndawuse River, Nigeria, surface water

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Authors: Ana Luiza Blanco, Luiza de Pádua Penteado, Daniella Pires Nunes

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Ageism is a widespread and prevalent phenomenon that affects older adults and directly affects healthy aging. Identifying the factors that contribute to ageism is important to discuss interventions that minimizes its social and emotional impact. To identify factors related with ageism in Brazilians older adults. Quantitative study, with a cross-sectional and analytical design. 134 older adults completed an online questionnaire about Sociodemographic and Health Characteristics, Discrimination (Ageism Survey), Depressive Symptoms (The Geriatric Depression Scale), Family Function (Family APGAR) and Loneliness. The Mann Whitney and Kruskal Wallis tests were used for data analysis, with a significance level of 5%. The mean age was 66.93 years (sd=0.50), mostly women (84.20%), married (52.60%) and with more than 12 years of schooling (75.93%). The results showed that older adults with a regular self-perception of health had higher median ageism scores when compared to individuals who rated their health as very good or good (p=0.006). The same occurred for individuals with depressive symptoms when compared to those without signs of depression (p=0.001). Regarding family function, it was observed that people with low family functionality tend to suffer more ageism than those with high functionality (p=0.017). Loneliness was also a factor related with the experience of ageism in this study. Lonely individuals had higher median ageism scores (p=0.002). There was relationship between ageism and self-perception of health, depressive symptoms, loneliness and dysfunctional family. Such findings demonstrate the importance of considering the psychosocial determinants of aging to reduce discrimination and promote healthy aging, focusing on social support and educational interventions.

Keywords: ageism, age stereotypes, healthy aging, social conditions

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Authors: Anne Tetens, Susan Andersen, Lars Ole Bonde, Pia Jeppesen, Katrine Rich Madsen

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Background: The World Health Organization (WHO) has emphasized the critical need for feasible and effective school-based mental health promotion interventions. High-quality music education in school has been suggested to promote well-being, inclusion, and positive relations, which are essential for children’s mental health. This study explores the potential of choir singing as a distinct approach to enhance children’s mental health within the school setting. ‘Everyone Can Sing’ is a class-based mental health promotion intervention for children in grades 0-3 (ages 5-10) in Danish primary school, which integrates choir singing into the students’ normal school schedule twice a week to promote mental health through the increase of school well-being, class coherence and social inclusion. The intervention uses trained choir leaders to lead the lessons in close collaboration with the class teacher, placing a distinct emphasis on well-being and the inclusive aspect of musical expression through body and voice. Aim: The aim of the study is to evaluate the feasibility of the Everyone Can Sing intervention with the specific objective to assess implementation and changes in mental health parameters, including school well-being, class coherence and social inclusion. Methodologies: The study is a feasibility study of a one-year intervention, which started in January 2024 and is being implemented in grades 0-3 (ages 5-10) across three different Danish primary schools. It is designed according to a mixed methods approach, including both quantitative and qualitative methods. Baseline questionnaires were obtained from students, parents and teachers, and follow-up is planned at 12 months. Participant observations of class choir and individual and group interviews with students, teachers, choir leaders, and school management are collected during the intervention period. The study uses the validated ‘Strengths and Difficulties Questionnaire’ for parent- and teacher-reports. The student questionnaire, which assesses school well-being, class coherence, social inclusion and indicators of mental health, was developed and validated for this study. Participant observations and interviews provide in-depth insights into the implementation process and participants’ experiences of the mental health-promoting potential of the intervention. Findings: The study included 41 classes across three schools (N=904) and questionnaire data from students (n=845, = 93%), teachers (n=890, = 98%), and parents (n=608, = 67%) at baseline. Follow-up data will be obtained in January 2025. While collection and analyses of data are still ongoing, preliminary implementation findings based on interviews and observations indicate high levels of engagement and acceptability. At 6 months into the intervention period, the study protocol is on track and suggests that the intervention is well-received. Further findings and analyses will be presented. The final results of the study will be used to decide whether the AKS intervention should proceed to a future, full-size effectiveness trial, return to refinement of the intervention or the evaluation design, or stop. Contributions: This study will provide valuable insights into new approaches to school-based mental health promotion initiatives. If feasible, the vision is to implement the intervention or elements of it in primary schools across all five Danish regions, potentially lowering the mental health burden.

Keywords: child mental health, early childhood, mental health promotion, mixed methods research, school-based intervention.

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Authors: Carlos V. Gonzalez

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Background: Providers of in-home and community based services strive for the elimination of preventable harm to the people under their care as well as to the employees who support them. Traditional models of safety and protection from harm have assumed that the absence of incidents of harm is a good indicator of safe practices. However, this model creates an illusion of safety that is easily shaken by sudden and inadvertent harmful events. As an alternative, we have developed and implemented an evidence-based resilient model of safety known as C.O.P.E. (Caring, Observing, Predicting and Evaluating). Within this model, safety is not defined by the absence of harmful incidents, but by the presence of continuous monitoring, anticipation, learning, and rapid response to events that may lead to harm. Objective: The objective was to evaluate the effectiveness of the C.O.P.E. model for the reduction of harm to individuals with mental disabilities who receive home and community based services. Methods: Over the course of 2 years we counted the number of incidents of harm and near misses. We trained employees on strategies to eliminate incidents before they fully escalated. We trained employees to track different levels of patient status within a scale from 0 to 10. Additionally, we provided direct support professionals and supervisors with customized smart phone applications to track and notify the team of changes in that status every 30 minutes. Finally, the information that we collected was saved in a private computer network that analyzes and graphs the outcome of each incident. Result and conclusions: The use of the COPE model resulted in: A reduction in incidents of harm. A reduction the use of restraints and other physical interventions. An increase in Direct Support Professional’s ability to detect and respond to health problems. Improvement in employee alertness by decreasing sleeping on duty. Improvement in caring and positive interaction between Direct Support Professionals and the person who is supported. Developing a method to globally measure and assess the effectiveness of prevention from harm plans. Future applications of the COPE model for the reduction of harm to people who receive home and community based services are discussed.

Keywords: harm, patients, resilience, safety, mental illness, disability

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Authors: Deborah Bailey-Rodriguez, Maria Paula Valdivieso Rueda, Gemma Reynolds

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In recent years, the mental health of Higher Education (HE) students has been a growing concern. This has been further exacerbated by the stresses associated with the Covid-19 pandemic, placing students at even greater risk of developing mental health issues. Support available to students in HE tends to follow an established and traditional route. The demands for counseling services have grown, not only with the increase in student numbers but with the number of students seeking support for mental health issues, with 94% of HE institutions recently reporting an increase in the need for counseling services. One way of improving the well-being and mental health of HE students is through the use of brief interventions, such as expressive writing (EW). This intervention involves encouraging individuals to write continuously for at least 15-20 minutes for three to five sessions (often on consecutive days) about their deepest thoughts and feelings to explore significant personal experiences in a meaningful way. Given the brevity, simplicity and cost-effectiveness of EW, this intervention has considerable potential as an intervention for HE populations. The current study, therefore, employed a mixed-methods design to explore the effectiveness of EW in reducing anxiety, general stress, academic stress and depression in HE students while improving well-being. HE students at MDX were randomly assigned to one of three conditions: (1) The UniExp-EW group was required to write about their emotions and thoughts about any stressors they have faced that are directly relevant to their university experience (2) The NonUniExp-EW group was required to write about their emotions and thoughts about any stressors that are NOT directly relevant to their university experience, and (3) The Control group were required to write about how they spent their weekend, with no reference to thoughts or emotions, and without thinking about university. Participants were required to carry out the EW intervention for 15 minutes per day for four consecutive days. Baseline mental health and well-being measures were taken before the intervention via a battery of standardized questionnaires. Following completion of the intervention on day four, participants were required to complete the questionnaires a second time and again one week later. Participants were also invited to attend focus groups to discuss their experience of the intervention. This will allow an in-depth investigation into students’ perceptions of EW as an effective intervention to determine whether they would choose to use this intervention in the future. Preliminary findings will be discussed at the conference as well as a discussion of the important implications of the findings. The study is fundamental because if EW is an effective intervention for improving mental health and well-being in HE students, its brevity and simplicity mean it can be easily implemented and can be freely available to students. Improving the mental health and well-being of HE students can have knock-on implications for improving academic skills and career development.

Keywords: expressive writing, higher education, psychology in education, mixed-methods, mental health, academic stress

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Authors: Mary A. Lindell

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Adults with intellectual disabilities (ID) are increasingly attending postsecondary institutions, including inclusive residential programs at four-year universities. The legislation, national organizations, and researchers support developing postsecondary education (PSE) options for this historically underserved population. Simultaneously, researchers are assessing the quality of life indicators (QOL) for people with ID. This study explores the quality of life characteristics for individuals with ID entering a two-year PSE program. A survey aligned with the PSE program was developed and administered to participants before they began their college program (in future studies, the same survey will be administered 6 months and 1 year after graduating). Employment, income, and housing are frequently cited QOL measures. People with disabilities, and especially people with ID, are more likely to experience unemployment and low wages than people without disabilities. PSE improves adult outcomes (e.g., employment, income, housing) for people with and without disabilities. Similarly, adults with ID who attend PSE are more likely to be employed than their peers who do not attend PSE; however, adults with ID are least likely among their typical peers and other students with disabilities to attend PSE. There is increased attention to providing individuals with ID access to PSE and more research is needed regarding the characteristics of students attending PSE. This study focuses on the participants of a fully residential two-year program for individuals with ID. Students earn an Applied Skills Certificate while focusing on five benchmarks: self-care, home care, relationships, academics, and employment. To create a QOL measure, the goals of the PSE program were identified, and possible assessment items were initially selected from the National Core Indicators (NCI) and the National Transition Longitudinal Survey 2 (NTLS2) that aligned with the five program goals. Program staff and advisory committee members offered input on potential item alignment with program goals and expected value to students with ID in the program. National experts in researching QOL outcomes of people with ID were consulted and concurred that the items selected would be useful in measuring the outcomes of postsecondary students with ID. The measure was piloted, modified, and administered to incoming students with ID. Research questions: (1) In what ways are students with ID entering a two-year PSE program similar to individuals with ID who complete the NCI and NTLS2 surveys? (2) In what ways are students with ID entering a two-year PSE program different than individuals with ID who completed the NCI and NTLS2 surveys? The process of developing a QOL measure specific to a PSE program for individuals with ID revealed that many of the items in comprehensive national QOL measures are not relevant to stake-holders of this two-year residential inclusive PSE program. Specific responses of students with ID entering an inclusive PSE program will be presented as well as a comparison to similar items on national QOL measures. This study explores the characteristics of students with ID entering a residential, inclusive PSE program. This information is valuable for, researchers, educators, and policy makers as PSE programs become more accessible for individuals with ID.

Keywords: intellectual disabilities, inclusion, post-secondary education, quality of life

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Authors: Joseph Kimuli Balikuddembe

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Road traffic incidents (RTIs) continue to be a serious public health and development burden around the globe. Compared to high-income countries (HICs), the low and middle-income countries (LMICs) bear the heaviest brunt of RTIs. Like other LMICs, Uganda, a country located in Eastern Africa, has been experiencing a worryingly high burden of RTIs and their associated impacts. Over the years, the highest number of all the total registered RTIs in Uganda has taken place in the Greater Kampala Metropolitan Area (GKMA). This places a tremendous demand on the few existing emergency medical services (EMS) to adequately respond to those affected. In this regard, the overall objective of the study was to risk map RTIs in the GKMA so as to help in the better planning of EMS for the victims of RTIs. Other objectives included: (i) identifying the factors affecting the exposure, vulnerability and EMS capacity for the victims of RTIs; (ii) identifying the RTI prone-areas and estimating their associated risk factors; (iii) identifying the weaknesses and capacities which affect the EMS systems for RTIs; and (iv) determining the strategies and priority actions that can help to improve the EMS response for RTI victims in the GKMA. To achieve these objectives, a mixed methodological approach was used in four phrases for approximately 15 months. It employed a systematic review based on the preferred reporting items for systematic reviews and meta-data analysis guidelines; a Delphi panel technique; retrospective data analysis; and a cross-sectional method. With Uganda progressing forward as envisaged in its 'Vision 2040', the GKMA, which is the country’s political and socioeconomic epicenter, is experiencing significant changes in terms of population growth, urbanization, infrastructure development, rapid motorization and other factors. Unless appropriate actions are taken, these changes are likely to worsen the already alarming rate of RTIs in Uganda, and in turn also to put pressure on the few existing EMS and facilities to render care for those affected. Therefore, road safety vis-à-vis injury prevention measures, which are needed to reduce the burden of RTIs, should be multifaceted in nature so that they closely correlate with the ongoing dynamics that contribute to RTIs, particularly in the GKMA and Uganda as a whole.

Keywords: emergency medical services, Kampala, risk mapping, road traffic incidents

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Authors: Richard Okyere Boadu, Godwin Adzakpah, Nathan Kumasenu Mensah, Kwame Adu Okyere Boadu, Jonathan Kissi, Christiana Dziyaba, Rosemary Bermaa Abrefa

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Information and communication technology (ICT) has significantly advanced global healthcare, with electronic health (e-Health) applications improving health records and delivery. These innovations, including electronic health records, strengthen healthcare systems. The study investigates healthcare professionals' perceptions of health information applications and their associated factors in the Cape Coast Metropolis of Ghana's health facilities. Methods: We used a descriptive cross-sectional study design to collect data from 632 healthcare professionals (HCPs), in the three purposively selected health facilities in the Cape Coast municipality of Ghana in July 2022. Shapiro-Wilk test was used to check the normality of dependent variables. Descriptive statistics were used to report means with corresponding standard deviations for continuous variables. Proportions were also reported for categorical variables. Bivariate regression analysis was conducted to determine the factors influencing the Benefits of Information Technology (BoIT); Barriers to Information Technology Use (BITU); and Motives of Information Technology Use (MoITU) in healthcare delivery. Stata SE version 15 was used for the analysis. A p-value of less than 0.05 served as the basis for considering a statistically significant accepting hypothesis. Results: Healthcare professionals (HCPs) generally perceived moderate benefits (Mean score (M)=5.67) from information technology (IT) in healthcare. However, they slightly agreed that barriers like insufficient computers (M=5.11), frequent system downtime (M=5.09), low system performance (M=5.04), and inadequate staff training (M=4.88) hindered IT utilization. Respondents slightly agreed that training (M=5.56), technical support (M=5.46), and changes in work procedures (M=5.10) motivated their IT use. Bivariate regression analysis revealed significant influences of education, working experience, healthcare profession, and IT training on attitudes towards IT utilization in healthcare delivery (BoIT, BITU, and MoITU). Additionally, the age of healthcare providers, education, and working experience significantly influenced BITU. Ultimately, age, education, working experience, healthcare profession, and IT training significantly influenced MoITU in healthcare delivery. Conclusions: Healthcare professionals acknowledge moderate benefits of IT in healthcare but encounter barriers like inadequate resources and training. Motives for IT use include staff training and support. Bivariate regression analysis shows education, working experience, profession, and IT training significantly influence attitudes toward IT adoption. Targeted interventions and policies can enhance IT utilization in the Cape Coast Metropolis, Ghana.

Keywords: health information application, utilization of information application, information technology use, healthcare

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Authors: Coulibaly Fatoumata, Gragnon Biego, Aka N. David, Mbari K. Benjamin, Soro Y. René, Ndiaye Jean-louis

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Poultry is nowadays one of the most consumed sources of protein, and its livestock represents one of the few opportunities for savings, investment and protection against risk. It provides income for the most vulnerable sections of society, in particular, women (70%) and children who mainly practice this breeding. A study was conducted in the commune of Korhogo at the level of 52 poultry farms, the objective of which was to know the epidemiological situation of parasitism external and internal poultry in order to contribute to the improvement of the health status of modern poultry farms in the said commune. The method described by OIE (2005), consisting of using the standard formula (n = δ2*p*(1-p) *c /i2), made it possible to calculate the size of the sample. Then, samples of droppings and ectoparasites were taken from the affected farms. After analysis and identification, two (2) species of mallophagous lice, including Menopon gallinae (50%) and Menacanthus stramineus (33%) and a species of bug Cimex lectularius (17%) were highlighted. The laying hens were more infested than broilers. Regarding gastrointestinal parasites, different species (six) have been identified: Trichostrongylus tenuis (17%), Syngamus trachea (19%), Heterakis sp (10%), Ascaridia sp (17%), Raillietina sp (8%) and Eimeria sp (29%). In addition, coccidiosis (Eimeria sp) proved to be the dominant pathology representing 67% of pathologies in broiler farms and 33% in poultry farms. The presence of these parasitoses in these modern farms constitutes a constraint major contribution to productivity and their development In view of all these difficulties, proposals have been made in order to participate in the establishment of a good prophylaxis program (health and medical). In addition, the Ivorian government, with the support of veterinarians, must interfere more in the organization of the health monitoring of traditional chickens and poultry in general through supervision and training in order to preserve public health ( animal, human and environmental health).

Keywords: gastrointestinal parasites, ectoparasites, pathologies, poultry, korhogo.

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Authors: Peter Adu

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Although research on the concept of Mental Health Literacy (MHL) is growing internationally, to the authors’ best of knowledge, the beliefs and knowledge of Ghanaians on specific mental disorders have not yet been explored. This vignette study was conducted to explore the relationships between religiosity, education, stigmatization, and MHL among Ghanaians using a sample of laypeople (N = 409). The adapted questionnaire presented two vignettes (depression and schizophrenia) about a hypothetical person. The results revealed that more participants were able to recognize depression (47.4%) than schizophrenia (15.9%). Religiosity was not significantly associated with recognition of mental disorders (MHL) but was positively related with both social and personal stigma for depression and negatively associated with personal and perceived stigma for schizophrenia. Moreover, education was found to relate positively with MHL and negatively with perceived stigma. Finally, perceived stigma was positively associated with MHL, whereas personal stigma for schizophrenia related negatively to MHL. In conclusion, education but not religiosity predicted identification accuracy, but both predictors were associated with various forms of stigma. Findings from this study have implications for MHL and anti-stigma campaigns in Ghana and other developing countries in the region.

Keywords: depression, education, mental health literacy, religiosity, schizophrenia

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Authors: Hareem Kausar

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Women of today’s world are energetic, enthusiastic and high-spirited. They tend to be the best in whatever they do and strive to accept and fulfil each challenge with utmost liveliness. The aim of the research was about studying the impact of Maternal Employment on the Child’s Behavioral Development. It was conducted as an initiative to study the impact factor in Pakistani culture and for deep insight to the subject using qualitative research methodology. The samples were interviewed through semi-structured interview method in three phases including two working mothers, two children and a day care center official and the data was collected and analyzed through content analysis. Further, it was linked with the literature from the west and the results show that children of working mothers tend to be sound mentally and physically but at some points they face the inner feeling of solitude. Overall, develop the mechanism in independence in their nature and behavior but maternal employment definitely affects the overall behavioral development of the children.

Keywords: maternal employment, child behavior- development, childhood, impact

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Authors: Abdulaziz Alakeel, Abdulrahman Alomair, Mohammed Fouda

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Introduction: Methotrexate (MTX) is an antimetabolite used to treat multiple conditions, including neoplastic diseases, severe psoriasis, and rheumatoid arthritis. Skin cancer is the out-of-control growth of abnormal cells in the epidermis, the outermost skin layer, caused by unrepaired DNA damage that triggers mutations. These mutations lead the skin cells to multiply rapidly and form malignant tumors. The aim of this review is to evaluate the risk of skin cancer associated with the use of methotrexate and to suggest regulatory recommendations if required. Methodology: Signal Detection team at Saudi Food and Drug Authority (SFDA) performed a safety review using National Pharmacovigilance Center (NPC) database as well as the World Health Organization (WHO) VigiBase, alongside with literature screening to retrieve related information for assessing the causality between skin cancer and methotrexate. The search conducted in July 2020. Results: Four published articles support the association seen while searching in literature, a recent randomized control trial published in 2020 revealed a statistically significant increase in skin cancer among MTX users. Another study mentioned methotrexate increases the risk of non-melanoma skin cancer when used in combination with immunosuppressant and biologic agents. In addition, the incidence of melanoma for methotrexate users was 3-fold more than the general population in a cohort study of rheumatoid arthritis patients. The last article estimated the risk of cutaneous malignant melanoma (CMM) in a cohort study shows a statistically significant risk increase for CMM was observed in MTX exposed patients. The WHO database (VigiBase) searched for individual case safety reports (ICSRs) reported for “Skin Cancer” and 'Methotrexate' use, which yielded 121 ICSRs. The initial review revealed that 106 cases are insufficiently documented for proper medical assessment. However, the remaining fifteen cases have extensively evaluated by applying the WHO criteria of causality assessment. As a result, 30 percent of the cases showed that MTX could possibly cause skin cancer; five cases provide unlikely association and five un-assessable cases due to lack of information. The Saudi NPC database searched to retrieve any reported cases for the combined terms methotrexate/skin cancer; however, no local cases reported up to date. The data mining of the observed and the expected reporting rate for drug/adverse drug reaction pair is estimated using information component (IC), a tool developed by the WHO Uppsala Monitoring Centre to measure the reporting ratio. Positive IC reflects higher statistical association, while negative values translated as a less statistical association, considering the null value equal to zero. Results showed that a combination of 'Methotrexate' and 'Skin cancer' observed more than expected when compared to other medications in the WHO database (IC value is 1.2). Conclusion: The weighted cumulative pieces of evidence identified from global cases, data mining, and published literature are sufficient to support a causal association between the risk of skin cancer and methotrexate. Therefore, health care professionals should be aware of this possible risk and may consider monitoring any signs or symptoms of skin cancer in patients treated with methotrexate.

Keywords: methotrexate, skin cancer, signal detection, pharmacovigilance

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Authors: Sasan Chalaki, Seyed Ali Mirgholange, Touba Nadri, Saman Chalaki

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In the current world, proper poultry nutrition has garnered special attention as one of the fundamental factors for enhancing their health and performance. Concerns related to the excessive use of antibiotics in the poultry industry and their role in antibiotic resistance have transformed this issue into a global challenge in public health and the environment. On the other hand, poultry farming plays a vital role as a primary source of meat and eggs in human nutrition, and improving their health and performance is crucial. One effective approach to enhance poultry nutrition is the utilization of the antibiotic properties of plant-based ingredients. The use of plant-based alternatives as natural antibiotics in poultry nutrition not only aids in improving poultry health and performance but also plays a significant role in reducing the consumption of synthetic antibiotics and preventing antibiotic resistance-related issues. Plants contain various antibacterial compounds, such as flavonoids, tannins, and essential oils. These compounds are recognized as active agents in combating bacteria. Plant-based antibiotics are compounds extracted from plants with antibacterial properties. They are acknowledged as effective substitutes for chemical antibiotics in poultry diets. The advantages of plant-based antibiotics include reducing the risk of resistance to chemical antibiotics, increasing poultry growth performance, and lowering the risk of disease transmission.

Keywords: poultry, antibiotics, essential oils, plant-based

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Authors: Esra Yuksel, Dilek Duman, Levent Yeniay, Sezgin Ulukaya

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Sentinel lymph node biopsy (SLNB) is a minimal invasive technique with lower morbidity in axillary staging of breast cancer. Isosulfan blue stain is frequently used in SLNB and regarded as safe. The present case report aimed to report severe decrement in SpO2 following isosulfan blue administration, as well as skin and urine signs and inconsistency with clinical picture in a 67-year-old ,77 kg, ASA II female case that underwent SLNB under general anesthesia. Ten minutes after subcutaneous administration of 10 ml 1% isosulfan blue by the surgeons into the patient, who were hemodynamically stable, SpO2 first reduced to 87% from 99%, and then to 75% in minutes despite 100% oxygen support. Meanwhile, blood pressure and EtCO2 monitoring was unremarkable. After specifying that anesthesia device worked normally, airway pressure did not increase and the endotracheal tube has been placed accurately, the blood sample was taken from the patient for arterial gas analysis. A severe increase was thought in MetHb concentration since SpO2 persisted to be 75% although the concentration of inspired oxygen was 100%, and solution of 2500 mg ascorbic acid in 500 ml 5% Dextrose was given to the patient via intravenous route until the results of arterial blood gas were obtained. However, arterial blood gas results were as follows: pH: 7.54, PaCO2: 23.3 mmHg, PaO2: 281 mmHg, SaO2: %99, and MetHb: %2.7. Biochemical analysis revealed a blood MetHb concentration of 2%.However, since arterial blood gas parameters were good, hemodynamics of the patient was stable and methemoglobin concentration was not so high, the patient was extubated after surgery when she was relaxed, cooperated and had adequate respiration. Despite the absence of respiratory or neurological distress, SpO2 value was increased only up to 85% within 2 hours with 5 L/min oxygen support via face mask in the surgery room as the patient was extubated. At that time, the skin of particularly the upper part of her body has turned into blue, more remarkable on the face. The color of plasma of the blood taken from the patient for biochemical analysis was blue. The color of urine coming throughout the urinary catheter placed in intensive care unit was also blue. Twelve hours after 5 L/min. oxygen inhalation via a mask, the SpO2 reached to 90%. During monitoring in intensive care unit on the postoperative 1st day, facial color and urine color of the patient was still blue, SpO2 was 92%, and arterial blood gas levels were as follows: pH: 7.44, PaO2: 76.1 mmHg, PaCO2: 38.2 mmHg, SaO2: 99%, and MetHb 1%. During monitoring in clinic on the postoperative 2nd day, SpO2 was 95% without oxygen support and her facial and urine color turned into normal. The patient was discharged on the 3rd day without any problem.In conclusion, SLNB is a less invasive alternative to axillary dissection. However, false pulse oximeter reading due to pigment interference is a rare complication of this procedure. Arterial blood gas analysis should be used to confirm any fall in SpO2 reading during monitoring.

Keywords: isosulfan blue, pulse oximetry, SLNB, methemoglobinemia

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Authors: Maria Cardova

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Aim and objectives: The purpose of this studywas to explore to what extent the deprivation statusinfluenced children’s physical activity, dietary behaviour, and health outcomes such as weight status. Background: The United Kingdom’s childhood obesity rates are currently ranked among the highest in Europe. North West England deals with highest rates of childhood obesity. Data from the UK Millennium Cohort Study suggested a deprivation gradient to childhood obesity in England, with obesity rates being the highest in the most deprived areas. Traditionally, it has been individual conception of health, but the contemporary stance is that health behaviours affecting obesity are influenced by a broad range of factors operating at multiple levels. According to socio-ecological model of health behaviour, differences in obesity rates and health outcomes are likely explained by differences in lifestyle behaviours including physical activity and diet behaviours. However, higher rates of obesity among deprived children are not due to physical inactivity, in fact, most socially disadvantaged children are the most physically active. Poor diet including high consumption of fast food and sugar-sweetened beverages and low consumption of fruit and vegetables was found to be the most prevalent among adolescents living in poverty. Methods: This study adopted quantitative approach. It consisted of combination of basic demographic data, anthropometry, and questionnaires. Children (N = 165, mean age = 10.04 years; 53.33% female; 46.66% male) completed survey packs during school day including KIDSCREEN, Youth Activity Profile, Beverage and Snack Questionnaire, and Child Body Image Scale questionnaires as well as had anthropometric measurements taken including Body mass index, waist circumference, weight, and height. Children’s deprivation status was based on the English Indices of Multiple Deprivation scores of the school they attended. Results: Children from more deprived areas had higher weight status, waist circumference. Deprivation status had also effect on some dimensions of the KIDSCREEN questionnaire, such as that those from more deprived areas felt less socially accepted and bullied by their peers, had worse feelings about themselves such as body image, and more difficulty with school and learning. Children from more deprived areas reported higher rates of physical activity and also differences in snack and fruit and vegetable intake than their more affluent peers. Conclusion: Results demonstrated that, children living in the most-deprived areas appear to be at greater risk of unfavourable health-related variables and behaviours and are exposed to home and neighbourhood environments that are less conducive to health-promoting behaviours compared to their peers from less deprived areas. These findings indicate that children living in highly deprived areas represent an important group for future interventions designed to promote health-behaviours that would impact on the quality of life of the child and other health variables such as weight status.

Keywords: children, dietary behaviour, health, obesity, physical Activity, weight Status

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Authors: Syeda Mahnaz Hassan

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Social work as a specialized field, grounded in scientific knowledge and skills, is more inclined towards problem-solving process rather than charity focused approach. Medical social work, as a primary method, deals with the bio-psychosocial-spiritual elements of an individual with a problem and assesses the pliability and strength of the patients, social support systems, and their families, to assist the patients to resolve their problems independently. The medical social worker, also known as case-worker or care-worker, has to play a substantial role in the rehabilitation and retrieval of an affected person. This paper examines the roles played and responsibilities discharged by the Medical Social Workers internationally and specifically concerning Pakistan. The capacity constraints and challenges confronted by Medical Social Workers in hospitals have also been highlighted, and some policy implications have been suggested to enhance the capabilities of Medical Social Workers for serving the patients in a befitting manner.

Keywords: medical social work, Pakistan, patients, rehabilitation

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Authors: Adrian Craig, Jonathan Easaw, Rose Jordan, Ben Hall

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The prescription of intravenous fluids is a fundamental component of inpatient management, but it is one which usually lacks thought. Fluids are a drug, which like any other can cause harm when prescribed inappropriately or wrongly. However, it is well recognised that it is poorly done, especially in the acute portals. The National Institute for Health and Care Excellence (NICE) recommends 1mmol/kg of potassium, sodium, and chloride per day. With various options of fluids, clinicians tend to face difficulty in choosing the most appropriate maintenance fluid, and there is a reluctance to prescribe potassium as part of an intravenous maintenance fluid regime. The aim was to prospectively audit the prescription of the first bag of intravenous maintenance fluids, the use of urea and electrolytes results to guide the choice of fluid and the use of fluid prescription charts, in a busy emergency department of a major trauma centre in Stoke-on-Trent, United Kingdom. This was undertaken over a week in early November 2016. Of those prescribed maintenance fluid only 8.9% were prescribed a fluid which was most appropriate for their daily electrolyte requirements. This audit has helped to highlight further the issues that are faced in busy Emergency Departments within hospitals that are stretched and lack capacity for prompt transfer to a ward. It has supported the findings of NICE, that emergency admission portals such as Emergency Departments poorly prescribed intravenous fluid therapy. The findings have enabled simple steps to be taken to educate clinicians about their fluid of choice. This has included: posters to remind clinicians to consider the urea and electrolyte values before prescription, suggesting the inclusion of a suggested intravenous fluid of choice in the prescription chart of the trust and the inclusion of a session within the introduction programme revising intravenous fluid therapy and daily electrolyte requirements. Moving forward, once the interventions have been implemented then, the data will be reaudited in six months to note any improvement in maintenance fluid choice. Alongside this, an audit of the rate of intravenous maintenance fluid therapy would be proposed to further increase patient safety by avoiding unintentional fluid overload which may cause unnecessary harm to patients within the hospital. In conclusion, prescription of maintenance fluid therapy was poor within the Emergency Department, and there is a great deal of opportunity for improvement. Therefore, the measures listed above will be implemented and the data reaudited.

Keywords: chloride, electrolyte, emergency department, emergency medicine, fluid, fluid therapy, intravenous, maintenance, major trauma, potassium, sodium, trauma

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Authors: Patricia Calvo, Francisco M. Sánchez, María J. Rodríguez

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Nowadays, food intake is becoming more irregular due to changes in family organization and lifestyle. Snacking is part of the day-to-day lives of people, however, most of the snacks have a high saturated fat, salt and refined sugar content; these dietary factors are believed to have negative health consequences. For this reason, there has been an increase in consumer demand for healthy, natural and convenient foods, so the development of a significant portion of new products focuses on improving the nutritional value of food snacks through modification its nutritional composition. In this paper, a new product made from vegetables has been designed. This new product would be an ideal food format to include ingredients with positive health benefits.

Keywords: healthy, pepper, dried, carotenes, polyphenols

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Authors: Mandy Wilson, Emma Vieira, Jocelyn Jones, Alice V. Brown, Lindey Andrews, Louise Southalan, Jackie Oakley, Dorothy Bagshaw, Patrick Egan, Laura Dent, Duc Dau, Lucy Spanswick

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Alcohol and drug dependency are pertinent issues for those experiencing homelessness. This includes Aboriginal and Torres Strait Islander people, Australia’s traditional owners, living in Perth, Western Australia (WA). Societal narratives around the drivers behind drug and alcohol dependency in Aboriginal communities, particularly those experiencing homelessness, have been biased and unchanging, with little regard for complexity. This can include the idea that Aboriginal people have ‘chosen’ to use alcohol or other drugs without consideration for intergenerational trauma and the trauma of homelessness that may influence their choices. These narratives have flow-on impacts on policies and services that directly impact Aboriginal people experiencing homelessness. In 2021, we commenced a project which aimed to listen to and elevate the voices of 70-90 Aboriginal people experiencing homelessness in Perth. The project is community-driven, led by an Aboriginal Community Controlled Organisation in partnership with a university research institute. A community-ownership group of Aboriginal Elders endorsed the project’s methods, chosen to ensure their suitability for the Aboriginal community. In this paper, we detail these methods, including semi-structured interviews influenced by an Aboriginal yarning approach – an important style of conversation for Aboriginal people which follows cultural protocols; and photovoice – supporting people to share their stories through photography. Through these engagements, we detail the reasons Aboriginal people in Perth shared for using alcohol or other drugs while experiencing homelessness. These included supporting their survival on the streets, managing their mental health, and coping while on the journey to finding support. We also detail why they sought to discontinue alcohol and other drug use, including wanting to reconnect with family and changing priorities. Finally, we share how Aboriginal people experiencing homelessness have said they are impacted by their family’s alcohol and other drug use, including feeling uncomfortable living with a family who is drug and alcohol-dependent and having to care for grandchildren despite their own homelessness. These findings provide a richer understanding of alcohol and drug use for Aboriginal people experiencing homelessness in Perth, shedding light on potential changes to targeted policy and service approaches.

Keywords: Aboriginal and Torres Strait Islander peoples, alcohol and other drugs, homelessness, community-led research

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Authors: Launcelot McGrath

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The Coronavirus disease 2019 (COVID-19) has spread rapidly around the world, resulting in high mortality rates and very large numbers of people requiring medical treatment in ICU. Management of patient hospitalisation is a critical aspect to control this disease and reduce chaos in the healthcare systems. Remote monitoring provides a solution to protect vulnerable and elderly high-risk patients. Continuous remote monitoring of oxygen saturation, respiratory rate, heart rate, and temperature, etc., provides medical systems with up-to-the-minute information about their patients' statuses. Remote monitoring also limits the spread of infection by reducing hospital overcrowding. This paper examines the potential of remote monitoring for Covid-19 to assist in the rapid identification of patients at risk, facilitate the detection of patient deterioration, and enable early interventions.

Keywords: remote monitoring, patient care, oxygen saturation, Covid-19, hospital management

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Authors: Amany ElShazly, Lubna A. Sherif

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The entanglement of humans with the environment has always been inevitable and often causes destruction. In this respect, ‘Ecolinguistics’ helps humans to understand the link between languages and the environment. Stibbe (2014a) has indicated that ‘linguistics’, particularly, Critical Discourse Studies (CDS), provides an interpretation of language which shapes world views, while the ‘eco’ side maintains the life-sustaining interactions of humans and the physical environment. This paper considers two key ecological instances, namely: The Grand Ethiopian Renaissance Dam (GERD) as a focal point of political dispute and THE LINE project as well as Etthadar lel Akhdar (Go Green Initiative) as two examples of combating ecological degradation. ‘Ecosophy’ as explained by Naess (1996) is used to describe the ecolinguistic framework, which assesses discourse where the linguistic lens focuses on the use of metaphor, and ‘Positive Discourse’ framework, which resonates with respect and care for the natural world.

Keywords: ecosophy, critical discourse studies, metaphor, positive discourse, social semiotics, ecolinguistics

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