Search results for: internet health check

Authors: Clare Victoria Martin

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With reports of increased mental health problems and a lack of proactive, consistent well-being initiatives, well-being is a topical issue in the workplace, as well as a wider public health concern. Additionally, workplace well-being is closely linked to performance, both from a business perspective and in psychological research. Businesses are therefore becoming increasingly motivated to promote well-being, yet there are still barriers, including a lack of evidence-based workplace interventions, issues with measuring effectiveness and problems creating lasting cultural change. This review aimed to collate workplace well-being research to propose a comprehensive new model for delivering evidence-based workplace well-being training with a real potential for lasting impact. Method: A narrative review was conducted to meta-synthesise relevant research. Thematic analysis was then adopted as a systematic method of identifying key themes from the review to lead to practical recommendations. Interventions focusing on strengths, psychological capital, mindfulness and positivity (SPMP) dominated the research in this area, suggesting benefits of incorporating all four into training. However, to avoid a ‘quick fix’ mentality, the concept of training ‘well-being ambassadors’ as a preventative counterpart to mental health ‘first aiders’ was proposed alongside a new ‘REST and RISE’ model: well-being interventions should be ‘relatable’, ‘enjoyable’, ‘sociable’ and ‘trackable’ (REST) in order to increase ‘resilience’, ‘innovation’, ‘strengths’ and ‘engagement’ (RISE). If the REST principles are applied to interventions focusing on SPMP, research suggests individuals will RISE. Future research should empirically test this new well-being ambassador programme and REST/RISE model in an applied setting.

Keywords: performance, positive psychology, thriving, workplace well-being

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Authors: Klaudia Pluta, Katarzyna Bialik-Wąs, Dagmara Malina, Mateusz Barczewski

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Hydrogel networks, due to their unique properties, are highly attractive materials for wound dressing. The three-dimensional structure of hydrogels provides tissues with optimal moisture, which supports the wound healing process. Moreover, a characteristic feature of hydrogels is their absorption properties which allow for the absorption of wound exudates. For the fabrication of biomedical hydrogels, a combination of natural polymers ensuring biocompatibility and synthetic ones that provide adequate mechanical strength are often used. Sodium alginate (SA) is one of the polymers widely used in wound dressing materials because it exhibits excellent biocompatibility and biodegradability. However, due to poor strength properties, often alginate-based hydrogel materials are enhanced by the addition of another polymer such as poly(vinyl alcohol) (PVA). This paper is concentrated on the preparation methods of sodium alginate/polyvinyl alcohol hydrogel system incorporating Aloe vera extract and glycerin for wound healing material with particular focus on the role of their composition on structure, thermal properties, and stability. Briefly, the hydrogel preparation is based on the chemical cross-linking method using poly(ethylene glycol) diacrylate (PEGDA, Mn = 700 g/mol) as a crosslinking agent and ammonium persulfate as an initiator. In vitro degradation tests of SA/PVA/AV hydrogels were carried out in Phosphate-Buffered Saline (pH – 7.4) as well as in distilled water. Hydrogel samples were firstly cut into half-gram pieces (in triplicate) and immersed in immersion fluid. Then, all specimens were incubated at 37°C and then the pH and conductivity values were measurements at time intervals. The post-incubation fluids were analyzed using SEC/GPC to check the content of oligomers. The separation was carried out at 35°C on a poly(hydroxy methacrylate) column (dimensions 300 x 8 mm). 0.1M NaCl solution, whose flow rate was 0.65 ml/min, was used as the mobile phase. Three injections with a volume of 50 µl were made for each sample. The thermogravimetric data of the prepared hydrogels were collected using a Netzsch TG 209 F1 Libra apparatus. The samples with masses of about 10 mg were weighed separately in Al2O3 crucibles and then were heated from 30°C to 900°C with a scanning rate of 10 °C∙min−1 under a nitrogen atmosphere. Based on the conducted research, a fast and simple method was developed to produce potential wound dressing material containing sodium alginate, poly(vinyl alcohol) and Aloe vera extract. As a result, transparent and flexible SA/PVA/AV hydrogels were obtained. The degradation experiments indicated that most of the samples immersed in PBS as well as in distilled water were not degraded throughout the whole incubation time.

Keywords: hydrogels, wound dressings, sodium alginate, poly(vinyl alcohol)

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Authors: Dwi Endarti, Susi a Kristina, Rizki Noorizzati, Akbar E Nugraha, Fera Maharani, Kika a Putri, Asninda H Azizah, Sausanzahra Angganisaputri, Yunisa Yustikarini

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Cost utility analysis is the most recommended pharmacoeconomic method since it allows widely comparison of cost-effectiveness results from different interventions. The method uses outcome of quality-adjusted life year (QALY) or disability-adjusted life year (DALY). Measurement of QALY requires the data of utility dan life years gained. Utility is measured with the instrument for quality of life measurement such as EQ-5D. Recently, the EQ-5D is available in two versions which are EQ-5D-3L and EQ-5D-5L. This study aimed to compare the EQ-5D-3L and EQ-5D-5L to examine the most suitable version for Indonesian population. This study was an observational study employing cross sectional approach. Data of quality of life measured with EQ-5D-3L and EQ-5D-5L were collected from several groups of population which were respondent with chronic diseases, respondent with acute diseases, and respondent from general population (without illness) in Yogyakarta Municipality, Indonesia. Convenience samples of hypertension patients (83), diabetes mellitus patients (80), and osteoarthritis patients (47), acute respiratory tract infection (81), cephalgia (43), dyspepsia (42), and respondent from general population (293) were recruited in this study. Responses on the 3L and 5L versions of EQ-5D were compared by examining the psychometric properties including agreement, internal consistency, ceiling effect, and convergent validity. Based on psychometric properties tests of EQ-5D-3L dan EQ-5D-5L, EQ-5D-5L tended to have better psychometric properties compared to EQ-5D-3L. Future studies for health related quality of life (HRQOL) measurements for pharmacoeconomic studies in Indonesia should apply EQ-5D-5L.

Keywords: EQ-5D, Health Related Quality of Life, Indonesian Population, Psychometric Properties

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Authors: David Bakker, Nikki Rickard

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Smartphone apps hold immense potential as mental health and wellbeing tools. Support can be made easily accessible and can be used in real-time while users are experiencing distress. Furthermore, data can be collected to enable machine learning and automated tailoring of support to users. While many apps have been developed for mental health purposes, few have adhered to evidence-based recommendations and even fewer have pursued experimental validation. This paper details the development and experimental evaluation of an app, MoodMission, that aims to provide support for low moods and anxiety, help prevent clinical depression and anxiety disorders, and serve as an adjunct to professional clinical supports. MoodMission was designed to deliver cognitive behavioural therapy for specifically reported problems in real-time, momentary interactions. Users report their low moods or anxious feelings to the app along with a subjective units of distress scale (SUDS) rating. MoodMission then provides a choice of 5-10 short, evidence-based mental health strategies called Missions. Users choose a Mission, complete it, and report their distress again. Automated tailoring, gamification, and in-built data collection for analysis of effectiveness was also included in the app’s design. The development process involved construction of an evidence-based behavioural plan, designing of the app, building and testing procedures, feedback-informed changes, and a public launch. A randomized controlled trial (RCT) was conducted comparing MoodMission to two other apps and a waitlist control condition. Participants completed measures of anxiety, depression, well-being, emotional self-awareness, coping self-efficacy and mental health literacy at the start of their app use and 30 days later. At the time of submission (November 2016) over 300 participants have participated in the RCT. Data analysis will begin in January 2017. At the time of this submission, MoodMission has over 4000 users. A repeated-measures ANOVA of 1390 completed Missions reveals that SUDS (0-10) ratings were significantly reduced between pre-Mission ratings (M=6.20, SD=2.39) and post-Mission ratings (M=4.93, SD=2.25), F(1,1389)=585.86, p < .001, np2=.30. This effect was consistent across both low moods and anxiety. Preliminary analyses of the data from the outcome measures surveys reveal improvements across mental health and wellbeing measures as a result of using the app over 30 days. This includes a significant increase in coping self-efficacy, F(1,22)=5.91, p=.024, np2=.21. Complete results from the RCT in which MoodMission was evaluated will be presented. Results will also be presented from the continuous outcome data being recorded by MoodMission. MoodMission was successfully developed and launched, and preliminary analysis suggest that it is an effective mental health and wellbeing tool. In addition to the clinical applications of MoodMission, the app holds promise as a research tool to conduct component analysis of psychological therapies and overcome restraints of laboratory based studies. The support provided by the app is discrete, tailored, evidence-based, and transcends barriers of stigma, geographic isolation, financial limitations, and low health literacy.

Keywords: anxiety, app, CBT, cognitive behavioural therapy, depression, eHealth, mission, mobile, mood, MoodMission

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Authors: Aryana Collins Jackson, Elisabetta Bevacqua, Pierre De Loor, Ronan Querrec

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This paper presents a taxonomy of non-technical skills, communicative intentions, and behavior for an individual acting as a medical coordinator. In medical emergency situations, a leader among the group is imperative to both patient health and team emotional and mental health. Situational Leadership is used to make clear and easy-to-follow guidelines for behavior depending on circumstantial factors. Low-level leadership behaviors belonging to two different styles, directive and supporting, are identified from literature and are included in the proposed taxonomy. The high-level information in the taxonomy consists of the necessary non-technical skills belonging to a medical coordinator: situation awareness, decision making, task management, and teamwork. Finally, communicative intentions, dimensions, and functions are included. Thus this work brings high-level and low-level information - medical non-technical skills, communication capabilities, and leadership behavior - into a single versatile taxonomy of behavior.

Keywords: human behavior, leadership styles, medical, taxonomy

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Authors: Sumudu Sameera Perera Kimmantudawage, Chapal Khasnabis

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Technology is changing at a rapid rate, with innovations in robotics being hailed and tested in countries such as Japan, the United States and Australia, however the conversation in a public health context is stagnant. While obvious barriers to robotics use in low and middle-income countries and regions exist, the avoidance of attempting to address these regions of the world may potentially lead to an ever-increasing divide between those of high income countries and those of less. A systematic review was undertaken to determine the number of projects involving research, development and testing of robotics considered low and middle-income regions. Major findings indicate that an overwhelmingly significant number of projects failed to consider low and middle-income countries or regions. These results are unsurprising however alarming, as bridging the divide is an important step forward in achieving the UN Sustainable Development Goals by 2030. It is hoped that this research would spawn future robotics research that focusses on lower and middle-income regions.

Keywords: assistive technology, health equality, robotics, socioeconomic

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Authors: Sonia Hirt

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The Planner's Triangle, an oft-cited model that visually defined planning as the search for sustainability to balance the three basic priorities of equity, economy, and environment, has influenced planning theory and practice for a quarter of a century. In this essay, we argue that the triangle requires updating and expansion. Even if planners keep sustainability as their key core aspiration at the center of their imaginary geometry, the triangle's vertices have to be rethought. Planners should move on to a 21st-century concept. We propose a Planner's Pentangle with five basic priorities as vertices of a new conceptual polygon. These five priorities are Wellbeing, Equity, Economy, Environment, and Esthetics (WE⁴). The WE⁴ concept more accurately and fully represents planning’s history. This is especially true in the United States, where public art and public health played pivotal roles in the establishment of the profession in the late 19th and early 20th centuries. It also more accurately represents planning’s future. Both health/wellness and aesthetic concerns are becoming increasingly important in the 21st century. The pentangle can become an effective tool for understanding and visualizing planning's history and present. Planning has a long history of representing urban presents and future as conceptual models in visual form. Such models can play an important role in understanding and shaping practice. For over two decades, one such model, the Planner's Triangle, stood apart as the expression of planning's pursuit for sustainability. But if the model is outdated and insufficiently robust, it can diminish our understanding of planning practice, as well as the appreciation of the profession among non-planners. Thus, we argue for a new conceptual model of what planners do.

Keywords: sustainable development, planning for sustainable development, planner's triangle, planner's pentangle, planning and health, planning and art, planning history

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Authors: Vinay Kumar, M. Kishor, Sathyanarayana Rao Ts

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Background: Growth of elderly people in the general population in recent years is termed as ‘greying of the world’ where there is a shift from high mortality & fertility to low mortality and fertility, resulting in an increased proportion of older people as seen in India. Improved health care promises longevity but socio-economic factors like poverty, joint families and poor services pose a psychological threat. Epidemiological data regarding the prevalence of mental disorders in geriatric population with physical illness is required for proper health planning. Methods: Sixty consecutive elderly patients aged 60 years or above of both sexes, reporting with physical illness to general outpatient registration counter of JSS Medical College and Hospital, Mysore, India, were considered for the Study. With informed consent, they were screened with General Health Questionnaire (GHQ-12) and were further evaluated for diagnosing mental disorders according to WHO International Classification of Diseases (ICD-10) criteria. Results: Mental disorders were detected in 48.3%, predominantly depressive disorders, nicotine dependence, generalized anxiety disorder, alcohol dependence and least was dementia. Most common physical illness was cardiovascular disease followed by metabolic, respiratory and other diseases. Depressive disorders, substance dependence and dementia were more associated with cardiovascular disease compared to metabolic disease and respiratory diseases were more associated with nicotine dependence. Conclusions: Depression and Substance use disorders among elderly population is of concern, which needs to be further studied with larger population. Psychiatric morbidity will adversely have an impact on physical illness which needs proper assessment and management. This will enhance our understanding and prioritize our planning for future.

Keywords: Geriatric, mental disorders, physical illness, psychiatry

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Authors: Stela Doncheva

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Postpartum distress, encompassing depressive symptoms, obsessions, and anxiety, remains a subject of significant scientific interest due to its prevalence among individuals giving birth. This critical and transformative period presents a multitude of factors that impact women's health. On the one hand, variables such as social support, satisfaction in romantic relationships, shared newborn care, and birth satisfaction directly affect the mental well-being of new mothers. On the other hand, the interplay of hormonal changes, personality characteristics, emotional difficulties, and the profound life adjustments experienced by mothers can profoundly influence their self-esteem and overall physical and emotional well-being. This paper extensively explores the factors of alexithymia, social support, partners' support, and birth satisfaction to gain deeper insights into their impact on postpartum distress. Utilizing a qualitative survey consisting of six self-reflective questionnaires, this study collects valuable data regarding the individual postpartum experiences of Bulgarian mothers. The primary objective is to enrich our understanding of the complex factors involved in the development of postpartum distress during this crucial period. The results shed light on the intricate nature of the problem and highlight the significant influence of bio-psycho-social elements. By contributing to the existing knowledge in the field, this research provides valuable implications for the development of interventions and support systems tailored to the unique needs of mothers in the postpartum period. Ultimately, this study aims to improve the overall well-being of new mothers and promote optimal maternal health during the postpartum journey.

Keywords: maternal mental health, postpartum distress, postpartum depression, postnatal mothers

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Authors: Poonsook Thatchaopas, Nik Kamariah Nikmat, Nattakarn Eakuru

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Since 2003, the Thai Government has implemented several initiatives to encourage and incubate entrepreneurial skills and motivation among her citizens. One of the initiatives is the “One College One Product” business model or well known as ‘OCOP’, launched by the Vocational Education Commission to encourage partnership between college students to choose at least one product for business venture. In line with this mission, several business enterprises were established such as food products, restaurants, spa, Thai massage, minimart, computer maintenance, karaoke centre, internet café, mini theater etc. Currently, these business incubator projects can be observed at 404 vocational colleges and 21 incubation centres to encourage entrepreneurial small and medium enterprise (SME) development. However, the number of successful OCOP projects is still minimal. Out of the 404 individual OCOP projects at Vocational Colleges around Thailand, very few became successful. The objective of this paper is to identify the critical success factors needed to be a successful OCOP business entrepreneur. This study uses qualitative method by interviewing business partners of an OCOP business called Crispy Roti Krua Acheeva Brand (CRKAB). It is a snack food company that is developed at Pattani Vocational College in South Thailand. This project was initiated by three female entrepreneurs who were alumni student cum owners of the CRKAB. The finding shows that the main critical success factors are self-confidence, creativity or innovativeness, knowledge, skills and perseverance. Additionally, they reiterated that the keys to business success are product quality, perceived price, promotion, branding, new packaging to increase sales and continuous developments. The results implies for a student business SME to be successful, the company should have credible partners and effective marketing plan.

Keywords: student entrepreneurship, business incubator, food industry, qualitative, Thailand

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Authors: Shahid Razzaq

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The governments around the globe have started taking into considerations the knowledge management dynamics while formulating, implementing, and evaluating the strategies, with or without the conscious realization, for the different public sector organizations and public policy developments. Health Department of Punjab province in Pakistan is striving to deliver quality healthcare services to the community through an efficient and effective service delivery system. Despite of this struggle some employee performance issues yet exists in the form of challenge to government. To overcome these issues department took several steps including HR strategies, use of technologies and focus of hard issues. Consequently, this study was attempted to highlight the importance of soft issue that is knowledge management in its true essence to tackle their performance issues. Knowledge management in public sector is quite an ignored area in the knowledge management-a growing multidisciplinary research discipline. Knowledge-based view of the firm theory asserts the knowledge is the most deliberate resource that can result in competitive advantage for an organization over the other competing organizations. In the context of our study it means for gaining employee performance, organizations have to increase the heterogeneous knowledge bases. The study uses the cross-sectional and quantitative research design. The data is collected from the knowledge workers of Health Department of Punjab, the biggest province of Pakistan. A total of 341 sample size is achieved. The SmartPLS 3 Version 2.6 is used for analyzing the data. The data examination revealed that knowledge management processes has a strong impact on knowledge worker performance. All hypotheses are accepted according to the results. Therefore, it can be summed up that to increase the employee performance knowledge management activities should be implemented. Health Department within province of Punjab introduces the knowledge management infrastructure and systems to make effective availability of knowledge for the service staff. This knowledge management infrastructure resulted in an increase in the knowledge management process in different remote hospitals, basic health units and care centers which resulted in greater service provisions to public. This study is to have theoretical and practical significances. In terms of theoretical contribution, this study is to establish the relationship between knowledge management and performance for the first time. In case of the practical contribution, this study is to give an insight to public sector organizations and government about role of knowledge management in employ performance. Therefore, public policymakers are strongly advised to implement the activities of knowledge management for enhancing the performance of knowledge workers. The current research validated the substantial role of knowledge management in persuading and creating employee arrogances and behavioral objectives. To the best of authors’ knowledge, this study contribute to the impact of knowledge management on employee performance as its originality.

Keywords: employee performance, knowledge management, public sector, soft issues

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Authors: O. J. Ajayi, J. H. Tsado, F. Olah

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The study analyzed the effect of information and communication technology (ICT) usage on cassava farmers in Otukpo local government area of Benue state, Nigeria. Primary data was collected from 120 randomly selected cassava farmers using multi-stage sampling technique. A structured questionnaire and interview schedule was employed to generate data. Data were analyzed using descriptive (frequency, mean and percentage) and inferential statistics (OLS (ordinary least square) and Chi-square). The result revealed that majority (78.3%) were within the age range of 21-50 years implying that the respondents were within the active age for maximum production. 96.8% of the respondents had one form of formal education or the other. The sources of ICT facilities readily available in area were radio(84.2%), television(64.2%) and mobile phone(90.8%) with the latter being the most relied upon for cassava farming. Most of the farmers were aware (98.3%) and had access (95.8%) to these ICT facilities. The dependence on mobile phone and radio were highly relevant in cassava stem selection, land selection, land preparation, cassava planting technique, fertilizer application and pest and disease management. The value of coefficient of determination (R2) indicated an 89.1% variation in the output of cassava farmers explained by the inputs indicated in the regression model implying that, there is a positive and significant relationship between the inputs and output. The results also indicated that labour, fertilizer and farm size were significant at 1% level of probability while ICT use was significant at 10%. Further findings showed that finance (78.3%) was the major constraint associated with ICT use. Recommendations were made on strengthening the use of ICT especially contemporary ones like the computer and internet among farmers for easy information sourcing which can boost agricultural production, improve livelihood and subsequently food security. This may be achieved by providing credit or subsidies and information centres like telecentres and cyber cafes through government assistance or partnership.

Keywords: ICT, cassava farmers, inputs, output

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Authors: Emilia Pietiläinen, Heikki Kyröläinen, Tommi Vasankari, Matti Santtila, Tiina Luukkaala, Kai Parkkola

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Working in the military sets special demands on physical fitness, however, reduced physical activity levels among employees in the Finnish Defence Forces (FDF), a trend also being seen among the working-age population in Finland, is leading to reduced physical fitness levels and increased risk of cardiovascular and metabolic diseases, something which also increases human resource costs. Therefore, the aim of the present study was to develop an eHealth intervention using accelerometer- smartphone app feedback technique, telephone counseling and physical activity recordings to increase physical activity of the personnel and thereby improve their health. Specific aims were to reduce stress, improve quality of sleep and mental and physical performance, ability to work and reduce sick leave absences. Employees from six military brigades around Finland were invited to participate in the study, and finally, 260 voluntary participants were included (66 women, 194 men). The participants were randomized into intervention (156) and control groups (104). The eHealth intervention group used accelerometers measuring daily physical activity and duration and quality of sleep for six months. The accelerometers transmitted the data to smartphone apps while giving feedback about daily physical activity and sleep. The intervention group participants were also encouraged to exercise for two hours a week during working hours, a benefit that was already offered to employees following existing FDF guidelines. To separate the exercise done during working hours from the accelerometer data, the intervention group marked this exercise into an exercise diary. The intervention group also participated in telephone counseling about their physical activity. On the other hand, the control group participants continued with their normal exercise routine without the accelerometer and feedback. They could utilize the benefit of being able to exercise during working hours, but they were not separately encouraged for it, nor was the exercise diary used. The participants were measured at baseline, after the entire intervention period, and six months after the end of the entire intervention. The measurements included accelerometer recordings, biochemical laboratory tests, body composition measurements, physical fitness tests, and a wide questionnaire focusing on sociodemographic factors, physical activity and health. In terms of results, the primary indicators of effectiveness are increased physical activity and fitness, improved health status, and reduced sick leave absences. The evaluation of the present scientific reach is based on the data collected during the baseline measurements. Maintenance of the studied outcomes is assessed by comparing the results of the control group measured at the baseline and a year follow-up. Results of the study are not yet available but will be presented at the conference. The present findings will help to develop an easy and cost-effective model to support the health and working capability of employees in the military and other workplaces.

Keywords: accelerometer, health, mobile applications, physical activity, physical performance

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Authors: KangQi Jin

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School-Related Gender-Based Violence (SRGBV) seriously impacts the victim's physical and mental health and academic and employment prospects. Due to the lack of protective policies for sexual minority students in mainland China at present, the well-being of those students in China is seriously endangered by SRGBV, and their physical and mental health is at great risk. By analyzing the current situation of stigmatization of sexual minority students and the harm brought to them by gender violence, this study proposes some strategies to reduce SRGBV on sexual minorities. First, the nation should set laws to protect the rights and interests of sexual minorities, and second, universities should make multifaceted efforts to reduce these violent phenomena. The violence experienced by students of sexual minorities has a crucial impact on their future physiology and psychology, and through the research, in this paper, the author hope can provide suggestions for scholars who try to study related fields in the future.

Keywords: sexual minority, school-related gender-based violence, response, strategies

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Authors: Ryeong-Hyeon Kim, Ah-Reum Lee, Seong-Soo Roh, Gyo-Nam Kim

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Appropriate regulation of melanogenesis is important for the management of skin pigmentation-related disease. Although several beneficial effects of fisetin (3,7,3’,4’-tetrahydroxyflavone) have been reported, the precise role and molecular mechanisms of fisetin in skin health both remain unclear. Here, we induced melanogenesis of HRM2 mice (n=7/group) by UVB irradiation for 20 days. UVB-induced HRM2 mice showed that the significantly increased melanin accumulation, however, fisetin treatment (25mg and 50mg/kg of body weight) dose-dependently and significantly inhibits UVB-induced melanogenesis. In line with this, fisetin treatment effectively down-regulated m RNA and expression levels of tyrosinase, TRP2, and MITF. In addition, our inhibitor assay revealed the down-regulated melanogenic marker genes by fisetin treatment were mediated with connective tissue growth factor (CCN2)/TGF-β signaling pathway. Useful information is provided for development of functional foods using fisetin for skin health.

Keywords: connective tissue growth factor, fisetin, melanogenesis, skin, TGF-beta

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Authors: Walid A. Alkeridy, Arwa Aljasser, Khalid Mohammed Alayed, Saad Alsaad, Amani S. Alqahtani, Claire Ann Lim, Sultan H. Alamri, Doaa Zainhom Mekkawy, Mohammed Al-Sofiani

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Introduction: The history of publicly funded Home Health Care (HHC) service in Saudi Arabia dates back to 1991. The first HC program was launched to provide palliative home care services for patients with terminal cancer. Thereafter, more programs launched across Saudi Arabia most remarkably was launching the national program for HHC by the Ministry Of Health (MOH) in 2008. The national HHC MOH program is mainly providing long-term care home care services for over 40,000 Saudi citizens. The scope of the HHC service program provided by the Saudi MOH is quite diverse, ranging from basic nursing care to specialized care programs, e.g., home peritoneal dialysis, home ventilation, home infusion therapy, etc. Objectives: The primary aim of our study is to report the prevalence of chronic conditions among Saudi people receiving long-term HHC services. Secondary aims include identifying the predictors of mortality among individuals receiving long-term HHC services and studying the association between frailty and poor health outcomes among HHC users. Methods: We conducted a retrospective and cross-sectional data collection from participants receiving HHC services at King Saud University Medical City, Riyadh, Saudi Arabia. Data were collected from electronic health records (EHR), patient charts, and interviewing caregivers from the year 2019 to 2022. We assessed functional performance by Katz's activity of daily living and the Bristol Activity of Daily Living Scale (BADLS). A trained health care provider assessed frailty using the Clinical Frailty Scale (CFS). Mortality was assessed by reviewing the death certificates if patients were hospitalized through discharge status ascertainment from EHR. Results: The mean age for deceased individuals in HHC was 78.3 years. Over twenty percent of individuals receiving HHC services were readmitted to the hospital. The following variables were statistically significant between deceased and alive individuals receiving HHC services; clinical frailty scale, the total number of comorbid conditions, and functional performance based on the KATZ activity of daily living scale and the BADLS. We found that the strongest predictors for mortality were pressure ulcers which had an odds ratio of 3.75 and p-value of < 0.0001, and the clinical frailty scale, which had an odds ratio of 1.69 and p-value of 0.002, using multivariate regression analysis. In conclusion, our study found that pressure ulcers and frailty are the strongest predictors of mortality for individuals receiving home health care services. Moreover, we found a high rate of annual readmission for individuals enrolled in HHC, which requires further analysis to understand the possible contributing factors for the increased rate of hospital readmission and develop strategies to address them. Future studies should focus on designing quality improvement projects aimed at improving the quality of life for individuals receiving HHC services, especially those who have pressure ulcers at the end of life.

Keywords: homecare, Saudi, prevalence, chronic

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Authors: Elena Cangelosi, Wayne Beyea

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This research expands the resilience planning literature by exploring the barriers and enablers to climate and health adaptation planning for small urban, coastal Great Lakes communities. With funding from the United States Centers for Disease Control and Prevention (CDC) Climate Ready City and States Initiative, this research took place during a 3-year pilot intervention project which integrates urban planning and public health. The project used the CDC’s Building Resilience Against Climate Effects (BRACE) framework to prevent or reduce the human health impacts from climate change in Marquette County, Michigan. Using a deliberation with the analysis planning process, interviews, focus groups, and community meetings with over 25 stakeholder groups and over 100 participants identified the area’s climate-related health concerns and adaptation interventions to address those concerns. Marquette County, on the shores of Lake Superior, the largest of the Great Lakes, was selected for the project based on their existing adaptive capacity and proactive approach to climate adaptation planning. With Marquette County as the context, this study fills a gap in the adaptation literature, which currently heavily emphasizes large-urban or agriculturally-based rural areas, and largely neglects small urban areas. This research builds on the qualitative case-study, survey, and interview approach established by previous researchers on contextual barriers and enablers for adaptation planning. This research uses a case study approach, including surveys and interviews of public officials, to identify the barriers and enablers for climate and health adaptation planning for small-urban areas within a large, non-agricultural, Great Lakes county. The researchers hypothesize that the barriers and enablers will, in some cases, overlap those found in other contexts, but in many cases, will be unique to a rural setting. The study reveals that funding, staff capacity, and communication across a large, rural geography act as the main barriers, while strong networks and collaboration, interested leaders, and community interest through a strong human-land connection act as the primary enablers. Challenges unique to rural areas are revealed, including weak opportunities for grant funding, large geographical distances, communication challenges with an aging and remote population, and the out-migration of education residents. Enablers that may be unique to rural contexts include strong collaborative relationships across jurisdictions for regional work and strong connections between residents and the land. As the factors that enable and prevent climate change planning are highly contextual, understanding, and appropriately addressing the unique factors at play for small-urban communities is key for effective planning in those areas. By identifying and addressing the barriers and enablers to climate and health adaptation planning for small-urban, coastal areas, this study can help Great Lakes communities appropriately build resilience to the adverse impacts of climate change. In addition, this research expands the breadth of research and understanding of the challenges and opportunities planners confront in the face of climate change.

Keywords: climate adaptation and resilience, climate change adaptation, climate change and urban resilience, governance and urban resilience

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Authors: Ivan Potapov

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Background: The aim of this paper is to investigate poly code texts in the communication of youth antisocial groups. Nowadays, the notion of a text has numerous interpretations. Besides all the approaches to defining a text, we must take into account semiotic and cultural-semiotic ones. Rapidly developing IT, world globalization, and new ways of coding of information increase the role of the cultural-semiotic approach. However, the development of computer technologies leads also to changes in the text itself. Polycode texts play a more and more important role in the everyday communication of the younger generation. Therefore, the research of functional and pragmatic aspects of both verbal and non-verbal content is actually quite important. Methods and Material: For this survey, we applied the combination of four methods of text investigation: not only intention and content analysis but also semantic and syntactic analysis. Using these methods provided us with information on general text properties, the content of transmitted messages, and each communicants’ intentions. Besides, during our research, we figured out the social background; therefore, we could distinguish intertextual connections between certain types of polycode texts. As the sources of the research material, we used 20 public channels in the popular messenger Telegram and data extracted from smartphones, which belonged to arrested members of antisocial groups. Findings: This investigation let us assert that polycode texts can be characterized as highly intertextual language unit. Moreover, we could outline the classification of these texts based on communicants’ intentions. The most common types of antisocial polycode texts are a call to illegal actions and agitation. What is more, each type has its own semantic core: it depends on the sphere of communication. However, syntactic structure is universal for most of the polycode texts. Conclusion: Polycode texts play important role in online communication. The results of this investigation demonstrate that in some social groups using these texts has a destructive influence on the younger generation and obviously needs further researches.

Keywords: text, polycode text, internet linguistics, text analysis, context, semiotics, sociolinguistics

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Authors: J. Al-Dmour, A. Sagahyroon, A. Al-Ali, S. Abusnana

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Radio Frequency Based Identification Systems have emerged as one of the possible valuable solutions that can be utilized in healthcare systems. Nowadays, RFID tags are available with built-in human vital signs sensors such as Body Temperature, Blood Pressure, Heart Rate, Blood Sugar level and Oxygen Saturation in Blood. This work proposes the design, implementation, and testing of an integrated mobile RFID-based health care system. The system consists of a wireless mobile vital signs data acquisition unit (RFID-DAQ) integrated with a fuzzy-logic–based software algorithm to monitor and assess patients conditions. The system is implemented and tested in ‘Rashid Center for Diabetes and Research’, Ajman, UAE. System testing results are compared with the Modified Early Warning System (MEWS) that is currently used in practice. We demonstrate that the proposed and implemented system exhibits an accuracy level that is comparable and sometimes better than the widely adopted MEWS system.

Keywords: healthcare, fuzzy logic, MEWS, RFID

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Authors: Vasuki Rayapati, Bhanu Duggal

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Trans catheter aortic valve replacement (TAVR) is the recommended treatment over surgical aortic valve replacement (SAVR) for high-risk groups, patients >75 years of age with severe symptomatic Aortic stenosis (AS). In high income countries TAVR is more cost effective because of – i) Reduction in total length of stay including less number of days in ICU ii) Non-procedural costs like cost of general anaesthesia are higher for SAVR. In India, there are two kinds of hospitals – Public and Private. Most patients visit public sector hospitals than private sector hospitals. In a LMIC like India, especially in the Public health sector cost of TAVR is prohibitive. In a small study from three (public) hospitals in India, it was envisaged that cost of TAVR should decrease at least by 2/3 to be a cost effective option in Public health sector for severe AS.

Keywords: cost effectiveness, TAVR vs SAVR, LMIC, HTA

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Authors: Deria Adi Wijaya, Amad Saeroji, Jimmi Sandi P., Nanang Wijayanto

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Tourism and the creative economy are combinations that can become a sustainable source of welfare that can boost the economy so as to increase the country's foreign exchange. Therefore the development of the tourism sector is one of the priorities in President Joko Widodo's leadership framework for the 2019-2024 period. Entering the current pandemic, each party is required to be able to implement strict health protocols to slow the rate of SARS-Cov2 infection, or what is known as the coronavirus, but on the other hand, the need to turn the wheels of the economy must continue. Therefore, an effort is needed to develop tourism activities that are full of experiences that add health benefits. Anticipating this, the Ministry of Tourism and Creative Economy collaborated with the Ministry of Health to offer an innovative development model, namely wellness tourism. The development of wellness tourism is an alternative that can make a positive contribution to the development of Indonesian tourism during the pandemic. This research seeks to synergize efforts to develop national tourism into the regional sphere; in this case, Baluwarti Tourism Village, which is located within the walls of the Surakarta Sunanate Palace, has the potential to be developed into a wellness tourism destination in Surakarta City. Considering that a village that is in the immediate vicinity of a palace certainly has a variety of potential attractions for royal wellness tourism. The main objectives of this study are 1) to identify the potential for palace-style wellness tourism in Baluwarti Tourism Village; 2) to formulate development in the form of tour packages in Baluwarti Tourism Village. Of course, the development of the wellness tour package is still based on local wisdom, namely a tour package that raises local potential as a palace-style wellness tourism attraction that can improve the economy of the local people through the tourism sector in the post-pandemic era.

Keywords: potential, wellness tourism, Baluwarti Tourism Village, Surakarta Sunanate Palace, Surakarta City

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Authors: Dhriti Kirpalani

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The survey aims to explore the impact of Instagram on the perception of lifestyle aspirations (such as social life, fitness, trends followed in fashion, etc.) and perception of self in relation to an idealized lifestyle: Amidst today's media-saturated environment, university students are constantly exposed to idealized portrayals of lifestyles, often leading to unrealistic expectations and dissatisfaction with their own lives. This study investigates the impact of media on university students' perceptions of their own lifestyle, the discrepancy between their self-perception and idealized lifestyle, and their mental health. Employing a mixed-methods approach, the study combines quantitative and qualitative data collection methods to understand the issue comprehensively. A literature review was conducted in order to determine the effects of idealized lifestyle portrayal on Instagram; however, less attention has been received in the Indian setting. The researchers wish to employ a convenience sampling method among undergraduate students from India. The surveys that would be employed for quantitative analysis are Negative Social Media Comparison (NSMCS), Lifestyle Satisfaction Scale (LSS), Psychological Well-being Scale (PWB), and Self-Perception Profile for Adolescents (SPPA). The qualitative aspect would include in-depth interviews to provide deeper insights into participants' experiences and the mechanisms by which media influences their lifestyle aspirations and mental health. With the aim of being an exploratory study, the basis of the idea is found in the social comparison theory described by Leon Festinger. The findings aim to inform interventions to promote realistic expectations about lifestyle, reduce the negative effects of media on university students, and improve their mental health and well-being.

Keywords: declined self-perception, idealized lifestyle, Instagram, Indian university students, social comparison

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Authors: Niranjana Soperna, Shivangi Nigam

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Violence against women is linked to their disadvantageous position in the society. It is rooted in unequal power relationships between men and women in society and is a global problem which is not limited to a specific group of women in society. An adolescent girl’s life is often accustomed to the likelihood of violence, and acts of violence exert additional power over girls because the stigma of violence often attaches more to a girl than to her doer. The experience of violence is distressing at the individual emotional and physical level. The field of research and programs for adolescent girls has traditionally focused on sexuality, reproductive health, and behavior, neglecting the broader social issues that underpin adolescent girls’ human rights, overall development, health, and well-being. This paper is an endeavor to address the understated or disguised form of violence which the adolescent girls experience within the social contexts. The parameters exposed under this research had been ignored to a large extent when it came to studying the dimension of violence under the social domain. Hence, the researchers attempted to explore this camouflaged form of violence and discovered some specific parameters such as: Diminished Self Worth and Esteem, Verbal Abuse, Menstruation Taboo and Social Rigidity, Negligence of Medical and Health Facilities and Complexion- A Prime Parameter for Judging Beauty. The study was conducted in the districts of Haryana where personal interviews were taken from both urban and rural adolescent girls (aged 13 to 19 years) based on structured interview schedule. The results revealed that the adolescent girls, both in urban as well as rural areas were quite affected with the above mentioned issues. In urban areas, however, due to the higher literacy rate, which resulted in more rational thinking, the magnitude was comparatively smaller, but the difference was still negligible.

Keywords: adolescent girls, education, social contexts, understated violence

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Authors: Lie-Fen Lin, Tzu-Hsuan Lin, Ching-Heng Lin

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Hospice care for terminally ill patients provides not only a better quality of life but also cost-saving benefits. However, the utilization of home-based hospice care (HBH care) remains low even for countries covered by National Health Insurance (NHI) programs in Taiwan. In the current commercial insurance policy, only hospital-based hospice benefits were covered. It may have an influence on the insureds chosen to receive end-of-life care in a hospitalized manner. Thus, how to propose a feasible method to advocate HBH care utilization rate of public health policies is an important issue. A total of 130,219 cancer decedents in the year 2011-2013 from the National Health Insurance Research Database (NHIRD) in Taiwan were included in this study. By adding a day volume pays benefits of HBH care as a commercial insurance rider, will provide alternative benefits for the insureds. A multiple-state Markov chain model was incorporated to estimate the transition intensities of patients in different states at the end of their lives (Non-hospice, HBH, hospital-based hospice), and the premiums were estimated. HBH care insurance benefits provide financial support and reduce the burden of care for patients. The rate-making of this product is very sensitive while the utilization rate is rising, especially for high ages. The proposed HBH care insurance is a feasible way to reduce the financial burden, enhance the care quality and family satisfaction of insureds. Meanwhile, insurance companies can participate in advocating a good medical policy to enhance the social image. In addition, the medical costs of NHI can reduce effectively.

Keywords: home-based hospice care, commercial insurance, Markov chain model, the day volume pays

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Authors: Mustafa Jahanara

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The aim of present research was to study of the relationship between emotional intelligence, perceived stress, positive religious coping with psychological distress to in a sample of undergraduate students in Polytechnic University in Kabul. One hundred and fifty-tow students (102 male, 50 female) were included in this study. All participants completed the Emotional Intelligence Scale (EIS), General Health Questionnaire (GHQ 12), Perceived Stress Scale (PSS-10), and the Brief RCOPE. The results revealed that EI was negatively associated with perceived stress and psychological distress. Also emotional intelligence was positively correlated with positive religious coping. Perceived stress was positive related with psychological distress and negatively correlated with positive religious coping. Eventually positive religious coping was significantly and negatively correlated with psychological distress. However, emotional intelligence and positive religious coping could influence on mental health.

Keywords: emotional intelligence, perceived stress, positive religious coping, psychological distress

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Authors: Jianan Sun, Ziwen Ye

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Multidimensional computerized adaptive testing (MCAT) is a popular research topic in psychometrics. It is important for practitioners to clearly know the item-trait patterns of administered items when a test like MCAT is operated. Item-trait pattern recognition refers to detecting which latent traits in a psychological test are measured by each of the specified items. If the item-trait patterns of the replenished items in MCAT item pool are well detected, the interpretability of the items can be improved, which can further promote the abilities of the examinees who attending the MCAT to be accurately estimated. This research explores to solve the item-trait pattern recognition problem of the replenished items in MCAT item pool from the perspective of statistical variable selection. The popular multidimensional item response theory model, multidimensional two-parameter logistic model, is assumed to fit the response data of MCAT. The proposed method uses the least absolute shrinkage and selection operator (LASSO) to detect item-trait patterns of replenished items based on the essential information of item responses and ability estimates of examinees collected from a designed MCAT procedure. Several advantages of the proposed method are outlined. First, the proposed method does not strictly depend on the relative order between the replenished items and the selected operational items, so it allows the replenished items to be mixed into the operational items in reasonable order such as considering content constraints or other test requirements. Second, the LASSO used in this research improves the interpretability of the multidimensional replenished items in MCAT. Third, the proposed method can exert the advantage of shrinkage method idea for variable selection, so it can help to check item quality and key dimension features of replenished items and saves more costs of time and labors in response data collection than traditional factor analysis method. Moreover, the proposed method makes sure the dimensions of replenished items are recognized to be consistent with the dimensions of operational items in MCAT item pool. Simulation studies are conducted to investigate the performance of the proposed method under different conditions for varying dimensionality of item pool, latent trait correlation, item discrimination, test lengths and item selection criteria in MCAT. Results show that the proposed method can accurately detect the item-trait patterns of the replenished items in the two-dimensional and the three-dimensional item pool. Selecting enough operational items from the item pool consisting of high discriminating items by Bayesian A-optimality in MCAT can improve the recognition accuracy of item-trait patterns of replenished items for the proposed method. The pattern recognition accuracy for the conditions with correlated traits is better than those with independent traits especially for the item pool consisting of comparatively low discriminating items. To sum up, the proposed data-driven method based on the LASSO can accurately and efficiently detect the item-trait patterns of replenished items in MCAT.

Keywords: item-trait pattern recognition, least absolute shrinkage and selection operator, multidimensional computerized adaptive testing, variable selection

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Authors: Rachel Dolan

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Background: Over two thirds of women in prison in England are mothers, and estimates suggest between 100 and 200 women per year give birth during imprisonment. There are currently six mother and baby units (MBUs) in prisons in England which admit women and babies up to the age of 18 months. Although there are only 65 places available, and despite positive impacts, they are rarely full. Mental illness may influence the number of admissions, as may interpretation of admission criteria. They are the only current alternative to separation for imprisoned mothers and their babies. Aims: To identify the factors that affect the decision to apply for/be offered a place in a prison MBU; to measure the impact of a placement upon maternal mental health and wellbeing; To measure the Initial outcomes for mother and child. Methods: A mixed methods approach - 100 pregnant women in English prisons are currently being recruited from prisons in England. Quantitative measures will establish the prevalence of mental disorder, personality disorder, substance misuse and quality of life. Qualitative interviews will document the experiences of pregnancy and motherhood in prison. Results: Preliminary quantitative findings suggest the most prevalent mental disorders are anxiety and depression and approximately half the participants meet the criteria for one or more personality disorders. The majority of participants to date have been offered a place in a prison MBU, and those in a prison with an MBU prior to applying are more likely to be admitted. Those with a previous history of childcare issues, who are known to social services are less likely to be offered a place. Qualitative findings suggest that many women are often hungry and uncomfortable during pregnancy, many have feelings of guilt about having a child in prison and that feelings of anxiety and worry are exacerbated by lack of information.

Keywords: mothers, prison, mother and baby units, mental health

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Authors: Mary-Luz Olivares-Tenorio, Ruud Verkerk, Matthijs Dekker, Martinus A. J. S. van Boekel

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Cape gooseberry, the fruit of the plant Physalis peruviana L. has gained interest in research given its contents of promising health-promoting compounds like contents. The presence of carotenoids, ascorbic acid, minerals, polyphenols, vitamins and antioxidants. This project aims to study thermal stability of β-carotene, ascorbic acid, catechin and epicatechin and antioxidant activity in the matrix of the Cape Gooseberry. Fruits were obtained from a Colombian field in Cundinamarca. Ripeness stage was 4 (According to NTC 4580, corresponding to mature stage) at the moment of the experiment. The fruits have been subjected to temperatures of 40, 60, 80, 100 and 120°C for several times. β-Carotene, ascorbic acid, catechin and epicatechin content were assessed with HPLC and antioxidant activity with the DPPH method. β-Carotene was stable upon 100°C, and showed some degradation at 120°C. The same behavior was observed for epicatechin. Catechin increased during treatment at 40°C, at 60°C it remained stable and it showed degradation at 80°C, 100°C and 120°C that could be described by a second order kinetic model. Ascorbic acid was the most heat-sensitive of the analyzed compounds. It showed degradation at all studied temperatures, and could be described by a first order model. The activation energy for ascorbic acid degradation in cape gooseberry was 46.0 kJ/mol and its degradation rate coefficient at 100 °C was 6.53 x 10-3 s-1. The antioxidant activity declined for all studied temperatures. Results from this study showed that cape gooseberry is an important source of different health-promoting compounds and some of them are stable to heat. That makes this fruit a suitable raw material for processed products such as jam, juices and dehydrated fruit, giving the consumer a good intake of these compounds.

Keywords: goldenberry, health-promoting compounds, phytochemical, processing, heat treatment

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Authors: S. Ramteke, K. S. Patel

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Aerosols are complex mixture of particulate matters (PM) inclusive of carbons, silica, elements, various salts, etc. Aerosols get deep into the human lungs and cause a broad range of health effects, in particular, respiratory and cardiovascular illnesses. They are one of the major culprits for the climate change. They are emitted by the high thermal processes i.e. vehicles, steel, sponge, cement, thermal power plants, etc. Raipur (22˚33'N to 21˚14'N and 82˚6'E) to 81˚38'E) is a growing industrial city in central India with population of two million. In this work, the distribution of inorganics (i.e. Cl⁻, NO³⁻, SO₄²⁻, NH₄⁺, Na⁺, K⁺, Mg²⁺, Ca²⁺, Al, Cr, Mn, Fe, Ni, Cu, Zn, and Pb) associated to the PM in the ambient air is described. The PM₁₀ in ambient air of Raipur city was collected for duration of one year (December 2014 - December 2015). The PM₁₀ was segregated into nine modes i.e. PM₁₀.₀₋₉.₀, PM₉.₀₋₅.₈, PM₅.₈₋₄.₇, PM₄.₇₋₃.₃, PM₃.₃₋₂.₁, PM₂.₁₋₁.₁, PM₁.₁₋₀.₇, PM₀.₇₋₀.₄ and PM₀.₄ to know their emission sources and health hazards. The analysis of ions and metals was carried out by techniques i.e. ion chromatography and TXRF. The PM₁₀ concentration (n=48) was ranged from 100-450 µg/m³ with mean value of 73.57±20.82 µg/m³. The highest concentration of PM₄.₇₋₃.₃, PM₂.₁₋₁.₁, PM₁.₁₋₀.₇ was observed in the commercial, residential and industrial area, respectively. The effect of meteorology i.e. temperature, humidity, wind speed and wind direction in the PM₁₀ and associated elemental concentration in the air is discussed.

Keywords: ambient aerosol, ions, metals, segregation

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Authors: Ahmed D. Balami, Salmiah Md. Said, Nor Afiah Zulkefli, Norsa’adah Bachok, Bala Audu

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The World Health Organization prescribes that women living in malaria-endemic regions sleep under an insecticide-treated net (ITN) and comply with intermittent preventive treatment in pregnancy (IPTp). However, compliance with these measures is generally poor in Nigeria, despite the high burden of malaria and its complications in pregnancy, as well as the proven efficacy of these preventive measures. This study aimed to develop, implement, and evaluate the impacts of information-motivation-behavioral skills-based health education modules (IMB-HEMOD) on malaria prevention among pregnant women in Borno state, Nigeria. A parallel-group randomized controlled trial was conducted, enrolling 372 pregnant women (186 participants each in the intervention or control groups) at an antenatal clinic in Borno state, Nigeria. IMB-HEMOD on malaria prevention was delivered to the intervention group. This comprised four sessions and was conducted over four hours. Session one comprised lectures on malaria causative agents, transmission, symptoms, complications, and prevention. Session two was a facilitated interactive session, where participants brainstormed through the potential barriers to compliance with these preventive measures and collectively developed solutions to them. Sessions three and four entailed practical demonstrations of how to use these preventive measures. Participants in the control group received a dummy intervention in the form of health education on breastfeeding, delivered by the same facilitator, for a similar duration, and using a similar approach as the experimental intervention. Validated questionnaires were used to collect baseline and follow-up data (at two months and four months post-intervention) on the dependent variables – malaria prevention knowledge, motivation, behavioral skills, practices, and clinical outcomes. The generalized linear mixed-models analysis was used to test the effects of the intervention on the dependent variables. The total knowledge, motivation, and behavioral skills scores of the intervention group were significantly higher by 12.8% (95% Confidence Interval [CI]: 9.50 - 16.01), 8.6% (95% CI: 6.74 - 10.36), and 6.4% (95% CI: 4.41 – 8.29) respectively over the control group. The results also showed that 32% (95% CI: 6 – 59) and 37% (95% CI: 26 – 47) of participants in the intervention group slept at least one day more frequently under an insecticide-treated net (ITN), and took one dose more of intermittent preventive treatment in pregnancy (IPTp), compared to the control group. The intervention group also achieved 0.8% (95% CI: 0.53 – 1.07) higher hematocrit levels compared to the control group. Overall, the study results revealed the promising potential of the modules for not only boosting compliance with the prescribed malaria preventive measures but also improving clinical outcomes. It is thus recommended to adopt the modules into routine antenatal care health education. Future research evaluating the cost-effectiveness and feasibility of long-term implementation would help inform policy adoption.

Keywords: health education intervention, insecticide-treated net, intermittent preventive treatment, malaria, pregnant women

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