Search results for: mental health status

Authors: Ishtiaque Qureshi, Erum Muzaffar

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This study aimed to analyze the causes of non-disclosure of intrafamilial childhood sexual abuse (IFCSA) among survivors studying in higher education institutions in Sindh, Pakistan. Employing a mixed-method approach, the research investigated the reasons behind non-disclosure. A quantitative survey conducted in higher education institutions identified IFCSA victims through purposive sampling, and the causes were assessed through in-depth interviews with 18 respondents. Subsequent analysis of the interview transcripts resulted in the categorization of respondents into three groups: (1) those fearing the consequences of revealing facts to their parents, (2) individuals unwilling to subject their parents to conflict with the perpetrator, and (3) those who could not disclose the abuse due to reasons not understood by them. Correlations among non-disclosing respondents were examined with respect to their socio-economic status, family structure, emotional availability of parents, and parenting style.

Keywords: intrafamilial childhood sexual abuse, non-disclosure, survivors of IFCSA, in-depth interviews

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Authors: Claudia Carbajal, Jija Dutt, Smriti Pahwa, Sumukhi Vaid, Karishma Vats

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ASER Centre, the research and assessment arm of Pratham Education Foundation sees measurement as the first stage of action. ASER uses primary research to push and give empirical foundations to policy discussions at a multitude of levels. At a household level, common citizens use a simple assessment (a floor-level test) to measure learning across rural India. This paper presents the evidence on the applicability of an ASER approach to the health sector. A citizen-led assessment was designed and executed that collected information from young mothers with children up to a year of age. The pilot assessments were rolled-out in two different models: Paid surveyors and student volunteers. The survey covered three geographic areas: 1,239 children in the Jaipur District of Rajasthan, 2,086 in the Rae Bareli District of Uttar Pradesh, and 593 children in the Bhuj Block in Gujarat. The survey tool was designed to study knowledge of health-related issues, daily practices followed by young mothers and access to relevant services and programs. It provides insights on behaviors related to infant and young child feeding practices, child and maternal nutrition and supplementation, water and sanitation, and health services. Moreover, the survey studies the reasons behind behaviors giving policy-makers actionable pathways to improve implementation of social sector programs. Although data on health outcomes are available, this approach could provide a rapid annual assessment of health issues with indicators that are easy to understand and act upon so that measurements do not become an exclusive domain of experts. The results give many insights into early childhood health behaviors and challenges. Around 98% of children are breastfed, and approximately half are not exclusively breastfed (for the first 6 months). Government established diet diversity guidelines are met for less than 1 out of 10 children. Although most households are satisfied with the quality of drinking water, most tested households had contaminated water.

Keywords: citizen-led assessment, rapid health assessment, Infant and Young Children Feeding, water and sanitation, maternal nutrition, supplementation

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Authors: Hale Kirer Silva Lecuna, Beyza Aydin

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Health is one of the main components of human capital and sustainable development, and it is very important for economic growth. Health economics, which is an indisputable part of the science of economics, has five stages in general. These are health and development, financing of health services, economic regulation in the health, allocation of resources and efficiency of health services. A well-developed and efficient health sector plays a major role by increasing the level of development of countries. The most crucial pillars of the health sector are the hospitals that are divided into public and private. The main purpose of the hospitals is to provide more efficient services. Therefore the aim is to meet patients’ satisfaction by increasing the service quality. Health-related studies in Turkey date back to the Ottoman and Seljuk Empires. In the near past, Turkey applied 'Health Sector Transformation Programs' under different titles between 2003 and 2010. Our aim in this paper is to measure how effective these transformation programs are for the health sector, to see how much they can increase the efficiency of hospitals over the years, to see the return of investments, to make comments and suggestions on the results, and to provide a new reference for the literature. Within this framework, the public and private hospitals in Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, Istanbul, Kirklareli, Kocaeli, Sakarya, Tekirdağ, Yalova will be examined by using Data Envelopment Analysis (DEA) for the years between 2000 and 2019. DEA is a linear programming-based technique, which gives relatively good results in multivariate studies. DEA basically estimates an efficiency frontier and make a comparison. Constant returns to scale and variable returns to scale are two most commonly used DEA methods. Both models are divided into two as input and output-oriented. To analyze the data, the number of personnel, number of specialist physicians, number of practitioners, number of beds, number of examinations will be used as input variables; and the number of surgeries, in-patient ratio, and crude mortality rate as output variables. 11 hospitals belonging to the Marmara region were included in the study. It is seen that these hospitals worked effectively only in 7 provinces (Balıkesir, Bilecik, Bursa, Edirne, İstanbul, Kırklareli, Yalova) for the year 2001 when no transformation program was implemented. After the transformation program was implemented, for example, in 2014 and 2016, 10 hospitals (Balıkesir, Bilecik, Bursa, Çanakkale, Edirne, İstanbul, Kocaeli, Kırklareli, Tekirdağ, Yalova) were found to be effective. In 2015, ineffective results were observed for Sakarya, Tekirdağ and Yalova. However, since these values are closer to 1 after the transformation program, we can say that the transformation program has positive effects. For Sakarya alone, no effective results have been achieved in any year. When we look at the results in general, it shows that the transformation program has a positive effect on the effectiveness of hospitals.

Keywords: data envelopment analysis, efficiency, health sector, Marmara region

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Authors: Sumaiya Amir Khan, Shayma Al-Sharif, Samiha Mazher, Neha Intikhab Khan

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This research paper aims to evaluate the effectiveness of sleep-tracking AI applications in smart-watches. It focuses on comparing the sleep analyses of two different smartwatch brands, Samsung and Fitbit, and measuring sleep at three different stages – REM (Rapid-Eye-Movement), NREM (Non-Rapid-Eye-Movement), and deep sleep. The methodology involves the participation of different users and analyzing their sleep data. The results reveal that although light sleep is the longest stage, deep sleep is higher than average in the participants. The study also suggests that light sleep is not uniform, and getting higher levels of deep sleep can prevent debilitating health conditions. Based on the findings, it is recommended that individuals should aim to achieve higher levels of deep sleep to maintain good health. Overall, this research contributes to the growing literature on the effectiveness of sleep-tracking AI applications and their potential to improve sleep quality.

Keywords: sleep tracking, lifestyle, accuracy, health, AI, AI features, ML

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Authors: Kenza Maher, Yahya Zakaria, Noora S. Al-Jaidah

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Temperature is a critical parameter for lithium-ion battery performance, life, and safety. In this study, four commercially available 18650 lithium-ion cells from four different manufacturers are subjected to accelerated cycle aging for up to 500 cycles at two different temperatures (25°C and 45°C). The cells are also calendar-aged at the same temperatures in both charged and discharged states for 6 months to investigate the effect of aging and temperature on capacity fade and state of health. The results showed that all battery cells demonstrated good cyclability and had a good state of health at both temperatures. However, the capacity loss and state of health of these cells are found to be dependent on the cell chemistry and aging conditions, including temperature. Specifically, the capacity loss is found to be higher at the higher aging temperature, indicating the significant impact of temperature on the aging of lithium-ion batteries.

Keywords: lithium-ion battery, aging mechanisms, cycle aging, calendar aging.

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Authors: Beatriz Mella Lira, Karla Yohannessen, Robin Hickman

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The aim of the paper is recognising inequalities through the self-assessment of health-related factors, in the context of daily mobilities in Santiago de Chile. Human capabilities will be used as the theoretical basis for the recognition and assessment of these factors regarding the functioning (what people are currently able to do) and capabilities (what people want to achieve and what is valuable for them), reflecting differences across social groups and among types of transport users. The self-assessment of health-related factors considers perceptions of stress, physical effort, proximity to other transport users, pollution, safety, and comfort. The types of transport users are classified as: private (cars, taxis, colectivos, motos), public (buses and metro) and active (bicycles and walking). The methodology follows a capability-based questionnaire, which was applied in different areas of Santiago de Chile, considering concepts extracted from the human capabilities list. The self-assessment of these health-related factors examines the context of peoples’ mobilities for performing their daily activities, considering socioeconomic differences as income, age, gender, disabilities, residence location and primary mode choice. The paper uses Relative Importance Index (RII) for weighting the relative influence or valuation of the factors. The respondents were asked to rate the importance of each factor on a scale from 1 to 5, in an ascending order of importance. The results suggest that these health-related factors impact not just the perceptions of users, but their well-being and their propensity for achieving their capabilities and the things they value in life. The paper is focused on the development of an applicable approach, measuring factors that should be included in transport project appraisal, as a more comprehensive and complementary method.

Keywords: active transport, health, human capabilities, Santiago de Chile, transport inequalities, transportation planning, urban planning

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Authors: Fatemeh Asadi Farsad, Sima Modirkhameneh

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The purpose of this study was to explore the pattern of Psychological Well-Being (PWB) of Iranian male and female EFL teachers during the pandemic. It was intended to see if such a drastic change in the context and mode of teaching affects teachers' PWB. Furthermore, the possible difference between the six elements of PWB of Iranian EFL male vs. female teachers during the pandemic was investigated. The other purpose was to find out the EFL teachers’ perceptions of any modifications, and factors leading to such modifications in their PWB during pandemic. For the purpose of this investigation, a total of 81 EFL teachers (59 female, 22 male) with an age range of 25 to 35 were conveniently sampled from different cities in Iran. Ryff’s PWB questionnaire was sent to participant teachers through online platforms to elicit data on their PWB. As for their perceptions on the possible modifications and the factors involved in PWB during pandemic, a set of semi-structured interviews were run among both sample groups. The findings revealed that male EFL teachers had the highest mean on personal growth, followed by purpose of life, and self-acceptance and the lowest mean on environmental mastery. With a slightly similar pattern, female EFL teachers had the highest mean on personal growth, followed by purpose in life, and positive relationship with others with the lowest mean on environmental mastery. However, no significant difference was observed between the male and female groups’ overall means on elements of PWB. Additionally, participants perceived that their anxiety level in online classes altered due to factors like (1) Computer literacy skills, (2) Lack of social communications and interactions with colleagues and students, (3) Online class management, (4) Overwhelming workloads, and (5) Time management. The study ends with further suggestions as regards effective online teaching preparation considering teachers PWB, especially at severe situations such as covid-19 pandemic. The findings offer to determine the reformations of educational policies concerning enhancing EFL teachers’ PWB through computer literacy courses and stress management courses. It is also suggested that to proactively support teachers’ mental health, it is necessary to provide them with advisors and psychologists if possible for free. Limitations: One limitation is the small number of participants (81), suggesting that future replications should include more participants for reliable findings. Another limitation is the gender imbalance, which future studies should address to yield better outcomes. Furthermore, Limited data gathering tools suggest using observations, diaries, and narratives for more insights in future studies. The study focused on one model of PWB, calling for further research on other models in the literature. Considering the wide effect of the COVID-19 pandemic, future studies should consider additional variables (e.g., teaching experience, age, income) to understand Iranian EFL teachers’ vulnerabilities and strengths better.

Keywords: online teaching, psychological well-being, female and male EFL teachers, pandemic

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Authors: Mohammad Ibrahim Alladin

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The Pedagogy of the Oppressed by Paulo Freire was first published in 1970. Since its publication it has become one of most cited book in the social sciences. Over a million copies have been sold worldwide. The Pedagogy of the Oppressed by Paulo Freire was published in 1970 (New York: Herder and Herder), The book has caused a “revolution” in the education world and his theory has been examined and analysed. It has influenced educational policy, curriculum development and teacher education. The revolution started half a century ago. “Paolo Freire’s Pedagogy of the Oppressed develops a theory of education fitted to the needs of the disenfranchised and marginalized members of capitalist societies. Combining educational and political philosophy, the book offers an analysis of oppression and a theory of liberation. Freire believes that traditional education serves to support the dominance of the powerful within society and thereby maintain the powerful’s social, political, and economic status quo. To overcome the oppression endemic to an exploitative society, education must be remade to inspire and enable the oppressed in their struggle for liberation. This new approach to education focuses on consciousness-raising, dialogue, and collaboration between teacher and student in the effort to achieve greater humanization for all. For Freire, education is political and functions either to preserve the current social order or to transform it. The theories of education and revolutionary action he offers in Pedagogy of the Oppressed are addressed educators committed to the struggle for liberation from oppression. Freire’s own commitment to this struggle developed through years of teaching literacy to Brazilian and Chilean peasants and laborers. His efforts at educational and political reform resulted in a brief period of imprisonment followed exile from his native Brazil for fifteen years. In Pedagogy of the Oppressed begins Freire asserts the importance of consciousness-raising, or conscientização, as the means enabling the oppressed to recognize their oppression and commit to the effort to overcome it, taking full responsibility for themselves in the struggle for liberation. He addresses the “fear of freedom,” which inhibits the oppressed from assuming this responsibility. He also cautions against the dangers of sectarianism, which can undermine the revolutionary purpose as well as serve as a refuge for the committed conservative. Freire provides an alternative view of education by attacking tradition education and knowledge. He is highly critical of how is imparted and how knowledge is structured that limits the learner’s thinking. Hence, education becomes oppressive and school functions as an institution of social control. Since its publication, education has gone through a series of reforms and in some areas total transformation. This paper addresses the following: The role of education in social transformation The teacher/learner relationship :Critical thinking The paper essentially examines what happened in the last fifty years since Freire’s book. It seeks to explain what happened to Freire’s education revolution, and what is the status of the movement that started almost fifty years ago.

Keywords: pedagogy, reform, curriculum, teacher education

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Authors: Vardan Melkonyan, Arman Azizyan, Astghik Boyajyan

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Virtual reality (VR) exposure therapy is a form of cognitive-behavioral therapy that uses immersive virtual environments to expose individuals to the feared stimuli or situations that trigger their phobia. VR exposure therapy has become an increasingly popular treatment for phobias, including fear of heights, public speaking, and flying, due to its ability to provide a controlled and safe environment for individuals to confront their fears while also allowing therapists to tailor the virtual exposure to the specific needs and goals of each individual. It is also a cost-effective and accessible treatment option, as it can be delivered remotely and does not require the use of drugs. Overall, VR exposure therapy has the potential to be a valuable tool for therapists in the treatment of phobias. But current methods may be improved by incorporating advanced technology such as photorealistic VR environments, tactile feedback suits, and responsive systems. The aim of this study was to identify the most effective approach for enhancing VR exposure therapy for the treatment of phobias. Photorealistic VR environments and stimuli can greatly enhance the effectiveness of VR exposure therapy for the treatment of phobias. By creating immersive, realistic virtual environments that closely mimic the real-life situations that trigger phobia responses, patients are able to more fully engage in the therapeutic process and confront their fears in a controlled and safe manner. This can help to reduce the severity of phobia symptoms and increase treatment outcomes. The use of tactile feedback suits and responsive systems can further enhance the VR exposure therapy experience by adding a physical element to the virtual environment. These suits, which can mimic the sensations of touch, pressure, and movement, allow patients to fully immerse themselves in the virtual world and feel as if they are physically present in the situation. This can help to increase the realism of the virtual environment and make it more effective in reducing phobia symptoms. Additionally, responsive systems can be used to trigger specific events or responses within the virtual environment based on the patient's actions, providing a more interactive and personalized treatment experience. A comprehensive literature review was conducted, including studies on VR exposure therapy for phobias and the use of advanced technology to enhance the therapy. Results indicate that incorporating these enhancements may significantly increase the effectiveness of VR exposure therapy for phobias. Further research is needed to fully understand the potential of these enhancements and to determine the optimal combination and implementation.

Keywords: virtual reality, mental health, phobias, fears, treatment, photorealistic, immersive, phobia

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Authors: A. Saghatelyan, Sh. Asmaryan, G. Tepanosyan, V. Muradyan

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One of major concern to Armenia has been soil degradation emerged as a result of unsustainable management and use of grasslands, this in turn largely impacting environment, agriculture and finally human health. Hence, assessment of soil degradation is an essential and urgent objective set out to measure its possible consequences and develop a potential management strategy. Since recently, an essential tool for assessing pasture degradation has been remote sensing (RS) technologies. This research was done with an intention to measure preciseness of Linear spectral unmixing (LSU) and NDVI-SMA methods to estimate soil surface components related to degradation (fractional vegetation cover-FVC, bare soils fractions, surface rock cover) and determine appropriateness of these methods for mapping man-induced soil degradation in high mountain pastures. Taking into consideration a spatially complex and heterogeneous biogeophysical structure of the studied site, we used high resolution multispectral QuickBird imagery of a pasture site in one of Armenia’s rural communities - Nerkin Sasoonashen. The accuracy assessment was done by comparing between the land cover abundance data derived through RS methods and the ground truth land cover abundance data. A significant regression was established between ground truth FVC estimate and both NDVI-LSU and LSU - produced vegetation abundance data (R2=0.636, R2=0.625, respectively). For bare soil fractions linear regression produced a general coefficient of determination R2=0.708. Because of poor spectral resolution of the QuickBird imagery LSU failed with assessment of surface rock abundance (R2=0.015). It has been well documented by this particular research, that reduction in vegetation cover runs in parallel with increase in man-induced soil degradation, whereas in the absence of man-induced soil degradation a bare soil fraction does not exceed a certain level. The outcomes show that the proposed method of man-induced soil degradation assessment through FVC, bare soil fractions and field data adequately reflects the current status of soil degradation throughout the studied pasture site and may be employed as an alternate of more complicated models for soil degradation assessment.

Keywords: Armenia, linear spectral unmixing, remote sensing, soil degradation

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Authors: Minna Pikkarainen, Yueqiang Xu

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The integration of digital technology with existing healthcare processes has been painfully slow, a huge gap exists between the fields of strictly regulated official medical care and the quickly moving field of health and wellness technology. We claim that the promises of preventive healthcare can only be fulfilled when this gap is closed – health care and self-care becomes seamless continuum “correct information, in the correct hands, at the correct time allowing individuals and professionals to make better decisions” what we call connected health approach. Currently, the issues related to security, privacy, consumer consent and data sharing are hindering the implementation of this new paradigm of healthcare. This could be solved by following MyData principles stating that: Individuals should have the right and practical means to manage their data and privacy. MyData infrastructure enables decentralized management of personal data, improves interoperability, makes it easier for companies to comply with tightening data protection regulations, and allows individuals to change service providers without proprietary data lock-ins. This paper tackles today’s unprecedented challenges of enabling and stimulating multiple healthcare data providers and stakeholders to have more active participation in the digital health ecosystem. First, the paper systematically proposes the MyData approach for healthcare and preventive health data ecosystem. In this research, the work is targeted for health and wellness ecosystems. Each ecosystem consists of key actors, such as 1) individual (citizen or professional controlling/using the services) i.e. data subject, 2) services providing personal data (e.g. startups providing data collection apps or data collection devices), 3) health and wellness services utilizing aforementioned data and 4) services authorizing the access to this data under individual’s provided explicit consent. Second, the research extends the existing four archetypes of orchestrator-driven healthcare data business models for the healthcare industry and proposes the fifth type of healthcare data model, the MyData Blockchain Platform. This new architecture is developed by the Action Design Research approach, which is a prominent research methodology in the information system domain. The key novelty of the paper is to expand the health data value chain architecture and design from centralization and pseudo-decentralization to full decentralization, enabled by blockchain, thus the MyData blockchain platform. The study not only broadens the healthcare informatics literature but also contributes to the theoretical development of digital healthcare and blockchain research domains with a systemic approach.

Keywords: blockchain, health data, platform, action design

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Authors: Ayodele E. Ikudayisi, Yomi M. D. Adedeji, Olumuyiwa B. Adegun

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The level of adoption of green building (GB) schemes in Nigeria is low. The prevailing focus on economic development has overshadowed sustainability concerns. Despite these, few project cases exist in Nigeria in which sustainability goals have been achieved. This study aims to draw lessons from these in order to understand the project attributes, certification status, and the delivery process. Through an exploratory case study approach, fifteen project cases across five cities in Nigeria were examined. These represent the first-generation of green buildings in Nigeria, a verifiable reference for future initiatives in Sub-Saharan Africa. From the result, three categories of green buildings were identified, namely certified projects, demonstration projects, and potential projects with varying delivery attributes. Then, it is concluded by setting research and practice agenda towards aligning Nigeria’s building industry with the global trends in sustainable building delivery.

Keywords: LEED, green building, Nigeria, project attributes

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Authors: Adaobi Anakwe, Wilson Majee, Kari White, Rhonda BeLue

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Background: Black men in the U.S. have overall poorer health, are more likely to experience unintended pregnancies, and have pregnancies (with their partner) at younger ages than other racial/ethnic groups. These factors increase the likelihood that pregnancies among Black fathers will occur at suboptimal paternal health. Although several community-based programs exist to support low-income Black fathers’ involvement with their families, little is known about the sexual and reproductive health, and family planning needs of fathers enrolled in these programs. The objective of this study was to quantitatively examine the relationship between Black fathers’ fertility desires and pregnancy prevention strategies and qualitatively explore the nuances of this relationship. Methods: A concurrent mixed-methods approach was used to survey 36 and interview 13 Black fathers from low-income backgrounds, who were participating in a community-based fatherhood program in a Midwestern urban area. Fathers in this study were ≥18 years old with at least one child. Differences between groups were compared using Fisher’s Exact tests and thematic analyses to examine the relationship between participants' fertility desires and reproductive planning practices. Results: Participants had a median age of 33 years, and 72% were non-residential biological parents. About 40% of men desired pregnancy, and 69% reported they or their partner always used contraception. In bivariate analysis, participants’ fertility desires were not associated with pregnancy prevention (p=0.251). Although most interview participants desired pregnancies, several factors contributed to their ability to plan for a pregnancy. Men felt that using contraception to prevent pregnancies was dependent on navigating trust with a partner. Health before pregnancy and financial stability were also important. Overall, participants thought that using an adult mindset, in which they considered the consequences of unprotected sex, was key to family planning. Conclusion: Black fathers may not desire pregnancy and consider a variety of factors, but this does not always result in active pregnancy prevention/contraceptive use. Community-based organizations already working with Black fathers can be leveraged to increase reproductive health awareness and facilitate reproductive planning for fathers.

Keywords: reproductive planning, reproductive health, preconception health, Black fathers, fertility desires, pregnancy

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Authors: Ledi Neçaj

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Objectives: The target of this paper is (1) to explain objectively physical activity model throughout three chronic cardiopulmonary conditions, and (2) to study the connection among physical activity dimensions with disease severity, self-reported physical and emotional functioning, and exercise performance. Material and Methods: This is a cross-sectional study of patients in their domestic environment. Patients with cardiopulmonary diseases were: chronic obstructive pulmonary disease (COPD), (n-63), coronary heart failure (n=60), and patients with implantable cardioverter defibrillator (n=60). Main results measures: Seven ambulatory physical activity dimensions (total steps, percentage time active, percentage time ambulating at low, medium, and hard intensity, maximum cadence for 30 non-stop minutes, and peak performance) have been measured with an accelerometer. Results: Subjects with COPD had the lowest amount of ambulatory physical activity compared with topics with coronary heart failure and cardiac dysrhythmias (all 7 interest dimensions, P<.05); total step counts have been: 5319 as opposed to 7464 as opposed to 9570, respectively. Six-minute walk distance becomes correlated (r=.44-.65, P<.01) with all physical activity dimensions inside the COPD pattern, the most powerful correlations being with total steps and peak performance. In topics with cardiac impairment, maximal oxygen intake had the most effective small to slight correlations with five of the physical activity dimensions (r=.22-.40, P<.05). In contrast, correlations among 6-minute walk test distance and physical activity have been higher (r=.48-.61, P<.01) albeit in a smaller pattern of most effective patients with coronary heart failure. For all three samples, self-reported physical and mental health functioning, age, frame mass index, airflow obstruction, and ejection fraction had both exceptionally small and no significant correlations with physical activity. Conclusions: Findings from this study present a profitable benchmark of physical activity patterns in individuals with cardiopulmonary diseases for comparison with future studies. All seven dimensions of ambulatory physical activity have disfavor between subjects with COPD, heart failure, and cardiac dysrhythmias. Depending on the research or clinical goal, the use of one dimension, such as total steps, may be sufficient. Although physical activity had high correlations with performance on a six-minute walk test relative to other variables, accelerometers-based physical activity monitoring provides unique, important information about real-world behavior in patients with cardiopulmonary not already captured with existing measures.

Keywords: ambulatory physical activity, walking, monitoring, COPD, heart failure, implantable defibrillator, exercise performance

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Authors: Zakia Fatima, Liu Lu, Donghao Li

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The analysis of biological fluid metabolites holds significant importance in various areas, such as medical research, food science, and public health. Investigating the levels and distribution of nutrients and their metabolites in biological samples allows researchers and healthcare professionals to determine nutritional status, find hypovitaminosis or hypervitaminosis, and monitor the effectiveness of interventions such as dietary supplementation. Moreover, analysis of nutrient metabolites provides insight into their metabolism, bioavailability, and physiological processes, aiding in the clarification of their health roles. Hence, the exploration of a distinct, efficient, eco-friendly, and simpler methodology is of great importance to evaluate the metabolic content of complex biological samples. In this work, a green and rapid analytical method based on an automated online two-dimensional microscale carbon fiber/activated carbon fiber fractionation system and time-of-flight mass spectrometry (2DμCFs-TOF-MS) was used to evaluate metabolites of urine samples after oral administration of food supplements. The automated 2DμCFs instrument consisted of a microcolumn system with bare carbon fibers and modified carbon fiber coatings. Carbon fibers and modified carbon fibers exhibit different surface characteristics and retain different compounds accordingly. Three kinds of mobile-phase solvents were used to elute the compounds of varied chemical heterogeneities. The 2DμCFs separation system has the ability to effectively separate different compounds based on their polarity and solubility characteristics. No complicated sample preparation method was used prior to analysis, which makes the strategy more eco-friendly, practical, and faster than traditional analysis methods. For optimum analysis results, mobile phase composition, flow rate, and sample diluent were optimized. Water-soluble vitamins, fat-soluble vitamins, and amino acids, as well as 22 vitamin metabolites and 11 vitamin metabolic pathway-related metabolites, were found in urine samples. All water-soluble vitamins except vitamin B12 and vitamin B9 were detected in urine samples. However, no fat-soluble vitamin was detected, and only one metabolite of Vitamin A was found. The comparison with a blank urine sample showed a considerable difference in metabolite content. For example, vitamin metabolites and three related metabolites were not detected in blank urine. The complete single-run screening was carried out in 5.5 minutes with the minimum consumption of toxic organic solvent (0.5 ml). The analytical method was evaluated in terms of greenness, with an analytical greenness (AGREE) score of 0.72. The method’s practicality has been investigated using the Blue Applicability Grade Index (BAGI) tool, obtaining a score of 77. The findings in this work illustrated that the 2DµCFs-TOF-MS approach could emerge as a fast, sustainable, practical, high-throughput, and promising analytical tool for screening and accurate detection of various metabolites, pharmaceuticals, and ingredients in dietary supplements as well as biological fluids.

Keywords: metabolite analysis, sustainability, carbon fibers, urine.

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Authors: Abigail Qian Zhou

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In today's China, the well-educated middle class, with stable jobs and above-average income, are the driving force behind its Internet society. Through the analysis of data from the 2015 Chinese General Social Survey and 50 interviewees, this study investigates the current situation of this group’s specific internet usage. The findings of this study demonstrate that daily life among the members of this socioeconomic group is closely tied to the Internet. For Chinese middle class, the Internet is used to socialize and entertain self and others. It is also used to search for and share information as well as to build their identities. The empirical results of this study will provide a reference, supported by factual data, for enterprises seeking to target the Chinese middle class through online marketing efforts.

Keywords: middle class, Internet use, network behaviour, online marketing, China

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Authors: Diana Peninger

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Over 10% of couples in the U.S. have infertility problems, with roughly 40% traceable to the male partner. Yet, little attention has been given to improving men’s contribution to the conception process. One solution that is showing promise in increasing conception rates for IVF and other assisted reproductive technology treatments is a first-of-its-kind semen collection that has been engineered to mitigate sperm damage caused by traditional collection methods. Patients are able to collect semen at home and deliver to clinics within 48 hours for use in fertility analysis and treatment, with less stress and improved specimen viability. This abstract will share these findings along with expert insight and tips to help attendees understand the key role sperm collection plays in addressing and treating reproductive issues, while helping to improve patient outcomes and success. Our research was to determine if male reproductive outcomes can be increased by improving sperm specimen health with a focus on technology. We utilized a redesigned semen collection cup (patented as the Device for Improved Semen Collection/DISC—U.S. Patent 6864046 – known commercially as a ProteX) that met a series of physiological parameters. Previous research demonstrated significant improvement in semen perimeters (motility forward, progression, viability, and longevity) and overall sperm biochemistry when the DISC is used for collection. Animal studies have also shown dramatic increases in pregnancy rates. Our current study compares samples collected in the DISC, next-generation DISC (DISCng), and a standard specimen cup (SSC), dry, with the 1 mL measured amount of media and media in excess ( 5mL). Both human and animal testing will be included. With sperm counts declining at alarming rates due to environmental, lifestyle, and other health factors, accurate evaluations of sperm health are critical to understanding reproductive health, origins, and treatments of infertility. An increase in the health of the sperm as measured by extensive semen parameter analysis and improved semen parameters stable for 48 hours, expanding the processing time from 1 hour to 48 hours were also demonstrated.

Keywords: reprodutive, sperm, male, infertility

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Authors: Asmit Neupane, Narayan Prasad Gautam, Prabin Bhusal

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Indian pangolin, locally called as ‘Salak’, ‘Sal machha’, ‘Pakho machha’, is a globally endangered species, nationally categorized as a critically endangered species, protected under the National Parks and Wildlife Conservation (NPWC) Act 1973 and appended in Appendix I of CITES. Indian pangolins occur in the tropical areas of Terai region and Chure foothills of eastern Nepal, and India, Bangladesh, Pakistan, and Sri Lanka. They utilize a wide range of habitats, including primary and secondary tropical forest, limestone forest, bamboo forest, grassland, and agricultural lands. So, in regard to this fact, this research is aimed to provide detailed information regarding the current distribution pattern, status, habitat preference, prevailing threats and attitude of local people towards species conservation in Madhesh Province, Nepal. The study was conducted in four CFs, two from Bara district and two from Dhanusha district. The study area comprised of Churia range and foothills with tropical and sub-tropical vegetation. A total of 24 transects were established, each of 500*50 m2, where indirect signs of Indian pangolin, including active/old burrows, pugmarks and scratches, were found. Altogether 93 burrows were found, where only 20 were active burrows. Similarly, a vegetation survey and social survey was also conducted. The data was analyzed using Stata 16 and SPSS software. Distance from settlement, ground cover, aspect, presence/absence of ants/termites and human disturbance were the important habitat parameters having statistically significant relationship with the distribution of Indian pangolin in the area. The species was found to prefer an elevation of 360 to 540m, 0-15º slope, red soil, North-east aspect, moderate crown and ground cover, without fire and rocks, vicinity of water, roads, settlement, Sal dominated forest and minimum disturbed by human activities. Similarly, the attitude of local people towards Indian pangolin conservation was found to be significantly different with respect to age, sex and education level. The study concludes that majority of active burrows were found in Churia hills, which indicates that Indian pangolin population is gradually moving uphill towards higher elevation as hilly area supports better prey availability and also less human disturbance. Further studies are required to investigate microhabitat preferences, seasonal variability and impacts of climate change on the distribution, habitat and prey availability of Indian pangolin for the sustainable conservation of this species.

Keywords: conservation, IUCN red list, local participation, small mammal, status, threats

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Authors: E. Bennion, A. Acharya, S. Barnes, D. Ferrell, S. Luckett-Cole, G. Mower, J. Nelson, Y. Nguyen

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Objective: This study aimed to evaluate the validity of a firearm injury query in the Early Notification of Community-based Epidemics syndromic surveillance system. Syndromic surveillance data are used at the Utah Department of Health for early detection of and rapid response to unusually high rates of violence and injury, among other health outcomes. The query of interest was defined by the Centers for Disease Control and Prevention and used chief complaint and discharge diagnosis codes to capture initial emergency department encounters for firearm injury of all intents. Design: Two epidemiologists manually reviewed electronic health records of emergency department visits captured by the query from April-May 2020, compared results, and sent conflicting determinations to two arbiters. Results: Of the 85 unique records captured, 67 were deemed probable, 19 were ruled out, and two were undetermined, resulting in a positive predictive value of 75.3%. Common reasons for false positives included non-initial encounters and misleading keywords. Conclusion: Improving the validity of syndromic surveillance data would better inform outbreak response decisions made by state and local health departments. The firearm injury definition could be refined to exclude non-initial encounters by negating words such as “last month,” “last week,” and “aftercare”; and to exclude non-firearm injury by negating words such as “pellet gun,” “air gun,” “nail gun,” “bullet bike,” and “exit wound” when a firearm is not mentioned.

Keywords: evaluation, health information system, firearm injury, syndromic surveillance

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Authors: Wanchak Noichan, Phakchira Noichan, Nuntiya Noichun

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The objectives of this research were 1) to study the level of community engagement, 2) to compare community engagement level of motorcycle taxi drivers in Bangkok, Thailand, classified by personal factors. The sample population of this study was 400 motorcycle taxi drivers in Bangkok, Thailand, using the unknown size method of W. G. Cochran's population. The sample was chosen by probability-based randomization. A study using quantitative methods (quantitative research) use the research tools as a questionnaire. The statistics used in the research were the mean, standard deviation, t-test, and F-Test (One-Way ANOVA). The study found that (1) the sample groups have a high level of community engagement (x̄=3.65, S.D.=0.735). (2) The sample groups with different ages, education, status, and income have different levels of community commitment with statistical significance at the level of 0.05.

Keywords: community engagement, motorcycle taxi drivers, Bangkok, Thailand

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Authors: Leslie M. Gutman

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Conduct problems (CP) represent a major dilemma, with wide-ranging and long-lasting individual and societal impacts. Children experience heterogeneous patterns of conduct problems; based on the age of onset, developmental course and related risk factors from around age 3. Early childhood represents a potential window for intervention efforts aimed at changing the trajectory of early starting conduct problems. Using the UK Millennium Cohort Study (n = 17,206 children), this study (a) identifies trajectories of conduct problems from ages 3 to 14 years and (b) assesses the cumulative and interactive effects of individual, family and socioeconomic risk factors from ages 9 months to 14 years. The same factors according to three domains were assessed, including child (i.e., low verbal ability, hyperactivity/inattention, peer problems, emotional problems), family (i.e., single families, parental poor physical and mental health, large family size) and socioeconomic (i.e., low family income, low parental education, unemployment, social housing). A cumulative risk score for the child, family, and socioeconomic domains at each age was calculated. It was then examined how the cumulative risk scores explain variation in the trajectories of conduct problems. Lastly, interactive effects among the different domains of cumulative risk were tested. Using group-based trajectory modeling, four distinct trajectories were found including a ‘low’ problem group and three groups showing childhood-onset conduct problems: ‘school-age onset’; ‘early-onset, desisting’; and ‘early-onset, persisting’. The ‘low’ group (57% of the sample) showed a low probability of conducts problems, close to zero, from 3 to 14 years. The ‘early-onset, desisting’ group (23% of the sample) demonstrated a moderate probability of CP in early childhood, with a decline from 3 to 5 years and a low probability thereafter. The ‘early-onset, persistent’ group (8%) followed a high probability of conduct problems, which declined from 11 years but was close to 70% at 14 years. In the ‘school-age onset’ group, 12% of the sample showed a moderate probability of conduct problems from 3 and 5 years, with a sharp increase by 7 years, increasing to 50% at 14 years. In terms of individual risk, all factors increased the likelihood of being in the childhood-onset groups compared to the ‘low’ group. For cumulative risk, the socioeconomic domain at 9 months and 3 years, the family domain at all ages except 14 years and child domain at all ages were found to differentiate childhood-onset groups from the ‘low’ group. Cumulative risk at 9 months and 3 years did not differentiate between the ‘school-onset’ group and ‘low’ group. Significant interactions were found between the domains for the ‘early-onset, desisting group’ suggesting that low levels of risk in one domain may buffer the effects of high risk in another domain. The implications of these findings for preventive interventions will be highlighted.

Keywords: conduct problems, cumulative risk, developmental trajectories, early childhood, adolescence

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Authors: Anne Giles

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Humans naturally wish they could forget traumatic experiences. To help prevent future harm, however, the human brain has evolved to retain data about experiences of threat, alarm, or violation. When given compassionate support and assistance with thinking helpfully and realistically about traumatic events, most people can adjust to experiencing hardships, albeit with residual sad, unfortunate memories. Persistent, recurrent, intrusive memories, difficulty sleeping, emotion dysregulation, and avoidance of reminders, however, may be symptoms of Post-traumatic Stress Disorder (PTSD). Brain scans show that PTSD affects brain functioning. We currently have no physical means of restoring the system of brain structures and functions involved with PTSD. Medications may ease some symptoms but not others. However, forms of "talk therapy" with cognitive components have been found by researchers to reduce, even resolve, a broad spectrum of trauma symptoms. Many cultures have taboos against talking about hardships. Individuals may present themselves to mental health care professionals with severe, disabling trauma symptoms but, because of cultural norms, be unable to speak about them. In China, for example, relationship expectations may include the belief, "Bad things happening in the family should stay in the family (jiāchǒu bùkě wàiyán 家丑不可外扬)." The concept of "family (jiā 家)" may include partnerships, close and extended families, communities, companies, and the nation itself. In contrast to many trauma therapies, Cognitive Processing Therapy (CPT) for Post-traumatic Stress Disorder asks its participants to focus not on "what" happened but on "why" they think the trauma(s) occurred. The question "why" activates and exercises cognitive functioning. Brain scans of individuals with PTSD reveal executive functioning portions of the brain inadequately active, with emotion centers overly active. CPT conceptualizes PTSD as a network of cognitive distortions that keep an individual "stuck" in this under-functioning and over-functioning dynamic. Through asking participants forms of the question "why," plus offering a protocol for examining answers and relinquishing unhelpful beliefs, CPT assists individuals in consciously reactivating the cognitive, executive functions of their brains, thus restoring normal functioning and reducing distressing trauma symptoms. The culturally sensitive components of CPT that allow people to "talk about it without talking about it" may offer the possibility for worldwide relief from symptoms of trauma.

Keywords: cognitive processing therapy (CPT), cultural norms, post-traumatic stress disorder (PTSD), trauma recovery

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Authors: Mohammad Ashraful Alam, Biro Judit

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Fear of gender-based crime and fear of crime victimization for women is a major concern in the urban areas of Bangladesh. Based on the recent data from various human rights organizations and international literature the study found that gender-based crime especially sexual assault and rape are increasing in Bangladesh at a significant rate in comparison to other countries. The major focus of the study was to identify the relationship between fear of gender-based crime and women empowerment. To explore the fact the study followed the mixed methodological approach comprising with quantitative and qualitative methods and used secondary information from national and international sources. Corresponding global pictures the present study found that gender, age, complexion, social position, and ethnicity were more common factors of sexual assault and victimization in Bangladesh which lead to women become more fearful about crime victimization than men. Fear of gender-based crime traumatizes women which leads to withdrawal of their non-essential everyday works and some time from the essential works based on their social position, financial status, and social honor in the society. The increasing crime rate also increases the propensity to fear of criminal victimization, traumatization, and feeling of helplessness which make them vulnerable. The patriarchal culture and practices in Bangladesh based on religious culture and established social norms women always feel defenseless therefore they withdraw themselves from various social activities and own interest. Women who have already victimized feel more fear and become traumatized, and who do not victimize yet but know the severity of victimization from the media and others’ have the feeling of fear of crime. Women who find themselves as weak bonding and low networks with their neighbors and living for a short duration have a feeling of more fear and avoid visiting a certain place in a certain time and avoid some social activities. The study found the young women have more possibilities to become victimized through the feeling of fear of crime is higher among elderly women than young. Though women feel fear of all kinds of crime but usually all aged women are more fearful of sexual assault and rape than other violent crimes. Therefore, elderly women and another person in the family does not allow younger girls to go and involve outside activities to secure their family status. On the other hand, fear of crime in public transport is more common to all aged women at a higher level and sometimes they compromise their freedom, independence, financial opportunities, the job only to avoid the perceived threat, and save their social and cultural honor. The study also explores that fear of crime does not always depend on crime rate but the crime news, the severity of the crime, delay justice, the ineffectiveness of police, bail of criminals, corruption and political favoritism, etc. Finally, the study shows that the fear of gender-based crime and violence is working as a potential barrier to ensuring women's empowerment in Bangladesh.

Keywords: compromise personal freedom, fear of crime, fear of gender-based crime, fear of violent crime victimization, rape, sexual assaults, withdrawal from regular activities, women empowerment

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Authors: Ismail Becenen

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Air pollution, a consequence of urbanization brought about by modern life, is as global as it is local and regional. Because of the adverse effects of air pollution on human health, air quality is given importance all over the world. According to the decision of the World Health Organization, clean air is the basic necessity for human health and well-being. It poses a very high risk especially for heart diseases and stroke cases. In this study, the positive effects of natural gas usage on air pollution in cities are explained by using literature scans and air pollution measurement values. Natural gas is cleaner than other types of fuel. It contains less sulfur and organic sulfur compounds. When natural gas burns, it does not leave ashes, it does not cause problems in the rubbish mountains. It's a clean fuel, it easily burns and shines. It is a burning gas that is easy and efficient. In addition, there is not a toxic effect for people in case of inhalation. As a result, the use of natural gas needs to be widespread to reduce air pollution around the world in order to provide a healthier life for people and the environment.

Keywords: natural gas, air pollution, sulfur dioxide, particulate matter, energy

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Authors: Ayesha Inam, R. Moazzam, Z. Akhtar

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School readiness plays a significant role in helping a child deal with various school demands and expectations as well as in determining academic success outcomes. There is a scarcity of data concerning the condition of school readiness in Pakistan. This qualitative research seeks to examine the perspective of mothers about school readiness along with its four domains (self-care, socio-emotional, physical and cognitive) as well as about the appropriate age of entry into formal preschool. Fifteen interviews were conducted with mothers of pre-school children in Islamabad and Rawalpindi. It was found that mothers shared the common perception that children should be socially, emotionally, physically and cognitively prepared to be ready for pre-school. The results concluded that the mothers unanimously agreed in their perceptions that three to four years was the appropriate age range for children to begin pre-school and that early or late entry into pre-school had negative implications for children’s ability to learn and understand, and hence, their school readiness. Mental age was perceived as a more important criterion for deciding when to send children to pre-school. Mothers were found to send their children to school earlier, and children were found to be increasingly exposed to technology, both of which were found to influence children’s readiness for school. Both schools and mothers were found to play an instrumental role in preparing children for school and in school adjustment by nurturing their skills and abilities.

Keywords: perception of mothers, Pakistan, school readiness, entry to preschool

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Authors: Chinasa U. Imo, Queen Chikwendu, Jonathan Ajuma, Mario Banuelos

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Background: Sociocultural norms primarily influence the health-seeking behavior of populations in rural communities. In the Nkporo community, Abia State, Nigeria, their sociocultural perception of diseases runs counter to biomedical definitions, wherein they rely heavily on traditional medicine and practices. In a state where birth asphyxia and sepsis account for the significant causes of death for neonates, malaria leads to the causes of other mortalities, followed by common preventable diseases such as diarrhea, pneumonia, acute respiratory tract infection, malnutrition, and HIV/AIDS. Most local mothers attribute their health conditions and that of their children to witchcraft attacks, the hand of God, and ancestral underlining. This influences how they see antenatal and postnatal care, choice of place of accessing care and birth delivery, response to children's illnesses, immunization, and nutrition. Method: To implement a community health improvement program, we adopted an asset-based community development model to address health's normative and social determinants. The first step was to use a qualitative approach to conduct a community health needs baseline assessment, involving focus group discussions with twenty-five (25) youths aged 18-25, semi-structured interviews with ten (10) officers-in-charge of primary health centers, eight (8) ward health committee members, and nine (9) community leaders. Secondly, we designed an intervention program. Going forward, we will proceed with implementing and evaluating this program. Result: The priority needs identified by the communities were malaria, lack of clean drinking water, and the need for behavioral change information. The study also highlighted the significant influence of youths on their peers, family, and community as caregivers and information interpreters. Based on the findings, the NGO SieDi-Hub collaborated with the Abia State Ministry of Health, the State Primary Healthcare Agency, and Empower Next Generations to design a one-year "Community Health Youth Champions Pilot Program." Twenty (20) youths in the community were trained and equipped to champion a participatory approach to bridging the gap between access and delivery of primary healthcare, to adjust sociocultural norms to improve health equity for people in Nkporo community – with limited education, lack of access to health information, and quality healthcare facilities using an innovative community-led improvement approach. Conclusion: Youths play a vital role in achieving health equity, being a vulnerable population with significant influence. To ensure effective primary healthcare, strategies must include cultural humility. The asset-based community development model offers valuable tools, and this article will share ongoing lessons from the intervention's behavioral change strategies with young people.

Keywords: asset-based community development, community health, primary health systems strengthening, youth empowerment

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Authors: Babak Nemat

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Background and Purpose: Non-alcoholic fatty liver is one of the most common liver disorders, which, as the most important cause of death from liver disease, has unpleasant consequences and complications. The aim of this study was to investigate the effect of an educational intervention based on a health belief model to prevent non-alcoholic fatty liver among women. Materials and Methods: This experimental study was performed among 110 women referring to comprehensive health service centers in Malayer City, west of Iran, in 2023. Using the available sampling method, 110 participants were divided into experimental and control groups. The data collection tool included demographic characteristics and a questionnaire based on the health belief model. In the experimental group, three one-hour training sessions were conducted in the form of pamphlets, lectures, and group discussions. Data were analyzed using SPSS software version 21, by correlation tests, paired t-tests, and independent t-tests. Results: The mean age of participants was 38.07±6.28 years, and most of the participants were middle-aged, married, housewives with academic education, middle-income, and overweight. After the educational intervention, the mean scores of the constructs include perceived sensitivity (p=0.01), perceived severity (p=0.01), perceived benefits (p=0.01), guidance for internal (p=0.01), and external action (p=0.01), and perceived self-efficacy (p=0.01) in the experimental group were significantly higher than the control group. The score of perceived barriers in the experimental group decreased after training. The perceived obstacles score in the test group decreased after the training (15.2 ± 3.9 v.s 11.2 ± 3.3, (p<0.01). Conclusion: The findings of the study showed that the design and implementation of educational programs based on the constructs of the health belief model can be effective in preventing women from developing higher levels of non-alcoholic fatty liver.

Keywords: non-alcoholic fatty liver, health belief model, education, women

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Authors: Kalyan Sundar Som, Ghanshyam Prasad Jhariya

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Population growth is an important pervasive phenomenon in the world. Its survival depends upon many daily needs and food is one of them. Population factors play a decisive role in the human endeavor to attain food. Nutrition and health status compose integral part of human development and progress of a society. Therefore, the neglect any one of these components may leads to the deterioration of the quality of life. Food is also intimately related with economic growth and social progress as well as with political stability and peace. It refers to the availability of food and its access to it. It can be observed from global to local level. Food scarcity has emerged as a matter of great concern all over the world due to uncontrolled and unregulated growth of population .For this purpose this study try to find out the deficit or surplus production of food availability in terms of their total population in the study area. It also ascertains the population pressure, demand and supply of food stuff and demarcation of insecure areas.The data base of the study under discussion includes government published data regarding agriculture production, yield and cropped area in 2005-06 to 2011-12 available at commissioner land record Madhya Pradesh, Gwalior. It also includes the census of India for population data. For measuring food security or insecurity regions is based on the consumption of net food available in terms caloric value minus the consumption by the weighted total population. This approach has been adopted because the direct estimate of production and consumption is the only reliable way to ascertain food security in a unit area and to compare one area with another (Noor Mohammad, dec. 2002). The scenario in 2005-06 is 57.78 percent district has food insufficient in terms of their population. On the other hand after 5 years, there are only 22 % districts are deficit in term of food availability where Burhanpur is the most deficit (56 percent) district. While 20% district are highly surplus district in the state where Harda and Hoshangabad districts are very high surplus district (5 times and 3.95 times) in term of food availability(2011). The drastic change (agriculture transformation) is happen due government good intervention in the agricultural sector.

Keywords: agriculture transformation, caloric value method, deficit or surplus region, population pressure

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Authors: Srushti R. Joshi, Ujjwal Rakesh, Spoorthi Sripad

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The rapid advancement of remote sensing technologies has revolutionized plant health monitoring, offering valuable insights for precision agriculture and environmental management. This paper presents a comprehensive comparative analysis between the widely employed normalized difference vegetation index (NDVI) and state-of-the-art hyperspectral sensors in the context of plant health assessment. The study aims to elucidate the weigh ups of spectral resolution. Employing a diverse range of vegetative environments, the research utilizes simulated datasets to evaluate the performance of NDVI and hyperspectral sensors in detecting subtle variations indicative of plant stress, disease, and overall vitality. Through meticulous data analysis and statistical validation, this study highlights the superior performance of hyperspectral sensors across the parameters used.

Keywords: normalized difference vegetation index, hyperspectral sensor, spectral resolution, infrared

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Authors: Kunthida Kulprateepunya, Napat Boontiam, Bunthita Phuasa, Chatsuda Kankayant, Bantoeng Polsawat, Sumran Poontong

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Frailty is the thin line between good health and illness. The syndrome is more common in the elderly who transition from strong to weak. (Vulnerability). Fragility can prevent and promote healthy recovery before it goes into disability. This research and development aim to analyze the situation analysis of frailty of the elderly, develop a program, and evaluate the effect of a health promotion program to prevent and solve the problem of frailty among the elderly. The research consisted of 3 phases: 1) analysis of the frailty situation, 2) development of a model, 3) evaluation of the effectiveness of the model. Samples were 328, 122 elderlies using the multi-stage random sampling method. The research instrument was a frailty questionnaire use of the five symptoms, the main characteristics were muscle weakness, slow walking, low physical activity. Fatigue and unintentional weight loss, criteria frailty use more than or equal to three or more symptoms are frailty. Data were analyzed by descriptive and t-test dependent test statistics. The findings showed three parts. First, frailty in the elderly was 23.05 percentage and 56.70% pre-frailty. Second, it was development of a health promotion program to prevent and solve the problem of frailty the elderly with a combination of Nine-Square Exercise, Elastic Band Exercise, Elastic Coconut Shell. Third, evaluation of the effectiveness of the model by comparison of the elderly's get up and go test, the average time before using the program was 14.42 and after using the program was 8.57. It was statistically significant at the .05 level. In conclusion, the findings can used to develop guidelines to promote the health of the frailty elderly.

Keywords: elderly, fragile, nine-square exercise, elastic coconut shell

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