Search results for: health risk assessments
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 13956

Search results for: health risk assessments

9006 A Qualitative Study on Exploring How the Home Environment Influences Eating and Physical Activity Habits of Low-Income Latino Children of Predominantly Immigrant Families

Authors: Ana Cristina Lindsay, Sherrie Wallington, Faith Lees, Mary Greaney

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Purpose: Latino children in low-income families are at elevated risk of becoming overweight or obese. The purpose of this study was to examine low-income Latino parents’ beliefs, parenting styles and practices related to their children’s eating and physical activity behaviors while at home. Design and Methods: Qualitative study using focus group discussions with 33 low-income Latino parents of preschool children 2 to 5 years of age. Transcripts were analyzed using thematic analysis. Results: Data analyses revealed that most parents recognize the importance of healthy eating and physical activity for their children and themselves. However, daily life demands including conflicting schedules, long working hours, financial constraints, and neighborhood safety concerns, etc., impact parents’ ability to create a home environment supportive of these behaviors. Conclusions: This study provides information about how the home environment influences low-income Latino preschool children’s eating and physical activity habits. This information is useful for pediatric nurses in their health promotion and disease prevention efforts with low-income Latino families with young children, and for the development of home-based and parenting interventions to prevent and control childhood obesity among this population group. Practice Implications: Pediatric nurses can facilitate communication, provide education, and offer guidance to low-income Latino parents that support their children’s development of early healthy eating and physical activity habits, while taking into account daily life barriers faced by families. Moreover, nurses can play an important role in the integration and coordination of home-visitation to complement office-based visits and provide a continuum of care to low-income Latino families.

Keywords: home environment, Latino, obesity, parents, healthy eating, physical activity

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9005 Approaches to Implementing and Financing Primary Health Care in Kenya

Authors: Helen Owino, Sharifa Hussein

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Background: Kenya has made significant strides in improving access to PHC services. However, challenges relating to equitable distribution of services, resource allocation, and financial sustainability must be addressed. Targeted policy interventions strengthened collaboration between public and private sectors, and innovative financing mechanisms are needed to bridge existing gaps and enhance the delivery of PHC services. A holistic and collaborative approach is essential to ensure PHC remains accessible, affordable, and of high quality for all its citizens. By addressing the identified issues and building on the existing strengths, Kenya can move towards a more resilient and inclusive health system. Study objectives: Inform scale-up of promising primary health care (PHC) approaches/models, Inform the development of PHC advocacy materials, and Contribute to country, regional, and global discourse on PHC financing. The methodology involved conducting a desk review of background literature and statistics on the current state of PHC and key informant interviews guided by a questionnaire based on the pillars or building blocks of Health Systems Strengthening (HSS). Summary of Key Findings: Strong support from leadership is key for the successful implementation of Primary Care Networks (PCNs), as seen in Kisumu and Nakuru, where County Health Management Teams (CHMTs) showed commitment to the success of PCNs even without partner support. Using already existing governance and human resources for health (HRH) mechanisms to implement PCNs is useful, especially where there are resource constraints and improve performance: An appointed PHC focal person/office is key to ensuring the planning and implementation of PCNs, e.g., Kisumu, Nakuru, and Garissa. Embracing joint planning and distribution of resources within PHC leads to more efficient use of resources coordination outcomes, for example, in Kisumu and Garissa. Subsequent prioritization and county funding have led to successful PCN implementation in Nakuru and Kisumu. Partner funding in Garissa has facilitated PCN functionality in Garissa and Nakuru. Intersectoral collaboration and public participation in the health sector lead to greater utilization of PHC services, e.g., in Kisumu, working with other ministries to improve infrastructure like road networks to facilities has improved access to PHC facilities.

Keywords: PHC policy and programming, innovations and adaptations, scale up, UHC

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9004 Ambulatory Care Utilization of Individuals with Cerebral Palsy in Taiwan- A Country with Universal Coverage and No Gatekeeper Regulation

Authors: Ming-Juei Chang, Hui-Ing Ma, Tsung-Hsueh Lu

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Introduction: Because of the advance of medical care (e.g., ventilation techniques and gastrostomy feeding), more and more children with CP can live to adulthood. However, little is known about the use of health care services from children to adults who have CP. The patterns of utilization of ambulatory care are heavily influenced by insurance coverage and primary care gatekeeper regulation. The purpose of this study was to examine patterns of ambulatory care utilization among individuals with CP in Taiwan, a country with universal coverage and no gatekeeper regulation. Methods: A representative sample of one million patients (about 1/23 of total population) covered by Taiwan’s National Health Insurance was used to analyze the ambulatory care utilization in individuals with CP. Data were analyzed by 3 different age groups (children, youth and adults) during 2000 to 2003. Participants were identified by the presence of CP diagnosis made by pediatricians or physicians of physical and rehabilitation medicine and stated at least three times in claims data. Results: Annual rates of outpatient physician visits were 31680 for children, 16492 for youth, and 28617 for adults with CP (per 1000 persons). Individuals with CP received over 50% of their outpatient care from hospital outpatient department. Higher use of specialist physician services was found in children (54.7%) than in the other two age groups (28.4% in youth and 18.8% in adults). Diseases of respiratory system were the most frequent diagnoses for visits in both children and youth with CP. Diseases of the circulatory system were the main reasons (24.3%) that adults with CP visited hospital outpatient care department or clinics. Conclusion: This study showed different patterns of ambulatory care utilization among different age groups. It appears that youth and adults with CP continue to have complex health issues and rely heavily on the health care system. Additional studies are needed to determine the factors which influence ambulatory care utilization among individuals with CP.

Keywords: cerebral palsy, health services, lifespan, universal coverage

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9003 Risk of Occupational Exposure to Cytotoxic Drugs: The Role of Handling Procedures of Hospital Workers

Authors: J. Silva, P. Arezes, R. Schierl, N. Costa

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In order to study environmental contamination by cytostatic drugs in Portugal hospitals, sampling campaigns were conducted in three hospitals in 2015 (112 samples). Platinum containing drugs and fluorouracil were chosen because both were administered in high amounts. The detection limit was 0.01 pg/cm² for platinum and 0.1 pg/cm² for fluorouracil. The results show that spills occur mainly on the patient`s chair, while the most referenced occurrence is due to an inadequately closed wrapper. Day hospitals facilities were detected as having the largest number of contaminated samples and with higher levels of contamination.

Keywords: cytostatic, contamination, hospital, procedures, handling

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9002 Analysis and Re-Design Ergonomic Mineral Water Gallon Trolley

Authors: Dessy Laksyana Utami

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Manual material handling activities often make it difficult for humans to work like this. Muscle injury due to incorrect posture.Workers need to facilitate their activities. One tool to assist their activities in the transportation of ordinary materials is a trolley. This tool is very useful because it can be used.It can bring many items without having to spend more energy to operate it. Very Comfortable used a trolley in the community. But the old design still have a complaint by worker, because lack of grip and capacity. After posture analysis with the REBA method, the value of risk need to be increased is obtained tool. Re design use Indonesian anthropometric data with the 50th percentile.

Keywords: Material Handling, REBA method, postural assessment, Trolley.

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9001 Glycemic Control on Self-Efficacy and Self-Care Behaviors among Omani Adults with Type 2 Diabetes

Authors: Melba Sheila D'Souza, Anandhi Amirtharaj, Shreedevi Balachandran

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Background: Type 2 diabetes has a significant impact on individuals’ health and well-being. Glycemic control may influence self-efficacy and self-care behaviors, and reduce the risk of complications among adults with type 2 diabetes. Type 2 diabetes has substantial morbidity and mortality and 60% of adults’ poor self-care. Glycemic control is associated with reported self-efficacy and self-care behavior. Adults with type 2 diabetes with less information were less likely to take diabetes self-care. Aim: To examine the relationship between glycemic control, demographic factors, clinical factors on self-efficacy, self-care behaviors among Omani adults with type 2 diabetes. Methods: A correlational, descriptive study was used. Omani adults with type 2 diabetes (n=140) were recruited from a public hospital in Oman. The data were collected during January-March 2015. Ethical approval was given by the college research and ethics committee, College of Nursing, and the Hospital, Sultan Qaboos University Data was collected on self-efficacy, self-care behaviors and glycemic control. The study was approved by the Institution Ethics and Research Committee. Bivariate and multivariate analyses were conducted. Results: Most adults had a fasting blood glucose >7.2mmol/L (90.7%), with the majority demonstrating ‘uncontrolled or poor HbA1c of > 8%’ (65%). Variance of self-care behavior (20.6%) and 31.3% of the variance of the self-efficacy was explained by the age, duration of diabetes, medication, HbA1c and prevention of activities of living. Adults with type 2 diabetes with poor glycemic control were more likely to have poor self-efficacy and poor self-care behaviors. Conclusion: This study confirms that self-efficacy model on outcome predicts self-efficacy and self-care behavior. Higher understanding of diabetes, prevention of normal daily activities, higher ability to fit diabetes life in a positive manner and high patient-physician communication were significant with self-efficacy and self-care behaviors. Hence, glycemic control has a high effect on improving self-care behaviors like diet, exercise, medication, foot care and self-efficacy among type 2 diabetes. Implications: Using these findings to improve self-efficacy, individualized self-care management is recommended for better self-efficacy and self-care behaviors among adults with type 2 diabetes.

Keywords: self-efficacy, self-care behaviors, self-care management, glycemic control, type 2 diabetes, nurse

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9000 Investigation of the Level of Physical and Mental Health of Patients Undergoing in Chronic or Transient Hemodialysis at Artificial Kidney Unit

Authors: Styliani Kotrotsiou, Evagelia Kotrotsiou, Fani Mokia, Theodosis Paralikas, Konstantinos Tsaras

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Objective: The objective of this study was the investigation of the mental health of patients undergoing chronic or transient hemodialysis at Artificial Kidney Unit, as well as its relationship to the demographic characteristic of patients. Material and Method: The study took place in Larisa during the month of December in 2016 and the sample was composed of 60 patients undergoing in chronic or transient hemodialysis at Artificial Kidney Unit of the University General Hospital of Larisa. For the investigation of the physical and mental health of patients who participated in the study, the tool measurement << General Health Questionnaire- 28 >> (GHQ-28) was used. The questionnaires were administered with the interview method during the hemodialysis. This survey is designed for the existence or not of a mental disorder. It examines four factors (physical symptoms, anxiety, social dysfunction and depression). Results: The hemodialysis patients gave the following scores: -to the physical symptoms, women showed a higher average value than men (1,16 ± 1,26 against 0,49 ± 0,93), -at the anxiety scale, it seems that women are superior to men (1,68 ± 1,20 against 0,90 ± 1,22), -at the social dysfunction scale, the elderly patients ( > 65 years old) were presented a with higher average (2,59), and -at the depression scale, patients with a higher average value were those who lived in non-urban areas. The appearance of mental disorder, in relation to patient characteristics, did not show significant statistical correlation. The sex, the age and the place of residence affect more the assessment of mental health, while education did not seem to have any significant effect on the other. Conclusions: The hemodialysis process can significantly affect the patient’s Quality of Life and it can bring adverse changes in lifestyle, affecting the physical, social and psychological state of the individual. For that reason, hemodialysis should be aimed not only at extending life but in upgrading the Quality of Life.

Keywords: hemodialysis, chronic kidney disease, depression, social dysfunction, physical condition

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8999 Analysis of Complex Business Negotiations: Contributions from Agency-Theory

Authors: Jan Van Uden

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The paper reviews classical agency-theory and its contributions to the analysis of complex business negotiations and gives an approach for the modification of the basic agency-model in order to examine the negotiation specific dimensions of agency-problems. By illustrating fundamental potentials for the modification of agency-theory in context of business negotiations the paper highlights recent empirical research that investigates agent-based negotiations and inter-team constellations. A general theoretical analysis of complex negotiation would be based on a two-level approach. First, the modification of the basic agency-model in order to illustrate the organizational context of business negotiations (i.e., multi-agent issues, common-agencies, multi-period models and the concept of bounded rationality). Second, the application of the modified agency-model on complex business negotiations to identify agency-problems and relating areas of risk in the negotiation process. The paper is placed on the first level of analysis – the modification. The method builds on the one hand on insights from behavior decision research (BRD) and on the other hand on findings from agency-theory as normative directives to the modification of the basic model. Through neoclassical assumptions concerning the fundamental aspects of agency-relationships in business negotiations (i.e., asymmetric information, self-interest, risk preferences and conflict of interests), agency-theory helps to draw solutions on stated worst-case-scenarios taken from the daily negotiation routine. As agency-theory is the only universal approach able to identify trade-offs between certain aspects of economic cooperation, insights obtained provide a deeper understanding of the forces that shape business negotiation complexity. The need for a modification of the basic model is illustrated by highlighting selected issues of business negotiations from agency-theory perspective: Negotiation Teams require a multi-agent approach under the condition that often decision-makers as superior-agents are part of the team. The diversity of competences and decision-making authority is a phenomenon that overrides the assumptions of classical agency-theory and varies greatly in context of certain forms of business negotiations. Further, the basic model is bound to dyadic relationships preceded by the delegation of decision-making authority and builds on a contractual created (vertical) hierarchy. As a result, horizontal dynamics within the negotiation team playing an important role for negotiation success are therefore not considered in the investigation of agency-problems. Also, the trade-off between short-term relationships within the negotiation sphere and the long-term relationships of the corporate sphere calls for a multi-period perspective taking into account the sphere-specific governance-mechanisms already established (i.e., reward and monitoring systems). Within the analysis, the implementation of bounded rationality is closely related to findings from BRD to assess the impact of negotiation behavior on underlying principal-agent-relationships. As empirical findings show, the disclosure and reservation of information to the agent affect his negotiation behavior as well as final negotiation outcomes. Last, in context of business negotiations, asymmetric information is often intended by decision-makers acting as superior-agents or principals which calls for a bilateral risk-approach to agency-relations.

Keywords: business negotiations, agency-theory, negotiation analysis, interteam negotiations

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8998 An Investigation of Pain and Life Satisfaction in Elderly Individuals in Turkey

Authors: Senay Karadag Arli, Ayse Berivan Bakan, Ela Varol, Gulpinar Aslan

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Objective: This study aims to investigate pain and life satisfaction in elderly individuals. Methods: This study, which is descriptive in nature, utilized relational screening model. It was conducted between September 2016 and March 2017, with 387 people aged 65 and over who were registered in Family Health Centers in Ağrı, a city located in eastern Turkey. Results: The Geriatric Pain Measure mean score of the participants was 53.23 ± 29.40, indicating moderate pain. The Life Satisfaction Scale mean score was found 8.50 ± 5.34, indicating moderate life satisfaction level. The study also found a statistically significant, negative relationship between life satisfaction and geriatric pain. Conclusion: Increase in elderly population brings along various health problems. Results of this study show that the rate of chronic diseases is very high in elderly individuals. Therefore, pain is one of the most frequently encountered health problems, and it has negative effects on life satisfaction. In conclusion, it is considered that elderly people’s life satisfaction could increase if their pain is identified and reduced effectively.

Keywords: geriatric pain measure, life satisfaction, pain, Turkey

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8997 Assessing Trainee Radiation Exposure in Fluoroscopy-Guided Procedures: An Analysis of Hp(3)

Authors: Ava Zarif Sanayei, Sedigheh Sina

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During fluoroscopically guided procedures, healthcare workers, especially radiology trainees, are at risk of exposure to elevated radiation exposure. It is vital to prioritize their safety in such settings. However, there is limited data on their monthly or annual doses. This study aimed to evaluate the equivalent dose to the eyes of the student trainee, utilizing LiF: Mg, Ti (TLD-100) chips at the radiology department of a hospital in Shiraz, Iran. Initially, the dosimeters underwent calibration procedures with the assistance of ISO-PTW calibrated phantoms. Following this, a set of dosimeters was prepared To determine HP(3) value for a trainee involved in the main operation room and controlled area utilized for two months. Three TLD chips were placed in a holder and attached to her eyeglasses. Upon completion of the duration, the TLDs were read out using a Harshaw TLD reader. Results revealed that Hp(3) value was 0.31±0.04 mSv. Based on international recommendations, students in radiology training above 18 have an annual dose limit of 0.6 rem (6 mSv). Assuming a 12-month workload, staff radiation exposure stayed below the annual limit. However, the Trainee workload may vary due to different deeds. This study's findings indicate the need for consistent, precise dose monitoring in IR facilities. Students can undertake supervised internships for up to 500 hours, depending on their institution. These internships take place in health-focused environments offering radiology services, such as clinics, diagnostic imaging centers, and hospitals. Failure to do so might result in exceeding occupational radiation dose limits. A 0.5 mm lead apron effectively absorbs 99% of radiation. To ensure safety, technologists and staff need to wear this protective gear whenever they are in the room during procedures. Furthermore, maintaining a safe distance from the primary beam is crucial. In cases where patients need assistance and must be held for imaging, additional protective equipment, including lead goggles, gloves, and thyroid shields, should be utilized for optimal safety.

Keywords: annual dose limits, Hp(3), individual monitoring, radiation protection, TLD-100

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8996 Ethnic Andean Concepts of Health and Illness in the Post-Colombian World and Its Relevance Today

Authors: Elizabeth J. Currie, Fernando Ortega Perez

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—‘MEDICINE’ is a new project funded under the EC Horizon 2020 Marie-Sklodowska Curie Actions, to determine concepts of health and healing from a culturally specific indigenous context, using a framework of interdisciplinary methods which integrates archaeological-historical, ethnographic and modern health sciences approaches. The study will generate new theoretical and methodological approaches to model how peoples survive and adapt their traditional belief systems in a context of alien cultural impacts. In the immediate wake of the conquest of Peru by invading Spanish armies and ideology, native Andeans responded by forming the Taki Onkoy millenarian movement, which rejected European philosophical and ontological teachings, claiming “you make us sick”. The study explores how people’s experience of their world and their health beliefs within it, is fundamentally shaped by their inherent beliefs about the nature of being and identity in relation to the wider cosmos. Cultural and health belief systems and related rituals or behaviors sustain a people’s sense of identity, wellbeing and integrity. In the event of dislocation and persecution these may change into devolved forms, which eventually inter-relate with ‘modern’ biomedical systems of health in as yet unidentified ways. The development of new conceptual frameworks that model this process will greatly expand our understanding of how people survive and adapt in response to cultural trauma. It will also demonstrate the continuing role, relevance and use of TM in present-day indigenous communities. Studies will first be made of relevant pre-Colombian material culture, and then of early colonial period ethnohistorical texts which document the health beliefs and ritual practices still employed by indigenous Andean societies at the advent of the 17th century Jesuit campaigns of persecution - ‘Extirpación de las Idolatrías’. Core beliefs drawn from these baseline studies will then be used to construct a questionnaire about current health beliefs and practices to be taken into the study population of indigenous Quechua peoples in the northern Andean region of Ecuador. Their current systems of knowledge and medicine have evolved within complex historical contexts of both the conquest by invading Inca armies in the late 15th century, followed a generation later by Spain, into new forms. A new model will be developed of contemporary  Andean concepts of health, illness and healing demonstrating  the way these have changed through time. With this, a ‘policy tool’ will be constructed as a bridhging facility into contemporary global scenarios relevant to other Indigenous, First Nations, and migrant peoples to provide a means through which their traditional health beliefs and current needs may be more appropriately understood and met. This paper presents findings from the first analytical phases of the work based upon the study of the literature and the archaeological records. The study offers a novel perspective and methods in the development policies sensitive to indigenous and minority people’s health needs.

Keywords: Andean ethnomedicine, Andean health beliefs, health beliefs models, traditional medicine

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8995 Alcohol Rituals and Active Ageing: A Thematic Analysis of Semi-Structured Interviews with Retirees in the West of Scotland

Authors: Deborah Nicholson, Fiona McCormack, Pete Seaman, Karen Bell

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This paper explores alcohol consumption amongst retirees in the West of Scotland in the context of active and healthy ageing discourses. The public health consequences of alcohol use are well documented and of growing concern to policy makers in Scotland and elsewhere. However, alcohol occupies a prominent position in a range of cultural and social practices and has associated meanings for users related to conviviality, leisure, sociability, and inclusion- features closely tied to active and healthy ageing. These perceived positive and negative meanings place alcohol in an ambiguous and contradictory position in relation to the Scottish Government’s key health policy initiatives aimed at healthy ageing and the reduction of alcohol-related ill-health. This paper explores these positive and negative associations through an examination of the meanings which retirees attach to alcohol and the routines and rituals they develop to navigate wider health concerns. Methods: participants were recruited from the West of Scotland area using a quota sampling design based around gender, age, and socioeconomic position. Forty participants were interviewed using a semi-structured interview schedule and qualitative techniques. The interviews were transcribed and thematic analysis of the data was conducted. Results: Alcohol use amongst retirees in Scotland was widely varied with marked differences noted in terms of gender and age group, but with less clear variance by socioeconomic position. A range of strategies was employed to limit alcohol use by time, context, location and/or volume and these strategies clearly drew on a perception of alcohol use in retirement as potentially more problematic than at earlier stage of life. Thus, the retirees in the sample used these limiting strategies to navigate the positive and negative meanings they attached to alcohol use.

Keywords: alcohol, health, retirement, routines

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8994 Money Laundering and Terror Financing in the Islamic Banking Sector in Bangladesh

Authors: Md. Abdul Kader

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Several reports released by Global Financial Integrity (GFI) in recent times have identified Bangladesh as being among the worst affected countries to the scourge of money laundering (ML) and terrorist financing (TF). The money laundering (ML) and terrorist financing (TF) risks associated with conventional finance are generally well identified and understood by the relevant national authorities. There is, however, no common understanding of ML/TF risks associated with Islamic Banking. This paper attempts to examine the issues of money laundering (ML) and terrorist financing (TF) in Islamic Banks of Bangladesh. This study also investigates the risk factors associated with Islamic Banking system of Bangladesh that are favorable for ML and TF and which prevent the government to control such issues in the Islamic Banks of Bangladesh. Qualitative research methods were employed by studying various reports from journals, newspapers, bank reports and periodicals. In addition, five ex-bankers who were in the policy making bodies of three Islamic Banks were also interviewed. Findings suggest that government policies regarding Islamic Banking system in Bangladesh are not well defined and clear. Shariah law, that is the guiding principle of Islamic Banking, is not well recognized by the government policy makers, and thus they left the responsibility to the governing bodies of the banks. Other challenges that were found in the study are: the complexity of some Islamic banking products, the different forms of relationship between the banks and their clients, the inadequate ability and skill in the supervision of Islamic finance, particularly in jurisdictions, to evaluate their activities. All these risk factors paved the ground for ML and TF in the Islamic Banks of Bangladesh. However, due to unconventional nature of Banking and lack of investigative reporting on Islamic Banking, this study could not cover the whole picture of the ML/TF of Islamic Banks of Bangladesh. However, both qualitative documents and interviewees confirmed that Islamic Banking in Bangladesh could be branded as risky when it comes to money laundering and terror financing. This study recommends that the central bank authorities who supervise Islamic finance and the government policy makers should obtain a greater understanding of the specific ML/TF risks that may arise in Islamic Banks and develop a proper response. The study findings are expected to considerably impact Islamic banking management and policymakers to develop strong and appropriate policy to enhance transparency, accountability, and efficiency in banking sector. The regulatory bodies can consider the findings to disseminate anti money laundering and terror financing related rules and regulations.

Keywords: money laundering, terror financing, islamic banking, bangladesh

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8993 Body Composition Analysis of University Students by Anthropometry and Bioelectrical Impedance Analysis

Authors: Vinti Davar

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Background: Worldwide, at least 2.8 million people die each year as a result of being overweight or obese, and 35.8 million (2.3%) of global DALYs are caused by overweight or obesity. Obesity is acknowledged as one of the burning public health problems reducing life expectancy and quality of life. The body composition analysis of the university population is essential in assessing the nutritional status, as well as the risk of developing diseases associated with abnormal body fat content so as to make nutritional recommendations. Objectives: The main aim was to determine the prevalence of obesity and overweight in University students using Anthropometric analysis and BIA methods Material and Methods: In this cross-sectional study, 283 university students participated. The body composition analysis was undertaken by using mainly: i) Anthropometric Measurement: Height, Weight, BMI, waist circumference, hip circumference and skin fold thickness, ii) Bio-electrical impedance was used for analysis of body fat mass, fat percent and visceral fat which was measured by Tanita SC-330P Professional Body Composition Analyzer. The data so collected were compiled in MS Excel and analyzed for males and females using SPSS 16.Results and Discussion: The mean age of the male (n= 153) studied subjects was 25.37 ±2.39 year and females (n=130) was 22.53 ±2.31. The data of BIA revealed very high mean fat per cent of the female subjects i.e. 30.3±6.5 per cent whereas mean fat per cent of the male subjects was 15.60±6.02 per cent indicating a normal body fat range. The findings showed high visceral fat of both males (12.92±3.02) and females (16.86±4.98). BMI, BF% and WHR were higher among females, and BMI was higher among males. The most evident correlation was verified between BF% and WHR for female students (r=0.902; p<0.001). The correlation of BFM and BF% with thickness of triceps, sub scapular and abdominal skin folds and BMI was significant (P<0.001). Conclusion: The studied data made it obvious that there is a need to initiate lifestyle changing strategies especially for adult females and encourage them to improve their dietary intake to prevent incidence of non communicable diseases due to obesity and high fat percentage.

Keywords: anthropometry, bioelectrical impedance, body fat percentage, obesity

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8992 Predicting Subsurface Abnormalities Growth Using Physics-Informed Neural Networks

Authors: Mehrdad Shafiei Dizaji, Hoda Azari

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The research explores the pioneering integration of Physics-Informed Neural Networks (PINNs) into the domain of Ground-Penetrating Radar (GPR) data prediction, akin to advancements in medical imaging for tracking tumor progression in the human body. This research presents a detailed development framework for a specialized PINN model proficient at interpreting and forecasting GPR data, much like how medical imaging models predict tumor behavior. By harnessing the synergy between deep learning algorithms and the physical laws governing subsurface structures—or, in medical terms, human tissues—the model effectively embeds the physics of electromagnetic wave propagation into its architecture. This ensures that predictions not only align with fundamental physical principles but also mirror the precision needed in medical diagnostics for detecting and monitoring tumors. The suggested deep learning structure comprises three components: a CNN, a spatial feature channel attention (SFCA) mechanism, and ConvLSTM, along with temporal feature frame attention (TFFA) modules. The attention mechanism computes channel attention and temporal attention weights using self-adaptation, thereby fine-tuning the visual and temporal feature responses to extract the most pertinent and significant visual and temporal features. By integrating physics directly into the neural network, our model has shown enhanced accuracy in forecasting GPR data. This improvement is vital for conducting effective assessments of bridge deck conditions and other evaluations related to civil infrastructure. The use of Physics-Informed Neural Networks (PINNs) has demonstrated the potential to transform the field of Non-Destructive Evaluation (NDE) by enhancing the precision of infrastructure deterioration predictions. Moreover, it offers a deeper insight into the fundamental mechanisms of deterioration, viewed through the prism of physics-based models.

Keywords: physics-informed neural networks, deep learning, ground-penetrating radar (GPR), NDE, ConvLSTM, physics, data driven

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8991 Delivering Comprehensive Sexuality Education to Students with Disability in Special Schools in Fiji

Authors: Sera Ratu, Jane Chivers, Jessica Botfield

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Objectives: The Reproductive and Family Health Association of Fiji (RFHAF) and Family Planning Australia are working together to introduce quality comprehensive sexuality education into Special Schools - which are schools for students with disability. Sexual and reproductive health information is needed by students with disability attending Special Schools. Children with special needs go through the same changes as able-bodied children. The Fiji Disability Inclusion project is a three-year project that started in 2015. One of its objectives is to increase exposure to comprehensive sexuality education for primary and secondary school students with disability. Method: A baseline survey was undertaken with 72 students with disability; it included questions about puberty, sexual health, and relationships. 34 teachers also completed a survey about their views of sexuality education and confidence in delivering it. Consent was facilitated by running information sessions with teachers and parents. The process of gaining consent and completing the surveys was designed to be accessible to students with disability. Given the sensitive nature of reproductive and sexual health, and the potential vulnerability of young people with disability, ethical considerations were important in the design and implementation of the surveys, and ethics approval was obtained. Results: Findings from the surveys suggest that students have mixed knowledge and awareness of sexual health issues. Most teachers reported a need for their students to learn about sexuality and relationships. A positive outcome of conducting the surveys was that RFHAF staff reported they have developed skills and confidence in communicating with young people with a range of disabilities. They have a greater understanding of what students want to learn, and what teachers feel is important. Conclusions: These survey findings will assist RFHAF in developing comprehensive sexuality education programs that are relevant and accessible to students in Special Schools, and to develop an appropriate professional development program for teachers. Findings may also be applicable to other Special Schools when developing sexuality education programs. The education programs developed for students as part of this project, and the professional development programs for teachers, may be relevant to other countries.

Keywords: comprehensive sexuality education, delivery, sexual and reproductive health and rights, special schools

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8990 Rice Area Determination Using Landsat-Based Indices and Land Surface Temperature Values

Authors: Burçin Saltık, Levent Genç

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In this study, it was aimed to determine a route for identification of rice cultivation areas within Thrace and Marmara regions of Turkey using remote sensing and GIS. Landsat 8 (OLI-TIRS) imageries acquired in production season of 2013 with 181/32 Path/Row number were used. Four different seasonal images were generated utilizing original bands and different transformation techniques. All images were classified individually using supervised classification techniques and Land Use Land Cover Maps (LULC) were generated with 8 classes. Areas (ha, %) of each classes were calculated. In addition, district-based rice distribution maps were developed and results of these maps were compared with Turkish Statistical Institute (TurkSTAT; TSI)’s actual rice cultivation area records. Accuracy assessments were conducted, and most accurate map was selected depending on accuracy assessment and coherency with TSI results. Additionally, rice areas on over 4° slope values were considered as mis-classified pixels and they eliminated using slope map and GIS tools. Finally, randomized rice zones were selected to obtain maximum-minimum value ranges of each date (May, June, July, August, September images separately) NDVI, LSWI, and LST images to test whether they may be used for rice area determination via raster calculator tool of ArcGIS. The most accurate classification for rice determination was obtained from seasonal LSWI LULC map, and considering TSI data and accuracy assessment results and mis-classified pixels were eliminated from this map. According to results, 83151.5 ha of rice areas exist within study area. However, this result is higher than TSI records with an area of 12702.3 ha. Use of maximum-minimum range of rice area NDVI, LSWI, and LST was tested in Meric district. It was seen that using the value ranges obtained from July imagery, gave the closest results to TSI records, and the difference was only 206.4 ha. This difference is normal due to relatively low resolution of images. Thus, employment of images with higher spectral, spatial, temporal and radiometric resolutions may provide more reliable results.

Keywords: landsat 8 (OLI-TIRS), LST, LSWI, LULC, NDVI, rice

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8989 Leisure, Domestic or Professional Activities so as to Prevent Cognitive Decline: Results FreLE Longitudinal Study

Authors: Caroline Dupre, David Hupin, Christ Goumou, Francois Belan, Frederic Roche, Thomas Celarier, Bienvenu Bongue

Abstract:

Background: Previous cohorts have been notably criticized for not studying the different type of physical activity and not investigating household activities. The objective of this work was to analyse the relationship between physical activity and cognitive decline in older people living in the community. Impact of type of physical activity on the results has been realised. Methods: The study used data from the longitudinal and observational study , FrèLE (FRagility: Longitudinal Study of Expressions). The collected data included: socio-demographic variables, lifestyle, and health status (frailty, comorbidities, cognitive status, depression). Cognitive decline was assessed by using: Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA). Physical activity was assessed by the Physical Activity Scale for the Elderly (PASE). This tool is structured in three sections: the leisure activity, domestic activity, and professional activity. Logistic regressions and proportional hazards regression models (Cox) were used to estimate the risk of cognitive disorders. Results: At baseline, the prevalence of cognitive disorders was 6.9% according to MMSE. In total, 1167 participants without cognitive disorders were included in the analysis. The mean age was 77.4 years, and 52.1% of the participants were women. After a 2 years long follow-up, we found cognitive disorders on 53 participants (4.5%). Physical activity at baseline is lower in older adults for whom cognitive decline was observed after two years of follow-up. Subclass analyses showed that leisure and domestic activities were associated with cognitive decline, but not professional activities. Conclusions: Analysis showed a relationship between cognitive disorders and type of physical activity. The current study will be completed by the MoCA for mild cognitive impairment. These findings compared to other ongoing studies, will contribute to the debate on the beneficial effects of physical activity on cognition.

Keywords: aging, cognitive function, physical activity, mixed models

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8988 The Application of Transcranial Direct Current Stimulation (tDCS) Combined with Traditional Physical Therapy to Address Upper Limb Function in Chronic Stroke: A Case Study

Authors: Najmeh Hoseini

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Strokerecovery happens through neuroplasticity, which is highly influenced by the environment, including neuro-rehabilitation. Transcranial direct current stimulation (tDCS) may enhance recovery by modulating neuroplasticity. With tDCS, weak direct currents are applied noninvasively to modify excitability in the cortical areas under its electrodes. Combined with functional activities, this may facilitate motor recovery in neurologic disorders such as stroke. The purpose of this case study was to examine the effect of tDCS combined with 30 minutes of traditional physical therapy (PT)on arm function following a stroke. A 29-year-old male with chronic stroke involving the left middle cerebral artery territory went through the treatment protocol. Design The design included 5 weeks of treatment: 1 week of traditional PT, 2 weeks of sham tDCS combined with traditional PT, and 2 weeks of tDCS combined with traditional PT. PT included functional electrical stimulation (FES) of wrist extensors followed by task-specific functional training. Dual hemispheric tDCS with 1 mA intensity was applied on the sensorimotor cortices for the first 20 min of the treatment combined with FES. Assessments before and after each treatment block included Modified Ashworth Scale, ChedokeMcmaster Arm and Hand inventory, Action Research Arm Test (ARAT), and the Box and Blocks Test. Results showed reduced spasticity in elbow and wrist flexors only after tDCS combination weeks (+1 to 0). The patient demonstrated clinically meaningful improvements in gross motor and fine motor control over the duration of the study; however, components of the ARAT that require fine motor control improved the greatest during the experimental block. Average time improvement compared to baseline was26.29 s for tDCS combination weeks, 18.48 s for sham tDCS, and 6.83 for PT standard of care weeks. Combining dual hemispheric tDCS with the standard of care PT demonstrated improvements in hand dexterity greater than PT alone in this patient case.

Keywords: tDCS, stroke, case study, physical therapy

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8987 Mapping Network Connection of Personality Traits and Psychiatric Symptoms in Chinese Adolescents

Authors: Yichao Lv, Minmin Cai, Yanqiang Tao, Xinyuan Zou, Chao Zhang, Xiangping Liu

Abstract:

Objective: This study aims to explore the network structure of personality traits and mental health and identify key factors for effective intervention strategies. Methods: All participants (N = 6,067; 3,368 females) underwent the Eysenck Personality Scale (EPQ) to measure personality traits and the Symptom Self-rating Scale (SCL-90) to measure psychiatric symptoms. Using the mean value of the SCL-90 total score plus one standard deviation as the cutoff, 854 participants (14.08%; 528 females) were categorized as individuals exhibiting potential psychological symptoms and were included in the follow-up network analysis. The structure and bridge centrality of the network for dimensions of EPQ and SCL-90 were estimated. Results: Between the EPQ and SCL-90, psychoticism (P), extraversion (E), and neuroticism (N) showed the strongest positive correlations with somatization (Som), interpersonal sensitivity (IS), and hostility (Hos), respectively. Extraversion (E), somatization (Som), and anxiety (Anx) were identified as the most important bridge factors influencing the overall network. Conclusions: This study explored the network structure and complex connections between mental health and personality traits from a network perspective, providing potential targets for intervening in adolescent personality traits and mental health.

Keywords: EPQ, SCL-90, Chinese adolescents, network analysis

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8986 PTSD, Depression and Anxiety among Immigrants and Refugees in Canada: A Narrative Review

Authors: Maryam Shafiee

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This narrative review explores the prevalence, contributing factors, and interventions related to depression, anxiety, and PTSD among immigrants and refugees in Canada. Drawing on a comprehensive analysis of peer-reviewed studies, the review identifies key mental health challenges driven by pre-migration traumas, post-migration stressors, and systemic barriers. Subpopulations such as women, refugees, elderly immigrants, and youth are highlighted for their unique vulnerabilities, including postpartum depression, trauma-related anxiety, social isolation, and cultural identity conflicts. The review underscores the critical role of community-based programs, culturally sensitive therapeutic approaches, and policy-level changes in addressing these challenges. Despite progress, significant gaps remain in research and practice, particularly in understanding the intersectionality of mental health with socioeconomic and racial factors. The findings emphasize the importance of a multidisciplinary approach that integrates clinical care, social support, and systemic reforms to promote equitable mental health outcomes for Canada’s diverse immigrant populations.

Keywords: depression, anxiety, PTSD, immigrants, refugee, Canada

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8985 Evaluating and Reflecting on Virtual Exercise Programs during the COVID-19 Pandemic

Authors: Teng Minnie Y., Jarus Tal, Wong Anita

Abstract:

Introduction: The COVID-19 pandemic has altered the lifestyle of all Canadians. While "stay-at-home" public health directives have been implemented to mitigate the spread of COVID-19, they may also lead to or worsen physical and social health challenges for older adults. In particular, older adults with disabilities are especially vulnerable. In response, we quickly adapted to virtual rehabilitation exercise intervention for older adults. Objectives: First, to identify the factors that influenced the acceptability and feasibility of virtual exercise implementation, and second, to evaluate whether the virtual delivery was effective for health promotion in older adults with disabilities. Methods: We carried out weekly virtual exercise programs from January 2021 to June 2021. We conducted semi-structured focus groups and interviews to explore the perspectives of participants who are older adults. The focus group and interview data are transcribed and coded thematically. Conclusions: The acceptability and feasibility of delivering exercises virtually were influenced by the provision of a safe and supportive environment for social connection, the availability of the necessary technology, and the role of the support system.

Keywords: physical activity, virtual exercises, older adults, people with disabilities

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8984 An Experimental Study on the Influence of Brain-Break in the Classroom on the Physical Health and Academic Performance of Fourth Grade Students

Authors: Qian Mao, Xiaozan Wang, Jiarong Zhong, Xiaolin Zou

Abstract:

Introduction: As a result of the decline of students' physical health level and the increase of study pressure, students’ academic performance is not so good. Objective: This study aims to verify whether the Brain-Break intervention in the fourth-grade classroom of primary school can improve students' physical health and academic performance. Methods: According to the principle of no difference in pre-test data, students from two classes of grade four in Fuhai Road Primary School, Fushan district, Yantai city, Shandong province, were selected as experimental subjects, including 50 students in the experimental class (25 males and 25 females) and 50 students in the control class (24 males and 26 females). The content of the experiment was that the students were asked to perform a 4-minute Brain-Berak program designed by the researcher in the second class in the morning and the afternoon, and the intervention lasted for 12 weeks. In addition, the lung capacity, 50-meter run, sitting body forward bend, one-minute jumping rope and one-minute sit-ups stipulated in the national standards for physical fitness of students (revised in 2014) were selected as the indicators of physical health. The scores of Chinese, Mathematics, and English in the unified academic test of the municipal education bureau were selected as the indicators of academic performance. The independent-sample t-test was used to compare and analyze the data of each index between the two classes. The paired-sample t-test was used to compare and analyze the data of each index in the two classes. This paper presents only results with significant differences. Results: in terms of physical health, lung capacity (P=0.002, T= -2.254), one-minute rope skipping (P=0.000, T=3.043), and one-minute sit-ups (P=0.045, T=6.153) were significantly different between the experimental class and the control class. In terms of academic performance, there is a significant difference between the Chinese performance of the experimental class and the control class (P=0.009, T=4.833). Conclusion: Adding Brain-Berak intervention in the classroom can effectively improve the cardiorespiratory endurance (lung capacity), coordination (jumping rope), and abdominal strength (sit-ups) of fourth-grade students. At the same time, it can also effectively improve their Chinese performance. Therefore, it is suggested to promote micro-sports in the classroom of primary schools throughout the country so as to help students improve their physical health and academic performance.

Keywords: academic performance, brain break, fourth grade, physical health

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8983 A Qualitative Look at Mental Health Stressors in Response to COVID-19

Authors: Gabriel G. Gaft, Xayvinay Xiong, Amanda Sunday

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The emergent pandemic from COVID-19 virus has forced people to adjust to major changes. These changes include all elements of family and work life and required people to engage in novel behaviors. For many people, the social norms to which they have been accustomed no longer prevail. Not surprisingly, such enormous changes in daily life have been associated with greater problems in mental health; and research regarding ways in which mental health professionals can support people is more necessary than ever before. It is often useful to assess people’s reactions through surveys and utilize quantitative data to answer questions about coping strategies etc. It is also likely, however, that a host of individual factors are going to contribute to what might be considered 'good' or 'bad' coping mechanisms to a worldwide pandemic. To this end, qualitative studies—where the individual’s subjective experience is highlighted—are likely to provide more vital information for mental health professionals interested in supporting the particular person in front of them. This study reports on qualitative data, where X participants were asked questions about social distancing, coping strategies, and general attitudes towards social changes resulting from the COVID-19 pandemic. Informal interviews were conducted during the months of June-July 2020. Data were analyzed using Interpretative Phenomenological Analyses. Themes were identified first for each participant and then compared across different individual participants. Several findings emerged. First, all participants understood major health messages being imparted by governing bodies such as the CDC and WHO. The researchers feel this finding is important as it suggests health messages are at least being effectively communicated. Second, there was a clear trend for themes which highlighted the conflicting emotions participants felt about the changes they were expected to endure: positive and negative elements were identified, although a participant who had pre-existing conditions placed greater emphasis on the negative elements. One participant who was particularly interested in impression management also exclusively emphasized negative emotions. Third, participants who were able to reevaluate priorities—what Lazarus might call secondary appraisals—experienced social distancing as a positive rather than negative phenomenon. Finally, participants who were able to develop specific strategies—such as boundaries for work and self-care—reported themes of adjustment and contentment. Taken together, these findings suggest mental health practitioners can assist people to adjust more positively through specific techniques focusing on re-evaluation of life priorities and strategic coping skills.

Keywords: COVID-19, pandemic, phenomenology, virus

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8982 Vibration-Based Data-Driven Model for Road Health Monitoring

Authors: Guru Prakash, Revanth Dugalam

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A road’s condition often deteriorates due to harsh loading such as overload due to trucks, and severe environmental conditions such as heavy rain, snow load, and cyclic loading. In absence of proper maintenance planning, this results in potholes, wide cracks, bumps, and increased roughness of roads. In this paper, a data-driven model will be developed to detect these damages using vibration and image signals. The key idea of the proposed methodology is that the road anomaly manifests in these signals, which can be detected by training a machine learning algorithm. The use of various machine learning techniques such as the support vector machine and Radom Forest method will be investigated. The proposed model will first be trained and tested with artificially simulated data, and the model architecture will be finalized by comparing the accuracies of various models. Once a model is fixed, the field study will be performed, and data will be collected. The field data will be used to validate the proposed model and to predict the future road’s health condition. The proposed will help to automate the road condition monitoring process, repair cost estimation, and maintenance planning process.

Keywords: SVM, data-driven, road health monitoring, pot-hole

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8981 Role of Male Partners in Postpartum Family Planning

Authors: Stephen Rulisa, Aimee Nyiramahirwe

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Background: Strategies to increase the uptake of contraception services have been adopted in Rwanda, but the unmet need for family planning remains high. Women in the postpartum period are at higher risk for unintended pregnancy due to the silent conversion from lactational amenorrhea to reactivation of ovulatory cycles. The purpose of this study was to explore the role of male partners in the uptake of postpartum contraception. Methods: A prospective cross-sectional study was conducted among women who delivered at the University Teaching Hospital of Kigali for a period of 3 months with random sampling. A questionnaire was used to collect socio-demographic and antenatal data, information on male companionship, and intent to use postpartum contraception at admission. Participants were contacted six weeks later to collect data on contraceptive use. The outcome variables were uptake of postpartum contraception and types of contraceptives taken (long-acting vs. short-acting), controlling for male companionship during the antenatal period. A Chi-square test was used and a p-value ≤0.05 was considered significant. Results: A total of 209 women were recruited with a mean age of 30.8±5.2 years. The majority (60.9%) were multigravida, and 66.5% were multiparous. More than half (55%) had male partner companionship, 18.3% had companionship for four antenatal visits, and 28.2% had education on contraception with their male partner. Factors significantly associated with uptake of postpartum contraception were: age above 30 years, owning or heading a business, multigravidity, multiparity, antenatal care at a health center or district hospital, cesarean delivery, and previous utilization of contraception. Male companionship significantly increased the intent to use contraception, uptake of modern contraception in general, and uptake of long active contraceptives but did not predict the uptake of short-acting contraceptives. Conclusions: Our study demonstrates a positive association between male companionship during antenatal care, labor and delivery with the uptake of postpartum family planning. Our study suggests more sensitization to involve the male partners, improving the education on contraception during antenatal care and further research to assess the sustained uptake of contraception beyond the postpartum period.

Keywords: postpartum, family planning, contraception, male partner, uptake

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8980 Practical Application of Business Processes Simulation

Authors: M. Gregušová, V. Schindlerová, I. Šajdlerová, P. Mohyla, J. Kedroň

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Company managers are always looking for more and more opportunities to succeed in today's fiercely competitive market. Maintain your place among the successful companies on the market today or come up with a revolutionary business idea; it is much more difficult than before. Each new or improved method, tools, or the approach that can improve the functioning of business processes or even the entire system is worth checking and verification. The use of simulation in the design of manufacturing systems and their management in practice is one of the ways without increased risk to find the optimal parameters of manufacturing processes and systems. The paper presents an example of using simulation to solve the bottleneck problem in concrete company.

Keywords: practical applications, business processes, systems, simulation

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8979 Global Indicators of Successful Remote Monitoring Adoption Applying Diffusion of Innovation Theory

Authors: Danika Tynes

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Innovations in technology have implications for sustainable development in health and wellness. Remote monitoring is one innovation for which the evidence-base has grown to support its viability as a quality healthcare delivery adjunct. This research reviews global data on telehealth adoption, in particular, remote monitoring, and the conditions under which its success becomes more likely. System-level indicators were selected to represent four constructs of DoI theory (relative advantage, compatibility, complexity, and observability) and assessed against 5 types of Telehealth (Teleradiology, Teledermatology, Telepathology, Telepsychology, and Remote Monitoring) using ordinal logistic regression. Analyses include data from 84 countries, as extracted from the World Health Organization, World Bank, ICT (Information Communications Technology) Index, and HDI (Human Development Index) datasets. Analyses supported relative advantage and compatibility as the strongest influencers of remote monitoring adoption. Findings from this research may help focus on the allocation of resources, as a sustainability concern, through consideration of systems-level factors that may influence the success of remote monitoring adoption.

Keywords: remote monitoring, diffusion of innovation, telehealth, digital health

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8978 A Study on the Relation among Primary Care Professionals Serving Disadvantaged Community, Socioeconomic Status, and Adverse Health Outcome

Authors: Chau-Kuang Chen, Juanita Buford, Colette Davis, Raisha Allen, John Hughes, James Tyus, Dexter Samuels

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During the post-Civil War era, the city of Nashville, Tennessee, had the highest mortality rate in the country. The elevated death and disease among ex-slaves were attributable to the unavailability of healthcare. To address the paucity of healthcare services, the College, an institution with the mission of educating minority professionals and serving the under served population, was established in 1876. This study was designed to assess if the College has accomplished its mission of serving under served communities and contributed to the elimination of health disparities in the United States. The study objective was to quantify the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities, which, in turn, was significantly associated with a health professional shortage score partly designated by the U.S. Department of Health and Human Services. Various statistical methods were used to analyze the alumni data in years 1975 – 2013. K-means cluster analysis was utilized to identify individual medical and dental graduates into the cluster groups of the practice communities (Disadvantaged or Non-disadvantaged Communities). Discriminant analysis was implemented to verify the classification accuracy of cluster analysis. The independent t test was performed to detect the significant mean differences for clustering and criterion variables between Disadvantaged and Non-disadvantaged Communities, which confirms the “content” validity of cluster analysis model. Chi-square test was used to assess if the proportion of cluster groups (Disadvantaged vs Non-disadvantaged Communities) were consistent with that of practicing specialties (primary care vs. non-primary care). Finally, the partial least squares (PLS) path model was constructed to explore the “construct” validity of analytics model by providing the magnitude effects of socioeconomic status and adverse health outcome on primary care professionals serving disadvantaged community. The social ecological theory along with statistical models mentioned was used to establish the relationship between medical and dental graduates (primary care professionals serving disadvantaged communities) and their social environments (socioeconomic status, adverse health outcome, health professional shortage score). Based on social ecological framework, it was hypothesized that the impact of socioeconomic status and adverse health outcomes on primary care professionals serving disadvantaged communities could be quantified. Also, primary care professionals serving disadvantaged communities related to a health professional shortage score can be measured. Adverse health outcome (adult obesity rate, age-adjusted premature mortality rate, and percent of people diagnosed with diabetes) could be affected by the latent variable, namely socioeconomic status (unemployment rate, poverty rate, percent of children who were in free lunch programs, and percent of uninsured adults). The study results indicated that approximately 83% (3,192/3,864) of the College’s medical and dental graduates from 1975 to 2013 were practicing in disadvantaged communities. In addition, the PLS path modeling demonstrated that primary care professionals serving disadvantaged community was significantly associated with socioeconomic status and adverse health outcome (p < .001). In summary, the majority of medical and dental graduates from the College provide primary care services to disadvantaged communities with low socioeconomic status and high adverse health outcomes, which demonstrate that the College has fulfilled its mission.

Keywords: disadvantaged community, K-means cluster analysis, PLS path modeling, primary care

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8977 Health and Greenhouse Gas Emission Implications of Reducing Meat Intakes in Hong Kong

Authors: Cynthia Sau Chun Yip, Richard Fielding

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High meat and especially red meat intakes are significantly and positively associated with a multiple burden of diseases and also high greenhouse gas (GHG) emissions. This study investigated population meat intake patterns in Hong Kong. It quantified the burden of disease and GHG emission outcomes by modeling to adjust Hong Kong population meat intakes to recommended healthy levels. It compared age- and sex-specific population meat, fruit and vegetable intakes obtained from a population survey among adults aged 20 years and over in Hong Kong in 2005-2007, against intake recommendations suggested in the Modelling System to Inform the Revision of the Australian Guide to Healthy Eating (AGHE-2011-MS) technical document. This study found that meat and meat alternatives, especially red meat intakes among Hong Kong males aged 20+ years and over are significantly higher than recommended. Red meat intakes among females aged 50-69 years and other meat and alternatives intakes among aged 20-59 years are also higher than recommended. Taking the 2005-07 age- and sex-specific population meat intake as baselines, three counterfactual scenarios of adjusting Hong Kong adult population meat intakes to AGHE-2011-MS and Pre-2011 AGHE recommendations by the year 2030 were established. Consequent energy intake gaps were substituted with additional legume, fruit and vegetable intakes. To quantify the consequent GHG emission outcomes associated with Hong Kong meat intakes, Cradle-to-ready-to-eat lifecycle assessment emission outcome modelling was used. Comparative risk assessment of burden of disease model was used to quantify the health outcomes. This study found adjusting meat intakes to recommended levels could reduce Hong Kong GHG emission by 17%-44% when compared against baseline meat intake emissions, and prevent 2,519 to 7,012 premature deaths in males and 53 to 1,342 in females, as well as multiple burden of diseases when compared to the baseline meat intake scenario. Comparing lump sum meat intake reduction and outcome measures across the entire population, and using emission factors, and relative risks from individual studies in previous co-benefit studies, this study used age- and sex-specific input and output measures, emission factors and relative risks obtained from high quality meta-analysis and meta-review respectively, and has taken government dietary recommendations into account. Hence evaluations in this study are of better quality and more reflective of real life practices. Further to previous co-benefit studies, this study pinpointed age- and sex-specific population and meat-type-specific intervention points and leverages. When compared with similar studies in Australia, this study also showed that intervention points and leverages among populations in different geographic and cultural background could be different, and that globalization also globalizes meat consumption emission effects. More regional and cultural specific evaluations are recommended to promote more sustainable meat consumption and enhance global food security.

Keywords: burden of diseases, greenhouse gas emissions, Hong Kong diet, sustainable meat consumption

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