Search results for: health professionals
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 9599

Search results for: health professionals

5849 Enhancing Oral Pre-Exposure Prophylaxis Uptake and Continuation among Adolescent Girls and Young Women in Busia District East Central Uganda

Authors: Jameson Mirimu, Edward Mawejje, Ibra Twinomujuni

Abstract:

Introduction: Adolescent girls and young women (AGYW) are a vulnerable category whose risk of acquiring HIV is 20 times compared to the general population accounting for 25% of the new infections. Despite proven scientific evidence of preventing HIV acquisition, Oral Pre-Exposure Prophylaxis (PreP) is less used as one of the biomedical interventions among the AGYW. By 2020, only 31000-32000 of the targeted 90,000 persons in Uganda enrolled on Oral PreP LPHS-EC project employed a combination of Expanded Peer Outreach Approach (EPOA) and Effective client follow-up to increase PreP initiation (PrEP_NEW) and continuation for more than three months (PrEP_CT). Method: Quantitatively, data from National Key population Combination tracker retrospectively analyzed by M&E, focused group discussion with AGYWs and Health care workers to identify barriers. Barriers found; hesitancy of AGYW, misconceptions about Oral PrEP, inadequate knowledge and skills in handling adolescent and Data quality issues. To address the mentioned barriers, youth friendly corners initiated in study sites, identified PrEP Champions among the AGYW, oral PrEP dialogues, group Antenatal counselling, CQI Projects initiated, weekly perfomance meetings to track performance. Results: Routine program data review PrEP_NEW and PrEP_CT increased from 5% (4/80) and 4% (2/54), respectively, in July 2022 to 90% (72/80) and 79% (43/54) respectively for PrEP_NEW and PrEP_CT at the end of March 2023. Lessons Learnt: Demystifying misconception about oral Prep through provision of adequate information by involving health care workers through skills enhancement, CQI projects are critical intervention. Conclusion: With improved safe spaces, skills enhancement of health workers, stakeholders’ engagement through Oral Prep dialogues is critical in improving PreP uptake and continuity among the AGYWS.

Keywords: prep, uptake, continuation, AGYW

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5848 Examining Coping Resources and Ways of Strategic Coping for Individuals with Spinal Cord Injury During the COVID-19 Crisis

Authors: Se-Hyuk Park, Hee-Jung Seo

Abstract:

Previous studies have investigated effective coping strategies for excessive stress, positive adaptation, resilience, mental health, and personal growth. However, to the best of the authors' knowledge, little research has been conducted to investigate how Koreans with physical disabilities deal with the COVID-19 pandemic. The purpose of this study was to identify coping strategies and coping resources that Koreans with physical disabilities utilized during the COVID-19 crisis. This study used semi-structured, in-depth interviews with 15 participants. Data were qualitatively analyzed using the constant comparative method with content mapping and content mining questions. We identified three salient themes that were used by participants as coping strategies to deal with various COVID-related challenges: (a) engagement in meaningful activities, (b) improvement of social and emotional support, and (c) experience of resilience. The findings of the present study highlighted that Korean adults with SCI actively engaged in various leisure activities, maintained and developed closer social relationships, and experienced resilience to face COVID-19-related stressors. These coping strategies were noted as a catalyst for physical health as well as psychological well-being of individuals with SCI.

Keywords: spinal cord injury, covid-19 pandemic, coping strategies, coping resources, leisure

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5847 Synthesis of Flavonoid Derivatives Precursors of Active Pharmaceutical Ingredients by Mechanical Chemistry

Authors: Imen Abid, Rachel Calvet, Michel Baltas

Abstract:

Flavonoids are secondary metabolites that belong to a polyphenolic class, present in fruits and vegetables, playing a significant role in biological systems. The structural variations of these flavonoids are associated with many biological and pharmacological activities (antioxidant, anti-inflammatory, anticancer, antibacterial, antifungal, antiviral, and antimalarial). Given their importance in plants and health-promoting roles in humans, significant efforts have been devoted towards their isolation of flavonoids and chemical elaboration (organic synthesis). But with the increasing public concern over environmental degradation and future resources, it is of great importance for chemists to come up with different approaches, less hazardous to human health and the environment. Being employed in large amounts, the solvents used in organic synthesis are high on the list of environmental pollutants. To overcome these problems, our approach is to develop unconventional processes involving solvent-free conditions. The application of mechanical forces to solvent-free or solvent-less reaction mixtures through the use of ball mills offers many advantages over traditional solvent-based strategies. It is one of the unconventional activation methods, which makes it possible to overcome the use of solvents, in the context of green chemistry and more respectful of the environment.

Keywords: organic synthesis, green chemistry, mecanochemistry, pharmaceutical molecules

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5846 Smart Textiles Integration for Monitoring Real-time Air Pollution

Authors: Akshay Dirisala

Abstract:

Humans had developed a highly organized and efficient civilization to live in by improving the basic needs of humans like housing, transportation, and utilities. These developments have made a huge impact on major environmental factors. Air pollution is one prominent environmental factor that needs to be addressed to maintain a sustainable and healthier lifestyle. Textiles have always been at the forefront of helping humans shield from environmental conditions. With the growth in the field of electronic textiles, we now have the capability of monitoring the atmosphere in real time to understand and analyze the environment that a particular person is mostly spending their time at. Integrating textiles with the particulate matter sensors that measure air quality and pollutants that have a direct impact on human health will help to understand what type of air we are breathing. This research idea aims to develop a textile product and a process of collecting the pollutants through particulate matter sensors, which are equipped inside a smart textile product and store the data to develop a machine learning model to analyze the health conditions of the person wearing the garment and periodically notifying them not only will help to be cautious of airborne diseases but will help to regulate the diseases and could also help to take care of skin conditions.

Keywords: air pollution, e-textiles, particulate matter sensors, environment, machine learning models

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5845 Students’ Perception of Guided Imagery Improving Anxiety before Examination: A Qualitative Study

Authors: Wong Ka Fai

Abstract:

Introduction: Many students are worried before an examination; that is a common picture worldwide. Health problems from stress before examination were insomnia, tiredness, isolation, stomach upset, and anxiety. Nursing students experienced high stress from the examination. Guided imagery is a healing process of applying imagination to help the body heal, survive, or live well. It can bring about significant physiological and biochemical changes, which can trigger the recovery process. A study of nursing students improving their anxiety before examination with guided imagery was proposed. Aim: The aim of this study was to explore the outcome of guided imagery on nursing students’ anxiety before examination in Hong Kong. Method: The qualitative study method was used. 16 first-year students studying nursing programme were invited to practice guided imagery to improve their anxiety before the examination period. One week before the examination, the semi-structured interviews with these students were carried out by the researcher. Result: From the content analysis of interview data, these nursing students showed considerable similarities in their anxiety perception. Nursing students’ perceived improved anxiety was evidenced by a reduction of stressful feelings, improved physical health, satisfaction with daily activities, and enhanced skills for solving problems and upcoming situations. Conclusion: This study indicated that guided imagery can be used as an alternative measure to improve students’ anxiety and psychological problems.

Keywords: nursing students, perception, anxiety, guided imagery

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5844 Longitudinal Examination of Depressive Symptoms among U.S. Parents who Gave Birth During the COVID-19 Pandemic

Authors: Amy Claridge, Tishra Beeson

Abstract:

Background: Maternal depression is a serious health concern impacting between 10-16% of birthing persons. It is associated with difficulty in emotional interaction and the formation of attachment bonds between parent and infant. Longitudinally, maternal depression can have severe, lasting impacts on both parent and child, increasing the risk for mental, social, and physical health issues. Rates of prenatal depression have been higher among individuals who were pregnant during the first year of the COVID-19 pandemic. Pregnant persons are considered a high-risk group for poor clinical outcomes from COVID-19 infection and may also have faced or continue to face additional stressors such as financial burdens, loss of income or employment, and the benefits accompanying employment, especially among those in the United States (U.S.). It is less clear whether individuals who gave birth during the pandemic continue to experience high levels of depressive symptoms or whether symptoms have been reduced as a pandemic response has shifted. The current study examined longitudinal reports of depressive symptoms among individuals in the U.S. who gave birth between March 2020 and September 2021. Methods: This mixed-method study involved surveys and interviews with birthing persons (18-45 years old) in their third trimester of pregnancy and at 8 weeks postpartum. Participants also completed a follow-up survey at 12-18 months postpartum. Participants were recruited using convenience methods via an online survey. Survey participants included 242 U.S. women who self-reported depressive symptoms (10-item Edinburgh Postnatal Depression Scale) at each data collection wave. A subset of 23 women participated in semi-structured prenatal and 8-week postpartum qualitative interviews. Follow-up interviews are currently underway and will be integrated into the presentation. Preliminary Results: Prenatal depressive symptoms were significantly positively correlated to 8-week and 12-18-month postpartum depressive symptoms. Participants who reported clinical levels of depression prenatally were 3.29 times (SE = .32, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Those who reported clinical depression at 8-weeks postpartum were 6.52 times (SE = .41, p < .001) more likely to report clinical levels of depression at 18 months postpartum. Participants who gave birth earlier in the pandemic reported significantly higher prenatal (t(103) = 2.84, p < .01) and 8-week postpartum depressive symptoms (t(126) = 3.31, p < .001). Data from qualitative interviews contextualize the findings. Participants reported negative emotions during pregnancy, including sadness, grief, and anxiety. They attributed this in part to their experiences of pregnancy during the pandemic and uncertainty related to the birth experience and postpartum period. Postpartum interviews revealed some stressors specific to childbirth during the COVID-19 pandemic; however, most women reflected on positive experiences of birth and postpartum. Conclusions: Taken together, findings reveal a pattern of persistent depressive symptoms among U.S. parents who gave birth during the pandemic. Depressive symptoms are of significant concern for the health of parents and children, and the findings of this study suggest a need for continued mental health intervention for parents who gave birth during the pandemic. Policy and practice implications will be discussed.

Keywords: maternal mental health, perinatal depression, postpartum depression, covid-19 pandemic

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5843 Framework for Explicit Social Justice Nursing Education and Practice: A Constructivist Grounded Theory Research

Authors: Victor Abu

Abstract:

Background: Social justice ideals are considered as the foundation of nursing practice. These ideals are not always clearly integrated into nursing professional standards or curricula. This hinders concerted global nursing agendas for becoming aware of social injustice or engaging in action for social justice to improve the health of individuals and groups. Aim and objectives: The aim was to create an educational framework for empowering nursing students for social justice awareness and action. This purpose was attained by understanding the meaning of social justice, the effect of social injustice, the visibility of social justice learning, and ways of integrating social justice in nursing education and practice. Methods: Critical interpretive methodologies and constructivist grounded theory research designs guided the processes of recruiting nursing students (n = 11) and nurse educators (n = 11) at a London nursing university to participate in interviews and focus groups, which were analysed by coding systems. Findings: Firstly, social justice was described as ethical practices that enable individuals and groups to have good access to health resources. Secondly, social injustice was understood as unfair practices that caused minimal access to resources, social deprivation, and poor health. Thirdly, social justice learning was considered to be invisible in nursing education due to a lack of explicit modules, educator knowledge, and organisational support. Lastly, explicit modules, educating educators, and attracting leaders’ support were suggested as approaches for the visible integration of social justice in nursing education and practice. Discussion: This research proposes approaches for nursing awareness and action for the development of critical active nurse-learner, critical conscious nurse-educator, and servant nurse leader. The framework on Awareness for Social Justice Action (ASJA) created in this research is an approach for empowering nursing students for social justice practices. Conclusion: This research contributes to and advocates for greater nursing scholarship to raise the spotlight on social justice in the profession.

Keywords: social justice, nursing practice, nursing education, nursing curriculum, social justice awareness, social justice action, constructivist grounded theory

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5842 Exploring the Suitability and Benefits of Two Different Mindfulness-Based Interventions with Marginalized Female Youth

Authors: Samaneh Abedini, Diana Coholic

Abstract:

The transition from adolescence into adulthood involves many changes that result in increased vulnerability to psychological challenges. This developmental stage can be especially stressful for female youth living in underserviced regions. If mental health problems are left untreated in socially marginalized youth, these challenges can extend into adulthood. We know that a lack of access to mental health services and supports can influence adolescents’ psycho-social development and well-being, while resilience and emotion regulation can help them cope with these challenges. Feasible therapeutic programs can play a significant role in assisting youth in developing these characteristics and skills. Mindfulness-Based Cognitive Therapy for Children (MBCT-C) and Holistic Art-Based Program (HAP) are two examples of mindfulness-based interventions (MBIs) that address emotion regulation, coping strategies, and resilience in marginalized youth. While each program’s beneficial effects have been documented, there is a lack of research comparing MBIs with youth, within underserviced geographical locations, and across different cultures. In this study, the sample was 42 female youth between the ages of 12 and 17 years from Iran. 42 female youth from the Elm o Honar High School, located in rural parts of Iran, Isfahan province, have been enrolled in the study. The participants were assigned to one of the MBIs (three MBCT-C experimental groups (n=20) and three HAP experimental groups (n=22)). All participants completed measures including the Child and Youth Resilience Measure-28 (CYRM-28), Child and Adolescent Mindfulness Measure (CAMM), and Difficulties in Emotion Regulation Scale (DERS) at baseline and post-intervention. At the end of intervention, the MBCT-C and HAP experimental groups showed significant changes in resilience and emotion regulation. However, the changes in resilience in HAP groups were not significant; the participants in MBCT-C experimental groups showed significant improvement in resilience. The study provided initial evidence that mindfulness-based intervention can be potentially beneficial for improving mental health status in marginalized Iranian female youth living in the middle east culture.

Keywords: benefits, female, marginalized, mindfulness, youth

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5841 The Intention to Use Telecare in People of Fall Experience: Application of Fuzzy Neural Network

Authors: Jui-Chen Huang, Shou-Hsiung Cheng

Abstract:

This study examined their willingness to use telecare for people who have had experience falling in the last three months in Taiwan. This study adopted convenience sampling and a structural questionnaire to collect data. It was based on the definition and the constructs related to the Health Belief Model (HBM). HBM is comprised of seven constructs: perceived benefits (PBs), perceived disease threat (PDT), perceived barriers of taking action (PBTA), external cues to action (ECUE), internal cues to action (ICUE), attitude toward using (ATT), and behavioral intention to use (BI). This study adopted Fuzzy Neural Network (FNN) to put forward an effective method. It shows the dependence of ATT on PB, PDT, PBTA, ECUE, and ICUE. The training and testing data RMSE (root mean square error) are 0.028 and 0.166 in the FNN, respectively. The training and testing data RMSE are 0.828 and 0.578 in the regression model, respectively. On the other hand, as to the dependence of ATT on BI, as presented in the FNN, the training and testing data RMSE are 0.050 and 0.109, respectively. The training and testing data RMSE are 0.529 and 0.571 in the regression model, respectively. The results show that the FNN method is better than the regression analysis. It is an effective and viable good way.

Keywords: fall, fuzzy neural network, health belief model, telecare, willingness

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5840 The Usefulness and Future of Hearing Aids Technologies and Their Impact on Hearing

Authors: Amirreza Razzaghipour Sorkhab

Abstract:

Hearing loss is one of the greatest common chronic health situations of older people. Hearing aids are the common treatment, and they recover the quality of life in older adults. Even so, comparatively few older adults with simple, mild to moderate, adult-onset, sensorineural hearing loss use hearing aids. It shouldn’t be expected that more expensive hearing aids always produce better outcomes. Given the importance of quality pledge, approaches of quantifying hearing aid fitting achievement are needed. Studies showed an important reduction in handicap following 3 weeks of hearing aid use, signifying the feasibility of using the Hearing Hindrance Inventory for the Elderly as an outcome measure for hearing aid success after a brief interval of hearing aid use. The results showed important development of the quality of life after three months of using a hearing aid in all members and improvement of their most important problems, i.e., the communication and exchange of data. Hearing loss can impair the conversation of information and so decreases the quality of life. Hearing aids have progressivemeaningfully over the past decade, chiefly due to the growing of digital technology. The next decade should see an even greater number of innovations to hearing aid technology. Development in digital hearing aids will be driven by investigate advances in the next fields such as wireless technology, hearing science, and cognitive scienceMoreover, emerging trends such as connectivity and individuation will also drive new technology. We hope that the advancement of technology will be enough to meet the needs of people with hearing aids.

Keywords: hearing loss, hearing aid, hearing aid technology, health

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5839 Interpersonal Communication Competence and Organizational Trust as Predictors of Psychological Wellbeing of Medical Practitioners in Imo State, Nigeria

Authors: Ethelbert C. Njoku

Abstract:

The primary determination of any individual is the achievement of wholesome health. This is applicable to the government too. This desire becomes a reality with the efforts of medical practitioners who work day and night to ensure that the health of people is not compromised in any form. To achieve this laudable goal, the psychological wellbeing of the practitioners must be unparalleled. They must be psychologically fit in order to deliver as expected. More so, the organization must be able to provide the basic ingredients of trust in the daily management of the organization. Significantly, proper Interpersonal Communication Competence remains a necessity in the overall realization of this goal. 200 participants took part in the study, and they were selected through convenient sampling method from hospitals in Imo State. The current study adopted cross sectional survey design in trying to find out if Interpersonal Communication Competence and Organizational Trust can predict Psychological Wellbeing of medical practitioners in Imo State. Standard Multiple Regression Analysis was used for data analysis. Interestingly, the results indicate that interpersonal communication competence and organizational trust predicted psychological wellbeing among medical practitioners. The implication of this study hinges on the fact that since Interpersonal Communication Competence and Organizational Trust are important for psychological wellbeing of medical practitioners, the government and managers should try to provide opportunities that enhance these variables in the organization for the psychological wellbeing of medical practitioners.

Keywords: interpersonal communication competence, medical practitioners, organizational trust, psychological wellbeing

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5838 Quality of Life of Patients on Oral Antiplatelet Therapy in Outpatient Cardiac Department Dr. Hasan Sadikin Central General Hospital Bandung

Authors: Andhiani Sharfina Arnellya, Mochammad Indra Permana, Dika Pramita Destiani, Ellin Febrina

Abstract:

Health Research Data, Ministry of Health of Indonesia in 2007, showed coronary heart disease (CHD) or coronary artery disease (CAD) was the third leading cause of death in Indonesia after hypertension and stroke with 7.2% incidence rate. Antiplatelet is one of the important therapy in management of patients with CHD. In addition to therapeutic effect on patients, quality of life is one aspect of another assessment to see the success of antiplatelet therapy. The purpose of this study was to determine the quality of life of patients on oral antiplatelet therapy in outpatient cardiac department Dr. Hasan Sadikin central general hospital, Bandung, Indonesia. This research is a cross sectional by collecting data through quality of life questionnaire of patients which performed prospectively as primary data and secondary data from medical record of patients. The results of this study showed that 54.3% of patients had a good quality of life, 45% had a moderate quality of life, and 0.7% had a poor quality of life. There are no significant differences in quality of life-based on age, gender, diagnosis, and duration of drug use.

Keywords: antiplatelet, quality of life, coronary artery disease, coronary heart disease

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5837 Probing Scientific Literature Metadata in Search for Climate Services in African Cities

Authors: Zohra Mhedhbi, Meheret Gaston, Sinda Haoues-Jouve, Julia Hidalgo, Pierre Mazzega

Abstract:

In the current context of climate change, supporting national and local stakeholders to make climate-smart decisions is necessary but still underdeveloped in many countries. To overcome this problem, the Global Frameworks for Climate Services (GFCS), implemented under the aegis of the United Nations in 2012, has initiated many programs in different countries. The GFCS contributes to the development of Climate Services, an instrument based on the production and transfer of scientific climate knowledge for specific users such as citizens, urban planning actors, or agricultural professionals. As cities concentrate on economic, social and environmental issues that make them more vulnerable to climate change, the New Urban Agenda (NUA), adopted at Habitat III in October 2016, highlights the importance of paying particular attention to disaster risk management, climate and environmental sustainability and urban resilience. In order to support the implementation of the NUA, the World Meteorological Organization (WMO) has identified the urban dimension as one of its priorities and has proposed a new tool, the Integrated Urban Services (IUS), for more sustainable and resilient cities. In the southern countries, there’s a lack of development of climate services, which can be partially explained by problems related to their economic financing. In addition, it is often difficult to make climate change a priority in urban planning, given the more traditional urban challenges these countries face, such as massive poverty, high population growth, etc. Climate services and Integrated Urban Services, particularly in African cities, are expected to contribute to the sustainable development of cities. These tools will help promoting the acquisition of meteorological and socio-ecological data on their transformations, encouraging coordination between national or local institutions providing various sectoral urban services, and should contribute to the achievement of the objectives defined by the United Nations Framework Convention on Climate Change (UNFCCC) or the Paris Agreement, and the Sustainable Development Goals. To assess the state of the art on these various points, the Web of Science metadatabase is queried. With a query combining the keywords "climate*" and "urban*", more than 24,000 articles are identified, source of more than 40,000 distinct keywords (but including synonyms and acronyms) which finely mesh the conceptual field of research. The occurrence of one or more names of the 514 African cities of more than 100,000 inhabitants or countries, reduces this base to a smaller corpus of about 1410 articles (2990 keywords). 41 countries and 136 African cities are cited. The lexicometric analysis of the metadata of the articles and the analysis of the structural indicators (various centralities) of the networks induced by the co-occurrence of expressions related more specifically to climate services show the development potential of these services, identify the gaps which remain to be filled for their implementation and allow to compare the diversity of national and regional situations with regard to these services.

Keywords: African cities, climate change, climate services, integrated urban services, lexicometry, networks, urban planning, web of science

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5836 The Effect of Disseminating Basic Knowledge on Radiation in Emergency Distance Learning of COVID-19

Authors: Satoko Yamasaki, Hiromi Kawasaki, Kotomi Yamashita, Susumu Fukita, Kei Sounai

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People are susceptible to rumors when the cause of their health problems is unknown or invisible. In order for individuals to be unaffected by rumors, they need basic knowledge and correct information. Community health nursing classes use cases where basic knowledge of radiation can be utilized on a regular basis, thereby teaching that basic knowledge is important in preventing anxiety caused by rumors. Nursing students need to learn that preventive activities are essential for public health nursing care. This is the same methodology used to reduce COVID-19 anxiety among individuals. This study verifies the learning effect concerning the basic knowledge of radiation necessary for case consultation by emergency distance learning. Sixty third-year nursing college students agreed to participate in this research. The knowledge tests conducted before and after classes were compared, with the chi-square test used for testing. There were five knowledge questions regarding distance lessons. This was considered to be 5% significant. The students’ reports which describe the results of responding to health consultations, were analyzed qualitatively and descriptively. In this case study, a person living in an area not affected by radiation was anxious about drinking water and, thus, consulted with a student. The contents of the lecture were selected the minimum amount of knowledge used for the answers of the consultant; specifically hot spots, internal exposure risk, food safety, characteristics of cesium-137, and precautions for counselors. Before taking the class, the most correctly answered question by students concerned daily behavior at risk of internal exposure (52.2%). The question with the fewest correct answers was the selection of places that are likely to be hot spots (3.4%). All responses increased significantly after taking the class (p < 0.001). The answers to the counselors, as written by the students, were 'Cesium is strongly bound to the soil, so it is difficult to transfer to water' and 'Water quality test results of tap water are posted on the city's website.' These were concrete answers obtained by using specialized knowledge. Even in emergency distance learning, the students gained basic knowledge regarding radiation and created a document to utilize said knowledge while assuming the situation concretely. It was thought that the flipped classroom method, even if conducted remotely, could maintain students' learning. It was thought that setting specific knowledge and scenes to be used would enhance the learning effect. By changing the case to concern that of the anxiety caused by infectious diseases, students may be able to effectively gain the basic knowledge to decrease the anxiety of residents due to infectious diseases.

Keywords: effect of class, emergency distance learning, nursing student, radiation

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5835 Nutritional Quality Assessment and Safety Evaluation of Food Crops

Authors: Olawole Emmanuel Aina, Liziwe Lizbeth Mugivhisa, Joshua Oluwole Olowoyo, Chikwela Lawrence Obi

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In sustained and consistent efforts to improve food security, numerous and different methods are proposed and used in the production of food crops, and farm produce to meet the demands of consumers. However, unregulated and indiscriminate methods of production present another problem that may expose consumers of these food crops to potential health risks. Therefore, it is imperative that a thorough assessment of farm produce is carried out due to the growing trend of health-conscious consumers preference for minimally processed or raw farm produce. This study evaluated the safety and nutritional quality of food crops. The objectives were to compare the nutritional quality of organic and inorganic farm produce in one hand and, on the other, evaluate the safety of farm produce with respect to trace metal and pathogenic contamination. We conducted a broad systematic search of peer-reviewed published literatures from databases and search engines such as science direct, web-of-science, Google scholar, and Scopus. This study concluded that there is no conclusive evidence to support the notion of nutritional superiority of organic food crops over their inorganic counterparts and there are documented reports of pathogenic and metal contaminations of food crops.

Keywords: food crops, fruits and vegetables, pathogens, nutrition, trace metals

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5834 Improved Computational Efficiency of Machine Learning Algorithm Based on Evaluation Metrics to Control the Spread of Coronavirus in the UK

Authors: Swathi Ganesan, Nalinda Somasiri, Rebecca Jeyavadhanam, Gayathri Karthick

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The COVID-19 crisis presents a substantial and critical hazard to worldwide health. Since the occurrence of the disease in late January 2020 in the UK, the number of infected people confirmed to acquire the illness has increased tremendously across the country, and the number of individuals affected is undoubtedly considerably high. The purpose of this research is to figure out a predictive machine learning archetypal that could forecast COVID-19 cases within the UK. This study concentrates on the statistical data collected from 31st January 2020 to 31st March 2021 in the United Kingdom. Information on total COVID cases registered, new cases encountered on a daily basis, total death registered, and patients’ death per day due to Coronavirus is collected from World Health Organisation (WHO). Data preprocessing is carried out to identify any missing values, outliers, or anomalies in the dataset. The data is split into 8:2 ratio for training and testing purposes to forecast future new COVID cases. Support Vector Machines (SVM), Random Forests, and linear regression algorithms are chosen to study the model performance in the prediction of new COVID-19 cases. From the evaluation metrics such as r-squared value and mean squared error, the statistical performance of the model in predicting the new COVID cases is evaluated. Random Forest outperformed the other two Machine Learning algorithms with a training accuracy of 99.47% and testing accuracy of 98.26% when n=30. The mean square error obtained for Random Forest is 4.05e11, which is lesser compared to the other predictive models used for this study. From the experimental analysis Random Forest algorithm can perform more effectively and efficiently in predicting the new COVID cases, which could help the health sector to take relevant control measures for the spread of the virus.

Keywords: COVID-19, machine learning, supervised learning, unsupervised learning, linear regression, support vector machine, random forest

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5833 Developing Wearable EMG Sensor Designed for Parkinson's Disease (PD) Monitoring, and Treatment

Authors: Bulcha Belay Etana

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Electromyography is used to measure the electrical activity of muscles for various health monitoring applications using surface electrodes or needle electrodes. Recent developments in electromyogram signal acquisition using textile electrodes open the door for wearable health monitoring which enables patients to monitor and control their health issues outside of traditional healthcare facilities. The aim of this research is therefore to develop and analyze wearable textile electrodes for the acquisition of electromyography signals for Parkinson’s patients and apply an appropriate thermal stimulus to relieve muscle cramping. In order to achieve this, textile electrodes are sewn with a silver-coated thread in an overlapping zigzag pattern into an inextensible fabric, and stainless steel knitted textile electrodes attached to a sleeve were prepared and its electrical characteristics including signal to noise ratio were compared with traditional electrodes. To relieve muscle cramping, a heating element using stainless steel conductive yarn Sewn onto a cotton fabric, coupled with a vibration system were developed. The system was integrated using a microcontroller and a Myoware muscle sensor so that when muscle cramping occurs, measured by the system activates the heating elements and vibration motors. The optimum temperature considered for treatment was 35.50c, so a Temperature measurement system was incorporated to deactivate the heating system when the temperature reaches this threshold, and the signals indicating muscle cramping have subsided. The textile electrode exhibited a signal to noise ratio of 6.38dB while the signal to noise ratio of the traditional electrode was 7.05dB. The rise time of the developed heating element was about 6 minutes to reach the optimum temperature using a 9volt power supply. The treatment of muscle cramping in Parkinson's patients using heat and muscle vibration simultaneously with a wearable electromyography signal acquisition system will improve patients’ livelihoods and enable better chronic pain management.

Keywords: electromyography, heating textile, vibration therapy, parkinson’s disease, wearable electronic textile

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5832 Assessing Public Open Spaces Availability and Distribution in a Socially Challenged City: A Case Study of Riyadh, Saudi Arabia

Authors: Abdulwahab Alalyani, Mahbub Rashid

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Public Open Space (POS) availability and distribution among urban communities have a central role to promotes community health. However, growing health challenges in a city would raise attention to the planning quality of these community's assets. This research aims to measure the existing availability and distribution equity of POS in the context of Saudi Arabia using Riyadh city as a case study. The methodology for the POS availability was by calculating the total POS with respect to the population total (m²/inhabitant). All POS were mapped using geographical information systems (GIS), and the total area availability of POS was compared to global, regional, and local standards. To evaluate the significant differences in POS availability across low, medium, and high-income Riyadh neighborhoods, we used a One-way ANOVA analysis of covariance to test the differences. The results are as follows; POS availability was lower than global standers. Riyadh has only 1.40m² per capita of POS. Spatial equity of the availability were significantly different among Riyadh neighborhoods based on socioeconomic status. The future development of POS should be focused on increasing general POS availability and should be given priority to those low-income and unhealthy communities. Accessibility indicators of POS should be considered in future studies.

Keywords: open spaces availability, open spaces distribution, spatial equity, healthy city, Riyadh City

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5831 Onco@Home: Comparing the Costs, Revenues, and Patient Experience of Cancer Treatment at Home with the Standard of Care

Authors: Sarah Misplon, Wim Marneffe, Johan Helling, Jana Missiaen, Inge Decock, Dries Myny, Steve Lervant, Koen Vaneygen

Abstract:

The aim of this study was twofold. First, we investigated whether the current funding from the national health insurance (NHI) of home hospitalization (HH) for oncological patients is sufficient in Belgium. Second, we compared patient’s experiences and preferences of HH to the standard of care (SOC). Two HH models were examined in three Belgian hospitals and three home nursing organizations. In a first HH model, the blood draw and monitoring prior to intravenous therapy were performed by a trained home nurse at the patient’s home the day before the visit to the day hospital. In a second HH model, the administration of two subcutaneous treatments was partly provided at home instead of in the hospital. Therefore, we conducted (1) a bottom-up micro-costing study to compare the costs and revenues for the providers (hospitals and home care organizations), and (2) a cross-sectional survey to compare patient’s experiences and preferences of the SOC group and the HH group. Our results show that HH patients prefer HH and none of them wanted to return to SOC, although the satisfaction of patients was not significantly different between the two categories. At the same time, we find that costs associated to HH are higher overall. Comparing revenues with costs, we conclude that the current funding from NHI of HH for oncological patients is insufficient.

Keywords: cost analysis, health insurance, preference, home hospitalization

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5830 Improving School Design through Diverse Stakeholder Participation in the Programming Phase

Authors: Doris C. C. K. Kowaltowski, Marcella S. Deliberador

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The architectural design process, in general, is becoming more complex, as new technical, social, environmental, and economical requirements are imposed. For school buildings, this scenario is also valid. The quality of a school building depends on known design criteria and professional knowledge, as well as feedback from building performance assessments. To attain high-performance school buildings, a design process should add a multidisciplinary team, through an integrated process, to ensure that the various specialists contribute at an early stage to design solutions. The participation of stakeholders is of special importance at the programming phase when the search for the most appropriate design solutions is underway. The composition of a multidisciplinary team should comprise specialists in education, design professionals, and consultants in various fields such as environmental comfort and psychology, sustainability, safety and security, as well as administrators, public officials and neighbourhood representatives. Users, or potential users (teachers, parents, students, school officials, and staff), should be involved. User expectations must be guided, however, toward a proper understanding of a response of design to needs to avoid disappointment. In this context, appropriate tools should be introduced to organize such diverse participants and ensure a rich and focused response to needs and a productive outcome of programming sessions. In this paper, different stakeholder in a school design process are discussed in relation to their specific contributions and a tool in the form of a card game is described to structure the design debates and ensure a comprehensive decision-making process. The game is based on design patterns for school architecture as found in the literature and is adapted to a specific reality: State-run public schools in São Paulo, Brazil. In this State, school buildings are managed by a foundation called Fundação para o Desenvolvimento da Educação (FDE). FDE supervises new designs and is responsible for the maintenance of ~ 5000 schools. The design process of this context was characterised with a recommendation to improve the programming phase. Card games can create a common environment, to which all participants can relate and, therefore, can contribute to briefing debates on an equal footing. The cards of the game described here represent essential school design themes as found in the literature. The tool was tested with stakeholder groups and with architecture students. In both situations, the game proved to be an efficient tool to stimulate school design discussions and to aid in the elaboration of a rich, focused and thoughtful architectural program for a given demand. The game organizes the debates and all participants are shown to spontaneously contribute each in his own field of expertise to the decision-making process. Although the game was specifically based on a local school design process it shows potential for other contexts because the content is based on known facts, needs and concepts of school design, which are global. A structured briefing phase with diverse stakeholder participation can enrich the design process and consequently improve the quality of school buildings.

Keywords: architectural program, design process, school building design, stakeholder

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5829 Clinical Application of Measurement of Eyeball Movement for Diagnose of Autism

Authors: Ippei Torii, Kaoruko Ohtani, Takahito Niwa, Naohiro Ishii

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This paper shows developing an objectivity index using the measurement of subtle eyeball movement to diagnose autism. The developmentally disabled assessment varies, and the diagnosis depends on the subjective judgment of professionals. Therefore, a supplementary inspection method that will enable anyone to obtain the same quantitative judgment is needed. The diagnosis are made based on a comparison of the time of gazing an object in the conventional autistic study, but the results do not match. First, we divided the pupil into four parts from the center using measurements of subtle eyeball movement and comparing the number of pixels in the overlapping parts based on an afterimage. Then we developed the objective evaluation indicator to judge non-autistic and autistic people more clearly than conventional methods by analyzing the differences of subtle eyeball movements between the right and left eyes. Even when a person gazes at one point and his/her eyeballs always stay fixed at that point, their eyes perform subtle fixating movements (ie. tremors, drifting, microsaccades) to keep the retinal image clear. Particularly, the microsaccades link with nerves and reflect the mechanism that process the sight in a brain. We converted the differences between these movements into numbers. The process of the conversion is as followed: 1) Select the pixel indicating the subject's pupil from images of captured frames. 2) Set up a reference image, known as an afterimage, from the pixel indicating the subject's pupil. 3) Divide the pupil of the subject into four from the center in the acquired frame image. 4) Select the pixel in each divided part and count the number of the pixels of the overlapping part with the present pixel based on the afterimage. 5) Process the images with precision in 24 - 30fps from a camera and convert the amount of change in the pixels of the subtle movements of the right and left eyeballs in to numbers. The difference in the area of the amount of change occurs by measuring the difference between the afterimage in consecutive frames and the present frame. We set the amount of change to the quantity of the subtle eyeball movements. This method made it possible to detect a change of the eyeball vibration in numerical value. By comparing the numerical value between the right and left eyes, we found that there is a difference in how much they move. We compared the difference in these movements between non-autistc and autistic people and analyzed the result. Our research subjects consists of 8 children and 10 adults with autism, and 6 children and 18 adults with no disability. We measured the values through pasuit movements and fixations. We converted the difference in subtle movements between the right and left eyes into a graph and define it in multidimensional measure. Then we set the identification border with density function of the distribution, cumulative frequency function, and ROC curve. With this, we established an objective index to determine autism, normal, false positive, and false negative.

Keywords: subtle eyeball movement, autism, microsaccade, pursuit eye movements, ROC curve

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5828 Empirical Study on Causes of Project Delays

Authors: Khan Farhan Rafat, Riaz Ahmed

Abstract:

Renowned offshore organizations are drifting towards collaborative exertion to win and implement international projects for business gains. However, devoid of financial constraints, with the availability of skilled professionals, and despite improved project management practices through state-of-the-art tools and techniques, project delays have become a norm these days. This situation calls for exploring the factor(s) affecting the bonding between project management performance and project success. In the context of the well-known 3M’s of project management (that is, manpower, machinery, and materials), machinery and materials are dependent upon manpower. Because the body of knowledge inveterate on the influence of national culture on men, hence, the realization of the impact on the link between project management performance and project success need to be investigated in detail to arrive at the possible cause(s) of project delays. This research initiative was, therefore, undertaken to fill the research gap. The unit of analysis for the proposed research excretion was the individuals who had worked on skyscraper construction projects. In reverent studies, project management is best described using construction examples. It is due to this reason that the project oriented city of Dubai was chosen to reconnoiter on causes of project delays. A structured questionnaire survey was disseminated online with the courtesy of the Project Management Institute local chapter to carry out the cross-sectional study. The Construction Industry Institute, Austin, of the United States of America along with 23 high-rise builders in Dubai were also contacted by email requesting for their contribution to the study and providing them with the online link to the survey questionnaire. The reliability of the instrument was warranted using Cronbach’s alpha coefficient of 0.70. The appropriateness of sampling adequacy and homogeneity in variance was ensured by keeping Kaiser–Meyer–Olkin (KMO) and Bartlett’s test of sphericity in the range ≥ 0.60 and < 0.05, respectively. Factor analysis was used to verify construct validity. During exploratory factor analysis, all items were loaded using a threshold of 0.4. Four hundred and seventeen respondents, including members from top management, project managers, and project staff, contributed to the study. The link between project management performance and project success was significant at 0.01 level (2-tailed), and 0.05 level (2-tailed) for Pearson’s correlation. Before initiating the moderator analysis test for linearity, multicollinearity, outliers, leverage points and influential cases, test for homoscedasticity and normality were carried out which are prerequisites for conducting moderator review. The moderator analysis, using a macro named PROCESS, was performed to verify the hypothesis that national culture has an influence on the said link. The empirical findings, when compared with Hofstede's results, showed high power distance as the cause of construction project delays in Dubai. The research outcome calls for the project sponsors and top management to reshape their project management strategy and allow for low power distance between management and project personnel for timely completion of projects.

Keywords: causes of construction project delays, construction industry, construction management, power distance

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5827 Inclusive Practices in Health Sciences: Equity Proofing Higher Education Programs

Authors: Mitzi S. Brammer

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Given that the cultural make-up of programs of study in institutions of higher learning is becoming increasingly diverse, much has been written about cultural diversity from a university-level perspective. However, there are little data in the way of specific programs and how they address inclusive practices when teaching and working with marginalized populations. This research study aimed to discover baseline knowledge and attitudes of health sciences faculty, instructional staff, and students related to inclusive teaching/learning and interactions. Quantitative data were collected via an anonymous online survey (one designed for students and another designed for faculty/instructional staff) using a web-based program called Qualtrics. Quantitative data were analyzed amongst the faculty/instructional staff and students, respectively, using descriptive and comparative statistics (t-tests). Additionally, some participants voluntarily engaged in a focus group discussion in which qualitative data were collected around these same variables. Collecting qualitative data to triangulate the quantitative data added trustworthiness to the overall data. The research team analyzed collected data and compared identified categories and trends, comparing those data between faculty/staff and students, and reported results as well as implications for future study and professional practice.

Keywords: inclusion, higher education, pedagogy, equity, diversity

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5826 Validity and Reliability of Lifestyle Measurement of the LSAS among Recurrent Stroke Patients in Selected Hospital, Central Java, Indonesia

Authors: Meida Laely Ramdani, Earmporn Thongkrajai, Dedy Purwito

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Lifestyle is one of the most important factors affecting health. Measurement of lifestyle behaviors is necessary for the identification of causal associations between unhealthy lifestyle and health outcomes. There was many instruments have been measured for lifestyle, but not specific for stroke recurrence. This study aimed to develop a new questionnaire of Lifestyle Adjustment Scale (LSAS) among recurrent stroke patients in Indonesia and to measure the reliability and validity of LSAS. The instrument consist of 33 items was developed from the responses of 30 recurrent stroke patients with the maximum age 60 years. Data was collected during October to November 2015. The properties of the instrument were evaluated by validity assessment and reliability measures. The content validity was judged adequate by a panel of five experts, with the result of I-CVI was 0.97. The Cronbach’s alpha analysis was carried out to measure the reliability of LSAS. The result showed that Cronbach’s alpha coefficient was 0.819. LSAS were classified under the domains of dietary habit, smoking habit, physical activity, and stress management. The results of Cronbach’s alpha coefficient for each subscale were 0.60, 0.39, 0.67, 0.65 and 0.76 respectively. LSAS instrument was valid and reliable therefore can be used as research tool among recurrent stroke patients. The development of this questionnaire has been adapted to the socio-cultural context in Indonesia.

Keywords: LSAS, recurrent stroke patients, lifestyle, Indonesia

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5825 Effects of National Policy on Montana Medicaid Coverage and Enrollment

Authors: Ryan J. Trefethen, Vincent H. Smith

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This study explores the relationship between national spending on the Medicaid program, and total Medicaid spending and enrollment in Montana, a state that ranks thirty-third in per capita income and thirty-seventh in median household income in the United States. The purpose of the research is to estimate the potential effects that specific changes to national healthcare policy would likely have on funding for the Montana Medicaid Program and enrollees in the program, members of families in poverty whose incomes are low, even though in many cases they have steady jobs. A particular concern is the effect on access to care for children in poverty who tend to be food insecure and, therefore, especially in need of access to health care. The research uses data collected from a variety of government publications, including the Medicaid Financial Management Report, the Medicaid Managed Care Enrollment Report, and the Centers for Medicare and Medicaid Services MSIS State Summaries for fiscal years 2000-2015. These data were examined using econometric analysis, to assess these impacts. The evidence indicates that the changes included in recent congressional legislative initiatives would potentially leave an additional 50,000 to 60,000 Montana residents, five to six percent of the state’s population, in poverty without access to health care. Impacts on children in poverty would potentially be substantial.

Keywords: children, healthcare, medicaid, montana, poverty

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5824 Prevalence of Behavioral and Emotional Problems in School Going Adolescents in India

Authors: Anshu Gupta, Charu Gupta

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Background: Adolescence is the transitional period between puberty and adulthood. It is marked by immense turmoil in emotional and behavioral spheres. Adolescents are at risk of an array of behavioral and emotional problems, resulting in social, academic and vocational function impairments. Conflicts in the family and inability of the parents to cope with the changing demands of an adolescent have a negative impact on the overall development of the child. This augers ill for the individual’s future, resulting in depression, delinquency and suicides among other problems. Aim: The aim of the study was to compare the prevalence of behavioral and emotional problems in school going adolescents aged 13 to 15 years residing in Ludhiana city. Method: A total of 1380 school children in the age group of 13 to 15 years were assessed by the adolescent health screening questionnaire (FAPS) and Youth Self-Report (2001) questionnaire. Statistical significance was ascertained by t-test, chi-square test (x²) and ANOVA, as appropriate. Results: A considerably high prevalence of behavioral and emotional problems was found in school going adolescents (26.5%), more in girls (31.7%) than in boys (24.4%). In case of boys, the maximum problem was in the 13 year age group, i.e., 28.2%, followed by a significant decline by the age of 14 years, i.e., 24.2% and 15 years, i.e., 19.6%. In case of girls also, the maximum problem was in the 13 year age group, i.e., 32.4% followed by a marginal decline in the 14 years i.e., 31.8% and 15 year age group, i.e., 30.2%. Demographic factors were non contributory. Internalizing syndrome (22.4%) was the most common problem followed by the neither internalizing nor externalizing (17.6%) group. In internalizing group, most (26.5%) of the students were observed to be anxious/ depressed. Social problem was observed to be the most frequent (10.6%) among neither internalizing nor externalizing group. Aggressive behavior was the commonest (8.4%) among externalizing group. Internalizing problems, mainly anxiety and depression, were commoner in females (30.6%) than males (24.6%). More boys (16%) than girls (13.4%) were reported to suffer from externalizing disorders. A critical review of the data showed that most of the adolescents had poor knowledge about reproductive health. Almost 36% reported that the source of their information on sexual and reproductive health being friends and the electronic media. There was a high percentage of adolescents who reported being worried about sexual abuse (20.2%) with majority of them being girls (93.6%) reflecting poorly on the social setup in the country. About 41% of adolescents reported being concerned about body weight and most of them being girls (92.4%). Up to 14.5% reported having thoughts of using alcohol or drugs perhaps due to the easy availability of substances of abuse in this part of the country. 12.8% (mostly girls) reported suicidal thoughts. Summary/conclusion: There is a high prevalence of emotional and behavioral problems among school-going adolescents. Resolution of these problems during adolescence is essential for attaining a healthy adulthood. The need of the hour is to spread awareness among caregivers and formulation of effective management strategies including school mental health programme.

Keywords: adolescence, behavioral, emotional, internalizing problem

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5823 Innovation Ecosystems in Construction Industry

Authors: Cansu Gülser, Tuğce Ercan

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The construction sector is a key driver of the global economy, contributing significantly to growth and employment through a diverse array of sub-sectors. However, it faces challenges due to its project-based nature, which often hampers long-term collaboration and broader incentives beyond individual projects. These limitations are frequently discussed in scientific literature as obstacles to innovation and industry-wide change. Traditional practices and unwritten rules further hinder the adoption of new processes within the construction industry. The disadvantages of the construction industry’s project-based structure in fostering innovation and long-term relationships include limited continuity, fragmented collaborations, and a focus on short-term goals, which collectively hinder the development of sustained partnerships, inhibit the sharing of knowledge and best practices, and reduce incentives for investing in innovative processes and technologies. This structure typically emphasizes specific projects, which restricts broader collaborations and incentives that extend beyond individual projects, thus impeding innovation and change. The temporal complexities inherent in project-based sectors like construction make it difficult to address societal challenges through collaborative efforts. Traditional management approaches are inadequate for scaling up innovations and adapting to significant changes. For systemic transformation in the construction sector, there is a need for more collaborative relationships and activities beyond traditional supply chains. This study delves into the concept of an innovation ecosystem within the construction sector, highlighting various research findings. It aims to explore key questions about the components that enhance innovation capacity, the relationship between a robust innovation ecosystem and this capacity, and the reasons why innovation is less prevalent and implemented in this sector compared to others. Additionally, it examines the main factors hindering innovation within companies and identifies strategies to improve these efforts, particularly in developing countries. The innovation ecosystem in the construction sector generates various outputs through interactions between business resources and external components. These outputs include innovative value creation, sustainable practices, robust collaborations, knowledge sharing, competitiveness, and advanced project management, all of which contribute significantly to company market performance and competitive advantage. This article offers insights and strategic recommendations for industry professionals, policymakers, and researchers interested in developing and sustaining innovation ecosystems in the construction sector. Future research should focus on broader samples for generalization, comparative sector analysis, and application-focused studies addressing real industry challenges. Additionally, studying the long-term impacts of innovation ecosystems, integrating advanced technologies like AI and machine learning into project management, and developing future application strategies and policies are also important.

Keywords: construction industry, innovation ecosystem, innovation ecosystem components, project management

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5822 Relationship-Centred Care in Cross-Linguistic Medical Encounters

Authors: Nami Matsumoto

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This study explores the experiences of cross-linguistic medical encounters by patients, and their views of receiving language support therein, with a particular focus on Japanese-English cases. The aim of this study is to investigate the reason for the frequent use of a spouse as a communication mediator from a Japanese perspective, through a comparison with that of English speakers. This study conducts an empirical qualitative analysis of the accounts of informants. A total of 31 informants who have experienced Japanese-English cross-linguistic medical encounters were recruited in Australia and Japan for semi-structured in-depth interviews. A breakdown of informants is 15 English speakers and 16 Japanese speakers. In order to obtain a further insight into collected data, additional interviews were held with 4 Australian doctors who are familiar with using interpreters. This study was approved by the Australian National University Human Research Ethics Committee, and written consent to participate in this study was obtained from all participants. The interviews lasted up to over one hour. They were audio-recorded and subsequently transcribed by the author. Japanese transcriptions were translated into English by the author. An analysis of interview data found that patients value relationship in communication. Particularly, Japanese informants, who have an English-speaking spouse, value trust-based communication interventions by their spouse, regardless of the language proficiency of the spouse. In Australia, health care interpreters are required to abide by the national code of ethics for interpreters. The Code defines the role of an interpreter exclusively to be language rendition and enshrines the tenets of accuracy, confidentiality and professional role boundaries. However, the analysis found that an interpreter who strictly complies with the Code sometimes fails to render the real intentions of the patient and their doctor. Findings from the study suggest that an interpreter should not be detached from the context and should be more engaged in the needs of patients. Their needs are not always communicated by an interpreter when they simply follow a professional code of ethics. The concept of relationship-centred care should be incorporated in the professional practice of health care interpreters.

Keywords: health care, Japanese-English medical encounters, language barriers, trust

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5821 Relevance for Traditional Medicine in South Africa: Experiences of Urban Traditional Healers, Izinyanga

Authors: Ntokozo Mthembu

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Access to relevant health indicates people’s likelihood of survival, including craft of indigenous healing and its related practitioners- izinyanga. However, the emergence of a dreaded novel corona virus - COVID-19 that has engulfed almost the whole world has necessitated the need to revisit the state of traditional healers in South Africa. This circumstance tended to expose the reality of social settings in various social structures and related policies including the manner coloniality reveal its ugly head when it comes treatment between western and African based therapeutic practices in this country. In attempting to gain a better understanding of such experiences, primary and secondary sources were consulted when collecting data that perusal of various literature in this instance including face-to-face interviews with traditional healers working on the street of Tshwane Municipality in South Africa. Preliminary findings revealed that the emergence of this deadly virus coincided with the moment when the government agenda was focussed on fulfilment of its promise of addressing the past inequity practices, including the transformation of medical sector. This scenario can be witnessed by the manner in which government and related agencies such as health department keeps on undermining indigenous healing practice irrespective of its historical record in terms of healing profession and fighting various diseases before times of father of medicine, Imhotep. Based on these preliminary findings, it is recommended that the government should hasten the incorporation of African knowledge systems especially medicine to offer alternatives and diverse to assess the underutilised indigenous African therapeutic approach and relevant skills that could be useful in combating ailments such as COVID 19. Perhaps, the plural medical systems should be recognized and related policies are formulated to guarantee mutual respect among citizens and the incorporation of healing practices in South African health sector, Africa and in the broader global community.

Keywords: indigenous healing practice, inyanga, COVID-19, therapeutic, urban, experience

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5820 Young Adult Gay Men's Healthcare Access in the Era of the Affordable Care Act

Authors: Marybec Griffin

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Purpose: The purpose of this cross-sectional study was to get a better understanding of healthcare usage and satisfaction among young adult gay men (YAGM), including the facility used as the usual source of healthcare, preference for coordinated healthcare, and if their primary care provider (PCP) adequately addressed the health needs of gay men. Methods: Interviews were conducted among n=800 YAGM in New York City (NYC). Participants were surveyed about their sociodemographic characteristics and healthcare usage and satisfaction access using multivariable logistic regression models. The surveys were conducted between November 2015 and June 2016. Results: The mean age of the sample was 24.22 years old (SD=4.26). The racial and ethnic background of the participants is as follows: 35.8% (n=286) Black Non-Hispanic, 31.9% (n=225) Hispanic/Latino, 20.5% (n=164) White Non-Hispanic, 4.4% (n=35) Asian/Pacific Islander, and 6.9% (n=55) reporting some other racial or ethnic background. 31.1% (n=249) of the sample had an income below $14,999. 86.7% (n=694) report having either public or private health insurance. For usual source of healthcare, 44.6% (n=357) of the sample reported a private doctor’s office, 16.3% (n=130) reported a community health center, and 7.4% (n=59) reported an urgent care facility, and 7.6% (n=61) reported not having a usual source of healthcare. 56.4% (n=451) of the sample indicated a preference for coordinated healthcare. 54% (n=334) of the sample were very satisfied with their healthcare. Findings from multivariable logistical regression models indicate that participants with higher incomes (AOR=0.54, 95% CI 0.36-0.81, p < 0.01) and participants with a PCP (AOR=0.12, 95% CI 0.07-0.20, p < 0.001) were less likely to use a walk-in facility as their usual source of healthcare. Results from the second multivariable logistic regression model indicated that participants who experienced discrimination in a healthcare setting were less likely to prefer coordinated healthcare (AOR=0.63, 95% CI 0.42-0.96, p < 0.05). In the final multivariable logistic model, results indicated that participants who had disclosed their sexual orientation to their PCP (AOR=2.57, 95% CI 1.25-5.21, p < 0.01) and were comfortable discussing their sexual activity with their PCP (AOR=8.04, 95% CI 4.76-13.58, p < 0.001) were more likely to agree that their PCP adequately addressed the healthcare needs of gay men. Conclusion: Understanding healthcare usage and satisfaction among YAGM is necessary as the healthcare landscape changes, especially given the relatively recent addition of urgent care facilities. The type of healthcare facility used as a usual source of care influences the ability to seek comprehensive and coordinated healthcare services. While coordinated primary and sexual healthcare may be ideal, individual preference for this coordination among YAGM is desired but may be limited due to experiences of discrimination in primary care settings.

Keywords: healthcare policy, gay men, healthcare access, Affordable Care Act

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