Search results for: health tourism

Authors: Espinosa Carlos, Nobrega Doris

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Children are at high risk for lead (Pb) exposure. The objective of this study was to identify risk factors that contribute to high blood lead (PbB) levels in Venezuelan children. The concentration of PbB was determined in 60 children (ages 4-9 years old), coming from the Michelena sector, Valencia District, Carabobo State. The relationship between these concentrations and socio-economical parameters (A: high quality life; B: fair quality life; C: critic poverty), Pb levels of faucet water (Pb-water) and dust Pb levels of floor (Pb-dust) of their houses, was established. Living areas were classified according to sectors and socio-economical status. Forty [40=66.7%] children resulted with PbB levels above the permissible concentration (LAPC). Average PbB was not significantly higher than the permissible levels. Odds ratio proved that children from status C are 7.28 times more likely to have LAPC of PbB than the ones coming from A or B. Thirty-four percent (34%) of the children with LAPC come from status C which could be considered the most critical status from the exposure risk point of view. The 76,3% of the sampled houses reported VSLP of Pb-water, being the Pb-water average in 35 ± 25.5 ug/L. This average significantly went superior to the permissible limit established by Venezuela and international organisms (10 ug/L). When grouping the results of PbB and Pb-water by sex, were that 50,8% of the children who presented/displayed VSLP of Pb-water and PbB. Was a significant relation (p ≤ 0.05), between masculine sex and the VSLP of PbB and Pb-water (x² = 3,672). In relation to the Pb-Dust analyses, were not statistically significant differences with respect to their permissible limit value (40 ug/pie²). This study shows that by correlating geographical and health data, we can identify 'high risk' areas, leading to a proactive public health action. The results of this study are excellent, in order to take preventive measures for the care from the health. Later studies are suggested predicting main to determine of more conclusive form of levels elevated of PbB in the investigated population.

Keywords: demographic, lead, risk, socio-economical status

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Authors: Abdessamad Dali-Ali, Houaria Beldjillali, Fouzia Agag, Asmaa Oukebdane, Ramzi Tidjani, Arslane Bettayeb, Khadidja Meddeber, Radia Dali-Yahia, Nori Midoun

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Healthcare-associated infections are a real public health problem, especially in intensive care units. The aim of our study was to describe the epidemiological profile and to estimate the incidence of these infections at the intensive care unit of our teaching hospital. A prospective study was conducted, from June 2012 to December 2013. During this period, 305 patients having a duration of hospitalization equal or more than 48 hours were included in the study. In terms of the incidence of healthcare associated infections, nosocomial pneumonia occupied the first position with a cumulative incidence rate of 20.0%, followed by bacteremia (5.6%), central venous catheter infections (4%), and urinary tract infections (3%). In the case of isolated microorganisms, Gram-negative bacilli not enterobacteriaceae occupied the first place with 48.5%, followed by enterobacteria (32.1%). Acinetobacter baumannii was the most common germ (27.6%). Our study showed that the rate of health-care-associated infections was relatively high in the intensive care unit. A control program to reduce all infections is a priority for the Infection Control Associated Committee.

Keywords: epidemiological profile, healthcare associated infections, intensive care units, teaching hospital of Oran, Algeria

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Authors: Daniella Kucsma

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The examination of the Privat Service Organization’s performance evaluation includes several steps that help Public organizations to develop a more efficient system. Public sector organizations have different characteristics than the competitive sector, so it can be stated that other/new elements become more important in their performance processes. The literature in this area is diverse, so highlighting an indicator system can be useful for introducing a system, but it is also worthwhile to measure the specific elements of the organization. In the case of a public service organization, due to the service obligation, it is usually possible to talk about a high number of users, so compliance is more difficult. For the organization, it is an important target to place great emphasis on the increase of service standards and the development of related processes. In this research, the health sector is given a prominent role, as it is a sensitive area where both organizational and individual performance is important for all participants. As a primary step, the content of the strategy is decisive, as this is important for the efficient structure of the process. When designing any system, it is important to review the expectations of the stakeholders, as this is primary when considering the design. The goal of this paper is to build the foundations of a performance management and indexing framework that can help a hospital to provide effective feedback and a direction that is important in assessing and developing a service and can become a management philosophy.

Keywords: health sector, public sector, performance management, strategy

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Authors: Dusanee Suwankhong, Pranee Liamputtong

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Mothers living with HIV tend to experience stigma and discrimination which has an impact on their psychological and social well-being and their human rights. This paper explores the lived experience of Thai mothers with HIV in their family. In-depth interviewing and drawing methods were employed to gain a deep understanding on the experience of 30 HIV-positive mothers in the southern community of Thailand. The data was analyzed using thematic analysis method. We found that the majority of HIV-positive mothers learned about their HIV status through blood test services during their antenatal care, but some decided to visit a doctor when their partner became chronically frail and showed some signs indicating HIV/AIDS. Learning about their HIV gave them a great shock, and they could not believe that they were infected with HIV/AIDS. They feared that their illness would be disclosed and hence attempted to keep their HIV secret. This was due to the fact that people in their community would blame and labeled them as a ‘disgusting person’. Besides, they would be separated from social contacts and networks, their individual rights would be disregarded, and their potential roles would be restricted. Although participants suggested that people had more positive view on HIV-infected person nowadays, all still wanted to keep it secret because of fear of stigma and discrimination. Thai health care has provided various kinds of support programs, but many mothers chose not to participate due to the fear of disclosure. However, the women attempted to seek some strategies to live a life which would be more acceptable by the community. We conclude that HIV is still seen as a stigmatised disease in rural community of southern Thailand. Local health care providers and relevant sectors in the locality should create suitable programs to enhance self-worth among those HIV-positive mothers because this could increase a quality of life of this vulnerable mothers. Providing sufficient and appropriate supports for better emotional wellbeing is an essential role of health professionals so that the feeling of isolation among these women could be eliminated and positive social justice can be achieved.

Keywords: HIV-positive mothers, lived experience, southern Thailand, stigma and discrimination

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Authors: Cledinaldo A. Dias, Isabela C. Santos, Marcus V. S. Siqueira

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In the contemporary globalization, the competitiveness generated in the search of new markets aiming at the growth of productivity and, consequently, of profits, implies the redefinition of productive processes and new forms of work organization. As a result of this structuring, unemployment, labor force turnover and the increase in outsourcing and informal work occur. Considering the different relationships and working conditions of outsourced employees, this study aims to identify the most present stressors among outsourced service providers from a Federal Institution of Higher Education in Brazil. To reach this objective, a descriptive exploratory study with a quantitative approach was carried out. The qualitative approach was chosen to provide an in-depth analysis of the occupational conditions of outsourced workers since this method seeks to focus on the social as a world of investigated meanings and the language or speech of each subject as the object of this approach. The survey was conducted in the city of Montes Claros - Minas Gerais (Brazil) and involved eighty workers from companies hired by the institution, including armed security guards, porters, cleaners, drivers, gardeners, and administrative assistants. The choice of professionals obeyed non-probabilistic criteria for convenience or accessibility. Data collection was performed by means of a structured questionnaire composed of sixty questions, in a Likert-type frequency interval scale format, in order to identify potential organizational stressors. The results obtained evidence that the stress factors pointed out by the workers are, in most cases, a determining factor due to the low productive performance at work. Amongst the factors associated with stress, the ones that stood out most were those related to organizational communication failures, the incentive to competition, lack of expectations of professional growth, insecurity and job instability. Based on the results, the need for greater concern and organizational responsibility with the well-being and mental health of the outsourced worker and the recognition of their physical and psychological limitations, and care that goes beyond the functional capacity for the work. Specifically for the preservation of mental health, physical and quality of life, it is concluded that it is necessary for the professional to be inserted in the external world that favors it internally since this set is complemented so that the individual remains in balance and obtain satisfaction in your work.

Keywords: occupational health, outsourced, organizational studies, stressors

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Authors: Aneta Nitsch-Osuch, Sylwia Dyk, Izabela Gołebiak

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Background. Since 2014 the pertussis vaccine is recommended to Polish health care workers who have close contacts with infants. Although this recommendation is implemented into the National Immunization Programme, its realization has remained unknown. The Purpose: The aim of the study, conducted at the department of Social Medicine and Public Health (Medical University of Warsaw, Poland), was to describe a perception, knowledge and coverage rates regarding pertussis vaccination among nursing staff. According to the authors' knowledge, it was the first study related to this topic in our country. Material and Methods: A total number of 543 nurses who work at pediatric or neonatal wards was included into the study (501 women and 42 men), average age was 47 years. All nurses were asked to fulfill the anonymous survey, previously validated. Results: 1. Coverage rates: The analysis of results revealed that only 4% of responders reported they were vaccinated with Tdpa within past 10 years, while 8% declared they would plan the vaccine in the future. 35% of responders would consider the Tdpa vaccine whether there is some kind of the reimbursement. 2. Perception and knowledge of the disease and vaccination: The majority (82%) of nurses did not recognize pertussis as a re-emerging infectious disease. 54% of them believed that obligatory vaccinations in the childhood protect against the disease and the protection is a life-long one. Only 15% of nurses considered pertussis as a possible nosocomial infection. The current epidemiology of the disease was known to 6% of responders, while 24% of them were familiar with pertussis vaccination schedules for infants, children and adolescents, but only 9% of responders knew that adults older than 19 years are recommended to be vaccinated with Tdpa every 10 years. Many nurses (82%) would expect more educational activities related to pertussis and methods of its prophylaxis. Conclusions: The pertussis vaccine coverage rate among Polish nurses is extremely low. This is a result of not enough knowledge about the disease and its prevention. Educational activities addressed to health care workers and reimbursement of the pertussis vaccine are required to improve awareness and increase of vaccine coverage rates in the future.

Keywords: coverage, nurse, pertussis, vaccine

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Authors: S. Ramia, N. Melhem, K. Kreidieh

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The world is facing an unprecedented displacement crisis. Recently, over 1.1 million asylum seekers have been granted protection status in the European Union (EU). The majority of these asylum seekers were from countries of the Middle East and North Africa (MENA) region.This influx carries with it a potential introduction of infectious diseases that have been eliminated in the EU, which poses a challenge for EU health authorities. Compared to MENA region countries where Hepatitis A Virus (HAV) endemicity is high to intermediate, member states of the EU show very low (Western Europe) to low (Eastern Europe) levels of HAV endemicity. Because of this situation, there is an ongoing public health concern in high-income countries, like members of the EU, that many adults remain susceptible to HAV outbreaks. The overwhelming majority of the EU members’ states do not include HAV vaccine in their immunization calendars. Hence, this paper urgently calls for the implementation of new policies regarding HAV in EU members’ states.

Keywords: European union, hepatitis A, MENA region refugees, vaccine preventable diseases

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Authors: Ling Choo Chiew, Yoke Yong Chen, Chuong Hock Ting, Raveca Ak Ridi

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Job frustration become a prevalent issue in many occupational settings and is linked to mental state, which affects workers when they face obstacles that block them from meeting professional objectives and/or the organization's mission. This study examined the relationship between job frustration and mental health among healthcare workers. A cross-sectional design using the Compassion Satisfaction and Fatigue test (CSF), Copenhagen Burnout Inventory (CBI), and Psychological Flexibility Questionnaire (PFQ) was employed to collect data from a sample of healthcare workers in Sarawak, Malaysia. The results showed that 44.3 % of the healthcare workers experienced compassion fatigue, 9.7% of the healthcare workers had personal burnt out, 3% were work-related burnt out, and 2% were client-related burnt out. On the other hand, the mean of psychological flexibility was 3.55 (SD = 0.838), which was found to be prevalent in the study sample, with varying degrees of severity. The results also indicated a significant association between compassion fatigue and psychological flexibility, F(₄, ₄₈₉) = 5.45, p<.001. Additionally, demographic factors were associated with higher levels of job frustration and burnout. The implications of these findings for developing targeted interventions and support strategies to promote mental well-being among healthcare workers are discussed.

Keywords: compassion fatigue, healthcare worker, job frustration, psychological flexibility

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Authors: Gedefaye Nibret Mihretie

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Background: Transactional sex is casual sex between two people to receive material incentives in exchange for sexual favors. Transactional sex is associated with negative consequences, which increase the risk of sexually transmitted diseases, including HIV/AIDS, unintended pregnancy, unsafe abortion, and physiological trauma. Many primary studies in Sub-Saharan Africa have been conducted to assess the prevalence and associated factors of transactional sex among women. These studies had great discrepancies and inconsistent results. Hence, this systematic review and meta-analysis aimed to synthesize the pooled prevalence of the practice of transactional sex among women and its associated factors in Sub-Saharan Africa. Method: Cross-sectional studies were systematically searched from March 6, 2022, to April 24, 2022, using PubMed, Google Scholar, HINARI, Cochrane Library, and grey literature. The pooled prevalence of transactional sex and associated factors was estimated using DerSemonial-Laird Random Effect Model. Stata (version 16.0) was used to analyze the data. The I-squared statistic was used to assess the studies' heterogeneity. A funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was performed to minimize the underline heterogeneity depending on the study years, source of data, sample sizes and geographical location. Results: Four thousand one hundred thirty articles were extracted from various databases. The final thirty-two studies were included in this systematic review, including 108,075 participants. The pooled prevalence of transactional sex among women in Sub-Saharan Africa was 12.55%, with a confidence interval of 9.59% to 15.52%. Educational status (OR = .48, 95%CI, 0.27, 0.69) was the protective factors of transactional sex whereas, alcohol use (OR = 1.85, 95% CI: 1.19, 2.52), early sex debut (OR = 2.57, 95%CI, 1.17, 3.98), substance abuse (OR = 4.21, 95% CI: 2.05, 6.37), having history of sexual experience abuse (OR = 4.08, 95% CI: 1.38, 6.78), physical violence abuse (OR = 6.59, 95% CI: 1.17, 12.02), and sexual violence abuse (OR = 3.56, 95% CI: 1.15, 8.27) were the risk factors of transactional sex. Conclusion: The prevalence of transactional sex among women in Sub-Saharan Africa was high. Educational status, alcohol use, substance abuse, early sex debut, having a history of sexual experiences, physical violence, and sexual violence were predictors of transaction sex. Governmental and other stakeholders are designed to reduce alcohol utilization, provide health information about the negative consequences of early sex debut, substance abuse, and reduce sexual violence, ensuring gender equality through mass media, which should be included in state policy.

Keywords: women’s health, child health, reproductive health, midwifery

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Authors: Abdullah Al. Morshed, Mohammad Nahid Mia

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Introduction: Food security refers to the availability of food and a person’s access to it. It is a complex sustainable development issue, which is closely related to under-nutrition. Food security, in turn, can widely affect the living standard, and is rooted in poverty and leads to poor health, low productivity, low income, food shortage, and hunger. The study's aim was to identify the most vulnerable women who are in insecure positions. Method: 17,842 married women were selected for analysis from the Bangladesh Demographic and Health Survey 2011. Food security defined as dichotomous variables of skipped meals and eaten less food at least once in the last year. The outcome variables were cross-tabulated with women's socio-demographic characteristics and chi2 test was applied to see the significance. Logistic regression models were applied to identify the most vulnerable groups in terms of food security. Result: Only 18.5% of women said that they ever had to skip meals in the last year. 45.7% women from low socioeconomic status had skip meal for at least once whereas only 3.6% were from women with highest socioeconomic status. Women meal skipping was ranged from 1.4% to 34.2% by their educational status. 22% of women were eaten less food during the last year. The rate was higher among the poorest (51.6%), illiterate (39.9%) and household have no electricity connection (38.1) in compared with richest (4.4%), higher educated (2.0%), and household has electricity connection (14.0%). The logistic regression analysis indicated that household socioeconomic status, and women education show strong gradients to skip meals. Poorest have had higher odds (20.9) than richest and illiterate women had 7.7 higher odds than higher educated. In terms of religion, Christianity was 2.3 times more likely to skip their meals than Islam. On the other hand, a similar trend was observed in our other outcome variable eat less food. Conclusion: In this study we able to identify women with lower economics status and women with no education were mostly suffered group from starvation.

Keywords: food security, hunger, under-nutrition, women

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Authors: Anu Shrestha, Krassi Rumchev, Ben Mullins, Yun Zhao, Linda Selvey

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Cycling is often promoted as a means of reducing vehicular congestion, noise and greenhouse gas and air pollutant emissions in urban areas. It is also indorsed as a healthy means of transportation in terms of reducing the risk of developing a range of physical and psychological conditions. However, people who cycle regularly may not be aware that they can become exposed to high levels of Vehicular Air Pollutants (VAP) emitted by nearby traffics and therefore experience adverse health effects as a result. The study will highlight the present scenario of ambient air pollution level in different cycling routes in Perth and also highlight significant contribution to the understanding of health risks that cyclist may face from exposure to particulate air pollution. Methodology: This research was conducted in Perth, Western Austral and consisted of two groups of cyclists cycling near high (2 routes) and low (two routes) vehicular traffic roads, at high and low levels of exertion, during the cold and warm seasons. A sample size of 123 regular cyclists who cycled at least 80 km/week, aged 20-55, and non-smoker were selected for this study. There were altogether 100 male and 23 female who were asked to choose one or more routes among four different routes, and each participant cycled the route for warm or cold or both seasons. Cyclist who reported cardiovascular and other chronic health conditions (excluding asthma) were not invited into the study. Exposures to selected air pollutants were assessed by undertaking background and personal measurements alone with the measurement of heart and breathe rate of each participant. Finding: According to the preliminary study findings, the cyclists who used cycling route close to high traffic route were exposed to higher levels of measured air pollutants Nitrogen Oxide (NO₂) =0.12 ppm, sulfur dioxide (SO₂)=0.06 ppm and carbon monoxide (CO)=0.25 PPM compared to those who cycled away from busy roads. However, we measured high concentrations of particulate air pollution near one of the low traffic route which we associate with the close proximity to ferry station. Concluding Statement: As a conclusion, we recommend that cycling routes should be selected away from high traffic routes. If possible, we should also consider that if the cycling route is surrounded by the dense populated infrastructures, it can trap the pollutants and always facilitate in increasing inhalation of particle count among the cyclists.

Keywords: air pollution, carbon monoxide, cyclists' health, nitrogen dioxide, nitrogen oxide, respirable particulate matters

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Authors: Umut Tuğlu Karslı

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While, port function had a major role during the antiquity and medieval times, it has started to lose its significance in 19th century. In many port cities, while heavy industrial functions and ports have been moved out of the former port districts, the resulting derelict spaces have been transformed to new waterfront quarters to accommodate commercial, tourism, cultural, residential and public uses. Primary aim of these operations is to revitalize abandoned spaces of historical potential and re-establish a relationship between the city and the coast. Karakoy Port, field of this study, located in the Bosphorus, was surrounded by the city centre in time due to the transformation of urban functions, and as a result it has lost its former significance. While Karakoy has 24 hours lively residential and commercial uses in old times; in early 1980s, became a district of mechanical, plumbing and electronic parts suppliers during the day and a place for homeless at night. Today, activities for revitalization of this region continue in two forms and scales. First of these activities is the "planned transformation projects," which also includes the most important one “Galataport project”, and the second one is "spontaneous transformation," which consists of individual interventions. Galataport project that based on the idea of arranging the area specifically for tourists was prepared in 2005 and became a topic of tremendous public debate. On the other hand, the "spontaneous transformation" that is observed in the Karakoy District starts in 2004 with the foundation of “Istanbul Modern Museum”. Istanbul Modern, the first contemporary arts museum of the city, allowed the cultural integration of old naval warehouses of the port to the daily life. Following this adaptive reuse intervention, the district started to accommodate numerous art galleries, studios, café-workshops and design stores. In this context, this paper briefly examines revitalization studies in obsolete port regions, analyzes the planned and ongoing socio-spatial transformations in the specific case of Karakoy under the subjects of "planned transformation projects" and "spontaneous transformation", and realizes a critical review of the sustainability of the proposals on how to reinstate the district in the active life of Istanbul.

Keywords: port cities, socio-spatial transformation, urban regeneration, urban revitalization

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Authors: Valentina Milanova, Kalina Mihaylova, Iva Lazarova

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The mechanisms by which female genital infections are detected are varied and include clinician-collected high vaginal swabs, clinician-collected endocervical swabs, patient-collected vaginal swabs, and first-pass urine samples. Vaginal health screening has chronically low rates of uptake. This highlights the unmet need for a screening tool with comparable diagnostic accuracy which is familiar, convenient and easy to use for people. The Daye™ medical grade tampon offers an alternative to traditional sampling methods with the potential of increasing screening uptake among people previously too embarrassed or busy to attend gynecological appointments. In this white paper, the results of stability studies and a comparative clinical trial are discussed to assess the suitability of the device for the collection of vaginal samples for various clinical assessments. The tampon has demonstrated good sample stability and comparable sample quality compared to a self-collected vaginal swab and a clinician-collected cervical swab.

Keywords: vaginal microbiome, vaginal infections, gynaecological infections, female health, menstrual tampons, in vitro diagnostics

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Authors: Yiqi Zhu, Jean Francois Trani, Rameez Ulhassan

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Extreme weather phenomena increased by 46% between 2007 and 2017 and have become more intense with the rise in global average temperatures. This increased intensity of climate variations often induces humanitarian crises and particularly affects vulnerable populations in low- and middle-income countries (LMICs). Expectant and lactating mothers are among the most vulnerable groups. Pakistan ranks 10th among the most affected countries by climate disasters. In 2022, monsoon floods submerged a third of the country, causing the loss of 1,500 lives. Approximately 650,000 expectant and lactating mothers faced systematic stress from climatic disasters. Our study used participatory methods to investigate the systematic impact of climatic disasters on maternal health. In March 2023, we conducted six Group Model Building (GMB) workshops with healthcare workers, fathers, and mothers separately in two of the most affected areas in Pakistan. This study was approved by the Islamic Relief Research Review Board. GMB workshops consist of three sessions. In the first session, participants discussed the factors that impact maternal health. After identifying the factors, they discussed the connections among them and explored the system structures that collectively impact maternal health. Based on the discussion, a causal loop diagram (CLD) was created. Finally, participants discussed action ideas that could improve the system to enhance maternal health. Based on our discussions and the causal loop diagram, we identified interconnected factors at the family, community, and policy levels. Mothers and children are directly impacted by three interrelated factors: food insecurity, unstable housing, and lack of income. These factors create a reinforcing cycle that negatively affects both mothers and newborns. After the flood, many mothers were unable to produce sufficient breastmilk due to their health status. Without breastmilk and sufficient food for complementary feeding, babies tend to get sick in damp and unhygienic environments resulting from temporary or unstable housing. When parents take care of sick children, they miss out on income-generating opportunities. At the community level, the lack of access to clean water and sanitation (WASH) and maternal healthcare further worsens the situation. Structural failures such as a lack of safety nets and programs associated with flood preparedness make families increasingly vulnerable with each disaster. Several families reported that they had not fully recovered from a flood that occurred ten years ago, and this latest disaster destroyed their lives again. Although over twenty non-profit organizations are working in these villages, few of them provide sustainable support. Therefore, participants called for systemic changes in response to the increasing frequency of climate disasters. The study reveals the systematic vulnerabilities of mothers and children after climatic disasters. The most vulnerable populations are often affected the most by climate change. Collaborative efforts are required to improve water and forest management, strengthen public infrastructure, increase access to WASH, and gradually build climate-resilient communities. Governments, non-governmental organizations, and the community should work together to develop and implement effective strategies to prevent, mitigate, and adapt to climate change and its impacts.

Keywords: climatic disasters, maternal health, Pakistan, systematic impact, flood, disaster relief.

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Authors: Sadia Munir, Diana White, Aya Albahri, Pratiwi Hastania, Eltahir Mohamed, Mahmood Khan, Fathima Mohamed, Ayat Kadhi, Haila Saleem

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Preeclampsia is a major complication of pregnancy. Prediction and management of preeclampsia is a challenge for obstetricians. To our knowledge, no major progress has been achieved in the prevention and early detection of preeclampsia. There is very little known about the clear treatment path of this disorder. Preeclampsia puts both mother and baby at risk of several short term- and long term-health problems later in life. There is huge health service cost burden in the health care system associated with preeclampsia and its complications. Preeclampsia is divided into two different types. Early onset preeclampsia develops before 34 weeks of gestation, and late onset develops at or after 34 weeks of gestation. Different genetic and environmental factors, prognosis, heritability, biochemical and clinical features are associated with early and late onset preeclampsia. Prevalence of preeclampsia greatly varies all over the world and is dependent on ethnicity of the population and geographic region. To authors best knowledge, no published data on preeclampsia exist in Qatar. In this study, we are reporting the incidence of preeclampsia in Qatar. The purpose of this study is to compare the incidence and risk factors of both early onset and late onset preeclampsia in Qatar. This retrospective longitudinal cohort study was conducted using data from the hospital record of Women’s Hospital, Hamad Medical Corporation (HMC), from May 2014-May 2016. Data collection tool, which was approved by HMC, was a researcher made extraction sheet that included information such as blood pressure during admission, socio demographic characteristics, delivery mode, and new born details. A total of 1929 patients’ files were identified by the hospital information management when they apply codes of preeclampsia. Out of 1929 files, 878 had significant gestational hypertension without proteinuria, 365 had preeclampsia, 364 had severe preeclampsia, and 188 had preexisting hypertension with superimposed proteinuria. In this study, 78% of the data was obtained by hospital electronic system (Cerner) and the remaining 22% was from patient’s paper records. We have gone through detail data extraction from 560 files. Initial data analysis has revealed that 15.02% of pregnancies were complicated with preeclampsia from May 2014-May 2016. We have analyzed difference in the two different disease entities in the ethnicity, maternal age, severity of hypertension, mode of delivery and infant birth weight. We have identified promising differences in the risk factors of early onset and late onset preeclampsia. The data from clinical findings of preeclampsia will contribute to increased knowledge about two different disease entities, their etiology, and similarities/differences. The findings of this study can also be used in predicting health challenges, improving health care system, setting up guidelines, and providing the best care for women suffering from preeclampsia.

Keywords: preeclampsia, incidence, risk factors, maternal

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Authors: Emran M. Badghish

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Overweight and obesity have now become an epidemic around the globe, both in high-, as well as low-income regions. It is important to use preventive measures that are cost-effective. Schools are the essence of building societies and engaging them in healthy nutrition will offer a way to reach individuals at an early stage in life, with many positive and significant impacts. Aim: Provide healthy food in schools of children aged 5 to 18 years old. Methods: Distributing healthy food to a school and implementation of a star rating system for healthier foods, with five stars for the healthiest option to a half a star for the unhealthiest. The stars system was developed in Australia and should motivate children to consume the healthier nutritional options. Each canteen should be allowed a minimum of 3.5 stars rating for the food provided. Outcome Measurement: Body-mass-index as an indicator of overweight and obesity should be checked at the beginning of the study annually for five years for all children. Another side measurement is the performance by checking the grades and a questionnaire on eating habits at the start of the study and yearly. Expected Outcome: A lower health-risk behaviour and assistance to children in reaching their potentials as they will adapt to eating healthier. Nutrition during childhood has the potential to prevent obesity, type 2 diabetes, dental diseases, hypertension and, in later life, cardiovascular disease, osteoporosis and a variety of cancers. In Australia NSW starting from 2016 is expecting a 5% reduction of childhood overweight and obesity by 2025. As for Saudi-Arabia, it is expected to have an, even more, reduction by 2023 as a lot of our children are canteen-dependent. Conclusion: Introducing healthy food in schools is a preventative method that would have significant influence on the reduction of the prevalence of obesity in Saudi-Arabia and improves its general health.

Keywords: food, healthy, children, obesity, schools

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Authors: Kulsoom S. Bughio, Naeem K. Janjua, Gordana Dermody, Leslie F. Sikos, Shamsul Islam

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The advancement in information and communication technologies (ICT) and wireless sensor networks have played a pivotal role in the design and development of real-time healthcare solutions, mainly targeting the elderly living in health-assistive smart homes. Such smart homes are equipped with sensor technologies to detect and record activities of daily living (ADL). This survey reviews and evaluates existing approaches and techniques based on real-time sensor-based modeling and reasoning in single-user and multi-user environments. It classifies the approaches into three main categories: learning-based, knowledge-based, and hybrid, and evaluates how they handle temporal relations, granularity, and uncertainty. The survey also highlights open challenges across various disciplines (including computer and information sciences and health sciences) to encourage interdisciplinary research for the detection and recognition of ADLs and discusses future directions.

Keywords: daily living activities, smart homes, single-user environment, multi-user environment

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Authors: Reza Behboodian

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Monitoring the structural health and diagnosing their damage in the early stages has always been one of the topics of concern. Nowadays, research on structural damage detection methods based on vibration analysis is very extensive. Moreover, these methods can be used as methods of permanent and timely inspection of structures and prevent further damage to structures. Non-destructive methods are the low-cost and economical methods for determining the damage of structures. In this research, a non-destructive method for detecting and identifying the failure location in structures based on dynamic responses resulting from time history analysis is proposed. When the structure is damaged due to the reduction of stiffness, and due to the applied loads, the displacements in different parts of the structure were increased. In the proposed method, the damage position is determined based on the calculation of the strain energy difference in each member of the damaged structure and the healthy structure at any time. Defective members of the structure are indicated by the amount of strain energy relative to the healthy state. The results indicated that the proper accuracy and performance of the proposed method for identifying failure in structures.

Keywords: failure, time history analysis, dynamic response, strain energy

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Authors: Ajay Kumar

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Using data from census of India, sample registration system and national family health survey (NFHS-3), this paper traces spatial pattern, trends and the factors which have played their role differently in fertility transition in Uttar Pradesh and Tamil Nadu. For the purpose spatial variation analysis, trend line and binary logistic regression analysis has been carried out. There exist considerable regional disparities in terms of fertility decline in northern and southern states. The pace of fertility decline has been faster in southern and coastal regions, and at a slow pace in backward northern state. In Tamil Nadu fertility declined substantially among the women of lower and higher age groups in comparison to Uttar Pradesh characterized by low literacy, low female age at marriage, poor health infrastructure and low status of women. The Study shows that Fertility rates have been higher among the most vulnerable and deprived sections of the society like Illiterate women, women belong to scheduled caste, scheduled tribe and women residing in rural areas.

Keywords: age specific fertility rate, fertility transition, replacement level, total fertility rate

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Authors: Saidia Houari

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The current coronavirus pandemic (COVID-19) is a special and unusual reality. It can affect people physically, but also psychologically. Indeed, in such a context, many people will experience reactions of stress, anxiety and depression, and Sports is known to be a great in improving the effectiveness of the nervous system and mental health. Professor Ango Frubuze“many studies proved that sports play an important role in fighting psychological tension and some other psychological problems, such as depression and sleep difficulties, but on condition of practicing them properly,choosing the kind that generates comfort and happiness for man “ .The sports university professor in the German city of Cologne added that the effort exerted during the exercise works on restoring balance to the stress hormones like cortisol.The case report provides an insight into the COVID-19 current situation and represents a picture of the current state of mental health and an overview of novel coronavirus (Covid-19) outbreaks in some countries of the world. Some procedures taken to combat the coronavirus. We proposed the practice of physical activities during the quarantine period, and we showed their importance and their positive effects.

Keywords: COVID-19, psycholiqical impacts, stress, physical activities

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Authors: Ana Mafalda Silva, Rebeca Fontes, Ana Paula Vaz, Carla Carreira, Ana Corte-Real

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Decades of research on the topic of interpersonal violence against minors highlight five main conclusions: 1) it causes harmful effects on children's development and health; 2) it is prevalent; 3) it violates children's rights; 4) it can be prevented and 5) parents are the main aggressors. The child abuse scenario is identified through clinical observation, administrative data and self-reports. The most used instruments are self-reports; however, there are no valid and reliable self-report instruments for minors, which consist of a retrospective interpretation of the situation by the victim already in her adult phase and/or by her parents. Clinical observation and collection of information, namely from the orofacial region, are essential in the early identification of these situations. The management of medical data, such as personal data, must comply with the General Data Protection Regulation (GDPR), in Europe, and with the General Law of Data Protection (LGPD), in Brazil. This review aims to answer the question: In a situation of medical assistance to minors, in the suspicion of interpersonal violence, due to mistreatment, is it necessary for the guardians to provide consent in the registration and sharing of personal data, namely medical ones. A scoping review was carried out based on a search by the Web of Science and Pubmed search engines. Four papers and two documents from the grey literature were selected. As found, the process of identifying and signaling child abuse by the health professional, and the necessary early intervention in defense of the minor as a victim of abuse, comply with the guidelines expressed in the GDPR and LGPD. This way, the notification in maltreatment scenarios by health professionals should be a priority and there shouldn’t be the fear or anxiety of legal repercussions that stands in the way of collecting and treating the data necessary for the signaling procedure that safeguards and promotes the welfare of children living with abuse.

Keywords: child abuse, disease notifications, ethics, healthcare assistance

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Authors: Anteneh Berhane Yeyi, Tefera Belachew

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Any woman who could become pregnant is at risk of having a baby with neural tube defects (NTDs). A spontaneous aborted women with immediately preceding pregnancy may have an increased risk of develop NTDs. Ethiopia has one of the highest rates of micronutrient deficiencies, including folate and iron deficiency. Currently, in Ethiopia, NTDs is emerged as a public health concern. Even if Ethiopia, has implement different strategies for reducing maternal and neonatal mortality and morbidity, there is no room in the health care system and lack of integration for preventing the risk of NTDs for those women who aborted spontaneously and women who discontinue long acting contraception to become pregnant. The purpose of this study was to evaluate the effect of preconception picture-based nutrition education on knowledge and adherence to iron-folic acid supplement (IFAS) intake to reduce the risk of developing neural tube defects (NTDs) and iron deficiency anemia (IDA) among women who had a planned to pregnancy in Ethiopia, a country with a high burden of NTDs. Methodology: This study was conducted in Eastern Ethiopia. A double blinded parallel randomized controlled trial design was employed among women in the age group of 18-45 years who requested to interrupt modern contraceptive who have an intention to be pregnant and women with spontaneous abortion who refused to take a contraceptive. The interventional arm (n=122) received a preconception picture-based nutrition education with iron-folic acid supplement, and the control arm (n=122) received only preconception IFAS. In this study male partners were participated. Result: After three months of intervention the proportion of adherence to IFAS was 23% (n=56). With regard to adherence within the groups, 42.6% (n=52) in the intervention group and 3.3% (n=4) in the control group and the intervention group were significantly higher than in control group. In the intervention group the proportion of adherence to IFAS intake among participants increased by 40.1% and there were statistically difference (P<0.0001). The difference in difference between the two groups of adherence to IFAS intake was 37.6% and there were a statistical significance (P<0.0001). Level of knowledge between the groups did differ before and after intervention (P= 0.87 Vs P<0.0001). The overall the mean change in knowledge Mean (+SE) between group was 0.9 (+3.04 SE) and there were significant differences between two groups (P<0.001). Conclusion: In general this intervention is effective toward adherence to IFAS and a critical milestone to improve maternal health and reduce the neonate mortality due to NTDs and other advert effect of pregnancy and birth outcomes. This intervention is very short, simple, and cost effective and has potential for adaptation, feasible development to large-scale implementation in the existing health care system. Furthermore, this type of interventional approach has the potential to reduce the country's ANC program dropout rates and increase male partner’s participation on reproductive health.

Keywords: NTDs, IFAS, WRA, Ethiopia

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Authors: Ergün Şakalar, Şeyma Özçirak Ergün, Emrah Yalazi̇, Emine Altinkaya, Cengiz Ataşoğlu

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In recent years, food allergies which cause serious health problems affect to public health around the world. Foodstuffs which contain allergens are either intentionally used as ingredients or are encased as contaminant in food products. The prevalence of clinical allergy to peanuts and nuts is estimated at about 0.4%-1.1% of the adult population, representing the allergy to pistachio the 7% of the cases of tree nut causing allergic reactions. In order to protect public health and enforce the legislation, methods for sensitive analysis of pistachio and peanut contents in food are required. Pea, pistachio and peanut are used together, to reduce the cost in food production such as baklava, snack foods.DNA technology-based methods in food analysis are well-established and well-roundedtools for species differentiation, allergen detection. Especially, the probe-based TaqMan real-time PCR assay can amplify target DNA with efficiency, specificity, and sensitivity.In this study, pistachio, peanut and pea were finely ground and three separate series of triplet mixtures containing 0.1, 1, 10, 100, 1000, 10,000 and 100,000 mg kg-1 of each sample were prepared for each series, to a final weight of 100 g. DNA from reference samples and industrial products was successfully extracted with the GIDAGEN® Multi-Fast DNA Isolation Kit. TaqMan probes were designed for triplex determination of ITS, Ara h 3 and pea lectin genes which are specific regions for identification pistachio, peanut and pea, respectively.The real-time PCR as quantitative detected pistachio, peanut and pea in these mixtures down to the lowest investigated level of 0.1, 0.1 and 1 mg kg-1, respectively. Also, the methods reported here are capable of detecting of as little as 0.001% level of peanut DNA, 0,000001% level of pistachio DNA and 0.000001% level of pea DNA. We accomplish that the quantitative triplex real-time PCR method developed in this study canbe applied to detect pistachio, peanut and peatraces for three allergens at once in commercial food products.

Keywords: allergens, DNA, real-time PCR, TaqMan probe

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Authors: Yuli Andrea P. Bermudez, Richard R. Lobo, Tamyres R. D. Amorim, Danny Alexander R. Moreno, Angelica Simone C. Pereira, Ives Claudio D. Bueno

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The use of natural antioxidants in animal feed can positively modify the profile of fatty acids (FAs) in meat, due to the presence of secondary metabolites, mainly phenolic and flavonoid compounds, which promote an increase in the associated polyunsaturated fatty acids (PUFA) with beneficial factors in human health. The goal of this study was to evaluate the effect of the dietary inclusion percentage of yerba mate extract (Ilex paraguariensis St. Hilaire) as a natural antioxidant on lamb meat quality. The animals were confined for 53 days and fed with corn silage and concentrated in the proportion of 60:40, respectively, were divided into four homogeneous groups (n = 9 lambs/group), to each of the treatments, one control group without yerba mate extract - YME (0%) and three treatments with 1, 2 and 4% the inclusion of YME on a DM basis. Samples of the Longissimus thoracis (LT) muscle were collected from the deboning of 36 lambs, analyzing pH values, color parameters (brightness: L*, red value: a*, and yellow: b*), fatty acid profile, total lipids, and sensory analysis. The inclusion of YME modified the value of b* (P = 0.0041), indicating a higher value of yellow color in the meat, for the group supplemented with 4% YME. All data were statistically evaluated using the MIXED procedure of the statistical package SAS 9.4. However, it did not show differences in the final live weight in the groups evaluated, as well as in the pH values (P = 0.1923) and the total lipid concentration (P = 0.0752). The FAs (P ≥ 0.1360) and health indexes were not altered by the inclusion of YME (P ≥ 0.1360); only branched-chain fatty acids (BCFA) exhibited a diet effect (P = 0.0092) in the group that had 4% of the extract. In the sensory analysis test with a hedonic scale it did not show differences between the treatments (P ≥ 0.1251). Nevertheless, in the just about-right test, using (note 1) to 'very strong, softness or moist' (note 5); the softness was different between the evaluated treatments (P = 0.0088) where groups with 2% YME had a better acceptance of tasters (4.15 ± 0.08) compared to the control (3.89 ± 0.08). In conclusion, although the addition of YME has shown positive results in sensory acceptance and in increasing the concentration of BCFA, fatty acids beneficial to human health, without changing the physical-chemical parameters in lamb meat, the absolute changes are considered to have been quite small, which was probably related to the high efficiency of PUFA biohydrogenation in the n the rumen.

Keywords: composition, health, antioxidant, meat analysis

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Authors: Harish Aryal, Thalia Balderas, Alondra Rodriguez

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Radioactivity present in nature possess a major challenge to public health and occupational concerns. Even at low doses, NORM can cause radiation-induced cancers, heritable diseases, genetic defects, etc. There have not been enough radiological studies and consequently, there is a lack of supportive data. In addition, there is no universal medical surveillance program for low-level doses and there is a need for NORM management guidelines for appropriate control. Naturally Occurring Radioactive Material (NORM) is present everywhere during oil/gas exploration. Currently, there is limited data available to quantify radioactivity. This research presents the study of radioactivity in different areas in the United States to be encouraged to be used for further study in Texas or similar areas within the oil and gas industry. Many materials that are found in the oil and gas industry are NORM (Naturally Occurring Radioactive Materials). The NORM is made of various types of materials, including Radium 226, Radium 228, and Radon 222. Efforts to characterize the geographic distribution of NORM have been limited by poor statistical representation in this area of study. In addition, the fate of NORM in the environment has not been fully defined, and few human health risk assessments have been conducted. To further comprehend how to measure radioactivity in oil and gas, it will be essential to understand the amount and type of radioactivity that is wasted on the water and soil of the industry.

Keywords: NORM, radium 226, radon 222, radionuclides, geological formations

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Authors: Sana Mohammad Jafar, Hossaini Seyahi Zohreh

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Infections and food intoxication caused by microbial contamination of food is of major issues in different countries, and diseases caused by the consumption of contaminated food included a large percentage of the country's health problems. Since traditional cheese for cultural reasons, good taste and smell in many parts of the area still has the important place in people's food basket, transmission of pathogenic bacteria could be at risk human health through the consumption of this food. In this study selected randomly 100 samples of 250 grams of traditional cheeses supplied in the city Behbahan market and adjacent to the ice was transferred to the laboratory and microbiological tests were performed immediately. According to the results, from 100 samples tested traditional cheese, 94 samples (94% of samples) were contaminated with coliforms, which of this number 75 samples (75% of samples) the contamination rate was higher than the limit (more than 100 cfu/g). Of the total samples, 36 samples (36% of samples) were contaminated with fecal coliform which of this number 30 samples (30% of samples) were contaminated with Escherichia.coli bacteria. Based on the results of agglutination test,no samples was found positive as pathogenic Escherichia.coli.

Keywords: determination, traditional cheese, Behbahan, Escherichia coli

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Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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Authors: Robert McGrath, Zara Qureshi

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A innovative leadership philosophy that is proposed herein is distinctly more humane than most leadership approaches Concerned Leadership. The central idea to this approach is to consider the whole person that comes to work; their professional skills and talents, as well as any personal, emotional challenges that could be affecting productivity and effectiveness at work. This paper explores Concerned Leadership as an integration of the two conceptual models areas examined in this paper –(1) leaderful organizations and practices, as well as (2) organizational culture, and defines leadership in the context of Mental Health and Wellness in the workplace. Leaderful organizations calls for organizations to implement leaderful practice. Leaderful practice is when leadership responsibility and decision-making is shared across all team members and levels, versus only delegated to top management as commonly seen. A healthy culture thrives off key aspects such as acceptance, employee pride, equal opportunity, and strong company leadership. Concerned Leadership is characterized by five main components: Self-Concern, Leaderful Practice, Human Touch, Belonging, and Compassion. As scholars and practitioners conceptualize leadership in practice, the present model seeks to uphold the dignity of each organizational member, thereby having the potential to transform workplaces and support all members.

Keywords: leadership, mental health, reflective practice, organizational culture

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Authors: Kanchan Negi

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Background: Modern work culture has 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 well-being (including happiness) in a sample of working women. Method: Primary data of 360 currently married women working in the education, health, banking and IT sector in Delhi, India, were analysed. Logistic regression was used to estimate physical and psychological well-being and happiness across work characteristics. Results: Relative to 35–40 hours/week, working longer related to poor well-being (ß=0.75, 95% CI 0.12 to 1.39). Compared with not working weekends, working most or all weekends is related to poor physical (ß=0.34, 95% CI 0.08 to 0.61) and psychological well-being (ß=0.50, 95% CI 0.20 to 0.79). Rigid work patterns (ß=0.17, 95% CI −0.09 to 0.42) are also related to poor well-being. Conclusion: Decreased well-being and unhappiness are significantly linked to strenuous and rigid work patterns, suggesting that modern work culture may contribute to poor well-being. Flexible timings, compensatory holidays, work-from-home, and daycare facilities for young ones must be welcomed by companies to ease the dual burden of homemakers and career makers.

Keywords: happiness, well-being, work pattern, working women

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Authors: Barby Jennette A. Florano

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Dietary intake has been associated with the health and wellbeing of adults, and lifestyle related diseases. The aim of this study was to investigate whether nutrition knowledge, food label use, and food preference are associated with the dietary intake in a sample of San Jose Del Monte City, Bulacan (SJDM) adults. A sample of 148 adults, with a mean age of 20 years, completed a validated questionnaire related to their demographic, dietary intake, nutrition knowledge, food label use and food preference. Data were analyzed using Pearson correlation and there was no association between dietary intake and nutrition knowledge. However, there were positive relationships between dietary intake and food label use (r=0.1276, p<0.10), and dietary intake and food preference (r=0.1070, p<0.10). SJDM adults who use food label and have extensive food preference had better diet quality. This finding magnifies the role of nutrition education as a potential tool in health campaigns to promote healthy eating patterns and reading food labels among students and adults. Results of this study can give information for the design of future nutrition education intervention studies to assess the efficacy of nutrition knowledge and food label use among a similar sample population.

Keywords: dietary intake, nutrition knowledge, food preference, food label use

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