Search results for: health counseling
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 8830

Search results for: health counseling

8380 Health Policies towards Refugees: A Comparison of Policy Implementations from the EU and Turkey

Authors: Pelin Sonmez

Abstract:

Health services provided to refugees and asylum seekers are very important and of priority due to their physical damages during the war and conflict situation, possible diseases in migration journey and negative psychological mood. However, there are very poor international standards in regards to providing health services to these people, which in return cause each country to differ their regulations. United Nations Sustainable Development Goals that are in effect as of 2016 assure that attention should be provided to non-citizen vulnerable groups in terms of health policies and they should be included in the global development, thereby aims to decrease the problems arising from providing health services to refugees. Though, we should not forget that these are the recent and yet uncertain attempts, mostly, as a result of Syrian War's forced migration wave. As an attempt to reveal different attitudes of international actors, this study compares/analyzes health services provided to refugees and asylum seekers on the basis of Turkey-EU policy implementations. While doing so, two research data will be focused upon. In this globe, results of the focus group interviews and a field study in a specific work (from its health related section) which was done in 2017 to 5000 Syrian women living in Turkey and presented to Republic of Turkey Disaster and Emergency Management Presidency will be utilized.

Keywords: European Union, health policies, refugee, Syrian women, Turkey

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8379 Family Caregivers' Burden in Providing Care to the Hospitalized Elderly: Findings from Two Hospitals in Kolkata, India

Authors: Tulika Bhattacharyya, Suhita Chopra Chatterjee

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Family caregivers are vital in providing physical and emotional care to the aged. Providing care to aged involves physical as well as psycho-socio-economic challenges, compels the caregiver to fit in manifold roles, feel overburdened; which in turn requires them to change their priorities in life. The study conducted on family caregivers of the hospitalized elderly explores caregiver’s burden using Zarit Burden Scale (ZBS). The data has been collected from two randomly selected Multispecialty Hospitals in Kolkata (India), after obtaining ethical clearance from the Institutional Review Board of both the hospitals. The predictors of burden were also assessed using interview schedules. Among fifty-seven caregivers who participated in the study, caregiver’s burden was identified among thirty respondents with twenty-six having mild to moderate burden and four having moderate to severe burden. Majority of the caregivers were found to be female, reflecting the gendered nature of caregiving. Family caregivers spent more than six hours per day on caregiving, which severely disturbed their work-life including loss of job. The study revealed that the caregivers’ marital status, family structure, academic qualification, occupation and time spent on caregiving are related to family caregivers’ burden. The burden of care giving was accentuated by poor access to information, counseling, and lack of supportive services. The paper concludes by indicating the need for greater state interventions for caregivers.

Keywords: caregivers burden, family caregiving, hospitalized elderly, elderly in Kolkata, India, Zarit Burden Scale

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8378 Systematic Review: Examining Teacher-Led Prevention Programs to Address Behavioral Concerns in Students

Authors: Mika Kaufman

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Behavioral health in school-age children is a great concern. Negative behaviors can affect mental and physical health and, if ignored, can lead to further problems later in life. Rural communities often lack resources for counselors, social workers, and mental health care in the hopes of intervening with children who exhibit negative behaviors. Because of this, schools in rural communities are more likely to have children with behavioral issues. Prevention programs to recognize and address these behavioral concerns can educate teachers about mental health, different negative behaviors that students might exhibit, and how to manage those behaviors and engage with students in a positive way.

Keywords: prevention programs, behavioral health, resources for teachers, rural schools

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8377 Climate Change and Health in Policies

Authors: Corinne Kowalski, Lea de Jong, Rainer Sauerborn, Niamh Herlihy, Anneliese Depoux, Jale Tosun

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Climate change is considered one of the biggest threats to human health of the 21st century. The link between climate change and health has received relatively little attention in the media, in research and in policy-making. A long term and broad overview of how health is represented in the legislation on climate change is missing in the legislative literature. It is unknown if or how the argument for health is referred in legal clauses addressing climate change, in national and European legislation. Integrating scientific based evidence into policies regarding the impacts of climate change on health could be a key step to inciting the political and societal changes necessary to decelerate global warming. This may also drive the implementation of new strategies to mitigate the consequences on health systems. To provide an overview of this issue, we are analyzing the Global Climate Legislation Database provided by the Grantham Research Institute on Climate Change and the Environment. This institution was established in 2008 at the London School of Economics and Political Science. The database consists of (updated as of 1st January 2015) legislations on climate change in 99 countries around the world. This tool offers relevant information about the state of climate related policies. We will use the database to systematically analyze the 829 identified legislations to identify how health is represented as a relevant aspect of climate change legislation. We are conducting explorative research of national and supranational legislations and anticipate health to be addressed in various forms. The goal is to highlight how often, in what specific terms, which aspects of health or health risks of climate change are mentioned in various legislations. The position and recurrence of the mention of health is also of importance. Data will be extracted with complete quotation of the sentence which mentions health, which will allow for second qualitative stage to analyze which aspects of health are represented and in what context. This study is part of an interdisciplinary project called 4CHealth that confronts results of the research done on scientific, political and press literature to better understand how the knowledge on climate change and health circulates within those different fields and whether and how it is translated to real world change.

Keywords: climate change, explorative research, health, policies

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8376 Exploring the Potential of Replika: An AI Chatbot for Mental Health Support

Authors: Nashwah Alnajjar

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This research paper provides an overview of Replika, an AI chatbot application that uses natural language processing technology to engage in conversations with users. The app was developed to provide users with a virtual AI friend who can converse with them on various topics, including mental health. This study explores the experiences of Replika users using quantitative research methodology. A survey was conducted with 12 participants to collect data on their demographics, usage patterns, and experiences with the Replika app. The results showed that Replika has the potential to play a role in mental health support and well-being.

Keywords: Replika, chatbot, mental health, artificial intelligence, natural language processing

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8375 Institutional Capacity of Health Care Institutes for Diagnosis and Management of Common Genetic Diseases-a Study from a North Coastal District of Andhra Pradesh, India

Authors: Koteswara Rao Pagolu, Raghava Rao Tamanam

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In India, genetic disease is a disregarded service element in the community health- protection system. This study aims to gauge the accessibility of services for treating genetic disorders and also to evaluate the practices on deterrence and management services in the district health system. A cross-sectional survey of selected health amenities in the government health sector was conducted from 15 primary health centers (PHC’s), 4 community health centers (CHC’s), 1 district government hospital (DGH) and 3 referral hospitals (RH’s). From these, the existing manpower like 130 medical officers (MO’s), 254 supporting staff, 409 nursing staff (NS) and 45 lab technicians (LT’s) was examined. From the side of private health institutions, 25 corporate hospitals (CH’s), 3 medical colleges (MC’s) and 25 diagnostic laboratories (DL’s) were selected for the survey and from these, 316 MO’s, 995 NS and 254 LT’s were also reviewed. The findings show that adequate staff was in place at more than 70% of health centers, but none of the staff have obtained any operative training on genetic disease management. The largest part of the DH’s had rudimentary infrastructural and diagnostic facilities. However, the greater part of the CHC’s and PHC’s had inadequate diagnostic facilities related to genetic disease management. Biochemical, molecular, and cytogenetic services were not available at PHC’s and CHC’s. DH’s, RH’s, and all selected medical colleges were found to have offered the basic Biochemical genetics units during the survey. The district health care infrastructure in India has a shortage of basic services to be provided for the genetic disorder. With some policy resolutions and facility strengthening, it is possible to provide advanced services for a genetic disorder in the district health system.

Keywords: district health system, genetic disorder, infrastructural amenities, management practices

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8374 Talent Management by Employee Involvement in Healthcare Industries of India: An Analytical Case Study

Authors: Alpa Mehta

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Talent acquisition, development, and retention are major issues encountered in the health care industries in any country. Recent authentic data showed that employee turnover in the field of health care is increasing day by day compare to other industrial sectors. There are many reasons behind retention issues. One of such can be the lack of involvement and engagement of health workers in day to day HRM. Health care is a noble profession and employee has to deal with the patient with the optimum level of satisfaction and productivity. So employee morale and motivation should be high. This area of concern is mostly ignored by management, and ultimately it turns into dissatisfaction and abandonment in search of other jobs. The paper analyses the HRM tools to retain healthcare employee with high moral through employee involvement. The paper includes the case study of One of the Prominent Health care institute of India has found out a way to retain talented employees in the organization with the tool of employee engagement.

Keywords: employee involvement, health care industry, human resources management, talent retention

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8373 Awareness about Authenticity of Health Care Information from Internet Sources among Health Care Students in Malaysia: A Teaching Hospital Study

Authors: Renjith George, Preethy Mary Donald

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Use of internet sources to retrieve health care related information among health care professionals has increased tremendously as the accessibility to internet is made easier through smart phones and tablets. Though there are huge data available at a finger touch, it is doubtful whether all the sources providing health care information adhere to evidence based practice. The objective of this survey was to study the prevalence of use of internet sources to get health care information, to assess the mind-set towards the authenticity of health care information available via internet sources and to study the awareness about evidence based practice in health care among medical and dental students in Melaka-Manipal Medical College. The survey was proposed as there is limited number of studies reported in the literature and this is the first of its kind in Malaysia. A cross sectional survey was conducted among the medical and dental students of Melaka-Manipal Medical College. A total of 521 students including medical and dental students in their clinical years of undergraduate study participated in the survey. A questionnaire consisting of 14 questions were constructed based on data available from the published literature and focused group discussion and was pre-tested for validation. Data analysis was done using SPSS. The statistical analysis of the results of the survey proved that the use of internet resources for health care information are equally preferred over the conventional resources among health care students. Though majority of the participants verify the authenticity of information from internet sources, there was considerable percentage of candidates who feels that all the information from the internet can be utilised for clinical decision making or were not aware about the need of verification of authenticity of such information. 63.7 % of the participants rely on evidence based practice in health care for clinical decision making while 34.2 % were not aware about it. A minority of 2.1% did not agree with the concept of evidence based practice. The observations of the survey reveals the increasing use of internet resources for health care information among health care students. The results warrants the need to move towards evidence based practice in health care as all health care information available online may not be reliable. The health care person should be judicious while utilising the information from such resources for clinical decision making.

Keywords: authenticity, evidence based practice, health care information, internet

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8372 Thrombophilic Mutations in Tunisian Patients with Recurrent Pregnancy Loss

Authors: Frikha Rim, Abdelmoula Bouayed Nouha, Rebai Tarek

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Pregnancy is a hypercoagulable state which causing a defective maternal haemostatic response and leading to thrombosis of the uteroplacental vasculature, that might cause pregnancy complications as recurrent pregnancy loss (RPL). Since heritable Thrombophilic defects are associated with increased thrombosis, their prevalence was evaluated in patients with special emphasis on combinations of the above pathologies. Especially, Factor V Leiden (FVL) G1691A, methylene tetra hydro folate reductase (MTHFR) C677T, and factor II (FII) G20210A mutations are three important causes of thrombophilia, which might be related to recurrent pregnancy loss (RPL). In this study we evaluated the presence of these three mutations [factor V Leiden (FVL), prothrombin G20210A (PTG) and methylenetetrahydrofolate reductase (MTHFR) C677T] amongst 35 Tunisian women with more than 2 miscarriages, referred to our genetic counseling. DNA was extracted from peripheral blood samples and PCR-RFLP was performed for the molecular diagnosis of each mutation. Factor V Leiden and Prothrombin mutation were detected respectively in 5.7% and 2.9% of women with particular history of early fetal loss and thrombotic events. Despites the luck of strength of this study, we insist that testing for the most inherited thrombophilia (FVL and FII mutation) should be performed in women with RPL in the context of thrombotic events. Multi-centre collaboration is necessary to clarify the real impact of thrombotic molecular defects on the pregnancy outcome, to ascertain the effect of thrombophilia on recurrent pregnancy loss and then to evaluate the appropriate therapeutic approach.

Keywords: thrombophilia, recurrent pregnancy loss, factor V Leiden, prothrombin G20210A, methylene tetra hydro folate reductase

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8371 Job Satisfaction and Associated factors of Urban Health Extension Professionals in Addis Ababa City, Ethiopia

Authors: Metkel Gebremedhin, Biruk Kebede, Guash Abay

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Job satisfaction largely determines the productivity and efficiency of human resources for health. There is scanty evidence on factors influencing the job satisfaction of health extension professionals (HEPs) in Addis Ababa. The objective of this study was to determine the level of and factors influencing job satisfaction among extension health workers in Addis Ababa city. This was a cross-sectional study conducted in Addis Ababa, Ethiopia. Among all public health centers found in the Addis Ababa city administration health bureau that would be included in the study, a multistage sampling technique was employed. Then we selected the study health centers randomly and urban health extension professionals from the selected health centers. In-depth interview data collection methods were carried out for a comprehensive understanding of factors affecting job satisfaction among Health extension professionals (HEPs) in Addis Ababa. HEPs working in Addis Ababa areas are the primary study population. Multivariate logistic regression with 95% CI at P ≤ 0.05 was used to assess associated factors to job satisfaction. The overall satisfaction rate was 10.7% only, while 89.3%% were dissatisfied with their jobs. The findings revealed that variables such as marital status, staff relations, community support, supervision, and rewards have a significant influence on the level of job satisfaction. For those who were not satisfied, the working environment, job description, low salary, poor leadership and training opportunities were the major causes. Other factors influencing the level of satisfaction were lack of medical equipment, lack of transport facilities, lack of training opportunities, and poor support from woreda experts. Our study documented a very low level of overall satisfaction among health extension professionals in Addis Ababa city public health centers. Considering the factors responsible for this state of affairs, urgent and concrete strategies must be developed to address the concerns of extension health professionals as they represent a sensitive domain of the health system of Addis Ababa city. Improving the overall work environment, review of job descriptions and better salaries might bring about a positive change.

Keywords: job satisfaction, extension health professionals, Addis Ababa

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8370 Health Education and Information: A Panacea to Tuberculosis Prevention and Eradication in Nigeria

Authors: Afolabi Joseph Fasoranti

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Tuberculosis (TB) is an infectious disease caused by mycobacterium tuberculosis. Tuberculosis is a major public health problem in Nigeria, being one of the ten leading causes of hospital admissions and a leading cause of death in adults, especially among the economically productive age group. This paper critically examined the importance of health education towards the eradication and prevention of tuberculosis in Nigeria. It was reviewed and discussed under the following subheadings; Global burden of tuberculosis in Nigeria, concept, definition and etiology of tuberculosis, Signs and symptoms of tuberculosis, diagnosis of tuberculosis, causative agent, modes of infection and incubation period, risk factors of pulmonary tuberculosis Dots and stop TB programmes in Nigeria Treatment and prevention of tuberculosis TB treatment strategies, Dealing with treatment problems in Nigeria Stigmatization against Tuberculosis Patients Health education as a tool for achieving free tuberculosis country. Emphasis for Tb control has been placed on the development of improved vaccines, diagnostic and treatment courses but less on health education and awareness. Although the need for these tools is indisputable, the obstacle facing the spread of TB go beyond technological. The findings of this study may stimulate health system policy makers, Government and non- governmental organizations, donor agencies and other stakeholders in planning and designing health education intervention programs on the control and eradication of tuberculosis. It therefore recommended that Government should implement health education as part of the DOTs, this will thus empower the tuberculosis patients on ways to live healthy, lifestyle, in doing this, they will recover fast and prevent them from spreading the disease.

Keywords: tuberculosis, health education, panacea, Nigeria, prevention

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8369 Health Challenges Of Unmarried Women Over Thirty In Pakistan: A Public Health Perspective On Nutrition And Well-being

Authors: Anum Obaid, Iman Fatima, Wanisha Feroz, Haleema Imran, Hammad Tariq

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In Pakistan, the health of unmarried women over thirty is an emerging public health concern due to its increasing prevalence. Achieving the Sustainable Development Goals (SDGs) requires addressing nutrition and public health issues. This research investigates these goals through the lens of nutrition and public health, specifically examining the challenges faced by unmarried women over thirty in Faisalabad, Pakistan. According to a recent United Nations report, there are 10 million unmarried women over the age of 35 in Pakistan. The United Nations defines health as "a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity." Being unmarried and under constant societal pressure profoundly influences the dietary behaviors and nutritional status of these women, affecting their overall health, including physical, mental, and social well-being. A qualitative research approach was employed, involving interviews with both unmarried and married women over thirty. This research examines how marital status influences dietary practices, nutritional status, mental and social health, and their subsequent impacts. Factors such as physical health, mental and emotional status, societal pressure, social health, economic independence, and decision-making power were analyzed to understand the effect of singleness on overall wellness. Findings indicated that marital status significantly affects the dietary patterns and nutritional practices among women in Faisalabad. It was also revealed that unmarried women experienced more stress and had a less optimistic mindset compared to married women, due to loneliness or the absence of a spouse in their lives. Nutritional knowledge varied across marital status, impacting the overall health triangle, including physical, mental, and social health. Understanding these dynamics is crucial for developing targeted interventions to improve nutritional outcomes and overall health among unmarried women in Faisalabad. This study highlights the importance of fostering supportive environments and raising awareness about the health needs of unmarried women over thirty to enhance their overall well-being.

Keywords: health triangle, unmarried woman over thirty, socio-cultural barriers, women’s health

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8368 Assessing Effectiveness of Schema Mode Therapy and Emotionally Focused Couples Therapy in Attachment Styles among Couples with Marital Conflict

Authors: Reza Johari Fard, Najmeh Cheraghi, Parvin Ehtesham Zadeh, Parviz Asgari

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The aim of this study was to investigate and comparison of the effectiveness of schema mode therapy and emotionally focused couples therapy in attachment styles (secure, avoidant, and anxious) in couples with marital conflict in a quasiexperimental method in a pretest, posttest, and follow up design with a control group. The statistical population of the study included all the couples with marital conflict who visited the Mehrana counseling center in 2019 in Ahvaz, Iran 45 couples were selected by voluntary sampling method and randomly divided into two experimental groups and one control group (15 pairs in each group). The participants completed the Adult Attachment Scale (Hazan and Shaver). The experimental groups underwent schema mode therapy and emotionally focused couples therapy for 12 sessions, but the control group did not receive any intervention. The data were analyzed by the statistical analysis of repeated measures in SPSS-19 software. The results showed that both schema mode therapy and emotionally focused couples therapy are effective in increasing the secure attachment style and reducing avoidant and ambivalent attachment styles in couples with marital conflict. There was no significant difference between the schema mode therapy group and the emotionally focused couple's therapy group in attachment styles. Therefore, it is recommended that therapists and family counselors use these therapies along with other therapeutic interventions to increase secure attachment styles and reduce marital conflicts.

Keywords: schema mode therapy, emotional focused couple therapy, attachment styles, marital conflict

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8367 In silico Analysis of a Causative Mutation in Cadherin-23 Gene Identified in an Omani Family with Hearing Loss

Authors: Mohammed N. Al Kindi, Mazin Al Khabouri, Khalsa Al Lamki, Tommasso Pappuci, Giovani Romeo, Nadia Al Wardy

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Hereditary hearing loss is a heterogeneous group of complex disorders with an overall incidence of one in every five hundred newborns presented as syndromic and non-syndromic forms. Cadherin-related 23 (CDH23) is one of the listed deafness causative genes. CDH23 is found to be expressed in the stereocilia of hair cells and the retina photoreceptor cells. Defective CDH23 has been associated mostly with prelingual severe-to-profound sensorineural hearing loss (SNHL) in either syndromic (USH1D) or non-syndromic SNHL (DFNB12). An Omani family diagnosed clinically with severe-profound sensorineural hearing loss was genetically analysed by whole exome sequencing technique. A novel homozygous missense variant, c.A7451C (p.D2484A), in exon 53 of CDH23 was detected. One hundred and thirty control samples were analysed where all were negative for the detected variant. The variant was analysed in silico for pathogenicity verification using several mutation prediction software. The variant proved to be a pathogenic mutation and is reported for the first time in Oman and worldwide. It is concluded that in silico mutation prediction analysis might be used as a useful molecular diagnostics tool benefiting both genetic counseling and mutation verification. The aspartic acid 2484 alanine missense substitution might be the main disease-causing mutation that damages CDH23 function and could be used as a genetic hearing loss marker for this particular Omani family.

Keywords: Cdh23, d2484a, in silico, Oman

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8366 Occupational Health Hazards of Itinerant Waste Buyers (IWBs) in Kathmandu, Nepal

Authors: Ashish Khanal, Suja Giri

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The scrap collection work is associated with multiple health hazards. Cut and scratches during collection and transportation of scraps are common. IWBs purchase the scraps mainly papers, cartoons, glass bottles and metals from the households. This study was conducted in Kathmandu, the capital city of Nepal. The location was chosen because Kathmandu is the biggest city of Nepal with highest number of IWBs. The research used a case study strategy to examine the occupational health hazards of IWBs. The only mode of collecting and transporting of scraps in Kathmandu is the bicycle. They have to do this regular work even during the scorching sun and chilled winter. The musculoskeletal and gastrointestinal disorders are the common health problem shared by IWBs in Kathmandu, Nepal. Despite of these problems, IWBs don’t take it seriously and rarely goes for the health check-up. There is need of personal protective equipment and guidance for safety of IWBs. IWBs need to wear closed shoes and use gloves to avoid cuts during the collection and transportation of the recyclables.

Keywords: itinerant waste buyers, Kathmandu, occupational health, scrap

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8365 Assessment of Routine Health Information System (RHIS) Quality Assurance Practices in Tarkwa Sub-Municipal Health Directorate, Ghana

Authors: Richard Okyere Boadu, Judith Obiri-Yeboah, Kwame Adu Okyere Boadu, Nathan Kumasenu Mensah, Grace Amoh-Agyei

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Routine health information system (RHIS) quality assurance has become an important issue, not only because of its significance in promoting a high standard of patient care but also because of its impact on government budgets for the maintenance of health services. A routine health information system comprises healthcare data collection, compilation, storage, analysis, report generation, and dissemination on a routine basis in various healthcare settings. The data from RHIS give a representation of health status, health services, and health resources. The sources of RHIS data are normally individual health records, records of services delivered, and records of health resources. Using reliable information from routine health information systems is fundamental in the healthcare delivery system. Quality assurance practices are measures that are put in place to ensure the health data that are collected meet required quality standards. Routine health information system quality assurance practices ensure that data that are generated from the system are fit for use. This study considered quality assurance practices in the RHIS processes. Methods: A cross-sectional study was conducted in eight health facilities in Tarkwa Sub-Municipal Health Service in the western region of Ghana. The study involved routine quality assurance practices among the 90 health staff and management selected from facilities in Tarkwa Sub-Municipal who collected or used data routinely from 24th December 2019 to 20th January 2020. Results: Generally, Tarkwa Sub-Municipal health service appears to practice quality assurance during data collection, compilation, storage, analysis and dissemination. The results show some achievement in quality control performance in report dissemination (77.6%), data analysis (68.0%), data compilation (67.4%), report compilation (66.3%), data storage (66.3%) and collection (61.1%). Conclusions: Even though the Tarkwa Sub-Municipal Health Directorate engages in some control measures to ensure data quality, there is a need to strengthen the process to achieve the targeted percentage of performance (90.0%). There was a significant shortfall in quality assurance practices performance, especially during data collection, with respect to the expected performance.

Keywords: quality assurance practices, assessment of routine health information system quality, routine health information system, data quality

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8364 Policy and System Research for Health of Ageing Population

Authors: Sehrish Ather

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Introduction: To improve organizational achievements through the production of new knowledge, health policy and system research is the basic requirement. An aging population is always the source of the increased burden of chronic diseases, disabilities, mental illnesses, and other co-morbidities; therefore the provision of quality health care services to every group of the population should be achieved by making strong policy and system research for the betterment of health care system. Unfortunately, the whole world is lacking policies and system research for providing health care to their elderly population. Materials and Methods: A literature review of published studies on aging diseases was done, ranging from the year 2011-2018. Geriatric, population, health policy, system, and research were the key terms used for the search. Databases searched were Google Scholar, PubMed, Science Direct, Ovid, and Research Gate. Grey literature was searched from various websites, including IHME, Library of the University of Lahore, World Health Organization (Ageing and Life Course), and Personal communication with Neuro-physicians. After careful reviewing published and un-published information, it was decided to carry on with commentary. Results and discussion: Most of the published studies have highlighted the need to advocate the funders of health policy and stakeholders of healthcare system research, and it was detected as a major issue, research on policy and healthcare system to provide health care to 'geriatric population' was found as highly neglected area. Conclusion: It is concluded that physicians are more involved with the policy and system research regarding any type of diseases, but scientists and researchers of basic and social science are less likely to be involved in methods used for health policy and system research due to lack of funding and resources. Therefore ageing diseases should be considered as a priority, and comprehensive policy and system research should be initiated for diseases of the geriatric population.

Keywords: geriatric population, health care system, health policy, system research

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8363 Exploring Factors That May Contribute to the Underdiagnosis of Hereditary Transthyretin Amyloidosis in African American Patients

Authors: Kelsi Hagerty, Ami Rosen, Aaliyah Heyward, Nadia Ali, Emily Brown, Erin Demo, Yue Guan, Modele Ogunniyi, Brianna McDaniels, Alanna Morris, Kunal Bhatt

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Hereditary transthyretin amyloidosis (hATTR) is a progressive, multi-systemic, and life-threatening disease caused by a disruption in the TTR protein that delivers thyroxine and retinol to the liver. This disruption causes the protein to misfold into amyloid fibrils, leading to the accumulation of the amyloid fibrils in the heart, nerves, and GI tract. Over 130 variants in the TTR gene are known to cause hATTR. The Val122Ile variant is the most common in the United States and is seen almost exclusively in people of African descent. TTR variants are inherited in an autosomal dominant fashion and have incomplete penetrance and variable expressivity. Individuals with hATTR may exhibit symptoms from as early as 30 years to as late as 80 years of age. hATTR is characterized by a wide range of clinical symptoms such as cardiomyopathy, neuropathy, carpal tunnel syndrome, and GI complications. Without treatment, hATTR leads to progressive disease and can ultimately lead to heart failure. hATTR disproportionately affects individuals of African descent; the estimated prevalence of hATTR among Black individuals in the US is 3.4%. Unfortunately, hATTR is often underdiagnosed and misdiagnosed because many symptoms of the disease overlap with other cardiac conditions. Due to the progressive nature of the disease, multi-systemic manifestations that can lead to a shortened lifespan, and the availability of free genetic testing and promising FDA-approved therapies that enhance treatability, early identification of individuals with a pathogenic hATTR variant is important, as this can significantly impact medical management for patients and their relatives. Furthermore, recent literature suggests that TTR genetic testing should be performed in all patients with suspicion of TTR-related cardiomyopathy, regardless of age, and that follow-up with genetic counseling services is recommended. Relatives of patients with hATTR benefit from genetic testing because testing can identify carriers early and allow relatives to receive regular screening and management. Despite the striking prevalence of hATTR among Black individuals, hATTR remains underdiagnosed in this patient population, and germline genetic testing for hATTR in Black individuals seems to be underrepresented, though the reasons for this have not yet been brought to light. Historically, Black patients experience a number of barriers to seeking healthcare that has been hypothesized to perpetuate the underdiagnosis of hATTR, such as lack of access and mistrust of healthcare professionals. Prior research has described a myriad of factors that shape an individual’s decision about whether to pursue presymptomatic genetic testing for a familial pathogenic variant, such as family closeness and communication, family dynamics, and a desire to inform other family members about potential health risks. This study explores these factors through 10 in-depth interviews with patients with hATTR about what factors may be contributing to the underdiagnosis of hATTR in the Black population. Participants were selected from the Emory University Amyloidosis clinic based on having a molecular diagnosis of hATTR. Interviews were recorded and transcribed verbatim, then coded using MAXQDA software. Thematic analysis was completed to draw commonalities between participants. Upon preliminary analysis, several themes have emerged. Barriers identified include i) Misdiagnosis and a prolonged diagnostic odyssey, ii) Family communication and dynamics surrounding health issues, iii) Perceptions of healthcare and one’s own health risks, and iv) The need for more intimate provider-patient relationships and communication. Overall, this study gleaned valuable insight from members of the Black community about possible factors contributing to the underdiagnosis of hATTR, as well as potential solutions to go about resolving this issue.

Keywords: cardiac amyloidosis, heart failure, TTR, genetic testing

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8362 Simplifying Health Risk Assessment (HRA) and Its Operationalisation for Turnaround Activities

Authors: Thirumila Muthukamaru

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The objective of a Health Risk Assessment (HRA) is to achieve a quality evaluation of risk assessments in a timely manner where adequate controls can be in place to protect workers health, especially during turnarounds where the exposure to health hazards is expected to rise during the performance of the many activities that take place, exposing workers to health risk. HRA development requires a competent team comprising experienced subject matter experts in the field, such as Industrial hygienists, Occupational Health Doctors, Turnaround Coordinators, Operation / Maintenance personnel, etc. The conventional way of conducting HRA is not only tedious and time-consuming but also less appreciated when it is not interpreted correctly, which may contribute to inadequate operationalization of it. Simplification can be the essence of timely intervention in managing health risks. This paper is intended as a sharing of the approach taken to simplify the methodology of developing the HRA report and operationalizing it. The approach includes developing a Generic HRA for turnaround activities to be used as a reference document and the empowerment of identified personnel through upskilling sessions to take up the role of facilitating HRA sessions. This empowerment is one of the key approaches towards the successful translation of the HRA into specific turnaround Job Hazard Analysis (JHA) that embed it in the Permit to Work (PTW) process. The approach used here increases awareness and compliance on HRA for turnaround activities through better interpretation and operationalization of the HRA report, adding value to the risk assessment for turnaround activities.

Keywords: industrial hygiene, health risk assessment, HRA, risk assessment

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8361 Physical Health, Depression and Related Factors for Elementary School Students in Seoul, South Korea

Authors: Kyung-Sook Bang

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Background: The health status of school-age children has a great influence on their growth and life-long health. The purposes of this study were to identify physical and mental health status of late school-age children in Seoul, South Korea and to investigate the related factors for their health. Methods: After gaining the approval from Institutional Review Board (IRB), a cross-sectional study was conducted with elementary students in grade 4 or 5. Questionnaires were distributed to eight elementary schools located different regions of Seoul in November, 2016, and 302 participants were finally included. From all participants, informed consents from the parents, and assents from children were received. Children's socioeconomic status, family functioning, peer relations, physical health symptoms, and depression were measured with self-reported questionnaires. Data were analyzed with descriptive statistics, t-test, Pearson’s correlations, and multiple regression. Results: Children's physical health symptoms and depression were not significantly different, and only their peer relations were significantly different according to their socioeconomic status (t=-3.93, p<.001). Depression showed significant positive correlation with physical health symptoms (r=.720, p<.001) and negative correlations with family functioning (r=-.428, p<.001) and peer relations (r=-.775, p<.001). The multiple regression model, which explained 73.5% of variance, showed peer relations (r2 =.604), physical health symptoms (r2 change=.125), and family functioning (r2 change=.005) as significant predictors for depression. Only the peer relations was significant predictor for their physical health symptoms and explained 50.6% of it. Conclusions: The peer relations was the most important factor in their physical and mental health at this age, and it can be affected by their socioeconomic status. Nursing interventions for promoting social relations and family functioning are required to improve children’s physical and mental health, especially for vulnerable population.

Keywords: child, depression, health, peer relation

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8360 Assessing In-Country Public Health Training Needs: Workforce Development to Meet Sustainable Development Goals

Authors: Leena Inamdar, David Allen, Sushma Acquilla, James Gore

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Health systems globally are facing increasingly complex challenges. Emerging health threats, changing population demographics and increasing health inequalities, globalisation, economic constraints on government spending are some of the most critical ones. These challenges demand not only innovative funding and cross-sectoral approaches, but also require a multidisciplinary public health workforce equipped with skills and expertise to meet the future challenges of the Sustainable Development Goals (SDGs). We aim to outline an approach to assessing the feasibility of establishing a competency-based public health training at a country level. Although the SDGs provide an enabling impetus for change and promote positive developments, public health training and education still lag behind. Large gaps are apparent in both the numbers of trained professionals and the options for high quality training. Public health training in most Low-Middle Income Countries is still largely characterized by a traditional and limited public health focus. There is a pressing need to review and develop core and emerging competences for a well-equipped workforce fit for the future. This includes the important role of national Health and Human Resource Ministries in determining these competences. Public health has long been recognised as a multidisciplinary field, with need for professionals from a wider range of disciplines such as management, health promotion, health economics, law. Leadership and communication skills are also critical to achieve the successes in meeting public health outcomes. Such skills and competences need to be translated into competency-based training and education, to prepare current public health professionals with the skills required in today’s competitive job market. Integration of academic and service based public-health training, flexible accredited programmes to support existing mid-career professionals, continuous professional development need to be explored. In the current global climate of austerity and increasing demands on health systems, the need for stepping up public health training and education is more important than ever. By using a case study, we demonstrate the process of assessing the in-county capacity to establish a competency based public health training programme that will help to develop a stronger, more versatile and much needed public health workforce to meet the SDGs.

Keywords: public health training, competency-based, assessment, SDGs

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8359 Environment and Health Quality in Urban Slums of Chandigarh: A Case Study

Authors: Ritu Sarsoha

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According to World Summit 2002 health is an integral component of sustainable development. Due to overpopulation and lack of employment opportunities in villages and small towns, the rural youth tend to migrate to the big cities causing mushrooming of slums. These slums lack most of the basic necessities of life particularly regarding environmental pollution and appropriate health care system. Present paper deals with the socio-economic and environmental status of people living in slum area of Chandigarh which has now grown as a big city today as it has become a hub for the migrants from U. P. and Bihar. Here is a case study of Colony no. 5 of Chandigarh which is divided into more than one block.

Keywords: slum, socio-economic, environment pollution, health

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8358 Functional Foods and Their Health Benefits with an Emphasis on Probiotics

Authors: Tanu Malik, Eusebe Gnonlonfoun, Eudes L. Anihouvi

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The rise of nutrition-related diseases, increase of health care cost, and the social perception that food could directly affect health have naturally created an environment conducive to the development of foods and beverages with an asserted health benefit. Consumer habits have turned considerably healthier in recent years and led to the demand for fortified and enhanced foods that could adequately provide health benefits beyond necessary nutrients for humans when they are consumed as part of the diet and regularly. These trends have developed a global market for functional foods, that grows annually and undoubtedly requires to be diversified. Product development appears thus as a key research priority for both the food industry and science sectors. The health benefits of these functional foods are summarized in two possible ways: either indirectly as a desired result of biogenic effect or through the direct interaction of ingested live microorganisms with the host (probiotic effect). This paper reviews functional foods and their beneficial health effects with a key focus on probiotics for the possible expansion of their use by the food industry in order to develop non-dairy based probiotics foods. Likewise, it reveals the need for more researches oriented towards an accurate understanding of the possible interaction between probiotic strains and the matrix and, on the other hand, the interaction between probiotic strains and some enzymes used during food manufacturing.

Keywords: functional foods, food industry, health benefits, probiotics

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8357 Detroit Latinx Adolescents Depend on Relationships, Recreation, and Internal Homeostasis to Live their Healthiest Lives

Authors: Jenny Clift, Rebeccah Sokol, LaTricia Mitchell, Nicholas Alexander, Karissa Rusnick

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Aims: This study sought to identify prevalent promotive factors supporting urban adolescent health and wellbeing, per adolescent and caregiver reports. Setting: The research team conducted online surveys with adolescent (n=520) and caregiver (n=73) respondents from a predominately Latinx urban high school. Methodology: A cross-sectional, qualitative study. Analysis: Inductive thematic analysis was used to analyze responses to open-ended questions. -Findings. Adolescent and caregiver respondents identified promotive factors (eight and six, respectively) that encourage adolescent health and well-being. Supportive relationships were the most frequently reported factor among adolescents (68%) and caregivers (55%). Implications: Health promotion interventions among adolescents should consider how to promote relationships to counteract negative social determinants of health (SDH) and promote optimal quality of life.

Keywords: Latinx adolescents, health and wellbeing, social determinants of health, school

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8356 Prenatal Diagnosis of Beta Thalassemia Intermedia in Vietnamese Family: Case Report

Authors: Ha T. T. Ly, Truc B. Truc, Hai N. Truong, Mai P. T. Nguyen, Ngoc D. Ngo, Khanh V. Tran, Hai T. Le

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Beta thalassemia is one of the most common inherited blood disorders, which is characterized by decreased or absent in beta globin expression. Patients with Beta thalassemia whose anemia is not so severe as to necessitate transfusions are said to have thalassemia intermedia. Objective: The goal of this study is prenatal diagnosis for pregnancy woman with Beta thalassemia intermedia and her husband with Beta thalassemia carrier at high risk of Beta thalassemia major in Northern of Vietnam. Material and method: The family has a 6 years-old compound heterozygous thalassemia major for CD71/72(+A) and Hbb:c. -78A>G/nt-28(A>G) male child. The father was heterozygous for CD71/72(+A) mutation which is Beta plus type and the mother was compound heterozygosity of two different variants, namely, Hbb: c. -78A>G/nt-28(A>G) and CD26(A-G) HbE. Prenatal Beta thalassemia mutation detection in fetal DNA was carried out using multiplex Amplification-refractory mutation system ARMS-PCR and confirmed by direct Sanger-sequencing Hbb gene. Prenatal diagnoses were perfomed by amniotic fluid sampling from pregnant woman in the 16-18th week of pregnancy after the genotypes of parents of the probands were identified. Result: When amniotic fluid sample was analyzed for Beta globin gene (Hbb), we found that the genotype is heterozygous for CD71/72(+A) and CD26(A-G) HbE. This genotype is different from the 1st child of this family. Conclusion: Prenatal diagnosis helps the parents to know the genotype and the thalassemia status of the fetus, so they can have early decision on their pregnancy. Genetic diagnosis provided a useful method in diagnosis for familial members in pedigree, genetic counseling and prenatal diagnosis.

Keywords: beta thalassemia intermedia, Hbb gene, pedigree, prenatal diagnosis

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8355 Effect of Recreational Soccer on Health Indices and Diseases Prevention

Authors: Avinash Kharel

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Recreational soccer (RS) as a medium of small-sided soccer game (SSG) has an immense positive effect on physical health, mental health and wellbeing. The RS has reflected both acute responses and long-term effects of training on sedentary, trained and clinical population on any age, gender or health status. The enjoyable mode of training elicits greater adherence by optimising intrinsic motivation while offering health benefits that match those achieved by treadmill and cycle ergometer programmes both as continuous and interval forms of training. Additionally, recreational soccer is effective and efficient regimens with highlighted social, motivational and competitive components overcoming the barriers such as cost-efficiency, time-efficiency, assess to facilities and intrinsic motivation. Further, it can be applied as an effective broad-spectrum non-pharmacological treatment of lifestyle diseases producing a positive physiological response in healthy subjects, patients and elderly people regardless of age, gender or training experience.

Keywords: recreational soccer, health benefits, diseases prevention, physiology

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8354 Community Participation in Health Related Activities in Ignié-Ngabé-Mayama Health District, Brazzaville, Republic of Congo

Authors: Tebeu Pierre Marie

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Introduction: WHO defines community participation as a process in which the local population, take responsibility in planning for their health, participates in the strategy’s development for implementation and accessibility to physical, moral and social well-being. For the purpose of dealing with health, the community participation is made through the organization called health Centre committee leader (HCCL/COSA) for Integrated health Center and District hospital committee leaser (HDCL/COGES) for District Hospital. Little is known about the effective participation of the community in health related activities in Ignié-Ngabé-Mayama health district. Objective: This study aimed at assessing the involvement of community in the health system running at the Ignié-Ngabé-Mayama health district. Methods: This was a qualitative cross-sectional study conducted in the Ignié-Ngabé-Mayama health district from 15 December 2020 to 30 April 2021. The study population consisted of 10 HCCL and one District hospital committee leaser (DHCL). Data were collected using a pretested questionnaire and validated by the investigating team. The variables of interest were; effective existence of HCCL/DHCL, their involvement HCCL/DHCL in health related activities, their financing management, planning of activities and leadership. Results: A total of 11 participants were interviewed, including 10 HCCL and 1 DHCL. The Sex-Ratio was 9/11; with primary level 6/11 and were mostly farmers 6/11. Analyzing the involvement of the HDCL/DHCL in health promotion and preventive activities; this was effective only for two of them (2/11). Analyzing the barriers for their involvement, the leaders reported the lack of financial support by the state, lack NGO support. Additionally, they reported to have been very active when there was Performance Based Founding Project in the District. Conclusion: Only two of the (HDCL/HCCL) out of 11 were really functioning. Reported barriers to their running were: lack of state/NGOs support and ending of PBF Project. There is a need to organize a tripartite forum including stats, NGOs and Community for boosting the community participation in health related activities in Ignié-Ngabé-Mayama health district.

Keywords: health district committee, health Centre committee, community participation, Brazzaville, Congo

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8353 An Android Application for ECG Monitoring and Evaluation Using Pan-Tompkins Algorithm

Authors: Cebrail Çiflikli, Emre Öner Tartan

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Parallel to the fast worldwide increase of elderly population and spreading unhealthy life habits, there is a significant rise in the number of patients and health problems. The supervision of people who have health problems and oversight in detection of people who have potential risks, bring a considerable cost to health system and increase workload of physician. To provide an efficient solution to this problem, in the recent years mobile applications have shown their potential for wide usage in health monitoring. In this paper we present an Android mobile application that records and evaluates ECG signal using Pan-Tompkins algorithm for QRS detection. The application model includes an alarm mechanism that is proposed to be used for sending message including abnormality information and location information to health supervisor.

Keywords: Android mobile application, ECG monitoring, QRS detection, Pan-Tompkins Algorithm

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8352 Adolescents’ and Young Adults’ Well-Being, Health, and Loneliness during the COVID-19 Pandemic

Authors: Jessica Hemberg, Amanda Sundqvist, Yulia Korzhina, Lillemor Östman, Sofia Gylfe, Frida Gädda, Lisbet Nyström, Henrik Groundstroem, Pia Nyman-Kurkiala

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Purpose: There are large gaps in the literature on COVID-19 pandemic-related mental health outcomes and after-effects specific to adolescents and young adults. The study's aim was to explore adolescents’ and young adults’ experiences of well-being, health, and loneliness during the COVID-19 pandemic. Method: A qualitative exploratory design with qualitative content analysis was used. Twenty-three participants (aged 19-27; four men and 19 women) were interviewed. Results: Four themes emerged: Changed social networks – fewer and closer contacts, changed mental and physical health, increased physical and social loneliness, well-being, internal growth, and need for support. Conclusion: Adolescents’ and young adults’ experiences of well-being, health, and loneliness are subtle and complex. Participants experienced changed social networks, mental and physical health, and well-being. Also, internal growth, need for support, and increased loneliness were seen. Clear information on how to seek help and support from professionals should be made available.

Keywords: adolescents, COVID-19 pandemic, health, interviews, loneliness, qualitative, well-being, young adults

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8351 Open Consent And Artificial Intelligence For Health Research in South Africa

Authors: Amy Gooden

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Various modes of consent have been utilized in health research, but open consent has not been explored in South Africa’s AI research context. Open consent entails the sharing of data without assurances of privacy and may be seen as an attempt to marry open science with informed consent. Because all potential uses of data are unknown, it has been questioned whether consent can be informed. Instead of trying to adapt existing modes of consent, why not adopt a new perspective? This is what open consent proposes and what this research will explore in AI health research in South Africa.

Keywords: artificial intelligence, consent, health, law, research, South Africa

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