Search results for: health risks

Authors: Padma Chutoo, Elena Kulinskaya, Ilyas Bakbergenuly, Nicholas Steel, Dmitri Pchejetski

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Transient ischaemic attacks (TIAs) are warning signs for future strokes. TIA patients are at increased risk of stroke and cardio-vascular events after a first episode. A majority of studies on TIA focused on the occurrence of these ancillary events after a TIA. Long-term mortality after TIA received only limited attention. We undertook this study to determine the long-term hazards of all-cause mortality following a first episode of a TIA using anonymised electronic health records (EHRs). We used a retrospective case-control study using electronic primary health care records from The Health Improvement Network (THIN) database. Patients born prior to or in year 1960, resident in England, with a first diagnosis of TIA between January 1986 and January 2017 were matched to three controls on age, sex and general medical practice. The primary outcome was all-cause mortality. The hazards of all-cause mortality were estimated using a time-varying Weibull-Cox survival model which included both scale and shape effects and a random frailty effect of GP practice. 20,633 cases and 58,634 controls were included. Cases aged 39 to 60 years at the first TIA event had the highest hazard ratio (HR) of mortality compared to matched controls (HR = 3.04, 95% CI (2.91 - 3.18)). The HRs for cases aged 61-70 years, 71-76 years and 77+ years were 1.98 (1.55 - 2.30), 1.79 (1.20 - 2.07) and 1.52 (1.15 - 1.97) compared to matched controls. Aspirin provided long-term survival benefits to cases. Cases aged 39-60 years on aspirin had HR of 0.93 (0.84 - 1.00), 0.90 (0.82 - 0.98) and 0.88 (0.80 - 0.96) at 5 years, 10 years and 15 years, respectively, compared to cases in the same age group who were not on antiplatelets. Similar beneficial effects of aspirin were observed in other age groups. There were no significant survival benefits with other antiplatelet options. No survival benefits of antiplatelet drugs were observed in controls. Our study highlights the excess long-term risk of death of TIA patients and cautions that TIA should not be treated as a benign condition. The study further recommends aspirin as the better option for secondary prevention for TIA patients compared to clopidogrel recommended by NICE guidelines. Management of risk factors and treatment strategies should be important challenges to reduce the burden of disease.

Keywords: dual antiplatelet therapy (DAPT), General Practice, Multiple Imputation, The Health Improvement Network(THIN), hazard ratio (HR), Weibull-Cox model

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Authors: Filip Ščerba, Veronika Pochylá

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Performing of the acts within criminal proceedings usually takes too long and thus this phenomenon can be regarded as one of the most burning problems which have plagued the criminal justice not only in the Czech Republic but at least all over Europe for the last few decades. This problem obviously has to be dealt with and thus the need to tackle this issue has resulted in the trend which is sometimes called Criminal Justice Rationalization, i.e. introducing and enforcing methods supporting the increase in efficiency of the criminal justice in order to make the criminal proceedings shorter and administrative procedure easier. This resulted in the introduction of institutes such as e.g. diversions in criminal proceedings or other forms of shortened pre-trial proceedings, which may be used primarily for dealing with less serious crimes. But also the institute, which was originally mentioned in connection with the system of criminal law in the countries belonging to the Anglo-Saxon legal order where it is frequently called of plea bargaining, has been introduced into the criminal law of many European countries, and it may be applied also in cases of serious crimes. All these special and shortened forms of criminal proceedings are connected with limited extent of process of evidence; in fact, some of these specific forms of criminal proceedings are designed for the purpose to simplify the process of evidence. That is also the reason, why some of these procedures are conditioned with the defendant’s confession. Main hypothesis: Limited process of evidence represents also a potential conflict with certain fundamental principles upon which the criminal proceeding in the Continental legal system is based. (A conflict with principle of material truth may be considered as the most important problem. This principle states that the bodies in criminal proceedings must clarify the facts of the case beyond reasonable doubt to such extent that a decision can be made; the defendant’s confession does not mean that these bodies are freed from the duty to review all the circumstances and facts of the case. Such principle is typical for criminal law in Central European region.) Basic methodologies: The paper is going to analyze such a problem of weakening of the principle of material truth in modern criminal law. Such analysis will be provided primarily on the base of the Czech criminal law, but also other legal regulations will be taken into consideration, and its result may have some relevance for all legal regulations belonging to the Continental legal system, so the paper offers also a comparison with legal systems of other Central European countries.

Keywords: burden of proof, central European countries, criminal justice rationalization, criminal proceeding, Czech legislation, Czech republic, defendant, diversions, evidence, fundamental principles, plea bargaining, pre-trial proceedings, principle of material truth, process of evidence, process of evidence

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Authors: M. Aouimeur

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The environmental risks of a dam and particularly the security in the Valley downstream of it,, is a very complex problem. Integrated management and risk-sharing become more and more indispensable. The definition of "vulnerability “concept can provide assistance to controlling the efficiency of protective measures and the characterization of each valley relatively to the floods's risk. Security can be enhanced through the integrated land management. The social sciences may be associated to the operational systems of civil protection, in particular warning networks. The passage of extreme floods in the site of the dam causes the rupture of this structure and important damages downstream the dam. The river bed could be damaged by erosion if it is not well protected. Also, we may encounter some scouring and flooding problems in the downstream area of the dam. Therefore, the protection of the dam is crucial. It must have an energy dissipator in a specific place. The basin of dissipation plays a very important role for the security of the dam and the protection of the environment against floods downstream the dam. It allows to dissipate the potential energy created by the dam with the passage of the extreme flood on the weir and regularize in a natural manner and with more security the discharge or elevation of the water plan on the crest of the weir, also it permits to reduce the speed of the flow downstream the dam, in order to obtain an identical speed to the river bed. The problem of the dimensioning of a classic dissipation basin is in the determination of the necessary parameters for the dimensioning of this structure. This communication presents a simple graphical method, that is fast and complete, and a methodology which determines the main features of the hydraulic jump, necessary parameters for sizing the classic dissipation basin. This graphical method takes into account the constraints imposed by the reality of the terrain or the practice such as the one related to the topography of the site, the preservation of the environment equilibrium and the technical and economic side.This methodology is to impose the loss of head DH dissipated by the hydraulic jump as a hypothesis (free design) to determine all the others parameters of classical dissipation basin. We can impose the loss of head DH dissipated by the hydraulic jump that is equal to a selected value or to a certain percentage of the upstream total head created by the dam. With the parameter DH+ =(DH/k),(k: critical depth),the elaborate graphical representation allows to find the other parameters, the multiplication of these parameters by k gives the main characteristics of the hydraulic jump, necessary parameters for the dimensioning of classic dissipation basin.This solution is often preferred for sizing the dissipation basins of small concrete dams. The results verification and their comparison to practical data, confirm the validity and reliability of the elaborate graphical method.

Keywords: dimensioning, energy dissipation basin, hydraulic jump, protection of the environment

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Authors: Yuki Hara

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Healthy assets are recognized as important for all people in the world through experiencing COVID-19. Each part of life and work is important to be changed against the preceding wide-spreading of COVID-19. Furthermore, it is necessary to innovate the whole structure of a city upon the sum of the parts. This study aims at creating a comprehensive strategy from a small practice of making healthier lives with collaborating local actors for a city. This paper employs action research as the research framework. The core practice is the 'Ken’iku Festival' at Ken’iku Festival Committee. The field locates the urban-rural fringe in the northwest part of Fujisawa city, Kanagawa prefecture, Japan. The data is collected through the author's practices for three years from the observations and interviews at meetings and discussions among stakeholders, texts in municipal reports, books, and movies, 3 questionnaires for customers and stakeholders at the Ken’iku Festival. These data are analysed by qualitative methods. The results show that couples in their 40s with children and couples or friends over the 70s are at the heart of promoting healthy lifestyles. In contrast, 40% of the visitors at the festival are the people who have no idea or no interest in healthier actions, which the committee has to suggest healthy activities through more pleasing services. The committee could organize staff and local actors as the core parties involved through gradually expanding its tasks relating to the local practices. This private sectoral activity from health promotion is covering a part of the whole-city planning of Fujisawa municipality by including many people over organisations into one community. This paper concludes from local practice networking through the festival that a comprehensive strategy for a healthy city is both a practical approach easily applied to each partner and one of the holistic services.

Keywords: communal practice network, healthy cities, health & development, health promotion, with and after COVID-19

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Authors: Wanda Luen-Wun Siu, Xiaowen Zhang

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This paper adopted a retrospective review of China’s assistance to Latin America from the1950s to 2020. Findings suggested that China’s assistance to Latin America can be roughly divided into five stages: The 1950s to 1960s was the initial stage of China’s assistance to Latin America, mainly focusing on the establishment of diplomatic relations with Cuba and other Latin American countries. The strategy has a strong ideological basis. The 1980s was the stage of development of China's aid to Latin America, which was characterized by consolidating and expanding diplomatic space, emphasizing the spirit of cooperation of equality, mutual benefit, and common development. 90-20 marked the further development of diplomatic relations with Latin American countries, plus domestic market-oriented reforms, emphasizing the importance of economic considerations and less ideological orientation, and this period also witnessed more Chinese state-owned enterprises going out to invest in Latin America. 2010-2019 marked the further development of Latin American relations. This paper contributes to the literature of diplomacy and health assistance to Latin America and highlights the importance of foreign aid and health assistance in sealing bilateral diplomatic relations.

Keywords: aid, china, latin america, bilateral relations

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Authors: Birendra Kumar Jha, Mingma L. Sherpa, Binod Kumar Dahal

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Background: The metabolic syndrome is emerging as a major public health concern in the world. Urbanization, surplus energy uptake, compounded by decreased physical activities, and increasing obesity are the major factors contributing to the epidemic of metabolic syndrome worldwide. However, prevalence of metabolic syndrome and its risk factors are little studied in Terai region of Nepal. The objectives of this research were to estimate the prevalence and to identify the risk factors of metabolic syndrome among adults in Terai region of Nepal. Method: We used a community based cross sectional study design. A total of 225 adults (age: 18 to 80 years) were selected from three district of Terai region of Nepal using cluster sampling by camp approach. IDF criteria (central obesity with any two of following four factors: triglycerides ≥ 150 mg/dl or specific treatment for lipid abnormality, reduced HDL, raised blood pressure and raised fasting plasma glucose or previously diagnosed type 2 diabetes) were used to assess metabolic syndrome. Interview, physical and clinical examination, measurement of fasting blood glucose and lipid profile were conducted for all participants. Chi-square test and multivariable logistic regression were employed to explore the risk factors of metabolic syndrome. Result: The overall prevalence of metabolic syndrome was 70.7%. Hypertension, increased fasting blood sugar, increased triglycerides and decreased HDL were observed in 50.7%, 32.4%, 41.8% and 79.1% of the subjects respectively. Socio-economic and behavioral risk factors significantly associated with metabolic syndrome were gender male (OR=2.56, 955 CI: 1.42-4.63; p=0.002), in service or retired from service (OR=3.72, 95% CI: 1.72-8.03; p=0.001) and smoking (OR= 4.10, 95% CI: 1.19-14.07; p=0.016). Conclusion: Higher prevalence of Metabolic syndrome along with presence of behavioral risk factors in Terai region of Nepal likely suggest lack of awareness and health promotion activities for metabolic syndrome and indicate the need to promote public health programs in this region to maintain quality of life.

Keywords: metabolic syndrome, Nepal, prevalence, risk factors, Terai

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Authors: Mohammad S. Razai, Jan Williams, Rachel Nestel, Dermot Dalton

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Purpose: This descriptive qualitative study aimed to obtain parents recommendations for improving the notification process and communication of positive newborn screening result for cystic fibrosis (CF). Methods: Thematic analysis of semi-structured open-ended interviews with 11 parents of 7 children with confirmed diagnosis of CF between 2 months — 2 years of age. Results: Parents preferred face to face disclosure of positive NBS results by a pediatrician with CF professional qualification. They trusted a pediatrician more than any other professional in providing accurate, credible and comprehensive information about the diagnosis and its implications. Parents recommended that health professionals be knowledgeable and provide clear, succinct and understandable information. Providers should also explore parents concerns and acknowledge feelings and emotions. Most parents reported that they preferred to be notified immediately as soon as the results were available. Several parents preferred to be told once the diagnosis was certain. Most parents regarded open access to CF team as the most significant part of care coordination. In addition to health professionals, most parents used internet as an important source of information, interaction and exchange of experiences. Most parents also used social networking sites such as Facebook groups and smart phone apps. Conclusion: This study provides significant new evidence from parental perspective in emphasizing the pivotal role of good communication skills deployed by a knowledgeable CF specialist in person. Parents use of social media and internet has replaced some traditional methods of information exchange and may reduce the need for professional input for newly diagnosed CF patients.

Keywords: care coordination, cystic fibrosis, newborn screening, notification process, parental preferences, professional-paren communication

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Authors: Danika Tynes

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Telehealth is a promising advancement in health care, though there are certain conditions under which telehealth has a greater chance of success. This research sought to further the understanding of what conditions compel the success of telehealth adoption at the systems level applying Diffusion of Innovations (DoI) theory (Rogers, 1962). System-level indicators were selected to represent four components of DoI theory (relative advantage, compatibility, complexity, and observability) and regressed on 5 types of telehealth (teleradiology, teledermatology, telepathology, telepsychology, and remote monitoring) using multiple logistic regression. The analyses supported relative advantage and compatibility as the strongest influencers of telehealth adoption, remote monitoring in particular. These findings help to quantitatively clarify the factors influencing the adoption of innovation and advance the ability to make recommendations on the viability of state telehealth adoption. In addition, results indicate when DoI theory is most applicable to the understanding of telehealth diffusion. Ultimately, this research may contribute to more focused allocation of scarce health care resources through consideration of existing state conditions available foster innovation.

Keywords: adoption, diffusion of innovation theory, remote monitoring, system-level indicators

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Authors: Abigail Bentley, Audrey Prost, Nayreen Daruwalla, Apoorwa Gupta, David Osrin

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BACKGROUND: Intimate partner violence (IPV) can impact a woman’s physical, reproductive and mental health, including common mental disorders such as anxiety and depression. However, people other than an intimate partner may also perpetrate violence against women in the family, particularly in India. This study aims to investigate the relationship between experiences of violence perpetrated by the husband and other members of the wider household and symptoms of common mental disorders in women residing in informal settlement (slum) areas of Mumbai. METHODS: Experiences of violence were assessed through a detailed cross-sectional survey of 598 women, including questions about specific acts of emotional, economic, physical and sexual violence across different time points in the woman’s life and the main perpetrator of each act. Symptoms of common mental disorders were assessed using the 12-item General Health Questionnaire (GHQ-12). The GHQ-12 scores were divided into four groups and the relationship between experiences of each type of violence in the last 12 months and GHQ-12 score group was analyzed using ordinal logistic regression, adjusted for the woman’s age and clustering. RESULTS: 482 (81%) women consented to interview. On average, they were 28.5 years old, had completed 7 years of education and had been married 9 years. 88% were Muslim and 47% lived in joint and 53% in nuclear families. 44% of women had experienced at least one act of violence in their lifetime (33% emotional, 22% economic, 23% physical, 12% sexual). 7% had a high GHQ-12 score (6 or above). For violence experiences in the last 12 months, the odds of being in the highest GHQ-12 score group versus the lower groups combined were 13.1 for emotional violence, 6.5 for economic, 5.7 for physical and 6.3 for sexual (p<0.001 for all outcomes). DISCUSSION: The high level of violence reported across the lifetime could be due to the detailed assessment of violent acts at multiple time points and the inclusion of perpetrators within the family other than the husband. Each type of violence was associated with greater odds of a higher GHQ-12 score and therefore more symptoms of common mental disorders. Emotional violence was far more strongly associated with symptoms of common mental disorders than physical or sexual violence. However, it is not possible to attribute causal directionality to the association. Further work to investigate the relationship between differing severity of violence experiences and women’s mental health and the components of emotional violence that make it so strongly associated with symptoms of common mental disorders would be beneficial.

Keywords: common mental disorders, family violence, India, informal settlements, mental health, violence against women

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Authors: Pukhrambam Helena Chanu, Janardan Yadav

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This study investigates the potential of various fungal isolates to solubilize zinc and counteract rice pathogens, with the aim of mitigating zinc deficiency and disease prevalence in rice farming. Soil samples from the rhizosphere were collected, and zinc-solubilizing fungi were isolated and purified. Molecular analysis identified Talaromyces sp, Talaromyces versatilis, Talaromyces pinophilus, and Aspergillus terreus as effective zinc solubilizers. Through qualitative and quantitative assessments, it was observed that solubilization efficiencies varied among the isolates over time, with Talaromyces versatilis displaying the highest capacity for solubilization. This variability in solubilization rates may be attributed to differences in fungal metabolic activity and their ability to produce organic acids that facilitate zinc release from insoluble sources in the soil. In inhibition assays against rice pathogens, the fungal isolates exhibited antagonistic properties, with Talaromyces versatilis demonstrating the most significant inhibition rates. This antagonistic activity may be linked to the production of secondary metabolites, such as antibiotics or lytic enzymes by fungi, which inhibit the growth of rice pathogens. The ability of Talaromyces versatilis to outperform other isolates in both zinc solubilization and pathogen inhibition highlights its potential as a multifunctional biocontrol agent in rice cultivation systems. These findings emphasize the potential of fungi as natural solutions for enhancing zinc uptake and managing diseases in rice cultivation. Utilizing indigenous zinc-solubilizing fungi offers a sustainable and environmentally friendly approach to addressing zinc deficiency in soils, reducing the need for chemical fertilizers. Moreover, harnessing the antagonistic activity of these fungi can contribute to integrated disease management strategies, minimizing reliance on synthetic pesticides and promoting ecological balance in agroecosystems. Additionally, the study included the evaluation of dipping time under different concentrations, viz.,10 ppm, 20 ppm, and 30 ppm of biosynthesized nano ZnO on rice seedlings. This investigation aimed to optimize the application of nano ZnO for efficient zinc uptake by rice plants while minimizing potential risks associated with excessive nanoparticle exposure. Evaluating the effects of varying concentrations and dipping durations provides valuable insights into the safe and effective utilization of nano ZnO as a micronutrient supplement in rice farming practices.

Keywords: biosynthesized nano ZnO, rice, root dipping, zinc solubilizing fungi.

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Authors: Gulay Aras, Isil Kutluturk Karagoz, Z. Candan Algun

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Background: Hypermetropia in school-age is a pathology that responds to treatment. In the literature, there has been no study of exercise practice in hypermetropia treatment. Objective: The purpose of this study was to investigate the effects of eye exercises and convergence exercise on visual acuity in school-age children with hypermetropia. Methods: Forty volunteer school-age children with hypermetropia (30 girls, 30 boys, between 7-17 years of age) were included in the study. Sociodemographic information and clinical characteristics were evaluated. 40 participants were randomly divided into two groups: eye exercises and convergence exercises. Home exercise protocols were given to all groups for six weeks, and regular phone calls were made once a week. Individuals performed eye exercises 10 times, convergence exercises 5 min. for two sessions per day for six weeks. The right and left eyes of all the subjects participating in the study were assessed separately by the eye doctor with a Snellen chart. The participants' quality of life was assessed using Pediatric Quality of Life Inventory Version 4.0. Physical health total score (PHTS) and scale total score (STS), which were obtained by evaluating Psychosocial health total score (PSHTS) school, emotional and social functioning, were calculated separately in the scores. At the end of the exercise program, the assessment tests applied at the beginning of the study were reapplied to all individuals. Results: There was no statistically significant difference between the pre- and post-Snellen chart measurements and quality of life in the eye exercises group (p > 0,05). There was a statistically significant difference in visual acuity of right and left eyes (p=0,004, p=0,014) and quality of life in PHTS, PSHTS and STS in the convergence exercise group (p=0,001, p=0,017, p=0,001). Conclusions: In school-age children, convergence exercises were found to be effective on visual acuity and health-related quality of life. Convergence exercises are recommended for the treatment of school-aged children with hypermetropia.

Keywords: convergence exercise, eye exercises, hypermetropia, school-age children

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Authors: Akbarova Gulnozakhon

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Relevance. Physical exercises can prolong the function of the growth zones of long tubular bones, delay the fusion of the epiphyses and diaphyses of bones and, thus, increase the growth of the body. At the same time, intensive strength exercises can accelerate the process of ossification of bone growth zones and slow down their growth in length. The influence of physical exercises on the process of biological maturation is noted. Gymnastics, which requires intense speed and strength loads, delays puberty. On the other hand, it is indicated that the relatively slow puberty of gymnasts is associated with the selection of girls with a special somatotype in this sport. It was found that the later onset of menstruation in female athletes does not have a negative effect on the maturation process and fertility (the ability to procreate). Observations are made about the normalizing influence of sports on the puberty of girls. The purpose of the study. Our goal is to study physical activity of varying intensity on the formation of secondary sexual characteristics and hormonal status of girls in adolescence. Each biological process peculiar to a given organism is not in a stationary state, but fluctuates with a certain frequency. According to the duration, there are, for example, circadian cycles, and infradian cycles, a typical example of which is the menstrual cycle. Materials and methods, results. Violations of menstrual function in athletes were detected by applying a questionnaire survey that contains several paragraphs and sub-paragraphs where passport data, anthropometric indicators, taking into account anthropometric indices, information about the menstrual cycle are indicated. Of 135 female athletes aged 1-3 to 16 years engaged in various sports - gymnasts, menstrual function disorders were noted in 86.7% (primary or secondary amenorrhea, irregular MC), in swimming-in 57.1%. The general condition also changes during the menstrual cycle. In a large percentage of cases, athletes indicate an increase in irritability in the premenstrual (45%) and menstrual (36%) phases. During these phases, girls note an increase in fatigue of 46.5% and 58% (respectively). In girls, secondary sexual characteristics continue to form during puberty and the clearest indicator of the onset of puberty is the age of the onset of the first menstruation - menarche. Conclusions. 1. Physical exercise has a positive effect on all major systems of the body and thus promotes health.2. Along with a beneficial effect on human health, physical exercise, if the requirements of sports are not observed, can be harmful.

Keywords: girls health, anthropometric, physical development, reproductive health

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Authors: Ashimolowo Olubunmi

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Contraception use helps prevent pregnancy as well as health-related challenges, most especially among youths and girls. Our communities are bedeviled with many problems, including rape, defilement, neglect by the spouse, and intimate partner violence. Current interventions target only adults, with most facilities having youth and unfriendly adolescent services. To further support the need for this research, especially with our target beneficiaries, the partnership embarked on qualitative evidence-finding research through focus group discussions and in-depth-interview in Abeokuta and Ibadan (the capital cities of Ogun). The Focus Group Discussion (FGD) sessions were held in the state with adolescents (10-18 years) and young women (18-30 years). The result revealed that teenagers and youths who receive formal and sexual education on abstinence, and birth control methods, are likely to have healthier sexual behaviours through the promotion of abstinence and the use of condoms and other forms of contraceptives at their first intercourse, thereby protecting themselves against HIV/AIDs (Human Immunodeficiency Virus/Acquired immunodeficiency syndrome. The result further revealed that parents do not discuss issues around Adolescent and Sexual Reproductive Health (ASRH) with their adolescent girls, leading to gaps in knowledge of ASRH. Stakeholders’ involvement and trust are low. Respondents noted that there were few outreaches on ASRH and that youth-friendly adolescent centres are not common in the community. Respondents noted that there were few outreaches on ASRH organised within the community. Also, youth-friendly services were not common. There is a need to work with all stakeholders to promote those foundational life skills on pubertal changes, menstruation, and sexual life to prepare youths and girls for challenges ahead through sex education; we should work to institutionalize youth and adolescent-friendly Sexual and Reproductive Health (SRH) in our communities.

Keywords: contraception, family planning, focus group discussion, adolescents

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Authors: H. Ju, M. Jones, G. D. Mishra

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Introduction: Limited longitudinal studies have examined the relationship between BMI and dysmenorrhea, resulting in mixed results. This study aims to investigate the long-term association between BMI and dysmenorrhea. Methods: 9,688 women from Australian Longitudinal Study on Women’s Health (ALSWH), a prospective population-based cohort study, were followed for 13 years. Data were collected through self-reported questionnaires repeatedly on all variables, including dysmenorrhea, weight and height. The longitudinal association between dysmenorrhea and BMI or BMI transition (change of BMI categories between two successive surveys) was investigated by generalized estimating equations. Results: When the women were aged 22 to 27 years, approximately 11% were obese, 7% underweight, and 25% reported dysmenorrhea. Over the study period, the prevalence of obesity doubled whereas that of underweight declined substantially. The prevalence of dysmenorrhea remained relatively stable. Compared to women with a normal weight, significantly higher odds of reporting dysmenorrhea were detected for both women who were underweight (odds ratio (OR) 1.25, 95% confidence interval (CI) 1.09, 1.43) and obese (OR 1.20, 95% CI 1.10, 1.31). Being overweight was not associated with increased risk of dysmenorrhea. Compared to women who remained at normal weight or overweight over time, significant risk was detected for women who: remained underweight or obese (OR 1.35, 95% CI 1.23, 1.49), were underweight but became normal or overweight (OR 1.29, 95% CI 1.11, 1.50), became underweight (OR 1.24, 95% CI 1.01, 1.52). However, the higher risk among obese women disappeared when they lost weight and became normal weight or overweight (OR 1.07, 95% CI 0.87, 1.30). Conclusions: A U-shaped association was revealed between dysmenorrhea and BMI, revealing higher risk of dysmenorrhea for both underweight and obese women. Further, the risk disappeared when obese women lost weight and acquired a healthier BMI. However obesity certainly poses a greater burden of disease from the public health perspective, thus requires greater effort to tackle the increasing problem at the population level. It is important to maintain a healthy weight over time for women to enjoy a better reproductive health.

Keywords: body mass index, dysmenorrhea, obesity, painful period, underweight

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Authors: Eze Chinwe Catherine, Orji Nkiru Marykate, Anyaegbunam L. C., Igbodika M.C.

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Uterine Leiomyomata (ULs) are the most frequently occurring pelvic and gynaecologic tumors in premenopausal women, occurring globally with a prevalence of 21.4%. UL represents a major public health problem in African women; therefore, this study aimed to reveal public health impact and risk factors associated with uterine leiomyomata among women in Imo state. A convenience sample of 2965 women was studied for gynaecological cases from October 2020 to March 2021 at the selected clinics of study. Eligible women were recruited to participate in a non interventional descriptive cross-sectional study. Data on socio demographic and gynaecological characteristics, BMI, parity, age, age at menarche, knowledge, attitudes, and perception were collected using a structured questionnaire, guided interviews, anthropometrics, and haematological tests. These were analyzed using SPSS Version 23. Associations between continuous variables were analysed appropriately and tested at 95% confidence level and standard error of 5%. A total of 652(22.0%) were diagnosed having uterine Leiomyomata (UL), and the overall prevalence of UF at clinics/Diagnostic centre in Imo State was 22%. A total of 652 women (46.1%) responded. More than half of the women had a parity of zero (1623: 54.8%), 664 (22.4%) had a parity of 1-2, and 491 (16.6%) had a parity of 3-4. Majority (68.6%) indicated that they experience an irregular menstrual cycle, and a similar proportion (67%) number experience pelvic pain. Age was found as a significant associating factor of uterine fibroids in this study (p=0.046, χ2= 6.158), lowest among the women between 16 to 25 years old and highest among the women between 36 – 45 years of age. The rate of UF was found to be 62.1% on the studied women menarche age of 11 years old or less while it was approximately 18% among the women whose age at menarche were at least 14 years old. Education ((p=0.003, χ²= 13.826), residency (p=0.066, χ²= 3.372). BMI (p= 0.000, χ²=102.36) were significantly associated with the risk of UL. Some of the Clinical presentation includes anaemia, abdominal pelvic mass, and infertility. The poor positive perception was obtained on the general perception (16.7%) as well as on treatment seeking behavior (28%). The study concluded that UL had a significant impact on health related quality of life on respondents due to its relatively high prevalence and their probable impact on patient’s quality of life.UL was especially prevalent in women aged between 36 to 45 years, nulliparous women, and women of higher BMI. Community enlightenment to enhance knowledge, attitude, and perception on fibroids and risk factors necessary to ensure early diagnosis and presentation, including patient centered treatment option.

Keywords: fibroids, prevalence, risk factors, body mass index, menarche, anaemia, KAP

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Authors: Carmen Axisa, Louise Nash, Patrick Kelly, Simon Willcock

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Introduction: Doctors experience high levels of burnout, stress and psychiatric morbidity. This can affect the health of the doctor and impact patient care. Study Aims: To evaluate the effectiveness of a workshop intervention to promote wellbeing for Australian Physician Trainees. Methods: A workshop was developed in consultation with specialist clinicians to promote health and wellbeing for physician trainees. The workshop objectives were to improve participant understanding about factors affecting their health and wellbeing, to outline strategies on how to improve health and wellbeing and to encourage participants to apply these strategies in their own lives. There was a focus on building resilience and developing long term healthy behaviours as part of the physician trainee daily lifestyle. Trainees had the opportunity to learn practical strategies for stress management, gain insight into their behaviour and take steps to improve their health and wellbeing. The workshop also identified resources and support systems available to trainees. The workshop duration was four and a half hours including a thirty- minute meal break where a catered meal was provided for the trainees. Workshop evaluations were conducted at the end of the workshop. Sixty-seven physician trainees from Adult Medicine and Paediatric training programs in Sydney Australia were randomised into intervention and control groups. The intervention group attended a workshop facilitated by specialist clinicians and the control group did not. Baseline and post intervention measurements were taken for both groups to evaluate the impact and effectiveness of the workshop. Forty-six participants completed all three measurements (69%). Demographic, personal and self-reported data regarding work/life patterns was collected. Outcome measures include Depression Anxiety Stress Scale (DASS), Professional Quality of Life Scale (ProQOL) and Alcohol Use Disorders Identification Test (AUDIT). Results: The workshop was well received by the physician trainees and workshop evaluations showed that the majority of trainees strongly agree or agree that the training was relevant to their needs (96%) and met their expectations (92%). All trainees strongly agree or agree that they would recommend the workshop to their medical colleagues. In comparison to the control group we observed a reduction in alcohol use, depression and burnout but an increase in stress, anxiety and secondary traumatic stress in the intervention group, at the primary endpoint measured at 6 months. However, none of these differences reached statistical significance (p > 0.05). Discussion: Although the study did not reach statistical significance, the workshop may be beneficial to physician trainees. Trainees had the opportunity to share ideas, gain insight into their own behaviour, learn practical strategies for stress management and discuss approach to work, life and self-care. The workshop discussions enabled trainees to share their experiences in a supported environment where they learned that other trainees experienced stress and burnout and they were not alone in needing to acquire successful coping mechanisms and stress management strategies. Conclusion: These findings suggest that physician trainees are a vulnerable group who may benefit from initiatives that promote wellbeing and from a more supportive work environment.

Keywords: doctors' health, physician burnout, physician resilience, wellbeing workshop

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Authors: Tak Mau Simon Chan

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While there is growing reflection of the adverse impacts instigated by the flourishing gaming industry on the physical health and job satisfaction of those who work in Macau casinos, there is also a critical void in our understanding of the mental health of croupiers and how casino employment interacts with the family system. From a systemic approach, it would be most effective to examine the ‘dealer issues’ collectively and offer assistance to both the individual dealer and the family system of dealers. Therefore, with the use of a mixed method study design, the levels of anxiety, depression and sleeping quality of a sample of 1124 dealers who are working in Macau casinos have been measured in the present study, and 113 dealers have been interviewed about the impacts of casino employment on their family life. This study presents some very important findings. First, the quantitative study indicates that gender is a significant predictor of depression and anxiety levels, whilst lower income means less quality sleep. The Pearson’s correlation coefficients show that as the Zung Self-rating Anxiety Scale (ZSAS) scores increase, the Zung Self-rating Depression Scale (ZSDS) and Pittsburgh Sleep Quality Index (PSQI) scores will also simultaneously increase. Higher income, therefore, might partly explain for the reason why mothers choose to work in the gaming industry even with shift work involved and a stressful work environment. Second, the findings from the qualitative study show that aside from the positive impacts on family finances, the shift work and job stress to some degree negatively affect family responsibilities and relationships. There are resultant family issues, including missed family activities, and reduced parental care and guidance, marital intimacy, and communication with family members. Despite the mixed views on the gender role differences, the respondents generally agree that female dealers have more family and child-minding responsibilities at home, and thus it is more difficult for them to balance work and family. Consequently, they may be more vulnerable to stress at work. Thirdly, there are interrelationships between work and family, which are based on a systemic inquiry that incorporates work- individual- family. Poor physical and psychological health due to shift work or a harmful work environment could affect not just work performance, but also life at home. Therefore, a few practice points about 1) work-family conflicts in Macau; 2) families-in- transition in Macau; and 3) gender and class sensitivity in Macau; are provided for social workers and family practitioners who will greatly benefit these families, especially whose family members are working in the gaming industry in Macau. It is concluded that in addressing the cultural phenomenon of “dealer’s complex” in Macau, a systemic approach is recommended that addresses both personal psychological needs and family issue of dealers.

Keywords: family, work stress, mental health, Macau, dealers, gaming industry

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Authors: Tessa Sellis, Marike A. Wierda, Elke Tichelman, Mirjam T. Van Lohuizen, Marjolein Berger, François Schellevis, Claudi Bockting, Lilian Peters, Huib Burger

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Introduction: Most women develop a healthy bond with their children, however, adequate mother-to-infant bonding cannot be taken for granted. Mother-to-infant bonding refers to the feelings and emotions experienced by the mother towards her child. It is an ongoing process that starts during pregnancy and develops during the first year postpartum and likely throughout early childhood. The prevalence of inadequate bonding ranges from 7 to 11% in the first weeks postpartum. An impaired mother-to-infant bond can cause long-term complications for both mother and child. Very little research has been conducted on the direct relationship between the personality of the mother and mother-to-infant bonding. This study explores the associations between maternal personality and postnatal mother-to-infant bonding. The main hypothesis is that there is a relationship between neuroticism and mother-to-infant bonding. Methods: Data for this study were used from the Pregnancy Anxiety and Depression Study (2010-2014), which examined symptoms of and risk factors for anxiety or depression during pregnancy and the first year postpartum of 6220 pregnant women who received primary, secondary or tertiary care in the Netherlands. The study was expanded in 2015 to investigate postnatal mother-to-infant bonding. For the current research 3836 participants were included. During the first trimester of gestation, baseline characteristics, as well as personality, were measured through online questionnaires. Personality was measured by the NEO Five Factor Inventory (NEO-FFI), which covers the big five of personality (neuroticism, extraversion, openness, altruism and conscientiousness). Mother-to-infant bonding was measured postpartum by the Postpartum Bonding Questionnaire (PBQ). Univariate linear regression analysis was performed to estimate the associations. Results: 5% of the PBQ-respondents reported impaired bonding. A statistically significant association was found between neuroticism and mother-to-infant bonding (p < .001): mothers scoring higher on neuroticism, reported a lower score on mother-to-infant bonding. In addition, a positive correlation was found between the personality traits extraversion (b: -.081), openness (b: -.014), altruism (b: -.067), conscientiousness (b: -.060) and mother-to-infant bonding. Discussion: This study is one of the first to demonstrate a direct association between the personality of the mother and mother-to-infant bonding. A statistically significant relationship has been found between neuroticism and mother-to-infant bonding, however, the percentage of variance predictable by a personality dimension is very small. This study has examined one part of the multi-factorial topic of mother-to-infant bonding and offers more insight into the rarely investigated and complex matter of mother-to-infant bonding. For midwives, it is important recognize the risks for impaired bonding and subsequently improve policy for women at risk.

Keywords: mother-to-infant bonding, personality, postpartum, pregnancy

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Authors: Aisha Giwa, Mohammed-Faosy Adeniran, Olufunke Femi-Ojo

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Four decades ago, the World Health Organization (WHO) launched the Expanded Programme on Immunization (EPI). The EPI blueprint laid out the technical and managerial functions necessary to routinely vaccinate children with a limited number of vaccines, providing protection against diphtheria, tetanus, whooping cough, measles, polio, and tuberculosis, and to prevent maternal and neonatal tetanus by vaccinating women of childbearing age with tetanus toxoid. Despite global efforts, the Routine Immunization (RI) coverage in two of the World Health Organization (WHO) regions; the African Region and the South-East Asia Region, still remains short of its targets. As a result, the WHO Regional Director for Africa declared 2012 as the year for intensifying RI in these regions and this also coincided with the declaration of polio as a programmatic emergency by the WHO Executive Board. In order to intensify routine immunization, the National Routine Immunization Strategic Plan (2013-2015) stated that its core priority is to ensure 100% adequacy and availability of vaccines for safe immunization. To achieve 100% availability, the “PUSH System” and then “Push-Plus” were adopted for vaccine distribution, which replaced the inefficient “PULL” method. The NPHCDA plays the key role in coordinating activities in area advocacy, capacity building, engagement of 3PL for the state as well as monitoring and evaluation of the vaccine delivery process. eHealth Africa (eHA) is a player as a 3PL service provider engaged by State Primary Health Care Boards (SPHCDB) to ensure vaccine availability through Vaccine Direct Delivery (VDD) project which is essential to successful routine immunization services. The VDD project ensures the availability and adequate supply of high-quality vaccines and immunization-related materials to last-mile facilities. eHA’s commitment to the VDD project saw the need for an assessment of the project vis-a-vis the overall project performance, evaluation of a process for necessary improvement suggestions as well as general impact across Kano State (Where eHA had transitioned to the state), Bauchi State (currently manage delivery to all LGAs except 3 LGAs currently being managed by the state), Sokoto State (eHA currently covers all LGAs) and Zamfara State (Currently, in-sourced and managed solely by the state).

Keywords: cold chain logistics, health supply chain system strengthening, logistics management information system, vaccine delivery traceability and accountability

Procedia PDF Downloads 277

Authors: Veenapani Rajeev Verma

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Context: Assessing facility readiness is paramount as it can indicate capacity of facilities to provide essential care for resilience to health challenges. In the context of decentralization, estimation of supply side readiness indices at sub national level is imperative for effective evidence based policy but remains a colossal challenge due to lack of dependable and representative data sources. Setting: District Poonch of Jammu and Kashmir was selected for this study. It is remote, rural district with unprecedented topographical barriers and is identified as high priority by government. It is also a fragile area as is bounded by Line of Control with Pakistan bearing the brunt of cease fire violations, military skirmishes and sporadic militant attacks. Hilly geographical terrain, rudimentary/absence of road network and impoverishment are quintessential to this area. Objectives: Objective of the study is to a) Evaluate the service readiness of health facilities and create a concise index subsuming plethora of discrete indicators and b) Ascertain supply side barriers in service provisioning via stakeholder’s analysis. Study also strives to expand analytical domain unravelling context and area specific intricacies associated with service delivery. Methodology: Mixed method approach was employed to triangulate quantitative analysis with qualitative nuances. Facility survey encompassing 90 Subcentres, 44 Primary health centres, 3 Community health centres and 1 District hospital was conducted to gauge general service availability and service specific availability (depth of coverage). Compendium of checklist was designed using Indian Public Health Standards (IPHS) in form of standard core questionnaire and scorecard generated for each facility. Information was collected across dimensions of amenities, equipment, medicines, laboratory and infection control protocols as proposed in WHO’s Service Availability and Readiness Assesment (SARA). Two stage polychoric principal component analysis employed to generate a parsimonious index by coalescing an array of tracer indicators. OLS regression method used to determine factors explaining composite index generated from PCA. Stakeholder analysis was conducted to discern qualitative information. Myriad of techniques like observations, key informant interviews and focus group discussions using semi structured questionnaires on both leaders and laggards were administered for critical stakeholder’s analysis. Results: General readiness score of health facilities was found to be 0.48. Results indicated poorest readiness for subcentres and PHC’s (first point of contact) with composite score of 0.47 and 0.41 respectively. For primary care facilities; principal component was characterized by basic newborn care as well as preparedness for delivery. Results revealed availability of equipment and surgical preparedness having lowest score (0.46 and 0.47) for facilities providing secondary care. Presence of contractual staff, more than 1 hr walk to facility, facilities in zone A (most vulnerable) to cross border shelling and facilities inaccessible due to snowfall and thick jungles was negatively associated with readiness index. Nonchalant staff attitude, unavailability of staff quarters, leakages and constraint in supply chain of drugs and consumables were other impediments identified. Conclusions/Policy Implications: It is pertinent to first strengthen primary care facilities in this setting. Complex dimensions such as geographic barriers, user and provider behavior is not under precinct of this methodology.

Keywords: effective coverage, principal component analysis, readiness index, universal health coverage

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Authors: Ni Luh Bayu PurwaEka Payani, Destin Ristanti

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Every child has the right to be healthy, and it is a parents’ obligation to fulfill their rights. In order to be healthy and prevented from the outbreak of infectious diseases, some vaccines are required. However, there are groups of people, who consider that vaccines consist of religiously forbidden ingredients. The government of Indonesia legally set the rule that all children must be vaccinated. However, merely based on religious beliefs and not supported by scientific evidence, these people ignore the vaccination. As a result, this anti-vaccine movement caused diphtheria outbreak in 2017. Categorized as a vulnerable group, child`s rights must be fulfilled in any forms. This paper tries to analyze the contradiction between religious beliefs and the fulfillment of child`s rights. Furthermore, it tries to identify the anti-vaccine movement as a form of human rights violation, especially regarding child's rights. This has been done by examining the event of the outbreak of diphtheria in 20 provinces of Indonesia. Furthermore, interview and literature reviews have been done to support the analysis. Through this process, it becomes clear that the anti-vaccine movements driven by religious beliefs did influence the outbreak of diphtheria. Hence, the anti-vaccine movements ignore the long-term effects not only on their own children’s health but also others.

Keywords: anti-vaccine movement, child rights, religious beliefs, right to health

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Authors: Ali Maksum

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In a number of countries, including Indonesia, the tendency for non-communicable diseases is increasing. As a result, health costs must be paid by the state continues to increase as well. People's lifestyles, including due to lack of physical activity, are thought to have contributed significantly to the problem. This study aims to examine the impact of participation in sports on quality of life, which is reflected in three main indicators, namely health, psychological, and social aspects. The study was conducted in the city of Surabaya and its surroundings, with a total of 490 participants, consisting of 245 men and 245 women with an average age of 45.4 years. Data on physical activity and quality of life were collected by questionnaire and analyzed using structural equation modeling. The test results of the model prove that the value of chi-square = 8,259 with p = .409, RMSEA = .008, NFI = .992, and CFI = 1. This means that the model is compatible with the data. The model explains that physical activity has a significant effect on quality of life. People who exercise regularly are better able to cope with stress, have a lower risk of illness, and have higher pro-social behavior. Therefore, it needs serious efforts from stakeholders, especially the government, to create an ecosystem that allows the growth of movement culture in the community.

Keywords: participation, physical activity, quality of life, structural equation modelling

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Authors: Rafael Andres Rincon Barrera

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Safety in global aviation plays a preponderant role in organizations that seek to avoid accidents in an attempt to preserve their most precious assets (the people and the machines). Human factors-based programs have shown to be effective in managing human-generated risks. The importance of training on human factors in maintenance has not been indifferent to the Colombian Air Force (COLAF). This research, which has a mixed quantitative, qualitative and descriptive approach, deals with its absence of structuring an instruction program in Human Factors in Aeronautical Maintenance, which serves as a tool to improve Operational Safety in the military air units of the COLAF. Research shows the trends and evolution of human factors programs in aeronautical maintenance through the analysis of a data matrix with 33 sources taken from different databases that are about the incorporation of these types of programs in the aeronautical industry in the last 20 years; as well as the improvements in the operational safety process that are presented after the implementation of these ones. Likewise, it compiles different normative guides in force from world aeronautical authorities for training in these programs, establishing a matrix of methodologies that may be applicable to develop a training program in human factors in maintenance. Subsequently, it illustrates the design, validation, and development of a human factors knowledge measurement instrument for maintenance at the COLAF that includes topics on Human Factors (HF), Safety Management System (SMS), and aeronautical maintenance regulations at the COLAF. With the information obtained, it performs the statistical analysis showing the aspects of knowledge and strengthening the staff for the preparation of the instruction program. Performing data triangulation based on the applicable methods and the weakest aspects found in the maintenance people shows a variable crossing from color coding, thus indicating the contents according to a training program for human factors in aeronautical maintenance, which are adjusted according to the competencies that are expected to be developed with the staff in a curricular format established by the COLAF. Among the most important findings are the determination that different authors are dealing with human factors in maintenance agrees that there is no standard model for its instruction and implementation, but that it must be adapted to the needs of the organization, that the Safety Culture in the Companies which incorporated programs on human factors in maintenance increased, that from the data obtained with the instrument for knowledge measurement of human factors in maintenance, the level of knowledge is MEDIUM-LOW with a score of 61.79%. And finally that there is an opportunity to improve Operational Safety for the COLAF through the implementation of the training program of human factors in maintenance for the technicians working in this area.

Keywords: Colombian air force, human factors, safety culture, safety management system, triangulation

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Authors: Iva Trako, Maris Micaela Sviatschi, Guadalupe Kavanaugh

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Domestic violence is a major concern in developing countries, with important social, economic and health consequences. However, institutions do not usually address the problems facing women or ethnic and religious minorities. For example, the police do very little to stop domestic violence in rural areas of developing countries. This paper exploits the introduction of women’s justice centers (WJCs) in Peru to provide causal estimates on the effects of improving access to justice for women and children. These centers offer a new integrated public service model for women by including medical, psychological and legal support in cases of violence against women. Our empirical approach uses a difference in difference estimation exploiting variation over time and space in the opening of WJC together with province-by-year fixed effects. Exploiting administrative data from health providers and district attorney offices, we find that after the opening of these centers, there are important improvements on women's welfare: a large reduction in femicides and female hospitalizations for assault. Moreover, using geo-coded household surveys we find evidence that the existence of these services reduces domestic violence, improves women's health, increases women's threat points and, therefore, lead to household decisions that are more aligned with their interests. Using administrative data on the universe of schools, we find large gains on human capital for their children: affected children are more likely to enroll, attend school and have better grades in national exams, instead of working for the family. In sum, the evidence in this paper shows that providing access to justice for women can be a powerful tool to reduce domestic violence and increase education of children, suggesting a positive inter-generational benefit.

Keywords: access to justice, domestic violence, education, household bargaining

Procedia PDF Downloads 168

Authors: D. Baranova, E. Neborak

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Polyphenols, particularly flavonoids like quercetin, fisetin, and kaempferol, have gained significant attention in nutrition due to their antioxidant, senolytic, and anti-inflammatory properties. These compounds are commonly found in various plant-based foods and are represented by diverse subclasses, each with unique health benefits. Understanding their absorption, metabolism, and bioactivity within the human body is crucial for unlocking their full potential. Quercetin, for instance, exists in multiple forms, impacting its solubility and absorption in the intestine. Its intake, often derived from sources like apples, is affected by cooking methods, with medium heat retaining its potency. Fisetin, also present in fruits and vegetables, demonstrates neuroprotective qualities and stability under varied conditions compared to quercetin. Similarly, kaempferol, found in fruits and vegetables, displays antioxidative effects but is influenced by cooking techniques, with specific methods preserving its polyphenolic content better. Overall, these polyphenols offer promising health benefits, yet their optimal dosage and specific dietary recommendations warrant further research to harness their full nutritional potential.

Keywords: polyphenols, flavonoids, absorption, quercetin, kaempferol, fisetin, senolytics, absorption, cooking method

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Authors: Selim M. Khan, Aaron A. Goodarzi, Joshua M. Taron, Tryggve Rönnqvist

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Indoor air quality, a prime determinant of health, is strongly influenced by the presence of hazardous radon gas within the built environment. As a health issue, dangerously high indoor radon arose within the 20th century to become the 2nd leading cause of lung cancer. While the 21st century building metrics and human behaviors have captured, contained, and concentrated radon to yet higher and more hazardous levels, the issue is rapidly worsening in Canada. It is established that Canadians in the Prairies are the 2nd highest radon-exposed population in the world, with 1 in 6 residences experiencing 0.2-6.5 millisieverts (mSv) radiation per week, whereas the Canadian Nuclear Safety Commission sets maximum 5-year occupational limits for atomic workplace exposure at only 20 mSv. This situation is also deteriorating over time within newer housing stocks containing higher levels of radon. Deep machine learning (LSTM) algorithms were applied to analyze multiple quantitative and qualitative features, determine the most important contributory factors, and predicted radon levels in the known past (1990-2020) and projected future (2021-2050). The findings showed gradual downwards patterns in Sweden, whereas it would continue to go from high to higher levels in Canada over time. The contributory factors found to be the basement porosity, roof insulation depthness, R-factor, and air dynamics of the indoor environment related to human window opening behaviour. Building codes must consider including these factors to ensure adequate indoor ventilation and healthy living that can prevent lung cancer in non-smokers.

Keywords: radon, building metrics, deep learning, LSTM prediction model, lung cancer, canada, sweden

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Authors: Aylin Hasbay Büyükkaragöz, Zehra Büyüktuncer, Tuğçe Nur Balcı, Nevin Ergun

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Purpose: Nutritional supplement usage is widespread among athletes all over the world. However, the usage among disabled athletes is not well-known. This study aimed to evaluate dietary supplement use in disabled athletes, their motivation for consuming supplements, sources of information, and their side effect. Methods: A total of 75 Turkish National Team's disabled athletes (38 female, 37 male) from 5 sport branches (soccer, weight lifting, shooting, table tennis and basketball), aged 13- 55 years, were participated in the study. Nutritional supplement usage was inquired using a questionnaire by a dietitian at their preparation camps. Results: A total of 22.7% of the athletes (18.4% and 27% of, respectively females and males) used some type of dietary supplements. Protein (35.3%), amino acid (29.4%), carnitine (29.4%), creatine (23.5%) and glucosamine (23.5%) were mostly preferred nutritional supplements by all athletes. The most common supplements use was obtained among weightlifters (71.4%), followed by the athletes of soccer (23.5%), table tennis (15.4%), and basketball (6.7%). No nutritional supplement usage was observed among shooters. Total of 41.2% consumers declared more than one reason for taking nutritional supplements. The main motivation for supplement usage was improving athletic performance (63.5%). Other reasons were weight loss, weight gain, muscle development, health protection and nutritional support. Athletes were more likely to get recommendation about nutritional supplement usage from team coaches (48.9%). Of 35.6% athletes reported that they made their own decision about using supplements. Other information sources were health professional, family member, friend and sale manager of sport retail store. Only 3 of 17 athletes reported side effects which were increased urine output, weight gain, loss of appetite and intestinal gas. Conclusions: Nutritional supplement usage was not common among disabled athletes. However, getting information from incompetent sources is disquieting. Considering their health problems, accurate information from competent sources should be provided to disabled athletes. Moreover, long term effects of nutritional supplements among disabled athletes should be examined in further studies.

Keywords: disabled athletes, ergogenic aid, nutritional supplement, vitamin supplementation

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Authors: Kayum Fokoue Carole

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This paper aims at verifying the effectiveness of reaching target populations while paying attention to their cultural background when communicating new knowledge, ideas or technology in a multicultural world. Our case study is an experiment on the communication of knowledge on breast cancer in three sub-Saharan countries (Ghana, Tchad, and Cameroon health). The methodology consisted of submitting a semi-structured questionnaire to local populations in some localities in these target countries in order to determine the cultural barriers hindering the effective communication of knowledge on breast cancer. Once this done, sensitization documents on breast cancer were translated into Ewe (Ghana), Mbaye (Tchad), Ghomala’, Ewondo, and Fufulde (Cameroon). In each locality, a sensitization programme was organised for two groups. For one group, the cultural barriers discovered were taken into consideration while communicating during the programme whereas in the other group, they were not. Another questionnaire was disseminated after three months to verify the level of appropriation of those who attended the campaign based on Chumbow’s appropriation theory. This paper, therefore, discusses some spiritual beliefs, representations and practices in the target African communities hindering effective communication of issues on breast cancer in the target localities. Findings reveal that only 38% of respondents in the group of those for whom cultural barriers were not taken into account during the programme had a high level of appropriation while for the other group, 86% had a high level of appropriation. This is evidence that the communication of issues on breast cancer can be more effective by reaching different populations in a language they best master while paying attention to their culture. Therefore, international communication of new knowledge should be culturally contextualised. Suggestions at the end of the paper are directed towards the achievement of these goals. The present work promotes international partnership in addressing and resolving global health preoccupations since research findings from one community/country can be mutualized in partnership with other communities and countries.

Keywords: cultural barriers, communication, health, breast cancer

Procedia PDF Downloads 321

Authors: Natchaphon Auampradit, Patama Vapattanawong, Sureeporn Punpuing, Malee Sunpuwan, Tawanchai Jirapramukpitak

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Longitudinal studies related to cognitive impairment in elderly are necessary for health promotion and development. The purposes of this study were (1) to examine changes in cognition of elderly over time and (2) to examine the impacts of changes in social determinants of health (SDH) toward changes in cognition of elderly by using the secondary data derived from the Kanchanaburi Demographic Surveillance System (KDSS) by the Institute for Population and Social Research (IPSR) which contained longitudinal data on individuals, households, and villages. Two selected projects included the Health and Social Support for Elderly in KDSS in 2007 and the Population, Economic, Social, Cultural, and Long-term Care Surveillance for Thai Elderly People’s Health Promotion in 2011. The samples were 586 elderly participated in both projects. SDH included living arrangement, social relationships with children, relatives, and friends, household asset-based wealth index, household monthly income, loans for livings, loans for investment, and working status. Cognitive impairment was measured by category fluency and delayed recall. This study employed Generalized Estimating Equation (GEE) model to investigate changes in cognition by taking SDH and other variables such as age, gender, marital status, education, and depression into the model. The unstructured correlation structure was selected to use for analysis. The results revealed that 24 percent of elderly had cognitive impairment at baseline. About 13 percent of elderly still had cognitive impairment during 2007 until 2011. About 21 percent and 11 percent of elderly had cognitive decline and cognitive improvement, respectively. The cross-sectional analysis showed that household asset-based wealth index, social relationship with friends, working status, age, marital status, education, and depression were significantly associated with cognitive impairment. The GEE model revealed longitudinal effects of household asset-based wealth index and working status against cognition during 2007 until 2011. There was no longitudinal effect of social conditions against cognition. Elderly living with richer household asset-based wealth index, still being employed, and being younger were less likely to have cognitive impairment. The results strongly suggested that poorer household asset-based wealth index and being unemployed were served as a risk factor for cognitive impairment over time. Increasing age was still the major risk for cognitive impairment as well.

Keywords: changes in cognition, cognitive impairment, elderly, KDSS, longitudinal study

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Authors: Panisa Harnpathananun

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This paper is 'Practical Experience Analysis' which aims to analyze critical obstacles hampering the growth of the functional milk industry and suggest recommendations to overcome those obstacles. Using the Sectoral Innovation System (SIS) along value chain analysis, it is found that restriction in regulation of milk disinfection process, difficulty of dairy entrepreneurs for health claim approval of functional food and beverage and lack of intermediary between entrepreneurs and certified units for certification of functional foods and milk are major causes that needed to be resolved. Consequently, policy recommendations are proposed to tackle the problems occurring throughout the value chain. For the upstream, a collaborative platform using the quadruple helix model is proposed in a pattern of effective dairy cooperatives. For the midstream, regulation issues of new process, extended shelf life (ESL) milk, or prolonged milk are necessary, which can be extended the global market opportunity. For the downstream, mechanism of intermediary between entrepreneurs and certified units can be assisted in certified process of functional milk, especially a process of 'health claim' approval.

Keywords: Thailand, functional milk, supply chain, quadruple helix, intermediary, functional food

Procedia PDF Downloads 129