Search results for: children health

Authors: Ronit Chakraborty, Sugata Banerji

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There has been a marked increase in the reported prevalence of Autism Spectrum Disorder (ASD) among children in the US over the past two decades. This research has analyzed the growth in state-level ASD prevalence against 45 different potentially explanatory factors, including socio-economic, demographic, healthcare, public policy, and political factors. The goal was to understand if these factors have adequate predictive power in modeling the differential growth in ASD prevalence across various states and if they do, which factors are the most influential. The key findings of this study include (1) the confirmation that the chosen feature set has considerable power in predicting the growth in ASD prevalence, (2) the identification of the most influential predictive factors, (3) given the nature of the most influential predictive variables, an indication that a considerable portion of the reported ASD prevalence differentials across states could be attributable to over and under diagnosis, and (4) identification of Florida as a key outlier state pointing to a potential under-diagnosis of ASD there.

Keywords: autism spectrum disorder, clustering, machine learning, predictive modeling

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Authors: Kebron Abich Asnake

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The outbreak of COVID-19 has had far-reaching socio-economic consequences globally, and Ethiopia is no exception. This abstract provides a summary of a research study on the socio-economic impact of COVID-19 in Ethiopia. The study analyzes the health impact, economic repercussions, social consequences, government response measures, and opportunities for post-crisis recovery. In terms of health impact, the research explores the spread and transmission of the virus, the capacity and response of the healthcare system, and the mortality rate, with a focus on vulnerable populations. The economic impact analysis entails investigating the contraction of the GDP, employment and income loss, disruption in key sectors such as agriculture, tourism, and manufacturing, and the specific implications for small and medium-sized enterprises (SMEs), foreign direct investment, and remittances. The social impact section looks at the disruptions in education and the digital divide, food security and nutrition challenges, increased poverty and inequality, gender-based violence, and mental health issues. The research also examines the measures taken by the Ethiopian government, including health and safety regulations, economic stimulus packages, social protection programs, and support for vulnerable populations. Furthermore, the study outlines long-term recovery prospects, social cohesion, and community resilience challenges. It highlights the need to strengthen the healthcare system and finds a balance between health and economic priorities. The research concludes by presenting recommendations for policy-makers and stakeholders, emphasizing opportunities for post-crisis recovery such as diversification of the economy, enhanced healthcare infrastructure, investment in digital infrastructure and technology, and support for domestic tourism and local industries. This research provides valuable insights into the socio-economic impact of COVID-19 in Ethiopia, offering a comprehensive analysis of the challenges faced and potential pathways towards recovery.

Keywords: impact, covid, ethiopia, health

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Authors: Igor A. Bessmertny, Bidru C. Enkomaryam

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Active involving patients and communities in health decisions can improve both people’s health and the healthcare system. Adopting artificial intelligence can lead to more accurate and complete patient record management. This review aims to identify the current state of researches conducted using artificial intelligence techniques to improve patient engagement and wellbeing, medical domains used in patient engagement context, and lastly, to assess opportunities and challenges for patient engagement in the wellness process. A search of peer-reviewed publications, reviews, conceptual analyses, white papers, author’s manuscripts and theses was undertaken. English language literature published in 2013– 2022 period and publications, report and guidelines of World Health Organization (WHO) were also assessed. About 281 papers were retrieved. Duplicate papers in the databases were removed. After application of the inclusion and exclusion criteria, 41 papers were included to the analysis. Patient counseling in preventing adverse drug events, in doctor-patient risk communication, surgical, drug development, mental healthcare, hypertension & diabetes, metabolic syndrome and non-communicable chronic diseases are implementation areas in healthcare where patient engagement can be implemented using artificial intelligence, particularly machine learning and deep learning techniques and tools. The five groups of factors that potentially affecting patient engagement in safety are related to: patient, health conditions, health care professionals, tasks and health care setting. Active involvement of patients and families can help accelerate the implementation of healthcare safety initiatives. In sub-Saharan Africa, using digital technologies like artificial intelligence in patient engagement context is low due to poor level of technological development and deployment. The opportunities and challenges available to implement patient engagement strategies vary greatly from country to country and from region to region. Thus, further investigation will be focused on methods and tools using the potential of artificial intelligence to support more simplified care that might be improve communication with patients and train health care professionals.

Keywords: artificial intelligence, patient engagement, machine learning, patient involvement

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Authors: Erickson Bernardo, Caridad Pineda

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The project Adolescent Reproductive Health Information and Services (ARHIS) is a nine-month pilot project which intends to bridge the existing gap between reproductive health information and services, particularly with regard to family planning and HIV, among adolescent boys and girls aged 10-19 years in the 2nd Congressional District of Quezon City, in the Philippines. It aims to increase adolescents' and young people's awareness about their reproductive health concerns and at the same time make a wide range of reproductive health (RH) services accessible and available to them. A number of methodologies were utilized in the implementation of the project. At the onset, a baseline survey was conducted by community mobilizers to gather a situational analysis of adolescents' and young people's issues and concerns. The results of this survey were then presented in a multi-stakeholders' meeting to gather community support and foster their involvement. Further, interactive learning sessions (ILS) on a variety of reproductive health topics, among young people, parents and community leaders based on the results of the baseline survey was conducted. With regard to reproductive health service provision, both facility-based delivery and conduct of outreach activities were employed. In the span of nine months, the project was able to yield the following results: • A total of 521 adolescents and youth (AY) were reached by ILS on puberty, responsible relationships, teenage pregnancy, family planning, as well as HIV & AIDS. • A total of 218 parents and community leaders were informed of AY RH-related issues and concerns. • More than 350 AYs availed of a wide range of FP services including pills – both combined oral and progestin-only, and progestin-only injectables and implants. • More than 380 AYs availed of condoms as means of STI and HIV prevention. A noble initiative of the project is the utilization of a "condom distributor", a youth leader who has been educated about STI and HIV prevention as well as correct condom use, as the focal point for condom access in the community. • A total of 25 young people, parents, and community leaders were identified as ARHIS champions who have been instrumental in the achievement of project deliverables through their dedication and commitment to support the project. The concept of adolescent sexual and reproductive health (ASRH) remains to be a major challenge in the Philippine context. This is due to the fact that majority of Filipinos are still not keen on discussing issues and concerns related to ASRH, albeit the alarming number of teenage pregnancies and the rapid increase of HIV cases among 15- 24 year olds. In addition, Republic Act 10354 or the Responsible Parenthood and Reproductive Health Act of 2012, requires minor adolescents to present a written parental consent prior to accessing RH services. However, with the involvement and support of parents and key community stakeholders, these barriers may be addressed. The project has demonstrated how adolescents and young people yearn for reproductive health information and services.

Keywords: adolescent sexual reproductive health, barriers to access, reproductive health information and services, teenage pregnancies

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Authors: Cindy Agyemang

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This study seeks to find out if racial sentiment toward immigrants still matters in the United States with COVID-19 present. It is argued that previous studies on immigration and racial attitudes or race conducted do not consider how health-related pandemics influence public opinion on immigration and the racial attitudes of people during severe health-related pandemics. In doing so, this paper hypothesizes that respondents' racial sentiment towards immigrants during this pandemic will influence their views on opposing immigration, those that believe the president handled cases on COVID-19 better are more likely to oppose immigration, and party affiliation affects respondents' views on immigration and COVID-19. For testing these hypotheses, the 2012, 2016, and 2020 American National Election Studies data was used. In accordance with the expectations of this study, it was observed that there was a statistically significant relationship between all my estimated models. This paper concludes that racial sentiment toward immigrants still matters even more in the United States, especially with the existence of health-related pandemics.

Keywords: COVID-19, immigration, racial attitudes, partisanship

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Authors: Jeremy Bekker, Guy Salazar

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Introduction: Nature-exposure interventions on university campuses may serve as an effective addition to overburdened counseling and student support centers. Nature-exposure interventions can work as a preventative well-being enhancement measure on campuses, which can be used adjacently with existing health resources. Specifically, this paper analyzes how spending time in nature impacts psychological well-being, cognitive functioning, and physical health. The poster covers the core findings and recommendations of this paper, which has been previously published in the BYU undergraduate psychology journal Intuition. Research Goals and Method: The goal of this paper was to outline the potential benefits of nature exposure for students’ physical health, mental well-being, and academic success. Another objective of this paper was to outline potential research-based interventions that use campus green spaces to improve student outcomes. Given that the core objective of this paper was to identify and establish research-based nature exposure interventions that could be used on college campuses, a broad literature review focused on these areas. Specifically, the databases Scopus and PsycINFO were used to screen for research focused on psychological well-being, physical health, cognitive functioning, and nature exposure interventions. Outcomes: Nature exposure has been shown to help increase positive affect, life satisfaction, happiness, coping ability and subjective well-being. Further, nature exposure has been shown to decrease negative affect, lower mental distress, reduce cognitive load, and decrease negative psychological symptoms. Finally, nature exposure has been shown to lead to better physical health. Findings and Recommendations: Potential interventions include adding green space to university buildings and grounds, dedicating already natural environments as nature restoration areas, and providing means for outdoor excursions. Potential limitations and suggested areas for future research are also addressed. Many campuses already contain green spaces, defined as any part of an environment that is predominately made of natural elements, and these green spaces comprise an untapped resource that is relatively cheap and simple.

Keywords: nature exposure, preventative care, undergraduate mental health, well-being intervention

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Authors: W. Ling, Mohamed Saufi Bin Awang

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Introduction: Mycobacterium tuberculosis post a major health problem worldwide. Central nervous system (CNS) infection by mycobacterium tuberculosis is one of the most devastating complications of tuberculosis. Although with advancement in medical fields, we are yet to understand the pathophysiology of how mycobacterium tuberculosis was able to cross the blood-brain barrier (BBB) and infect the CNS. CNS TB may present with nonspecific clinical symptoms which can mimic other diseases/conditions; this is what makes the diagnosis relatively difficult and challenging. Public health has to be informed and educated about the spread of TB, and early identification of TB is important as it is a curable disease. Case Report: A young 21-year-old Malay gentleman was initially presented to us with symptoms of ear discharge, tinnitus, and right-sided headache for the past one year. Further history reveals that the symptoms have been mismanaged and neglected over the period of 1 year. Initial investigation reveals features of inflammation of the ear. Further imaging showed the feature of chronic inflammation of the otitis media and atypical right cerebral abscess, which has the same characteristic features and consistency. He further underwent a biopsy, and results reveal positive Mycobacterium tuberculosis of the otitis media. With the results and the available imaging, we were certain that this is likely a case of disseminated tuberculosis causing CNS TB. Conclusion: We aim to highlight the challenge and difficult face in our health care system and public health in early identification and treatment.

Keywords: central nervous system tuberculosis, intracranial tuberculosis, tuberculous encephalopathy, tuberculous meningitis

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Authors: Salam Labidi, Sonia Machraoui, Souha Gharbi

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Radium isotopes (226Ra, 228Ra) and uranium isotopes (234U, 238U) activity concentrations were determined in most popular Tunisian bottled mineral waters samples. Activity concentrations of uranium were studied by radiochemical separation procedures followed by alpha spectrometry and that of radium isotopes by gamma-ray spectrometry. The activity concentrations of 238U, 234U, 226Ra and 228Ra in water samples varied in range 3.3 - 22.5 mBq.L−1, 4.0 - 34.2 mBq L−1, 2.0 - 67.0 mBq L−1 and 2.0 - 30.2 mBq L−1, respectively. These values are comparable with those reported for many other countries in the world for different types of water. Based on the activity concentration results obtained in this study, the estimated annual ingestion dose rates for three different age groups (babies, children and adults) due to the ingestion of radium and uranium isotopes through drinking water are lower than the limit of intake prescribed by WHO. The annual doses exceed the recommended value of 0.1 mSv y-1 in one case for babies.

Keywords: mineral water, natural radioactivity, radiation dose, radium, uranium

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Authors: Michelle Nighswander

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Suicide can be a tragic response to mental illness. It is difficult for people to disclose or discuss suicidal impulses. The stigma surrounding mental health can create a reluctance to seek help for mental illness. Patients may feel pressure to exhibit a socially desirable demeanor rather than reveal these issues, especially if they sense their healthcare provider is pressed for time or does not have an extensive history with their provider. Overcoming these barriers can be challenging. Although there are several validated depression and suicide risk instruments, varying processes used to administer these tools may impact the truthfulness of the responses. A literature review was conducted to find evidence of the impact of the environment on the accuracy of depression screening. Many investigations do not describe the environment and fewer studies use a comparison design. However, three studies demonstrated that computerized self-reporting might be more likely to elicit truthful and accurate responses due to increased privacy when responding compared to a face-to-face interview. These studies showed patients reported positive reactions to computerized screening for other stigmatizing health conditions such as alcohol use during pregnancy. Computerized self-screening for depression offers the possibility of more privacy and patient reflection, which could then send a targeted message of risk to the healthcare provider. This could potentially increase the accuracy while also increasing time efficiency for the clinic. Considering the persistent effects of mental health stigma, how these screening questions are posed can impact patients’ responses. This literature review analyzes trends in depression screening methodologies, the impact of setting on the results and how this may assist in overcoming one barrier caused by stigma.

Keywords: computerized self-report, depression, mental health stigma, suicide risk

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Authors: J. Niyitegeka, G. Nshimirimana, A. Silverstein, J. Odhiambo, Y. Lin, T. Nkurunziza, R. Riviello, S. Rulisa, P. Banguti, H. Magge, M. Macharia, J. P. Dushime, R. Habimana, B. Hedt-Gauthier

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In low-resource settings, women needing an emergency cesarean section experiences various delays in both reaching and receiving care that is often linked to poor neonatal outcomes. In this study, we quantified different measures of delays and assessed the association between these delays and neonatal outcomes at three rural district hospitals in Rwanda. This retrospective study included 441 neonates and their mothers who underwent emergency cesarean sections in 2015 at Butaro, Kirehe and Rwinkwavu District Hospitals. Four possible delays were measured: Time from start of labor to district hospital admission, travel time from a health center to the district hospital, time from admission to surgical incision, and time from the decision for the emergency cesarean section to surgical incision. Neonatal outcomes were categorized as unfavorable (APGAR < 7 or death) and favorable (APGAR ≥ 7). We assessed the relationship between each type of delay and neonatal outcomes using multivariate logistic regression. In our study, 38.7% (108 out of 279) of neonates’ mothers labored for 12 to 24 hours before hospital admission and 44.7% (159 of 356) of mothers were transferred from health centers that required 30 to 60 minutes of travel time to reach the district hospital. 48.1% (178 of 370) of caesarean sections started within five hours after admission and 85.2% (288 of 338) started more than thirty minutes after the decision for the emergency cesarean section was made. Neonatal outcomes were significantly worse among mothers with more than 90 minutes of travel time from the health center to the district hospital compared to health centers attached to the hospital (OR = 5.12, p = 0.02). Neonatal outcomes were also significantly different depending on decision to incision intervals; neonates with cesarean deliveries starting more than thirty minutes after decision had better outcomes than those started immediately (OR = 0.32, p = 0.04). Interventions that decrease barriers to access to maternal health care services can improve neonatal outcome after emergency cesarean section. Triaging could explain the inverse relationship between time from decision to incision and neonatal outcome; this must be studied more in the future.

Keywords: Africa, emergency obstetric care, rural health delivery, maternal and child health

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Authors: Sheikh Mohammed Rafiul Huque

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Bangladesh since its inception has been an economy that is fuelled by agriculture and agriculture has significant contribution to the GDP of Bangladesh. The agriculture of Bangladesh predominantly and historically dependent on organic sources of raw material though the place has taken in decades by inorganic sources of raw materials due to the high demand of food for rapidly growing of population. Meanwhile, a new market segment, which is niche market, has been evolving in the urban area in favor of organic products, though 71.1% population living in rural areas is dependent mainly on conventional products. The new market segment is search of healthy and safer source of food and they could believe that organic products are the solution of that. In Bangladesh, food adulteration is very common practices among the shop-keepers to extend the shelf life of raw vegetables and fruits. The niche group of city dwellers is aware about the fact and gradually shifting their buying behavior to organic products. A recent survey on organic farming revealed that 16,200 hectares under organic farming in recent time, which was only 2,500 hectares in 2008. This study is focused on consumer awareness of organic products and tried to explore the factors affecting organic food consumption among high income group of people. The hypothesis is developed to explore the effect of gender (GENDER), ability to purchase (ABILITY) and health awareness (HEALTH) on purchase intention (INTENTION). A snowball sampling was administered among the high income group of people in Dhaka city among 150 respondents. In this sampling process the study could identify only those samples who has consume organic products. A Partial Least Square (PLS) method was used to analyze data using path analysis. It was revealed from the analysis that coefficient determination R2 is 0.829 for INTENTION endogenous latent variable. This means that three latent variables (GENDER, ABILITY, and HEALTH) significantly explain 82.9% of the variance in INTENTION of purchasing organic products. Moreover, GENDER solely explains 6.3% and 8.6% variability of ABILITY and HEALTH respectively. The inner model suggests that HEALTH has strongest negative effect on INTENTION (-0.647) followed by ABILITY (0.344) and GENDER (0.246). The hypothesized path relationship between ABILITY->INTENTION, HEALTH->INTENTION and GENDER->INTENTION are statistically significant. Furthermore, the hypothesized path relationship between GENDER->ABILITY (0.262) and GENDER->HEALTH (-0.292) also statistically significant. The purpose of the study is to demonstrate how an organic product producer can improve his participatory guarantee system (PGS) while marketing the products. The study focuses on understanding gender (GENDER), ability (ABILITY) and health (HEALTH) factors while positioning the products (INTENTION) in the mind of the consumer. In this study, the respondents are found to care about high price and ability to purchase variables with loading -0.920 and 0.898. They are good indicators of ability to purchase (ABILITY). The marketers should consider about price of organic comparing to conventional products while marketing, otherwise, that will create negative intention to buy with a loading of -0.939. Meanwhile, it is also revealed that believability of chemical free component in organic products and health awareness affects health (HEALTH) components with high loading -0.941 and 0.682. The study analyzes that low believability of chemical free component and high price of organic products affects intension to buy. The marketers should not overlook this point while targeting the consumers in Bangladesh.

Keywords: health awareness, organic products, purchase ability, purchase intention

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Authors: Igna Brajević Gizdić, Gorka Vuletić

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Introduction: Addiction is a chronic brain relapsing disorder. Opioid Substitution Therapy (OST) using buprenorphine as a medical treatment option shows as a promising option for achieving and maintaining abstinence in opioid-addicted patients. This research aimed to determine and evaluate the quality of life (QoL) in opiate-addicted patients after five years of buprenorphine therapy. Method: The total sample included 44 buprenorphine-maintained opiate addicts in outpatient treatment. The participants were administered the QoL questionnaire (WHOQOL-BREF) at two-time points (T1 and T2) with an interval of at least five years. WHOQOL-BREF contains a total of 26 questions. The first two questions, related to overall QoL and general health status, and the remaining questions (3–26), which represented four domains—physical, psychological, social, and environmental health—were evaluated separately. Results: The results indicated no significant differences in overall self-assessed QoL nor in individual domains after five years (T2) of abstinence with OST buprenorphine- maintenance. Conclusion: These findings indicated no improvement in QoL of buprenorphine-maintenance opiate addicts in outpatient treatment. However, this might be due to the smaller sample size and participants' overall high scores in QoL at T1. This study suggests the importance of expectations when considering the QoL and general health of buprenorphine-maintenance opiate addicts in outpatient treatment.

Keywords: abstinence, addicts, buprenorphine, opioid substitution therapy, quality of life

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Authors: Suresh Sharma, Neeti Goutam

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In India abortions are legal and with the exceedingly liberal and broadened law that was passed in 1971, “Medical Termination of Pregnancy Act” had opened a new window to Women’s’ freedom and choice over their fertility. This paper would like to focus on the factors responsible for or leading to unsafe abortion as well as such high incidence of abortion in India which can help in understanding the ways in which we can prevent this apathy. To study the intricacies involved in delivering safety to womanhood in terms of safe abortion practice which includes more trained personnel, detailed explanation and consequences of conducting an abortion, fine reporting, awareness regarding family planning measures and not only pressurizing them to sterilize immediately after an abortion but also prior to that informing them and lastly easy accessibility of Contraceptives with a educated and brief information on that. Data has been drawn from various sources such as National Family Household Survey (1, 2, 3), Health Management Information System and Annual Health Survey. To safeguard the interest of women when it comes to complications resulting from unsafe abortions, Reproductive Health laid its strict adherence to it in its guidelines. The Government could induce more measures in terms of family planning measures and increase in the number of skilled medical health force, chiefly in rural areas to prevent the illegality of abortions. But before that fine reporting on the number of abortions performed will give an insight to this very issue only then policies and programs will work much better in favor of women.

Keywords: abortion, MTP act, India, women

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Authors: A. Sottomayor, M. Perez Duque, M. C. Henriques

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Introduction: Migration is not a new phenomenon; nomads often traveled, seeking better living conditions, including food and water. The increase of migrations affects all countries, rising health-related challenges. In Portugal, we have had migrant movements in the last decades, pairing with economic behavior. Irregular immigrants are detained in Santo António detention center from Portuguese Immigration and Borders Service (USHA-SEF) in Porto until court decision for a maximum of 60 days. It is the only long stay officially designated detention center for immigrants in Portugal. Immigrant health is important for public health (PH). It affects and is affected by the community. The XXVII Portuguese Government considered immigrant integration, including access to health, health promotion, protection and reduction of inequities a political priority. Many curative, psychological and legal services are provided for detainees, but until 2015, no structured health promotion or prevention actions were being held at USHA-SEF. That year, Porto Occidental PH Local Unit started to provide vaccination and health literacy on this theme for detainees and SEF workers. Our activities include a vaccine lecture, a medical consultation with vaccine prescription and administration, along with documented proof of vaccination. All vaccines are volunteer and free of charge. This action reduces the risk of importation and transmission of diseases, contributing to world eradication and elimination programs. We aimed to characterize the demography of irregular immigrant detained at UHSA-SEF and describe our activity. Methods: All data was provided by Porto Occidental Public Health Unit. All paper registers of vaccination were uploaded to MicrosoftExcel®. We included all registers and collected demographic variables, nationality, vaccination date, category, and administered vaccines. Descriptive analysis was performed using MicrosoftExcel®. Results: From 2015 to 2018, we delivered care to 256 individuals (179 immigrants; 77 workers). Considering immigrants, 72% were male, and 8 (16%) women were pregnant. 85% were between 20-54 years (ᵡ=30,8y; 2-71y), and 11 didn’t report any age. Migrants came from 48 countries, and India had the highest number (9%). MMR and Tetanus vaccines had > 90% vaccination rate and Poliomyelitis, hepatitis B and flu vaccines had around 85% vaccination rates. We had a consistent number of refusals. Conclusion: Our irregular migrant population comes from many different countries, which increases the risk of disease importation. Pregnant women are present as a particular subset of irregular migrants, and vaccination protects them and the baby. Vaccination of migrant is valuable for them and for the countries in which they pass. It contributes to universal health coverage, for eradication programmes and accomplishment of the Sustainable Development Goals. Peer influence may present as a determinant of refusals so we must consistently educate migrants before vaccination. More studies would be valuable, particularly on the migrant trajectory, duration of stay, destiny after court decision and health impact.

Keywords: migrants, public health, universal health coverage, vaccination

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Authors: Arindam Roy

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Public policy is an intriguing terrain, which involves complex interplay of administrative, social political and economic components. There is hardly any fit-for all formulation of public policy as Lindbloom has aptly categorized it as a science of muddling through. In fact, policies are both temporally and contextually determined as one the proponents of policy sciences Harold D Lasswell has underscored it in his ‘contextual-configurative analysis’ as early as 1950s. Though, a lot of theoretical efforts have been made to make sense of this intricate dynamics of policy making, at the end of the day the applied area of public policy negates any such uniform, planned and systematic formulation. However, our policy makers seem to have learnt very little of that. Until recently, policy making was deemed as an absolutely specialized exercise to be conducted by a cadre of professionally trained seasoned mandarin. Attributes like homogeneity, impartiality, efficiency, and neutrality were considered as the watchwords of delivering common goods. Citizen or clientele was conceptualized as universal political or economic construct, to be taken care of uniformly. Moreover, policy makers usually have the proclivity to put anything into straightjacket, and to ignore the nuances therein. Hence, least attention has been given to the ground level reality, especially the socio-cultural milieu where the policy is supposed to be applied. Consequently, a substantial amount of public money goes in vain as the intended beneficiaries remain indifferent to the delivery of public policies. The present paper in the light of Reproductive Health Care policy in rural West Bengal has tried to underscore the criticality of socio-cultural factors in public health delivery. Indian health sector has traversed a long way. From a near non-existent at the time of independence, the Indian state has gradually built a country-wide network of health infrastructure. Yet it has to make a major breakthrough in terms of coverage and penetration of the health services in the rural areas. Several factors are held responsible for such state of things. These include lack of proper infrastructure, medicine, communication, ambulatory services, doctors, nursing services and trained birth attendants. Policy makers have underlined the importance of supply side in policy formulation and implementation. The successive policy documents concerning health delivery bear the testimony of it. The present paper seeks to interrogate the supply-side oriented explanations for the failure of the delivery of health services. Instead, it identified demand side to find out the answer. The state-led and bureaucratically engineered public health measures fail to engender demands as these measures mostly ignore socio-cultural nuances of health and well-being. Hence, the hiatus between supply side and demand side leads to huge wastage of revenue as health infrastructure, medicine and instruments remain unutilized in most cases. Therefore, taking proper cognizance of these factors could have streamlined the delivery of public health.

Keywords: context, policy, socio-cultural factor, uniformity

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Authors: Ismail Bile Hassan, Masrah Azrifah Azmi Murad

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This study discovers a novel framework of individual level technology adoption known as I-P (Individual- Privacy) towards Smart National Identity Card health information application. Many countries introduced smart national identity card (SNIC) with various applications such as health information application embedded inside it. However, the degree to which citizens accept and use some of the embedded applications in smart national identity remains unknown to many governments and application providers as well. Moreover, the previous studies revealed that the factors of trust, perceived risk, privacy concern and perceived credibility need to be incorporated into more comprehensive models such as extended Unified Theory of Acceptance and Use of Technology known as UTAUT2. UTAUT2 is a mainly widespread and leading theory existing in the information system literature up to now. This research identifies factors affecting the citizens’ behavioural intention to use health information application embedded in SNIC and extends better understanding on the relevant factors that the government and the application providers would need to consider in predicting citizens’ new technology acceptance in the future. We propose a conceptual framework by combining the UTAUT2 and Privacy Calculus Model constructs and also adding perceived credibility as a new variable. The proposed framework may provide assistance to any government planning, decision, and policy makers involving e-government projects. The empirical study may be conducted in the future to provide proof and empirically validate this I-P framework.

Keywords: unified theory of acceptance and use of technology (UTAUT) model, UTAUT2 model, smart national identity card (SNIC), health information application, privacy calculus model (PCM)

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Authors: Sarah A. Alotaibi, Mohammed A. Almutairi, Abdullah A. Alsayari, Adibah M. Almutairi, Somaiah K. Almubayedh

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Concerns over the presence of acrylamide in food date back to 2002, when Swedish scientists stated that, in carbohydrate-rich foods, amounts of acrylamide were formed when cooked at high temperatures. Similar findings were reported by other researchers which, consequently, caused major international efforts to investigate dietary exposure and the subsequent health complications in order to properly manage this issue. Due to this issue, in this work, we aim to determine the acrylamide level in different foods (coffee, potato chips, biscuits, and baby food) commonly consumed by the Saudi population. In a total of forty-three samples, acrylamide was detected in twenty-three samples at levels of 12.3 to 2850 µg/kg. In reference to the food groups, the highest concentration of acrylamide was found in coffee samples (<12.3-2850 μg/kg), followed by potato chips (655-1310 μg/kg), then biscuits (23.5-449 μg/kg), whereas the lowest acrylamide level was observed in baby food (<14.75 – 126 μg/kg). Most coffee, biscuits and potato chips products contain high amount of acrylamide content and also the most commonly consumed product. Saudi adults had a mean exposure of acrylamide for coffee, potato, biscuit, and cereal (0.07439, 0.04794, 0.01125, 0.003371 µg/kg-b.w/day), respectively. On the other hand, exposure to acrylamide in Saudi infants and children to the same types of food was (0.1701, 0.1096, 0.02572, 0.00771 µg/kg-b.w/day), respectively. Most groups have a percentile that exceeds the tolerable daily intake (TDI) cancer value (2.6 µg/kg-b.w/day). Overall, the MOE results show that the Saudi population is at high risk of acrylamide-related disease in all food types, and there is a chance of cancer risk in all age groups (all values ˂10,000). Furthermore, it was found that in non-cancer risks, the acrylamide in all tested foods was within the safe limit (˃125), except for potato chips, in which there is a risk for diseases in the population. With potato and coffee as raw materials, additional studies were conducted to assess different factors, including temperature, cocking time, and additives affecting the acrylamide formation in fried potato and roasted coffee, by systematically varying processing temperatures and time values, a mitigation of acrylamide content was achieved when lowering the temperature and decreasing the cooking time. Furthermore, it was shown that the combination of the addition of chitosan and NaCl had a large impact on the formation.

Keywords: risk assessment, dietary exposure, MOA, acrylamide, hazard

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Authors: Maria Sonto Maputle, Rhulani C. Shihundla, Rachel T. Lebese

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Background: Patients’ information must be complete and accurately documented in order to foster quality and continuity of care. The multidisciplinary health care members use patients’ documentation to communicate about health status, preventive health services, treatment, planning and delivery of care. The purpose of this study was to determine the practice of nursing documentation of patients’ information at selected Primary Health Care (PHC) facilities in Vhembe District, Limpopo Province, South Africa. Methods: The research approach adopted was qualitative while exploratory and descriptive design was used. The study was conducted at selected PHC facilities. Population included twelve professional nurses. Non-probability purposive sampling method was used to sample professional nurses who were willing to participate in the study. The criteria included participants’ whose daily work and activities, involved creating, keeping and updating nursing documentation of patients’ information. Qualitative data collection was through unstructured in-depth interviews until no new information emerged. Data were analysed through open–coding of, Tesch’s eight steps method. Results: Following data analysis, it was found that professional nurses’ had knowledge deficit related to insufficient training on updates and rendering multiple services daily had negative impact on accurate documentation of patients’ information. Conclusion: The study recommended standardization of registers, books and forms used at PHC facilities, and reorganization of PHC services into open day system.

Keywords: documentation, knowledge, patient care, patient’s information, training

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Authors: Preeti Tiwari, Jay Wood, Duncan Babbage

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Family planning plays a role in saving lives across the globe by preventing unwanted pregnancies. The purpose of this multidisciplinary research was to determine the impact of mHealth tools have on psychosocial determinants of behaviour for family planning. The present study examines a topic that is very relevant in times where human-technology interaction is at its peak. It is probably one of the first studies that have investigated the impact of mobile phone technology on the underlying mechanisms of behaviour change for family planning using primary data. To examine the association between exposure to mHealth tools and predictors of behaviour, data was collected from mHealth intervention areas in India. A post-intervention quasi-experimental study with a 2x2 factorial design was conducted among 831 men and women from the state of Bihar. The quantitative data analysis evaluated the extent of influence that predictors of behaviour (beliefs, social norms, perceived behaviour control, and outcome behaviour) have on a woman’s decisions about family planning. The results indicated an association between exposure to mHealth tools and improved communication about family planning among various family members after receiving health information from a health worker (H1). A relationship between exposure to mHealth tools and increased support women received from their husbands and extended family (mothers-in-law specifically) and peers (H2) was also found. A further result showed that knowledge about family planning was greater among users of family planning (H4). mHealth tools empower women to communicate with family members. This has important implications for developing mobile phone-based tools, as they can be used as a crucial communication channel that can be an effective method of increasing communication among family members about contraceptives. Thus, it can be implied that where women feel nervous talking about contraception, the successful application of mHealth tools can strengthen the interactivity of the health communication and could increase the likelihood of using contraception. However, while it may improve health communication that can inform health decisions, it may be insufficient on its own to cause behaviour change.

Keywords: contraceptive, e-health, psycho-social, women

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Authors: Ram Sharan Mehta, Naveen Kumar Pandey, Binod Kumar Deo

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Quality of Life (QOL) is an important component in the evaluation of the well-being of People Living with AIDS (PLWA). This study assessed the effectiveness of education intervention programme in improving the QOL of PLWA on ART attaining the ART-clinics at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal. A pre-experimental research design was used to conduct the study among the PLWA on ART at BPKIHS from June to August 2013 involving 60 PLWA on pre-test randomly. The mean age of the respondents was 36.70 ± 9.92, and majority of them (80%) were of age group of 25-50 years and Male (56.7%). After education intervention programme there is significant change in the QOL in all the four domains i.e. Physical (p=0.008), Psychological (p=0.019), Social (p=0.046) and Environmental (p=0.032) using student t-test at 0.05 level of significance. There is significant (p= 0.016) difference in the mean QOL scores of pre-test and post-test. High QOL scores in post-test after education intervention programme may reflective of the effectiveness of planned education interventions programme.

Keywords: telephone, AIDS, health service, Nepal

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Authors: A. Chandra, M. Arthur, L. Mize, A. Pomeroy-Stevens

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Background: Lower and middle-income countries (LMICs) in Asia face rapid urbanization resulting in both economic opportunities (the urban advantage) and emerging health challenges. Urban health risks are magnified in informal settlements and include infectious disease outbreaks, inadequate access to health services, and poor air quality. Over the coming years, urban spaces in Asia will face accelerating public health risks related to migration, climate change, and environmental health. These challenges are complex and require multi-sectoral and multi-stakeholder solutions. The Building Health Cities (BHC) program is funded by the United States Agency for International Development (USAID) to work with smart city initiatives in the Asia region. BHC approaches urban health challenges by addressing policies, planning, and services through a health equity lens, with a particular focus on informal settlements and migrant communities. The program works to develop data-driven decision-making, build inclusivity through stakeholder engagement, and facilitate the uptake of appropriate technology. Methodology: The BHC program has partnered with the smart city initiatives of Indore in India, Makassar in Indonesia, and Da Nang in Vietnam. Implementing partners support municipalities to improve health delivery and equity using two key approaches: political economy analysis and participatory systems mapping. Political economy analyses evaluate barriers to collective action, including corruption, security, accountability, and incentives. Systems mapping evaluates community health challenges using a cross-sectoral approach, analyzing the impact of economic, environmental, transport, security, health system, and built environment factors. The mapping exercise draws on the experience and expertise of a diverse cohort of stakeholders, including government officials, municipal service providers, and civil society organizations. Results: Systems mapping and political economy analyses identified significant barriers for health care in migrant populations. In Makassar, migrants are unable to obtain the necessary card that entitles them to subsidized health services. This finding is being used to engage with municipal governments to mitigate the barriers that limit migrant enrollment in the public social health insurance scheme. In Indore, the project identified poor drainage of storm and wastewater in migrant settlements as a cause of poor health. Unsafe and inadequate infrastructure placed residents of these settlements at risk for both waterborne diseases and injuries. The program also evaluated the capacity of urban primary health centers serving migrant communities, identifying challenges related to their hours of service and shortages of health workers. In Da Nang, the systems mapping process has only recently begun, with the formal partnership launched in December 2019. Conclusion: This paper explores lessons learned from BHC’s systems mapping, political economy analyses, and stakeholder engagement approaches. The paper shares progress related to the health of migrants in informal settlements. Case studies feature barriers identified and mitigating steps, including governance actions, taken by local stakeholders in partner cities. The paper includes an update on ongoing progress from Indore and Makassar and experience from the first six months of program implementation from Da Nang.

Keywords: informal settlements, migration, stakeholder engagement mapping, urban health

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Authors: Kalayanee Senasu

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Research on happiness has been growing in recent decades. In the early stages, scholars were primarily concerned with establishing the validity of happiness measures and with exploring socio-economic correlates of happiness. More recent studies have focused on outcomes of happiness as well as the identification of happiness policies. This research investigates the happiness levels and influences of quality of life in terms of mental health satisfaction, family satisfaction, community satisfaction, and work satisfaction as determinants of happiness in Thailand during 2009-2014. The data collected by the National Statistic Office of Thailand in the project of Socio-economic Survey inclusion of Mental Health Survey in 2009, 2010, and 2012; and in the project of Labor Force Survey inclusion of Mental Health Survey in August 2014 were employed. There was a total of 59,430, 64,720, 54,736, and 9,997 respondents who were at least 15 years old in the survey during 2009-2014. Statistical analyses include both descriptive and inferential statistics. All research hypotheses were tested by means of hierarchical regression analysis. The analysis results reveal that happiness means during the studied period are quite at high levels (in the range of 7.42 to 7.60 from the scale 0-10). And the results indicate that all model variables (i.e., mental health satisfaction, family satisfaction, community satisfaction, and work satisfaction), have positive effects on happiness in Thailand. Additionally, the mental health satisfaction plays the most important role in predicting happiness. Further, our results indicate significant positive relationship between education, and income/expense and happiness, while other socio-economic variables reveal variety relationships during the studied period. Our results not only validate research findings in other countries but also verify the importance of quality of life (in terms of mental health satisfaction, family satisfaction, community satisfaction, and work satisfaction) as important factors of happiness for public policy makers. One conclusion stands firm in our study: happiness can be advanced in many ways. At the society level, greater happiness for people can be achieved by policies that aim to promote good health, an engaged family relationship, a high community as well as work qualities. A contented population is advantaged in many ways over one that is not. Government or policy makers should understand and realize that happiness is a valuable and tangible aspect of the population for which they are responsible. Therefore, they should include happiness issues in their political agenda.

Keywords: community satisfaction, family satisfaction, mental health satisfaction, work satisfaction, happiness, Thailand

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Authors: Mombaur Busisiwe, Lesosky Maia, Liebenberg Lisa, Heckmann Jeannine

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Introduction: To assess age- and gender-specific incidence rates (IR) of acetylcholine receptor (AChR)-antibody positive myasthenia gravis (MG) in South Africa, and geographical variation in incidence. Methods: IRs were calculated from positive AChR antibody laboratory data between 2011 and 2012, using 2011 population census data. Results:890 individuals were seropositive, for an annual IR of 8.5 per million. Age-standardized IR for early- (< 50) and late-onset (≥ 50) MG were 4.1 and 24 per million, respectively, and for juveniles, 4.3 per million. The IR between provinces ranged from 1 to 19 per million. Conclusions: In this Southern hemisphere African population, the overall IR and peak IR (in older men) for seropositive MG is comparable to that in Europe and North America, arguing against environmental factors. However, IRs may be higher among children with African genetic ancestry. Geographical variation in incidence underscores the importance of outreach programs for regions with limited resources.

Keywords: incidence rates (IR), acetylcholine receptor (AChR), myasthenia gravis (MG), South Africa

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Authors: J. N. Bardi, N. Wright, S. Timmons, P. Crawford

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Introduction: In the United Kingdom (UK), the transfer of care from the asylums to the community has meant that some people with mental health problems (MHP) may not have access to suitable or adequate statutory community mental health services (CMHS). However, in addition to statutory CMHS, there are informal CMHS that provide spaces where people with MHP can attend such as faith communities, clubhouses, user-led organisations, day centres including drop-in-centres and community hubs and community mental health cafés (CMHCs). Aim: To qualitatively understand what happens in a community mental health café in relation to the place, people and processes, from the participant's perspective. Methodology: Ethnography Methods: Data collection will be field notes from observations written as thick description and interviews with participants. Data analysis will be thematic and narrative analysis. Relevance: The study seeks to observe what happens in a user-led community mental health café and explore if it provides the services that it claims to offer. Therefore, a literature review was conducted to examine the research evidence related to informal CMHS, focusing on similarities and differences. Results indicated that informal CMHS differ with regards to why, how, who set them up and who funds them, but they are similar because people with MHP who attend them report related psychological, vocational, and social interaction benefits. In addition to the differences listed above, CMHCs differ in their adoption of the commercial café model of social space and some CMHCs claim to address needs of social isolation and loneliness which they assert are not properly addressed by statutory CMHS and some informal CMHS. Therefore, CMHCs explicitly differentiate themselves from statutory CMHS and some informal CMHS such as day centres, hospitals and social services. However, CMHCs were found to be like drop-in-centres and community hubs which are also free for MHP to attend without the need for assessments, membership or appointments. To situate community mental health café within other informal CMHS and provide a rationale for the proposed study a scoping review was conducted to determine the scope of available research evidence on CMHCs. Findings from the scoping review reflected the literature review findings with regards to the benefits of attending informal CMHCs for people with MHP. Of the ten studies included in the scoping review, seven were on CMHCs for people living with dementia and two were on CMHCs for people with a broader range of MHP. The researcher hopes that findings from the proposed PhD study will build on the existing understanding of informal CMHS, extend the research evidence on CMHCs and address any gap in the literature.

Keywords: cafe, community, ethnography, mental health

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Authors: Mary Ann L. Halliday, Zoengpari Gohain

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The stigma associated with HIV-AIDS negatively affect mental health and ability to effectively manage the disease. While the number of People living with HIV/AIDS (PLHIV) has been increasing day by day in Mizoram (a small north-eastern state in India), research on HIV/AIDS stigma has so far been limited. Despite the potential significance of Internalized HIV Stigma (IHS) in the lives of PLHIV, there has been very limited research in this area. It was therefore, felt necessary to explore the internalized HIV stigma, mental health, coping and perceived social support of PLHIV in Aizawl District, Mizoram. The present study was designed with the objectives to determine the degree of IHS, to study the relationship between the socio-demographic characteristics and level of IHS, to highlight the mental health status, coping strategies and perceived social support of PLHIV and to elucidate the relationship between these psychosocial variables. In order to achieve the objectives of the study, six hypotheses were formulated and statistical analyses conducted accordingly. The sample consisted of 300 PLWHA from Aizawl District, 150 males and 150 females, of the age group 20 to 70 years. Two- way classification of “Gender” (male and female) and three-way classification of “Level of IHS” (High IHS, Moderate IHS, Low IHS) on the dependent variables was employed, to elucidate the relationship between Internalized HIV Stigma, mental health, coping and perceived social support of PLHIV. The overall analysis revealed moderate level of IHS (67.3%) among PLHIV in Aizawl District, with a small proportion of subjects reporting high level of IHS. IHS was found to be significantly different on the basis of disclosure status, with the disclosure status of PLHIV accounting for 9% variability in IHS.  Results also revealed more or less good mental health among the participants, which was assessed by minimal depression (50.3%) and minimal anxiety (45%), with females with high IHS scoring significantly higher in both depression and anxiety (p<.01). Examination of the coping strategies of PLHIV found that the most frequently used coping styles were Acceptance (91%), Religion (84.3%), Planning (74.7%), Active Coping (66%) and Emotional Support (52.7%). High perception of perceived social support (48%) was found in the present study. Correlation analysis revealed significant positive relationships between IHS and depression as well as anxiety (p<.01), thus revealing that IHS negatively affects the mental health of PLHIV. Results however revealed that this effect may be lessened by the use of various coping strategies by PLHIV as well as their perception of social support.

Keywords: Aizawl, anxiety, depression, internalized HIV stigma, HIV/AIDS, mental health, mizoram, perceived social support

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Authors: Lily Yarney, Emmanuel M. Y. Seidu, Thomas Chireh Kuusaanu, Belinda Adzimah-Yeboah

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Healthcare delivery is labor-intensive; the role of the health worker is, therefore, indispensable in maintaining and improving individual and population health. In Ghana, doctor-patient ratio is 1:10,450, with a disproportionate tilt in favor of the relatively resource rich southern part of the country. The Upper West Region located in Northern Ghana, is among the poorest regions in the country. The study was aimed at finding out the reasons why medical doctors are unwilling to accept postings to the Upper West Region where their services are needed most despite some efforts to attract, motivate and retain them. Current initiatives by the Ministry of Health and its partners to attract and retain doctors in the region were also examined. Qualitative methodology was employed with an in-depth interview guide to collect data. Sixteen respondents comprising medical doctors, health managers, and other health-related partners purposively selected took part in the study. Data were recorded, transcribed, coded, and categorized into themes in tandem with the objectives of the study. The study found that medical doctors are unwilling to take up appointments in the Upper West Region because of limited opportunities for career and continuing professional development, poor financial inducement, and weak leadership, among other important contextual social and cultural factors. Critical success factors to surmount these challenges include concessions and sponsorship for medical specialization training for doctors and clear implementable national and local policies on postings.

Keywords: attraction, retention, medical doctors, deprived regions, Ghana

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Authors: R. S. Fisca, Y. R. Elox, L. Umi, U. Z. Luttfia, Kun Harismah

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Petai (Parkia speciosa) is a plant indigenous to Southeast Asia. It is consumed either raw or cooked. It has been used in folk medicine to treat diabetes, hypertension, and kidney problems. It contains minerals and vitamins. Petai contains a lot of chemical compounds that are beneficial for health, including antioxidants, Vitamin B6 0,9mg, energy 142 g. cal, 10.4 g protein. 2 g fat, 22 g carbohydrates, 95 mg calcium, phosphorus 115 mg, 1 mg iron, 200 IU of vitamin A, vitamin B1 0.17 mg, 36 mg of vitamin C that can resolve various health problems. These chips are the result of innovation from petai packaged in such a way becomes a tasty snack chips and can be enjoyed by many people to relax and also nutritious for health. In the manufacture of petai chips require several steps of them start by boiling, flating, drying and the last frying. In introducing the products widely we sell petai chips with several methods. Some of these methods include direct sales, delivery order, online/social media, and open some booth at a few places and the car free day in Solo every sunday. Opportunity in selling petai chips is very wide because there is no competitors with similar business. With the innovation of petai chips become healthy snacks can be introduced to the public and can even be exported out of the country as one of the extraordinary snacks from Indonesia.

Keywords: antioxidants, chips, healty, petai

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Authors: Alaa Jawad Hassan, Saad Marza Al-Aaraji, Fadil Abbas Hamad

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The current study was designed to assess some immunological parameters and pedigree analysis for atopic dermatitis patients, as the study included 64 patients (37 males and 27 females) and 24 healthy individuals (12 males and 12 females) with no history of the AD. The cases of this study were divided into two age groups; the first is infant and children (1-10 years), while the second is adolescent and adults (11- 60 years). The number of cases was 51 and 13 in each age group respectively. Sera samples from confirmed AD patients and healthy control were analysed by mean of ELISA for assessment the concentrations of IL-1β, IL-2, IL-4 and IgE. The study showed that a significant increase (P < 0.05) in IL-1β, IL-4 and IgE levels in the patients compared with the control group in both age groups and gender, while there was no significant difference (P < 0.05) in the concentration of IL-2. The study of pedigree analysis shows the genetic tendency in the frequency of disease depending on the genetic history of family, where more patients returning to families in which both parents or one of them infected with AD, whereas the patients were no parents infected with AD they are suffering from asthma and the disease recurs in their uncles.

Keywords: atopic dermatitis, cytokines, IgE, molecular biology

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Authors: Oljana Hoxhaj

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The integration process of Albania into the European family carries many difficulties. In this context, the Albanian legislator is inclined to implement in the domestic legal framework models which have been successful in other countries. Our paper aims to present an analytical and comparative approach to the health system in Albania and France, mainly focusing on citizen’s access to these services. Different standards and cultures between states, in the context of an approximate model, will be the first challenge of our paper. Over the last few years, the Albanian government has undertaken concrete reforms in this sector, aiming to transform the vision on which the previous health system was structured. In this perspective, the state fulfills not only an obligation to its citizens, but also consolidates progressive steps toward alignment with European Union standards. The necessity to undertake a genuine reform in this area has come as an exigency of society, which has permanently identified problems within this sector, considering it ineffective, out of standards, and corrupt. The inclusion of health services on the Albanian government agenda reflects its will in the function of good governance, transparency, and broadening access to the provision of quality health services in the public and private sectors. The success of any initiative in the health system consists of giving priority to patient needs. Another objective that should be in the state's consideration is to create the premise to provide a comprehensive process on whose foundations partnership and broader co-operation with beneficiary entities are established in any decision-making that is directly related to their interests. Some other important and widespread impacts on the effective realization of citizens' access to the healthcare system coincide with the construction of appropriate infrastructure, increasing the professionalism and qualification of medical staff, and the allocation of a higher budget. France has one of the most effective healthcare models in Europe. That is why we have chosen to analyze this country, aiming to highlight the advantages of this system, as well as the commitment of the French state to drafting effective health policies. In the framework of the process of harmonization of the Albanian legislation with that of the European Union, through our work, we aim to identify the space to implement the whole of these legislative innovations in the Albanian legislation.

Keywords: effective service, harmonization level, innovation, reform

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Authors: Warsi A. Ibrahim, Qureshi A. Ambrina, Younus M. Anjum

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Introduction: Oral lesions related to commercially available Smokeless Tobacco (ST), such as, Pan, Gutka, Mahwa, Naswar is considered a serious challenge for dental health care providers in Pakistan. Majority of labored Pakistani population consume ST, where public transporters and drivers are no exception. It was necessary to identify individuals of this particular population group and screen their oral health and early signs of pre-cancerous lesions so that appropriate preventive measures could be taken to reduce the burden on health providers. Aim of Study: To estimate Prevalence of ST consumption and perception of use, and to evaluate Oral Health status among public drivers of Karachi. Material & methods: A cross-sectional study survey was conducted over duration of 2 months, through convenient sampling. Sample size (n=615) of public drivers (age > 18 years) all over Karachi was gathered. A structured proforma was used to record socio-demographics, addiction profile, perception of use and oral health status (oral lesions, oral sub-mucosal fibrosis and dental caries) of study participants. Data was entered and analyzed using SPSS version 16.0 using descriptive statistics only. Results: Prevalence of ST consumption among the study participants was figured to 92.5%. Out of these almost 70% suffered from one or the other form of oral lesion(s). Four major types of ST consumption were observed out of which 60 % of oral lesion were related to Gutka chewers showing early signs of oral cancer. In addition, occurrence of Oral sub-mucosal fibrosis (OSF) was found to be significantly high around 54.8%. Overall dental caries status was also high, showing on an average 5 teeth of an individual were decayed, missing or filled deviating from WHO normal criteria (mean < 3). It was thus proven from the study that public drivers relied on oral tobacco consumption because it helps them ‘Improve consciousness’ (p-value: < 0.01; using chi-square test). Multivariate analysis showed that there were higher prevalence of smokeless tobacco among highway drivers versus local drivers (A.O.R: 2.82 [0.83-9.61], p-value: < 0.01) Conclusion: Smokeless tobacco (ST) consumption has a direct effect on oral health. However, the type of ST, the duration of consumption are factors which are directly related to the severity. Moreover, Gutka may be considered as having most lethal effects on oral health which may lead to oral cancer and affect individual’s quality of life. Specific preventive programs must be undertaken to reduce the consumption of Gutka among public transporters and drivers.

Keywords: smokeless tobacco, oral lesions, drivers, public transporters

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